Rheumatoid Arthritis Exercise, Part 3
Rheumatoid 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.
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:
- Rheumatoid Arthritis Joint Protection
- Should Rheumatoid Arthritis Patients Exercise?
- Should Rheumatoid Arthritis Patients Exercise, Part 2
- The Truth About Rheumatoid Arthritis Info Will Be Told!
Very informative, Kelly. It is so frustrating just getting through the day, sometimes, that I cannot even contemplate exercise in the traditional sense. I USED to (pre-RA) love to exercise and I know how beneficial it is but it’s unrealistic for some of us. Gentle stretching and easy walking are the best I can do on a VERY good day. If I can, boy do I rejoice!!!Most days though, I rejoice if I can shower and a huge bonus If I get a load of laundry done.
I cannot put any weight on my left ankle last couple of weeks. Can barely walk since I can’t figure out how to limp on 2 legs! Both hips & knees are awful. Shoulders, elbows, wrists are useless. My hands scream so loudly, I keep asking others whether they can hear it. 😉 That is the tip of the iceberg… I grieve that I cannot exercise. I am not enjoying taking this position. I’m so glad for friends like you who understand.
PS- love the picture accompanying your entry. Adorable!
This was a couple of years ago. What I love about this picture at the USMC Museum is that I can see how much I’m straining to lift my son and still smile. I remember being so determined to have a “normal day.”
I exercise when I can, and don’t when I can’t. Unfortunately, friends and neighbors don’t understand the up and down nature of this disease. I get very frustrated when I hear, “but yesterday, I saw you walking the dog, in the garden, etc.” Often times, I can’t, because when I can be out and active, it feels so good after not being able to do anything from joint pain and fatique, that I don’t realize I’m overdoing it. I try to stop before I feel tired and remind myself that I need to save some for another day. I’m trying to learn to read my own body and smooth out my energy levels. Sometimes I’m successful, but often it’s beyond my control.
Sounds like you are on the right track though – listening to your body.
I had the same question years ago, and I no longer remember who finally clarified it for me. Gentle — emphasize GENTLE – Range of motion exercises only for affected joints while in active flare. Do not try to reach past your range of motion, while is likely more limited during the flare. Just go to about 80-90% of extension. This is necessary to help preserve the range of motion that you have. Gentle is the key!
It was more confusing for me for many years because for many years I did not have a single day without flares. Not one! It wasn’t until I quit work and was able to really rest that I finally experienced good days, days with minimal or even *no* pain. It was at least 3 months after quitting working before that happened. Until then, my attitude about exercising when not in a flare was, “yeah, right.” Still, I really didn’t fully comprehend how bad it was until I finally got relief.
The truth is, when you often are unable to move comfortably to do whatever it is you want to do, you really tend to enjoy exercise when you are not in active inflammation. Even then, the fear of overdoing it is also a concern, particularly since we often don’t get feedback from our bodies to quit doing whatever until it’s too late. Then we spend the next day to several days – minimum – recovering. That tends to make people reluctant to do too much. It takes a LOT of experience and listening to your body to figure out some reasonable limits to allow yourself some activiites, again when you are not having active flares.
Exercise is good, but do it safely. We do need strong muscles to help counteract the joint damage. I highly recommend getting a good physical therapist if at all possible. Even a few visits can make a huge difference. But don’t take just anyone. Contrary to popular belief, PT does NOT stand for pain and torture and if your physical therapist insists on exercises that cause you pain, after you tell them, then that is not a good therapist for you. Good physical therapy should NOT hurt!
I have personally learned more about how to care for this arthritic body from physical therapists than all the doctors combined over 20 years. Not that doctors don’t have their place, but it is the job of physical therapists to find SAFE ways to get you moving comfortably.
Thanks for great comments, Mary. Well said about ROM (range of motion) I wish this were what people read in the arthritis magazines.
Also, I’m interested in what you said about stopping regular work and then improving somewhat. I’ve heard this from others about starting work again, too – how they became “useless” again after trying to keep up a full time schedule. I think this just proves out the Usage Principle as a reality of RA.
I totally get the “laundry hands” and have that issue on a regular basis. Great picture!
AMEN, SISTER!!
I fortunately have a mild case of seronegative RA which is well-controlled, but oh, I remember the days when it WAS NOT CONTROLLED and I could barely lift a mug of coffee without dropping in and pulling my socks on took all my energy. My wonder (really) Rheumetologist didn’t tell me that 90% of all his patients were bedridden for SIX MONTHS after diagnosis…silly me, I took two weeks off and wondered why I could barely function.
I came down with really bad RA symptoms only 3 weeks after my CRP shot up to 17. I was on a two week holiday in Hawaii and boy was I miserable. I almost died after two hours of horseback riding (I still can’t remember how I got on and off the horse). I managed to snorkle, but if anyone thinks that you can do vigorous pool laps with RA, they are totally demented!!
I did see a Rheumy immediately after I got home, had all kinds of tests and was put on DMARDs right away. It has take TWO YEARS for me to be able to do Pilates again. But that’s only because I have no swollen joints.
Hope you continue to do well. Pilates sounds great.
I’m still at that “barely lift a coffee cup” stage after 4 years. But ya’ll give me hope.
I agree Kelly, if you can do it, if not don’t. I used to exercise at a gym 3-4 times a week, rollerblade, walk, etc. Now I just try and do some stretching and easy walking when I can. I bought a DVD called Yoga for Aches and Pains. Haven’t done it yet, in fact have had it for a couple of months, but just the thought of maybe doing a yoga position that puts pressure on my hands and wrists makes me cringe. I will try it though when I am not in as much pain. I miss being active, just today I could barely close my umbrella as I was coming into work. Which today I probably will go home early because my body is extremely exhausted and aching today, my hands, wrists and shoulder have that ” Kathy Bates hit me with a sledge hammer feeling” (sorry I love that movie and that comparison LOL). I am fortunate to have an understanding boss and he seems to understand “RA” and he lets me do what I have to as far as arranging my work hours.
I too have had people say, well won’t exercise help, and you have to explain to them. Oh well, and yes I get the laundry hands too!!
She must have come after my knee and my ankle and my shoulder on the way back from your house…
I began Simponi 6 months ago and had profound success! I felt as though it were a miracle! I was so happy, I began a walking program with my father at the local mall. We were going 3 days per week (M-W-F) We did 2 and a 1/4 miles each day. I have not done a lick of exercise in 10 years. I was so proud of myself. We walked for 3 weeks, and I have since had to stop. I am in a constant flare, back on prednisone. Had to stop the methotrexate for a week, then go for bloodwork, and then begin methotrexate again as my liver function was high. My friend just asked me this morning, “do you think the walking could have set you back?”
Thinking about it, I would have to say No. Given my history with all the medications, if I am not allergic to it, it usually works for 6 months and suddenly stops working for me. I am in total agreement, if you can, go for it. If you can’t, then don’t. While I could, I did and my self esteem skyrocketed. Now, it is at the bottom of the totem pole. I feel useless. Laundry hands…..sometimes makes me cry.
Great post Kelly.
Cindy
Hi Cindy. I still have yet to see that success, but I hope you get it back. It must give you hope that you did get there once!! 😎
My orthopedic surgeon says I’m out of shape and need to exercise more. My Rheumatologist on the other hand says I’m nuts when i asked her about getting a treadmill. The risk of injuring myself on one of those is greater than the benefit. Yes, I am out of shape and it has me totally pissed at life. I still plan on climbing a mountain, just as soon as I can get out of this chair, LOL…ciao
Sounds like your rheumy is a realist. I love that you still have your goal …and your sense of humor! 😎
As a Physical Educator who recently had to take a disability retirement due to severe RA, it has been a real struggle. I have been athletic and worked out as long as I can remember and have preached the importance of regular exercise to all my students for 24 years. However, I have had to change my entire mindset when it comes to my own workouts…some days just dusting the house is considered my workout for the day, others I can do a Pilates workout where u stretch and build strength at same time, and on my good days I make myself ride the Lifecycle at the health club to keep my leg strength up as my knee is my worst joint….right knee, left ankle….like u described how do u walk with these joints impacted? The important thing is to listen to your body…I have a hard time doing this and often put a guilt trip on myself if I can’t workout…it has literally been my life. I’m trying to get better because when I have pushed thru the pain to workout I have had setbacks and worse pain the next day or several days! Easier for me to give others good advice, but much harder for me to take it.
Thanks, Lori. The dusting comment clearly describes the situation. We do work out – my almost 5 year old is very heavy for his age – I pick him up many times a day – It’s taking all I have to do this now. But I swear I’ll do it if I possibly can at all. He never knows how much it hurts me to dress him and bathe him – my other kids offer – but I want to do it as much as Dan wants to climb those mountains! Just like you, I know most of us do as I wrote in the post “as much as possible” every day, like you said, “pushing thru pain”. btw: That goes for typing my blog, too.
Another great post, Kelly.
You’ve once again made to me think about my situation and activity levels, and as a result I am a little closer to fully understanding my battle with RA.
I have ALWAYS led a very active lifestyle (professionally and personally). I am an outdoor journalist and author, writing about my first-hand experiences in all forms of outdoor recreation — from hiking and mountain climbing to cycling and kayaking. Until my onset of RA, I regularly hiked 2,500 to 5,000 miles per year in the mountains, as well as numerous days skiing, snowshoeing, cycling, climbing, etc. There were years I spent as many as 180 night per year in a tent in the wilderness.
About 4+ years ago, I was finally diagnosed with RA (my onset came well before the official diagnosis — see my onset story on this site). It was determined that I currently have moderately severe RA. But because my life literally revolves around physical activity, I still exercise regularly. But even though I’m still physically active, my level of activity has declined significantly since onset. Last year, I hiked fewer than 800 miles, and had less than 15 days of skiing. Though that level of activity may seem high to some, it is a substantial reduction for me.
As noted repeatedly by others, we need to do as much as we can while protecting our long-term health. For me, outdoor recreation is a core part of my existence. I need the connection with the mountains (and deserts) to keep myself mentally fit and psychologically centered.
If I am unable to get out for a hike, climb, paddle trip, etc. at least a couple times per month, I find the psychological pain of NOT being outside and active is as bad as the physical pain of being active with RA.
So I have had to find a balance, and many times I do suffer days (and even weeks) of physical pain after a strenuous outing in the mountains. For me, that is a price I am willing to pay for the benefits of being in that wilderness world I love (and need). For others, that price will be far too high.
Bottom line, we each need to find the balance in our lives, between what we need to do, what we want to do and most importantly, what we can do. And only we — not our doctors, not our friends, and not even our family — can set those balance points for ourselves.
Thanks again for another great post that sparks such beneficial introspection.
Dan, I want you be able to keep climbing just like you want me to keep writing. Thanks for great comments that prove we are all pushing our limits the best we can – and not a group of shirkers. 😎
“It’s as if the principles of exercise work backwards with RA.”
I would say the principles have to be applied differently and at a much slower pace, glacial if you will. I agree wholeheartedly that inflamed joints should not be taxed and that if you are in a flare you should skip exercise for that period.
I can’t remember how many times I’ve overdone it with my exercise routine, resulting in a set back. But every time was and is part of a learning process. Like I said, I take it slow and learn along the way. But I keep at it, because even though it sometimes make me feel worse or increases pain, in long run, it benefits me. My brother once ran a marathon without the proper preparations. He completed it, but paid for it for a week (sometimes he’s ego gets the better of him..). RA patients run ‘marathons’ every day, our bodies reach their limits a lot quicker than people who are not affected by disease.
I’ve talked to a lot of people in the world of arthritis, professionals and patients, here in Holland about this topic since Kelly started it and one of them made an interesting observation. It seems that the arthritis community in the US and Canada, are more conservative towards exercise than over here and I’m referring mostly to the medical field. I’ve started a discussion on a Dutch RA forum and to my surprise no one questions the benefits of exercise for RA patients, even if they are unable or unwilling to exercise themselves.
I find this fascinating and wonder where the difference lies; is it cultural? Do the Dutch simply accept the line that ‘exercise is good’ and not question it?
I’ve been trying to find links to studies about the Dutch approach to exercise and here’s one that’s interesting.
All I can say is, exercise makes me feel good, physically + mentally, and I’m going to be giving it more of a concerted try. I’ll report back on how it goes on my blog!
I have to agree with Mary about a good physiotherapist. I started physio 3 weeks ago for calcific tendonitis in the rotator cuff. Told the physio I have RA and he was great, no weights, just stretching, range of motion and light resistance. I had amazing progress, was feeling good. I saw a different physio on Wednesday to work it into my schedule and I am PAYING for it. He worked me hard with 3lb weights and strong resistance training. Now my shoulder is burning and my hands and elbows are inflamed too. I’ve learned my lesson, I’ll wait for the usual guy who bothered to take note of my condition…. once the inflammation subsides of course!
Kelly, I’m grateful that you are here and providing a place to talk about this stuff.
I’m having a hard week, mostly because I’ve been too busy at work and that always has a backwash where my joints are concerned. Today my right foot has been dragging intermittently. It’s so weird to be fine (relatively) most days and then suddenly by borderline shambling.I have a dog to walk, and sometimes we walk for 20 minutes, and sometimes for 30. I want to go farther, do more, but when I stretch to 45, I pay for it. That seems ridiculous! Why should 15 minutes of walking make such a negative difference?!?!!
If last summer (my first with RA controlled by medication) is any measure, I’ll be able to do more when the weather isn’t so cold and my work schedule isn’t so demanding. But from now until Easter–I’m a pastor–I’ll have to try harder to balance work and rest than I did this week.
Kelly,
The reason your blog works is because you seem to have a rational scientific grasp on most apects of the disease, and you do a good job of explaining that sort of scientific aspect to everyone.
However, this is one subject where your science is not making sense.
It is true that the symptoms of RA can worsen if we overdo the excercise. However, it is also true that the symptoms of RA worsen when we spend too long at “rest.” I mean, have you ever tried to sit still a good hour or two to read since having this disease? If you have, you know that that can be enough to make every joint as creaky as the tin man’s.
Before RA, I did workout 6 days week. After RA, I found out that I had to cut that back to 3 days, but trust me when I tell you that during the years I worked out, my RA was better controlled overall. The problem is last year I stopped taking MTX in the effort to get pregnant again. When I did that, I had to stop all excercise, and my RA has done NOTHING but get worse. I finally started back to the gym 2 weeks ago. It is a slow process. I have to start at the pool again until I can hopefully make it back to the treadmill and perhaps the elliptical if my knees will let me. All along the way, I will use either the resistance of the water or light weights to build the muscles around the joints in order to alleviate some of the pressure on my joints.
And so right there, you have two reasons why excercise IS important to RAers. The stiffness factor is increased if we don’t move, and we need to build up the strength of our muscles to help support the joints.
That’s science and observation.
That is real.
And before you say yours is worse than mine, I would have to disagree. I have been following your symptoms here for over a year, and I’d say we’re very similar. We are also around the same age, and my RA has been around about 2 years longer.
There is a reason all of those articles reccomend excercise. It helps.
– RA SB
You’ve already decided, so I didn’t need to reply. However, some others have indicated that they need a reply. So, for the sake of readers, here is my response:
——————————————————-
Regarding the usage principle and RA: I will not reiterate so much about exercise that I have explained here in this post and in the previous 2 parts of this series. As it says the comment to Dan, every day, I do as much as I possibly can.
There are many things I cannot do any more, but I do not give up. Some days, I cannot walk or hold up my head. Every day is filled with “No, Momma let us help you with that.” And “No, I can get it, just let me try.”
It might take me 10 minutes to open a can of tomatoes and 3 hours to cook a pot of soup, but I do it. I walk the sidelines of the football games and tennis matches until I have to be helped to the car. I struggle to dress my son when his sister would gladly do it for me. I do it because I want to fight for whatever of my life I can keep. There is no day which ends in which there is any fight left in me. I leave it all on the field.
Regarding scientific evidence: The links in this post and every article I’ve ever read says not to exercise a joint in flare. Perhaps that is the communication gap here. If I ever do get a moment without a flare in a couple of dozen joints, I will not use that moment to clean my house. I will play tennis …right after I run on the beach. I have not had a moment like that in the last four years.
Helpful comments here and here and here. If my RA is ever controlled, I will not change my stance on behalf of my friends in wheelchairs, etc. who need my voice.
Regarding me: My website is only about 6 months old. There was a Blogger blog for a couple of months before that. I’ve had RA for 32 years. I’m not getting into a contest with anyone about whose RA is worse.
Most of my personal and medical information is not on the internet. I do not discuss most of my “symptoms” online. However, what is on this site is true. If you do not believe it, that is your prerogative.
Regarding you: Perhaps it was stopping the methotrexate and not stopping the gym which made your RA less controlled. I will say a prayer for you as I post this. I have no way to know what your RA is like, but if it’s anything like mine, you need it.
Kelly….have you tried using an electric can opener? It has helped me a lot..no more trying to open a can with a manual can opener with my RA fingers.
As always, I can totally relate to your posts. I sit here reading statements out loud to my husband, almost with a “see…I am not alone” type of tone.
I have come to realize my limits: I can swim, and I can walk, and I can use a glider (gazelle), use my 2 pound weights, do a few crunches per day… But other than that…I pay dearly after.
I have tried to join gyms. They talk the talk like they truly understand the repurcussions, and then they have me practically doing handstands while my wrists feel like they are going to split in two. They have me lifting weights while my shoulder joints are on fire and feeling like they are going to pop right out of the skin…I could go on…
I love your website! I’m torn between all of the comments. I agree that exercise is a necessary evil, but with RA it is SO difficult! I was an avid exerciser once, what seems a very long time ago. I would work out 6-7 days a week, strength training and cardio. Since I’ve drawn the short straw with RA, I struggle to get into the gym. I go, but I pay the price.
My mom wanted me to show her some yoga the other day, like everyone else in the post I weighed what the consequences would be to my wrists and hands and I really didn’t think it would be THAT bad. I was SO wrong, 15 minutes of yoga equaled the entire day of swollen fingers and sore wrists. 15 minutes….geez. I try to exercise, try to dust, try to pull the laundry out of the machine (that is SO true!), try to clean my house and I wonder alot of the time if it is just me. Thankfully, Kelly has been kind enough to create this website to keep us all from losing what’s left of our minds.
I do weigh the consequences of my actions daily. Whether or not I go to the gym, whether or not I take the stairs instead of the elevator, I hate having to do it but after 2 years with RA it’s just what you do to protect yourself. Today, it’s my left ankle, right knee and I swear I must’ve cut a move yesterday because my hips are killing me. My loving hubby asks me…”what did you do to it?” My answer “uh, used it to walk?” The funny thing is that’s true…I didn’t do anything out of the ordinary and wa-la, sore hips, knee and ankle.
Thank you Kelly for your website and all of your informative articles, I know I’m not alone.
I wish I could exercise more than I do. I am so busy trying to straighten my elbows to reach for a cup and then bend them again to get the cup to my mouth, using every ounce of strength to wipe my bottom, and doing a marathon with my legs to transfer to my wheelchair. Oh how I wish I could give my husband and daughter real hugs instead of squeezing them with my forearms. If there was a way for me to exercise I would do it in a heartbeat. I have tried pool therapy and had to rest for 3 days after a half hour session. I have tried the thera-band stretches and succeeded in stretching my tendons and ligaments to new levels of pain. Any more I consider self care and may be one small household chore a full day workout. I thought it was just me, but most of the above answers prove me wrong!!!!!
Kelly,
Wow….I admit I read often and rarely comment but given how I have been feeling lately this really hit the nail on the head for me in so many ways. When I am doing well I love exercise. I love to run and play with my dog. My passion is horses; I ride no matter what. I want to ride my whole life. I have recently come to realize I may eventually need special dispensations to compete as very soon I may need special reins in order to be able to hold them, but I told myself it would be ok- I would be strong and make it work. Riding horses is my dream.
But this weekend that was challenged. I was taking my regular lesson and was approaching the end when the pain in my hands got so bad I literally stopped my horse very abruptly and broke down in tears. I couldn’t push through it anymore. I had already taken my anti-inflamatory for the day and about twice as much tylenol as I should. It was the first time my RA has brought me to tears. lately I haven’t been running and I had been feeling guilty. I wanted to run. I wanted to ride more and have more energy. But this weekend made me realize the concept is not, “use it or lose it,” but rather, “do what you can, when you can, and learn when to stop.” I will not give up my passion because of RA but, as your post has reminded me and I learned this weekend, I may have to go about it differently than how I planned. I have to be willing to take the scenic route.
I appreciate the post as it is a good reminder to me that I can slow down every once in a while (since my RA forces me anyway) and not feel guilty about it.
This post hit home here. Beautiful sunny day here, finally after months of cold, so I took the kids to the park and we ended up walking aroung the lake, well they ran and I hobbled. I kept telling myself, my body needs this, it’s exercise, this will help my RA. Long story short, by the time we got home, I hurt so bad, I had to lay down for an hour. My body now feels worse than it did before exercise. I think exercising and RA is something to be handled individually. Maybe one day it is just stretching and on a good day a walk or swim and on another it is resting. I am really seeing now that what you read in books or online can be helpful but for those of us with RA, it hits us all differently, what may work for one may not work for others.
Many emails I receive say something like this comment which was just left on another post. For anyone researching how exercise or movement can affect flaring RA, the comment about exercise is interesting. Click here.
My goodness, now I have something to go by with regards to exercise. I was wondering why I got more pain with it when my friends quickly recovered. I got to the point where my knees were so unstable I could hardly walk let alone run. I’m going to test myself with some mild exercise and let my body tell me what I can and can’t do. Thanks! So hard to get a straight answer from health professionals.
Lisa, I think they don’t give the “straight answer” on this because they honestly do not know. We are still in the dark ages of this disease. However, learning fast hopefully. Good luck to you.
Reading the points raised it appears that it is not exercise that is the problem more of what type of exercise suits your level of incapacity.
Non-Load bearing exercise and Aerobic such as cycling, swimming.
Key thing is the variable nature of the disease and how it affects people differently.
I agree. The first day I get relief from a treatment, I’m putting on the sneakers. Still hoping the day will come.
Hi Kelly. I was diagnosed when I was 32, and had a newborn and a 3 year old. I’m 48 now. I have found that exercise is critical: strength training (weights), cardio, and flexibility training (yoga) are all key. I also subscribe to the “do it when you can, don’t do it when you can’t” credo. Another reason to be physically active is that living with a chronic disease can be kind of depressing and physical activity is huge in keeping the spirit up. I have not found any doctors who really know anything about nutrition and arthritis, but I have found that what I eat makes a huge difference in how I feel. My overall strategy for handling this disease is I need to be as healthy as possible, so as not to add additional physical problems on top of the one I already have. Best to you.
Hi Kate,
I don’t think anyone in the world loves exercise more than I do. I so hope I’ll respond to one of these treatments one day & be able to walk normally and move my arms freely. If I do, I’ll get a bike and a dog the very next day. No matter how much I’ve been pressured to do so, I haven’t sold my tennis raquet. I insist on maintaining hope.
I cracked up at the end of this article. It absolutely epitomizes the way I feel. I so desperately want to exercise to lose some weight, to strengthen my muscles & joints and for the euphoric high you get; but how can I do that when I can barely sort through the laundry and find it excruiating to pull the clothes from the dryer.
I can’t explain to you how grateful and thankful I am to have find this blog & the RA Warrior website. It may sound selfish, but it sure feels good to know that I am not alone in this daily struggle.
Tonia! don’t think you are selfish – it helps me too. 🙂 Your comment made me feel better, too. Here’s to doing our best. :rainbow:
I just hAd Carpel Tunnel, Guyon’s canal Syndrome & Trigger Finger surgery on my left hand last week. Just trying to make somewhat of a fist is a mini-miracle at this point. I would love to be able to get out & walk 3 miles daily like I used to but now if I can get down on the rug do a few stretches and manage to get myself back up I consider it a victory!
Exercise used to. E my life. Triathlons, working out at the gym, running 4-6 miles a day. And now stretching and trying to flex so that I can still get out of bed the next morning makes me feel like I’m doing something!! And I’m like a lot of other RA’ers – I dont look all mangled up and sick so why am I not out there anymore. Makes me want to slap anyone who says that to me but then I would suffer the next day! As to the woman whose rheumy wanted to shake her hand, I shake my head & say not today. If that doesn’t give him a clue then he needs a new field!!
It is not only the inflamed joint issue. For me it is the fatigue. I am so tired all the time. If I do anything physical like shopping I am done for the day. The thought of even walking a mile some days is exhausting. Since I have to go to work and drive a school bus for approximately 6 hours a day(with a break) I get exhausted just doing that. I cannot retire for 5 more years. Then maybe I can do some exercising without feeling exhausted.
You’re right, Nancy. I’m sorry I didn’t focus more on that. There is a lot of literature claiming that exercise is the remedy for fatigue, but I wonder if there is a physiological reason that it works differently in most rheum patients.
Hi. I really appreciated this article. I’ve kept relatively quiet about my RA for five years. It’s been difficult to explain to people why one day I’ll be training my daughter’s horse and the next I can’t be bothered to clean my own kitchen. I have to make choices about what’s most important and cleaning seems to be pretty low on the priority list. I was so sorry to see in one of the posts that her equestrian competition was drailed by her RA pain. Sometimes the most I can do is go outside and lean against my Thor (Morgan) and smell him! It’s sad, but I’ve found myself making “safer” choices while riding/training because I’m afraid of getting hurt. I enjoy watching my daughter ride, though. I hope there’s someone in her life she’s able to teach and encourage and share her love for horses with:) Thanks so much for sharing.
Hi kelly.. I have a very important question..Or important to me.. I understand you are not a doctor, but I follow you and get better advice from your posts..I have terrible severe pain in both my feet even though I am on all the newest biologics and meds..Nothing touches the pain in my feet. I have two little dogs that I must walk every day for at least 45 min. and the pain in my feet is getting worse daily.. What is your advice.. Should I be seeing a physio therapist or what do I do.. I am very desperate.. thanks so much for all the good that you do for people like me. And yourself..
Donna, have you had any imaging done of your feet such as xray or mri? Maybe it’s time for that. What does your rheum doc say? Have you seen an orthopedist? To know what would help, they need to know why it hurts / what’s going on. That is a lot of walking every day for the dogs. If your feet are inflamed, walking that long might make them hurt a lot more. The idea with those medications is to get that inflammation down so you can do those things, but you have to find the medicine that works for you.
Hi all.. To add to what I just wrote.. I have had feet xrays done and yes there is lots of damage and my doc is suggesting cortisone shots in my feet.. Is this the normal route and does it really help… Gosh I am so confused.. the pain is burning throbbing, crucial stabbing, you name it .. Both in the feet and ankle.\
So sorry to go on and on and I have just read some interesting info from others.. Thanks
Since being diagnosed three years ago (I’m 55) I have gained 70lbs…and had a bypass last yr with complications so I was in bed for 7 months. I began walking in August …take a few steps, rest, take a few more steps, rest…I am grateful my fox terrier is so patient with me. The challenge for me is that in spite of NSAIDs, DMARDS and biologics, my RA is not in control. I have never been flare free. But, I too am a warrior and willing to try any reasonable approach or activity. Imagine my surprise when 40minutes of swimming and walking in a pool caused me to flare in my ankles and shoulders. If it wasn’t so pathetic I might laugh at the complete absurdity of it all.
I’ve found that it is difficult for some to understand that exercise advice for people with no health problems is a lot different than exercise for those who do. My irritation level was absurdly high when I read “pool exercises are low impact and great for arthritis” and found that the five minute walk from my car to the indoor pool was more like a hobble. Getting in the pool was nice, but then I had to get out and make the walk again.
Most of what I do is on the floor and involves squishy things. I can use yoga blocks (squishy) to “touch my toes” (wearing squishy Crocs) which is on my (squishy) yoga mat. I removed the weights from my wrist weights (ouch, things hanging off of my wrists), which are a little squishy and I’m using in soup can weight style. This all takes place for ten minutes after 100 mg of tramadol. Then it’s lay down time for a bit.
I used to do high impact sports and running. I don’t get the same gratification out of ten minutes of squishy exercise as I do sending someone a foot back after kicking a bag. Eh. Just shooting for keeping bone mass these days.
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I have been able to do some chair yoga recently and really enjoyed it. I doubt I will ever be able to do unmodified yoga because I can’t put that much weight on my wrists and I can’t kneel. I can only do what I can do. Somedays that is just be.
Thank you for this post! I have been struggling with the same issue. How on earth do I exercise when I can barely get off the couch? I too have gone very quickly from an active lifestyle to a sedentary one. It is painful emotionally to be unable to participate in the swimming, walking, and gardening that were part of my everyday life until just 3 months ago. It did not make any sense to me that I should be suffering extreme pain and exhaustion just to say that I got my 30 minutes of exercise. I feel validated after reading these articles and will work on getting my symptoms under control before worrying about my activity level. At this point, I am just trying to come to terms with my new reality.