Rheumatoid Arthritis: Exercises to Avoid

Life can be difficult for someone with RA, for sure. The pain and stiffness you feel during flare-ups are only part of the difficulty. Trouble sleeping, stress, worry, fatigue, and isolation can add to the troubles one has to deal with. While it is true that certain exercises and movements can help improve the overall symptoms of RA, there are still a variety of activities that you should be cautious when doing or avoid altogether. Following a few simple guidelines (and your doctor’s recommendations) can help you to make the best choices for which exercises are best for you and which are not. Also, you should know when to take time to rest or recover from an injury.

12 Steps to Exercising with Arthritis

The following 12 steps are exercise and rheumatoid arthritis relief recommendations from Dr. Thomas K. Jamieson, the owner of the Jamieson Total Health Care Center in Lansing, Michigan:

1. Stretch. Always stretch and warm up thoroughly before any exercise. Warm muscles and joints are more flexible and less likely to become strained or pulled. Cool down properly after exercising.
2. Posture. Try to adopt the correct posture whenever resting or at play, and avoid slouching.
3. Weight. Strive to maintain your correct body weight. Obesity can create more stress and strain on weight-bearing joints (such as hips, knees, and ankles), which can contribute to or cause osteoarthritis by at least 50 percent.
4. Less Stress. Some of the least stressful exercises for your joints are to walk or jog on a trampoline or walk on a treadmill. Always use handrails for balance and support when needed and ask your RA specialist or physical therapist what your ideal speed and distance should be. When walking, always wear supportive shoes and comfortable clothing. Start with a short time or distance and gradually work up to longer increments. For example, 5 minutes of walking the first week, then add 5 minutes each week, eventually walking 20 - 30 minutes per day.
5. Water Exercises. Swimming or water exercise programs are ideal for strength training or range-of-motion needs. These exercises allow greater mobility for those suffering from acute and chronic symptoms of RA.
6. Keep Warm. In cold weather, be sure to keep your joints warm with proper clothing and accessories (such as knee socks or leg warmers).
7. Rest. Rest as needed. Your muscles are less capable of helping your joints when they are tired or injured.
8. Heat Relief. If you take a warm bath or apply a heating pad before exercising, this will improve your blood flow and help relax your muscles and joints. The proper application of heat can also provide relief from pain and swelling, which can make it easier to exercise.
9. Injury. Avoid exercising during acute inflammation or if you have injured your joints, unless your doctor or physical therapists suggests otherwise.
10. Weight-training. Weight-training exercises can build strength and improve both endurance and flexibility, while also improving structural support and muscle balance.
11. Supervision. Supervised workouts can help ensure motivation and proper technique, which may alleviate any concerns about exercising. If you check through the Arthritis Foundation or your local WMCA club, you may even be able to find some fitness programs that are designed specifically for individuals with RA.
12. Have Fun. Whatever you end up doing, find exercise activities and a routine that you thoroughly enjoy. If an activity is fun and you enjoy it, you will be much more likely to continue with it and will continue to build stronger bones, muscles, and ligaments.

When to Rest

People with RA have to take a few extra precautions when exercising to avoid getting any injuries. Aside from avoiding any high-impact, or dangerous activities, you should also know what the signs look like if you’re overdoing it and need to rest. The 5 signs are:

1. Sudden fatigue
2. Persistent fatigue
3. Pain that lasts longer than an hour
4. Decreased range of motion
5. Increased joint swelling

The Importance of Rest

While exercise is certainly an important factor for healthy living, rest plays a huge role for the patient who has RA. There are no exercises known that will ease the inflammation in your joints the way that rest will. Adequate rest will also play a huge role in combating the all-too-common fatigue that often plagues the RA sufferer. In addition, rest is also extremely important for you mental and emotional well-being, contributing to your overall optimal health.

To begin with, make sure that you are getting plenty of sleep at night. Where most adults need at least eight hours of sleep each night, adults with RA may need as many as ten hours. Unfortunately, sleep can be extremely difficult for people with the chronic pains, stress, and loneliness often associated with a serious disease, such as RA. If you find you are having more and more trouble either falling asleep, or staying asleep, then you may have insomnia and might benefit from talking to your physician. You may also find relief in adopting some meditation and relaxation techniques that you can learn about from books or online videos. If your insomnia is bad enough, your physician may suggest you see a sleep specialist or a mental health professional to help you get to the root of your sleeping problems.

During the day, if your job and duties allow it, you should try to nap or rest whenever you feel fatigued or stressed out. You may need to set a schedule to take a quick ten or thirty minute nap. Even if a short nap is not possible (such as if you are at work or with small children), then perhaps just a short rest period between activities will help to alleviate some of your inflammation. Regardless of which rest solutions you adopt, your overall goal with RA is to do what you can to limit your bouts of fatigue and to not become too overtired.

9 Exercises to Avoid with Arthritis

1. Running
2. Jogging
3. Roller skating
4. Ice skating
5. Jumping rope
6. Bicycling (except stationary)
7. High-impact aerobics
8. Horseback riding (except therapeutic activities)
9. Any activity in which you have both feet off the ground

Injury Care

In case of an injury:

Remember the “R.I.C.E.” acronym:

• R = REST. If you find yourself getting injured easily, it is a good sign that you may be overdoing things and may need to rest for a while.
• I = ICE. You can reduce swelling in an injured area by applying cloth-wrapped ice (don’t apply ice directly to skin).
• C = COMPRESSION. Wrap the injured muscle or bones with an ace bandage to prevent the swelling from spreading to other parts of the limb).
• E = ELEVATE. Raise the injured are in between ice applications to reduce the blood flow and slow any swelling.

Unless suggested by your RA specialist or physical therapist, heat should never be applied to an injury. Heat can cause additional swelling and increase your rehabilitation period.

If pain lasts more than two days and ice, compression, and rest have not helped reduce the pain, you should contact your doctor.

You should also contact your physician any time you feel numbness or tingling as this could be a sign of a serious injury.

Additional Resources

American College of Rheumatology: www.rheumatology.org

Arthritis Foundation: www.arthritis.org
National Institute of Arthritis and Musculoskeletal and Skin Diseases: www.niams.nih.gov