Should Rheumatoid Arthritis Patients Exercise, Part 2

 

rheumatoid arthritis patients exercise tennisShould Rheumatoid Arthritis patients exercise or not?

There was a bit of a backlash to the Part 1 blog post to this series on exercise and Rheumatoid Arthritis. A few people even unsubscribed. But, staying out of trouble is not a goal of this blog. Truth-telling is.

Specifically, what I have challenged is the kneejerk “Use it or lose it” approach to exercise and Rheumatoid Arthritis. It is simply ironic when joint protection is considered. As I explained in Should Rheumatoid Arthritis Patients Exercise, Part 1, I do not oppose exercise generally.

Recently, I wrote that “Use it or lose it” should be re-written. It ought to be: If you can exercise, you should; If you can’t, you should not.

Logic

Let me paint a picture for you: massage is a good thing, right? Everyone knows it can be very beneficial in the right context. However, imagine massaging a sunburned back.

Doesn’t work, does it?

That’s the same thing as prescribing exercise for Rheumatoid Arthritis patients who are damaged, inflamed, or barely able to move.

Are people saying that the crutches, canes, wheelchairs, and braces of many patients are just props and that they need to cast them aside and rise up and walk? Or are they implying that those with Rheumatoid Arthritis are in this condition because they were too inactive to begin with? We just need common sense on this issue.

It’s one of those things that does not need to be explained to those of us who know. The problem is, it is nearly impossible to explain it to those who don’t know. How can they know what they cannot experience?

Bluntly, if you are still able to view exercise as helpful to you, then you can probably still exercise. And you probably should – whether you have Rheumatoid Arthritis or not. If you are not sure, it’s easy enough to find out.

Experiments

Several months ago, I could not resist the draw of my kids and the tennis rackets. I determined to hit a few with my 12 year old. I could barely hold onto the lightweight racket. But, my willpower is iron.

I managed to force my wrist to awkwardly hold out that racket. I thought: I WILL do this! And then my child tapped a ball in my direction. It felt like a cannonball hit my racket. The shock of that ball sent pain through my hand and arm that did not fade in a few moments.

I did not give up. Over and over, I tried to ignore the pain. I missed more and more balls because my hips would not let me move sideways. I did not want to, but eventually I had to quit, of course.

I did not complain. I had done this voluntarily. I just had to know whether I could hit the ball. It looks so easy…

For several days, my hand and wrist were useless. Was it worth it to play a bit of really crummy tennis? No.

However, I am hoping it was worthwhile for another reason. It was a useful experiment. Think of it as a research trial.

Recommended reading:

Kelly Young

Kelly Young is an advocate providing ways for patients to be better informed and have a greater voice in their healthcare. She is the president of the Rheumatoid Patient Foundation. Kelly received national acknowledgement with the 2011 WebMD Health Hero award. Through her writing, speaking, and use of social media, she is building a more accurate awareness of Rheumatoid disease aka Rheumatoid Arthritis (RA) geared toward the public and medical community; creating ways to empower patients to advocate for improved diagnosis and treatment; and bringing recognition and visibility to the Rheumatoid patient journey. In 2009, Kelly created Rheumatoid Arthritis Warrior, a comprehensive website about RA of about 950 pages and writes periodically for other newsletters and websites. Kelly served on the Mayo Clinic Center for Social Media Advisory Board. There are over 42,000 connections of her highly interactive Facebook Fan page. She created the hashtag: #rheum. Kelly is the mother of five, a home-schooler, Bible teacher, NASA enthusiast, and NFL fan. You can also connect with Kelly by on Twitter or YouTube, or LinkedIn. She has lived over nine years with unrelenting Rheumatoid disease. See also http://www.rawarrior.com/kelly-young-press/

35 thoughts on “Should Rheumatoid Arthritis Patients Exercise, Part 2

  • August 24, 2009 at 9:00 am
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    I agree with you whole heartedly on this one Kelly, as you know I've had RA for 22 years so have lots of experience of trying to exercise with RA. Simply put, when my joints are inflamed it is impossible to exercise, a lot of the time the joint(s) are so inflamed they are fixed at an angle making them impossible to move one way or the other. My elbow locks so that I cannot straighten it or reach my head, my knee locks so that I can neither straigten it or fully bend it, can you imagine exercising with jonts like this (not to mention the pain involved!) I am however a strong advocate of excercise when we RAers are having a good day, excercise keeps our muscles strong and supports the joints so it is vital that we do what we can WHEN we can do it. The best exercise for me is swimming, pilates (even Yoga is too much!)gentle walking and carefuly planned gym 'workouts'. We have to be realistic about what we can do with RA and be kind to our bodies, it is incredibly frustrating but it does get easier with time!

    Reply
  • August 24, 2009 at 11:10 am
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    Amen, sistah!

    Caysea

    Reply
  • August 24, 2009 at 5:04 pm
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    I realize that I'm nowhere near the condition of a lot of RA patients. I have an exercise schedule of walking 30 minutes 4 days a week and I work out with weights 3 days a week. However there are days that I hurt too much to hit the gym so I don't. I don't worry about it, nor do I feel guilty about missing a day here and there.

    My feeling on this is if you can exercise, you should. It will help you mentally and physically.

    Reply
  • August 25, 2009 at 9:15 am
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    Great comments, guys.
    AND THAT'S THE WAY IT IS… 😀

    Oh, and check out the next post about the New Way RA videos; someone is listening to us!

    Reply
  • January 4, 2010 at 9:46 pm
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    swimming is a good way to exercise if you can.
    my mom actually recommended it to me 😛
    makes me feel like I can do anything 🙂
    because for awhile my arm will do what i want it to! haha
    and the hot tub is great to relax your joints and muscles if you have the same trouble getting in and out of a the bathtub

    Reply
  • January 4, 2010 at 9:52 pm
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    haha 😛 i should read both parts and comments before I post 🙂
    I know I am not the only person to have discovered swimming to be the most relieving form of exercise 😛 🙂 oh well.

    Reply
  • March 13, 2010 at 8:35 pm
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    I have tried unsuccessfully for years and years (seriously!) to explain to my doctors that the pain came BEFORE the weight!! Its the chicken and the egg question in an RA format – the only difference being that I find people are not willing to even consider that I AM telling the truth. Its like they look at me and think to themselves “yeah, right”. Well, you know what? I’m done!! If I have a day where a short walk in the store can be done rather than a scooter, then I will, but walking up and down the street is an experience in more bone jarring due to the unevenness of the pavement and actual fear of being too far away from home to make it back in the door. I’m tired of trying to explain myself to closed minded people. So, its all between me and God now. Because HE loves me in spite of what I look like on the outside…

    Reply
    • March 13, 2010 at 8:45 pm
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      Doreen, You are right – he does love you – and so do many others! O:-)

      I, too, am tired of people acting like I’m not telling the truth too. God knows this RA is not my fault.

      Reply
  • December 30, 2010 at 12:36 am
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    Hi Kelly,

    you know I have almost exactly the same tennis story, my aim this year is to try table tennis, I might be able to hit a pin pong ball!

    On exercise I might also add that while I have sore and swollen, toes, feet, heels, knees, ankles and hips, and every joint north of the waistline, I don’t seem to have a problem when I dance! Every now and then I have had a good jig around the living room to a favourite song and I don’t end up in massive pain with flare-ups afterward.

    I’ve tried a few different forms of exercise, and even overdoing the aqua-aerobics has caused a flare-up in the past, but never once have I had any flare-ups after dancing.

    A few years ago, when I could still wear shoes other than running shoes, I went dancing for my hens night (I’d had active RA for about 6 years at that stage). I danced all night (in the most comfortable Stuart Weisman shoes ever). Not a problem! Couldn’t even get the shoes on these days, but I can still have a dance (in my comfy Brooks runners) and not have a flare up. I cannot however walk very far, stand for very long or even sit down for too long, but the occasional dance does me wonders!

    I wonder if it’s anything like the parkinson’s sufferers who can’t walk well, but can ride a bike?

    Who knew? What’s that all about?

    Reply
    • January 4, 2011 at 10:53 pm
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      the only explanations I can imagine Tracey are adrenaline or endorphins. It does sound wonderful though and I hope you can do it often. Even at home.

      Reply
  • March 8, 2011 at 1:09 pm
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    I mentioned to a friend who has OA (I have RA, OA, and osteoporosis, and I am a type 1.5 diabetic) that I was beginning to hunch over when I walked. She informed me that SHE would never walk like that, that SHE was going to go for physical therapy. I merely hung my head and said, “I hope you never have to walk like this.” I have not felt the same way since about this “FRIEND.”

    Reply
  • April 15, 2011 at 12:42 am
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    I had a rheumatologist tell me once that he would stop treating me if I did not workout. I thankfully am not seeing him anymore. Now I still do not have an RA diagnosis but sort of leaning that way. My hip joint is the worst. My ankles are red at the joint and hurt all the time now. I knees and shoulders, and elbows bother me at the gym but I press through. I am only 23 but very active before I got sick in 09 so I do my best to stay active even when it hurts. I am stuck with no answers from the doctors. Until then I push through my workouts 4-5 x a week.

    Reply
    • April 15, 2011 at 8:58 pm
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      Hi Traci, I hope you find answers and a better rheumatologist. I’m not sure what explanation the doctors could offer someone your age with that many painful joints, but it needs to be identified so it can be treated. If it were RA, pushing through pain could end up causing damage. I hope its not.

      Reply
  • May 30, 2011 at 8:42 am
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    Thank you so much for this website it has been a great help to me. I was just diagnosed with RA in Jan. of this year. I have been trying so hard to exercise and I do for about three days and then it seems that I would start getting a flare up so I would stop. Was begining to wonder if it was all in my head and I was just getting ‘lazy’ one thing that I have never been. Thanks again for the info maybe it’s time to try something different.

    Reply
    • May 30, 2011 at 7:13 pm
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      Mary, I’m sure you are doing the best you can. And when you are more able, you will do more. It’s not in your head if there are different limits now than before. I hope your treatment brings relief so you can do ALL the things you want to do.

      Reply
  • June 26, 2011 at 3:01 pm
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    I have just been diagnosed with RA and still await my first appointment with my rheumatologist (4 month wait). Everyday feels like a fight to just get through the day. But when I am in the swimming pool – I feel great again. My shoulders, hands and feet still hurt a bit but for some strange reason I can move. I often thought if I could just live in the swimming pool – life would be better. But sometimes it is such a task to get to the swimming pool – even just putting on the bathing suit seems like such a hard task. I find myself real sad on somedays especially starting to see one of my fingers start to indent. I am only 41 and worry what the future is to bring. Thx so much for your blog – I think it will help me especially to get through to the next month when I finally get to see the specialist I have been needing.

    Reply
    • June 27, 2011 at 3:56 pm
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      Oh I feel for you Kristen…your bathing suit comment struck a chord in me. Not funny (well, sort of), but totally relatable. Last night as I finished my bath I had one of those darned moments when the skin is still slightly moist and I found myself wrestling with my bra. By the time I’d gotten the straps all untwisted I was so frustrated, tired and achy I just flopped backwards on the bed to recover from the episode! I think I a better strategy is in order. Perhaps a little powder. Keep smiling.

      Reply
      • June 27, 2011 at 7:02 pm
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        Oh can I identify with you both, have had the same bra moment! Plus I love it when you try to put a t shirt on and it gets stuck right at the shoulder level. My upper arms are weak as it is, makes me want to give up wearing clothes.

        Reply
  • June 28, 2011 at 12:51 am
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    I just finished reading your great blog. I’m so frustrated right now. My mother-in-law left today after visiting for a few days. She lives in another state and we see her once a year. She was asking about my hands which are visibly damaged and constantly in pain. Then she made the comment “Well, my doctor says I have arthritis in my hands too, but mine don’t hurt. It’s because I’m so active.” People just don’t get it.
    Thank you for your wonderful blog.

    Reply
  • August 5, 2011 at 1:48 am
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    Thank you all! I feel much better now. I am currently trying to hit the pool 3 days a week if I can. I use crutches/walker.

    Reply
  • November 20, 2011 at 12:27 am
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    So I have all the symptoms of RA, my hands, wrists, shoulders, hips, neck, etc. all hurt and look like RA. So why do the doctors (I use that term loosely) not see it. My hands used to swell; however, that has stopped. I have the valleys, the lumps, not only in my hands, wrists, forearms, elbows, and feet, yet why am I told it’s not RA.

    I also have osteoarthritis in just about every joint in my body, yet RA is different.

    Can someone out there help me?

    Reply
  • November 20, 2011 at 12:30 am
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    So I have all the symptoms of RA, my hands, wrists, shoulders, hips, neck, etc. all hurt and look like RA. So why do the doctors (I use that term loosely) not see it. My hands used to swell; however, that has stopped. I have the valleys, the lumps, not only in my hands, wrists, forearms, elbows, and feet, yet why am I told it’s not RA.

    I also have osteoarthritis in just about every joint in my body, yet RA is different.

    Oh, I also have blurred vision, my eyes sting and are sensitive to light.

    Can someone out there help me?

    Reply
    • November 20, 2011 at 10:14 pm
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      Velva, I am so sorry you are going through this. My experience has been that there are some doctors that will not treat you for RA if your RA blood test comes back negative. When I first got sick, the PA at the clinic I went to said she was treating me for RA based on symptoms. Yet when I finally got in to see a Rheumatologist, he took me off of the meds(which were only prednisone and pain meds) because my RA factor was negative. Finally after a sonogram of my hands revealed active RA, he put me back on the meds, doubled and started adding more every visit.

      Maybe if you ask for a sonogram of hands or feet, they can diagnose then. I am sero-negative, just means that my blood test is negative which puts me in the group of about 30% of folks with RA. You could very well be in the same group.

      Be prepared though that if you turn out to be sero-negative that most will think your disease is not very active or disabling, that your pain level is not very high, etc. I don’t know about other’s pain levels, but I know mine hurts enough to make my life miserable. If my level is low, then I really feel for the rest of folks with RA.

      I believe that they will find eventually that most of the preconceptions of sero-positive, sero-negative, swelling, no swelling, high blood levels, low blood levels, really do not tell the whole picture. RA is the most different disease from patient to patient as you will ever see. The patient is really the only one qualified to determine pain level. Some day maybe they will develop a machine that will allow doctors and others to “feel” your pain. Bet there won’t be a long line for that!!

      Reply
  • September 29, 2012 at 9:04 pm
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    Hi Kelly,

    I was diagnosed w/ RA in 2009. For 2 years I was on medication. I was in terrible pain. I couldn’t write, couldn’t open doors, had extreme difficulty driving, I couldn’t even sit on the water closet without holding on to something. I was depressed. I woke up everyday at 1 or 2am because of the throbbing pain in my joints. I couldn’t put my clothes on, I couldn’t take care of my kids properly.
    In 2010, I had a lumpectomy & I suspected it’s because of the methotrexate. The only time I felt pain free & was able to function properly is when I had my dipropos injection. I lost weight drastically & I felt I was getting thinner. From 55kgs – my weight went own to 51kgs, I’m 168cm tall.. I researched on the side effects & I realized that dipropos is wasting my bones away so I stopped all my medications.
    For 1 year now, I’ve been going to the gym, lifting weights except treadmills & leg curls. I managed to strengthen my joints & tone my muscles. I fell stronger now. I still feel pain & stiffness in the mornings & it’s still a struggle to get up. To manage it, I stretch & do some exercises I learned from webMD. It was difficult for me to get on the machines as my joints were so stiff then. I felt like a robot in pain. I couldn’t bend my knees or elbows. With difficulty, I persevered, now I’m more flexible. I could do housework & take care of my family again.
    I started doing water exercises too w/ a friend who also has RA & for 1 hr 4x a week we do water exercises together. It has improved the quality of our lives.

    Reply
  • January 15, 2013 at 7:14 am
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    I was diagnosed three years ago and from then on, i have had fever and pain every day of my life! Everyone says, “You should exercise more, eat less, go on as before and so forth. it truly feels as though no one understands me. Every time i try to exercise, i am in pain for a week afterwards. I can’t even go swimming, because my shoulders and feet feel like they are falling off! My feet are the worst, my doctors have already fused 8 of my toes, by removing the joint completely. That was three months ago, the RA is eating through the newly grown bones and my toes are going in all directions again! Do people really expect me to exercise?

    Reply
  • April 10, 2013 at 11:13 am
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    WOW! I just found this section. Pre RA, I was at the gym 6 times a week weightlifting, and jogging/running 3 times. Now, when I get home from work, and my feet aren’t killing me, I will take the dog for a walk, however, I can’t even go 1 mile. I have gained 50 lbs., some from medication, some from lack of activity. The sad part is, I LOVE to exercise! I joined a new gym with a pool, but have yet to use it. I am so tired when I’m through with work, the thought of going to the gym, changing into a suit, trying to swim or do the aerobics is more than I can handle! The membership has been put on hold. God willing, I will feel better now that the warm weather is here and go for the plunge.
    As I sit here right now though, my hands are killing me, my thumbs especially, my hip hurts my back hurts, my elbow hurts. I know when I get up to walk, my feet will be killing me. But such I life. This RA has given me a stubbornness, and drive, it’s taught me to push the pain to the back and keep on living! Then again, I really don’t have much of a choice, do I?

    Reply
  • July 1, 2013 at 2:08 am
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    Thank you! Exercise, really? Most days I am thankful to get up and work a full day. Coworkers think I have special treatment because I come in later… If special means taking two hours to get your legs and feet functioning before you can begin your day then that’s me SPECIAL! As they are leaving at 5pm I’m working to make up my hours. While they are out doing Zumba, at the gym on the stair master, or riding the stationary bike, I’m hoping for enough energy to get myself home and start the cycle over again.

    Reply
  • July 12, 2013 at 5:36 pm
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    I’m so happy to have found your blog. I was diagnosed about three years ago with adult onset mytochondrial myopathy, in which the muscles are gradually weakened over time. It’s very similar to adult muscular dystrophy. Until very recently, I’ve also had chronic daily migraine. Exercise was just not possible.

    I see a pain management physician monthly, and for about four months now, have been complaining of intermittent severe burning pain in my hands (clearly distinct from my previous deep muscle aches). Two weeks ago, my knuckles started swelling, and off and on since then, I get swelling of my elbows, knees, feet, ankles and the base of my skull. All swelling and pain is symmetrical, except the base of the skull. Even with migraines, I’ve never had swelling there before! My Dr put me on a short prednisone course, which helped for the two days of strong dose, but today I’m in agony with just two days of prednisone to go.

    My Dr will not consider rheumatoid arthritis because I don’t follow the usual checklist. In specific, exercise makes the pain worse, I have no nodules(!don’t want them!) and my most severe symptoms are not in the morning. For some reason, no matter amount of rest or sleep, pain and swelling occur between 5-7 pm. I do basic low impact exercises, but more than a very little causes a severe reaction later. At this point, after reading about how people have such varying symptoms, especially early on, I’m going to request testing at the least, and referral if this gets worse. It’s wonderful to know that checklist is not all that accurate for everyone. I’ve been in pain a long time, I’m already on narcotics. This new joint pain is very sudden and very severe. I know something is badly wrong, and after 11 years of specialists trying to figure out the muscle pain, I refuse to have the joint problems dismissed so lightly. It helps so much to read this, though!

    Reply
  • July 31, 2013 at 9:25 am
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    I understand exactly what you are saying about exercise . I am now 42 and have had RA since I was 34. My RA is currently well managed by a cocktail of drugs, and the only time I get a flare up is 1-2 days after doing something ” strenuous” or out of the ordinary. Like going for a jog/ run on my treadmill after not being on it for a while . I am about to start yoga again, as I love it so much, but I will be very careful to start off slowly and easily. Even then, I know there is a high chance I will get a flare up. I have started card making again, and I use a timer to stop me after 1 hour so I can have a break. When I clean my house , I do it over 2-3 days, not all in one morning like I once could . I am now an assistant nurse at an aged care facility ( part time) – I know, I must me mad, but I love it so much and I cannot imagine what else I could do. I make sure every one knows I have RA and I listen to my body & know my limitations. I only do afternoon/evening shifts, as I cannot do mornings (6:30 am starts) for obvious reasons. And, I always have a nap before I go to work, to help ward off fatigue and pain. It all works for me.
    I only discovered this website today and I already love it and will keep on reading. THANK YOU.

    Michelle

    Reply
    • August 1, 2013 at 2:54 pm
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      Welcome, Michelle.
      It’s good to meet you and hear about your familiar fight to keep doing the good things in your life that you love!

      When it comes to “exercise,” if a person does not have wrists or hips or knees (or whatever) affected and can do yoga still – I would say, as always, more power to them! I just know a lot of people who have a real challenge to just get dressed or help fix dinner & yet they are told to do the impossible (“exercise”).

      Reply
  • May 27, 2014 at 5:30 am
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    Hi,

    In case some people think of us as lazy, I just wanted to share my experience. I’m not a sports addict but I do love swimming and I really miss it when I can’t go. Sometimes I can’t do any sports for months in a row and I end up DREAMING about it! I dream that I’m in the pool trying to swim and that the water is so hard that I have trouble moving my arms and getting them through the water(I do crawl). That’s me in my bed pushing my arms on the matress in my sleep and feeling frustrated that it’s not working hehe.

    So, I think it’s fair to say that if I miss swimming to the point of dreaming about it at night, you can’t say that I’m lazy and not willing to move, but that there’s a serious reason why I can’t do it (ie: RA).

    Thanks for this wonderful blog. I live in Belgium by the way, and you have a few fans in our RA association here!

    Reply
  • February 3, 2016 at 12:09 pm
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    My first rheumy doc said, try walking if you need to exercise…but if you hurt worse; find something different to do…she also had RA.
    That has been some time ago…last summer, my pelvic bones shifted and therefore threw out hip/leg/knee…I was incapacitated for months..finally after NO LUCK with local Rheumy DOC..called my chirorpractor(she knows my problems) and once she got my joints back where they belonged, then I battled with a strained hamstring most of the summer/fall and now into winter….BUT I can walk, for my hands- I crochet or knit simple things every other day IF I am not in horrid pain, it keeps my fingers moving.
    I will be 70 in March of this yr…and my dear mom by my age had frozen fingers like claws and could not do much…was difficult to dress etc. and now am Finding putting on a bra a major ordeal..need front closures I guess?
    THANKS AGAIN KELLY…you are truly a BLESSING!!

    Reply
    • February 3, 2016 at 1:21 pm
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      do you turn it around backwards and then put your arm straps on? this is how I do it – still hard, but reaching behind my back is impossible.

      Thanks for your kind words Linda. It means a lot.

      Reply
  • March 12, 2017 at 10:04 am
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    Thank you for this series of articles on why movement hurts RA. I am newly diagnosed, and people seem to think I can just power through it and that exercise will somehow help. In fact, some of the first symptoms I had for a couple of years ago in my feet when exercising. Since I have told people of my diagnosis, I am getting the usual round of questions about why is there a diet I can follow, are there supplements I can take, and the general ignorance of the seriousness of this disease. In fact, I am also coming to terms with the seriousness of the disease, so it’s hard to blame well-meaning people. Anyhow appreciate this website and the articles which show what life with this is really like. As you say, even reputable medical websites seem to gloss over some of these facts, especially the exercise dilemma.

    Reply

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