My living room looks a lot like an in-progress home gym project.
I have just about every piece of fitness equipment that will conveniently fit in a small apartment, from the bicycle mounted on the wall to the suspension training straps tossed over the front door. Yoga blocks and mats lie at the base of my mountain of medicine balls, resistance bands, and other generic fitness paraphernalia.
Sometimes I gawk at it in all its towering glory and am reminded of the peaks and valleys I’ve hiked over the years in the old hiking shoes by my front door. Most days, however, I wince at the sight of it, partially because it’s a cluttered mess that’ll inevitably destabilize, but mostly for how much dust it’s collected.
These items sit largely unbothered, serving as constant reminders of how much my body has changed.
At one time, the fitness paraphernalia in my living room wasn’t just for show. They were as much part of my day and self-care routine as my toothbrush.
I was happiest after a good sweat. I felt most liberated after leaving a Vinyasa yoga class. But when I started having unusual aches and pains and began tiring after a walk through the park, I was flabbergasted but deduced that the only explanation for this was overtraining. I must have been overworking my body.
As time went on, It was evident that this was more than a case of overtraining.
I’d eventually learn that these symptoms were consistent with rheumatoid arthritis (RA). After some lab work and several trips back and forth to the doctor, I received an official diagnosis.
I was terrified, but initially, the symptoms and diagnosis were just a minor inconvenience. I was able to maintain an active lifestyle despite the discomfort I was experiencing.
My primary forms of exercise were running and hiking. However, as time went by, I went from being super active to almost sedentary.
The brakes on my bike gathered dust. My favourite pair of minimalist running shoes were now buried in the depths of my closet after a podiatrist suggested I switch up my footwear. The nature trails that I frequented — that were my respite from the concrete jungle and the confines of pandemic quarantine — angered me as I drove past them.
I tried telling myself that I could muster up the mental grit to push through it all. But my ankles weren’t having hours on the trail, traversing rocks and snake holes. The uneven ground only aggravated my subtalar joint, a joint in the foot commonly impacted by RA, rendering the trek unbearable.
I knew that with RA, exercise is especially important for combating the most aggravating symptoms at bay. But eventually, I just about convinced myself that I would never be active again, that my athletic days were over, and I may as well toss out my activewear along with any plans to run races, climb mountains, and cycle a century.
So when the realization hit — almost out of thin air — that there was still at least one option I hadn’t considered, I almost chuckled out loud at the grocery store. I, a self-proclaimed fitness buff, had failed to recognize that I had not exhausted all of my options.
It finally occurred to me that I had yet to chart the waters (pun intended) of the chlorinated deep blue depths at my local swimming pool.
I did not have much experience in the pool. Intense aquaphobia kept me far from the pool deck, despite learning of the many benefits of swimming throughout the years.
I’d heard numerous accounts of people turning to pools to alleviate pain and discomfort from injuries or degenerative arthritis. In RA specifically, a 2017 study found that participating in a 16-week aquatic exercise program led to improved disease activity and functional ability in women with RA.
I’d heard of the successes that athletes had in recovering from injuries using aquatic physical therapy. Older adults in my circle spoke about doing water aerobics.
When I stopped running, maintaining my cardiovascular fitness was a primary concern. Luckily, swimming is an aerobic exercise much like running, and you don’t have to spend all of your time swimming freestyle to reap the benefits.
Aquatic exercise, like deep water running, is used as a rehab exercise for athletes due to its low impact and cardio benefits. Maybe running wasn’t completely off the table. I knew that once I mastered the skill, I could trade in pavement pounding for aquatic exercises like deep water running and still work toward increasing my aerobic capacity and endurance.
The evidence was all around. It was a no-brainer that it was time for me to dive in (again, pun intended).
My journey started with a good ol’ internet search. Before I could reserve a lap at the swim stadium, I’d have to figure out how not to drown.
I never learned to swim in my youth, so finding an affordable swim instructor willing to contend with an adult beginner with intense water anxiety was the first challenge. Fortunately, after only a few phone calls and emails, I sifted through overpriced swim schools and poorly reviewed instructors and found the right fit.
I watched instructional videos on what to expect to help quell my fears. I searched for how to put on a swim cap and consulted webpage after webpage about swim goggles. After I bought a pair of swim goggles, I searched up whether they were supposed to feel like barnacles stuck to the orbits of my eyes. I didn’t find a definitive answer, so I purchased and swapped out a few until I found a comfortable pair.
I scheduled my lessons, found my swimsuit, and thought to myself, “Um. How am I going to do this?”
Eventually, the day arrived. As I gathered my things to head for the pool, the mountain of gear in my living room began to resemble an iceberg. All the things that might go wrong in the water started to fill my head.
Maybe it had something to do with growing up in the ’90s and watching one too many movies about boats and icebergs, but the mere thought of the water made me want to reconsider this whole swimming thing. Still, I made my way toward the pool.
Those first steps into the water were enough to make my heart rate skyrocket. Although the pool was heated, the water felt ridiculously cold. The frigid temperatures paired with arthritic joints made me question whether I should proceed.
Before I could give it too much thought, my instructor told me to take a deep breath and put my face in the water. This took some getting used to and was manageable.
We did a few more water confidence exercises and the whole ordeal seemed a bit more approachable. We did some jogging in the water, and wow, this was it! I hadn’t run in over a year. This was going great!
Then, we broached the subject of floating. Was I really supposed to float in the pool during the first lesson? I had come here to increase my health and quality of life, but all of a sudden, I was on the fast track to certain death.
We started with holding onto the wall. This is when I began to realize that this wouldn’t be so simple. I held onto the side of the pool for dear life. I noticed the weakness and pain in my hands. I didn’t have much confidence in my body’s ability to collaborate with the water and regain my footing after floating.
I realized that these lessons would really be an exercise in trust and letting go, embracing this new environment, and adapting to a body that was going through some changes.
When I finally entered a back float without any assistance, I could only stare at the open sky above. How humorous. I was given a preview of what would come next (my ascent into the heavens) because learning how to swim would surely only end in my untimely demise.
After about a week of consistently going to the pool daily, however, I noticed a huge difference. There were major ups and downs and some days fear got the best of me, but the water had done my body good.
I felt more limber. I felt my quads turning on for the first time in what felt like forever. My arms were the “good kind” of sore. I felt like myself again.
I recognized that familiar post-workout hunger pang. Best of all, I hadn’t drowned!
I’d love to paint a picture of swimming as an easy exercise alternative for RA. Truthfully, it comes with its difficulties that are unique to both the sport and the athlete with RA.
Swimming gear and equipment isn’t inherently RA-friendly
RA affects my grip strength and causes swelling and pain in the joints of my hand. From the start to the finish of a swim session, these joints are taxed.
Putting on a swim cap, tugging at the tight Lycra as I put on a swimsuit, and putting on swim goggles present challenges before I’ve even approached the pool. Then, entering a pool via ladder (versus steps that allow you to get into the pool as if you’re using stairs) meant grabbing and holding onto the rail as I went into the pool.
Grabbing onto a kickboard was yet another stressor for my hands, which were already over gripping the board and edge of the pool wall from anxiety.
Be mindful of your pain management regimen and consider the modifications it may require.
Gear aside, it’s still not 100-percent pain-free
Countless articles insist that aquatic exercise is a heavenly experience that even those with the worst kind of pain can enjoy. In my experience, that’s just not the case. It’s not as simple as it’s been marketed.
Like all exercise, it requires effort and energy, the latter of which must be rationed for most individuals with autoimmune diseases (see “Spoon Theory”).
A lot of us must manage fatigue and malaise. Thirty minutes of exercise can mean being bedridden the next day.
The water does an excellent job of reducing gravity and taking much of the strain off of one’s joints, but I still left most sessions needing to slather on the menthol creams.
Moving through the resistance and “pulling” the water works muscles and joints. Albeit significantly less than weight training at a gym, I still experienced some pain during movement and swelling post-swim. In fact, my swim journey took a minor blow when my doctor told me my recent shoulder issues were due to biceps tendonitis.
Be kind to yourself, pace yourself, and understand your limits.
You need to be mindful of swimming-related illness
DMARDs (disease modifying antirheumatic drugs) are part of the treatment plan for a lot of people with RA. These medications can lower one’s ability to fight infection.
Recreational water illnesses can be a real concern when your immune system is suppressed. Contaminants such as faecal matter, sweat, skin, bacteria, and fungus could be a threat when your immune system may be functioning at lower than normal levels due to medications.
Swimmers should be mindful of the potential for contracting a swimming-related illness and look out for symptoms, such as diarrhoea or vomiting, skin rashes, and cough or congestion.
Accessibility is an issue
The topics of swimming and disabilities have at least one important issue in common: accessibility. Having access to a pool is not a reality for a lot of individuals, especially once the weather changes in certain parts of the country. Gym memberships for gyms with pools can be expensive.
People with disabilities often experience
These costs that can seem minuscule for some can be considered luxuries when you’re in a community that experiences high rates of poverty.
If swimming lessons in your area are not in your budget, there may still be some options. After finishing my first set of lessons, I looked into getting additional swim instruction and found that my city offers free lessons in the summer to those from low-income households.
Also, check with your doctor or insurance plan to see if aquatic therapy is covered by your insurance. Your copay may potentially be less than the cost of swim lessons and lane rentals.
If you are able to find a pool, check with your pool staff to ensure they have a working water lift to allow for easy access in and out of the pool if descending stairs is difficult.
As my lessons came to a close, I had made significant progress. I need more lessons, though, before I can claim that I know how to swim.
I look forward to improving my swimming skills because I believe this will be the key to me integrating physical activity with RA.
I spend time in the shallow end of the pool, work on my water confidence, and plan on taking more lessons because movement is so important for taking care of ourselves.
It runs deeper than exercise and fitness. Having RA means your body may show signs of damage from disease activity or prevent you from living the life you desire. It means some days you go to the pool, and some days you drown yourself in a pool of menthol cream.
I still believe our bodies are worth being celebrated. My pool time has become a celebration of a body that isn’t diseased or disabled, but always changing and adapting.
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