Exercise and Rest

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By ACCORDANT HEALTH SERVICES

Would you like to feel better? Sleep better? Have more energy during the day?

Do you wish you felt happier? Had a better grip on your weight?

The surprising key to all of these benefits is...exercise!

Because you have RA, exercise is very important to your health and well-being. Staying positive, being full of energy, and being healthy means learning how to balance exercise and rest. This means you should not exercise when your RA is very active, and you should exercise more when you feel better.

If you are not used to exercising, this may be a change in how you live your life. But if you want to live well with RA, this is a change you need to think about. Here are some questions and answers about exercise, rest, and RA.

Q. What will happen if I exercise regularly?
A. You will notice changes in how you feel each day.

• You might start feeling more comfortable in your clothes. One day you may pass a mirror and notice that you're looking better in your jeans. (Because exercise will help you control your weight.)
• Your family and friends may comment that you "seem to be feeling better" and that it's "more fun" to spend time with you now. (Because exercise helps reduce pain, relieve constipation, improve your mental outlook, and gives you a better night's sleep.)
• You might need less help at the grocery store. You might be able to shop longer at the mall. Your dogs may even wag their tails more — because you'll have the energy to walk them every day!
• You will protect your overall health. Exercise makes you less likely to get diabetes, heart disease, and high blood pressure.

Exercise is good for you in so many ways! Regular exercise makes the muscles around your joints stronger. Strong muscles absorb more shock and protect your joints better. Exercise improves blood flow around your joints. It also improves flexibility. With good flexibility, there is less chance of a sprain. You will probably also have less pain and stiffness in your joints. And because exercise helps with weight control, your joints will have less stress to bear.

The rest of your body benefits from exercise too. It makes your bones, lungs, and heart stronger. It helps keep you from extreme tiredness. It gives you more energy. It not only helps you stay positive it also makes you more mentally alert. There is less of a chance you'll get depressed.

Q. So...what will happen if I choose not to exercise regularly?
A. You will probably not enjoy all the benefits mentioned above. With RA, too little movement leads to stiffness, weakness, pain, and feeling very tired. People who do not exercise have weaker muscles and bones and less flexible joints. They are more likely to feel anxious and depressed. They also have more problems with constipation, high blood pressure, and weight control.

Q. What does "balance exercise and rest" mean?
A. Seven out of ten people with RA have "flares" — times when RA gets worse. Then they have "remissions," when RA is less active and they feel better. In general, you should rest more when RA is active. When it is in remission, you should exercise more and stay active. Rest helps reduce inflammation and pain. You need both rest and exercise, and you need to keep them in balance to stay healthy. Try to have some times when you rest each day. Between those times, stay active! However, ask your doctor what kind of exercise is best during a flare.

Q. What kind of exercise do I need?
A. Each week, most people with RA need to do three kinds of exercise:

• Every day: flexibility ("range of motion") exercise
  This is the most important kind of exercise for people with RA. It is gentle, stretching movement that helps protect your joints from injury. Flexibility exercises help you relax. They also help relieve morning stiffness. Yoga and tai chi are flexibility exercises.

• Every other day: strengthening exercise
  This type of exercise builds muscle to protect your joints. Every other day, after you warm up with flexibility exercises, do strengthening exercises. These exercises work in one of two ways:

  • tightening muscles without moving the joints, or
  • moving muscles by moving the joints

  You can choose how you want to work out, based on how your joints feel. Many people do strengthening exercises in warm water. Water supports the joints. It also provides slight resistance that helps build muscle strength.

• Three times a week: endurance (cardiovascular or "cardio") exercise
  This type of exercise makes your heart, lungs and large muscles work harder. Endurance exercises burn calories, build bones, and will make you feel better. Always choose exercises that are "joint safe." Swimming, walking, and bike riding are all good options. Be sure to warm up with flexibility exercises!

Before you Start to Exercise...
Do not start to exercise before you talk with your doctor. Your doctor will give you "customized" advice about exercise based on:

• whether you have other health issues besides RA
• which joints RA has affected
• how mild or severe your RA is

Physical and Occupational Therapy
Your doctor may ask you to meet with a physical therapist or an occupational therapist. Both kinds of therapists are licensed professionals. They are experts with special training that can help people with RA.

Physical therapists know ways to help improve flexibility, endurance, strength, and range of motion. They can teach you the best ways to exercise while also protecting your joints. They can give you advice about overall health and fitness too.

Occupational therapists can teach you ways to reduce joint strain when you exercise and also in your everyday tasks. They can suggest ways to exercise that will build up your strength. They can also provide wrist and hand splints or other helpful devices if you need them. If you are very stressed or depressed you may be able to find an occupational therapist who also focuses on these issues.

My Next Steps: Exercise

References

National Institutes of Health.NAIMS. Handout on Health: Rheumatoid Arthritis. http://www.niams.nih.gov/hi/topics/arthritis/rahandout.htm#ra_4. Accessed January 16, 2007.

Lorig K, Fries JF. Exercise for fitness and better living. The Arthritis Helpbook. 6th ed. Cambridge, MA: Da Capo Press; 2006:133-191.

Arthritis Foundation. http://www.arthritis.org/letstalkra. Accessed March 24, 2008.

Arthritis Foundation. http://www.arthritis.org/types-exercise.php. Accessed March 12, 2008.

Arthritis Foundation. Water Exercise: Pools, Spas And Your Arthritis (brochure). Arthritis Foundation; 2006.

Arthritis Foundation. Keep Moving: People with arthritis can exercise! (brochure). 2005.

Guidelines for the management of rheumatoid arthritis: 2002 Update. Arthritis Rheum. 2002;46(2):328-346.

Last Modified Date: December 28, 2009 © Accordant Health Services, a CVS/Caremark company.   All rights reserved. This article has been reviewed for accuracy by a member of the Accordant Health Services Medical Advisory Team. This information is not intended to be a substitute for professional medical advice. You should not use this information to diagnose or treat a health problem or disease without consulting with a qualified healthcare provider. Please consult your healthcare provider with any questions or concerns you may have regarding your condition. Use of this online service is subject to the disclaimer and the terms and conditions.