According to the Arthritis Foundation, arthritis is the No. 1 cause of physical immobility in the United States. More than 43 million Americans - one in six - have this disease. And while it affects people of all ages, the percentage of people with arthritis increases with age.

The aging of Americans not only presents an ongoing health challenge, but it also provides an opportunity to expand club services to meet the demand of a changing population. Arthritis represents just one debilitating disease that all centers should be prepared to address.

The recommended treatment for arthritis includes anti-inflammatory medication, cold or heat therapy, and exercise. As a treatment, exercise will strengthen the muscles around the joint, increase range of motion and reduce pain. Inactivity, on the other hand, will increase the symptoms that accompany arthritis.

Club operators need to make sure that members who suffer from arthritis consult with their physicians prior to beginning exercise programs. Exercise programs for individuals with arthritis include the same components as those for healthy individuals, but are modified to meet the physical limitations that result from the disease. The following points should be considered as your program expands to meet the needs of people with arthritis.

* Be prepared. Initially, the symptoms may get worse with exercise before they improve.

* Take it day by day. Individuals should avoid or modify exercise during times of inflammation and pain. They will usually have reduced inflammation and pain near the same time each day, and some days it will be worse.

* Enjoy a hot shower or bath. The heat from taking a hot shower/bath prior to exercising will increase circulation to the joints and help increase joint mobility.

* Make it short but sweet. Perform multiple short bouts of exercise rather than a single session of extended duration.

* Stay flexible. Flexibility exercises should be performed daily preceded by a five- to 10-minute warm-up. This will help maintain and even improve range of motion and reduce the incidence of injury. Improved flexibility will help reduce the pain associated with arthritis and at the same time make it easier to perform activities of daily living.

* Show your strength. Strength training should be performed two to three days per week because it strengthens the muscles surrounding the affected joints and helps reduce pain. People with arthritis should perform high repetitions with low resistance. When strength training, excessive weight may cause an inflammatory reaction, while too few repetitions will not elicit a strength response. A good alternative to using free weights or variable resistance machines is resistance exercise bands.

* Get your heart pumping. Cardiovascular exercises will improve circulation to the joints, as well as improve heart, lung and muscle function. Low-impact exercise should be performed so that the joints are not aggravated, which causes inflammation and pain.

* Take a dip. Aquatic exercise programs are ideal for individuals with arthritis because it allows them to exercise in a stable environment. Warm water (92 to 96 degrees Fahrenheit) programs are especially beneficial because it increases circulation to the joints. Water provides low-impact resistance against movement while stabilizing the joint at the same time.

We know that exercise can have a profound impact on people who suffer from arthritis. With this information, we as health professionals must determine how to help this population. Health and fitness centers are in a unique position to address the changing health needs of an aging membership.