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Mental health is a core component of holistic arthritis treatment

swimming therapy physiotherapy
swimming therapy physiotherapy
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Jack March

Rheumatology Clinical Lead at Chews Health, and member of the Chartered Society of Physiotherapy

Having arthritis shouldn’t mean you can’t do what you love. Physiotherapists are working to dispel negative attitudes towards a condition which should no longer prevent an active lifestyle.


The role of physiotherapy in the treatment of arthritis is far more wide-reaching than you might think.

A truly holistic approach, which incorporates both a patient’s physical and mental health, is vital in terms of helping individuals manage their arthritis and general wellbeing.

Jack March, Rheumatology Clinical Lead at Chews Health, says physiotherapists first look to establish what an individual has lost the ability to physically do due to their arthritis.

They can then build an exercise plan that will enable them to get back to doing what they love most.  

“The biggest impact of physiotherapy is increasing the function of the joint,” he said.

“Simply reducing pain isn’t necessarily the most helpful measure to work from. The focus should be on how we can empower individuals to return to their preferred activity, whether that be vigorous exercise or gardening.”

Positive messages help people to cope

Historic clinical advice was often centred around negative rhetoric, suggesting that arthritis was caused by ‘wear and tear’ or that a joint would only have a certain amount of mileage. This is something Mr March feels has changed, with a more positive outlook now being encouraged.

“Piling negativity on to people is unhelpful in the long run. We look to educate people on how to manage and monitor their arthritis.”

Global assessments promoting better understanding

The initial assessment session focuses on the individual’s needs, establishing the range of motion of the joint as well as the strength of the surrounding muscles.

Gaining a handle of the general conditioning of an individual is also vital, according to March.

“Someone might have excellent muscular conditioning in their legs, but have poor cardiovascular health, meaning they’re not getting enough oxygen to those muscles. By understanding these factors, we can then work towards giving them an exercise plan that’s tailored towards their individual goals.”

Mental and physical health are closely connected in the healing process

Understanding an individual’s mental health has come more sharply in to focus too, as people with poorer mental health have been proven to report pain more acutely.

Indeed, March believes assessments should go well beyond simply helping individuals increase joint function.

“We need a picture of their general health, with diet and sleep patterns being just as important as joint function.”

Patients need to be able to enjoy their exercise plan

When motivating individuals to exercise regularly, enjoyment is really important. There’s little mileage in prescribing gym work to someone who’s never set foot in a gym.

Instead, the approach is tailored to the individual and their desire to achieve their own personal goals.

“Swimming is a really popular exercise, with people often having enjoyed it at school but not kept it up,” March said.

“It can increase weight bearing in the joint, and the muscular strength around it, without the impact of running or lifting heavy weights.”

Following a programme of exercise should mean that no exercise type – including running or weight lifting – is off the table for most arthritis patients. Managing expectations and educating individuals on how to build their strength up is a key role for physiotherapists.

“Venus Williams has an inflammatory condition, which she manages. Having arthritis doesn’t mean people can’t be active anymore, but individuals do need to be mindful of their own bodies.”


Jack March is a member of the Charterd Society of Physiotherapy.

The Chartered Society of Physiotherapy has grown to become the profession’s largest membership organisation. Learn about their structure, partnerships and international activities here.

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