Pictures Slideshow: Rheumatoid Arthritis (RA) - Joint-Friendly Exercises & Fitness Routines
Reviewed by Andrew Seibert, MD on Thursday, October 06, 2011
More Slideshows from eMedicineHealth
Watch and learn from these additional pictures slideshows.
Decrease Pain, Increase Energy
Exercise more to decrease pain and feel more energetic? Hardly seems possible with RA. But it's true! Inactivity decreases joint motion and flexibility. Inactivity also can lead to weak muscles and deformed joints. Regular exercise helps reverse joint stiffness, builds muscle, and boosts overall fitness. With regular exercise, you can feel stronger with less fatigue. But first, see your doctor before starting an exercise program.
Choose Low-Impact Aerobics
These exercises build endurance and strong bones and also strengthen leg muscles. Low-impact aerobic exercises include stair climbing, walking, dancing, and low-impact cardio machines, like the elliptical trainer.
To do: Start by exercising a few minutes each day, adding more time as you can. Aim to exercise at a moderate pace, 30 to 60 minutes, most days each week.
Strengthen Muscles and Bones
Include resistance exercises two to three times a week to improve muscle strength and mobility and decrease joint pain. Stronger muscles decrease joint pain by better supporting the joints. Strengthening exercises also increase your metabolism and help you shed pounds.
To do: Use elastic bands, free weights, or machines for resistance. Ask the trainer at your local fitness center to show you how to use resistance machines.
Swimmers, Take Your Mark!
Swimming is a great way to increase conditioning for all your joints, as well as strengthen your back, without putting excess stress on your joints.
To do: Start slowly with just a few minutes in a heated pool. Use a kickboard when you first start to get used to moving in the water. Gradually build to a goal of swimming 30 minutes at a time. Increase physical activity with each exercise period until you reach your goal time.
Healthy Body, Healthy Heart
Aerobic exercise helps build a healthy body and a stronger heart. People with RA are more likely to develop heart disease. However, getting your heart pumping with exercise helps reduce that risk. Aerobic exercise reduces blood pressure and improves cholesterol. Because bone loss often occurs with RA, weight-bearing exercise like walking, dancing, and climbing stairs helps prevent osteoporosis.
When regular strength training is painful on the joints, isometric exercise is another way to build muscle. Isometrics involve tensing the muscle without any visible movement.
Isometric Chest Press
To do: With your arms at chest level, press the palms of your hands together as hard as you can. Hold the press for 5 seconds; then rest for 5 seconds. Do another 5 second press and a 5 second rest. Do 5 repetitions. Slowly build up to holding the press for 10 to 15 seconds at a time. If this exercise hurts your joints, ask a trainer to show you another isometric chest exercise.
Isometric Shoulder Extension
To do: This isometric exercise is done standing with your back against a wall and your arms at your sides. With your elbows straight, push your arms back toward the wall. Hold for 5 seconds, and then rest. You can repeat this 10 times. If this exercise hurts your joints, ask a trainer to show you another isometric shoulder exercise.
This exercise strengthens the thigh muscles, which are a major support for the knees.
To do: Sit on the floor or a bed with one leg straight and the other bent. Then tighten the thigh muscles of your straight leg as hard as you can. Keep the thigh muscle tight and count to six. Relax, and then repeat. Do with the opposite leg, gradually increasing up to five, then 10, then 15 repetitions, twice daily with each leg. If this exercise hurts your joints, ask a trainer to show you another isometric thigh exercise.
Stretch to Increase Flexibility
Regular stretching is important to increase flexibility and restore joint motion. To ease pain and stiffness, use moist heat or warm baths before and after stretching exercises. Also, warm up with light aerobic exercise such as walking for 10 minutes before stretching to decrease risk of injury. Hold stretches for 30 seconds without bouncing or jerking. Tip: Use a towel to bridge the distance between your hands if you cannot comfortably connect them.
Stretch Your Fingers
To do: Close your fingers, making a fist. Then, open and extend the fingers as straight as possible. Repeat this exercise, gradually increasing up to 20 times, twice daily. To further increase strength, squeeze a foam or sponge ball about the size of a tennis ball. Release and extend the fingers.
Keep Wrists Flexible
To do: This exercise is done sitting at a table or desk. With your left forearm on the table, let your left hand hang over the edge of the table. Using your right hand, grab the fingers of your left hand and bend your left hand at the wrist, slowly moving it up and then down as far as possible without pain. Repeat with the opposite hand. Increase up to 20 repetitions, twice daily.
Perform an Elbow Stretch
To do: With your arm extended, parallel to the floor, position your palm face up. Using your opposite hand, grab hold of the fingers and pull the palm of the extended hand toward the floor. Hold for 30 seconds. Now, do the same exercise, except this time turn your palm face down. Using the opposite hand and push the top of your extended fingers and hand down toward the floor. Hold for 30 seconds.
Try Hip Rotation
To do: Sit or lie on your back on the floor or on a bed, feet slightly apart. With your legs and knees straight, turn your knees in toward each other and touch the toes of your feet together, holding for 5 seconds. Now turn the legs and knees out, and hold for 5 seconds. Repeat this, gradually increasing up to five, 10, and then 20 repetitions, twice daily.
Get Flexible Feet
To do: Facing the wall, place palms flat on the wall, one foot forward, and one foot back. Leaving your heels on the floor, lean forward. As you do so, feel the pull in the calf of your back leg and the Achilles tendon at the back of the ankle. Hold for 30 seconds. Do three repetitions. Then reverse the position of your legs and repeat.
Tai Chi Increases Flexibility
The ancient discipline of tai chi can help those with RA increase range of motion, boost flexibility, and tone muscles to provide better balance. The focus of tai chi is on breathing and creating an inner stillness, allowing participants to relax.
Avoid High-Impact Exercise
High-impact exercises, such as jogging, running, or playing tennis on hard pavement, can put excess stress on your joints. Lifting heavy weights may also not be the best form of exercise for people with RA. Looking for a more intense workout? Talk with your doctor first to see if you can do more taxing exercises such as heavy weight lifting, tennis, basketball, or volleyball without risk of joint injury.
Balance Rest with Exercise
Fatigue is common with RA, making it difficult to feel energetic, so balance rest with exercise. During a flare, short periods of rest are important to reduce active joint inflammation and pain and to fight fatigue. This doesn't mean bed rest, unless your doctor recommends it. Too much inactivity weakens muscles and can increase joint pain.
Consider a Personal Trainer
Talk with your doctor about the benefits of a personal trainer. Having a personal trainer may allow you to personalize your exercise regimen, while increasing fitness and avoiding injury. Don't let the fact that you have rheumatoid arthritis stop you from exercising the way you'd like.
More Reading on Rheumatoid Arthritis & Exercise