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. RELATED: Remote Fitness Classes Can Improve Pain, Stiffness, and Fatigue in People With Many Conditions Spoiler alert: There are true benefits associated with regular physical activity and exercise, even 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.” RELATED: How to Stretch When You’re in Pain
Sorting Out Misconceptions About Exercising When You Have Rheumatoid Arthritis
It’s understandable why people living with chronic pain may associate movement with increased pain. This is especially true of people with moderate to severe pain. In fact, regular physical activity and exercise does not make your arthritis worse, notes Mayo Clinic. The right exercise can:
Reduce joint painIncrease strength of muscles which surround your jointsHelp to maintain bone strengthImprove flexibilityImprove your energy levelImprove your quality of sleepHelp control your weightImprove your balanceImprove your moodLower the risk of cardiovascular disease (a common comorbid condition associated with RA)Improve or maintain physical functionImprove 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 the American College of Rheumatology, 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.
Consult Your Doctor About Appropriate Exercise Before You Begin
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 regimen 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. RELATED: Physical Therapy and Occupational Therapy for Rheumatoid Arthritis Hand and Foot Pain According to a research review published in May 2020 in the journal Current Opinion in Rheumatology, guidance and direction from your doctor regarding appropriate physical activity is essential. The authors stated that: “Patient 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.”
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 using light weights, performing a specific number of repetitions, two or three days a week rather than daily. RELATED: The Surprising Ways Pilates Can Ease Rheumatoid Arthritis Symptoms 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 the 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 the perfect piece of exercise equipment for someone with moderate to severe RA. People with RA should also explore other gentle forms of exercise which 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 doing 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. RELATED: The Best and Worst Types of Yoga for Rheumatoid Arthritis
Fitting a Regular Exercise Routine Into Life With RA Is a Challenge
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 appointments — whatever needs to get done must be done! But by evening or nighttime, people with RA are typically too tired to exercise. RELATED: The Best and Worst Exercise Trends for Arthritis 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.
Did COVID-19 Interfere With Your Exercise Goals?
Incorporating regular physical activity and exercise into your daily routine is challenging enough during normal times, but the challenge is magnified with disruption. Enter the COVID-19 pandemic. People found themselves working from home, home-schooling children, ordering groceries online, and pulling their hair out. Could there have been a better reason to ditch the exercise? According to a study published in the February 2021 issue of Rheumatology International, physical activity, especially light physical activity and walking, was positively associated with mental health and psychological well-being in RA during the pandemic. In other words, there may never have been a more important time to include physical activity — which is worth keeping in mind going forward.
Athletes Living With — and Competing With — Rheumatoid Arthritis: The Ultimate Inspiration
Olympic snowboarder Spencer O’Brien competed in the 2018 Winter Olympics. She has rheumatoid arthritis. As you watched her compete, did you wonder 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 shares. “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.”
Finding a Balance Between Diet, Exercise, and Medicine
“The right combination of exercise, diet, and medicine is key,” Stracner says. “Diet is especially important. Garbage in, garbage out. Not to say there is no room for dessert, because there is always room for dessert. But putting fresh food in your body helps so much. I get up at 4:30 every morning for my workout, and I can’t imagine ever stopping. I’m a runner, triathlete, and kayaker. In addition to RA, I have severe osteoporosis and tend to break my bones every few years. So this is also an important way to build bone density.” 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.” RELATED: 9 Dos and Don’ts for Pain-Free Exercise With RA
The Bottom Line on Physical Activity and RA
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. Start with as little as three to five minutes twice a day. Then build on it.Set realistic goals.Keep a diary and a log so you can assess progress and identify any problems. This will also help you stick to your commitment.
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.
