“Keep moving” they say. “Regular exercise is essential” they say. But surely that recommendation is not aimed at people with rheumatoid arthritis (RA).
Actually, it is.
Does it surprise you that experts recommend movement for people who live with chronic arthritis pain? Seems counterintuitive, right? Let’s explore the recommendations, as well as why this is not as far-fetched as it seems.
Spoiler alert: There are true benefits associated with regular physical activity and exercise, even or especially for people with RA. For clarity, physical activity is defined as bodily movement produced by skeletal muscles requiring an expenditure of energy. Exercise is included in “physical activity.”
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Benefits of Exercise When You Have Rheumatoid Arthritis
It’s understandable why people living with chronic pain, especially when it’s moderate to severe, may associate movement with increased pain. Yet regular physical activity and exercise does not make your arthritis worse, notes Mayo Clinic. The right exercise can:
- Reduce joint pain
- Increase the strength of muscles that surround your joints
- Maintain bone strength
- Improve flexibility
- Improve your energy level
- Improve your quality of sleep
- Control your weight
- Improve your balance
- Improve your mood
- Lower the risk of cardiovascular disease (a common comorbid condition associated with RA)
- Improve or maintain physical function
- Improve overall well-being
After you realize there are potential benefits, if you’re still stuck on the idea that you simply can’t exercise, think again. It is the lack of exercise that increases joint pain and stiffness. It is the lack of exercise that can contribute to muscle weakness, according to Johns Hopkins Arthritis Center, leading to inadequate support for your joints.
A common misconception is that someone with rheumatoid arthritis can’t do enough to make a difference. Realistically, any movement is better than no movement. Your muscles must be worked to stay as strong as possible. That said, the level of exercise must be appropriate for you, taking into consideration your level of disease.
Talk to Your Doctor First
Before you start any regular exercise regimen, you should discuss appropriate exercise with your doctor. Your rheumatologist may suggest a consultation with a physical therapist or a limited number of physical therapy sessions to get you on the right track. After you’re given an exercise routine designed for you and are shown how to do the exercises properly, you can feel confident that what you are doing is beneficial, not damaging.
According to a research review published the journal Current Opinion in Rheumatology, guidance and direction from your doctor regarding appropriate physical activity is essential. The authors stated that “[p]atient barriers to engaging in physical activity may include fears of joint damage, rheumatoid arthritis symptoms, and lack of understanding that physical activity improves the symptoms that may be barriers. However, the greatest barrier to healthy levels of physical activity among individuals with rheumatoid arthritis appears to be the lack of direction from healthcare providers.”
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Types of Exercise That Are Necessary and Beneficial for RA
You can expect your exercise regimen to include some range-of-motion exercises, strengthening exercises, and aerobic exercise.
The range-of-motion exercise involves movements that put your joints through their full range of motion. Ideally, you should do it daily.
Strengthening exercises are designed to strengthen muscles and thereby protect and support your joints. Strengthening exercise (aka strength training) typically involves the use of light weights, in a specific number of repetitions, two or three days a week rather than daily.
Aerobic exercise is also sometimes referred to as endurance exercise. Low-impact aerobic exercise would logically be optimal for a person with arthritis to keep stress on joints to a minimum. Low-impact aerobic exercise includes bicycling, walking, swimming, and use of an elliptical machine. There are recumbent elliptical machines available, too, which may be more appropriate for some people with RA.
I have used a BioStep and NuStep, and they are perfect pieces of exercise equipment for someone with moderate to severe RA.
People with RA should also explore other gentle forms of exercise that focus on balance, coordination, stability, flexibility, and even relaxation. Yoga, Pilates, tai chi, and Zumba are possibilities.
According to the Centers for Disease Control and Prevention (CDC), research shows that 130 to 150 minutes (2 hours and 10 minutes to 2 hours and 30 minutes) a week of moderate-intensity, low-impact aerobic activity can improve your ability to manage arthritis pain and do everyday tasks, while making your quality-of-life better.
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How to Fit Exercise Into Your Day
It can definitely be difficult for someone with RA to determine the best time of day to exercise. Morning stiffness is a common characteristic associated with RA. Many patients will say that mornings and exercise don’t mix. After morning stiffness subsides, people with RA typically become involved with usual daily activities — work, household chores, shopping, doctor’s appointments — whatever needs to get done must be done! But by evening or nighttime, people with RA are typically too tired to exercise.
Our lives are not all the same, so a one-size-fits-all recommendation can’t be made. But you must carve out the best time and commit to it. If it’s impossible to carve out a full hour, break up your routine into manageable chunks of time. Exercise is as essential as eating, sleeping, hygiene, or any other must-do activity in your life. Commitment is the key — find a way.
Get Started and Stick With It
There is sufficient evidence that regular physical activity and exercise provide numerous health benefits in people with RA, without aggravating symptoms or worsening joint damage. Perceived barriers to exercise should not be allowed to interfere.
- Start slow. Begin with as little as three to five minutes twice a day. Then build on it.
- Set realistic goals.
- Keep a diary or a log so you can assess progress and identify any problems — and solve them.
The difference between someone with RA who does exercise and someone with RA who does not is that the one who exercises finds a way to overcome barriers to exercise. It’s all about willingness and commitment.
Looking for Inspiration?
The professional snowboarder and Olympian Spencer O’Brien has rheumatoid arthritis. If you’ve watched her compete, have you wondered how it was even possible with RA? Did you want to start taking whatever she is taking?
Jeri Stracner of Carlisle, Kentucky, lives with RA and is the co-administrator of a Facebook group called Athletes Beating Rheumatoid Arthritis. “We have athletes of every type — runners, triathletes, hikers, ice skaters, white-water rafters, golfers, equestrians,” she says. “RA athletes come with a different set of challenges. Many people in the group have joint replacements. I have a reverse shoulder replacement. One amazing young woman is an accomplished triathlete with two hip replacements. We discuss medicines, diet, and the modifications we have to make. One athlete went from runner to hand cyclist. One went from gymnastics competition to teaching and coaching. The thing we all have in common is that moving keeps us going.”
I asked Stracner the secret — just how do the athletes with RA do it? Her reply confirmed what I suspected: “You definitely have to be committed to healthy living. Once you embrace the mindset, it’s just a way of life.”