Get the new year off to a great start. If you have rheumatoid arthritis, gentle exercise can help your joints and muscles and benefit your heart, bones, and mood.
If you have rheumatoid arthritis (RA), low-impact exercise can help prevent stiff joints, build muscle, improve endurance, and benefit your heart, bones, and mood.
Of course, make sure to rest when your joints are inflamed. Listen to your body when deciding how much to exercise. Work with a healthcare provider to find the right exercise for you and discuss when you should rest instead.
What Is Rheumatoid Arthritis?
Rheumatoid arthritis is a disease that causes inflammation in certain parts of the body—specifically your hands, wrist, and knee joints. The tissue in the joint becomes damaged because your immune system attacks healthy cells by mistake. This can cause symptoms such as:1
- Fatigue
- Joint pain or aching
- Join stiffness
- Tenderness in the joints
- Weight loss
- Weakness
Getting physically active is one way to improve your quality of life with rheumatoid arthritis. Physical activity can reduce the risk of developing other diseases and it can help to improve symptoms of rheumatoid arthritis.12
How Much Physical Activity Should You Get?
The Centers for Disease Control and Prevention (CDC) recommends most adults get either 150 minutes of moderate-intensity aerobic activity or 75 minutes of vigorous-intensity aerobic activity every week. But, for people with RA, your exercise routine may look a little different. Ask a healthcare provider how much exercise they recommend for you.2
In addition, you should also work on muscle-strengthening, flexibility, and balance exercises as well—these are important to keeping your joints healthy.2
Low-impact aerobic activities like walking, cycling, or swimming, are best for those with rheumatoid arthritis.2 Here are some low-impact activities that can keep you physically active and help to improve rheumatoid arthritis symptoms.
Chair Stand
Who it’s good for: People who want to build leg muscles
Start by sitting in a normal-height chair. Stand up and then sit down again in a controlled motion, using your arms to assist you if needed. Try doing 10 to 15 reps.
If you want a harder version, try a lower-height chair. If the normal height chair is too difficult, use a higher-height chair.
“As your legs get strong, you can control that motion more with your legs and less with your arms,” said Lesley Hlad, DPT, PT, a physical therapist at Duke Cardiopulmonary Rehabilitation at Croasdaile.
Yoga
Who it’s good for: Almost everyone, even people with tender, swollen joints
Yoga packs a few great benefits for people with RA:3
- Builds muscle strength
- Improves balance
- Improves pain and stiffness
- Can ease stress and anxiety
A small study found that yoga may also be beneficial for improving physical function, disease activity, and grip strength.4
“Avoid power yoga, hot yoga, and flow (also known as Vinyasa yoga), which can increase internal heat and put excessive pressure on the joints,” said certified yoga specialist Robin Rothenberg, C-IAYT, of Essential Yoga Therapy in Fall City, Washington.
Walking
Who it’s good for: Almost everyone (unless walking is too painful
Walking is a great joint-friendly, bone-strengthening, and aerobic activity. It also has a low risk of injury and doesn’t involve twisting the joints too much.2
The Arthritis Foundation recommends that you think about the FIT formula (frequency, intensity, and time) when you walk:5
- Frequency: You should aim to walk everyday, if you can. If not, try to aim for three to five times per week.
- Intensity: Try to aim for moderate intensity (two to three miles per hour).
- Time: A good goal is to walk for 30 minutes to one hour every day.
Everyone has a different level of fitness, and you should slowly buildup to your goal.
Additionally, if you want to work on your balance, you can try walking backwards. If you are at risk of falling, the CDC recommends doing balance exercises at least three days per week.2
Pilates
Who it’s good for: People with RA who want stronger muscles.
Pilates may provide relief for symptoms associated with rheumatoid arthritis. One study showed that, for people with rheumatoid arthritis, pilates significantly improved symptoms of:
- Fatigue
- Depression
- Aerobic capacity
- Quality of life for people
- Sleep quality
Water Aerobics
Who it’s good for: People who have significant joint pain
Working out in a lap pool (usually four feet deep) can be a good option for people with significant pain because the buoyancy of the water relieves pressure on your joints.2
When you exercise in the pool, try walking from one side of the pool to the other at a brisk pace. If you work out in a health center with an underwater treadmill, your trainer can adjust the speed of the exercise.
Additionally, consider exercising using a water jogging belt. It suspends you above the pool floor so you can move without putting any pressure on your hips, knees, or ankles, said Ann Rosenstein, a fitness professional based in Lakeville, Minnesota, and author of Water Exercises for Rheumatoid Arthritis.
Stretching
Who it’s good for: Anyone with RA, as long as you do not overexert yourself
Stretching is important for people who experience joint stiffness since stiff joints can make daily tasks more difficult. Stretching can help with your flexibility and make it easier to do household tasks or hobbies.2
You can stretch sitting in a chair if that helps. Additionally, you can use a Stretch-Out Strap, a nylon strap with built-in loops for your hands and feet.
Try this: Place the ball of your foot through a loop, grasp each end of the strap with your hands, and straighten your leg. Lift your leg, gently pulling on the straps. “You’re not reaching your toes, you’re taking the strap and pulling up, so you’re still getting a hamstring stretch,” said Stefanie Fleming, an exercise physiologist at Swedish American in Rockford, Illinois.
Tai Chi
Who it’s good for: People looking for a low-impact exercise
Tai Chi involves slow, gentle movements that connect to your breathing and help to strengthen the body, reduce pain, and improve flexibility. Tai Chi can also improve your overall physical and mental health.7
If you have problems with balancing or are at risk of falling, Tai Chi can be a great exercise to improve your balance as well.2
In general, don’t practice Tai Chi longer than the amount of time you can walk comfortably, advised Paul Lam, MBBS, a family physician and director of the Tai Chi for Health Institute in Australia.
Weight Lifting
Who it’s good for: Anyone, as long as you know your limits
Stronger muscles help you perform daily activities. But it might be difficult to know what is safe and best for your joints.
You can start by doing bicep curls with light hand weights, no more than two to five pounds, and build your endurance over time by adding weight and sets.
You can also do this exercise in the water—hold foam dumbbells in each hand, pull down, and let the weights slowly float up to work your arms, shoulders, chest, and back.
Cycling
Who it’s good for: Anyone with feet or ankle problems
Whether you’re riding outdoors or using an exercise bike, cycling avoids the pounding of high-impact aerobic activities but still packs great cardiovascular benefits. It also strengthens the quads.
You can start by cycling for 10 minutes at a time at 10 miles per hour, or faster. Try to work your way up to 75 minutes each week to get some vigorous intensity (but low impact) exercise in.2
You can try cycling on an upright or recumbent bike, whichever is more comfortable for you.
Hand Stretch
Who it’s good for: People with pain in their fingers and hands.
Spread your fingers as wide as they can go, then make a fist. Repeat that stretching and squeezing motion.
If you’re in the water, open and close your hands underwater, or try squeezing a foam ball. Let it absorb the water before squeezing it out again.
Zumba
Who it’s good for: People with RA who want to complete high-intensity exercise without hurting their joints.
What makes Zumba—the Latin-inspired dance fitness class—different from high-impact aerobics classes? It burns calories without jarring your joints.
If you are just starting out, ease into Zumba. You will be using all your muscles, so beginners are at risk of over-using them. Taking twice-weekly classes will help you learn the choreography.
Qi Gong
Who it’s good for: Anyone desiring better balance, improved posture, a stronger core.
When standing tall or sitting up straight in a chair, imagine a spring is lifting you from above, suggested exercise physiologist Tess Sibug-Franklin, a Health Coach, Educator, and Health Screener at Interactive Health, Inc. in Michigan.
Close your eyes and take deep, relaxed breaths in through your nose and out from your mouth. Place your hands on your stomach and focus on moving your diaphragm in and out with each breath. Concentrate on strengthening the core muscles of your abdomen to maintain your balance and posture.
Elliptical Training
Who it’s good for: People who have good balance and exercise endurance
Do not try riding an elliptical machine if you are an exercise novice. This exercise is ideal for people in good cardiovascular condition who want a higher-intensity, no-impact challenge.
Start at a constant ramp height and constant resistance, and make adjustments as you get stronger. Alternatively, choose a pre-set cross-training program. Adding arm movements will increase the cardiovascular benefit.
Gardening
Who it’s good for: People who enjoy recreational exercise
Gardening burns calories and can help to ease depression symptoms that can be associated with RA.8 But you need to pace yourself. If you’ve got RA in your wrists, digging for hours at a time may cause a flare-up.
Suspension Training
Who it’s good for: People with RA who are interested in a more challenging core workout who don’t have serious wrist or ankle issues
With suspension training, you leverage your own body weight from straps hanging from an anchor point. Place your feet in the stirrups and hold your body up with your hands or resting flat on your forearms. Holding a plank position works muscles in the abdomen, back, and shoulders. Work up to a 30-second hold with a 20-second rest between reps.
3-Way Hip Exercises
Who it’s good for: People with weak hip muscles
Try this out.
1. Face the kitchen sink and hold on. Alternate bringing each knee up like you’re marching in place. This will work muscles in the front of your hips.
2. Keep your toes facing forward. Raise a leg out to the side and back to work the outer thighs and glutes. Alternate legs.
3. Face forward. Extend a leg out behind you until it’s a few inches off the ground. Hold and lower it slowly, then switch legs. This works your butt and lower back.
You should do these exercises around the kitchen sink because it is something sturdy to hold onto in case you lose your balance, Hlad said.
Exercising with rheumatoid arthritis may come with challenges. It isn’t easy to exercise when you are experiencing joint pain, but physical activity can help improve your symptoms, strengthen your muscles, and improve the mobility of your joints.
Remember to start slowly and build your way up to your goal. People with rheumatoid arthritis may have different symptoms and varying fitness levels so start where you are comfortable and work your way up.
Reviewed by Jane Kim, MD – Seen in Health