As a frequently crippling chronic disease affecting roughly 1% of the population, Rheumatoid Arthritis (RA) has long been associated with reduced mobility due to the significant pain that sufferers can feel in their swollen, painful joints. None of us wants to move when it is painful to do so and for those with Rheumatoid Arthritis, the situation is no different. Unfortunately, because the pain of RA generally does not go away, or goes away only for short time periods, those with the condition who do not fight the pain to be active are often left vulnerable to the health problems that arise from a sedentary lifestyle. These risks are in addition to the risks of the disease itself.
Sedentary living has been associated, for more than 20 years, with increased rates of heart disease, cancer, back problems, and respiratory problems to name only a few issues. In fact, the effects of sedentary living are reported by the World Health Organization (WHO) as being the number one cause of preventable deaths worldwide. As a result, it is very important to consider the effects that a lack of activity can have on the overall health of the those with Rheumatoid Arthritis.
What's more, for those with the condition, additional problems can arise due to lack of physical activity. One common problem for Rheumatoid Arthritis sufferers is a loss of cell mass and in particular, loss of muscle mass. Here the disease and physical inactivity work together to cause muscle wasting that reduces the strength and ability to function for people with the disease. A second major problem is an increased risk of heart disease and stroke in those with RA that is caused by ongoing inflammation and damage to blood vessels. Here again, sedentary living is dangerous because the lack of exercise means that the heart and circulatory system are not kept strong in order to reduce the risks just mentioned.
Now some people might be quick to blame those with RA for not taking the initiative to become active despite their pain. However, in many cases the rheumatologists have been partially to blame for encouraging a more sedentary lifestyle. In a study completed by the University of Florida, researchers found that almost 70% of the time, rheumatologists underestimated the ability of their patients to work and exercise when compared to what patients indicated they themselves were able to do. The result of this is that patients have received less encouragement to be active or in some cased have been discouraged from physical activity when it could be helpful.
And, active living is beneficial for those with RA. In a study from 2007 published in the Oxford Journal of Rheumatology, researchers found that exercise ranging anywhere from low to high intensity was associated with improvements in disease symptoms and with general ability to function day-to-day.
In another article published in the American College of Rheumatology, researchers indicated that patients aged 40 to 70 who exercised 30 to 60 minutes 3 times per week had decreased feelings of pain and fatigue. In a similar study completed at the University of Georgia, researchers determined more specifically that patients who were involved in only low intensity aerobic exercise were able to reduce levels of fatigue by 65% and increase energy levels by 20%. Lastly, in a study from the Netherlands, researchers found that those who took part in a two year program of high intensity exercise were able to both maintain muscle strength and prevent an increase in disease activity.
These findings are significant because they offer those with the RA some ability to control symptoms and slow progression of the disease.
So given that exercise is good for those with RA and in some ways even more important than for those without the condition, you might ask for which exercises to do to best maintain your health. From a number of studies, some of the exercises performed were:
strength training with weights
walking
jogging
bicycle riding at 70-90% of maximum heart rate
a number of low impact sports like badminton, soccer, etc.
In addition to these exercises, some research has been performed on other activities that Rheumatoid Arthritis sufferers might specifically try.
Swimming - research from Sahlgrenska University Hospital found that those with RA exercising in a pool twice per week over 12 weeks were able to significantly improve the endurance of their extremities. They were also able to improve the gripping force of their hands.
Gripping Exercises - published in the Journal of Rehabilitation Medicine, researchers found that people with RA who performed hand gripping exercises regularly for 6 weeks were able to significantly increase their hand strength and the use of their hands.
Tai Chi - although this martial art of slow controlled movement has been found to benefit those with osteoarthritis, several research articles, including one published in the British Journal of Sports Medicine, have found that Tai Chi offers no such benefit in terms of muscle strength or joint flexibility
The preceding list represents a number of possible options for adding exercise to the lives of those with RA. Whatever exercise you take up, it is important to talk to your rheumatologist about what exercises you can safely do before starting. For many with the condition, the first movements of the morning are the most difficult as the joints can swell and stiffen considerably overnight so consider warming up slowly or exercising later in the day to reduce the discomfort and pain of putting yourself in motion.
Are you someone with RA who is thinking about exercise or is active regularly? Consider sharing your thoughts or successes with others in the Rheumatoid Arthritis Forum.
Swimming is a great exercise for anyone living with joint pain. The wonderful floatation that water gives is ideal for easing the weight off the joints. It's relaxing, cool and soothing. My favourite exercise!
member1 - November 14th, 2009 at 11:23
My personal favorite, of course, is biking, despite the pain I now have in my feet. Nothing like getting the blood pumping on the road. The pain just slows me down...
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