Okay, everyone knows that exercise is essential to help prevent disease and improve health and fitness, however in the case of rheumatoid arthritis sufferers the situation is a bit different. RA sufferers can often find it difficult and perhaps even impossible to do any kind of useful exercise due to pain, inflammation, fatigue, and restriction of movement. Also, the reasons why an RA sufferer should exercise regularly are slightly different from those of the rest of the population (although the benefits are similar, just more critical for RA sufferers). Until fairly recently, I hadn’t realised the significance of these differences and as a result of my research into exercise and rheumatoid arthritis, I’ve now given a much higher priority to this component of my recovery.
In rheumatoid arthritis sufferers (and osteoarthritis sufferers) joints tends to deteriorate over time and generally the older a person gets the worst the deterioration. I’m convinced that poor blood (and lymph) circulation plays a much bigger role in this than people often realise. I’d overlooked this point myself until I began looking into it more deeply. The poor diet and lifestyle choices that lead to the development of rheumatoid arthritis are the same poor choices that lead to the development of atherosclerosis and hypertension i.e. reduced circulation capacity, efficiency and reach.
Therefore, it’s even more critical that RA sufferers focus on regular and effective aerobic exercise in order to improve circulation since our inflamed and painful joints are warning us that our circulation is restricted, in the same way an angina sufferer is being warned that their heart’s circulation is being restricted. Our joint pain and inflammation is our equivalent to hypertension or angina, these symptoms are not just an indication that we have rheumatoid arthritis, (and this is the important bit) they are also a warning to us that we need to improve our circulation or suffer the consequences (further restriction and disability).
I’d like to emphasise four reasons why exercise is critical for rheumatoid (and osteo) arthritis sufferers.
1) We need to reverse the damage and restriction caused to our circulatory system by our poor diet and lifestyle choices in order to improve the oxygen supply, nutrient supply, waste removal, and immune system access to the vicinity of our joint capsules. This will improve the chances of protecting, repairing and slowly reconstructing our joints.
2) Having begun to improve the circulation to our joints we then need to do specific exercises to persuade nutrients, oxygen, and immune system components to enter the joint cavity and diffuse into cartilage and other joint components that have poor to non-existent blood supply. At the same time removing waste materials and toxins from the joints.
3) This next reason might seem simplistic but we need to tell our brains that we still need our joints. When a person has rheumatoid arthritis the temptation is to take the weight off joints and to reduce the necessity for movement in order to prevent pain or perceived further damage. I’ve experienced this myself of course and I understand this motivation very well, however these are the very decisions that will lead to further and more rapid joint deterioration, for some of the reasons I’ve mentioned above.
Our brains (and other organs) will prioritise areas of our body that are critical to our survival for example our brain :-) and of course our heart, liver and so on. For critical systems our brain does a good job of prioritising and maintenance, and keeps us alive. However, for less critical components, resources are allocated based upon perceived need. Whenever we reduce our use (including range of motion) of joints and muscles, important resources are allocated elsewhere to the more demanding components of our body. Therefore, it’s important that we continue to use and exercise our joints in order to divert attention and vital resources towards them.
4) Finally, regular and consistent aerobic exercise helps to improve our gut health (critical for rheumatoid arthritis recovery), it has an overall anti-inflammatory effect on the whole body, it improves our digestion and our sleep, it reduces stress levels and improves mood, it improves insulin sensitivity, and it improves our general structural strength and endurance capability. All of these benefits of aerobic exercise are especially important for rheumatoid arthritis sufferers.
What Is the Best Kind of Exercise for Rheumatoid Arthritis?
Any exercise that you are capable of doing and maintaining on a regular basis is the correct type of exercise for rheumatoid arthritis treatment and recovery. More specifically, aerobic exercise and range of movement exercises.
For those of us with RA; walking and cycling, (and swimming if available) are probably the best options for aerobic exercise since they are low impact, require a fair range of movement, and are sustainable and effective. Walking and cycling can also be done indoors using a treadmill or an exercise bike (recumbent if necessary).
The most important thing is to exercise consistently and regularly, twenty minutes per day would be very beneficial but we should aim for up to ninety minutes of aerobic exercise per day broken into two or three sessions. Don’t worry too much about the duration of the exercise initially if you’re just beginning, regularity is more important. Remember, you want cardiovascular/aerobic exercise in order to improve your circulation, don’t overdo it – you’re not training for a marathon (although you never know, post-RA recovery!). Just walk or cycle at a manageable pace that suits your current level of fitness and ability,
Obviously if you have any other health conditions which might affect your ability to exercise safely, then take it slowly and consult your healthcare provider when necessary.
Regular walking or cycling exercise will improve circulation and provide all the other benefits which I’ve discussed above. However, there is one further exercise which I want to mention, which is excellent for the knees. Sit on a table that is high enough to prevent your feet from reaching the floor, position yourself so that your knees protrude slightly over the edge of the table and let your legs dangle loosely. Then alternately swing your legs forward and backwards gently but in a very relaxed way. This will provide negative pressure between the joint cartilages and encourage nutrients to wash over the cartilage surfaces.
Nutrients have to rely largely on diffusion to enter cartilage within the joint capsule, to achieve this, joints need to be compressed and decompressed. Compression is usually not an issue, for example when walking or climbing stairs etc., but decompression during normal exercise often only goes as far as removing the weight from the joint, but not actually stretching the joint. Stretching and compressing a joint allows for greater diffusion and mobility of nutrients.
My increased aerobic exercise is definitely helping me and my circulation is improving as well as my strength and flexibility. Plus my mood has improved significantly. I’m currently exercising three times each day and aiming for a consistent total of ninety minutes. I’m able to do this by using a recumbent exercise bike which I’ve adjusted to suit my range of motion. I wrote this post to draw attention to the specific benefits of aerobic exercise for rheumatoid arthritis sufferers. The necessity for and the benefits of aerobic exercise in our case, are much greater then we might previously have realised.
Walking image is public domain