Exercises for Rheumatoid Arthritis – Why, How and When?

Rheumatoid arthritis is one of the most severe kind of arthritis characterized by pain, stiffness and inflammation in the joints among the patients.  It is an auto-immune disorder and can affect people at any age. In severe cases it can lead to serious deformity in the patient and can make it impossible to perform routine day-to-day activities.

Usually rheumatologists administer the NSAIDs and DMARDs to alleviate the symptoms of the disease; but still bouts of excessive pain and discomfort are common among patients.

However this does not mean that patients with arthritis cannot lead a normal life. With certain changes in diet, lifestyle, regular medications and few precautions; patients with rheumatoid arthritis can learn to live with this disease without much difficulty. The most important point to mention here is that you have to take control of your situation! Knowing one’s body and recognising its bodily symptoms is important for the patients with rheumatoid arthritis.

Exercise in Rheumatoid arthritis – A Yes or a No?

It is commonly known that patients with Rheumatoid arthritis must take as much rest as possible as it prevents excessive damage to the rheumatic joints and also relieves the pain. However complete inactivity can have serious implications as well! Consider your body as a machine. What happens to the levers and moving parts of your old machines which are never put to any use for decades? They get rusted and ruined! This is exactly what can happen to your moving joints, if not put to use.

Long periods of inactivity can lead to decreased pain tolerance, stiff joints, weak muscles and poor balance. In short, it might aggravate the symptoms of arthritis. In addition it might lead to other heath troubles in the form of cardiovascular diseases or type 2 diabetes. Hence mild exercise is extremely important for the patients of arthritis in order to lead a healthy life. It provides strength to the bones and muscles and restores mobility in many patients.

But again doing the right type of exercises in the right amount is very important for the patients with rheumatism. Patients must make sure that they do not strain themselves to perform extremely difficult exercises and in turn cause additional damage to their joints. Resting on the days of excessive pain and discomfort is always advisable for the patients. So a proper balance must be struck in such matters. Again it must be realized that exercising is not a cure for arthritic pain.

Pain might still occur! The only help which exercising could provide is, in lesser occurrences of these bouts of pain and lowered intensity of these attacks. So one must not be discouraged from exercising just because it might not cure there condition. Patients must consider the health benefits that exercising has on their general health and mobility before making their choice .

Why should you do Exercise in Rheumatoid arthritis? 

We all are well aware about the benefits of exercising on the health of general public. But patients with Rheumatoid arthritis have additional benefits too, which include;

Pain Reduction : Regular exercise leads to reduced pain and discomfort in patients with Rheumatoid arthritis. In general, people who exercise regularly live longer despite their health conditions.

Muscle Strength: Strengthening exercises helps in building the muscle strength and thus improve the ability of various muscles to bear the weight of bones. Thus stronger muscles help better in providing support and movement to the joints.

Bone Strength: Exercising is crucial for bone strength as well. Regular exercise leads to strengthening of the bones. Since thinning of bones is one of the outcomes of rheumatoid arthritis; thus exercising can help restore that strength for the patients.

Mobility: Proper exercising helps to restore and maintain the mobility of various arthritic joints. Due to improved functional ability of the joints; one can perform the day-to-day activities with ease.

Joint Suppleness: Exercising also assists in maintaining the joint suppleness. Morning stiffness is one of the common symptoms of rheumatoid arthritis. Exercise can help overcome these signs.

Breathing and Circulation: Exercising has an overall effect on the body and affects all the main organ systems. Regular exercise helps in improving the breathing and circulation. Hence risks of cardiovascular diseases also subside.

Stress Reduction: It is a good means to reduce stress and tiredness from the body. Physical activity leads to a feeling of general well-being among the patients which in turn reduces stress and other psychological symptoms caused as a result of arthritis.

Better Digestion: Physical activity improves digestion and hunger in the patients. Thus patients can eat healthy and regular meal to supplement their diet with necessary minerals and vitamins that are essential for strengthening their bones and muscles.

Weight Control: Excessive weight may cause severe and quick damage to some joints in the body. Exercising is the natural and most effective method to control excessive weight among patients. As such being overweight is not a good sign and might lead to other health complications including heart diseases, diabetes, and hormonal imbalances. Exercising can help keep all these ill effects under check.

Better Sleep: Exercising also enables better sleep patterns among the patients. As a result they can take proper rest without taking any extra medications and feel refreshed every morning. This helps to improve the body’s immunity and helps it cope better with the disease.

Who should do Exercise?

Everyone!
Exercise is recommended for every person in general due to its positive effects. As a rheumatic patient, inclusion of exercise to your schedule becomes even more crucial. So until and unless you have been advised otherwise; you must follow some type of mild or moderate fitness regimen in order to perform your routine activities without much hassles.

Most of the time, doctors encourage patients to perform some amount of exercise but when one is experiencing excess pain or in case of severe damage to a particular joint; movement is prohibited. Rest can be the best medicine only when one is experiencing chronic pain or discomfort. At other times exercise is necessary.

However in case you are in doubt, you must consult your health care provider and get some advice in terms of the duration and type of exercise which might be most suited for your condition.

A number of scientific studies as well conclude the significance of regular exercise in patients with rheumatoid arthritis. In a study performed on a group of 120 patients with Rheumatoid arthritis; effects of aerobic exercises like walking, aerobic aquatics was compared with non-aerobic exercises for a period of 12 weeks.

During this span; exercise tolerance, self-reported health status and disease-related measures were analysed. The group performing aerobic exercises showed considerable improvement in comparison to non-aerobic group in terms of walking time, aerobic capacity, anxiety, depression and physical activity. This study documents the efficacy and feasibility of regular exercise in people with rheumatoid arthritis.

Many people believe that long-term intensive exercise is not meant for arthritis patients. But this myth has also been proven ill-found from a study conducted few years back.

This study looked into the effects of intensive exercise over a period of two long years in patients with rheumatism. 309 patients were assessed during this trial and it was found to be highly effective than physical therapy. It was reported that intensive exercise does not aggravate the symptoms of arthritis or increase the damage to large joints.

However it should not be believed that one needs to perform these exercises under guidance of a trainer or with complex equipment. Basic home exercises could even show equal benefits in patients with rheumatoid arthritis. A study tested the effects of cognitive treatment and home exercises over a 12 weeks’ period.

This study showed highly encouraging results. It was concluded that home exercises helps in improving the self-efficacy for fatigue and mood, pain and physical activity in patients . Such results prove the importance of daily exercises in patients with rheumatoid arthritis.

Exercises for Rheumatoid arthritis

In patients with Rheumatoid arthritis, there are 4 types of exercises that could prove to be highly beneficial. These exercises are as follows:

Flexibility Exercises

These include Range-of-Motion (ROM) exercises and stretching exercises. These help in improving the flexibility and movement in affected joints and surrounding muscles. These exercises contribute to a better posture, improved functionality of joints and reduced risk of further damage and injuries to the joints.

These fall under the category of the simplest and easiest of the exercises that could be performed by patients suffering from Rheumatoid arthritis.

Duration of Exercise: Patients are advised to perform the Range-of-Motion exercises for 5 to 10 times daily. It is known that in patients with Rheumatoid arthritis, these exercises if performed in the evening could reduce the symptoms of morning stiffness. Stretching exercises could be performed 3 days a week. It is recommended that each stretch be held for around 30 seconds’ time. 

Strengthening Exercises

These are much more vigorous form of exercises and involves working the muscles against resistance. These resistance could include lifting limbs against gravity, pushing/pulling resistance against weight machine or use of hand held weights or elastic bands. Such exercises help strengthen the bones and muscles to provide better joint support and assists in lowering the stress at painful joints. As a result such exercises increase the activity levels of the rheumatoid patients. 

Duration of Exercise: These exercises must be performed about twice or thrice in a week. It must include a set of 8 to 10 exercises, each performed for 8 to 12 times. For elder individuals it is advisable to reduce the resistance and increase the number of repetitions of these exercises to avail similar results.

Aerobic Exercises

These exercises are extremely important not only for the health of joints but also for proper functioning of cardiovascular system. They include activities to use major muscles of the body in a repetitive and rhythmic fashion.

Safe forms of such exercises include walking, aerobic dance, bicycling, aquatic exercises, or exercises using equipment treadmills, stationary bikes or elliptical trainers. 
Walking is the most common and safest type of aerobic exercise that can be performed. For rheumatic patients walking can be extremely effective. But a few factors must be considered.

For example; patients must wear comfortable shoes or boots while walking. People who are not in a habit of walking long distances must walk short distances at first and increase the distances slowly and steadily. In case of pain or discomfort, long walks must be avoided. Also patients are advised to walk at a comfortable pace to avoid any pain or side effects. 

Duration of Exercise: Patients are recommended to practise 150 minutes of moderate aerobic exercises in a week. In case patient are uncomfortable while performing these exercises for long durations, they must divide them in bouts of 10 minutes during the course of a day or week.

Body awareness exercises

These are not usually included as a separate class and usually gets covered in the above mentioned three classes; but it is worth mentioning owing to its significance. These exercises included activities which help patients improve their posture, co-ordination, balance and relaxation techniques.

Yoga and Tai chi possess some elements of such exercises. These are of utmost importance to patients with arthritis and thus must be practiced as they do not show any ill effects.

When and Where to do exercise ?

There is no set time or place to do exercise. This might change from person to person and must be performed as per the convenience of an individual. Generally patients with rheumatoid arthritis prefer certain exercises during the evening as it alleviates the symptoms of morning stiffness.

But again in case exercising in a stretch seems difficult for the patients, they must break their regimen into small bouts of 10 minutes and perform them from time to time. 

As far as the place is concerned one can perform easy exercises at home or go to a park or a gym for outdoor or complex exercises. Most of the time finding the right motivation becomes a problem. There are people who start their fitness regimens with quite an enthusiasm but discontinue it after slight discomfort or due to lack of motivation.

Under such circumstances, your circle of friends and family could be of great help. Share your plans with some close friend and family member and talk to them about your progress. Set easy and attainable targets for yourself in order to stay focussed.

If possible, ask one of your friend or family member to accompany you to some leisurely activities like walking, aerobics or yoga. In this way you might find it to be enjoyable and fun and will not see it as a task. In no time, exercise might become a part of your daily routine and you will start noticing its positive effects .

ten rules for exercising in Rheumatoid arthritis1

Precautions 

Though exercising has a lot of positive effects on our mind and body; but still some precautions must be taken by patients suffering from arthritis. These include:

  • Patients with Rheumatoid arthritis must avoid jogging especially on hard surfaces as this might increase the harmful impact on affected joints
  • Heavy weight lifting is not recommended for patients with rheumatism. Mild to moderate weights should only be used while exercising by these patients.
  • Pain must never be overlooked. If a particular fitness regimen or exercise results in pain or discomfort, it must be immediately discontinued. One should set realistic goals and then try and achieve them. 

Summary

Inactivity worsens the symptoms of Rheumatoid arthritis. Patients that remain inactive for long periods of time face an increased risk of joint strains, sprains and pain.

It is because their muscles become unfit to react or signal when joints are moved beyond their limit of safe range-of-movement due to long periods of inactivity. Such people face problems in performing normal day to day activities and walk with an uneven, jarring gait. Thus exercising is equally important for patients with rheumatoid arthritis as any other individual. Patients must try and include some amount of moderate exercises in their daily regime.

These exercises can include simple stretching or muscle strengthening exercises. Aerobic exercises like yoga or aquatic aerobics have also been found to be extremely successful in providing muscle strength in the patients.

Regular exercise ensures to maintain the muscle and bone strength and keeps the joints supple and moving. In addition it maintains proper breathing, digestion and cardio vascular functions in patients.

Thus exercise is crucial for the overall health and well-being of the patients.