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Rheumatoid Arthritis

Exercise for rheumatoid arthritis

It is important to balance rest and activity. Rest is important for inflamed joints, but too much rest will make them stiff. Exercise can protect the joints by keeping the muscles strong, and it can also maintain a healthy weight or reduce excess weight. (See 'Ongoing symptoms - pain, fatigue, depression and weight change'). Exercise will not make arthritis worse as long as it is the right type of exercise (see 'Physiotherapy and hydrotherapy').

 

Finds that swimming helps control her weight.

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Finds that swimming helps control her weight.

Age at interview: 37
Sex: Female
Age at diagnosis: 19
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I do, one thing I did want to mention as well is I do have a problem with my weight with the steroids  I think it whether it slows the metabolism down or just makes you more prone to put on weight, but I've never let it get out of control and I find that if I keep up the swimming exercise it's a lot easier to control then, because as I've slowed down towards each operation I've put weight on, and after every operation I've got rid of it again, so but it does take a while, it maybe takes up to a year or so after the operation before I can get it back down to like what's an acceptable level for me.

And I am very conscious of the fact that the heavier I am the more wear I'll put on these on these artificial joints, so I do try and keep my weight down for that reason as well. But it is a lot easier to control when you're doing exercise definitely. 

Because prior to my knee replacements I was swimming regularly for probably 3 years more or less as I'd left work and I had the time to do it and you know I didn't sort of let it lapse or anything and it did keep my weight down. And as soon as I had to stop with my knees the weight started to creep on again. 

So I probably don't change my eating habits that much, but it's the exercise that makes the difference, so I would stress to anybody that if they can, you know if they can fit in some exercise that doesn't hurt too much and mainly it is swimming then you know the benefits are very good, definitely.

Most people we interviewed recognised the importance of regular exercise. One woman explained that it was a balance of keeping active and managing 'flare ups'. A 42-year-old man tried to keep mobile in the office and did a bit of gardening in the summer. Many people mentioned walking in moderation as a good way to stay fit; one man took brisk walks with his dog twice a day.

 

He tries to keep mobile by moving around the office and by gardening.

He tries to keep mobile by moving around the office and by gardening.

Age at interview: 42
Sex: Male
Age at diagnosis: 17
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I certainly know the benefits of doing the exercises. I wouldn't say that I'm motivated to do them at all but I know the benefits of keeping everything mobile and you know, I, I do tend to, to do that specifically like at work  you know, get up and go down the office to do a bit of photocopying and rather than perhaps do it all in one go or saving it up and doing it in one go. Then I'll, I'll make sure that I get up and go down a few times.

Just keep myself moving and I do find that does tend to be a lot better, to keep that mobility there. And certainly I like to try and move around in the summer and potter around do a bit of gardening and things like that. And I find that the more you can move, move around, the better, again, that, that helps with you sort of thing. It does makes you a lot more mobile and the joints aren't as stiff and awkward as they can be at times. 

One woman said that exercise helped to take away the pain. At first she hadn't realised that exercises were so important and she regretted that as the result of inactivity she had lost some movement in one arm. She had done a course of Tai Chi for people with arthritis and recommended it.

 

She wishes that she had done more exercises because she has lost some movement in her shoulder.

She wishes that she had done more exercises because she has lost some movement in her shoulder.

Age at interview: 21
Sex: Female
Age at diagnosis: 12
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And so when I'm on the drug it's, it's not about taking away the pain but it gives you energy and when it gives you energy you have energy to exercise. And exercise will take away the pain, it'll make you stronger, make your muscles stronger. 

But also, I would also advise to, to do what they ask you to. You know, do, do your exercises and I know it's laborious and you have to fit it into your day but it's, it's really, really worthwhile because without exercise then I may have lost a lot more of my joints. And I think it's quite important, even if it hurts.

Like I say, you have to try and fight through the pain and sometimes you have to know when to do that and when not to. If it's a tired pain, then you're not going to work through that but if it's a pain from maybe after an operation and it's hurting and it's feeling stiff, you just have to go through it and exercise it as much as you can within reason not, not so you're damaging it. And just keep working through it because it will get better and you'll see the benefits of it. 

I wish I had known that my exercises were so, so, so important because I didn't exercise my left arm properly and now I can't tie my hair back and I can't wash my face with it. And a lot of things that I would be able to do if I had of, have kept on with it. Because I don't really remember anybody saying to me, 'You'll lose the movement in your shoulder if you don't exercise it.' Because you don't really want to scare people in saying that kind of thing. But I think sometimes they need to be told.

 

Talks about the benifits of Tai Chi.

Talks about the benifits of Tai Chi.

Age at interview: 21
Sex: Female
Age at diagnosis: 12
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I did a course Tai Chi for arthritis in London. I went to Swiss Cottage which is quite a nice area and I did Tai Chi there with a German lady and she, I think she lives over here now, but she's from Germany and she's, she was great. She was really lovely and she doesn't have arthritis herself. But she did a course taught by a man, I think he's from America, Dr Lamb, and he came up with the idea of Tai Chi for arthritis because Tai Chi's good for everybody. 

But for arthritis it's difficult to do everything that everybody does because there is a lot arm raising. But the way you do it is if you can't do something in your body, you do it in your mind and I've always said that's, to be honest that's how I seen myself. In my mind, my wrists do bend and they do move and they do look like other people's.

But in actuality they don't, and the Tai Chi was, was really great for that because it, it really does show you that we are all the same inside and I think it's easy to forget about that because we do become preoccupied with our physical selves, our self image and our body and, like I said, the material things about ourselves and you do forget that inside, we're all the same really.

And it's, it's nice because you focus on that and it's a lot of energy and it's all to do with a, your Chi and positive energy and your negative energy and the way it flows through you and giving off energy. And that was really good and I'd recommend that to to anybody, not just with arthritis but to anybody because it really does I never quite got to the stage where I felt that energy rush but I feel that I was getting there, I was starting to feel something. 

Some people could do yoga, but others found it too painful (also see 'Complementary therapies'). Other classes people found helpful included Pilates and water aerobics.

Many people found swimming beneficial and recommended regular sessions. Some also enjoyed spending time in a jacuzzi. One woman swam five days a week. She made new friends and said she felt much better physically and mentally as the result of her activity.

 

Swimming has helped her physically and she enjoys the social side too.

Swimming has helped her physically and she enjoys the social side too.

Age at interview: 53
Sex: Female
Age at diagnosis: 49
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But, and then I think it was about two years ago now I started swimming and that has just been fantastic. Because that is something I can do and I do it five days a week, every morning. I started off it, doing, it was this time of year, October, I got into the pool and I could do 35 lengths and I thought by Christmas I want to swim a mile and at Christmas I did. I was doing my 64 lengths in the hour.

And now there's a new pool opened, and the same group of people go, and we all sort of, I mean they're not all sufferers, some just go because they enjoy going but  we all sort of support each other, if you like, and I haven't been for two days this week so I'm already in trouble. 

But I can swim now for about an, well I could swim for 2 hours if I wanted to but I don't because I have other things to do, but I, I have found that that has helped and my consultant, you know, just sees me, says, 'ah my swimmer'. You know, he's, he's really impressed that  of the you know, the way I've sort of dealt with it. I didn't think, 'Ah, my life has ended, I'm never going to be able to do anything'. I just thought 'Well OK, this is what it is and  I'm not going to let it beat me, you know. So I don't, I try to do everything as I did before, but in moderation and that seems to have worked quite well so far. I do still have bad days and sometimes the medicine upsets me . 

But I would say in general I feel better now than I did, you know, sort of 4 or 5 years ago. So  and I think that it's really. That's sort of, you know, I mean when I tell people I've got RA, they, I mean it doesn't really come up in conversation, but if, if it does, and I say, they say 'I can't believe it, you know, you don't look as if you're suffering'. But I do, you know, I can't walk as far as I used to be able to .

But I do think that swimming has  has helped and I know that if I don't go, I miss, I miss not only the sort of social side,  but the fact that I've had an hour or an hour and half's exercise, that's  you know done me sort of good overall, not just my, my joints. 'Cos swimming keeps the muscles strong and of course the muscles support the joints, so it has to be good.

Another woman also found that swimming helped her psychologically as well as physically. She preferred swimming in a specially heated pool, so that she could stand still and work on particular joints. She also preferred swimming with a small group of other people, so that she had plenty of space. One woman who swam emphasised the need to strike a balance between keeping fit and making her symptoms worse.

 

Swimming helps her physically and psychologically and she enjoys special sessions in a hydro pool...

Swimming helps her physically and psychologically and she enjoys special sessions in a hydro pool...

Age at interview: 53
Sex: Female
Age at diagnosis: 30
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So you continue to do physio exercises when you are at home?

I try, but if I did all the exercises every day I wouldn't do anything else, because my disease is in every joint in my body. And  there aren't enough hours in the day to do all the exercises. And with the best will in the world, this level of ongoing grinding pain de-motivates you, it's depressing, you don't feel like getting up and doing your exercises. 

This is why the, the, the focus of having a session in a hydro pool means that two or three times a week I know that I'm going to be exercising all of my muscles, And it's also pleasurable. So it helps psychologically as well as physically. And I think that also having a relationship with a particular physiotherapist, it, it would be much more encouraging than seeing the clinic once every six months and then being sent away to get on with it. 

I mean we can still do the swimming but I have to go to a sheltered disabled session, I can't go to a normal swimming session because people in a normal general swimming session don't give each other space I need to go to a sheltered session where people give each other plenty of room where I know I'm not going to have somebody heading straight for me or jumping in right next to me. 

 

Some form of swimming is good but moderation and pacing are key.

Some form of swimming is good but moderation and pacing are key.

Age at interview: 63
Sex: Female
Age at diagnosis: 36
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I will swim again and the warmth of the water resembles a hydrotherapy pool. So if you do your gentle warm-up in the, just stretching your joints and your muscles and then I could, I would swim twenty lengths or so, if I was feeling good. But not in a competitive way, a relaxed stroke, plenty of rests and  then just some gentle stretching at the edge before I got out and it's brilliant. I think it's, whether you like swimming or not, I think, I used to take a friend of mine who also had rheumatoid, who couldn't swim and she walked under the water for maybe 6 or 7 lengths, just doing a breast stroke movement with her arms.

She couldn't get her feet off the ground but it was wonderful exercise for her in the water. And so I feel there's some, a bit of swimming for everybody really, as though whether you like it or 'unfortunately a lot of people find it very boring to swim. But if it's a means to an end, to put your joints through a good range of movement, I think it's an excellent thing to do in an lov, if you've got a good warm pool. I'm a great believer in, in that.

And having done a swimming session would you then sort of feel any effects of it, in terms of tiredness or feeling better or'?

No. I'd feel good that I'd managed to do it because of my personality. I'd think, well, 'I've done that, I've achieved that'. I wanted to be like everybody else. If the next day I felt stiff, then I thought 'well I'd overdone it' 'cos I always counted the number of lengths that I did so that I was in control. It's like when I walk, I try and walk for a period of time, you know, at a sort of pace where you get your heart rate up a bit, otherwise if, if you feel stiff the next day, you think, 'well how long did I, how many lengths did I do'. 

So I think if you're gonna get a therapeutic benefit out of it, you need to be quite careful with your exercise, 'cos if you over do it, there's no point, if you're just causing another inflammation I mean the trick with rheumatoid is to try and get the amount of exercise just right for your joints so that you keep the range of movement that you've got but you don't go into the over exercise bit where you cause an inflammation. But you know in, you get to know your own body and it's a, you have to keep working at it all the time [laugh]. 

Many people who went to the swimming pool continued to use the exercises they had learnt in hydrotherapy sessions. Two women had negotiated with the owners of the local pool to raise the temperature on one day so groups of swimmers with disabilities could use it.

A few people, on the other hand, found swimming painful. One person had to stop doing it, and a 70 year old man found that over-arm or back stroke caused shoulder pain, although he could do gentle breast stroke. Sometimes he had pain after swimming and he wondered if the water was too cold. Someone else found that breast stroke hurt her knees.

One woman cycled to keep her young daughter company, but sometimes her knees hurt and she wondered if she was damaging her joints.

A 49 year old woman enjoyed exercising in a gym. She used equipment which was easy to set up and took care not to put too much strain on her joints. But some people were warned that they might be doing the wrong type of exercise. A 38 year old woman was advised to stop going to the gym because she had overdone the exercises, and was putting excess weight on her joints.

 

She enjoys exercising in a gym and uses a treadmill when she can't walk outside.

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She enjoys exercising in a gym and uses a treadmill when she can't walk outside.

Age at interview: 49
Sex: Female
Age at diagnosis: 36
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So I just said to them, the guy well in fact the first one was at this hotel and I said to this very young lad, you know, 'I want to do something  not just swimming now. But I don't know what I can use in the gym.' And he fair enough said to me, 'Well, actually, tomorrow Steve will be here and he's got, he's got a degree in Sports Science and he knows all about that.' So I said, 'Fine, I'll come and see him.' 'Cos I'd said, you know, 'I want, I didn't want things straining my joints'. 

So he, he went through all the equipment with me. Some of it, that, that gym was difficult. It was difficult to set up 'cos you have to move things and get, get the weights right for yourself and that was a problem. Some of the stuff was difficult to set up. The gym I go to now, it's all been designed to be very, very easy to set up, you know, so if I couldn't set up a bit of  equipment there's always people floating around not doing very much who would come and do it for me, really. So it is good. 

And  they got me on a treadmill as well. I've tried a few things. I'm not, I'm keen on the cycling I, I just don't like that but when I couldn't walk outside very much I was doing a bit on the treadmill anyway, 'cos it's fairly controlled what you're doing, you know. And if you get tired you can just stop. Whereas if you're out for a walk and you get tired, well you've still got to get home again, haven't you? Whereas there you just, you just stop. 

Cos often with these exercises that you do without equipment you're putting strain on other joints when you're doing, when you're exercising one joint. But these, this, all this equipment is, is, it is very good. 'Cos the, each, each piece of equipment's designed to exercise one muscle group only. So you're not putting any strain on any other part of your body  So it is, it is good.  And so long as you, you, I mean, I've got, 'cos I know a bit about it anyway, so between us we can work out stuff that I can do that's not going to put any strain on my joints. And then  after that I usually go, I, I always go in the pool, so that I don't get stiff afterwards, so, 'cos the pools are nice and warm. As well, so, yeah it can be done. But most people would be scared to do it really, I think they'd have to go to a gym or whatever.

 

She used to enjoy going to the gym but had to stop because her joints were suffering.

She used to enjoy going to the gym but had to stop because her joints were suffering.

Age at interview: 40
Sex: Female
Age at diagnosis: 2
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And I actually got the taste for, which is really stupid, I got a taste for going to the gym, you know to the normal gym and that's where I didn't do myself a lot of good, because I improved all my muscles and then because my legs and muscles were a lot stronger I started to walk about more and my hips packed up.

So I mean, I had been brought up as a child to, you know physio, physio, physio, physio, physio and I think you do become obsessed with physio and I still look at muscly arms and legs and think, I'm paranoid about them you know thinking, 'Oh God, I wish I was as muscly as that, because strong muscles make healthy bones', and that's what I was told, its like an inbuilt indoctrination of it. So I did go to the gym for nine months and God I did feel well and my muscles were dead strong and then I went a bit mad actually I went like one of these adrenalin junkies and that's when my hips started to, sort of not be very happy.

And what were you doing at the gym?

I was  doing sit ups, up the wall, I was up the wall on the. I used to go out with the lad in the gym and he got me into it really and I went along to the gym with him, I couldn't do much, I mean you know, but I was there with all these big muscly men doing little tiny sit ups and me you know, but I loved it and it did make me feel well, because my legs were stronger because my muscles were stronger and I felt really good and I did it for nine months and then I got stopped, told it was bad, very bad for me, which it was because I was putting excess weight on your joints that can't really stand it.  

Some participants were motivated to exercise at home and built stretching exercises into their daily routine. One woman found gentle stretching beneficial even whilst experiencing a flare up.

 

Her daily routine includes stretching and gentle exercises morning and evening.

Her daily routine includes stretching and gentle exercises morning and evening.

Age at interview: 74
Sex: Female
Age at diagnosis: 73
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So I must, I must make, I must make the effort and do it more often because it's important to get the exercise. I've got exercises to do at home as well, which I do  morning and evening normally yep.

So you feel quite motivated to do them do you?

I do normally, I've just had, I've just had a drippy cold and I did make an excuse with that not to do them, but normally, normally I'm quite good and they don't take very long and its well worth it.

And what sort of exercises are they?

Stretching, moving my feet up and down, its a pedal movement, leg raising that sort of thing yes. Nothing to arduous, it's quite pleasant, it doesn't hurt [laughs].

Another woman had an exercise bike, but was told that it was not suitable for someone with artificial knees, so she started swimming instead.

One woman enjoyed aerobic exercises but was told by her consultant that she should only do low impact aerobics and that if she found her joints were 'hot' an hour after the aerobics she should stop doing it altogether. She was told that Aquafit (exercises in water) would be better for her joints.

Several people reported a sense of achievement after completing some form of exercise and it generally made them feel better.

Last reviewed August 2016.

Last updated September 2010.

 

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