Because of my rheumatoid arthritis (RA), often the very thought of lifting something heavy is terrifying — I can already feel the pain in my joints just thinking of it.
You can imagine how I feel about certain types of exercises. Give me an elliptical and I’m as happy as can be. But push-ups? Deadlifts? Sit-ups? Burpees? Ouch and no thank you. Especially not in a gym around people where I will sound like Rice Krispies in milk: snap, crackle, pop.
When I first got into exercising after my RA diagnosis five years ago, I didn’t know much about strength training. When I attempted it, I usually ended up hurting myself or couldn’t stay motivated. I knew how to walk or run in a straight line for 30 minutes and manage some push-ups, but because I of my rheumatoid arthritis, they’re not exactly the easiest task to complete. These wrists really don’t like doing push-ups.
Venturing into the weight room at my gym was intimidating. I realized I had no clue what I was doing when I thought a really cute guy was checking me out, but when he came up to speak to me, he told me I was using one of the machines wrong.
I wanted to learn how to strength train with rheumatoid arthritis, but I also wanted someone I could trust to understand my disease and exercise abilities and limitations. Over the years, people without a proper understanding of my illness have offered me some very bad advice for someone living with a chronic joint condition.
However, with proper guidance, strength training has become one of my favorite tools for managing my painful battle with rheumatoid arthritis. It’s a critical part of my exercise routine and overall treatment plan.
Four years ago, I never could have imagined myself co-presenting a study with arthritis researchers at the 2019 American College of Rheumatology annual meeting on the benefits I’ve found from strength training, and how research has helped me take control of my disease. But that’s exactly what I did last year — you can see the study findings here.
Barriers to Strength Training with Rheumatoid Arthritis
For me personally, there was a laundry list of issues that prevented me from being comfortable with strength training, including:
- Lack of understanding of how to strength train
- Pain (and the fear of more pain)
- Lack of equipment
- Lack of motivation and consistency
- Comorbidities like depression, anxiety, neuropathy, infections, and osteoarthritis
- Inconsistency in routine (chronic illness is bumpy — sometimes I feel too sick to exercise, need surgery, or have to adapt to new symptoms)
- Medication side effects and finding an effective treatment (finding the right medication for RA can take years)
- Not knowing who to trust to teach me how to exercise with a joint disease
- Brain fog (not remembering how to do the exercises or what I was told during appointments)
How did I overcome these barriers while living with rheumatoid arthritis? One arthritic step at a time.
My First Arthritic Step Forward
First, you have to understand how important exercise has become to managing my RA. I credit many hours at the gym to helping me lose more than 60 pounds after I was diagnosed with RA. Along with constant tinkering to find the right medication regimen, I credit this weight loss and regular exercise to how much better I’m feeling today than when I was newly diagnosed.
But I knew that pounding the elliptical alone wasn’t enough. Benefits of strength training (whether you use weights or not) include: helping to ease joint pain and stiffness, build bone health, maintain a healthy weight, and improve balance.
I went to professionals trained in arthritis care who could help me understand my disease. Physiotherapists and occupational therapists are a wealth of knowledge when it comes to adapting to life with arthritis. Here in Canada, the Arthritis Society offers many great information sessions on exercise with arthritis and The Mary Pack Arthritis Center near my home in Vancouver has professionals trained in arthritis care to get me started
Educating myself about my disease and exercise made it a lot easier to do so.
My Second Arthritic Step Forward
I joined the Arthritis Research Canada patient advisory board in September 2018. If I were to experience benefits from exercise to treat my RA, I wanted those results to be recorded in research so health care providers could use this information to help their patients and other people with RA could learn from my experience to improve their health.
When I joined a research study being led by Jasmin Ma, MSc, PhD, a post-doctoral fellow in Knowledge Translation at Arthritis Research Canada and the University of British Columbia, I discovered I wasn’t alone in my barriers to strength training.
Many others living with RA were experiencing the same setbacks as I was. Her research is focused on supporting people with rheumatoid arthritis to start and stick to strength training, and developing methods for tailored physical activity interventions.
I met a lot of other patients with similar interests and struggles when I participated in this research. Fellow patients speak a certain language that only we understand — it’s from our lived experiences with our diseases. This is also why patient engagement in research is so important.
My Third Arthritic Step Forward
I applied what I learned from being in the study to my personal lifestyle and gave it time to stick. Like starting a new medication, it takes time to adopt a new routine and see the benefits of exercise. But once I got the hang of things, I understood why some people say they are addicted to exercise. It took time for me to understand when my body needed breaks and what good pain versus bad pain felt like.
I could feel the benefits over time and what they were doing for my disease activity. When I started to add strength training into my daily life, I noticed things that it became easier to go up and down stairs and carry groceries. My posture and balance improved. Maintaining my weight loss became easier. I had less back pain.
I started to celebrate small fitness victories, like being able to do lunges without holding on to something for balance or planking for one minute straight.
These exercises were making my life with rheumatoid arthritis easier. At the beginning of my diagnosis, I had little hope or expectations on improving my health, but here I am five years later, at age 34 and in the best shape of my life.
The Benefits of Strength Training for Rheumatoid Arthritis
Having strong muscles is important for people with rheumatoid arthritis, but few regularly do strength training exercises, even among those with well-controlled disease. Strength training has a lot of important benefits for people with rheumatoid arthritis. In addition to reducing pain and fatigue, it also lowers the risk for cardiovascular disease, which is a leading cause of death for those living with rheumatoid arthritis.
What are the benefits of strength training when living with rheumatoid arthritis? Dr. Ma says it can include:
- Body composition: increased muscle mass, and decreased body fat
- Muscle function: increased muscle strength and endurance, which also helps with supporting the surrounding joints
- Ability to perform activities: strength training increases your ability to do your daily tasks (including playing with your kids)
- Psychological: increased confidence and better mental health
- Disease process and symptoms: decreased inflammation, pain, stiffness, and fatigue
In Dr. Ma’s study, we want to find out what helps people with rheumatoid arthritis to take up strength training. Ultimately, this work will help develop effective strategies to empower people to take part in this type of activity in order to improve their health. We know strength training is an important disease management strategy for people with RA, the tricky part is figuring out how we can support people with RA to participate in strength training.
During interviews of people with RA, Jasmin Ma’s team discovered more than 50 barriers to strength training for people with RA, like experiencing brain fog or memory loss that makes it challenging to remember strength training exercises, or the challenge of deciphering bad joint pain from normal muscle pain that you may experience from starting a new strength training routine.
How to Start Strength Training When You Live with Rheumatoid Arthritis
Here is some advice from Dr. Ma and from me:
Start small and find the exercises you enjoy. Remember that strength training doesn’t need to be done in a gym. You can exercise at home with resistance bands, dumbbells, kettlebells, a yoga mat, a step, and ankle weights. Comfort is important for me to be consistent. At first, when I was just getting into strength training, I would break up my exercises throughout the day until I became stronger and could tolerate more at a time.
Take a rest day or more in between sessions so you can monitor how your body is responding, says Dr. Ma. “Typically pain in the muscle is fine, particularly if it doesn’t last longer than 24 hours,” she says. “Sometimes you can get delayed-onset muscle soreness where your muscles feel achy a couple of days after your workout. Persistent joint pain, though, may be a sign that you should decrease your exercise load.”
Be careful during disease flares. When in a flare pay attention to your body and how much and what type of strength is appropriate for you on that particular day, says Dr. Ma. “For example, if you’re experiencing a flare, you may want to exercise the muscles that avoid the affected joint or decrease the intensity,” she says. “Doing a bodyweight warm-up can help you take a scan of your body and how you’re feeling that day to allow you to adjust accordingly. Be prepared to do some trial and error and also be kind and flexible with your expectations.”
Try to make it part of your everyday routine. Developing a routine that involved strength training took time, commitment, and educating myself but eventually became part of my everyday activities because my body craves it. I only do the exercises that my joints are comfortable doing, which can be different each day because RA is an unpredictable bumpy chronic illness.
At first, I did only exercise that used my own bodyweight, but as I got stronger I could add more weights and exercises. I typically stick to exercising in the morning when my pain and fatigue are less severe. However, some afternoons I find myself doing more strength training moves because they help with my pain — remember motion is lotion for your joints.
Try doing strength before cardio. I have found that doing my strength training exercises before cardio and after a good stretch makes them a lot easier and prevents muscle fatigue.
Compile visual resources to guide you. Videos and graphics on sites such as Fitness Blender, YouTube, and Instagram helped me target the memory issues that come with my RA. Having that tailored exercise prescription and list of what to do makes it easier on days when I am having a lot of brain fog. I can’t do intense workouts every day, so it’s also been helpful to have workouts for the not-so-good days when I need to be more gentle with my stiff achy joints.
Finally, remember that every case of arthritis is different, and what works for one may not work for another. This is why it’s key to have a personalized plan with guidance from an experienced physical therapist or trainer. I highly recommend speaking to a physical therapist today about a tailored strength training prescription tailored for you.
Use Our ArthritisPower App and Be Part of Arthritis Research
If you are diagnosed with arthritis or another musculoskeletal condition, we encourage you to participate in future studies by joining CreakyJoints’ patient research registry, ArthritisPower. ArthritisPower is the first-ever patient-led, patient-centered research registry for joint, bone, and inflammatory skin conditions. Learn more and sign up here.