Getting Started With An Ra Exercise Plan
Patients with RA can and should exercise regularly, period, says Elaine Husni, MD, MPH, vice chair of rheumatology and director of the Arthritis and Musculoskeletal Center at Cleveland Clinic in Ohio and an assistant professor at the Cleveland Clinic Lerner College of Medicine of Case Western Reserve University. However, there may be modifications needed to try different modalities, depending on your level of fitness and ability. Think about water-based exercises to start, then move up to more traditional land-based exercises, or start with chair yoga instead of classic yoga classes.
For starters, always warm up before exercising and cool down afterward, Dr. Husni says. Also, be sure to use pain as your guide. Exercise should not be painful, so the onset of pain tells you to slow down or modify your exercise, she explains.
The goal is to keep moving at your fitness level to prevent injuries, Husni says. If you are new to exercise, you may benefit from group classes or a trainer, so someone with experience can watch and teach you how to exercise safely.
Its important to incorporate exercise into your routine as soon as youre diagnosed with RA. The best strategy is to consult a physical therapist specifically trained in inflammatory conditions youll benefit by working with an expert whos familiar with your RA needs.
Importance Of Healthy Weight For Ra
There’s ample evidence that having a body mass index in the obese or overweight category increases the risk of rheumatoid arthritis. Taking positive steps with your eating habits and exercise can help you achieve a healthier weight.
Reducing your body fat percentage supports RA management in multiple ways. Fat, or adipose tissue, produces hormones that contribute to your body’s overall inflammation level. Larger individuals require higher dosages of RA medication for treatment to be effective.
Furthermore, every extra pound of body weight places additional stress on your knees, hips, and ankle joints. Shedding extra weight through healthy lifestyle changes can slow the progression of RA and improve your quality of life.
What Types Of Sports Are Suitable In Rheumatoid Arthritis
Suitable types of sports and exercise for people with rheumatoid arthritis include the following:
- Strengthening exercises: For instance, exercises using light weights to strengthen the muscles in the legs, arms and back.
- Aerobic exercise: Sports that strengthen your heart and lungs, such as brisk walking, cycling, swimming and dancing.
- Exercises and water aerobics
- Tai chi
In general, the activities that are suitable for people with rheumatoid arthritis are those that don’t put too much stress on the joints. Research has shown that exercise isn’t associated with risks in most people who have rheumatoid arthritis. If someone’s joints are already very damaged, though, they should avoid doing intensive exercise. Evidence suggests that this kind of exercise can increase joint damage.
Personal preference is important when choosing the right type of exercise because it can only be effective if you do it regularly. Making exercise part of your daily routine is a lot easier if it’s fun and makes you feel good.
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Cardiovascular Disease And Exercise
A goal for any RA treatment regime should be to reduce cardiovascular comorbidity, in line with the overall aim of prolonging and improving quality of life. The benefits of physical activity, exercise training, and cardiorespiratory fitness in primary and secondary cardiovascular disease prevention are well established . Low aerobic fitness is strongly associated with all-cause and cardiovascular disease mortality in apparently healthy men and women, those with comorbid conditions and those with known coronary artery disease .
In general, patients with RA are less physically active and have aerobic capacities, the measure of cardiorespiratory fitness, 20 to 30% lower than age-matched healthy controls . Furthermore, in a cross-sectional study of 65 RA patients , Metsios et al. observed that physically inactive RA patients had a significantly worse cardiovascular risk factor profile when compared with physically active RA patients.
Summary of CV Health and RA â
RA patients have an increased CV risk factor profile RA patients have been shown to be less active and have poor aerobic fitness the relationships between physical activity, aerobic fitness, and CV risk in RA patients requires more research reducing CV risk through exercise could have an enormous impact in patients with RA.
Combination Of Aerobic And Strength Exercises
The optimum exercise program for RA patients would include both aerobic and resistance training. With poor cardiovascular health being the main cause of death in RA and with RA patients tending to have poor cardiorespiratory fitness, the requirement of aerobic exercise as part of treatment is crucial. Whilst the addition of strengthening exercises helps to mitigate rheumatoid cachexia and other musculoskeletal and joint health issues, and induces substantial improvements in physical function and the ability to perform ADLs. Both types of exercises may need to be required for maintaining BMD .
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Best Putty: Vive Therapy Putty 4 Pack
Therapy putty allows your inner child to play while also forcing you to use your hands full range of motion. Dr. Folden uses therapy putty with patients by having them dig into the putty to work on their finger extensions or bare dexterity and making them find things like beads, pebbles, or pennies. Vive Therapy Putty is color-coded by level of resistance, which ranges from soft to firm, so that people can gradually increase their hand and grip strength based on what they feel they can handle that day.
The putty comes in four, three-ounce containers and is odorless, non-toxic, latex free. This silicone-based putty will last without graining, so stretch, squeeze, and poke it all you want. Your hands will thank you later.
What About During A Flare
During a flare it is usually recommended to rest the affected joint. You should still gently move the affected joint as far as is comfortable several times a day as this may help prevent stiffness. However you should not apply any force or resistance to the affected area. For example, if your wrist is affected, do not use any weights or resistance bands with that arm. If you are feeling otherwise well, you can still do some gentle exercise for the rest of your body. Talk to your rheumatologist or physiotherapist for more information.
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Shoulder Exercise: Crossover Arm Stretch
Stretches the back of your shoulder
- Stand straight, with your shoulders relaxed.
- Gently pull one arm across your chest as far as comfortable, holding at your upper arm.
- Hold the stretch for 30 seconds, and then relax for 30 seconds. Repeat with the other arm.
- Repeat the sequence three more times.
Tip: Dont pull or put pressure on your elbow.
Precautions Before Exercising With Shoulder Arthritis
If youre new to exercise, its always smart to first talk to your doctor. Your doctor or physical therapist can make sure the exercises are safe and help you gain mobility and strength without exacerbating inflammation or aggravating joint pain. If youve had surgery on your shoulder, get guidance from your doctor or physical therapist on which shoulder exercises are safe for you. More tips to help protect your joints:
Start slowlyEase your joints into exercise if you havent been active for a while, say experts. Push too hard too fast, and you can overwork your muscles and worsen joint pain. Go easy at first, then increase the length and intensity of your workout as you progress.
Move gentlyAlways warm up or stretch at the start of every exercise activity and do it again at the end. Dont force any stretches. Dont have someone else push on your shoulder to help you stretch more because that can set off a flare up, advises Dr. Yen Shipley. Instead, keep your movements slow and easy. Push to the point of feeling a good stretch without pain. With strength training, begin with fewer reps , and build up gradually.
Stop if your shoulder hurtsListen to the pain, says Shroyer. Take a break when your joint starts to ache. If you feel any new joint pain, its time to stop. Talk to your doctor about what pain is normal and when its a sign of something more serious.
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Data Analysis And Synthesis
Tables and forest plots were produced to tabulate and visually display the results of the individual studies and syntheses. RevMan5.3 software was used for statistical analysis. Since the measure of dispersion for change was not always available, we imputed a change-from-baseline standard deviation using a correlation coefficient as recommended by the Cochrane Handbook . The measurement data used the mean difference or standard mean difference as the effect analysis statistics, and each effect size provided a 95% CI. The heterogeneity among the results of the included studies was analysed by 2 tests , and the degree of heterogeneity was quantitatively judged by combining with I2. Given I2< 50% and p> 0.1, a fixed-effects model was used for analysis if I2> 50% and p< 0.1, a random-effects model was applied. The level of meta-analysis was set to =0.05. In addition, subgroup analysis was adopted. Two subgroups, short-term and long-term , were divided according to the length of the intervention.
Rheumatoid Arthritis: Is Exercise Important
Many people with rheumatoid arthritis tend to avoid exercise because they’re afraid that the activity might worsen their joint pain. But exercise is one of the key treatments to help reduce the disability often associated with rheumatoid arthritis.
Regular exercise can boost strength and flexibility in people who have rheumatoid arthritis. Stronger muscles can better support your joints, while improved flexibility can aid joint function.
Exercise can reduce fatigue and ease depression. And better overall fitness helps prevent heart disease and diabetes, two life-shortening ailments that often accompany rheumatoid arthritis.
Rheumatoid arthritis also accelerates the loss of muscle mass that typically occurs as people get older. That’s why it’s important to do exercises that will build muscle, in addition to aerobic exercises, which strengthen your heart and lungs.
Weight-bearing exercises, such as walking, can help prevent a loss of bone density , which can result from rheumatoid arthritis.
Studies indicate that exercise will not worsen rheumatoid arthritis symptoms. But if rheumatoid arthritis has severely damaged your hips or knees, you may want to choose low-impact exercises, such as swimming, water aerobics, walking or bicycling.
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Diet And Exercise For Rheumatoid Arthritis
If you have rheumatoid arthritis , you’d probably like to know the secret to controlling your symptoms. Fortunately, choosing healthy foods and getting certain types of physical activity can make a big difference in how you feel on a daily basis. Here’s what you should know about eating right and exercising with RA.
Why Exercise Can Be So Draining For People With Rheumatoid Arthritis
Even a gentle session of leg lifts set off an exaggerated nervous system reaction in older women with rheumatoid arthritis.
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Exercise can feel more difficult and draining than usual if you have rheumatoid arthritis, and its not just because of the stiff and painful joints caused by this autoimmune disorder. In a groundbreaking new experiment involving older women and exercise, researchers found that even a gentle session of leg lifts set off an exaggerated nervous system reaction in those with rheumatoid arthritis. Light exercise also negatively affected the inner workings of their muscles and blood vessels.
The findings build on earlier research about rheumatoid arthritis and the nervous system and raise pressing new questions about the best and safest ways for people with this disorder or similar autoimmune diseases to become and remain active.
Anyone who has rheumatoid arthritis or is close to someone who has it knows the havoc it creates in the body. Immune cells mistakenly attack healthy tissue, especially in joints, causing swelling, pain and deterioration, along with full-body inflammation and fatigue. Rheumatoid arthritis also often results in cardiovascular disease, which initially puzzled doctors, since the misguided immune cells do not directly target the heart or arteries.
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Physical Activity For Arthritis
If you have arthritis, participating in joint-friendly physical activity can improve your arthritis pain, function, mood, and quality of life. Joint-friendly physical activities are low-impact, which means they put less stress on the body, reducing the risk of injury. Examples of joint-friendly activities include walking, biking and swimming. Being physically active can also delay the onset of arthritis-related disability and help people with arthritis manage other chronic conditions such as diabetes, heart disease, and obesity.
Learn how you can increase your physical activity safely.
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Stay as active as your health allows, and change your activity level depending on your arthritis symptoms. Some physical activity is better than none.
For substantial health benefits, adults with arthritis should follow the Physical Activity Guidelines for Americans recommendations for Active Adult or Active Older Adult, whichever meets your personal health goals and matches your age and abilities. Learn more at the Physical Activity GuidelinesExternal website.
Learn how you can safely exercise and enjoy the benefits of increased physical activity with these S.M.A.R.T. tips.
- Start low, go slow.
- Modify activity when arthritis symptoms increase, try to stay active.
- Activities should be joint friendly.
- Recognize safe places and ways to be active.
- Talk to a health professional or certified exercise specialist.
Start low, and go slow
Guidelines For Exercising With Ra
There are no specific recommendations for how much exercise people with RA or other autoimmune diseases need. Instead, experts recommend that almost everyone follow these general guidelines:16
- Get a total of at least 150 minutes of moderate aerobic exercise each week. Workout time can be spread outâfor example, 30 minutes of exercise 5 times a week. Any physical activity that gets the heart beating faster than normal counts as moderate aerobic exercise.
- Doing vigorous aerobic exercise for at least 75 minutes each week is okay, too. Sweating, breathing harder, an increased heart rate, and muscle fatigue are signs of vigorous exercise.17
- In addition to aerobic exercise, do strength exercises that build muscles at least 2 days a week.
Some strength exercises require equipment, such as weights and resistance bands. Other exercises, such as squats, hip bridges, and many yoga poses, use a personâs own body weight for resistance. When doing strength exercises, slow, controlled movements can help build muscle and guard against injury.
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Best For Wrist Strength: Peradix Hand Grip Strength Trainer
Although the Peradix Hand Grip Strength Trainer is still a type of stress ball, its ergonomic design helps to fit it perfectly to your hand and more effectively train all your fingers. The shape of these colorful trainers, which coordinate with resistance progression from 15kg to 25kg to 30kg, allow to more easily isolate areas of your hand and give more attention to your wrist.
Precautions To Keep In Mind Before Exercising
If youre new to exercise, its always smart to first talk to your doctor to make sure the exercises are safe and appropriate for you, without exacerbating inflammation or aggravating joint pain. Likewise, if youve had surgery on your foot or ankle, get guidance from your doctor or podiatrist on what exercises are safe for you.More tips to help protect your joints:
Start slowly. Ease your joints into exercise if you havent been active for a while, say experts. Push too hard too fast, and you can hurt yourself or worsen joint pain, says Dr. Zinkin. Go easy at first, then increase the length and intensity of your work out as you progress.
Move gently. At the start of every exercise activity, start with slow gentle stretches or a ball massage to help warm up ligaments and get joints moving though a range of motion, says Dr. Silverman. Dont force any stretches and keep your movements slow and easy. People sometimes feel like the more they do, or the harder they push, the better, but thats not true, especially when youre first starting out and when you have arthritis, adds Dr. Zinkin.
Stop if your foot hurts. Take a break when your joints start to ache. If you feel any new joint pain or pain that is sharp, stabbing, or constant, its time to stop.
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Flowing Movements Such As Tai Chi And Yoga
A of participants with RA who had done group tai chi suggested that tai chi could reduce anxiety and depression while increasing self-motivation and self-esteem.
The participants did tai chi twice a week for 12 weeks.
A 2013 study of women with RA who did Iyengar yoga suggests that this exercise had mood, fatigue, and pain disability benefits. The participants did yoga twice a week for six weeks.
It is possible to find free online videos or apps like Gaia for tai chi or yoga workouts, including some yoga workouts specifically for people with RA. A person should always talk to their doctor before starting a yoga or tai chi practice.
Shoulder Exercise: Wall Crawl
Improves range of motion and strengthens shoulder muscles
- Stand in front of a wall, about an arms reach away, so your fingers can just touch it.
- Using your affected arm, slowly crawl your fingers up the wall as high you can comfortably go.
- Hold for 15 to 30 seconds then crawl back down.
- Repeat one or two more times, trying to reach higher each time.
Tip: If you feel a twinge of pain or your shoulder tightens as you crawl your fingers up, pause for a second and focus on relaxing the shoulder muscle, advises Shroyer. You may be able to go a little higher once your shoulder is relaxed. If you feel a twinge again, youve reached your max range of motion.
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