The Role of Exercise in Psoriatic Arthritis Management
Findings from a study published in February 2018 in the journal Clinical Rheumatology suggest that exercise helps reduce joint pain, strengthen your bones, and increase strength and flexibility in muscles supporting the joints. “Exercise may help people with psoriatic arthritis prevent joint degeneration while increasing functional abilities and improving their quality of life,” explains Raymond Peralta, PT, DPT, a board-certified clinical specialist in orthopedic physical therapy at NYU Langone Orthopedic Center in New York City. “Moderate exercise enhances the immune system by lowering cytokine levels and increasing anti-inflammatory compounds.” There are, of course, plenty of other health benefits of fitness as well — whether or not you have psoriatic arthritis. Regular exercise gives you more energy during the day and helps you sleep better at night. Staying active helps you maintain a healthy weight, protects your heart, reduces stress, and may even improve your mental health and mood. “Exercise should make daily physical activities easier and provide general ease of movement as you stay stronger throughout life,” adds Ryan Buus, PT, DPT, a musculoskeletal physical therapist at the Mayo Clinic in Rochester, Minnesota.
How Much Exercise Should You Be Getting?
The Centers for Disease Control and Prevention (CDC) recommends that all Americans aim to get at least 150 minutes of moderate-intensity cardiovascular activity (about 30 minutes a day, five days per week) plus two days of strength training each week. That’s a good goal for people with psoriatic arthritis as well, say Buus and Peralta. If it sounds like a lot, remember to start small, as some movement is far better than none.
How to Fit in Fitness at Home
Online workout classes are one great way to hit your exercise goals, especially when you’re home more often than usual or if you don’t have access to a gym. But with all the class options out there, it can be difficult to know where to start. As with any new exercise program, you’ll have to find an instructor you like, a routine you enjoy, moves you can do, and something that doesn’t require too much space or equipment. And if you’re dealing with psoriatic arthritis symptoms like joint pain and stiffness, you may need to be even more selective about which workouts you choose.
What to Think About When Choosing an Online Workout
Here are a few things people with psoriatic arthritis should consider when choosing an online class to try.
1. Your fitness goals
There are tons of online exercise class options from apps and studios across the country. Knowing your fitness goals can help you to choose a class that best suits your needs. Do you want to focus on building muscle? Improving flexibility? Increasing endurance? Cardiovascular, stretching, and strengthening exercises are all safe for people who have psoriatic arthritis. Choose classes that specialize in these areas to help you get closer to your goals:
Aerobic classes, such cycling, help increase cardiovascular strength and endurance.Strengthening classes, which may include weight lifting, bodyweight exercises like pushups, or resistance-band training, help boost muscle strength.Stretching classes, like yoga or Pilates, help increase flexibility and range of motion in joints while also offering some improvements in strength.
2. Your fitness level and limitations
If you already exercise regularly, choose classes that will challenge you. Just don’t choose anything that pushes you too far, too fast. If you’re a workout newbie, start with 10 minutes (or less, if necessary) and increase gradually from there, says Peralta. Remember: You don’t have to spend hours sweating it out to reap the benefits of exercise. Even a few minutes here and there can quickly add up to half an hour per day. A study published in November 2014 in the journal Health Psychology suggests that intimidation and lack of knowledge are the most common reasons people quit a new exercise routine. So seek out classes that are designed for beginners and work your way up to more advanced courses.
3. The workout’s intensity and impact
Exercise classes can be very low or very high intensity. Most people who have psoriatic arthritis do best with low-impact exercises to reduce the risk of aggravating their joints. Buus and Peralta recommend body weight-based and functional exercises like yoga, Pilates, tai chi and barre. Something like a chair-based yoga class may be a better option to reduce pressure on the joints in your hands and wrists, Buus adds. It’s generally recommended to avoid high-intensity, high-impact classes like boot camp or HIIT training if you have psoriatic arthritis, since they may harm your joints. That said, if you’re already used to working out and don’t have a lot of symptoms, you may be able to try out these options. “There’s no clear evidence that people who have psoriatic arthritis cannot engage in high-impact activities,” says Peralta. Just be sure to train carefully, monitor for pain, and avoid strenuous exercise during flare-ups, he says.
4. Your energy level
A study published in July 2019 in The Journal of Rheumatology that surveyed more than 1,000 people with psoriatic arthritis found at least half say they experience high levels of fatigue. Although fatigue undoubtedly dampens your drive to exercise, some physical activity may actually boost your energy levels. “A significant barrier to individuals with arthritis starting an exercise program is a belief that exercise will exacerbate joint damage and symptoms like fatigue,” says Peralta. “But exercise is safe and helps to reduce pain, fatigue, inflammation, and disease activity.” If you’re experiencing fatigue due to psoriatic arthritis, choose an activity that matches your energy level. Even a 10-minute gentle yoga class is good to get the blood flowing and increase energy. “Sometimes you need to do less intense activities to increase your energy levels,” says Buus.
5. Your preferences
The best workout is one you enjoy and feel motivated to keep doing. According to the Office of Disease Prevention and Health Promotion (ODPHP), people who enjoy an exercise program are more likely to stick with it and to exercise in general. Choose an activity you like, whether it’s yoga, barre, strength training, dance, or any other type of workout that seems fun to you. Enjoying your workout also increases the odds you’ll make it a habit. “You realize that you feel good after completing exercise,” says Buus. Finally, remember that it’s perfectly fine to ditch a class you don’t like. “There are so many workouts available online, you should be able to find a program you enjoy,” says Buus.
6. Whether the class is live or prerecorded
Do you struggle to stick with a new routine? Consider a live class. According to the ODPHP, social support and accountability encourage people to stick to their goals. An online personal trainer or exercise group offers extra social support, guidance, accountability, and reassurance, says Peralta. And these days, plenty of fitness studios and gyms are offering live or on-demand workouts.
7. The trainer’s credentials and specialties
Any Instagrammer with a smartphone can become a fitness influencer. That doesn’t mean they have the training to instruct a safe class — especially if you need to stay away from exercises that put extra strain on your joints due to a chronic condition such as psoriatic arthritis. Try to find a class taught by a fitness instructor who already works with people with chronic diseases, suggests Peralta. They should have an advanced degree in exercise science, physiology, kinesiology, or physical or occupational therapy. You can also check if an instructor is certified by the American College of Sports Medicine (ACSM) or the National Strength & Conditioning Association (NSCA), Peralta adds. The American Council on Exercise (ACE) also offers certification programs for exercise specialists.
8. The space and equipment required
Some classes require specialized and often pricey equipment. For example, cycling is a high-quality, low-impact cardiovascular exercise. But an indoor bike can cost anywhere from $200 for a bare-bones model to $1,900 or more for more specialized bikes designed to be used with specific classes. You’ll also need to have space at your home to store your bike or equipment such as hand weights. Online classes like yoga, Pilates, tai chi, and barre require minimal space and often nothing more than your body and a mat. Extra points if a class uses elastic bands, says Buus: They’re compact and ideal for resistance training, since they limit hand and wrist pain. (That said, exercises that use hand weights or machines are also perfectly fine for people with psoriatic arthritis, Peralta adds.) For quality cardio exercise, a seated stepper may be a good option if you have limited space at home, suggests Buus. And if you want to take your workout offline, going for a walk outside is always a good idea, weather permitting.
9. Reviews from other users
Take a peek at what other people think of the classes. While you may not always agree with their opinions, learning more about a class’s intensity or structure may help you to avoid something that just isn’t right for your needs.
Tips for a Safe and Effective Online Workout
Always check in with your doctor before you start a new exercise routine to be sure any underlying psoriatic arthritis inflammation is under control. It’s also a good idea to see an orthopedic physical therapist (PT), says Peralta, especially if you have more moderate to severe disease. A PT can give you tips to meet your goals safely, evaluate any pain you’re experiencing during exercise, and help you to determine whether an online class you’re considering is appropriate for psoriatic arthritis. To find a PT near you, check the American Physical Therapy Association’s website or ask for a referral from your doctor, and be sure to ask your insurance provider whether physical therapy is covered to avoid any billing surprises. When you begin a new program, start slowly and gradually build in time and intensity. “The most important thing is to listen and respond to what your body is telling you before and after exercise,” says Buus. Continue to watch for symptoms for a day or two after your workout. Signs that you may have hurt yourself or pushed too hard include sharp pain during or after exercise, or joint pain for more than an hour after you work out, says Peralta. Some muscle soreness is totally normal, but it should be gone within two to three days, Buus explains. If you experience these symptoms, it’s probably time to reduce your workout intensity or find another program. And if exercising continues to worsen joint inflammation and pain, be sure to see your doctor.
