The fatigue and joint pain associated with RA makes it extremely difficult to remain physically active. Yet I know that inactivity can exacerbate muscle atrophy, reduce joint flexibility, decrease cardiovascular health, and diminish mental wellbeing. During the past year as various flares and experimentation with the usual RA medications occurred, I found myself considering my options. This “considering” dragged on for many months. But as my RA symptoms seem to be under better control (not remission), I find myself thinking
more about physical activity once again…”should I plow or let the ground lay fallow?” My rheumatologist has never mentioned anything about stretching, physical therapy, or exercise. I will be making it a point of bringing this up at our next appointment in April.
There is a debate in RA circles between “use it or lose it” and “use it and damage it more”. Any RA sufferer can attest to cases where overuse of a joint caused more pain and suffering. While I can point to over 20 joints affected by RA to various degrees, my right thumb is a case in point. Over the past few months, it’s been a source of regular joint pain, swelling, stiffness, and lack of mobility. After I returned from snow skiing on Monday when I was grabbing ski poles for several hours, these symptoms increased and are now accompanied by a sharp pain when flexed. I don’t want to exacerbate damage to my thumb. So it’s probably best to rest that joint at this time to avoid further damage. But surprisingly, other joints like my knees and ankles seemed to recover from the skiing after a few days (granted, they still show plenty of RA symptoms). What are we to do? I think this quote provides some direction,
“Although long term effects of dynamic weight bearing exercise on those with RA remains unclear, current data suggests that vigorous exercise may be used to improve joint mobility, muscle strength, and aerobic capacity without causing joint damage (except when there is acute joint inflammation or uncontrolled systemic disease).”[i]
There must be a balance point between necessary physical activity to counter the effects of RA and when activity is actually contraindicated. The question at hand is how to determine the balance point. Below are some guidelines I will be using.
- Exercise if you can.
- Push through mental roadblocks.
- Listen to your body. Stop when necessary.
- Don’t do something that will damage joints.
- If your RA is not under control, the threshold for physical activity will be much lower.
- Speak to your doctor and other caregivers about the topic.
- Seek out safe forms of exercise depending on your individual symptoms. The Arthritis Foundation sponsors swim exercise programs all over the country.
The sun is shining and it is almost 60 degrees in Seattle…so I’m off for a vigorous, cardiovascular walk with my dog…unless my knee screams at me!