My medications seem to be kicking in and I am beginning to feel much better and so would really like some advice about exercise. I have been given a physio referral but unfortunately there is a long wait. Do you have any suggestions about what I can do?

Taken from NRAS magazine, Winter 2011

Your email reinforces some of the data we collected in our recent RA and phyiostherapy survey (you can find out the results of this survey here), showing that access to this service is very variable and in some areas there are long waiting times.  Exercise is certainly a very important factor in managing your RA and in maintaining a healthy lifestyle.

There is a lot of advice available about exercise and the NRAS website has several useful articles in its Living with RA /Lifestyle section which may be a good starting point and likewise the Arthritis Research UK (ARUK) have a variety of leaflets which include advice on exercising, pacing of activities, footwear and the ‘Keep Moving’ booklet which includes a pull-out poster of possible exercises.

The following suggestions about exercise are taken from the article on the NRAS website written by Cathy Cameron who is Clinical Team Leader Physiotherapist at the Hallamshire Hospital in Sheffield.

•    Low impact activities are best as this reduces the strain on your joints, ligaments and muscles. Swimming, walking and cycling come into this category. Contact sports are best avoided ie football, squash.
•    With any activity it is always advisable to start at a low intensity and gradually build up the amount you do.
•    Preparation is key. Make sure you warm up before starting your activity. Well fitting, shock absorbing footwear, suitable for the activity, may also be a factor.
•    Swimming is an excellent form of exercise as it causes very little strain on joints while allowing you to exercise to your full potential. It involves most muscles and joints and is a good all-round workout.
•    Don’t underestimate the importance of doing an activity you enjoy, as you are much more likely to continue doing it! Also exercising with someone else can make exercising more enjoyable and help with motivation.
•    If after starting a new activity you find that at first it seems to make you worse there are changes to your exercises that you can try. It is probably worth reducing how often you do the activity and to reduce the amount you do to see if this helps, then gradually build up the time or intensity.
•    If you are in a flare up it is best to focus on letting the joints settle down and doing range of movement exercises rather than other exercise activities.. Once the flare subsides then you can gradually return to an increased level of exercise.

If your means allow then you could consider a private physiotherapy appointment.  The Chartered Society for Physiotherapy has an area on their website which allows you to search for a suitably qualified physio.  It is important that you check that the therapist is chartered and if possible has an interest in rheumatology.