Exercise, how much?

[slewis]

I was diagnosed with PMR in March, and am at present on 11.5mgs Prednisolone, and doing quite well. The problem is mainly in my upper arms, and I have pain raising them over head and putting weight on them, as in kneeling to do yoga exercises, and so I limit these activities. I thought that if I try to strengthen my upper arms by doing non weight bearing exercises, it would improve matters. So I saw a physiotherapist and he gave me some exercises, which involve stretching arms up a wall, a little and often he advised.

My question is, will this approach improve matters or more importantly will it do any harm. I'm certainly not going to give up my yoga, as I can still do lots of exercises that are no problem, and the breathing and meditation practice helps with the PMR.

I would be grateful for any advice from more experienced members of the PMR club.

[SheffieldJane]

The inability to raise my arms above my head was one of my earliest symptoms. If that returned I would consider upping my Prednisolone dose a little because the inflammation is harmful as well as painful. Your exercise regime sounds sensible but it's difficult to gauge how much to do, because you don't get the normal warning signs until it's too late. I find that walking on the flat for about an hour each day, if possible suits me without ill effects. I found my Physio excesses more of a challenge. Gentle yoga is great for body, mind and soul. I would be unable to participate fully in all of the moves though. Go well slewis.

[PMRpro Ambassador]

I had yoga exercises adjusted for me - I did Iyengha yoga. There were some I simply couldn't do though, any involving weight on my shoulders included. It won't do a lot of harm probably - but if it hurts or even is uncomfortable why put yourself through it? In general, if it hurts much afterwards then you are probably overdoing it. I accepted a bit of discomfort, but nothing that took more than a few hours to recover. If it still hurt the next day I counted that as too much.

If your symptoms haven't gone I'd suggest your current dose is a bit low - or that you didn't stay high enough for long enough to improve the shoulder inflammation, particularly if it is both sides. You really need to stay at the starting dose until all the symptoms have improved as much as they can, only then should you start to reduce. I found it took several months for the hip and hand/foot tendonitis/bursitis to fade. The shoulder stiffness went very quickly so I obviously didn't have too much shoulder bursitis.

[slewis in reply to PMRpro]

Thanks for that advice. I'm reluctant to increase my dose, I know everyone is, and I've been on 12mgs for a few months now, before reducing now to 11.5 using very slow method. I think it's a question of how much pain is acceptable. I've read on this site that many people have pain in the morning, and after taking the magic pills, it wears off. This is what I have. If I then have a reasonably inactive day, all is well, no further pain, it's only when I do active things, like gardening that I am in trouble.

The hardest thing for about this disease is that I can't do anything about it. I keep thinking if I was the type of person who liked sitting around doing very little, it would be easier. However, I realise I must try to limit my activities, and it's hard!

[PMRpro Ambassador in reply to slewis]

Try taking your pred as early as possible in the morning as you can. Many people wake early, take their pred and settle down for another couple of hours by which time the pred is starting to work.

[slewis in reply to PMRpro]

I do take some of my tabs early in the morning. I'm glad to say my sleep has improved over the past few weeks, I was waking at 3am, but now I wake about 4.30 and go back to sleep for another hour. So this is an improvement I think. I've tried taking the whole dose early in the morning, but was completely exhausted by the afternoon, so splitting the dose works better for me. I've learnt from other people on the site that you find out by trial and error what works best for you, horses for courses.

[DorsetLady PMRGCAuk volunteer]

Hi,

Try Pilates for a change, similar in lots of ways to Yoga, but I find it better for me - my problem is now arthritis rather than GCA related, in knee and shoulder. Most of the poses are done lying down (although the cat is a favourite in Pilates as in yoga) so that releases some of the stress on your body.

The only problem with doing the Physio recommended arm stretches is your muscles post PMR and Pred don't like too many repetitive type exercises, so just be careful when you've doing them, it could be making things worse instead of better.

Totally agree that exercise is a very positive thing, but it must be gentle and relaxing and certainly not 'going for the burn'.

[slewis in reply to DorsetLady]

Thanks for your advice. I will try to do gentle exercise. I can walk, no problem, so that's good exercise, and I'll do gentle gardening which is also therapeutic.

[DorsetLady PMRGCAuk volunteer in reply to slewis]

Quite agree about the gardening, and wish I could still walk like I used to (arthritic knee..grr), but life is what it is!

[Roltuba]

I'd suggest you keep up the exercise. I wouldn't say I'm that experienced though and I would be reluctant to challenge the advice of a professional. However, the old axioms "if you don't use it you lose it" and "little and often" ring bells for me and that's how I'm dealing with my own much reduced abilities in the exercise department.