From healthcentral.com
Developed in partnership with Hospital for Special Surgery, this short series of moves specifically addresses your RA joint issues
Rheumatoid arthritis (RA) is not a one-size-fits-all condition but if you’re among the 1.3 million Americans living with this autoimmune inflammatory disease, you know that symptoms like morning stiffness and chronic joint aches can come with the territory.
That doesn’t mean that you have to be sidelined from staying active—far from it. For many RA warriors diagnosed today, when the disease is caught in early stages, exercise is an essential ingredient in your care plan to keep symptoms from progressing.
“Taking a more holistic approach works well for those with RA,” says Elizabeth Schulman, M.D., an attending rheumatologist at the Hospital for Special Surgery in New York City. “Medication is definitely needed to help control inflammation and prevent joint damage. However, exercise is also essential, and early incorporation of an exercise program, either on your own or with a physical therapist or personal trainer, is imperative.”
To help you tap the benefits of daily movement, HealthCentral has partnered with the renowned Hospital for Special Surgery (HSS) to bring you the RA-specific guidance you need to get going. Bookmark this spot and use it as your go-to fitness plan, including ten foundational exercises that help support joints commonly impacted by RA and tips for getting more movement into your routine.
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The Benefits of Exercise for Rheumatoid Arthritis
Though it might sound like the last thing you want to do when you’re in pain, if your body allows it, exercise will do you a world of good. “Most people with rheumatoid arthritis feel better when they’re active and worse when they’re not,” says Dr. Schulman. “Movement helps push the excess fluid [from swollen] joints and back into the circulatory system, decreasing pain and helping improve mobility. Activity also maintains muscle strength, which is essential for pain management and preserving muscle and joint function.”
A quick look at the science makes it clear just how potent physical activity can be with helping to tame RA symptoms. According to recent research published in the Journal of Science in Sport and Exercise, exercise increases mobility, reduces pain, improves sleep, betters the quality of life, and reduces disease activity in those with RA.
Additionally, “exercise strengthens your muscles, including the heart muscle, supports your bones, and protects your cardiovascular system,” says Dr. Schulman. She notes that this is especially important since having untreated RA also puts you at risk of other health issues such as cardiovascular disease (CVD) and osteoporosis.
Maintaining your fitness can also keep weight gain in check, another important plus that will help you better manage RA. According to recent research, even light-to-moderate physical activity improved body composition and physical function in those with RA, and another study found that exercise helped reduce abdominal fat, and improved strength and overall health—without an increase in disease activity and pain.
And let’s not forget the mental boost you derive from making movement part of your routine. One 2024 scientific review of the connection between exercise and quality of life in people with RA found that moderate exercise improved their mental health, helping quell the anxiety, stress, and depression that can often come with this condition.
Inspired? The team at HSS has developed a simple exercise plan to help proactively take control of your RA symptoms.
The RA Workout
“I have noticed that those who stick to an exercise plan, even a low-level plan, have less frequent flare-ups—and when they do occur, they are less severe,” says Zachary Rogers, a doctor of physical therapy, board-certified orthopaedic clinical specialist, and certified strength and conditioning specialist at HSS in New York City.
Your first stop: Get guidance from your care team before starting a new exercise routine. “I recommend consulting your medical team or physical therapist about helping you develop a plan that is right for your specific needs,” Rogers says. “For example, someone with a knee or hip issue will be very different from someone with a wrist or spine issue.”
This workout, designed by Rogers, consists of five mobility moves and five strength moves that mainly target your spine, core, and lower body. “Remember, an exercise plan should be tailored to your individual needs, but I find these exercises to be helpful for most people with RA,” says Rogers. “When done regularly, this program can improve functional fitness, which translates to improvement with daily activities.”
If you’ve got the greenlight from your doctor, get started—and go at your own pace. “Listen to your body,” reminds Rogers. “Do as much or as little as is appropriate for you each day.” Your long-term goal? Two sets of 10 repetitions for each strength move. But if that is too challenging to start with, aim for two sets of 5 reps.
Supine Hip Flexor Stretch
Why it works: Here, you use gravity to your advantage, passively stretching your hip without excessive strain on the joint.
How to do it: Lying on back in bed, position yourself so that you are near the right edge of your mattress with your arms along your sides and your legs straight. Keeping your body stable, slide your right leg over and allow it to hang off the edge of your bed; your right knee can be straight or bent. You should feel a stretch in your right hip. Hold for 20 to 30 seconds, then bring it back onto the bed. Repeat once or twice more. Switch sides, lying on back near the left edge of your mattress, and repeat with your left leg.
Number of reps: Three sets of 20- to 30-second stretches
Supine Hamstring Stretch
Why it works: This move stretches your hamstrings one at a time, allowing you to focus on each side individually. You might even notice that one side is tighter than the other, and can give it extra attention in the future.
How to do it: Lie on your back on the floor or in your bed with your knees bent and your feet flat. Extend your right leg directly above your right hip and grasp behind your right thigh with both hands. Slowly pull your right leg toward your chest, keeping it as straight as possible, and hold for 20 to 30 seconds when you feel a stretch. Return to the start. Repeat once or twice more. Switch sides and repeat with your left leg.
Number of reps: Three sets of 20- to 30-second stretches
Double Knee-to-Chest Stretch
Why it works: This move gently stretches your lower back and glutes without putting excessive pressure on your spine.
How to do it: Lie on your back on the floor or in your bed with your knees bent and raised above your hips (so that feet are off the floor). Wrap your hands around your knees and pull both knees gently toward your chest until you feel a stretch. Hold the stretch for 20 to 30 seconds. Return to the start, rest briefly, then repeat once or twice more.
Number of reps: Three 20- to 30-second stretches
Lower Trunk Rotation
Why it works: Gravity works in your favour again with this move, gently drawing your legs toward the ground to stretch your trunk and back.
How to do it: Lie on your back on the floor or in your bed with your knees bent and your feet flat. Extend your arms out to the sides for stability, or cross them over your chest. Slowly lower your knees to the right, pausing when you feel a gentle stretch in your back. Hold for 20 to 30 seconds, then return to the start. Continue, alternating sides, until you’ve done two or three stretches per side. “You don’t have to get your knees all the way to the floor,” says Rogers. “The goal is to feel a light stretch in the back, so only go as far as is comfortable for you.”
Number of reps: Three sets of 20- to 30-second stretches
Seated Calf Stretch
Why it works: Doing this move in a seated position allows you to stretch your calves without adding pressure on your feet and ankles.
How to do it: Sit tall on the floor or in your bed, with your back against a wall for more support. Extend your left leg on the floor in front of you and wrap a belt, towel, or even a pet leash around the ball of your left foot, holding the ends in each hand. Keeping your left knee straight, gently pull back on your left foot until you feel a stretch in your calf and hold for 20 to 30 seconds. Release and rest briefly. Repeat once or twice more, then switch legs, using the belt to stretch your right calf.
Number of reps: Three sets of 20- to 30-second stretches
Straight Leg Raise
Why it works: This exercise strengthens your hips flexors one at a time, helping stabilize your hips and strengthen your trunk.
How to do it: Lie on your back on the floor or in your bed with your arms along your sides, your left leg straight, and your right knee bent with right foot flat on the floor. Slowly raise your left leg until your left thigh is parallel with your right thigh. Slowly return to the start with control and repeat. Do 5 to 10 reps. Then switch sides, lifting your right leg, and repeat. Complete two sets per leg.
Number of reps: Two sets of 5 to 10 reps
Side-Lying Hip Abduction
Why it works: This move helps strengthen the outer hip and glute muscles, an area where many people are weak.
How to do it: Lie on your left side on the floor or in your bed with your hips and knees stacked and your legs straight. Extend your left arm and use it to cushion your head. Raise your right leg as high as you can without leaning forward or back, or tilting your pelvis. Slowly return to start with control and repeat. Do 5 to 10 reps. Then switch sides, lifting your right leg, and repeat. Complete two sets per leg. “You can also do this move standing,” says Rogers. “Some people like the standing version better, while others find it is too much stress on their joints.”
Number of reps: Two sets of 5 to 10 reps
Prone Hip Extension
Why it works: Your gluteal muscles are responsible for hip extension, and doing this move one leg at a time helps ensure equal strength between your two sides.
How to do it: Lie face-down on the floor or on your bed with your legs straight and together. Place your hands on the floor or bed under your forehead as a cushion, or extend your arms along your sides. Without allowing your hip to come off the floor, slowly lift your left leg as high as you can and pause. Return to the start with control. Rest briefly then repeat. Do 5 to 10 reps. Then switch sides, lifting your right leg, and repeat. Complete two sets per leg. “This move also can be done standing,” says Rogers. “Try both versions and see which you prefer.”
Number of reps: Two sets of 5 to 10 reps
Sit-to-Stand
Why it works: This exercise mimics a movement you do every day, and helps improve strength in your lower body and trunk.
How to do it: Sit on a sturdy chair or on the side of your bed with your feet flat and your arms at your sides. Keep your back straight as you lean forward slightly from your hips, then extend your hips and knees to stand all the way up. Sit back down slowly with control. Do 5 to 10 reps. Complete two sets. “If you need to, you can use your hands to help you get up for the first few reps, but make it your goal not to use your hands by the end,” says Rogers.
Number of reps: Two sets of 5 to 10 reps
Leg Extension
Why it works: This exercise strengthens the quadriceps of each leg individually, helping stabilize your knees for improved strength and balance.
How to do it: Sit on a sturdy chair or the edge of your bed with your feet flat on the floor. Slowly extend your left knee until your left leg is straight and hold briefly. Return to the start. Do 5 to 10 reps. Then switch sides, lifting your right leg, and repeat. Complete two sets.
Number of reps: Two sets of 5 to 10 reps
Your Pro-Active Workout Plan
You may know that the latest physical activity guidelines for adults call for a minimum 150 minutes per week of moderate-intensity exercise (or 75 minutes of vigorous exercise) plus two or more weekly sessions of strength exercises. But checking those boxes can look different for any adult, never mind if you also happen to be navigating a chronic condition like RA. “Any exercise plan should be individualized and tailored to each person,” stresses Rogers.
Still some structure is helpful, and these are the general guidelines Rogers likes to give his clients with RA, which you can discuss with your care team:
Do 30 minutes of aerobic exercise five days per week. “Low-impact activities that don’t put a lot of stress on your joints are best,” he says. “Swimming, using a stationary bike or elliptical trainer, and walking on a flat surface are all great activities.”
Stretch every day. “Mobility exercises can improve your range of motion and reduce pain and inflammation,” says Rogers. The stretches you do may differ from person to person, depending on the location of your flare-ups, but no matter which ones you choose, do them slowly and gently.
Strength train at least two to three days per week. “Again, choose movements that are low-impact that focus on large muscle groups to improve function as well as strength,” he says. Bodyweight exercises, free weights, or weight machines are all fair game, depending on your level of fitness.
Modify your activity when needed. “If you’re having a flare-up, listen to your body and do your best to work around it,” says Rogers. Consider fewer reps and sets and don’t be afraid to take a break and “use a heating pad or ice pack to calm down some of your symptoms,” he says. “Do what you can to keep active without exacerbating or worsening your flare-up.”
Now that you have a toolkit to help with incorporating exercise into your RA care, make sure you consult your medical team about your plans, and above all, feel confident that you’re “moving” toward a healthier future.
Unlike in generations past, for people with RA today, “when we treat early, implement lifestyle changes such as exercise, and find the right medication, people can go into sustained remission,” says Dr. Schulman. “It’s like they never had the disease, and that is the goal.”
https://www.healthcentral.com/condition/rheumatoid-arthritis/stronger-body-with-ra-workout