Eight years ago, I was diagnosed with rheumatoid arthritis (RA), a condition that initially left me overwhelmed. Through self-management and a commitment to exercise, I’ve managed to live an active life and manage my disease effectively.
Regular exercise is essential for managing RA as it reduces inflammation and pain while improving overall health and well-being. Balancing exercise and rest can be challenging, but with proper guidance and education, strength training can be safe and beneficial for people with RA.
Finding the Right Help
As a member of Arthritis Research Canada’s arthritis research patient advisory board since September 2018, I have been involved in a study that sparked my interest as someone living with rheumatoid arthritis. The study, called I START – Improving Strength Training and Tailoring Among People with Rheumatoid Arthritis, was conducted by Arthritis Research Canada and the University of British Columbia, led by Dr. Jasmin Ma (kinesiologist). Its purpose was to tackle the issue of why 86 percent of people with RA do not strength train and how exercise professionals can better assist RA patients with a tailored prescription in strength training.
As I approach my fifth year in this partnership, I have presented at conferences, webinars, and even hosted an exercise class for arthritis alongside Jasmin. I believe this is a perfect example of effective patient engagement in research and program development to help patients live a healthier life. Thanks to this partnership, I have learned so much and gained confidence in exercising with this disease.
However, it wasn’t just this study that helped me learn to be physically active with this disease. I am grateful for the guidance on how to safely exercise that I have received from skilled physiotherapists and kinesiologists studying exercise and arthritis.
Despite my positive experiences, I have hired personal trainers or gone to the nearest physiotherapy clinic only to feel that I wasn’t finding the right advice I needed for my needs as someone living with inflammatory arthritis. From my experience, unless they have a background in arthritis care, many exercise experts do not properly understand RA.
My advice for patients is to ask their rheumatologist if they know of any physiotherapists with extensive knowledge in inflammatory arthritis.
Unique Barriers to Exercising with Rheumatoid Arthritis
There are unique barriers to exercising with rheumatoid arthritis, including:
- Anxiety
- Cognitive dysfunction
- Depression
- Fatigue
- Hand pain and strength
- Infections
- Medication timing
- Mobility issues
- Pain
- Painsomnia
- Surgeries
It took some time for me to figure out how to exercise with my RA without making things worse. Exercise is different for everybody. I’ve learned to listen to my body and rest when I need to. Teaming up with a physical therapist and personal trainer has really helped me learn how to exercise safely and in a way that helps me feel better.
I’m still figuring out how to manage my RA, but I’m so grateful for the support from my doctor, physical therapist, and personal trainer. They’ve helped me find the right exercises for me, and that’s made a big difference in how I feel.
My Personal Barriers to Exercise
For me, my biggest barriers are depression and fatigue. Both are incredibly common in those with inflammatory arthritis.
Fatigue robs me of energy, making tasks like showering, the dishes, laundry, preparing food, all physically and emotionally draining. Fatigue weighs me down.
Depression can significantly reduce the ability to experience pleasure and joy in simple daily activities often making things feel like a massive chore to complete. This illness can impact my confidence and my motivation to exercise.
Regular exercise can significantly help with these emotions, however getting started is really the hardest part next to staying consistent.
How do I get through this and keep moving?
- Medications
- Therapy
- Knowing how exercise will make me feel after
- Doing things I enjoy like painting, gardening, writing, and spending time in nature
- Volunteering and being an active patient advocate
What I’ve Learned About Exercise
Undoubtedly, exercise is beneficial for many people, and for those living with rheumatoid arthritis, it is crucial.
Exercise can improve various aspects of living with RA:
- Assists in maintaining a healthy weight, easing the load on joints
- Balance improvement
- Corrects posture
- Mental health and cognitive health enhancement
- Pain reduction – decreases inflammation and joint stiffness
- Prevents sarcopenia – the loss of muscle mass and strength common in RA patients
- Reduces comorbidity risks, especially cardiovascular disease, the leading cause of death for those with RA
- Sleep improvement
- Stamina enhancement
- Supports medications in working more effectively
Making Exercise Consistent
Consistency can be difficult when living with a bumpy chronic illness. I often feel like I have to go through moments where I need to pick myself back up and start over because my disease got in the way. I can experience a lot of guilt and negative emotions when this happens, but the important thing is I pick myself back up and not let myself stew in those negative emotions.
There are events that stop me from exercising that are out of my control. Those include surgeries, tests, infusions, my menstrual cycle, or infections.
Staying Motivated
Discovering ways to stay motivated and developing healthy habits are crucial for overcoming this barrier. For me, being an active patient partner in research and advocacy keeps me motivated. Working with physiotherapists and kinesiologists, exercising with a buddy (my son), enjoying motivating music, or rewarding myself with a sauna session helps keep me moving.
Switching up my exercise routine also boosts my motivation, especially outdoor activities like hiking, swimming, or biking. The warmer months inspire me to be more active. In contrast, winter months can be draining and challenging for maintaining motivation.
Regular vitamin D supplementation can significantly help with increased fatigue during winter, and using a sauna can provide warmth. Vitamin D deficiency is common among people with RA.
Knowing the Right Time to Exercise
Finding ways to add exercise into my day is just as effective as sticking to a strict fitness program every day. On busy days or days with high fatigue, I try to add small amounts of exercise throughout the day. If I have a physically demanding task that day, like mowing the lawn or deep cleaning the house, I count that as my exercise instead of my usual routine.
I find this approach beneficial for managing RA, especially for those with sedentary jobs that require a lot of sitting. It helps alleviate pain and build strength gradually over time without pushing too hard.
I prefer exercising in the morning when I have the most energy or throughout the day while I work on my computer. I’m not a fan of evening workouts as I turn into an arthritic pumpkin around 5 or 6 pm, especially during winter. However, regular exercise does help reduce my arthritic symptoms during those times.
Knowing When Not to Exercise
I follow my health care provider’s advice and avoid exercise after surgery, a cortisone injection, injury, biopsy, or infusion.
My chronic illness can be unpredictable, so I always ask my doctor if it’s safe to exercise and for how long. Due to my weakened immune system, it takes me longer to heal from injuries, and I need to listen to my body and take it slow after a break from exercise.
When I exercise too much, I experience joint aggravation that feels like hot burning pain with swelling that feels like jelly under my skin. I also get sore muscles and an increase in fatigue and cognitive dysfunction (brain fog).
Pain can happen immediately from doing too much intensity or having improper form. If I overdo it, the pain or increase in fatigue can show up from 2 to 48 hours later. Rest is as important as movement, but balance is crucial. If I need to rest for more than two hours after a workout, I probably overdid it.
Another way I tell if I have overdone it, especially with walking or running, is when my lower legs flare up. Spending too much time on my feet, especially with the wrong shoes, can cause my feet, ankles, knees, hips, and lower back to feel discomfort.
Mistakes I Made Exercising When Starting Exercise
When I was diagnosed with RA, I lived close to a community center that had a gym, pool, and sauna. I knew I needed to lose weight and get healthier, but even walking short distances was a challenge. One day, I mustered up the courage to enter the gym and get on the elliptical, and I’m so glad I did.
I pushed myself to exercise for 30 to 60 minutes, as many days a week as I could, and then hit the sauna. The cardio and elliptical helped me lose weight, strengthen my lower body, and improve my overall health.
One day, I decided to attend an accessible exercise class at a community center. It was a gray and gloomy day, and I was highly fatigued. The 45-minute class had no breaks, and I was struggling to keep up while feeling embarrassed that older women were handling the workout better than me. To make matters worse, the instructor called me out for not being able to keep up, which left me feeling even more self-conscious about exercising in public.
I was also intimidated by strength training and avoided it entirely because I didn’t know how to use the machines. Additionally, I made the mistake of not setting goals or establishing a routine. I was constantly overdoing it on the elliptical and pushing myself to keep up with “normal” healthy people.
Eventually, I realized that I needed to accept that life with RA was going to look different for me. With time and patience, I found a routine that worked for me and helped me achieve my health goals. I learned that exercise was an essential part of managing my RA, and I hope my experience can inspire others to find an exercise routine that works for them too.
Be a More Proactive Patient with ArthritisPower
ArthritisPower is a patient-led, patient-centered research registry for joint, bone, and inflammatory skin conditions. You can participate in voluntary research studies about your health conditions and use the app to track your symptoms, disease activity, and medications — and share with your doctor. Learn more and sign up here.
