Rheumatoid arthritis (RA) is an inflammatory autoimmune disease affecting once-healthy joints that may become painful, swollen, and stiff, and may also cause disease symptoms of fatigue and depression. Though there are antirheumatic drugs available to manage this disease, they can come with uncomfortable side effects. Impaired joint functionality is common in people with rheumatoid arthritis, but daily exercise may be helpful in managing and improving joint function and other active disease symptoms, and movement is a low cost, low risk option to manage your RA. Focusing on building strength, balance, and flexibility, this article will highlight aerobic fitness and conditioning as well as non-aerobic exercises for people with RA to improve quality of life on a daily basis without worsening active disease symptoms. (Source)

Benefits of Exercise

The Physical Activity Guidelines for Americans, provided by the U.S. Department of Health and Human Services, states that adults should try to exercise at moderate intensity for 150 minutes per week, or engage in 75 minutes of vigorous aerobic activity per week. Even if you can’t manage this level of activity, you should aim to be as active as possible. (Source)

For many with chronic illness this goal may seem unattainable, but finding the appropriate exercise plan may help:

• improve range of motion
• decrease the risk of comorbidities such as cardiovascular disease
• gain muscle mass
• improve immune function
• reduce inflammation
• Improve energy

It’s quite common for those with RA to limit movement, but this may lead to further progression of symptoms and loss of joint function and muscle strength. Movement may lower inflammatory markers within your body, but overdoing it may tax your system. There is an array of slow and deliberate low-impact exercises, flexibility exercises, and resistance exercises that will get you moving to help keep your joints functioning well, without aggravating the inflammation you may be experiencing. (Source, Source)

Types of Beneficial Movement 

If you have RA it is important to engage in purposeful physical activity to manage symptoms while keeping your joints functioning optimally. There are many different types of exercise, but the 8 best exercises for RA can be categorized under the following:

• aerobic training
• resistance training
• balance and stretching 

Read on for some useful RA friendly exercises you can add to your routine. (Source)

Aerobic Exercise

Aerobic exercise is movement that increases cardiorespiratory fitness by raising the heart rate 50%–80% higher than usual, while increasing the body's need for oxygen. Research has shown consistent practice of aerobic exercise may reduce your risk of developing RA or delay the onset of disease. The recommendation for weekly aerobic exercise is to engage for 30 minutes per day, 5 days per week, although exercise intensity and duration may vary a bit depending on your disease status. Aerobic conditioning may improve quality of life for those with RA as well as include health benefits of:

• increased cardiovascular health
• reduced joint damage and inflammation
• improved energy
• improved muscular strength and joint mobility
• reduced pain

The following low impact, moderate intensity aerobic activities may be appropriate for you if you have RA. (Source)

Cycling

Whether you join a gym or buy a stationary bike, cycling is a great low-impact activity to build up strength in your core and legs. Stronger muscles can better support your joints, possibly relieving some pain and improving functionality. There are different types of stationary bikes to choose from including upright, recumbent, or spin bikes. Once you settle on a model that is right for you, be sure to adjust it so you can reach the handlebars comfortably while having the seat at hip height — this can be ensured by having the bike professionally fitted. It is suggested to start without resistance and slowly work up to more as your body becomes more comfortable in the movement. (Source)

Dancing

If you’re looking for a fun way to improve joint mobility and pain levels, finding an aerobic dance class may be right for you. Whether you engage in local group dance classes, private lessons, or online classes, dancing may improve your energy along with reducing depression. There are a lot of dance styles to choose from such as Zumba, salsa, and belly dancing. (Source)

Swimming

Exercising in the water is easy on the joints and may relieve pain, improve mobility, and lower disease activity. Water-based exercise may look like swimming laps or joining a water aerobics class at your local pool. Focusing on high-intensity exercise will be more beneficial in managing your RA effectively. Meeting new people and bonding in your choice of movement may help to relieve symptoms of depression as well. (Source)

Walking

Walking is a popular activity for those with RA, and can be a great low-cost option. If you live in a mild climate without risk of falling on icy or dangerous sidewalks, walking outside while getting some fresh air and sunshine may work for you. Purchasing a treadmill or joining a gym may be an option as well if you live in an area with iffy seasonal conditions. Purchasing a comfortable pair of walking shoes is a good idea to provide your joints with the support and stability you need, preventing pain or further injury in the long run. (Source)

Resistance Training

Resistance training, also known as strength training, is a form of therapeutic movement that may be beneficial for those with RA by:

• improving strength in muscles and joints
• improving joint pain 
• reducing morning stiffness
• delaying the onset of disease activity

Duration and intensity of resistance training specific to RA has not been studied in depth, but working with a knowledgeable trainer may help you safely navigate this movement and may result in anti-inflammatory effects. Methods of strength training may include the following.

Resistance Bands

Resistance bands are elastic bands of varying stiffness, used to perform several exercises to strengthen joints and muscles. These exercises may include squats and lunges, as well as arm exercises such as rowing, chest presses, tricep extensions, and bicep curls. These movements include both the upper and lower muscle groups for overall strength improvement. The goal is to start out using the lightest resistance and, once your body adjusts, continue to increase resistance by using increasingly stiffer bands. (Source)

Weightlifting

Weightlifting can be quite therapeutic for those living with RA. Not only does lifting weights increase strength and aerobic endurance, but it also contributes to improving bone mineral density and joint health. Loss of muscle mass can be common if you have a sedentary lifestyle,  or if you use steroid medication to manage your disease. The exercises mentioned above and performed with resistance bands can also be done with weights. Start with low weight and work up to a weight that is a bit of a challenge to you without compromising your form and joints. Working with a trainer can help ensure you are lifting weights safely with the right form. Walking with a light set of weights may be a useful addition to your morning stroll. (Source)

Balance and Stretching Exercises

Balance and stretching movements are key pieces to an RA friendly exercise program to improve range of motion and strengthen the mind-body connection. The following balance and stretching movements may be especially appropriate if you have RA.

Tai Chi 

Tai chi is a martial arts practice that ties together slow and deliberate movements with mental focus on form and breath. This is great movement for those just starting out on an RA friendly exercise program, as you can focus on achieving balance while improving pain levels and body awareness and reducing stress. Participating in tai chi is equivalent to taking an aerobic walk that moderately increases your heart rate. Not only is this gentle movement enjoyable, but the beneficial effects of the strengthened mind-body connection you will experience may improve your overall quality of life with RA. (Source)

Yoga

Yoga may be helpful to improve flexibility and strength in those with rheumatoid arthritis, while engaging and building strength in core muscles. It is important to keep in mind that if you have spinal mobility issues you may need to adjust your yoga practice with modifications that fit your level of flexibility. In addition to the beneficial effects yoga has on the body, the mindfulness and positivity that follow your yoga practice can be mentally beneficial for combating fatigue and depression. (Source)

Getting Started With Exercises for RA

Being inactive with RA may cause damaging effects in the long run, but exercising regularly can keep your joints mobile and your muscles strong. Starting an exercise program with RA can be safe and beneficial if you know how to prevent injury with this inflammatory condition. Finding an occupational therapist to work with may be a good start for some guidance on which exercises will suit you best and how to perform them safely. Focus on movement that improves your range of motion, while increasing strength and endurance to have a positive impact on your RA. (Source)

Bottom Line on Exercises for RA

Rheumatoid arthritis isn’t curable, but a daily routine of regular exercise training programs may be helpful in managing symptoms of joint pain, swelling, fatigue, joint stiffness, and depression. To avoid over-stressing your body and causing more symptoms of pain and discomfort, choose activities that are appropriate for where you are in your RA journey, and be sure to start new exercise routines slowly and ease into new habits. Listen to your body, go at your own pace, and back off if necessary to prevent injury. 

If you are considering making some changes to achieve a reduction in RA symptoms, the WellTheory 1-1 coaching membership can help take the guesswork out of a personalized dietary and activity approach that supports your condition. Working with a Nutritional Therapy Practitioner can provide hands-on guidance so you can identify a personalized nutrition and lifestyle plan that supports your body and mind while living with RA.