“Exercise for the treatment of RA”: My local gym has... - NRAS

NRAS

31,148 members37,693 posts

“Exercise for the treatment of RA”

Mittagating
Mittagating

My local gym has stated “there are specific exercises used for the treatment of RA” which they claim to have training for. They go on to state “they can help reduce inflammation in the joints, relieve pain, prevent or slow down joint damage, reduce disability.” Does anyone have experience of such a programme? Why, over the course of 6 years and 3 Rheumys have I only ever been told to stay as fit as possible, do as much as I can when I can. I am very cynical about the claims made by a hymn bunny, even one with sports rehab and various other training. I would love to hear opinions - admin/people of knowledge please comment too!!

I’m being offered biologic as soon as paperwork through and I’m not in remission yet (far from) so very wary of ‘overdoing’ things. I want to be sure gym bunnies telling the truth!!!

37 Replies

Personally, I would not be undertaking any programme without rheumatology input whilst undergoing a drug change. If you are moving onto a biologic I presume things are not great with your RD ?

Keeping moving and fit is essential for the health of RD joints, but before you do that, you need to protect your joints whilst they are inflamed and the disease active.

A few questions I would ask: What 'training' do the people at the gym have, the details? ? Is the programme designed for people in remission?

What about people with active synovitis ? Do they understand what synovitis is ? (Which I presume you have of moving to biologics ? )

Have you been referred to a rheumatology physiotherapist ? That might be a good starting place rather than a commercial gym ?

Mittagating
Mittagating in reply to Mmrr

Thx. I rather expected these answers! The gym (not hymn😂) person has lots of genuine qualifications but is not a medical/Rheumy therapist. I want to use treadmill for walking when weather sends me indoors, they offer a medical referral reduced rate. I got gp referral but they won’t let me use it unless they design a programme For me!! We reached an acrimonious impasse! I’ve not had a Rheumy physio referral, I’ll ask next time I see anyone. Should be within 6 wks I’m told for next step towards biologic. Yes, disease very active, mostly in my hands and I just don’t see why they think they can manage my disease better than I can!! Thx for reply, good info.

Mmrr
Mmrr in reply to Mittagating

Good luck

Mmrr is right! My specialist RA Physiotherapist saw me in the time between stopping DMARDs and getting biologic drug instead; steroids had calmed the severest symptoms but I was told to forget my neck exercises etc meantime and go back once the disease is well controlled.

I’d not be trusting any gym programme with claims you describe!

Mittagating
Mittagating in reply to charisma

Glad to know I’m not just being “awkward”! Which I know I can be!! Yes, I’m in the space between DMARD and biologic. They gave me jab last Thursday but negligible improvement in hands. My overall physical health is pretty good, hands and wrists well... least said!! Now I need to decide whether to cancel gym membership altogether (in a pet) or keep it and pay full whack cos I won’t risk their programme but want to use facilities. Thx for input, all helps.

charisma
charisma in reply to Mittagating

If you don’t have lasting relief from a jab, you might ask for oral steroids. I am still on a taper, hoping I won’t be bent over and barely able to move again before biologic kicks in about mid Dec. If it does worsen, I am certainly going to ask for more steroid tablets. 🙂

Mittagating
Mittagating in reply to charisma

Really hope you get some improvement and hang on in till the biologic. With the exception of my hands and wrists I am totally mobile. I have real problems dressing and can’t write or cut steak at the mo ☹️ But I can walk up a storm!

charisma
charisma in reply to Mittagating

Thanks! Comparatively speaking, I am much improved since June but that’s steroids. Had a five week break from those and biologic after only two injections, fighting infections.

So restarted from scratch, had second injection a few days ago.

I can’t cut meat or anything either. I use a fork and spoon for my meals.

But can sometimes chop onion, again due to steroids at the moment. I wish I had energy to walk and walk... love it! But I manage about 10,000 steps unless too fatigued.

We get through. 🙂

I’ve been ‘criticised’ for talking about the benefits of exercise. And upon reflection I understand the points raised and the insensitivity of precious posts.

However if you can; yes exercise and move. I’m still able too and it makes me feel great.

I fully appreciate that others can’t; but whilst you can, do.

Kalimers65
Kalimers65 in reply to Jamarruk

20 years ago when I was practically bed ridden I called an RA helpline and the the person said how important it was to keep moving and doing gentle exercise. Yoga has helped me no end. Sorry for the late reply.

Precious ?!? Previous even (it’ll be the lager !)

I listened to the NRAS podcast on exercising with RA which I found interesting. It will probably still be on the website. The researcher was getting all the RAers to go to his gym class. He didn't say what they did when there. He did say there was no list of approved gyms/physical trainers for RA in the UK. Maybe nobody has decided what is good and what isn't.

Rheumy would presumably only offer therapies available on the NHS....which presumably is not what is offered at your gym?

Rheumy’s never even mentioned exercise 😂

I think our rheumatologists expect us to keep moving as much or as little as we are capable .......we all know not using joints means they freeze up .....I find a little pain stretching each day has certainly helped my joints.

That was pretty much my argument to the gym that I want to do as much as I can, but I can’t lift a kettle without both hands never mind grip anything in a gym! And I like the water workout class but most other classes don’t suit. And them setting a timetable which my RA will, of course, ignore is just demoralising! I’m going to research her claim to being specially trained in exercise for RA because, quite frankly, I don’t believe her.

It’s quite possible she may have been trained in exercises beneficial to people with RA..but presumably the classes will be a little “extra” at your gym?

I have never yet found a gym that doesn't try to persuade members to take classes not included in their regular membership. I’ve given up on gyms now.

As I say I do a few stretches recommended years ago by a physio ....I don’t feel the need for anything more strenuous.

I don’t own a kettle anymore...I have a little water heater that holds 2.5L of water...I fill it every morning with a jug......you just put your cup under the spout & press a button fo tea,coffee,soup etc...one of the best gadgets ever!

Total bumpkin.... GPs don’t get RA or most physio’s never mind a fitness instructor

'The importance of physical activity in rheumatoid arthritis' by Professor George Metsios (recorded in September 2018) is a webinar on the NRAS website which you will probably find helpful.

My Rheumy has referred me for hydrotherapy and I'm about to start a 6-week programme which I'm really looking forward to. I hope to get a sequence of helpful exercises that I can continue in a pool working by myself. My feet, ankles and knees are too bad to walk 50 metres let alone do exercise so country walks, running and using the gym are out.

I would be concerned at how well qualified/informed about RA any gym trainer would be, as others here have said. Do get proper advice from your Rheumatology Department.

I shall look for that webinar. I love my water workout class the only thing I don’t do is use the gloves (give you webbed hands) and I avoid creating too much resistance with my hands in the water but I do all the rest with gusto! I hope it works for you. The classes are included in my gym membership but most are not for me. Most of the equipment is not for me which is why I chased medical discount. GP v happy to refer, it’s the gym’s red tape tripping me up. I’ve never been good at conformity!!

Enjoy the water!

Thank you! I’m hoping to get back to my Aqua Fitness class too eventually. Small steps ...

My reason for going to the gym is to do Aquarobics.

You put in as much effort as you can or wish. Its easy on the joints. good fun and a good workout

I was always fit then ra struck and I lost all my fitness and didn't do much for 5 years, it hurt so much. Eventually they found a biologic that worked for me and so I employed a personal trainer (3 months) to tailor a GENTLE programme to get me moving after 5 years of inactivity. I'm fit again. but I walk (a lot) swim and do lots of Pilates classes. Nothing that pounds the joints. I also work part time. I have a pilates class at 8.45 this morning which I walk to so I'd better get going. I find this one harder as it's early. I would say if it hurts don't do it. I'm 59 this month.

I have two experiences of PT instructors. One great, the other not so much. One suggested exercise bands for strengthening muscles etc...around the joints to support them. He gave me a series of exercises increasing in strength. Good PT.

Other, gentle lunges. Knee clicked and couldn’t put my foot on the ground for two weeks and still difficult. Not so good PT.

My rheumy suggested the exercise bands, swimming, stationary bike and yoga (if possible). All non weight bearing stuff.

Gosh. I too would be suspicious of such claims and would seek clarity and evidence of their qualifications and experience. Most people do not understand RA/RD - do wish they would rename it as the disease it is. Arthritis is so misleading.

Anyway, I try to go to a class a couple of times a week. The class depends on my hands and wrists in particular as Pilates, my preferred option, is impossible when I am unable to bear weight on them. I think my point is that we are individual in all things, including our disease and there can't possibly a ongoing programme that fits all or even one person over time.

I too am lucky enough to be able to still walk, occasionally play golf even (well after a steroid injection anyway), and attend some kind of fitness class.

Also I am waiting to start on a Biologic - just waiting for test results and paperwork.

Good luck, stay well.

Surely there's no 'one set of exercises that fits all', not only for those with RA but any health condition or even people without any specific health issues, depending on their age and level of fitness. There are so many variables how can they make such a claim? It's misleading.

My Rheumy physio designed me a programme which I carried out 2/3 times a week at the small gym attached to the medical specialities dept at the hospital. It used to cost £25 for 3 months and I could choose which day/time I wanted to go. I loved it because the exercises really helped my general fitness and mobility, I was in a safe environment and I didn't feel 'out of place' when I took things slowly or struggled with some exercises. I never came away covered in sweat or out of breath but steadily got fitter.

Sadly, budget cuts meant the closure of the gym and transfer to another hospital which is much more difficult to get to and is very restrictive on when I can attend so I no longer go. I did check out private gyms nearer to home but none were suitable.

Can't help thinking that if the NHS had a gym attached to each hospital it would help in reducing costs in the long run.

Ferret18
Ferret18 in reply to Maggsie

Hi Maggsie

I was very fit before RA struck a year ago and now struggling with doing very much. Can you remember the exercises your rheumy physio gave you? I’d be very interested

Thanks

Maggsie
Maggsie in reply to Ferret18

I started with a 5 min warm up on the stationary bike, moved onto leg presses, moved on to shoulder and hip work on the weight machine using the ropes and loops, went onto the rowing machine, used hand weights for wrist and biceps and finished on the treadmill as a wind down

I started very gently and built up the reps, weights and distances slowly. The whole routine took about 45 mins.

Hope this helps

Ferret18
Ferret18 in reply to Maggsie

Thanks Maggsie

If the medical discount is worth having I'd join the gym, accept their 'programme' - and then just do as you wish.

In my experience gym trainers have no conception of RA at all and I'm not sure I'd trust one to design an exercise programme for me. The quotes above sound a lot of guff to me although that alone would not stop me from going.

I do use the gym, primarily for a bit of cardio, and I use weights etc, when I can.

Before RA I was very fit and addicted to exercise classes. After diagnosis I managed to see a specialist hospital physio who recommended exercise bands as the most suitable way to strengthen my joints. I've never liked using them much and tbh they hurt my hands too much so I gave up with them pretty quickly.

I have a 'programme' designed by my gym - maybe it's a legal thing? but I've never followed it. The main thing is that I go, and get some exercise. If you like walking, using the treadmill is a great way of keeping fit over the winter and you can use incline to add exertion without hurting your joints. You'll probably be able to use the bikes - I never hold on, I just lean on the handlebars with my forearms.

There'll be a range of machines you can use without gripping with your hands, and I have some velcro weights I can strap round my wrists and ankles though I can't do them up myself if my hands are bad.

My main problem with the gym is flaring with fatigue if I'm not very careful about hard I push myself. I think the main things to bear in mind is not to exercise joints that hurt. They need to be kept gently mobile but not exacerbated in any way. Also if you're flaring and don't feel well, it's not a good time to go to the gym - you can't work through it with RA - or I certainly can't.

We all know our own bodies better than anyone else so have faith in your own judgement about what's good for you or not. By all means attend the gym assessment and hear what they say - you don't have to follow their regime. It might be the case that together you could actually work out a programme that you enjoy which will help you stay fit.

Let us know how you get on - am really interested to hear more!

There is a great deal here that resonates with me, and to think about. Thx

J1707
J1707 in reply to StormySeas

I Agree with everything you said Stormy. Some excellent advice . Find the exercise that works for you. Like you working out while having a flare is a no no. I learnt this to my cost when I pushed myself too hard during a flare...extra working hours and exercise I ended up having severe a allergic reaction now have an epipen as my body is so stressed during a flare large or small.

I have had some really interesting and helpful responses, thank you all! I will try and sort my plans an let you know how it goes.

Thanks for this. I find gentle running on the treadmill, yoga and Pilates really helps me. If I do nothing my joints are really stiff and achy and I feel absolutely tired so I would highly recommend exercise. I just listen to my body & if something hurts I stop. This is my consultants advice.

Exercise is beneficial for RD but “treating the disease”??!

We have to give priority to disease modification and protection of our joints and then we strive to eat right and exercise but doing so in moderation so as not to aggravate inflammation or cause additional damage. We also must be cautious not to overdo things and cause a massive flare up of symptoms.

We also need to keep in mind the type of exercise.

It can help strengthen the muscles which in turn can help the joints but it wont stop or reverse damage. It’s an autoimmune disease unlike osteoarthritis.

As has been mentioned, always follow your Rheumatologists recommendations. They know the ins and outs of the disease and they know you as an individual.

Personally I try to do some Pilates if I can, which involves a lot of stretching and gentle exercises to keep my joints mobilized but honestly I have to be careful as many of the exercises im not able to do. And quite frankly, I don’t do it regularly due to my Rd- pain, inflammation and fatigue. Personally, I would never work with an individual that doesn’t understand what RA is.

I do yoga classes every week I find it really helps me.

You may also like...