Exercise and RA #RAblog

I have always been an exerciser. Gym junkie.  Runner.  Karate-geek.  There has always been exercise in my life.  When I was younger it was all about trying to tame my large build and change my body into something more socially acceptable. Something it couldn’t be.  It wasn’t healthy.  It was obsessive.

Somewhere in my twenties it became more about health, and feeling good, although body image still loomed large.

In my thirties I was 20 kilograms overweight because of Hashimoto’s thyroiditis and PCOS but I was fitter than I’d ever been. I ran 5km most days, because I enjoyed it and I enjoyed being cardio fit.  I lifted weights because I wanted to be strong.  I liked that I could lift my young kids with no problems.  I liked that I could keep up with them and play soccer with them.  And I’d made peace with the fact that I can’t change my large build and excess body fat.  I just enjoyed exercise for the way it made me feel.  It staved off the bouts of depression that came with hypothyroidism and the hormonal imbalances that polycystic ovarian syndrome caused.  Exercise kept me strong. It made me feel good.

I did have these recurring episodes of pain though.  Strange injuries.  Weird, because I’d often injure both knees at once.  Or both ankles at once. Or both wrists.  I could never remember how, but figured it happened while running. Or lifting.  It always went away though, so I just took some anti-inflammatories and didn’t worry about it.  When I did ask my doctor, she just said it was because of my hypothyroidism.

Then one day the joint pain was so bad I couldn’t walk. I couldn’t move.  I couldn’t comprehend it at all. I couldn’t get up.  I crawled.

Something was wrong.  Very wrong.

I didn’t get back up for about five months. Until a doctor finally gave me prednisone.

To cut a very long story short, it was, of course, Rheumatoid Arthritis.  Not injuries.

For two years I thought I would never exercise again.  I couldn’t. It hurt too much.  None of the medications helped me much. And I was always in pain, right from the beginning.  Some days were milder. Some days were unbearable.

Then one day some guy knocked on our door and asked us if we were interested in Karate.  I said ‘no’ right away. But my husband really wanted to try it. He’d always wanted to do a martial art.  He’d done Tae Kwon Do when he was a teenager, and loved it back then. He had always wanted to get back into it.

Our marriage had become rocky since I became ill, so I thought maybe it would give us something to do together again.

Martial arts are also highly recommended for kids with an Autism Spectrum Disorder (ASD).

I signed the whole family up.

And I hated it.

For the first two months, I went twice a week to these classes. I felt like I’d joined some weird cult.  The Japanese, the bowing, the ritual.   So. Not. Me.

But I was exercising again.  The moves were simple – it was a family based, non-contact style.  And I was doing it for my family.  It was self-paced to a degree, and low impact exercise. And then I slowly realised that, once I got moving, my joint pain improved.  The truth was, that fifteen minutes into a class I was as close to pain free as I ever got.

The synovial fluid that lines the joints becomes thickened and inflamed in Rheumatoid Arthritis.  Exercise causes the synovial fluid to become more viscous, which lubricates the joint and reduces inflammation and pain.

In short, exercise is good for joints. Exercise reduces pain, no matter how counter-intuitive that sounds, as long as you do the right kind of exercise.  And you have to persevere through the inevitable muscle soreness when you begin.

And then somewhere along the line I started to love karate.  I met people, got involved in the social life, and it did give my husband and I something in common again.  For a while.

It also encouraged me to get back into other forms of exercise. I set up the home gym again. Started doing weights again. And I even started running again, although I wasn’t able to run often. Only when did prednisone bursts.  I got some of ‘me’ back.

As my disease progressed, and I progressed through the karate belts, the standard expected of me was higher, and I could no longer perform at a level I was happy with.  Gammy joints and pain meant I couldn’t execute the moves the way they should be executed.  I couldn’t earn the belts honestly.  Yes, they would have allowed me to progress, taking my medical issues into account, but that wasn’t the way I wanted to earn my belts.  So my karate journey ended, but on my terms.  I left with a brown belt and a lot of good memories.

I joined a gym and started doing yoga based classes.  I learned that you can exercise and work up a sweat by standing still. No joint movement required.  I built muscle and flexibility and strengthened my tendons, ligaments and joints.

It hurt.  It always hurts.  But it was doing my body good.  Exercise is short term pain for long term gain.  This is true for everyone, but even more so for people with inflammatory arthritis.

As I got stronger, I started doing classes with light weights as well, and spin classes.  Zero impact cardiovascular training.

One of the biggest risks people with RA face is heart disease.  Cardiovascular training reduces that risk markedly.

There are days when I can’t exercise at all. There are days when I am too sick from the medication side effects to exercise.  I quickly notice that when I can’t exercise, my mood drops.  Depression is another comorbidity of rheumatoid arthritis that exercise can improve.

I have made friends at the gym.  Some truly great people.  Some weeks the only social contact I have is making small talk for a few minutes at gym.  I fight just as hard to keep those moments, as I do for the physical aspects.

I know I’m lucky. I have always enjoyed exercise.  If you hated exercise when you were well, it’s only going to be harder with RA.  But appropriate exercise is the single most important thing you can do for your health, aside from taking your medications as directed.

If you’re going to start, start slow.  Talk to your doctors.  If you’re not experienced, find a good trainer or exercise physiologist to help you get started.  Understand that it will hurt more before it hurts less. Understand that it will take time to feel the full benefits.

We all accept that DMARDs take time to work.  Exercise is the same.  We accept that DMARDs will cause side effects.  So will exercise – your muscles will hurt more to begin with.  And hey, you’re in pain already, who needs more?  But its temporary pain.  That ultimately will do your health the world of good.

It’s just about finding a form of exercise that you can enjoy.  There’s a whole lot of options.  And who knows, you might find something that you love too.