Should Rheumatoid Arthritis Patients Exercise?
Can we talk about exercise?
There is an elephant in the room. Not a cute and helpful one like Horton. It is one of those proverbial elephants no one wants to address. It’s a big and annoying issue that won’t go away, yet everyone tries to ignore.
I do not fancy myself an elephant tamer. However, I have a constant urge to state the unspoken. So, let’s get this out in the open.
Exercise is a touchy subject in the world of Rheumatoid Arthritis.
Proponents of exercise strongly advocate it. No one I know actually opposes exercise, but it does raise several questions. I wonder why I do not hear them asked.
Early in 2006, when I began to suspect that I had RA, I began to read research articles about it. I was leery of internet Quackdom, so I limited myself to medical universities and hospitals like Cleveland Clinic, Mayo, and Johns Hopkins. Soon, my search expanded to other websites like Web MD and About.com. I looked for legitimate information, not fairy-world cures.
I read about protecting my joints by not doing things that caused increased pain or stress. That sounded very important to me, so I printed off lots of pages about it. Later, when I began to hear how some RA-ers are pressured to exercise, it struck me as odd. The two ideas are in direct conflict. I cannot protect my inflamed joints from use at the same time that I am using them to exercise.
I read every theory I could find to explain the causes of Rheumatoid Arthritis. I did not read any which pointed to laziness or lack of exercise as a reason for RA. To be blunt, but if sloth did not cause my RA, then workouts will not cure it.
My doctors have prescribed vitamins, chemo shots, funky Biologic drugs, rest, anti-inflammatory medicines and even a high Omega-3 diet to attempt to gain control of my RA symptoms. Funny, they have not prescribed exercise. Why not?
It would have been an appropriate prescription if I had come into the office with one of many other conditions. But, I was disabled by RA, not idleness. Some people are truly disabled by RA. And they cannot exercise for either fun or strength because of their functional status.
There are other people who have RA, but who are not disabled. Many people with RA have times between flares—however brief—when they can safely exercise. And a few others actually have only a few number of joints that are affected. Of course, they can exercise using the unaffected joints.
Because I always loved exercise, I don’t feel comfortable defending this position. But, frankly, I am never comfortable anymore. I am in pain. It’s not pleasant or popular to say so, but it’s true.
I am very uncomfortable to sound like I am opposing something as wonderful as exercise. I half expect to be stoned. But, of course—
I am not arguing with exercise
I am arguing with the preposterous proposition that if RA’ers would just exercise, they would feel better or get well. That is so absurd that I can’t think anyone really believes it. If they do, I am willing to walk in their shoes. Can they stand in mine?
I wish that people with RA would not have to ever defend themselves about exercise. We did not get Rheumatoid Arthritis because we were less active; we became less active because we have RA.
Recommended reading:
- Rheumatoid Arthritis Exercise, Part 3
- Should Rheumatoid Arthritis Patients Exercise, Part 2
- The Truth About Rheumatoid Arthritis Will Be Told! (About exercise)
- What Is it Like to Have Rheumatoid Arthritis? Part 1: The Usage Principle
- Rheumatoid Arthritis Makes Things Difficult
Ok I will confess I workout. I can’t walk but I love to lift weights. I am doing competitive power lifting bench press only. I have had RA for ten years. I don’t have a lot of joint involvement, I mostly get lots of tendinitis. I currently have carpal tunnel syndrome, tarsal tunnel syndrome and plantar fascistis. I also have arthritis in my lumbar spine which is why I only do bench press. So I can’t walk any distance but I can bench press 210 lbs. I do cardio by using recumbent machines such as recumbent exercise bike. It has taken my longer then is typical to reach competitive weights for my bench press and I have at times had to stop for awhile due to shoulder problems. I also use a trainer so that I can insure that I am lifting correctly. So now reading the other posts I wonder if I am wrong in doing this on the other hand I probably won’t give it up even if I am wrong:)
Kathy, as I’ve written here many times, I would do the same if I could. I’m glad you don’t have much joint involvement and you’re able to do these things. I never give up hope that I may be able to do some of them again one day.
I posted previously that I do power lifting but I forgot to say why. Five years ago I was diagnosed with prediabetes and was well on my way to developing diabetes. There is lot of people in my family with diabetes and also heart disease. My father died of a heart attack at the age of 55. So I decided that I needed to exercise in order to stay healthy despite the risk to my joints.
Wow you hit this right on the head, my family not my wife and children, they see me day in and day out, but my siblings have no idea about RA AND YOU KNOW I WONDER HOW MANY RA PEOPLE WERE ABUSED, YES I THINK THERE IS A CONNECTION BETWEEN ABUSE AND RA
Thanks for that article, i sent in to a few people who always tell me exercise ,you will feel better, When they say this it is always when they want me to do something, Like cut the bushes holding them 5 pound clippers , Than get mad when i say i cant do it, it always family members who say this ,sisters ,mother, brother,I am thankful my wife and children understand
It would be so nice if it were clear to others what we deal with and that we can’t just do what we want to any more. I so much WANT to do some pushups and run around the block and play tennis…
And yes, I used to ENJOY using the heavy electric yard tools all the time. I’d much rather do that sit here in pain.
I was diagnosed with RA when I was 26 years old. At that time I was working 12 to 14 hours days as a waitress in a very large restaurant. During that time my joints felt like they were on fire. The pain was horrible. It took almost a year to get diagnosed and prior to that I worked two years with it not knowing what was wrong. At the time of my diagnosis my doctor informed me that my current means of employment had to stop. He said I would never be able to do that kind of work again due to the continuous damage that it would place on my joints. I was devastated. In that moment my entire life changed. But in response to the question. My thoughts are this. If you are able to then yes do so but not with heavy weights or anything straining. Do things like walking, stretching, mild forms of yoga, or water therapy. But if you cannot, then dont. The damage will only get worse if you do.
I continue to battle with the pain of exercise, including weight lifting (with high repetitions) in an effort to somehow take control of this horrific disease. I often will have terrible flares if I overdo it, but I am pleased to tell you I have felt much better (especially in terms of “fitting in” with society) since I started my program, etc.
I have had to fight through the pain just to maintain what little self esteem I have left. It has given me a ray of hope, especially in a world that simply does not understand your pain and fatigue issues. I remain hopeful…
This breaks my heart. I have arthritis and quite possibly RA but I know friends and family that do have it and it is the sadest unseen thing there is. Thanks for your frankness! Made my day!
Dear Debbie, I hope you don’t have RA. But I’m glad you found us & it sounds like your friends are lucky to have such a compassionate friend.
Thank you! You articulate exactly how I think & feel. I try to walk when I am up to it. We bought a high end, all the bells & whistles, kind of treadmill in hopes it would inspire me.
First time I used it was also first time on it, dumb, I know. I hurt, thinking of course! I was so out of shape it was no surprise.
I used it again. OMG! My surprise was how much it pulled & stretched things! I didn’t realize that part. My neck! I could barely move. That’s when I found out just how badly I have spinal stenosis, & how much RA is settling into other small joints, vertabrae for instance.
Appt. with Rheumy, then injections with pain specialist, treadmill off to Craigslist. Now, I have a beautiful cruiser style bike with TALL handlebars (no crouching over), I ride it on occasion when I am up to it. I long for water excersising, which my rheumy thinks I’ll be able to handle & I’m sure would love it…Ever since I had to quit working, money is tight, tight, tight. Waiting to hear on my disability is slower tha molasses. When & if i ever get the disability, YMCA, here I come.
Meanwhile, I do Know I need to excersise! But please understand it is NOT going to make all of *this* go away!
Thank you for your writings & for ” listening* to my rant!
Sherri
I hear you!
I have severe, extensive, long term RA and live in constant pain and with many mobility issues.
I used to be a slender, sporty type with boundless energy.
I desperately need to exercise to lose weight and thereby lower risks of nasty things like stroke and heart attack!
I have looked high and low for exercise that is suitable for RA, i.e. doesn’t damage the joints. Warm water therapy seems to be the only thing that is really suitable. But how, where and when can you access this necessary resource? There are heated spas called Swim Spas that would be suitable, but the prices start at $17,000. There are hydrotherapy pools but you must be accompanied by a physiotherapist and this will only be available during working hours and will cost you at least $25 per session. If you have RA and are till holding on to the notion that you are entitled to be able to work for a living (and to pay your medical costs), the hydrotherapy pool is not available to you.
Anyone have any other suggestions?
I was diagnosed with RA eight days before my twenty first birthday,.back then I was at the prefect.weight then gained weight due to bad diet and prednisone, and even though I was relatively small the pain was excruciating. Now almost 100 pounds heavier than I was back then, I keep hearing if you lose weight you’ll feel better and I don’t see how since honestly back when I was much smaller the disease was much worse, and its not that I don’t want to exercise I really do! Every time I get going with some type of routine I get sick and it takes forever for me to recover. By the time I do recover it will be a month or two of inactivity. And I so wish I could do swimming for exercise but I don’t have access to a pool and I can’t swim, I’m willing to learn tho.
Finally, I can stop feeling guilty when it hurts too much to do anything. I’ve tried “muscling through” and it only makes things worse. For all those people who almost convinced me that I could control this thing, you may kiss my a$$.
I’m fortunate in that I can still get around pretty well, and I can still till up my garden and plant it. I’m terrified though that this is the last garden I’ll be able to plant — it’s been so much harder this year to get everything in, and quite honestly I don’t know how I’m going to get everything put up.
Yesterday we had some heavy weather come through, and when I got up I could barely walk. It took me 5 minutes to go from the bedroom to the kitchen, a trip that usually takes about 15 seconds!
So while Use It Or Lose It is fine for some people, I think for RA people it’s Use It Until You Lose It — in other words, make the most of the days you can move and exercise, and accept the days you can’t. I don’t like it, but that’s my reality now.
Disgusted reading this. I’m a firm believer that an obese person should always lose the weight first before claiming that weight played no part in their disease/illness. In my research on RA, I’ve read many articles on women who lost significant amounts of weight and whose pain significantly lessoned and in some cases ceased. I’m annoyed this page will encourage obese people to not take action for their own good. I wonder how active the author was prior to developing the disease.
I’m not saying being inactive and obese are causes but if we do not know the cause how can you rule out weight control and exercise so completely?
Go ahead walk in my shoes but I wont be standing in yours…I’ll be running!
Those are pretty strong judgments for someone who has obviously not read much of the hundreds of pages here.
“I wonder how active the author was prior to developing the disease.”
The author you refer to (me) was very active, strong, and fit before being suddenly struck down with RD. One day, I could run for hours on the beach, play tennis, or carry 50 lb bags of concrete mix, and the next – I could barely walk to the bathroom, and could not brush my hair or floss my teeth. No, I don’t think I’ve ever been obese since I’ve weighed about 117 all my life, except for during pregnancies.
“I’m not saying being inactive and obese are causes but if we do not know the cause how can you rule out weight control and exercise so completely?”
None of the thousands of academic articles I’ve ever read has indicated that inactivity or obesity cause RD.
Jodi, go troll somewhere else. Your angry and insulting comments are not welcome here.
Swimming flared my shoulders , elbows, wrists, hips , knees and ankles even though I only went for 40 minutes, didnt do aggressive laps…just paddled around. Now i have an open plntars wart, picked up at the pool, being treated for over a year…I take biologics…other exercise, walking. Yoga, light weight lifting…when able but doesnt seem to be consistent enough to get any real benefit for me…at present…tenosynovitis both hands , wrists , feet and ankles. Sigh
Dear Fiona, I adore swimming. And running, tennis, weightlifting, and even weeding – wayyy more than sitting. But, yes for many it does aggravate the inflammation that’s already simmering there. Just do what you can & take good care of yourself. And if an activity aggravates the tendons or other parts of the joints, you might have to avoid it for awhile.
Thank you for stating the obvious! I wish I could accurately tell you how many people have told me that if I was ONLY more active I would not have gained so much weight. I am sick of it. Between not being able to work due to flares, steroids that offer only temporary help, and just the everyday pain that can be triggered instantly by something as simple as lifting my water glass, OFCOURSE I have gained weight! What can I realistically DO about it? Almost nothing. I am one of the lucky ones who has days that I feel almost normal- but all it takes is one step of the foot, one trip to the store, one walk to the mailbox, and I pay for it with swollen joints and pain for days. I wish that people in general were not so judgmental in general, Don’t ever assume that people with RA are just lazy.
thank you so much for this. My firefighter/soldier boyfriend is always trying to get me to exercise more because he’s sure it will help. what he doesn’t realize is that when after 12 hours of sleep i’m still too tired to get up and in too much pain to move, exercise seems like the cruelest recommendation one could make.
I am a physical therapist with a 20+ year history of RA. So I have both treated patients with RA AND walked in their orthopedic shoes. My answer to your question “Should RA patients exercise?” is absolutely yes! Exercise should be tailored to the individual at an appropriate level, with modifications included as necessary. Exercise for one person may be a 20 minute walk followed by weight training. For another person (or the same person during a flare) it might be range of motion and stretching exercises in bed. Lack of movement leads to loss of movement, and the circle needs to be broken by medication and exercise. To put in a plug in for my profession, a physical therapist is uniquely trained to develop an individualized program, and should be the second healthcare provider you see after your rheumatologist. Hope this helps!
Thanks so much for this site! I new to this (lucky me!), so I am seeking any guidance I can find. I like your honesty. It gives me hope that I can keep living, but also validates the discomfort and pain I feel ALL of the time! I will visit often!
Interesting reading this. I told my Rheumatologist that I was walking on my treadmill 20 minutes a day which I was VERY proud of. Like you Kelly, my big toe on my right foot turned (we got it under control before the left toe finished turning), but it caused a large lump on the top of my foot called and exostosis, and it is incredibly painful to walk – impossible with shoes on unless they are Crocs – Thank God for Crocs! Her reaction? “I want 20 more!” Really???
Hi, I’ve recently been diagnosed with RA after being ill for a year. My mum has sever RA so I knew from the off what was wrong, but getting a doctor to take me seriously took forever. In the meantime, I have damage in my feet and they fee l like I’ve dropped a bowling ball on them (not to mention the bunions that pre end me from wearing most shoes!). I have major hip and knee pain as well as my back. I used to run. A lot. I ran marathons. Now I limp. I move like I’m stuck in glue. I’ve just started MTX, my second dmard. A guy at work also has RA. He runs marathons. He cycles 10 miles to work every day. Way to go him. If he tells me I need to exercise to get well one more time, I’ll scream!!! I’m glad he is able to do those things. I am not. He seems to think we are the same as we both have RA but we are not. He thinks I’m overplaying it, but I’m not. I’m amazed I go to work and have the energy to pretend I’m fine! I can barely walk let alone run. One day, I hope to get there, but pressure to exercise my way to good health, even from another RA sufferer makes me feel even more useless than I do already. And the steroid weight gain really doesn’t help with that! I’m not gaining weight because I’m lazy; I can’t work off those few extra pounds. Argh!!!
Thank you for sharing. Your experiences sum up what so many go through.
Education about RD is so lacking – even in doctors and patients.
Thank you, it spoke right to my circumstances. I did not ask for this. I used to be very active, now I’m just continually frustrated. I would love to challenge anyone who thinks if I would just get off my bum and move that I would feel better to walk in my shoes for just five minutes. Because that is about the length of time I can without excruciating debilitating pain.
Wow, how great was it to read that post! I’ve lived a very active life but as my RA got worse I’ve become more seditary. When I hurt the last thing I want to do is EXERCISE! Even after all these years I still feel guilty for just sitting around or god forbid for taking pain medication when I am in pain and stuff. I find people just don’t understand the pain, fatigue, stiffness and weakness people with RA sometimes feel. They always compare it to osteoarthritis. Thank you for being a voice for all of us!
I was very active throughout my childhood, I had ballet classes 7 days a week, jazz class saturdays, pilates, among other dancing classes. I got diagnosed at 18 but started developing issues since 16. I always felt tired, fatigued, always thought it was dancing, the exercise. My doctor said if it wasn’t because of dancing I wouldn’t have been able to move by age 20. RA runs in my family, and I always read how I should exercise but I feel like that’s something I can no longer do, it might’ve helped me before it fully developed but now everytime I try to exercise between flares I just get hurt. Somedays I can’t even hold things, my only exercise consists of walking, because it’s the only thing I can still do. But people don’t understand that, because they don’t live in our constant daily life of pain, they don’t understand because we don’t look sick, exercising won’t prevent from developing RA, it can help to an extent and that’s it. As a dancer I learned if you can’t do something, don’t push it, is better to not do it than get hurt.
Well stated, Janet.
And one of the biggest misunderstandings about “can’t” is that It’s Just Pain, Right? RD is not just pain and pain is not the main reason for loss of function—it is actual loss of function. But even the pain is not just pain.
In my book, I quote a recent study—the first FINALLY—examining how higher activity levels / “physical workload” contribute to a greater RA / RD risk. A likely reason so many commenters on RAW talk about having been so strong and active before getting sick.