Rheumatoid Arthritis Exercise, Part 3

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Pushups with my sonRheumatoid Arthritis exercise impasse

Is there any mainstream medical website or magazine that does not preach exercise for Rheumatoid Arthritis? I have not found one. What is the truth about Rheumatoid Arthritis, exercise, and health?

Earlier posts on RA exercise have discussed plain RA facts of life, striving to present a realistic view of exercise and RA. Believing common sense should prevail, I proposed this theory about exercise and RA: If you can, you should; if you can’t, you shouldn’t.  

The original post remains popular since the perpetual Rheumatoid Arthritis exercise dictate is a sore point for many patients, who are sore enough already. But the argument is far from settled for those who write arthritis magazines and preach exercise as a chief road to relief and remission from RA. Bluntly, it’s like this: Experts loudly proclaim that RA patients must get off their bums and workout so they can feel better. Patients are embarrassed that they can’t do as they’re told and wonder what they are doing wrong. Countless RA’ers have told me of frustration and shame about physical fitness…sometimes from their wheelchairs.

Google entry RA exercise is key

My best shot: Rheumatoid Arthritis exercise facts of life

I can only write so loudly; so, please listen as loud as you can.

Certain Rheumatoid Arthritis patients can exercise in the traditional sense…

  • …because they are not in constant flare.
  • …because they have several unaffected joints.
  • …because they have a mild case of RA.

However, most Rheumatoid Arthritis patients do not perform any strenuous exercise. The National Data Bank of Rheumatic Diseases reported that only 18 percent of people with RA do any aerobic exercise and only six percent do substantial (aerobic) exercises. If you have moderate to severe RA, you know why that is. If you don’t, I’ll try to explain this to you. You might start by reading this post about the Usage Principle.

Evidence about exercise

In Consultant Live, a publication for physicians, I read Exercise Programs for Your Arthritis Patients. It begins, “Exercise is a safe and effective therapy for patients with osteoarthritis or rheumatoid arthritis.” Sounds familiar…  but read on. Deeper into the article, find this: “Relative contraindications to exercise include recent joint replacement, significant joint damage, or an actively inflamed joint. Such conditions may necessitate avoidance of certain ranges of motion so as not to increase pain or cause additional damage.”

A typo? No, that exact statement is repeated twice in different sections of the same article. Sounds akin to this: If you can, you should; if you can’t, you shouldn’t.

The American College of Sports Medicine publishes guidelines for exercise safety. The statements about RA in their materials are oft quoted. Consider this page on the website of the National Center on Physical Activity and Disability. It says:

According to The American College of Sports Medicine (ACSM), vigorous exercise is contraindicated in the presence of acute joint inflammation or uncontrolled systemic disease. Plata and Russell suggest 48-72 hours of rest for those experiencing diffuse flares of RA. Iversen et al. highlight that those with an acute flare-ups (signs and symptoms include redness, inflammation, pain, and stiffness) of RA can participate in static strengthening (muscle contraction without joint movement) and gentle ROM exercises to enhance muscle strength and ROM without causing detrimental effects. These exercises should be performed one time per day on all muscle groups and held for a six-second count when acute flare-ups occur.

For Rheumatoid Arthritis patients who can exercise, caution is still advised: “According to The American College of Sports Medicine (ACSM), those with RA can stretch on days when RA flares and other forms of strenuous activity are contraindicated, but stretching unstable, hyper-mobile joints should be avoided, and people with RA should concentrate on not over-stretching the joints.

What my Suburban and gumbo say about RA exercise

One day, I did a hundred pushups. The next day, I could not carry my own purse. If you are wondering what makes me so sure I’m correct about Rheumatoid Arthritis exercise, that’s it. Sudden onset of physical disability from RA is not caused by laziness.

Recently, I parked my Suburban without power steering.  It was difficult for me to pull hard enough to control the truck. I could feel each joint in my hands pulling loose since they are all unstable. For days, my wrists and shoulders hurt more than they usually do.

It’s extremely hard for me to do most things; but, I do as much as possible. Movement brings pain and weakness, not increased strength. It’s as if the principles of exercise work backwards with RA.

If I make the bed or cook a pot of gumbo or dress my four year old, there are consequences. Just this week, a commenter mentioned how difficult it is to pull laundry from the washer with her RA hands. Once, I mentioned that on the blog and I got a few messages about it. I’m not an isolated case.

Recommended reading:

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Kelly Young. All rights reserved.

This entry was posted on Friday, March 12th, 2010 at 7:06 am and is filed under Reality Check. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.

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