Cartoon shows a woman doing a forward lunge stretch inside a pool
Credit: Tatiana Ayazo

The American College of Rheumatology (ACR) strongly recommends consistent exercise for people with rheumatoid arthritis over no exercise and conditionally recommends aerobic, aquatic, resistance, and mind-body exercises. These recommendations are found in the first-ever ACR Guideline for Exercise, Rehabilitation, Diet, and Additional Integrative Interventions for Rheumatoid Arthritis. 

This likely doesn’t come as a surprise with numerous studies demonstrating the benefits of exercise for those of us with RA, as well as other types of inflammatory arthritis. Exercise has been found to reduce stress, fatigue, brain fog, inflammation, and body fat.  

But how do you know which type of exercise is best? And what about frequency, intensity, and duration? ACR has not formally defined this criteria, but instead, recommends that exercise should be tailored to each patient based on their:  

  • Disease trajectory 
  • Capabilities 
  • Access 
  • Other health conditions 

In other words, there is not one best exercise for all and it’s up to you to find what works for you. To help get you inspired to incorporate movement into your overall treatment plan, we’ve asked several people with inflammatory to share their routines.  

There’s Not One Best Exercise for All

The following people are all living with inflammatory arthritis  — but how and when they exercise varies immensely.  

Sara’s Routine: Fitness Classes 5-6 Days Weekly

Sara King-Dowling attributes sticking to a routine exercise program as a key factor in keeping her ankylosing spondylitis (AS) symptoms at bay. Her routine consists of attending group fitness classes five to six days each week. These classes incorporate a variety of cardio and resistance-based exercises targeting the whole body to improve endurance and strength.  

The workouts change every day, but some common movements include:  

  • Romanian deadlifts 
  • Kettlebell swings 
  • Chest presses 
  • Cycling 
  • Jumping jacks 
  • Burpees 

Exercise is a vital component of Sara’s wellness plan, and she recently documented her success in a Patient Perspectives poster for the American College of Rheumatology (ACR) convergence 2022 entitled “Exercise as a Supportive Treatment for my Ankylosing Spondylitis.”

If your exercise routine does not include much cardio or strength-training, you are not alone. Even people with similar conditions have their own unique set of attributes, including fatigue and pain levels, muscle strength, flexibility, stamina, and disability, which may hinder certain types of exercise.  

Elisa’s Routine: Hiking, Water Therapy, Stretching

Like many, Elisa Comer’s exercise routine changes based on good and bad days with RA. Her favorite activity: hiking an easy trail. Other exercises in her rotation include: 

  • Warm water therapy 
  • Stretching 
  • Using gentle resistance bands 
  • Floor exercises with a firm foam roller (to ease her back pain) 

Ashley’s Routine: Dance Class, Strength-training, Swimming, Walking

Ashley Newton was once a distance runner, obsessed with beating her best time, longest distance, and number of competitive events. Before being diagnosed with RA, her goal was centered on cardio, weight management, and personal growth.  

Today her routine changes based on how her body and joints feel.   

On good days, Ashley enjoys: 

  • Hip-hop dance class 
  • Barre with modified moves 
  • Strength-training with light free weights 
  • Swimming  
  • Walking (for more than 30 minutes at varying speeds) 

When her body is not feeling as well, her activity includes: 

  • Short walks at a slower speed 
  • Gentle stretching with deep breathing 
  • Physical therapy (PT) exercises 
  • Walk laps in the pool 

 Adapting to New Forms of Exercise

Lauren Scholl’s career as a personal trainer requires her to bend over and pick up weights as she demonstrates exercises. A reverse lunge, for example, involves stepping back and bending the toes. “There are days where I can’t do it. I can’t demo that for someone,” she shares on the Psoriatic Arthritis Club Podcast 

Lauren’s psoriatic arthritis symptoms make it challenging to demonstrate exercises for clients like she did in the past, so she demonstrates using her words. “I’ve tried to learn ways to work around it, I’ve changed my training style,” Lauren explains.  

For Lauren, like so many others with inflammatory arthritis, it’s about finding a good balance. “If I am flaring, it is hard, and I have to like, really listen to my body and know what I can handle.”

Find What Works for You

In the past, my own exercise level varies based on how I feel and my schedule — but the new ACR guidelines have redirected me toward more consistent exercise.  

When I feel unmotivated to exercise, I remember how great I feel after a good walk. If I step outside and walk around my neighborhood or on a path at the park, my energy level increases while my fatigue level decreases. On some days, I can hike on rough terrain up and down hills and other days I can only walk on paved surfaces on flat ground.  

It’s important to keep in mind that each person is unique. Even if we have similar conditions, there will always be differences between us all. A person’s pain and fatigue levels may be different and they may feel pain in a different part of the body. Since we can’t generalize how each person feels and reacts to treatment, we can’t generalize how each person should engage in exercise.  

When I see someone with a chronic condition on social media showing how they ran a marathon or participated in Zumba classes, I cheer them on, but I avoid comparing myself to them because everybody is different.  

Getting Started with Arthritis-Friendly Exercise

A good first step is talking to your doctor about your desire to exercise — and how you can approach movement without overtaxing your joints. In the meantime, here are some patient recommendations for getting back into a daily exercise routine. 

  • Work with a physical therapist. A PT can help you choose exercises that do not cause additional pain or damage. 
  • Think slow and steady. Do a few minutes of low-impact exercise and then lengthen the duration and intensity as your body becomes accustomed to the movement.   
  • Consider arthritis-friendly aids. Wearing hand, wrist, or back braces or applying kinesiology tape prior to exercise can help support the joints and muscles.  
  • Find the fun. Do something you love to do like biking, walking, stretching, tai chi, yoga, or swimming. Get more ideas on how to make exercise with arthritis easier. 

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.

American College of Rheumatology. 2022 American College of Rheumatology (ACR) Guideline for Exercise, Rehabilitation, Diet, and Additional Integrative Interventions for Rheumatoid Arthritis. October 2022. https://www.rheumatology.org/Portals/0/Files/Integrative-RA-Treatment-Guideline-Summary.pdf.

King-Dowling S. Exercise as a Supportive Treatment for My Ankylosing Spondylitis [abstract]. Arthritis & Rheumatology. 2022. https://acrabstracts.org/abstract/exercise-as-a-supportive-treatment-for-my-ankylosing-spondylitis/.