You might have some reluctance when it comes to exercising with RA; perhaps a fear of aggravating inflamed joints, says Andrew Naylor, PT, DPT, a physical therapist at Bellin Health Titletown Sports Medicine and Orthopedics in Green Bay, Wisconsin. And there may be times when you just can’t handle a heavy workout session, such as during an RA flare. But regular exercise is recommended for most people who have RA, says David Pisetsky, MD, PhD, a rheumatologist and professor of medicine and immunology at Duke University School of Medicine in Durham, North Carolina. But first, it’s important to work with your doctor to get your RA under good control. “Our goal is to get people into the lowest disease activity state, and then to exercise,” says Dr. Pisetsky. “We don’t want people to get injured.” Regular exercise can help boost joint function and improve overall function, according to the Arthritis Foundation (AF). In addition, it’s good for bone health, muscle strength, and cardiovascular fitness — all of which are important for people who have RA, according to Pisetsky. “The key is to find the right amount and type of exercise for you,” Naylor adds.
Tips for RA-Friendly Exercise
Even if you have never exercised before, it’s never too late to start a workout program and reap its benefits. Although exercise can’t reverse existing joint damage, it can help you change the way your body perceives the damage, Naylor says. So despite RA-affected joints, staying active can help you become stronger, more flexible, and more functional — which can, in turn, help you perform daily activities with less pain. Ready to work out? Start with these RA-friendly do’s and don’ts:
- Do: Warm up and cool down. Even just five minutes of walking or easy jogging, both before and after each workout, is essential for pain-free exercise. A warm-up helps your joints and muscles adapt to the change in activity, while the cooldown helps decrease post-activity soreness, Naylor says. This is also when you should stretch because muscles will be warm. If joints are sore or stiff pre-workout, apply a heat pack as part of your warm-up routine, the AF suggests.
- Don’t: Perform the same exercises at every workout. You don’t want to work the same muscles and joints multiple days in a row because they can get sore and aggravated, so it’s important to change up your workouts. Naylor suggests a cross-training routine to avoid injuries from overuse. This can be as simple as biking one day, swimming the next day, and walking on the third day.
- Don’t: Jump into high-impact exercises. In general, high-impact exercises, such as running, jumping, and activities like basketball, aren’t recommended for people who have RA because these activities increase the risk of inflaming your joints or aggravating pain. Focus on low-impact choices such as swimming, yoga, or walking, the American College of Rheumatology (ACR) recommends. You can work your way up gradually: “Take walks,” suggests Pisetsky. “You can go slowly if you want. If you’re feeling worse, back off.”
- Do: Wear comfortable, sturdy shoes. Comfort is key, Naylor says. Look for a shoe with plenty of cushion, a wider toe box, and appropriate arch support.
- Don’t: Push through any pain. It’s normal for joints to be a little uncomfortable at first, but that discomfort should ease within a few minutes, according to the AF. “Do what you can within your limits to progress, but once you start to feel pain come on, that’s a cautionary flag. You never want to exercise so hard on a Monday that you can’t exercise again until Friday,” Naylor says. “If you’re getting very symptomatic after exercise, you may be doing too much or the wrong kind,” agrees Pisetsky. Opt for activities you can do without pain, whether it’s a short walk, some gentle yoga poses, or a slow, easy swim. If a particular joint is very painful on a given day, focus on another area of the body instead, the AF suggests.
- Do: Make adaptations. Even a simple sleeve or brace for a joint that’s painful or unstable can be a big help. These supports offer joint protection and help ease swelling, Naylor says. Certain types of fitness equipment might be better for you than others. For instance, if you love to bike but find it hard to climb onto a stationary bike, opt for a recumbent bike, which is lower to the floor, Naylor suggests.
- Don’t: Get discouraged if one exercise doesn’t work for you. In addition to being RA-friendly, the right exercises are those you enjoy — activities you’ll feel motivated to keep doing. If you’re social, you may enjoy group classes such as Pilates or martial arts, according to the AF. If you love being outdoors, try hiking, walking, or biking. If you’re a film fan, using an elliptical or treadmill while you watch a movie may work best…the possibilities are endless!
- Do: Find the best time of day for fitness. If you’re stiff first thing in the morning, it’s probably best to exercise later in the day, according to the ACR. If you have trouble sleeping, doing aerobic exercise earlier in the day may help, followed by gentle stretches closer to bedtime. An exercise routine at the right time of day can help you get the most benefits from movement. When it comes to pain-free exercise with RA, listen to your body and find exercises that make you feel strong and healthy. Each day, your goal should be to try to do just a little more than the day before. Additional reporting by Erica Patino.
