Inspire Summer 2024

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information booklets are here to offer advice for all aspects of living with arthritis.
Versus Arthritis

Welcome...

… to the Summer edition of Inspire, the magazine for everyone with arthritis.

The Olympics and Paralympics are back, topping off a long summer of sporting highlights. It might feel like an overwhelming time when you are living with arthritis each day, and we understand how the condition may limit your ability to take part in sports and hobbies that you enjoy – it’s tough.

In this edition, we look at ways to remain active with arthritis, as physical activity can have an incredible impact on your symptoms. We meet Jon, on page 20, who was taken off the joint-replacement surgery waiting list after he took up weight training. And we talk to Josephine, who started kayaking when her osteoarthritis made long walks too difficult. Read more on page 38

We also dive headfirst into the latest research into drugs, which could prove to be a lifeline for people with arthritis. We know research takes time, but our article on page 8 shows that there is hope.

Our contributors this issue

Dr Lee David is a GP, CBT therapist and published wellbeing author. In her spare time, she loves walking, running with friends, and singing in a choir.

Thank you for being an Inspire member –your donations are helping to fund so much of this exciting work.

Many people find cooking therapeutic, but it, too, can be overwhelming if you have arthritis. Ian, who has fibromyalgia and osteoarthritis, reignited his passion for cooking after some tough times, and has created a fabulous arthritis-friendly cookbook – read about it on page 27. We really hope you enjoy this edition and find ways to live your life the way you choose. We are always here for you. For more advice, visit versusarthritis.org or call our helpline on 0800 5200 520.

Warm wishes,

Individual Giving Manager, Versus Arthritis

Holly TreacyWest is a freelance health writer and new mum. She loves walking and enjoys yoga in her spare time.

Angie Jefferson is a registered dietician and passionate foodie. She enjoys walking and swimming, as well as sharing meals with family and friends.

Editor: Tracey Lattimore inspire@versusarthritis.org 01223 378000

Design and production: CPL One

1 Cambridge Technopark, Newmarket Road Cambridge CB5 8PB 01223 378000, cplone.co.uk

For Versus Arthritis: enquiries@versusarthritis.org 0300 790 0400

Arthritis helpline: 0800 5200 520

Registered charity nos: 207711, SC041156

Registered office: Copeman House, St Mary’s Court, St Mary’s Gate, Chesterfield S41 7TD ©Versus Arthritis 2024

Views expressed in Inspire are not necessarily those of Versus Arthritis or Inspire (the Editor, the Editorial Advisory Board or the Executive Board). No responsibility or liability will be accepted, either for their contents or accuracy, or for any action taken as a result of anything contained in Inspire. Products, treatments and services in Inspire are not necessarily recommended by Versus Arthritis. Versus Arthritis is not equipped to test and approve products, treatments and services available to the general public. Please exercise your own judgement about whether or not the item or service advertised is likely to help you personally and, where appropriate, take professional advice from your doctor, nurse, physiotherapist or occupational therapist before buying or trying something. Photography and illustration: iStock, Ian Taylor (page 20), Sam A Harris (page 29)

3 versusarthritis.org Upfront
Summer 2024 CONTENTS HEALTH 5 Health update 8 Drug research 10 Meditation and pain 15 Sun safety 18 Ask the experts 20 Real life REGULARS International Yoga Day page 5 Love your garden page 33 Finding new arthritis drugs page 8 HOW TO USE A QR CODE A QR code (black and white square a bit like a bar code) is a quick and easy way to go to a website, without typing in the address. Simply open the camera on your smartphone or tablet, aim it at the QR code for a few seconds, then click on the icon or web address that pops up on your screen. This will take you straight to the website.

Health update

Our roundup of research, news and tips

Just breathe

Celebrate International Yoga Day on 21 June by adding just one new way of moving into your day. Moving your body is one of the best ways to reduce pain and stiffness, improve stability and muscle strength, and boost mental wellbeing. So, try a seated side stretch:

1 Take a deep breath, raise your arms above your head, drop your shoulders and, as you breathe out, slowly tilt to the left. You should feel a stretch on the right side of your body.

2 Breathe in, move back to centre, and as you breathe out, bend to the right.

3 Repeat a few times on International Yoga Day, and if you enjoy it, try again the following day!

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I want to ride my bicycle

Cycling is a great exercise to get your lower body moving, especially for people with arthritis – it is low impact, and good for your heart and lungs. With Bike Week starting on 10 June – hosted by charity Cycling UK – which celebrates cycling to work and a host of benefits that comes with it, a member of our community shares her experiences of cycling.

‘I have psoriatic and osteoarthritis that affect my ankles, knees, hips and lower back as well as my neck. I cycle regularly and find it a lot easier than walking – not huge distances, but better than nothing. Cycle paths are great as stopping and resting is easier. A pedal-assist electric bike helps a lot, especially on hills. Give it a try and see.’

Cycling to work, where accessible, is a good way to add movement into your day. Alternatively, consider cycling to your local shop instead of driving or getting the bus. Start local and see where your wheels take you!

Did you know?

Tai chi is a traditional Chinese martial art, which has become a popular exercise for people with arthritis. It focuses on the mind and the body together. Scan the QR code to try our introduction video.

Up close and personal

Researchers have found that personalised treatments before jointreplacement surgery can improve quality of life for patients on waiting lists. The OPPORTUNITY study, funded by Versus Arthritis, showed that people were more likely to stick to their pre-operative care when it was personalised. The package included exercise, weight loss, shoe inserts and painkillers, as needed by the individual. What’s more, this personalised care can also improve both surgery outcomes and recovery times. The trial showed that these interventions are beneficial when given in a tailored way, suggesting this should be done across the NHS. These findings will hopefully be used in a larger-scale trial, with many hospitals involved. From this, there may be policy change when it comes to the standard of care people receive prior to replacement surgery.

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Getting involved in research

Funded by the Medical Research Council (MRC) and Versus Arthritis, the CLUSTER consortium is a group of researchers who focus on juvenile idiopathic arthritis (JIA) and eye condition uveitis. Our researchers work closely with people who have JIA and uveitis, as well as parents and carers and charity partners, called ‘CLUSTER Champions’. This collaboration helps researchers understand the realities of living with arthritis, so they can make sure that their research is genuinely helpful and relevant. In its latest paper, CLUSTER worked together with the CLUSTER Champions to create a step-by-step guide about involving patients in research. It also highlighted some of the challenges and barriers that researchers may face. This work will help to make sure that people with arthritis are at the heart of research.

Back to business

Versus Arthritis researchers at the Primary Care Centre, Keele University, have developed a tool that hopes to tackle lower back pain, an issue that affects millions. But what works for one person might not be right for another.

To tackle this, Professor Elaine Hay and Dr Jonathan Hill developed a screening tool called STarTBack. Using it has been shown to decrease disability from back pain, reduce time off work by half, and save £226.23 for our

Move easy

We Are Undefeatable, a movement supporting people with long-term health conditions, has developed the ‘Five in Five’ mini workout to help you build movement into your day. Here are their top tips for building activity into your daily life.

1. Add movement breaks into your day. Move as you wait for the kettle to boil, during ad breaks, or while watching TV.

2. Move in different spaces Vary where you do your activities around the home to keep it fun.

3. Use objects as weights Exercise with objects found in your house, such as tins from your cupboard. Check out the ‘Exercises with Accessories’ Five in Five routine to give this a go.

Find the Five in Five workout at weareundefeatable.co.uk

healthcare system for every £1 spent on delivering the service. It has also been translated into more than 27 languages and is being used in clinical settings in countries around the world. Find out more at startback.hfac.keele.ac.uk.

News
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A DIVE INTO drug research

Lots of scientific research goes on behind the scenes before a new treatment is released that might help arthritis – so what’s in the pipeline?

Every day, clinical trials are taking place across the UK to discover new, safe and effective treatments for arthritis and related conditions. Large clinical trials can often take 10-15 years to complete, but the good news is that lots of progress is being made, and we are learning every step of the way.

‘Clinical trials test the best way to give a new treatment, whether it’s safe, works as planned, and is

better than existing treatments,’ says Professor Lucy Donaldson, Director of Research and Health Intelligence at Versus Arthritis. ‘Clinical trials also often lead to new discoveries.’

Versus Arthritis funds research with a high potential for good outcomes, so we can be hopeful. Here is a roundup of some exciting clinical research into medicines that could help to ease symptoms and improve the lives of people with arthritis in the future.

Cell-based therapy

Funded by: Versus Arthritis

The ASCOT clinical trial focuses on cell-based therapy to stop early knee osteoarthritis getting worse or developing after a cartilage injury. Cell-based therapy (autologous chondrocyte implantation, or ACI) uses the body’s own cells to repair damaged cartilage. It’s available on the NHS, but only for specific

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patients at this time. A surgeon removes a small sample of tissue from a patient’s joint, which is used to grow new cartilage cells in a laboratory. The surgeons puts the new cells into the joint, which grow new, healthy cartilage to repair the damage.

The aim: The ASCOT researchers hope surgeons can eventually inject new cells directly back into a patient’s joint, rather than them needing extra surgery. The clinical trial is based at the Robert Jones and Agnes Hunt Orthopaedic Hospital in Oswestry, in partnership with Keele University.

Retinoic acid research

Funded by: Versus Arthritis

New research at the Centre for Osteoarthritis Pathogenesis at the University of Oxford is looking into all-trans retinoic acid as a treatment for severe hand osteoarthritis. Retinoic acid is found naturally in the body, made from vitamin A. Researchers have found that people with severe hand osteoarthritis are more likely to have genetic changes that lead to lower levels of all-trans retinoic acid in their body – low levels can increase joint cartilage inflammation. There is a treatment already licensed that can keep retinoic acid levels higher.

The aim: The clinical trial is looking to see if this drug will act as an anti-

Further hope

New treatments go through several clinical trials of safety and effectiveness before they can be approved. Some Versus Arthritisfunded research in the earlier stages is looking at:

•Whether a new blood-thinning medicine, called rivaroxaban, can help people with lupus and thrombotic antiphospholipid syndrome that increases the risk of stroke

•The best route for injecting special immunosuppressive cells into people with rheumatoid arthritis – injecting these cells may help to override an overreactive immune system

•Finding more effective ways of working out which children and young people with juvenile idiopathic arthritis are most likely to respond well to methotrexate

•How well certain inflammation-suppressing drugs and therapies work in people with rheumatoid arthritis – and the possible side-effects.

inflammatory agent, and maybe even slow the progression of hand osteoarthritis. A larger trial could follow.

Targeted lupus treatment

Funded by: Versus Arthritis

The BEAT Lupus clinical trial at University College London has been looking into using combinations of the biological medicines rituximab and belimumab for people with severe lupus that don’t respond to other treatments. Rituximab can work well in lupus patients, but lupus symptoms often flare up again afterwards. Treating people with belimumab after rituximab may help to reduce these flare-ups. BEAT Lupus researchers have found that many people who responded better to both rituximab and belimumab, rather than rituximab on its own, had lower blood levels of a specific antibody.

The aim: It’s hoped that blood tests for this antibody could help doctors decide when a combination

of rituximab and belimumab is most likely to be successful. This could eventually create personalised, targeted, effective treatments with fewer side-effects.

Delaying rheumatoid arthritis

Funded by: drug company

Bristol Myers Squibb

The APIPPRA clinical trial has discovered that a medicine called abatacept may delay or even prevent rheumatoid arthritis in people at high risk of the disease. Doctors identified high-risk patients by testing for a specific blood marker called anticitrullinated peptide antibody (ACPA). People with ACPA and symptoms such as joint pain are more likely to develop rheumatoid arthritis within two years.

The aim: In the APIPPRA trial, people identified as high risk who were given abatacept for a year were much less likely to develop rheumatoid arthritis than people who weren’t given this medicine.

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CAN meditation HELP WITH pain?

A growing body of research suggests that mindful meditation could be used to ease pain, but how exactly does it work? We delve into the facts...

It’s no exaggeration to say that meditation has gone mainstream in recent years. Once deemed to be the preserve of sandalwearing hippies, it’s now been embraced by a huge crowd –and for good reason. The evidence showing the benefits of meditation is compelling, with studies pointing to its ability to lower stress levels, improve self-esteem and bolster emotional resilience.

On top of this, an increasing amount of research is suggesting that regular practice could help ease pain,

something that could have untold benefits for those with chronic pain-causing conditions such as arthritis.

‘Studies have shown that mindfulness meditation can reduce the intensity of pain and the emotional reaction to it,’ explains Dr Alka Patel, a longevity and lifestyle doctor (dralkapatel. com). ‘A review [comparing several research studies] published in the Journal of the American Medical Association, for example, found some evidence that mindfulness meditation was

associated with reductions in pain, depression and anxiety scores.’ More evidence is needed, however.

Dr Liza Thomas-Emrus is the clinical lead for a Wellness Service in the NHS, and a meditation teacher who creates meditations for various health conditions (reviveprescribed.com). She has seen the benefits first hand.

‘Mindfulness and meditation are tools we coach patients to use to regain control over their pain, and we have supported countless

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patients who live with chronic pain, many from arthritisrelated conditions,’ she says. ‘Patients have reported less pain and less requirement for pain medications, and, in turn, more energy and a clearer mind.’

How it works

Experts are still investigating the precise effects of meditation on our body and brain, but they believe the reasons are multifaceted.

First, meditation has been shown to reduce stress, which is important because of the relationship between increased anxiety and pain symptoms. It’s particularly notable for those with arthritis, as some studies indicate that stress can worsen rheumatoid arthritis symptoms and even cause flare-ups, which is something of a vicious circle.

As Dr Deepak Ravindran, a pain expert and author of The Pain-Free Mindset (deepakravindran.co.uk), says, science indicates that meditation can change the way pain is perceived and evaluated by the brain and, therefore, reduce the intensity of sensations.

‘The research performed suggests that expert meditators are able to change the way circuits are wired in the brain, so actual changes in neuroplasticity can be seen in those who have regular practice,’ he explains.

Various studies have been undertaken in this area, with one showing that long-term meditators had increased cortical thickness in certain brain regions that were associated with a

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decreased sensitivity to pain. Other studies using brain scans have demonstrated that pain produces very different patterns of brain activity in participants who practised mindful meditation, compared with those who didn’t.

It’s thought that mindfulness and meditation can impact our attitude towards our situation and support us in developing coping strategies. Meditation is also believed to release endorphins, which are natural pain-relieving chemicals in the brain.

What’s really heartening is that specific studies into arthritis pain and meditation have also proved positive.

‘Research indicates that mindfulness-based stress reduction (MBSR) and other meditation techniques can reduce pain significantly and improve quality of life in individuals with arthritis,’ confirms Dr Patel. ‘One study of 63 participants, published in the Annals of Rheumatic Diseases, found that six months of MBSR added value in managing

‘Mindfulness and meditation can impact our attitude towards our situation’
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pain, stiffness, and physical function in patients with rheumatoid arthritis.’

Getting started Keen to try it yourself? Most of the research around pain and meditation has been based on MBSR, which was developed by Dr Jon KabatZinn in the 1970s. It’s a form of meditation therapy often undertaken as part of an eight-week course, where the focus is on training your mind to stay in the present moment, being aware of and accepting thoughts, feelings and sensations. However, most studies were carried out on healthy volunteers. If you’re just beginning your meditation journey, there are plenty of MBSRguided practices you can try online, and other guided sessions available that are designed specifically for pain management. You can find these on apps such as Headspace, Calm, Insight

Timer and Curable, and via online videos or local classes. The key is to find something that works for you. ‘Many pain patients find it difficult to meditate in the traditional sense [sitting in one place and focusing], so, in those situations, I ask them to do a mindful practice – this can be movement such as walking, dancing, singing, running or cooking,’ Dr Ravindran says. He also suggests starting small, with something that can be added to your routine easily, and recommends sticking to a regular and consistent practice, as it can take time to notice changes. All in all, it’s important to remember that meditation is not a cure for all types of pain and may not be effective for everyone. With its long list of farreaching benefits, however, it could certainly be worth trying alongside treatments recommended by healthcare professionals.

Try it yourself

Dr Liza Thomas-Emrus shares three meditation techniques to help with pain. You can also try her free meditation practices at reviveprescribed.com

Start with a body scan: Slow your breaths and then focus on one area of your body in turn, starting at the top of the scalp and moving down towards your toes. Tense the area by squeezing the muscles and then relax, releasing the tension. This is a great practice to do just before going to sleep.

Use visualisation: Imagine an insulating blanket inside

your body and place it over the area of pain. Imagine that the pain signals can no longer travel up to the brain to be interpreted as pain. Be as vivid as you can when imagining your blanket, and the more effective it will be.

Imagine a pain dial: Imagine your pain has a dial that reads from zero to 10, relating to how strong your pain is. Notice what

level the pain is at and imagine the dial pointing to that number. Accept the number and validate your feelings in regard to this. Then visualise turning the dial down as far as you can. You can use the exhale to turn the dial further down. Imagine as the dial moves that it stops pain signals moving through your body to be interpreted by the brain and you are stopping pain in its tracks.

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OVER TO YOU

Here's your chance to have your say

A healthy mind

So much of the Spring edition of Inspire was relatable to me. I was diagnosed with osteoarthritis when I was 16 – I’m now 57. I also have Scheuermann's disease, fibromyalgia, asthma and Raynaud’s. I’ve had nine spinal operations. A few years ago, my local pain clinic ran an eightweek course (like the one mentioned in the magazine), and it gave me so much insight. I also met one of my best friends on that course, and we are both members of our local Versus Arthritis group. My coping strategies are varied. I volunteer and try to remain active. I go to aquafit and the gym when pain allows, and do a lot of crafting – weaving on a small loom (when my fingers will work) and making decorations and mosaics. I also get away in my caravan for a couple of nights each month if I can. Life is too short not to have a go. It’s too short not to laugh, or eat cake, or drink gin, or reach out and experience new things and meet new people. Never give up. Emma, via email

Feeling better

I have bone-on-bone arthritis in one knee and was referred to a programme at my local gym called Escape Pain – 10 onehour sessions, twice a week, costing £35 for the course. Each session involved half an hour of discussions, and half an hour of gentle circuit training. I enjoyed the exercise so much that I signed up for RightStart, for older people. It is one hour, once a week, of circuit training, with an instructor who is aware of each person's capabilities I am so pleased I opted for exercise; I feel much better. Helen Stevens, via email

There are Escape Pain classes that we helped fund across the country – visit escape-pain.org

Work it out

Is there anything a physio can do, using massage or movement, to ease arthritis in my hip and knee? My NHS physio gives me exercises, but appointments are infrequent. I am lucky in that I can pay for extra help, and would welcome your advice. Thank you for my magazine – I am so glad I joined Versus Arthritis, as the help has been invaluable. Mary Brocken, via email

We asked Dr Sarah Jarvis to answer your question – turn to page 19 to read her advice. We hope it helps!

Get in touch!

Send your tips and letters to Inspire magazine, 1 Cambridge Technopark, Newmarket Road, Cambridge CB5 8PB, or email inspire@ versusarthritis.org

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STAYING SAFE IN the sun

Taking certain medications means you might be more susceptible to sunburn or rashes – here’s how to enjoy summer safely

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Summer sunshine can be good for you in small doses. It boosts your body’s vitamin D levels, which is important for healthy bones and a strong immune system, and your sore joints may feel better in the heat. But too much exposure can damage your skin – even a slight suntan is a sign of overexposure to the sun’s ultraviolet (UV) rays.

UVA rays can age your skin, while UVB rays can cause sunburn. Both can contribute to skin cancer, so it’s important to keep yourself safe and protected. If you have some forms of arthritis or related conditions such as lupus (SLE) or psoriatic arthritis,

1Seek shade

Don’t rely on sunscreen alone to protect you from the sun. Avoid strong sunlight by staying in the shade when the sun is at its hottest (usually between 11am and 3pm in the UK). You can burn just as easily in the garden as you can on a beach, even when it’s cloudy. Take a break in a shady corner.

2 Know your

4 Protect your eyes

Strong sunlight can burn your eyes, so wear UV-protection sunglasses. The darker the lenses, the stronger the protection. Look for the CE Mark and UV 400 label and/or 100% UV protection written on the label or sticker. Wraparounds, sports glasses and large-style sunglasses will protect the sides of your eyes.

Check your medicines

Ask your pharmacist or doctor whether your arthritis medicines could make you more prone to sun-related skin reactions. ‘This can look and feel like sunburn or a rash,’ says Hana. ‘It can occur with both low-dose and  high-dose medicines.’

6 Care for your skin

If your skin burns in the sun, sponge it with cool water and apply a soothing aftersun moisturiser. Drink lots of fluids to prevent dehydration. If your skin feels sore, take paracetamol (as long as it’s suitable for you). Cover up and stay out of the sun until your skin no longer looks red. If your skin is swollen or blistered, you have a fever, chills or headache, or feel sick or dizzy, seek medical advice.

Health

‘Don’t let it hold you back’

Dealing with arthritis as a child can be hard – but it’s a hurdle that can be overcome

I’ve been privileged over the years to meet so many people who are living with arthritis, and doing so with great zest and determination. Inevitably, some make more of an impression than others – partly because of their sheer force of personality – but, often, it’s the stories, rather than the individuals, that stay with me. And when those stories are of young people – children – they hit home even more. This is one such story.

Newsround – a BBC programme I remember fondly from the days of John Craven – discovered Evan, a keen under-11s footballer from Grimsby. His dad played the sport at a professional level for Sheffield United, Derby and Portsmouth, and Evan hopes to follow in his footsteps. But for most of last year he wasn’t able to play at all because he was in near-constant pain, and he even found it difficult to walk at times. He eventually got a diagnosis – JIA, juvenile idiopathic arthritis.

I made a series of features about arthritis for Radio 4 a few years ago, and one focused on the way the condition affects young people. I was astonished by the figures. According to the National Rheumatoid Arthritis Society, one in every 1,000 young people under the age of 16 is

Julian

Worricker is a BBC TV and radio presenter, and journalist. He has psoriatic arthritis

affected by it. JIA is, therefore, one of the most common causes of physical disability in childhood.

When I read about Evan’s treatment, it sounded strikingly familiar. He takes medication every day, including tablets to help manage pain and prevent his joints from becoming inflamed. The ingredients in the tablets can lower his immune system, which means he can pick up infections more easily. He also takes painkillers and goes to hospital twice a

Help at hand

If you or someone you know is a young person living with arthritis, Versus Arthritis can help. From face-to-face events, to our Tracker App to help

month to have an injection. Recently, Evan has also been trying a new treatment as part of a clinical trial, and is only the second person in England to do so.

Now, after months of pain and frustration, he is feeling a lot better and has been able to return to training – and that’s why he spoke to Newsround.

‘When I tell my friends I have arthritis, they say: “My Nana’s got that” – but kids can get it too.’ He says when he was first diagnosed he felt embarrassed, but now he wants to share his story so other young people with the condition can feel positive about all the things they can do, and not feel limited or ashamed.

I particularly liked his final sentiment in the interview, one to which we can all relate. He said: ‘Even if you have got a condition like me, don’t let it hold you back!’

Let’s hope his dreams of becoming a professional footballer one day are fulfilled, despite the medical hurdles he has to overcome.

keep track of symptoms when speaking to doctors, and online resources and support for parents, there is lots available. Visit versusarthritis.org

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THE EXPERTS ASK

Got a niggling question or a worry that won’t go away? Our experts are here to help

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Dr Sarah Jarvis is a medical writer and broadcaster. She has been the BBC Radio 2 doctor for many years, and is doctor to the BBC’s The One Show

Q Is there anything a physio can help with, using massage or movement, to ease my hip and knee arthritis?

A Physiotherapists are the experts in muscle and joint problems, but you won’t improve unless you practise exercises the physio recommends between appointments. One of their main roles is education – looking at the body as a whole and advising on ways to improve your wellbeing.

They will also design a programme of exercises centred on the parts of the body where you’re experiencing symptoms, but you’ll need to do them once (at least) daily for best effect.

In addition, they can use manual therapy – massaging and mobilising parts of your body to improve movement, relieve pain and promote relaxation. Sometimes, they may recommend hydrotherapy –exercising in warm, shallow water, which supports your joints.

Dr Lee David is a GP and CBT therapist. She has written books on wellbeing and supports health professionals struggling with mental and physical health

Q How can I stop worrying about my health or how my arthritis may get worse in the future?

A Many people experience anxiety when living with a longterm condition such as arthritis. Remember, your worries are not facts. They are just thoughts, often involving exaggerated risks and worst-case scenarios. Can you visualise your worries as a movie playing in your mind? Instead of watching on the big screen, try shrinking the image so it’s playing on a tiny phone. Now, put it in your pocket and get on with your day.

Another helpful technique is ‘worry time’. Set aside 15-30 minutes daily to talk about your health concerns, or write them in a journal. Once the time is up, shift your focus to other, enjoyable activities.

If worries show up outside this time, remind yourself to deal with them in the next ‘worry time’, and carry on.

Catherine is a helpline advisor for Versus Arthritis. She enjoys swimming, travelling and music, and has just joined a fun running club for slower runners

Q Do you have any tips for people with arthritis for staying active outdoors?

A Tailor activities to your abilities and health needs, helping you to enjoy the experience and avoid injury. Low-impact exercises, such as walking, swimming or tai chi, can be beneficial, and can be adjusted to suit your comfort level. Talking to your GP or physiotherapist can help with this. Keep hydrated and be aware that certain medications and conditions can make you more sensitive to the sun. Wear lightweight, breathable clothing, a hat and use sunscreen (see page 15).

Plan your activities during cooler parts of the day. This can help prevent overheating and ensure a more pleasant experience. Pay attention to your body and pace yourself. If you feel fatigued, or experience any discomfort, take a break. Rest when needed.

The Versus Arthritis community is here for you. Our website is full of useful advice and stories about how to manage your arthritis, and you can order free information booklets at shop.versusarthritis.org . Meet people in person at our local support groups, or chat to us online at community.versusarthritis.org or on the phone on 0800 5200 520.

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Jon says weight training, spin classes, cycling and walking his dog have all helped him avoid the need for knee surgery

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'WEIGHT TRAINING HAS MADE THE BIGGEST DIFFERENCE'

With all things sporting in the spotlight, and the Paris Olympics and Paralympics coming up this summer, we speak to Jon Reeves, 57, from Chipping Norton, who increased his level of exercise and activity and managed to overcome the need for a double knee replacement

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Ihad always been fit, playing badminton two to three times a week, swimming and running. But my recovery times started increasing, and I found I was constantly wearing knee supports. The leg action of breaststroke also became painful, so I stopped swimming. My doctor referred me for an X-ray, which led to a diagnosis, in July 2022, of severe bone-on-bone osteoarthritis in both knees. I was scheduled for two full knee replacements. I saw a physio, who prescribed daily

movements to strengthen and stabilise my knees, but I first needed effective pain management, so got a prescription for naproxen and omeprazole to control the inflammation. I still couldn’t do all the repetitions at first, so I broke the routine down into bite-sized chunks; if I had to do 25 lunges, I’d do 15, stop, then come back later to do the last 10. Eventually, I’d tick each box for the day, but my symptoms worsened – and, six months later, I could barely walk downstairs.

Becoming my own expert

My research led me to the Versus Arthritis website. I called the helpline and spoke to a nice lady who recommended trying a TENS machine, a topical gel called FlexiSEQ, a deep-tissue massage gun, and some alternative therapies, including acupuncture, which I started last April. After eight weeks, I saw benefits and my flare-ups were pretty much gone. It also vastly reduced my pain. At first, I had acupuncture weekly, then fortnightly, and now I go once a month.

I cut down on refined sugar and hydrogenated fats, found in most junk foods. Most of the foods for controlling inflammation are part of the Mediterranean diet: olives, oily fish, garlic, onions, dark green leafy veg, and nuts, all of which I love. I also switched to wholewheat pasta instead of white, and the same with rice.

Exercise little and often, and be kind to yourself, says Jon

My first steroid injection worked well as I still had some cartilage left, but the second one didn’t, and made me feel quite sick. I also tried every supplement under the sun, some of which made me feel ill. Hyaluronic acid, glucosamine, chondroitin, fish oil and green-lipped mussel extract – all the ones recommended for joints – seemed to make the inflammation worse and led to more tendon locks.

What did work for me was curcumin –the anti-inflammatory compound of turmeric – and I still take SuperSelf Turmeric Curcumin Extract with Black Pepper, containing 500mg curcumin per serving.

Real life 22 versusarthritis.org

Good to know

You can help strengthen your joints using resistanceband workouts – see our videos at versusarthritis.org/resistance-bands

Different treatments work for different people, so speak to your medical team before making any changes to your diet or trying supplements.

1 KNOWLEDGE IS POWER

Learn as much as you can about your condition. Use the Versus Arthritis website and social media pages. You need to help yourself. Remember, you may have arthritis, but arthritis doesn’t have you!

2 FOCUS ON TWO KEY THINGS

Focus on pain management, plus physio and exercise. You need to develop your muscles and tendons, but it can be agony unless you get pain under control.

3

HAVE A REGULAR ROUTINE

If you follow the same routine every day it becomes easier. Use the carrot approach rather than the stick: if you challenge yourself with a long walk, reward yourself. After my climb up Snowdon, I celebrated with a beer!

4

TAKE BABY STEPS

Physio in the early days can be painful. Try breaking it into bite-sized chunks. Do exercises little and often throughout the day, and be kind to yourself.

23 versusarthritis.org Real life
top tips
Jon’s
‘I had so much pain with arthritis –now I compete in powerlifting!’

Kelly Clark, 59, from South Yorkshire, took up powerlifting to help improve her joint health

’I was diagnosed with osteoarthritis (feet, hip, knees, shoulder, hands) in 2010 and prescribed diclofenac, with no other advice other than to lose weight. At that point, I couldn’t close the boot of my car or reach into a high kitchen cupboard using my right arm. I was struggling with knee and hip pain walking upstairs, and my hip pain kept me awake at night.

’I started weightlifting in 2013, after first trying HIIT [high-intensity interval training] to improve mobility, but finding it too tough on my joints. I picked up a barbell and loved it! My mobility improved, pain decreased, and I was able to come off prescribed medication after four months.

’In 2017, I was a powerlifting volunteer for the Special Olympics in Sheffield, where I met

a number of referees who convinced me to take part in a competition.

’My first was in March 2018, at 53 years old, when I qualified for the British Championships in Belfast and was placed sixth. The following year, I placed third at the British Championships, and then went to the 2019 World Championships in South Africa, where I came fourth.

‘I’m currently the BDFPA [British Drug Free Powerlifting Association] and WDFPA [World Drug Free Powerlifting Association] British, European and World Champion, and world record holder for the equipped bench (68kg) and deadlift (132.5kg).

’My next competition will be the WDFPA Single Lift World Championships in Amsterdam in June.

‘Lifting weights has changed my life. I could never have imagined looking or feeling as I do. I have lost more than 3.5 stone in weight and I’m fitter than I’ve ever been.’

New forms of exercise

I needed low-impact ways to stay fit and get an endorphin boost. I signed up to spin classes at my local sports centre, where I got chatting to a guy who told me about the GP exercise referral programme.

I went to my GP and was invited to a one-to-one session with a fitness specialist, who put together a weighttraining programme to strengthen my leg muscles and tendons. I now do an hour’s routine at my local gym every day.

This, plus the acupuncture, has made the biggest difference in improving my quality of life. It’s not a quick process though; I started weights last August and didn’t see the benefits until October, when a friend and I hiked up Snowdon in North Wales. I had no pain and didn’t need recovery time.

A healthy mindset

I’m feeling so much better now that I’ve postponed my knee op indefinitely. It was my decision – it’s major surgery after all, and I was scheduled for the full one. But the implants only last 15-25 years, and I’m young for implants. However, my joint pain is now completely manageable thanks to the things I take, as well as daily weight training, spin classes, hiking and cycling. I walk my dog, Oscar, a good half mile every day. Walking is such good exercise for arthritis as it’s low impact (so causes less damage to affected joints), can strengthen muscles to aid stability, and keeps stiffness at bay. Throw in some hills and it even crosses the line into cardio exercise, so it’s good for fitness levels, too. Exercise little and often, and be kind to yourself. Just know there is light at the end of the tunnel if you can be proactive.

Real life 24 versusarthritis.org

A marathon achievement

On 21 April, 126 runners took to the streets of London for the 2024 TCS London Marathon in support of Versus Arthritis. After many months of training and preparation, their hard work paid off and they crossed the finish line with a smile and a medal. A huge congratulations! Alongside all the training, they were fundraising, too, and have raised more than £240,000. This will help support us to invest in world-class research, continue delivering high-quality services and campaign on issues that matter the most to people with arthritis.

Read more on our website or scan this QR code.

Just the ticket

What would you do with £25,000? Sign up for the Versus Arthritis lottery today and not only will you have the chance to win weekly cash prizes, but you’ll also be funding life-changing research and services for people with arthritis. It is quick and easy to sign up, from £1 a

Give as you earn

Thought about donating through your pay or pension? It’s an easy, tax-efficient way to support Versus Arthritis, as donations are deducted automatically from your gross pay or pension so you don’t pay tax on them. For every £1 you give, the cost from your take-home pay will be no more than 80p, or 60p if you’re a higher taxpayer. Speak to your employer about an existing scheme, complete the form on our website, or call us on 0300 790 0400.

Funding the future of arthritis research

Over the next year, thanks to our community of supporters, we are able to invest £15.5 million into arthritis research. This will include ground-breaking multidisciplinary research consortia who will bring together partners beyond lab researchers to drive innovation and impact for people with arthritis –from local authorities, GPs, and other health practitioners. They aim to connect people across many areas, working towards a shared goal –a future free from arthritis. We will be investing in six consortia over the next three years. The first two will be in the areas of epidemiology and inflammatory arthritis.

week, and you’ll have the chance to win every single week. Every ticket you buy brings a cure for arthritis even closer. Last year, our community raised more than £117,000 to fund life-changing research and services. You can join today at lottery.versusarthritis.org – it’s win-win!

Charity
26 versusarthritis.org

‘COOKING COMPLETELY CHANGED MY LIFE’

How a love of cooking transformed Ian Taverner’s outlook on life

When physical or mental health conditions take hold, cooking can be one of the first things to go. Finding the time, energy and inspiration to get busy in the kitchen can feel like too much. But with nutrition being a cornerstone of wellbeing, this can further exacerbate problems.

Despite now being known as the “mindful chef”, this is also how it was for Ian Taverner, 54, author of Cookfulness: A therapeutic approach to cooking. While working hard holding down a successful career in financial services, Ian suddenly found himself grappling with anxiety, panic attacks, and unexplained physical pain. The relentless cycle of illness and uncertainty left him feeling overwhelmed and withdrawn.

‘I was in so much pain, I couldn’t do anything. I was laid off from my job for taking

so much time off and I started to feel really disconnected from my family,’ Ian recalls. For about five years, he felt as though he missed everything – school trips, his kid’s gym competitions, time with his wife. But it wasn’t until he reached a breaking point, having both hips replaced and being diagnosed with conditions ranging from arthritis to functional neurological disorder, along with depression and anxiety, that he embarked on a path of self-discovery and healing through cooking.

‘After years of medical procedures and consultations, I finally secured a place on a four-week residential programme at the Centre for Pain Services in Bath. Here, I received not just treatment, but also a new perspective that I could choose to live differently.’

In a turning-point moment, Ian was asked by a doctor on the course what he actually wanted, and he realised that, more than anything, he wanted to be part of the family again. ‘I wanted to be more visible, more available. It wasn’t about suddenly running marathons, because that was just not realistic. But simply, how can I become more upright? Can I be more available to do things with my family – and how can I get there?’ says Ian.

Finding a way forward

After exploring barriers to his goals, Ian decided that

27 versusarthritis.org Food

cooking would be a great way to start – but it wasn’t plain sailing. When Ian got into the kitchen, it was a complete disaster. Things he had never considered to be a problem before were now hazardous.

‘I’d never had to be so wary of hot things, heavy things, and sharp things. Also, my brain wasn’t functioning the way it used to, so I couldn’t comprehend cookbooks. I felt like I couldn’t do it,’ says Ian.

But he didn’t give up. Instead, he set about disassembling the cooking process to make it work for him.

‘I realised it had to be about the process, and the achievement of creating something, even if it didn’t come out perfect,’ says Ian. ‘The first time I tried to make a dish – end to end – and it worked, it felt incredible. It didn’t matter that I’d used pre-chopped vegetables, how long it took me or what it looked like. It was the amazing impact it had on me and my family. I felt positive for the first time in ages.’

Cooking in this way had such a profound impact on Ian that he decided it was his duty to share his method with the world. And so his cookbook was born – a guide for all those who struggle with cooking, just like him, to help them towards the same sense of empowerment he experienced.

Feeling stronger

Now, Ian offers online classes, has toured the world giving workshops, and even ended up on TV doing a guest-chef spot.

‘I’m not a chef, you know, I’m just a cook,’ says Ian. ‘I still have to work at this every day, because it’s so hard to keep doing it. I’m still in the same level of pain I was, but, mentally, I’m much stronger. Cooking has completely changed my life, and I only hope I can help others reclaim their agency, too.’

Follow Ian on Instagram, Facebook and LinkedIn at @cookfulness, visit cookfulness.co.uk and check out his YouTube channel, Cookfulness.

Ian’s top tips

Give yourself time

Don’t expect to get things done as quickly as a recipe states. Allow at least an extra half an hour, and be patient with yourself.

Use smart ingredients

There’s no shame in using pre-chopped, frozen vegetables if that’s what you need to do. Find what works for you.

Don’t compare

Be proud of what you achieve and don’t compare yourself with others.

Have fun!

Get the music on – you could even create a cooking playlist.

Widen your kitchen

Use your kitchen table and any other available surfaces to give yourself the space and seating you need.

28 versusarthritis.org Food
cookfulness ian taverner Create Space For The Happy Stuff! This cookbook is crammed full of new and innovative ways, hints and tips, designed specifically for people with chronic pain and mental health conditions, by me, a fellow sufferer. It is all to help you WANT to cook, not have to! Cooking really can be a therapy. Cooking really can ignite your passions. Cooking really is possible! If you are having bad day, I want to make it better. If you are having better day, I want to make it good. If you are having a good day, want to make it great. If you are having a great day, good on you! All From ‘A Man In Pain, A Life To Gain’ Buy Cookfulness by Ian Taverner at waterstones.com or amazon.co.uk

GOURMET TO GO

These recipes might look fancy, but they are cooked in minutes in the microwave!

Recipes 29 versusarthritis.org

Steamed aubergine salad

Serves 2

Ingredients

1 aubergine

1 shallot, thinly sliced, with the grain

2 small tomatoes, quartered

Generous handfuls of mint and coriander leaves

1 fresh lime leaf, thinly sliced (optional)

For the dressing:

2 tbsp light brown sugar Juice of 1 lime (about 1tbsp)

1 tbsp fish sauce

½ tsp smoked paprika

1 bird’s eye or similar small, hot chilli, thinly sliced

1 garlic clove, thinly sliced

Method

1 Stir the dressing ingredients together until the sugar dissolves. Make at least an hour in advance to allow the flavours to mingle.

2 Cut the aubergine into quarters lengthways, so you have four long, baton-shaped pieces. Bundle these

pieces up and wrap them in cling film, then cook in the microwave for 4-6 minutes, turning the bundle once during cooking. The aubergines should be totally soft, so if there are any firm bits, keep cooking for 1-2 minutes.

3 Transfer to the refrigerator to chill (this will take at least an hour).

4 To serve, unwrap the chilled aubergines and lay on a plate. Scatter over the raw shallots, tomatoes and fresh herbs, then pour over the dressing.

30 versusarthritis.org Recipes

Sweetcorn with sour cream

Serves 2

Ingredients

2 tsp soy sauce

2 pieces of sweetcorn

2 tbsp sour cream

1 heaped tbsp mayonnaise

¼ tsp smoked paprika

30g feta, pecorino or Wensleydale

cheese, grated or finely crumbled

Dash of hot sauce

½ lime

Chilli flakes or powder, to taste

Method

1 Rub the soy sauce into each corn cob so it sinks into the kernels. Place the corn on a plate and cover, then cook for 5 minutes, turning the corn over halfway through cooking.

2 While the corn is cooking, stir together the sour cream, mayo and paprika until smooth.

3 When the corn is done, uncover it and let it cool slightly, then slather it in the sour cream-mayo mixture. Top with the cheese and hot sauce, then squeeze over the lime and sprinkle with as much chilli as you like.

Good to know

With microwave cooking, err on the side of caution, with lower cook times and possibly lower power levels if you have a really strong microwave. These recipes were tested in an 800W microwave, but when you cook a new recipe, it is wise to check on the food as it cooks. And always use microwavesafe containers.

Recipes
31 versusarthritis.org

Recipes from Microwave Meals by Tim Anderson

(£17, Hardy Grant Books)

Smoked haddock en papillote Serves 2

Ingredients

½ red pepper, thinly sliced

1 garlic clove, thinly sliced

8-10 pitted black olives, roughly chopped

A couple of spoonfuls of capers

2 smoked haddock fillets (200g–250g), skinless and boneless

A couple of drizzles of olive oil

A couple of splashes of white wine

A little flat-leaf parsley or dill, chopped

Method

1 Cut two large squares of parchment, as wide as the roll of baking parchment itself. Lay

a little mound of sliced peppers, garlic, olives and capers in the middle of each one, then place a haddock fillet on top of each mound.

2 Add a drizzle of oil and a tiny splash of white wine to each fillet. Add the parsley or dill, then fold the sides of the parchment over the fish like an envelope. Gather up the other sides and bundle them together as if you’re packing a paper bag. Use a small wooden skewer or a toothpick to keep the bundle closed (poke it through the parchment just below the bundledup top, which will be too thick to punch through).

3 Place the parcels on a plate and cook for 5 minutes. Serve in the parcels and unwrap at the table.

32 versusarthritis.org Recipes

With an angled handle and non-slip grip, this trowel is easy and comfortable to use in the garden, and helps prevent strains.

2. Orangery Leaf cushion, £18 johnlewis.com Pretty up your outdoor seat with this gorgeous, soft cushion, and enjoy some rest breaks in the garden while you admire your hard work.

3. Orangery picnic side plates, £12 for four johnlewis.com Brighten up mealtimes with these pretty plates, perfect for alfresco dining or bringing some summer cheer into your home.

THE SHOPPING EDIT

4. Homesense plant tend flowers and herbs, and avoids the need to

5. Ergo deadheader, £12 shop.nationaltrust.org.uk Deadheading’s a doddle with this tool, which fits in the palm of your hand and has a finger loop for extra control and grip.

6. Solar Flame string lights, £4.99 homebargains.com Bring a warm glow to your garden with these pretty solar string lights – perfect to drape around shrubs or garden walls.

33 versusarthritis.org Lifestyle
Things to make you feel better, brighter and just more joyful
3 5

MASTERING the art of A BETTER barbecue

tweaks – and hopefully some sunshine – you can make barbecue food both healthier and tastier.

Avoid the burn

Headlines sometimes shout that eating burnt barbecue food increases risk of cancer. However, the science behind this is not clear cut. The risks from consuming processed foods and sugary drinks, combined with too few fruits

avoid a burnt outside and raw inside is important to avoid food poisoning.

If cooking over charcoal, light up early (at least 30 minutes ahead of cooking) so the flames die down. The time to cook is when the charcoal is an even white/grey colour. Thin meats need a shorter cooking time and so are less likely to char. Larger pieces of meat or chicken on the bone can be started in the

Switch up the sides

Try serving crudités (stick of vegetables such as carrots, pepper, baby sweetcorn or sugar snap peas) with hummus or salsa instead of crisps – a tasty nibble that provides fibre, vitamins, minerals and a boost to your five-a-day. Craft colourful vegetable kebabs from chunks of red onion, courgette, mushroom, cherry tomatoes and peppers; create your own coleslaw from red

34 versusarthritis.org

and white cabbage with a reduced fat crème fraîche dressing; or try one of my favourites: a tabbouleh salad (see recipe, right).

Get fishy

Increase your intake of oily fish, such as salmon, trout and mackerel, by grilling them gently on the barbecue. They are the best source of longchain omega-3 fatty acids, which are important for overall

health and can help reduce inflammation in people with some types of arthritis. Fish needs gentle cooking so avoid the hottest part of the barbecue. Slash the skin and into the flesh of whole fish to help distribute the heat, and avoid turning too often. Marinade beforehand in lemon and herbs to enhance flavour. Cooking time will vary according to the size of the fish, but, generally, allow eight to 10 minutes per inch of fish in terms of thickness.

It's not all about the beef Have you tried making your own burgers? They are easier than you think, and can be a much healthier choice. Use a low-fat mince (5% fat beef, chicken or pork, or 2% fat turkey mince), add a sprinkle of herbs or spices, a handful of wholemeal breadcrumbs, 150g finely grated carrot (optional) and seasoning. Mix well and shape into patties. Mashing a can of drained kidney or black beans and mixing with the mince cuts the cost of each burger, plus adds fibre and plant protein. For a vegan option use mashed roast squash and black beans.

Healthy sticks

Kebabs are an easy way to cook and serve meat, vegetarian and fish options to suit all tastes. Any lean meat or poultry, prawns, monkfish, fresh tuna, salmon, halloumi or marinated tofu all work well. You can buy them pre-made from any butcher or supermarket, or it’s easy to make your own. Presoak wooden kebab sticks in water to stop them burning, or invest in a set of metal skewers.

Tabbouleh salad

Traditionally made using bulgur wheat, tabbouleh can also be made using wholegrain couscous, or a less well-known grain called freekeh. This should look like a green herb salad flecked with grain. Easy to make in larger amounts, it makes a great leftovers lunch.

Serves 4 as a side dish

Ingredients

75g bulgur wheat (rinse, cover with water in a pan and simmer for 10 mins with lid on until tender)

3 tomatoes, diced

1 pack each of flatleaf parsley and mint, finely chopped

6 spring onions, thinly sliced

2 tbsp olive oil

Zest and juice of 1 lemon 100g pomegranate seeds (optional)

Method

Drain the bulgur wheat and allow to cool. Mix all ingredients together in a large bowl (keep the pomegranate as a colourful topping if preferred). Serve with a pile of baby gem lettuce leaves to scoop the salad into.

If using other grains, cook to pack instructions. You can also add cucumber, chickpeas, sweetcorn, diced peppers and some fresh chilli for heat. Use this Middle Eastern recipe as inspiration, and then make it your own.

35 versusarthritis.org Food

Step change

Walking

is beneficial in so many ways, and

there's lots of different styles to choose from. Here’s how to make it – dare we say – fun!

‘Walk 10,000 steps a day and you will reap the rewards’ is the mantra we have all heard a thousand times, but that’s a big ask when you are in pain and don’t have the motivation. But moving –even a bit more than the day before – will pay dividends.

‘Rather than thinking of arthritis like having a car component that is broken, think of it as more of an ecosystem that needs nurturing,’ says Matthew Daly, advanced practice physiotherapist. ‘Walking is inherently safe and you can experience pain, but it rarely means that you are damaging yourself or wearing yourself out.'

The physical benefits are numerous. You will have better joint health, weight loss, stronger lower limbs, better muscle health, and good circulation, to name a few. If you’re up for trying a different style of walking, see if any of these take your fancy.

Nordic walking

It sounds hearty, but it is actually suitable for anyone who can walk. It’s the use of the special poles that makes it unique. Nordic walking is different, as it works your upper body as well as your legs. It's brilliant for people with mobility issues, as the poles make it easier than normal walking, but it burns 20 per cent more calories – what’s not to love?

How do I get started? Find a Nordic walking group near you by visiting the websites below – there are online courses on how to use the poles. Or go along to a local group and find out more from experienced walkers.

What do I need? A good pair of walking boots. Plus walking poles, which retail from about £25 upwards. britishnordicwalking.org.uk nordicwalking.co.uk

36 versusarthritis.org Exercise

Wellbeing walks

You can sign up for wellbeing walks throughout the country by groups such as The Ramblers. You can join a walk, free of charge, usually led by a volunteer who will take you on a walk depending on your mobility. This will give you a chance to get some fresh air, meet other people, and do some bone-building exercise. Some councils also run wellbeing walks. Versus Arthritis also runs health walks in Scotland with Paths for All.

Walk and talk therapy is where a qualified counsellor takes you out and about in nature to talk about your issues without being constrained indoors. This can make people feel freer and more likely to open up, and benefit from exercise. What do I need? Trainers or walking boots, waterproofs and some water.

Pathsforall.org.uk

The Ramblers.co.uk

Power walking

It’s all about speed with power walking. At the upper end of natural walking without putting pressure on your joints, it raises your heart rate and has many physical benefits. It’s all in the technique – you need good posture, don’t lean forward, and it’s important not to overstride. Smaller steps are key.

How do I get started? You can start slowly and build it up. Warm up first and make sure you have a good posture. Land on your heel and roll your foot forward, keep your arms active, and bend each elbow at about a 90-degree angle. Form your hands into relaxed fists and swing your arms as you walk. You should be able to talk, but not sing!

What do I need? You don’t need any special equipment except a sturdy pair of trainers and a decent route.

'Walking

changed my life’

Physiotherapist Matthew Daly found that walking boosted his energy and helped reduce aches and pains

‘I have inflammatory arthritis called axial spondyloarthropathy that affects my spine, but can affect my tendons and other joints, too. I can have aches and pains first thing in the morning, reduced spinal rotational movements and I get neck stiffness. Fatigue can be an aspect of it. Pain on movement can be discouraging, but once you get going, things start to feel better.

‘Walking is a low-intensity exercise that gives my body time to adapt, and I feel that consistency is where the real gains are to be made. I look at the frequency of my walking, usually four to five times a week. Growing distances can encourage you to push for longer distances, but doing big walks infrequently isn’t where the health gains are.

‘Now I have fewer aches and pains, and, when I come back from a walk, I work better, with improved concentration. I can “sort out the world” on a walk, too, and I usually have a sense of feeling refreshed. If I take a lunchtime walk, I feel energised for my afternoon clinics.’

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ON THE WATER

Kayaking has become increasingly popular over the past few years, and it can be an accessible sport for many people. Here’s why you might want to give it a try

Think adventure sports are out for you because of your arthritis? Think again! Kayaking invites a gentle approach to nature immersion, and is a great alternative to other activities that might feel out of reach. Not only does being on the water move you into a state of mind that can help with mental health, but the low-impact movements of kayaking offer a fantastic form of exercise, with minimal stress on joints. It also helps improve cardiovascular health and muscle strength, while exercise triggers the release of endorphins, the body’s natural painkillers.

So, how can you get started, and is kayaking right for you? Let’s dive in…

At one with nature

Kayaking is great for getting you outside; it’s fun in warmer weather and can be a really sociable activity. The challenge of it will depend on how close you live to an accessible river or sea, but

there are plenty of groups and clubs to join all over the UK.

Part of the joy of kayaking is embracing the elements – the water, the breeze, glorious sunshine, or the pitter-patter of rain. This is also what makes it a unique experience every time you go. As well as the immersion in nature (you see so much more from the perspective of the waterline on a river), paddling can be relaxing, as well as exhilarating.

Although it can be quite physical on the upper body, kayaking can be a nearmeditative experience on calm-water days.

You’ll also be gifted the opportunity for some unique wildlife spotting. Depending on where you paddle, you may encounter seals, otters and even dolphins.

Look up as you paddle out to sea or along the river to try to catch a glimpse of herons and birds of prey, or join a kayaking night group (safety in numbers!) for an evening of stargazing.

Exercise 38 versusarthritis.org

What you’ll need

Kayak: Beginners can rent kayaks from local outfitters. Sit-on-top kayaks are recommended because of their stability and ease of use.

Paddle: Choose a lightweight paddle with an adjustable length, to ensure comfort and efficiency while paddling.

Buoyancy aid: Safety should be a priority, so wear a properly fitted buoyancy aid.

Clothing: Wear moisture-wicking layers to stay comfortable. Quick-drying materials such as nylon or polyester are ideal, and don’t forget sunscreen and  a hat if it’s hot.

Health benefits

Getting enough cardio is a tall order for many people with chronic pain, but it can be helpful if you can manage some form of exercise. Studies in healthy people found that regular exercise strengthens your body, improves flexibility, and can reduce feelings of pain and raise people’s pain thresholds. Kayaking is one way to get your heart pumping without impacting your lower body.

For Josephine, long walks had become painful, but she was determined to stay active outside – and kayaking turned out to be the perfect fit.

Retired swimming teacher Josephine Wells, 76, from Surrey (below), found that kayaking opened up a whole new world of possibilities.

‘Having osteoarthritis and fibromyalgia can make exercise very difficult,’ she says. ‘But when I tried kayaking for the first time, it just felt perfect. I went out on a local lake with my daughter and just thought ‘‘Wow! I’m out in the fresh air, I’m moving, but I’m not putting weight on my legs.” It was just lovely.’

Although daunting at first, Josephine quickly discovered that she could push herself more than she expected.

‘I visited my son in France and went out for a 14km kayak along the River Loire. We reached the finish point half an hour quicker than suggested, so I was pleased.’

You can kayak alone safely with the right kit and common sense, but it’s a good idea to join a group, especially if you’re a beginner. If you really love it, you can even head off on a sea-kayaking holiday. Josephine, a member of the Let’s Move Versus Arthritis Facebook group, where people with arthritis can connect over exercise and share tips, created her own group after introducing kayaking to friends at the Women’s Institute.

‘We have a group called “Have a Go”,’ explains Josephine.

‘I asked them if they fancied going kayaking, and we did a taster session at Hawley Lake sailing club. Now we have a regular slot there once a week. The staff have been so accommodating and helpful.’ Fancy a go? Find your nearest club at gopaddling. info/find-paddling-clubs

39 versusarthritis.org Exercise
Josephine Wells

Ease into it

Are tricky buttons, zips and clasps making getting dressed a little harder? Here are the stylish solutions to everyday dressing

For some of us, the toughest part about getting dressed in the morning is deciding what to wear. For people with arthritis, however, this daily task poses many more challenges. We spoke to Katie Ellis, founder of The Able Label, to uncover the hacks that make getting dressed with arthritis a little easier.

‘I worked as a fashion buyer in London, and thrived on bringing in new collections that I knew our customers would love,’ Ellis tells us.

‘I got a buzz from seeing our customers feel fantastic when wearing the clothes I’d worked so hard on each season.’

individuals who were unable to feel this –unable to dress in high-street clothes. That was until her grandmother was diagnosed with Parkinson’s.

‘I saw first-hand how she struggled –not only with dressing independently, but also with maintaining her sense of style and identity through clothes,’ Ellis explains. ‘She loved fashion and didn’t want to sacrifice this; she desperately wanted her independence back.’

Like many of us, however, Ellis admits that she had never considered the many

Having searched for solutions, Ellis was shocked by the lack of options available, so decided to put her expertise to the test and solve some of the problems herself.

‘The Able Label was created to bridge the gap between function and fashion. Our aim is to give back independence and grow self-confidence,’ she says.

40 versusarthritis.org Self
Katie Ellis

Steps to easy dressing

According to Ellis, there are three key areas in which people struggle the most when dressing:

1 Physical – reduced movement/dexterity, poor balance and lack of strength, particularly in the hands, which is crucial for manipulating fastenings. ‘This is the main area of concern that we seek to address with our adaptive designs,’ says Ellis. ‘Sometimes, the smallest changes can make the biggest difference – avoiding fiddly fastenings and overhead dressing make a huge difference when getting in and out of our clothes.’

2 Cognitive – dressing back to front, and sometimes freezing, unsure how to put items on. ‘We have items that use colour-coordinated internals to aid dressing the correct way round,’ explains Ellis.

3 Assisted – ‘With carers supporting dressing, and reduced movement, it can be challenging to get arms and legs into clothing. Raglan sleeves [that extend in one piece from the arm to the collar] and back-opening options can help here,’ says Ellis.

While advice will be different for every individual, the first steps to easy dressing generally involve:

• Front-opening clothes, as these avoid

possible discomfort from overhead dressing

• Touch-close fastenings, such as Velcro, help overcome fiddly fastenings, such as buttons

• Raglan sleeves give a greater surface area, making it easier to get arms into armholes

• Slippery clothes linings can make getting clothes on and off far easier

• Pull-on trousers with elasticated waistbands can be helpful. Look out for options with belt loops or side pulls to aid pulling up trousers. Also consider your surroundings before starting to dress. ‘Is the room warm enough, light enough, and should the curtains be drawn? Dress in a seated position or with the support of a rail or handle, and in front of a mirror if possible,’ says Ellis. If you are affected by fatigue, get dressed in stages to reduce time standing and bending.

Try these fashion brands

• The Able Label has a plethora of stylish items for men and women, and you can shop by your specific need. There’s also a guide to shopping with arthritis. Visit theablelabel.com

• Made in the USA, but available to the UK, Buck and Buck has a range of assisted dressing options. Head over to buckandbuck.com

• Arthritis in the feet can make putting on shoes uncomfortable and even painful, so it can be tough to find footwear that’s practical and stylish. Calla shoes don’t compromise on either. Visit callashoes.co.uk

• Grace and Able compression gloves, (£15.99) have been designed by a hand therapist and thoroughly patient tested. They are available exclusively in the UK from the Versus Arthritis shop. shop.versusarthritis.org

• Our hand-stitched sock aid (£27.99) helps you put socks on in a seated position find it at shop.versusarthritis.org

versusarthritis.org Self
Shirt and dress with touch-close fastenings from The Able Label

SUMMER LOVIN’

Leah Nicholas, 33, paces herself so she can still enjoy the Notting Hill Carnival

Leah Nicholas has been involved with the Notting Hill Carnival since she was 12.

It was while she was busy making costumes for Carnival when she was in her 20s that she started getting pain in her fingers and wrists, which was put down to repetitive strain injury. When the pain spread to her feet and ankles, she went back to see her doctor, who diagnosed rheumatoid arthritis – which came as a total shock.

One of Leah’s main concerns was how to continue taking part in Carnival, such a major part of her life. She’s since had to learn how to pace herself.

‘You have to listen to your body, because when you are out having fun, you can get caught up and push yourself too far,’ she says. ‘I make sure

I take regular breaks and sit down when I can – I can still be part of what is going on. And be honest – everyone will understand if you explain you need to rest.

‘Keep your painkillers handy. I often pack an ice pack and my pain relief spray that I know will help with my flare-ups while I’m out. Once you accept you can’t do what you used to and make peace with that, it helps just a little bit.’

Follow our tips on how to manage your condition – and have fun at festivals!

Accessible areas

Apply for accessible camping: it’s usually near the main site and often has a dedicated team. You can also apply for viewing platform access.

Hire some wheels

Look into hiring a mobility scooter, which can be delivered to the site. Or consider a rollator – these support you to get about and give you a seat to rest on.

Wise up to welfare

Know where the welfare points are in case you need them. They often have fridges in which to store medicines.

Be prepared

Plan in advance what you really want to see –you can always add in more if you feel ok on the day.

Be mindful

Rest when you need to – tell friends and family so they can support you. Book an extra day off work and don’t plan anything taxing on your return.

Under canvas

If you are camping, a higher bed can be easier to get in and out of. Take a hot water bottle, stove and kettle to keep toasty all night, and lightweight blankets to drape over your shoulders and knees.

Keeping moving

Be aware of seizing up if you remain in one position for long periods. Try leg raises or pelvic exercises to bring in some movement. Standing by a rail or fence can help you take the weight off your feet and stretch, too.

42 versusarthritis.org

Have you recently…

If so, you may need to update your will. And we can support you to take the next steps.

Planning for the future is important for everyone. An up-todate will helps us to look after our loved ones when we die, and makes sure that our wishes are carried out, so the right people receive what we want them to. This can give those closest to us peace of mind at the most important time.

Despite this, most of us don’t have a recent will in place. This is often because we don’t know where to start, or there might be other challenges, like cost, to consider. We understand this and can help you to write your will, for free, through our will writing services.

Whether you’re starting the process from scratch – or perhaps a recent life event like marriage or grandchildren means you wish to update your will – the process is simple. Get in touch on the details below and we can connect you

to the service that works best for you. And don’t worry, we understand it’s not always easy to get out and about – there are options to write your will online or at home with a solicitor.

“I didn’t hesitate to add Versus Arthritis to my will – and their free will service made it so easy. A gift in your will is a belief in more amazing, life-changing moments, for more people in the future.”

Ian, who lives with psoriatic arthritis

Once you’ve taken care of your loved ones, we’d be so grateful if you could consider a gift in your will to Versus Arthritis. These special donations fund a third of the work we do and are essential to the future plans we’re making. With your support, we can fund new advances in world class arthritis research, could help more people access treatments that ease their pain, and the tools they need to manage their condition – or perhaps the cures they need to stop their arthritis all together. All gifts, no matter what size, make a real difference.

Get in toucH, we’re Here to Help If you would like more information about our will writing services, or about how a gift in your will can make a difference, you can speak to Gill and Anna in our Gifts in Wills team: By phone on 0300 790 0406 or by email at giftsinwills@versusarthritis.org Retired? Welcomed a new addition to the family? Moved house? Married or remarried? Entered a civil partnership?
Find out more at versusarthritis.org Versus Arthritis: Registered Charity England and Wales No. 207711, Scotland No. SC041156. Discover our wide range of services for people with arthritis. Get active with arthritis call our free helpline 0800 5200 520 ask our online community Browse our online resources

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