Exercising with Rheumatoid Arthritis
For those with Rheumatoid Arthritis (RA), have you ever noticed pain after going for a long walk, or bending trying to play with the grandchildren? These movements can be painful for those with RA, and you may think that avoiding these activities can help to reduce pain and disease progression. In this article we will discuss the role of exercise and its ability to help manage your condition, reduce symptoms, and get you back to doing the things that you enjoy in your daily life.
Let’s start with what Rheumatoid Arthritis is…
It’s an inflammatory condition causing joint inflammation and pain. It is an autoimmune disease, which means your own body’s immune system mistakenly affects your body’s tissue. In this case, it attacks the lining of joints, called the synovium, leading to joint pain and stiffness (Aletaha and Smolen, 2018).
This disease usually attacks the small joints in our hands and feet first, and as the disease progresses, it can move up to the larger joints such as the knees, hips, and elbows. People with RA usually have pain in bilateral joints, meaning that you will have pain in both sides of the same joint. The most common symptoms of RA include joint pain, swelling, tenderness and stiffness that lasts for six weeks or longer. People usually have stiffness in the morning that lasts more than 30 minutes and it can also be accompanied by chronic fatigue and a low-grade fever. Whilst most of the symptoms will be noticed within your joints, RA can also affect other parts of the body like the eyes, skin, lungs, heart, and bones.
It is common for symptoms of RA to come and go in cycles of flare ups and then periods of remission, where symptoms seem much less severe. This disease effects women more than men, and has a strong hereditary component associated with this condition.
There have been some major advancements in medications recently to help treat RA, having a significant impact on the disease course, progression and helping to improve the quality of life of individuals. Disease modifying antirheumatic drugs (DMARDs) are drugs that regulate immune system function, to help reduce the attacks on your own body, improving symptoms and inhibiting progression of joint damage (Aletaha and Smolen, 2018).
How can exercise help?
When starting exercise with Rheumatoid Arthritis it can be challenging as it may provoke your symptoms during, and the following days afterwards. This can be scary as you may feel like you are making your condition worse, however when done properly exercise is a great way to manage your condition. Exercise in forms of both aerobic and resistance training can help to strengthen the supporting structures around our joints including our muscles, tendons, ligaments, and bones. These structures can help take load away from our joints, reducing our symptoms and improving our function.
There has also been research into the anti-inflammatory aspects of exercise, whereby partaking in regular exercise can reduce the amount of joint inflammation and further reduce an individual’s symptoms.
This sounds great, but where do I start?
A few tips that we recommend include:
- ‘Start low and go slow’ – Start with exercise that is easy and does not provoke your symptoms. If you can manage this then slowly increase the time that you exercise for or the weight to gradually improve your strength.
- Use your symptoms as a guide – Some pain is ok if it’s tolerable and settles down after completing exercise. If it lingers around or bothers you the following day, then maybe take a step back to something easier and build up from there
- An example: You have knee pain during squats, especially deeper in the movement. The pain goes away when you take a rest after exercise, and you do not notice it later that night or the following morning. This is an example of pain that is completely fine, and you should not be concerned about this.
- A combination of aerobic and resistance exercise – As we said before, start slow and work yourself up. As you become fitter and stronger, try to meet a 150 minutes of moderate intensity exercise (e.g., walking) and 2 sessions of strength training a week, as these is the minimum amount recommended for a healthy lifestyle
Summary…
To sum up, what we have talked about in this article, exercise is a great way to help manage rheumatoid arthritis. It can help to strengthen muscles and other bodily structures to give your joints more support. It’s important to start slow and build yourself up, to ensure you do not aggravate symptoms. If you are not on medication for RA, then be sure to seek your GP’s advice, as this has the most benefit on disease progression and severity.
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