How Athletic Directors Can Cope With Rheumatoid Arthritis

written by Tarin Garrison & Kayla Smith

Introduction

Rheumatoid arthritis (RA) is an autoimmune disease that affects the joints and synovial fluid of the joint (CDC, 2010). According to the CDC, in 2005 1.5 million people in the USA were affected with RA. It's a disease that presently cannot be cured and treatment is not always effective. RA inflames the infected joints and with inflammation comes chronic pain (CDC, 2010). In addition to pain to the joints, RA makes it harder to use them. It can affect people at any age and is not age specific. This is problematic for Athletic Directors because the pain has to be dealt with while working in an often physically challenging environment.

The Disease Physically, Mentally, and Spiritually

RA has three different disease pathways: monocyclic, polycyclic, and progressive. Monocyclic RA is described as "have one episode which ends within 2-5 years of initial diagnosis and does not reoccur. This may result from early diagnosis and/or aggressive treatment" (CDC, 2010). With polycyclic RA "the levels of disease activity fluctuate over the course of the condition" while in progressive RA the RA "continues to increase in severity and is unremitting" (CDC, 2010).

With RA an early diagnosis is key. The earlier the diagnosis the quicker treatment can begin and if the treatment is effective RA can go into remission. Unlike other autoimmune diseases RA can become dormant and the pain can subside. According to Iversen and Brandenstein (2012), RA usually attacks the feet and hands first and within two years can start to cause deformities. Those with RA are 33%-55% physically weaker than healthy people (Iversen & Brandenstein, 2012). Along with physical implications, RA can lead to depression, anxiety, feelings of helplessness, and low self-esteem (NIH, 2009).

Virginia Anderson, a person currently living with RA, has what she refers to as "flair ups" where it hurts more at times than others. Anderson has been living with RA for twenty-five years. She was diagnosed at the age of 41 and has tried multiple treatment options from pills to juices to visiting the Radon Mines in Montana. For Anderson, the Radon Mines have been the most successful in diminishing her pain. But dealing with the pain has been a never-ending battle. "It is never completely gone but some days are better than others. When I go to the mines I have longer lasting relief" (V. Anderson, personal communication, June 1, 2013).

The Radon Mines are not a conventional method of treatment but rather part of a holistic treatment. Anderson noted, "some days it is a challenge to get up and start the day but I know stuff need to get done so I do it." She lives on a five-acre piece of land and does the entire upkeep herself. Mentally she has to push herself to work out because she knows that working out will help her to feel better. Spiritually, she has to keep perspective that she can live with this disease and things could be worse (V. Anderson, personal communication, June 1, 2013).

Cuperus, Hoogeboom, Neijland, Van Den Ende, & Keijsers, (2012) examined whether people with rheumatoid arthritis who undertook activity-pacing were at risk of being too physically inactive. They found that consistent exercise with rest had more pain relief benefits than that of paced exercise with little rest. Patients reported they felt better when they didn't over exert themselves with irregular paced exercise. Instead, they had pain improvement when they followed a plan and took single days of rest (Cuperus & et al., 2012). Anderson also agreed that when she exercised at a lower intensity for a longer period of time with scheduled rest days she felt better than when she pushed herself too hard and then needed multiple days of rest.

Protection, Prevention, and Avoidance

"The etiology or cause of RA is unknown. Many cases are believed to result from an interaction between genetic factors and environmental exposures" (CDC, 2010). RA has been linked as a genetic disorder. If a family member has RA there is a greater risk (CDC, 2010). If there is a genetic predisposition, smoking should be avoided because smoking leads to earlier onset RA for those possessing the genetic factor (Silman, 2001). Smoking also increases the risk of RA in those without the genetic factor (Silman, 2001).

RA is more prevalent in women by a ratio of two to three and women have specific ways to decrease their chances of RA (Silman, 2001). It was found that women who took oral contraceptives and breastfed had a decreased risk (CDC, 2010). In contrast, women who had irregular menstrual cycles, hit early menopause, or had never had a live birth had a higher risk of RA (CDC, 2010). The National Institute for Health (NIH) reported, “Rheumatoid arthritis develops as a result of an interaction of many factors. Researchers are trying to understand these factors and how they work together” (NIH, 2009).

Effects of RA on Working as an Athletic Director

As with most active jobs, RA is going to have an extremely negative impact on athletic directors if they are not able to control their pain. Workdays for athletic directors are often long and tiring. School generally starts early in the day and sporting events continue into the evening. Athletic directors who regularly have occurring flare-ups are going to have a rough time staying late to watch their teams play. Athletic directors also have many duties that either need to be typed out or handwritten. An athletic director job description from the web site www.about.com noted, "They prepare a budget and allocate spending on items like coach’s salaries, team travel, equipment purchases, and facility upkeep." All of these responsibilities need to be planned and documented. Athletic directors must be able to control their RA if they expect to be able to sit at a desk and type on a computer for an extended time. An individual who has been affected by monocyclic RA is going to have a better chance of completing the tasks of an athletic director than someone who has polycyclic or progressive RA.

Responsible for department employees and coaches, athletic directors are on the move a lot. Because these individuals are working with children, teenagers, and young adults, they need to visit, observe, and supervise them regularly. Many other tasks require athletic directors to be mobile and can become stressful if RA makes it difficult or painful for them to complete these job related responsibilities.

Support for Athletic Directors with RA

For athletic directors with RA there are several approaches to minimizing the negative health and performance consequences. One treatment shown to help reduce RA is exercise. Knowledgeable health and fitness advocates surround athletic directors. Developing a regular workout plan with one or two colleagues can not only minimize the impact of arthritis, but also help with building trusting relationships with staff.

The disease affects many people mentally and some days they have a hard time staying positive due to the intense pain. The workday for athletic directors is often even longer than the 8 hour American average. Many of these hours are going to be spent with other coaches and staff members in the athletic department. Just as in a family, there are going to be decisions to be made and disagreements to be resolved. Because athletic departments works so closely together, there are definitely opportunities for staff members to help individuals suffering from RA to reach their full potential. Fortunately, most athletic departments are filled with individuals who want to help their colleagues overcome debilitating physical conditions and to be successful.

Technology can also be very helpful for athletic directors experiencing RA. With careful planning, much of the documentation that needs to be done can be automated and today, voice recognition programs can relieve much of the stress of typing.

Conclusion

Rheumatoid arthritis is an autoimmune disease of unknown causes that affects a person’s joints. There are three different types of RA: Monocyclic, polycyclic, and progressive. For athletic directors, polycyclic and progressive RA are the most difficult types of arthritis to overcome because of the wide variety of task associated with their work. Living and working with Rheumatoid Arthritis is challenging and can be stressful. Fortunately, there are many ways in which co-workers and technology can help athletic directors overcome the limitations of RA especially on those difficult days when the pain is intense.

References:

Anderson, V. M. (2013, June 1). Interview by K.M. Smith

Category. (n.d.). Athletic director job description-athletic director career-athletic director. Sports Careers - Tips for Your Sports Careers Search. Retrieved June 1, 2013, from http://sportscareers.about.com/od/careerpaths/a/ADprofile.htm

Centers for Disease Control and Prevention. (2012). Rheumatoid arthritis. Retrieved from http://www.cdc.gov/arthritis/basics/rheumatoid.htm

Cuperus, N., Hoogeboom, T., Neijland, Y., Van Den Ende, C., & Keijsers, N. (2012). Are people with rheumatoid arthritis who undertake activity pacing at risk of being too physically inactive? Clinical Rehabilitation, 26(11), 1048-1052.
Health Guide. (n.d.). New York Times. Retrieved June 1, 2013, from health.nytimes.com/health/guides/disease/rheumatoidarthritis/overview.html

Iversen, M. D., & Brandenstein, J. S. (2012). Do dynamic strengthening and aerobic capacity exercises reduce pain and improve functional outcomes and strength in people with established rheumatoid arthritis? Physical Therapy, 92(10), 1251-1257.

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