Contrary to what people may believe is the case, exercise does not make rheumatoid arthritis worse. Instead, it increases strength and flexibility and helps people feel better. It also decreases fatigue. However, caution and moderation when exercising are in order. This is particularly the case during flare-ups, or times of acute joint inflammation. For those with rheumatoid arthritis who plan to start exercising, it is best to ask a doctor or physical therapist for advice about what is appropriate first.
A comprehensive exercise program has three parts: flexibility training, aerobic exercise, and strength training.
Flexibility training, or stretching, helps to keep joints and muscles limber, make movement more comfortable, and may reduce the risk for strains and injury. A simple stretch for your shoulders and elbows is to raise both hands over your head and stretch your arms as far as you can. You will feel the stretch the most where you are least flexible.
Aerobic exercise improves your heart health and increases your endurance for daily activities. Any activity that requires the continuous movement of the large muscles of your body, such as walking, bicycling, swimming, or aerobics classes, is considered aerobic exercise. You can get the health benefits of aerobic exercise by doing 30 minutes of moderate-intensity activity on most days of the week. Benefits are the same whether you do the 30 minutes all at once or in two or three shorter sessions.
You are considered to be working at a moderate intensity when you are breathing a little harder than usual, your heart is beating a little faster, and you are warmer than usual. However, you should be able to carry on a normal conversation while you are exercising and feel that you could continue the activity for at least 30 minutes. On a scale of 1–10, you should feel you are working at about a 5 (somewhat hard).
If you have not been physically active for a while, it is best to start your aerobic activity at a low intensity and to do it for short periods. As your body adapts to being more active, you can increase both the intensity and the time you spend being active. A rule of thumb is to increase aerobic activity by 10% to 20% each week. For example, if you can do 10 minutes of activity, increasing to 12 minutes the next week is enough.
Strength training, which is often called resistance training, increases the strength in the muscles you exercise. For example, using a leg press machine strengthens your leg muscles. Strength exercises should be done no more than two or three days a week. A good rule of thumb when starting out is to use a weight or resistance band that you can lift (or push or pull) with good form for at least 12–15 repetitions. You want the weight to feel easy in the beginning in case you have any underlying injuries that you don’t know about; too tough a workout may make them worse. Once you know your joints and muscles are healthy, you can start gradually increasing the weight. When you can do an exercise easily for 12 or more repetitions, increase the weight or resistance of the band by 3–5 pounds. Remember to allow at least 48 hours of rest between strength-training sessions.
Making exercise a habit
Adopting any new healthy habit takes work, and regular exercise is no exception. Many people start with high expectations and overly ambitious plans, then quickly get discouraged and give up. Some ways to avoid this are the following:
- Think about which activities you like. What have you done in the past that you enjoyed? It may be a sport, walking with a friend or dog, taking a dance class, doing yard work, or volunteering for a job where you walk or are physically active. See if you can include these activities in your new exercise plan.
- Make a plan that makes sense for your life. Think about easy ways to work exercise into your current daily routine. Big plans to “turn over a new leaf” are often too much of a change to keep up.