Features June 2007 Issue

RA And Exercise: Making The Right Choices

To preserve joint strength and function, find the right balance between physical activity and rest.

Exercise is essential for maintaining your overall health, as well as the health of your joints. A well-rounded exercise program provides increased cardiovascular fitness, flexibility, endurance, and strength. For arthritis patients, strong muscles improve body alignment and take pressure off painful joints.

If you suffer from rheumatoid arthritis (RA), however, you need to carefully decide which activities are safe to do and just how much you can exert yourself.

"Thereís a window of safe exercise, which can vary depending on the day," says Rochelle Rosian, M.D., staff rheumatologist at Cleveland Clinic. "Exercise is good for everyone but, if you have rheumatoid arthritis, itís important to know the right exercises so that you get the maximum benefit and donít do more harm than good."

Overcome reluctance

RA is a chronic inflammatory disease that causes pain, stiffness, and swelling of joints. Over time, affected joints can become damaged and deformed.

Physical activity should be part of any RA treatment plan, but many RA patients are reluctant to adopt an exercise program. "People with rheumatoid arthritis may be afraid of doing the wrong thing or aggravating their condition," says Dr. Rosian. "Some people are not used to exercising or donít understand the benefits."

Yet, if you suffer from RA, exercise is especially important, since youíre at greater risk for heart disease than the general population. A recent study tracked people with early-stage RA who participated in a bi-weekly program that included 20 minutes of strength training with weights, 20 minutes of bicycle riding, and 20 minutes of sports, such as golf. Results showed that participants who had no large-joint damage experienced significantly improved aerobic fitness without harm to their joints.

Choose a low-impact activity, such as walking, water exercise, or exercising on a stationary bicycle. If you prefer a class, try to find one with adaptations for arthritis patients or with seated exercises.

Consult a pro

Itís a good idea to meet with a physical therapist or personal trainer who can customize your program, provide modifications and joint-protection techniques, and explain the types of exercise, and how much of it, you can safely do. Youíll learn the proper way to hold weights, grip the handles of an exercise machine, or use elastic resistance bands to protect your hand or wrist joints while working your upper arms.

"If you enjoy sports, you can make modifications, such as using a lighter ball for bowling or thickening the grips on your golf clubs. You can also use knee braces or wrist or ankle splints to provide support," says Dr. Rosian. "With proper training and some modifications, you can continue to enjoy your favorite sport, even though it might mean riding a golf cart and playing nine holes instead of 18."

Take it easy

Although you can keep active when your disease is under control, you should rest when it flares up. "If you aggravate joints that are hot, red, inflamed or swollen, you may prolong the flare," says Dr. Rosian. "Easy range-of-motion exercises are the best at that time." Donít over-tire yourself during a flare. Avoid unnecessary walking or other activities that stress the joints. When your joints feel better, increase your activity.

If your disease is advanced, avoid excessive activity, which can aggravate the inflammation in a deformed joint. Be especially cautious about putting pressure on a joint. Instead, focus on moving joints without stressing them.

Stay active

Physical activity includes much more than exercise. Yard workócutting grass, gardening, plantingóis a good form of exercise. To keep small joints flexible, many people find needlepoint, knitting, crocheting, and other crafts helpful.

"Donít be competitive with yourself or with others," says Dr. Rosian. "You may not be able to do everything. With rheumatoid arthritis, you need to listen to your body."