The Best Rheumatoid Arthritis Exercise Program

// by Jenn W

We all have good days and bad, but one of the best things for your body is to keep it moving. I’ve tried just about every rheumatoid arthritis exercise plan that I could find, but the best results I’ve ever gotten have been with Pilates. There’s no doubt about it, if you want to see fast results and improve your range of motion while you reduce joint pain and swelling, you need to take a look at Pilates workouts.

What is Pilates?

Pilates is a low impact exercise program that incorporates cardio and resistance in order to increase strength and flexibility. It doesn’t require a bunch of fancy equipment or expensive classes, you can do it at home, and Pilates works even on days when your range of motion isn’t what it should be.

In some ways Pilates is like yoga or water aerobics. It challenges your body in order to strengthen your muscles and joints without subjecting your body to the impact so many other workouts can, which can trigger an RA flare up. Unlike water aerobics or yoga, however, Pilates leads to much faster results, adds much more strength and flexibility. You can actually find some great Pilates-based rheumatoid arthritis exercise programs available for free online, as easy to follow videos.

Pilates can also be done in a studio setting with an instructor and reformers. A reformer is a piece of equipment that uses springs, pulleys, bars & straps to perform over 500 exercises in a variety of positions. To use a reformer you would need to attend a Pilates class or take a 1-on-1 training session. A big benefit of going into a Pilates class is that you’ll be working with an instructor. The instructor will be able to work with you and any restrictions you may have due to joint fusions or other issues that prevent you from performing certain exercises. The instructor will also make sure your body is in the correct positions as you work through each exercise, and help with modifications to ensure you’re getting the most out of the work out. It really depends on the financial resources available to you, as classes typically range from $15 to $50 per session.

The main focus of Pilates is building strength through low impact, controlled movements done with or without resistance. Pilates uses a lot of slow, smooth movements in contrast to many other forms of cardio and strength training. You’ll never find yourself struggling under the weight of a barbell with Pilates, although sometimes you might feels your legs shake as you struggle to maintain a pose or flow through a movement.

If you’re going to give Pilates a shot, and in my opinion just about everyone with rheumatoid arthritis should try it, then I’ve put together a short list of tips and tricks in order to help you get started. Most of these are common sense, but feel free to use this as a checklist before you workout for the first time. You can avoid a lot of next-day soreness if you follow all five tips.

5 Tips and Tricks for Exercising with Rheumatoid Arthritis

Don’t Forget to Stretch
You need to warm up even for low impact exercise routines like Pilates. Take your time and stretch all of your muscle groups, even the ones that you won’t be focusing on, because a lot of stabilization muscles are needed in order to properly move smoothly through the workout. Sometimes these muscles are nowhere near the muscle group that you’ll be exercising, but you might be surprised how easy it is to pull one of them when you least expect it. So stretch and warm up every time.

Use a Foam Roller Before and After
In my opinion, a foam roller is a great tool to have no matter what type of exercise you’re doing. If you’ve never seen one before, it looks like a thicker version of a pool “noodle” toy, although it’s made of stiffer foam. You can use it as a tool to give yourself massages, working any kinks out of your muscles and help to reduce post-workout inflammation. Foam rollers are also very relaxing, depending on how hard you work your muscles with one. Make rolling out your arms, core and legs part of your pre-workout warm up and post-workout cool-down and it can really help reduce the amount of muscle pain and soreness that you have to deal with.

Reduce Pain and Stiffness with NSAIDs
Most of us are prescribed NSAIDs in order to reduce the pain and swelling that accompanies rheumatoid arthritis. Before you begin exercising, make sure that you’ve had a chance to take your medicine. Even if you aren’t in pain, the NSAID will reduce any swelling in your joints and muscles during and immediately after exercise. On my worst days, I’ve combined NSAIDs with topical creams in order to make sure that I don’t experience a flare up after a tough workout. Usually though, just making sure that I’ve taken my medicine before I workout is plenty of protection against pain and stiffness.

Modify Your Movements
Sometimes a movement or transition is just too much, especially as you’re getting started. It’s better to take slow, shallow movements rather than try to rush through quickly and hurt yourself. If you can’t bend your knees entirely while you’re going into a squat, for instance, don’t force the issue. Do what you can without sharp pain, keep working your exercise routine, and you’ll notice an improvement over time.

Stay Hydrated
One thing that everyone should do, whether they’re working out or not, is stay hydrated. Drinking plenty of water helps your body replenish the natural lubrication in your joints, the stuff that makes cartilage so slippery. It’s a good idea to keep some water with you when you workout in general, but for RA sufferers it’s never optional. Don’t workout without having a bottle of water handy. It’s also a good idea to look for ways to incorporate more water into you daily routine as much as you can. It just may mean a few extra trips to the bathroom, but your joints will thank you.

Working Out Your Whole Body Using Pilates

Regardless of the program you’re following, the instructor you have, or the exercise video that you’re following along with, Pilates exercises can help you focus on just about every muscle in your body. Below is a list of the major areas that Pilates works, along with a few examples of some common exercises and what areas of your body can benefit.

#1: Knees
A lot of people start to feel their rheumatoid arthritis in their knees before anywhere else. Your knees are some of the biggest and most important joints in your body, and it’s only natural that RA would tend to attack them. Pilates exercises like dips, squats and lunges all work the knees, and they can help you restore range of motion and make it easier to walk, stand and sit down. Don’t neglect your knees during your Pilates workouts, there aren’t too many other joints that we use anywhere near as frequently.

#2: Shoulders
Shrugs and arm circles are the most popular Pilates exercises for your shoulders, along with the clinically-named ‘scapula isolations’. All of these exercises help to strengthen and tone your shoulders and upper arms, as well as your upper back and traps. If you find yourself limited in how high you can raise your arm due to mobility issues, make sure you pick a program that helps you focus on shoulder exercises to help improve range of motion and flexibility.

#3: Elbows
Overhead stretches and wrist curls, along with the occasional set of pushups, are some of the elbow exercises that you’ll see most frequently in Pilates. In some cases, especially if you play or played a sport like tennis, rheumatoid arthritis will likely be especially bad in the elbows. Pilates has a lot of options, some exercises with resistance and some without it, for giving your elbows a great workout and helping you focus on maintaining flexibility and strength in your arms.

#4: Back
There aren’t too many other places on your body that can affect you like a sore, swollen, painful back and spine. Fortunately Pilates has a ton of low impact exercises that focus on this region, and it’s one of the areas that people make progress on fastest. Chest lifts, pelvis curls and the child’s pose, a kneeling posture with your arms outstretched, are all common Pilates exercises that work your back and strengthen your spine. Creating a strong core is something you’ll be working on with every Pilates workout. Its is one of the core values of Pilates, as so many exercises focus first on what you need to do with your core to stabilize before you begin any Pilates movement. Take care to do your stretches on days when you’re working your back, since it’s a large area with a lot of very strong, complex muscle groups.

#5: Hips
Nothing helps with chronic rheumatoid arthritis-induced hip pain like Pilates. If you wake up with sore hips, or you have problems sitting or standing for long periods of time because of them, Pilates is a great way to improve the way your body is feeling. Exercises like the straight leg raise, hip extensions and bridging will help to relieve your pain and stiffness. A lot of back exercises, especially the ones that work your lower back, also help to build up core strength which in turn will help your hips. If you have limited mobility in your hips and swelling caused by RA, then Pilates might be just what you need.

#6: Feet & Ankles
Finally, we get to feet and ankles. It’s pretty common for rheumatoid arthritis sufferers to have bad ankles, and Pilates has a lot of different low impact exercises that isolate and strengthen them. For instance, there’s the ankle roll, heel lifts, knee bends and toe lifts to name just a few. All of these exercises also help to work the muscles in your lower legs and strengthen your feet.

Cooling Down the Right Way

After you’re finished with your Pilates workout it’s important to have a nice, relaxing cool-down. Cooling down will help with muscle soreness and stiffness the next day, and it really shouldn’t be skipped unless you’re eager to spend a couple of hours in a hot bath. Go through each area of your body that you worked on and slowly do a few easy stretching exercises.

When you’ve worked your way through a bit of light stretching, you can try using the foam roll on your major muscle groups. After a workout your body may be tense, especially when you’re first getting back into exercise. Take as long as you need to stretch and foam roll, it’s worth the time spent!

Optional Pilates Accessories

Over the course of this article there have been a couple of different accessories mentioned, although the main focus has been on the exercises. Hopefully the fact that you don’t need an expensive shopping list in order to get into Pilates will motivate more people to give it a try, but advanced users might want to pick a few things up in order to either increase the difficulty or make themselves more comfortable during your Pilates workout sessions.

The first product worth looking into is a Pilates mat, or a yoga mat. Especially if you’re feeling a rheumatoid arthritis flare up coming on, being able to put a bit of padding between you and the ground is always nice. While these mats are pretty affordable, they aren’t strictly necessary, and a lot of other soft surfaces can be used. Many exercises can even be done on a carpeted floor, just put down a towel first.

Resistance bands are another popular Pilates accessory, and they can really boost the level of difficulty. Even when resistance bands are used, the goal of Pilates is the same: Slow, steady, carefully controlled movements are key. The bands should be light enough to keep your form.

The final accessory, and one that everyone should really look into, is a foam roller. In fact, once you really get going on Pilates you might find yourself with more than one of them. To begin with, find a roller that isn’t too big, one that you can tuck under your knees and lay on your back without having your legs lifted uncomfortably. A foam roller is perfect for warming up and cooling down, but it can also be used for more advanced balancing exercises.

Relieve Pain and Increase Range of Motion with Pilates
If you’ve managed to make it all the way to the end, then you should have a pretty good idea of what Pilates can do for the average rheumatoid arthritis sufferer. In contrast to other exercise programs, with heavy weights and painful movements, Pilates is a low impact way to build stamina, core strength, improve mobility and, eventually, increase your quality of life. You can get started today, for free, with resources available online. In a month, after you’re standing without pain and you don’t wake up with your hips aching, you’ll be glad you did.