Rheumatoid Arthritis and exercise – barriers to exercise

spin class

Everyone has genuine barriers to exercise, especially those of us with health issues.  People who say “You can find a way if you want to badly enough” don’t have chronic pain, I’m sure.  However, there are often ways around the challenges, you just have to be a bit creative sometimes.  Some barriers are more like excuses, but some are very real.  Mine are as follows:

Rheumatoid arthritis

Health issues. I have Rheumatoid Arthritis, my joints are painful and often inflamed.  I know that there will be some days where I genuinely can’t, and should not, exercise.  It’s important to be realistic. Therefore, I don’t set myself a goal of exercising at a high intensity every day. That just isn’t going to happen, and that’s setting myself up to fail.  

Realistic is four or five times per week, at a pace depending on how my body is feeling that day.  That’s more than enough to make a difference to my health and fitness, and maybe even change my body shape.

Exercise anaphylaxis

I also have had two episodes of exercise anaphylaxis. Yep, that’s a thing.  I had no idea you could be allergic to exercise, but you can. Life threateningly so. Two of my doctors had never heard of it, but one had. My immunologist.  It seems to only occur if I eat wheat within an hour or two of my workout. So I don’t do that. I also have to carry an epipen at all times, and especially to gym.  I am not supposed to work out alone, in case I have an anaphylactic reaction.  That’s another reason why group fitness classes are best for me.  There are always other people around. Should I have an allergic reaction, there will be people there to give me my epipen injection and send me off to hospital.

Cholinergic urticaria

I also have cholinergic urticaria.  Its basically an allergic reaction to heat. I get hives when my body temperature gets too high, and I sweat.  When I exercise, I obviously get hot and sweaty.  And so I get hives.  It looks pretty impressive sometimes, but it’s not usually dangerous.  It’s just very uncomfortable. Itchy. Sore.  It generally goes away within an hour or two.  Bad attacks can cause abdominal pain, or even fainting, so its something I try hard to avoid.  I take four times the daily recommended dose of antihistamines, as prescribed by my immunologist, and that seems to keep it at bay for the most part.  I haven’t had an attack in a while, but I always have to be aware.  And never skip my antihistamines! 

Spinal nerve compression

Most disabling though, is my left side paralysis.  I have ongoing left sided weakness, which happened after my hysterectomy.  It has improved with time and physiotherapy, but my left side is still significantly weaker than my right.

Far worse than that though, is the nerve compression in my lumbar spine.  My sciatic nerve is compressed at S1, to the extent that I have numbness down the outside of my left leg, pain on the outside of my foot, and complete paralysis of my calf muscle. I physically cannot run, I can’t push off with my left leg at all.  I can’t raise my bodyweight with my left calf muscle, I have profound weakness that could only be resolved with decompression surgery.  That’s not going to happen, because I can’t have surgery due to medical PTSD.  Which means I have to work around it.  There’s a lot I can do, however.  Plenty of exercises are possible, and I can compensate with my right side.

My lumbar spine is all degenerated. I have disk fragments floating around and sometimes different nerves are compressed.  The pain in my spine is like a knife permanently lodged in my spine, and sometimes someone twists it.  It’s excruciating.  Thing is, its excruciating if I sit still, so I may as well move.  I do have to be very careful HOW I move though.  Proper technique, and not too much load.  If my right leg becomes partially paralysed as well, I’ll require a wheelchair permanently instead of only sometimes. That’s not something I want. 


Then there are the financial barriers. I need to work out with others because of my allergies.  Therefore, I need to join a gym.  It is expensive, especially when you’re living on disability.  However, I honestly do look at it as an investment in my health and future.  I really can’t afford NOT to exercise.  I choose to miss out on other things rather than miss out on a gym membership.  I don’t go out for coffees, or eat out at all.  I don’t buy magazines, I don’t have massages or manicures. I don’t even have haircuts.  All of these things are less important to me than my health, so I skip those and choose gym.


And of course there’s time.  Time is precious. I never have enough of it.  I am a disabled, single mother.  There is always too much to do, and not enough time. 

But…I need some time for myself.  This is an investment in my health.  As I get stronger, I may find I have more functional hours in a day.  It might actually buy me time, in the medium term.  Either way, I just have to find the time. Its just that important.  If it means the dishes don’t get done and the floors aren’t mopped, well, so be it.

So that’s it. 

Your list of barriers will look different, but you get the gist.  All my problems have solutions, or at least workarounds. There will be days where I can’t exercise, but most of the time I can.  The final barrier is just plain motivation. Some days I don’t want to. I know it will hurt.  It will take time, and time is precious.  It will take energy that I don’t feel I have, even though I know that exercise improves the fatigue of rheumatoid arthritis.  Still some days I’ll make excuses and want to skip class.  Those days it’s just down to sheer willpower.  Determination. Commitment.  Forcing myself to go, even when I don’t feel like it.  Eventually it will be a habit.  I know from past experience that eventually going to gym will feel so normal that I’ll feel strange when I don’t go.  I’ll regret not going.  It will just take time to build that habit again.

In the meantime, I’ll go. Every day that I don’t want to go, I remind myself why I started back to  gym.  Strength, fitness, mobility, flexibility…those are just words. What they mean is a more functional life.  Being stronger, having more stamina, less fatigue.  I’m buying time for myself.  Time every day, feeling healthier, and time added on to the end of my life.  Those are my motivating factors.  I remind myself often.

Your barriers will be different. Maybe some are the same, maybe you have a few more or a few less.   Either way, many can be overcome.  An adapted workout, or a shorter workout is far better than no workout at all.


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