Rheumatoid Arthritis Exercise, Round 5

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Fish at fish marketThis is the third post in the Frying Pan series to honor of the blog’s 3rd year, considering some significant issues from the last couple years. Sometimes the frying pan is more suitable than the sword. Today we’ll consider Rheumatoid Arthritis & exercise for the fifth time.

The relationship between exercise and Rheumatoid Arthritis

One of the first things that tips me off that someone does not understand Rheumatoid Arthritis is the promotion of exercise as a therapy for active Rheumatoid disease. As well documented in the other exercise posts, the relationship between RA and exercise is has always been clear:

  1. Exercise is healthy for RA patients, as it is for everyone else, when the joints are not in flare.
  2. Flaring joints should not be used vigorously, but destructive inflammation should be quelled, as with an injury.

An exercise expert wonders why RA patients don’t exercise more

The level of misunderstanding about how to heal RA is sometimes hilarious.

Other times, it’s frustrating:

An article in Rheumatology NewsRA Patients Shun Exercise, but Most Know of Benefits” features a survey that proves patients have gotten the message “Exercise is helpful to RA,” but don’t act upon it because they are in pain and worried about harming their joints further.

The survey was conducted by Ms. Rebecca-Jane Law of the School of Sport, Health, and Exercise Sciences at Bangor University, who says, “The benefits of high-intensity exercise in RA include improvements in aerobic capacity, strength, physical function, and psychosocial well-being.”

According to Law, “RA patients tend to be less active than… the general population.” She performed the survey of 247 patients “to determine why this might be,” “despite the known benefits of exercise.”

RA patients’ opinions on exercise

Over half of RA patients (52%) admitted that they did not exercise because it caused pain. Pain is a sign, according to experts, of active disease in a joint, meaning that it should be rested – not stressed. Several links to expert opinions support that viewpoint, but RA patients don’t need experts to tell them. They know when a joint is flaring too much to stress it. That’s why 44% of patients surveyed said they worried about causing harm to joints. Patients know what they are able to do. However…

Only 19% said they felt health care professionals knew how to advise RA patients on exercise.

Why not? Because, we live with the Usage Principle. We know the consequences of “high-intensity exercise” with active RA even though others might not understand it.

Exercise does not treat flaring Rheumatoid Arthritis

  1. Some people have RA that only affects certain joints. Of course the unaffected joints can be exercised, depending upon systemic flaring symptoms such as fever and fatigue.
  2. Some have RA which flares and remits; they can exercise between flares.
  3. In no case does exercise itself lessen the flaring of Rheumatoid disease.

If you’re a care giver or medical professional uncertain about exercise with flaring Rheumatoid Arthritis, I recommend that you ask patients what it’s like to move with RA. Remember that 19% number and help improve understanding by learning about the RA experience. Here’s a start:

Consider the jaw and the sternum joints:

RA inflames the jaw, regardless of how much patients use it to talk or eat. Exercise does not prevent or improve it. However, moving it can become impossible during flares, making eating difficult. RA frequently inflames sternum joints, regardless of how much a person breathes to exercise them.

Consider the reality of exercise and RA:

I go shopping with my kids, stopping occasionally to rest or get snacks. Afterward, all of my joints are always stiff, painful, weak, and sometimes swollen. Typically, the next morning, I’m awakened with piercing pain in one ankle, the other knee, a hip, and a few toes. Both ankles are always tender and weak, yet 5 days after that moderate exercise, one of them is still flaring sharply. Does that one ankle not know that exercise is good for RA?

Please do not blame the victim. The people I know with RA do as much as they can every day. And many of them sorely miss the ability to exercise the way they did the day before they got RA.

Recommended article from Musculoskeletal Network about RA disease & exercise.

musculoskelatal report exercise

Recommended reading

Bonus: Ironic story about the over-exercising baby boomers and knee replacements

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Kelly Young. All rights reserved.

This entry was posted on Tuesday, October 25th, 2011 at 11:00 am and is filed under RA Education, 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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