Exercise & Rheumatoid Arthritis

Cathy Cameron, Clinical Team Leader Physiotherapist, Rheumatology Unit at the Royal Hallamshire Hospital in Sheffield
Original article: 27/06/2006
Reviewed: 27/02/2009
Next review due: 27/02/2012

There is a lot of advice available about exercise. For people with RA exercise is an important factor in managing their condition and maintaining a healthy lifestyle. There are many places where you can find information on exercising. Arthritis Research UK (ARUK) have a variety of leaflets which include advice on exercising, pacing of activities, footwear etc.

There are some main factors to take into account before you exercise:

Everyone is different. What may work for one person may not suit you. If in doubt it is advisable to ask your GP or ask to be referred to a physiotherapist who will be able to guide you.

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.

How much do you normally exercise? With any activity it is always advisable to start at a low intensity and gradually build up the amount you do. After all you wouldn’t start training for a marathon by doing a 20 mile run! The same principle applies whether you are considering starting a walking programme or learning to play badminton.

Preparation is also 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.

If you are usually mobile and in otherwise good health then it may be that you will be able to cope with something more demanding such as a walking programme, aquaerobics, badminton.

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.

And finally ……

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. Don't forget that it may also be beneficial to use cold therapy to reduce pain and swelling in a flared joint. Once the flare subsides then you can gradually return to an increased level of exercise.

Useful links:

The evidence for the effectiveness and safety of intensive land-based exercise in patients with rheumatoid arthritis - Zuzana de Jong, Rheumatologist, Leiden Medical Centre, Netherlands

ARUK: Footwear and Arthritis

ARUK: Keep Moving Poster

ARUK: Looking after your joints