Rheumatoid Arthritis and exercise – how to get started

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spin class

Many people just don’t enjoy exercise.  Here’s the thing…no one enjoys exercise to start with.  Working out at an intensity that will change the shape of your body is hard.  Your muscles burn. Your lungs burn.  The next day your muscles ache. The day after its even worse!  But working out doesn’t have to be at that intensity to do you good, to improve your health.  A light workout will still give you huge benefits, and is far better than no workout at all.

If you have arthritis, your joints might hurt more in the beginning.  Your joints should, however, feel much better while you are working out.  It is the hallmark of inflammatory arthritis that pain and inflammation improve with exercise.  Rheumatologists even use it as a criteria to differentiate osteoarthritis from inflammatory arthritis. They will ask if your pain improves with rest (osteoarthritis) or with movement (inflammatory arthritis).

For me, that’s a huge incentive.  I feel the closest to pain free in the middle of a workout. Once I’m warm and moving, it’s the best I ever feel. 

And still, I find it hard to get motivated.

If you’ve never exercised, or haven’t exercised in years, the idea can be overwhelming.  Too big.  Too hard. So you procrastinate, find excuses and reasons why you can’t, and you just don’t start.

So let’s break it down.  How do you overcome those reasons and get started with exercise?

Medical clearance

First, get medical clearance. Talk with your doctor.  If you have severe joint pain and inflammation, or need help getting started with exercise, he or she can refer you to an exercise physiologist.  They will devise a program to start you slowly and safely and build strength and endurance.

Choose an exercise

Next, decide what you want to do. Something that you don’t hate.  People are always telling me I should swim. Swimming is great exercise for people with arthritis, sure. But I HATE swimming. Still people insist that I’ll learn to love it. I won’t, I promise you. And I get tired of people ramming it down my throat, lecturing and then giving me the holier than thou “well, if you won’t help yourself…” routine to actually bully me into swimming. 

I will not swim.  You know why?  I have extremely dense bones.  Seven standard deviations above the norm.  It is a rare bone disease, my immunologist just isn’t sure which one.  He’s working on it.  My bone density is literally a one in six million result.  I am that rare.  But what it means in the real world is that I sink like a stone.  Swimming is very, very hard for me. I have to work seven times harder than the average person just to stay afloat.  It’s exhausting and I always feel like I’m going to drown. It is NOT fun. It will NEVER be fun. 

Therefore, I don’t swim.  

Point is, choose something you don’t hate, something that sounds like you could do regularly, and may even enjoy a bit.  For me, that’s group exercise classes.  I like to go to gym and switch off. I want to turn up, be told what to do, and not have to think.  I want to have control of the intensity of my workout.  And I know how to adapt exercises and take joint safe options.  That’s me.  Find something that works for you.

Generally speaking, low impact exercise is best.  Although studies have shown that even running doesn’t cause joint damage and is completely safe for people with arthritis.  Still, logic says that avoiding impact is going to feel better and be safer. 

Lots of people like walking. Walking is just as painful as running for me.  Yoga and/or pilates are great.  Yes, I know…we’ve all been told to try yoga and it will cure us of all our ills. It won’t.  But it will help.  It will increase strength, flexibility, mobility and fitness.  All good things.

If walking is too painful, hydrotherapy or warm water exercise is a great place to start.  Your doctor will know if there’s a hydrotherapy pool near you, or google.  As you improve and get stronger, you can do water aerobics and group fitness classes in water.  Very low impact but still a great workout as the water provides resistance, while supporting your body and joints.

Spin classes, or indoor cycling are low impact and great for people of all fitness levels.  You are in complete control of the intensity of your workout.  They do, however, cost a fair bit of money.  You usually need to join a gym to access the classes, and that can be very expensive.  Some gyms will give you a discount if you explain you’re disabled.  My last gym gave me the student rate.  They may not, but its always worth an ask.

Ultimately, you’ll want to do some range of motion exercises to improve your mobility. You’ll want some resistance training to improve your strength. And you’ll want cardiovascular exercise, something that makes you huff and puff, to improve your cardiovascular fitness and heart health.  I get all of those things out of one group exercise class.  Perfect…for me.

Start slow

Obviously, you need to start slow.  Work out gently in the beginning, listen to your body and don’t push too hard too soon.  Take note of how your body recovers after the workout, and how you feel the next day. If you’re sore, that’s fine. It’s a good thing.  It means you worked hard.  If you’re super sore, and can’t lower yourself onto the toilet without whimpering, you pushed too hard.  You didn’t do any permanent damage, the soreness will go away.  Take it a little easier next time.  But keep going!  Lots of people quit after the first workout because they’re sore the next day. Adding muscle pain to joint pain can make the whole things seem not worth it.  But you have to persevere. Everyone is sore at first when they start a new exercise program. Everyone.  One hundred percent healthy people get sore in the beginning. It will go away soon, you’ll adapt and you’ll get stronger.  Just keep going.

Staying motivated

If you can find an exercise buddy, that’s brilliant.  Having a friend to work out with keeps you motivated.  Once you’ve arranged to meet at gym, or for a walk, or at the yoga studio, you have to go.  You can’t bail.  It keeps you honest.

I like to have goals.  Small ones and bigger ones. Long term ones, mid-term ones and short-term ones.  This week my short-term goal is to do three workouts this week.  I did my first one yesterday, I’m booked for another one today.   I like lists and ticking things off.  I find it motivating and satisfying.  That doesn’t work for everyone.  My friend feels pressured and rebels against her own to-do list, which I find hysterical.  Do what works for you.

Show up

Next, just do it.  Nike is right. You just have to turn up, work hard, and go home. Simple, right? 

Yes, simple, but always easy.  There will be things that get in the way of that simplicity. Figure out what those things are. Your personal barriers to exercise.

Mine are pretty simple, you’ll find them at the link above.  It’s a pretty long list, but all of them can be overcome. Figure out what your barriers are and find work arounds.  And just start.  Go today.  And tomorrow. And the next day.  Rinse and repeat.  In time, it’ll become second nature.  Like eating breakfast, or having a shower, you might even look forward to your workouts.  Or maybe they’ll always be hard work.  But you will love the way being fit makes you feel.

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