Exercise and sports for rheumatoid arthritis
Many people who have rheumatoid arthritis avoid exercise because they worry that it might damage their joints or make their symptoms worse. But there are a number of different sports that are suitable for people with rheumatoid arthritis, as well as good reasons for staying physically active: Exercise and sports improve physical fitness and flexibility, and they can also help with disease-related exhaustion.
Rheumatoid arthritis is the most common inflammatory rheumatic condition. It causes joint pain and swelling, inflexible joints and physical weakness. It's also associated with general weakness, tiredness and exhaustion. The fingers, wrists and feet are often affected first, but it can also cause symptoms in larger joints as well, such as the knees, hips or shoulders.
Joint damage is a major problem associated with rheumatoid arthritis, so many people worry that a lot of exercise - or the wrong kind - could cause their condition to flare up, the exhaustion to get worse, or their joints to become even more damaged. Also, the pain and exhaustion can make it more difficult to do any sports. But there are a number of exercises that are well suited for people who have rheumatoid arthritis. The main ones include the following:
- Strengthening exercises: Exercises with light weights for strengthening your legs, arms and back, for example.
- Conditioning: Sports for strengthening your heart and lungs, such as brisk walking, bicycling, swimming and dancing.
- Aerobics and water aerobics
- Tai chi (shadowboxing): Originally a type of Chinese martial arts, these exercises are made up of slow, continuous movements.
- Yoga: Exercises for controlling your body and breathing to improve flexibility and coordination, as well as provide relaxation.
In general, the activities that are suitable for people with rheumatoid arthritis are those that don't put too much stress on the joints. It's best to talk with your doctor about which exercises would be best for you personally. If you're doing occupational therapy or physiotherapy, you can also ask about what kinds of other, related exercises might be suitable for you. The important thing is to first rest your joints if you have an acute flare-up or if you have just had surgery, and then slowly increase the intensity of the exercises.
What does the research tell us about how effective exercise is?
Overall, physical activity has positive effects - it can improve fitness, strength and general flexibility, for instance. A systematic review of studies has also shown that physical activity can relieve rheumatoid arthritis-associated exhaustion.
A series of studies have looked into the effect of strengthening exercises, especially in the arm and leg muscles. Participants in the studies trained using light weights or strengthening equipment for 30 to 60 minutes, two to three times per week. This improved their strength and also reduced arthritis-related limitations somewhat. It was easier for them to do everyday tasks like getting dressed and washed or handling dishes and a fork and knife. But the training had no effect on the severity of the pain.
Other studies investigated how conditioning influences arthritis symptoms. Training for this study was also held two to three times per week. Most sessions lasted between 45 and 60 minutes. Different types of conditioning were tried out, such as bicycling or swimming, often in combination with other exercises. Moderate conditioning, which doesn't aim to increase the heart rate too much, was used in these studies. It also showed positive effects: It improved quality of life, and it also had an evident effect on limitations of daily life. It also managed to relieve some pain.
Water aerobics is often recommended to people who have joint problems, because exercises done in the water hardly put any strain on the joints. The benefits of water aerobics have been tested in several studies. The research results so far aren't enough to be able to tell whether water aerobics can relieve rheumatic symptoms such as pain, or improve joint function. But participants in other studies reported that they felt the exercises were good for them.
Tai chi and yoga
There is less research on the effects of tai chi and yoga on arthritis symptoms than there is on conditioning and strengthening exercises, so it hasn't been possible to scientifically assess their effect.
Personal preference is important in choosing the right sport, because training needs to be regular in order to be effective. Making exercise part of your daily routine is a lot easier if it's fun and makes you feel good. Joining a sports group could help if it's difficult to get started at home on your own.
Are there any risks involved?
Training only rarely caused joint damage in the studies. But generally speaking, it's not very likely that physical activity will damage the joints in people who have early-stage or slowly progressing rheumatoid arthritis. Only in one study did some participants who did exercise have more joint damage. Most of the people in the study had a larger joint, such as a shoulder, that was already severely damaged before the study started. Because these studies lasted a maximum of two years, it's difficult to assess the long-term effects of the sports that were tested.
People who had very advanced rheumatic arthritis participated in only a few of these studies, so it's difficult to tell what kind of sports would be best suited for them. Sports that involve twists and blows to the joints like tennis or jogging put a lot of strain on the joints. Water aerobics and swimming, on the other hand, are especially gentle on the joints, because in water hardly any weight is put on the joints.
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