When you have rheumatoid arthritis, without regular exercise and stretching, your joints can become so tight and stiff that they can't move or bend. With exercise, you can better maintain range of motion and possibly control pain, says Elizabeth Araujo, MD, a rheumatologist and assistant professor at the University of Cincinnati College of Medicine in Ohio.
However, you need to approach exercise differently when you have rheumatoid arthritis and take special precautions to avoid causing more rheumatoid pain and injury to already damaged joints. Your fitness focus should be to "learn exercises to strengthen the musculature and take the weight off joints," says Dr. Araujo.
And this approach to rheumatoid arthritis treatment should start as soon as you’re diagnosed. The best strategy is a consultation with a physical therapist specifically trained to work with people with inflammatory conditions — you want an exercise expert familiar with the needs of patients with rheumatoid arthritis. A therapist can map out a customized routine for you, so that you know which exercises you can do and which you should avoid. Even just one session with a physical therapist can teach you how to get the most out of exercise, says Araujo.
Finding the Right Rheumatoid Arthritis Exercise for You
For Julie Tollinchi, 29, of Bloomfield, N.J., the answer was swimming. As a child, Tollinchi played softball and baseball and was generally active. But that changed when she was diagnosed with juvenile rheumatoid arthritis just after her 14th birthday. Her condition was so severe that she spent several years in a wheelchair. It was only after having both knees and one of her hips replaced that she could finally walk again.
Tollinchi finds the greatest relief from her rheumatoid pain in the water. "Swimming really helps because you're weightless in the water," says Tollinchi who works out in the indoor pool of a nearby gym. "And you can stretch a lot more than you can regularly without being in a lot of pain."
10 Ways to Tailor Exercise for Rheumatoid Arthritis
The benefits of exercise for people with rheumatoid arthritis are not only physical, but emotional as well. Exercise can "decrease the incidence of depression associated with debilitating disease," says Heather Nettle, MA, coordinator of exercise physiology services at the Cleveland Clinic Sports Health and Orthopaedic Rehabilitation in Ohio.
While exercise can help you function better on a daily basis and prevent muscles from atrophying, your exercise choices have to be specific to maintaining joint integrity and pain management, Nettle explains.
Nettle offers these 10 simple adjustments that people with rheumatoid arthritis can make to protect their joints without sacrificing physical activity:
  1. Choose low-impact exercises that don’t stress the joints, such as walking, biking, or swimming.
  2. Properly condition muscles before you challenge yourself in your workouts.
  3. Work out for a shorter time and at a lesser intensity when you're having a flare-up or are experiencing pain and swelling.
  4. Try exercising in several short bursts throughout the day rather than one long workout session.
  5. Create a routine that combines aerobic activity and resistance exercises that build muscle to help you avoid an overuse injury.
  6. Always warm up properly before you exercise.
  7. Always cool down afterward.
  8. Add flexibility exercises to your routine to help increase range of motion.
  9. Wear good athletic shoes that offer shock absorption and support for your feet.
  10. Try other types of water therapy, like walking in a pool, when the condition is very active, if you're having a flare, or if your rheumatoid arthritis is very severe.
For the best results, always discuss your exercise options with your health care provider before starting a program, stresses Nettle. With the right guidance and commitment on your part, exercise can be an invaluable part of an effective rheumatoid arthritis treatment plan.