Chronic pain, fatigue, and stiffness can make it seem impossible to get up and get moving. But the truth is that exercise is one of the key tools in your kit to help you feel better. Exercise or regular physical activity can help curb the symptoms of RA, including pain, stiffness, and lack of mobility. People with arthritis who exercise regularly may also have improved sleep and better daily function.
You may be wondering, how do I get started? What kinds of exercise are best and safe for me? The answer: It really depends on your symptoms, your overall fitness and health, and which activities you like to do the most. Keep reading for advice on getting started and different exercises to try for your RA.
Along with your rheumatologist, there are other experts who can help you create and follow an exercise plan, such as physical therapists and occupational therapists. Remember to check with your health insurance plan before seeing a provider to confirm coverage.
Physical therapists (PT) prescribe exercise like doctors prescribe medication. They choose the right type of exercise (medicine), intensity (dose), and frequency that fits your abilities and works best to address your problems. The tailored programs they create for patients with RA can help improve function and reduce pain. PTs can also help you maintain your long-term health by providing exercises you need to use out of the office, even after you’ve completed your PT, to manage pain flare-ups and improve daily quality of life.
An occupational therapist (OT) is a professional who helps develop, improve, or maintain skills needed for daily activities. OTs focus on how to better use your hands and arms, including prescribing or making splints to protect fragile joints, showing you how to do tasks in ways that minimize pain, or helping you find products that make performing tasks easier.
Before starting any new exercise routine, talk to your doctor so you know it’s safe and healthy for you.
Give your exercise your best each day, understanding that your best may be different from one day to the next based on your arthritis activity, pain, fatigue, and many other factors. It’s okay to cut your exercise short on days you aren’t feeling as well. Don’t do anything that adds more pain and discomfort or could cause an injury.
Start slowly with any new exercise you try, and then work up to longer or more challenging routines. Break up your exercise routine into shorter segments. The most important thing is how regularly you exercise, not how hard or how long.
If you experience more pain or other worsened symptoms after an exercise, it may have been the wrong exercise for you. The exercise could have been too much or too aggressive, or maybe you weren’t using proper form while doing it. Discuss any new or worsened symptoms you develop with your PT, OT, or your doctor to modify the exercise to better meet your goals.
Having several exercise options and locations keeps you from becoming bored and provides alternatives on those days when getting up seems downright impossible. It’s also a good idea to have different routines for days when you need more gentle activity (such as simple stretches during a flare) vs. when you’re feeling well and can do a more rigorous workout, such as a longer walk or ride on a stationary bike.
Exercising with a partner can help you both stay motivated. You can meet in person to exercise together or do a virtual workout. Either way, you will hold each other accountable to meeting your exercise goals.
Pay attention to your body and any changes in your symptoms during the day and plan to exercise around this. If you have morning stiffness, more gentle movements may be helpful in the morning with more rigorous exercise later in the day. For others, exercise can help loosen stiff joints. Exercising at the right time of day can also help you sleep better, but exercising late in the evening may activate your body and make it harder to go to sleep.
Starting a regular exercise program can be challenging. Start off slowly and set small goals for yourself. Goals can help you stay motivated and allow you to see the progress you are making.
If starting an exercise routine sounds intimidating, do something light that just gets you moving. Try taking the stairs instead of the elevator, walking down the block, standing during a phone call, or stretching while watching television. Remember, getting started is the hardest part. Exercising will get easier as you build it into your routine and it becomes a daily habit.
Some people like to use personal fitness tracking devices like a Fitbit or pedometer to track their daily activity. This helps to remind and encourage you to regularly exercise.
Here are some suggested exercises for people with RA.
Daily stretching can help you manage your arthritis and improve your range of motion. Remember to warm-up before you stretch to avoid an injury.
Start slowly and walk at an easy pace. Try to avoid the common mistake of doing too much too soon, which can increase your fatigue and pain in a way that discourages you. It’s better to walk for a shorter distance for several days in a row than a longer walk only once. As you feel more confident, challenge yourself to gradually expand your walking for a longer period until you reach 35-45 minutes. Then, you can try to walk a little faster or farther , or both.
Tai chi is a series of flowing movements designed to help you improve function and balance. Tai chi is very low impact and includes movements that can improve function. It is known to reduce the risk of falling.
Yoga, which comes in many different styles, usually involves poses and stretches that can improve arthritis symptoms and mood. Yoga can provide simple, gentle movements that gradually build strength, balance, and flexibility. It may be useful to begin with one-on-one instruction to modify poses to account for your arthritis. Others start with a beginning class and let the instructor know of any limitations they may have. Certain advanced poses may be unsafe for those with RA.
Exercising in water is great if you have RA, because the water’s buoyancy supports your weight so you can move around without putting lots of pressure on your joints. Water also offers some resistance as you move, so it can help you work your joints and muscles, and get stronger. You might start with walking in chest-deep water at a moderate pace for 5-10 minutes. Specialized water PT programs can develop a more specific program of exercise just for you.
You can relieve stress on damaged or weakened joints by building muscles around them. Strength training is a great way to do that. You can do specific exercises that target those muscles on your own, on a weight machine, or with small free weights. Never push your joints beyond the range of motion that is comfortable. Start with less weight and perform more repetitions of each exercise. Have a PT or personal trainer evaluate your form before you add more weight. Make sure anyone who helps create a weightlifting program for you is familiar with how to adapt these programs for RA.
Riding a bike, either stationary or regular, can help you ease stiffness, improve range of motion or flexibility, and build endurance and muscle tone. It can also help strengthen your heart, which is important because people with RA have a higher risk of heart disease.
Pilates is a low-impact exercise that helps improve posture and core strength through a series of small, targeted movements. Pilates works to strengthen core muscles, which can take pressure off painful joints and help maintain mobility.
Here are some additional articles and videos to help you exercise safely with rheumatoid arthritis.
u.S. Centers for Disease Control and Prevention
HOSPITAL FOR SPECIAL SURGERY
American College of Rheumatology