What are Some Joint-Friendly Exercises for Rheumatoid Arthritis?

In my previous post – Exercise Must Not be Ignored in Rheumatoid Arthritis Treatment – I have highlighted the very reasons why we should keep our bodies moving. No matter how much pain we are finding ourselves in, we shouldn’t take these as an excuse for us to bury ourselves in our beds. It is because of these pains that the more we should start concern ourselves about exercising.

When RA first struck me, I have turned from a physically active person – one who goes for anaerobic exercises, spinning, dancing, high impact aerobics, etc – to one who uses the pain, the swelling and the lack of energy as an excuse to avoid all physical activities. Soon, these very lack of movements are leading me deeper into a world of physical inactivity. I felt heavy whenever walking up the flight of stairs, then I started to become so lazy that I find it difficult to stand up from the couch; and eventually I found myself in bed most of the times. Get what I am trying to say? If we do not start moving our bodies, we are going to be stuck in this vicious cycle of inactivity, which will then render us a life that is as good as staying in a prison (well, I think it’s worse than this). Realise this, if we do not use our joints, we are going to lose all functions of the joints. Period.

Of course, while we get our bodies moving, we have to pace ourselves well with the types of activities that we can perform based on our individual physical bodily conditions, making sure that we are not stressed out by the exercise routine. It is important to ensure that we stop at the point where our bodies are telling us to cease. Get good rest following the exercise and continue working out the next day. If possible, design a routine that you stick with day in a day out (just like you are making sure that you eat every meal at a specific time of the day). Start slow, 10 or 15 minutes a day. Do not overstretch yourself, it doesn’t have to be that way. Exercising should be a norm, a habit and an integral part of your life. Hence, we must love exercise to ensure that this becomes sustainable part of our lives. It’s important to enjoy it. Choose a combination of exercises you can perform based on your condition and enjoy working out according to the pace and duration you can endure. Always remember, it takes time and patience to regain health the natural way and this principle works the same way for exercise as a therapy for RA.

Here, I’m going to list out some joint-friendly exercises that are suitable for people with RA. And of course, the list is not exhaustive. If your health condition permits, you may engage in any forms of exercises so long as you can protect your joints and ensure that the exercises that you are performing, particularly those high impact and anaerobic exercises – will not exert undue stress on your joints. This is important as well – joints protection.

Some Joint-Friendly Exercises for RA

(1) Daily gentle massaging and muscle tensing – Gently massaged affected arthritic skin surfaces and joints daily, anytime desired. With my everyday shower, I performed muscle group tensing and relaxation, where I performed up to 3 cycles of tensing a group of muscles for 5 seconds and relaxing for 10 seconds.

(2) Range-of-motion exercise – Range of motion is the normal amount of movement your joints can be moved in certain directions. Range-of-motion exercise or flexibility exercise helps maintain normal joint function by increasing and preserving joint mobility and flexibility. What you do is to gently straighten and bend the joints in a controlled manner as far as they comfortably can go, and progressively farther until normal or near-normal range is achieved.

(a) Head Turn
Look straight ahead
Turn your head to look over your shoulder
Hold for three seconds
Return to front
Repeat to other side

(b) Elbow Bend
With arms at your sides, bend the elbows bringing palms towards the shoulders
Turn palms down as you straighten elbows down to your sides

(c) Forward Arm Reach
Hold arms out in front, palms facing one another
Raise one or both arms as high as possible
Lower your arms slowly

(d) Back Pat
Reach each one arm up to pat back
Reach the other arm behind lower back
Try to slide both hands towards each other
Hold for 3-5 seconds
Alternate the arms positions

(e) Legs Rock & Roll
Sit straight in a chair with hands on hips
Gently rock hips from side to side

(3) Stretching – Moving a group of joints and muscles through and slightly beyond their normal range of motion and holding them in position for at least 15-20 seconds.

(a) Arm and Chest Stretch
Look straight ahead
Stand with both arms by your side
Keep back straight and clasps your hands behind your back
Squeeze shoulder blades together
Roll your shoulders forward and backward

(b) Lower Back, Hips & Buttocks Stretch
Lie on your back. Face up facing the ceiling.
Bend both knees
Bring one knee into your hands and gently pull it towards your chest
Hold then lower the bent leg
Repeat with the other leg

(c) Back of the Arms & Shoulder Stretch
Bring your arms above your head
Bend your left elbow so that it points towards ceiling
Feel the fingers of that hand down the back
Reach over with your right hand and gently press down on elbow
Hold then switch arms

(d) Overhead Side Bend
Stand comfortably, feet at shoulder-width apart
Lift both arms over head
Lightly clasp both hands
Gently pull your shoulders back and stretch
Hold then lean to right
Hold then lean to left

(e) Hips, Knees & Thigh Stretch
Brace against a wall or back of a chair with one hand
Bend the opposite knee
Grab your leg just above the ankle and pull backwards towards buttocks
Hold with buttocks tucked and tummy tight
Relax then switch legs

(f) Fingers Stretch
Close your fingers, making a fist
Then open and extend fingers as straight as possible
Repeat 10 times
Build up to 20 times twice daily
(You may squeeze a sponge ball about side of a tennis ball to increase strength)

(g) Wrists Stretch
Sit at a table
Put your left forearm on the table
Let your left hand hang over the edge of table
Using right hand, grab fingers of left hand
Bend your left hand at wrist, and slowly move it up and down as far as possible
Relax and change hand
Repeat 10 times
Build up to 20 times twice daily

(3) Strengthening or Endurance exercise – Moving muscles against some resistance. Studies have shown that moderate or high intensity resistance training is well tolerated in people with RA and help increase or maintain muscle strength. It is best to include this type of exercise twice or thrice a week to improve muscle strength, mobility and decrease joint pain. Stronger muscles decrease joint pains by better supporting the joints. There are usually two types of strengthening exercises:

(i) Isometric Strengthening – Tightening of a muscle or holding against the resistance of gravity or immovable object without moving the joint.

(a) Isometric Chest Press
Hold both arms at chest level, press palms together as hard as possible
Hold press for 5 seconds and rest for 5 seconds
Repeat 5 times
Build up to hold for 10-15 seconds at a time

(b) Isometric Shoulder Extension
Stand with back against a wall with arms at your side
Elbows stay straight
Push both arms back towards the wall
Hold press for 5 seconds and rest for 5 seconds
Repeat 10 times

(c) Isometric Feet Press
Face the wall with palms flat on the wall
Place one foot forward and the other back
Leave your heels on the floor and lean forward
Hold for 30 seconds.
Change position of legs and repeat.
Repeat 5 times.

(ii) Isotonic Strengthening – Moving a joint through its range of motion against the resistance of a weight or gravity. This involves the use of resistance bands, weights, etc.

(4) Conditioning exercise – Conditioning or aerobic exercises include walking, biking, rebounding, swimming, climbing of stairs, dancing, Tai Chi, etc. This exercise can improve your health and prevent disability from RA. It is important for all people with RA to consult with health professional on which forms of exercises are safe and suitable to start based on each individual’s condition.

Final Words on Exercise
Remember, ditch those excuses of how you do not have time or energy to exercise and start working out to rid yourself of those joints discomforts. The initial stage of working out can be daunting and lethargic particularly if you are not a person who exercises from time to time. Here are some more tips of maintaining a healthy exercise routine for building strong muscles to guard the joints against further wear and tear and maintain joint flexibility through motions:

(1) Make sure that you enjoy working out: Do the forms of exercise that you love. It is a great idea to combine a number of different work out programs including aerobic exercise, strength training, etc so you are not likely to get bored of just working out a single way. Find a companionship. Having a friend working out together can be another form of motivation that pushes your limits. This way, you can ensure that you are getting enough exercise to achieve all the benefits, at the same time, having a variety to condition and build your entire body and prevent boredom.

(2) Start small and slow: Do not give up if you do not witness any immediate changes. The changes take time to effectuate and all you have to do is believe in yourself and continue working out based on a fixed set of timetable. Make exercising a routine activity just as having your dinner at a fixed time of the day. Consider and document your own exercise prescription based on factors such as your current and desired physical condition, your health concerns, activities you enjoy and best time of day to work out. Build up on the exercises programs as you get stronger and better at them. Avoid high impact exercises or intense workout such as basketball or volleyball initially to avoid putting excess stress on the joints.

(3) Balance rest with exercise. Fatigue is common with RA. If necessary, give yourself a break for working hard throughout the week. Do not punish yourself or push yourself too hard with exercising. During a flare, a short period of rest is also important to reduce the overly active joint inflammation and pain. So, practice balance rest with exercise.

Once again, this life with RA that you are living now is all the life you have when you are alive. Like many others, we do not need to feel that we are deprived from exercises because we are arthritic. To live this life meaningfully, we need to at least get ourselves moving so that we can take in more that the life has to offer. For me, my motivation for exercising is quite simple – I want to stay active so that I can still run around the house, chasing my kids, playing hide and seek. In the past, it was torturing and depressing enough not able to do anything for my toddlers as they are growing up because I lacked confidence and beliefs in myself. I was glad to have finally found the motivation that allows me to start working out. And I sincerely hope that you can also find your true motivation for making differences in your life!

At the conclusion of my ‘exercise’ thoughts, I’d like to share with you a YouTube video that I’m sharing on my Pinterest. Be inspired by Arthur’s endurance, determination and eventual transformation.