Increasing exercise while on low dose prednisolone - PMRGCAuk


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Increasing exercise while on low dose prednisolone


Hi evryone. Hope you are all managing to fight this dreaded illness.

I have a question and would welcome any experience on the matter. Is it OK to do a fairly moderate-high impact exercise? I did lots of gym classes pre diagnosis but have been a bit scared to do much since. My Rheumatologist said it would be fine and if it hurts then stop.

I struggle to meet the 8-10,000 step goal but some of it is due to my type of work. I am now on alternating 3/2 mg and exactly a year since diagnosis (started at 15 mg). l like running and spin, combat classes. Is anyone managing to do such exercises? I am not good with just walking except when on holiday. Exercise has previously kept me feeling fit & healthy so greatly missed. I did go to a high impact class a few weeks ago and felt a bit stiff the next day but it gradually went so presumed it was normal but have not been back.

Any advice would be welcomed as I have read previously about people on this site that have taken part in marathons and doing thousands of steps each day. I am also worried that I am finding it too easy to make excuses about not attending my gym that I pay a monthly fee for.

Enjoy the rest of your weekend and thanks for all the support given by this site.

26 Replies
DorsetLadyPMRGCAuk volunteer


I think it depends on lots of factors - how fit you were pre PMR, how long long before diagnosis, if it’s diagnosed quite quickly then probably not much muscle damage whereas if it’s gone untreated for a long time, then a lot of strength has gone. How long you’ve been on Pred, and what doses.

If you went to high impact classes and it’s appeared to be okay after a few days, then you sound fitter than many, but as you know best to start easy and build up gradually. You certainly can’t expect to step back to the level of fitness pre PMR straight away.

Mitziecat in reply to DorsetLady


Thank you for your reply and good advice. I think I had some symptoms for about a few months before diagnosis but mainly just leg cramp when running. Main hip, groin and thigh stiffnes started end of March & I saw GP In May as physio did not work. My thinking is that I was diagnosed quite quickly but I had lost over half a stone by then & mainly from my leg muscle.

I have put back on the weight since medication but not the muscle tone as I have not done a lot of exercise. I will try and build up gradually build up but keen not to cause a flare up of my symptoms.


The guy doing marathons didn't do them while his PMR was active - though he did work up to 10km I think.

Exercise is fine providing you go about it gently in terms of training, building up slowly. If you just dive straight in to a full class without "training" you may well develop really severe DOMS that will last a long time, weeks as opposed to days. The actual disease process continues in the background, the pred does nothing at all to it, and leaves your muscles intolerant of acute exercise. That means they don't signal you are overdoing it and then they don't recover in the same way.

Providing this isn't the first exercise you have done for that year, I would start with half a class, if that is fine then the following class you could do nearer 3/4. How you feel next day is the criterion. And be careful - your muscles will possibly injure more easily after a year on pred. But you know how you felt after the first attempt a few weeks ago so go by that.

I continued going to the gym from my PMR starting and I wasn't on pred either. It was the only thing that kept me at all mobile. I did an aquafit class every day - and Pilates and yoga once I could move after the aquafit. I had had to change gyms as the first didn't have a pool and I found I could do less and less of the classes I had been doing - even though they were by no means even moderate impact. Once I could get to the pool I started at a very low level - aquafit is hard work, everything in the water takes 7x the effort so trying to go all out immediately is asking for trouble but after a few months I was doing almost as much as the others.

You just have to have a go and see how you get on - but start lower rather than higher intensity and build up.

Mitziecat in reply to PMRpro

Thank you PMRpro for the good advice. Will start slow and build up-within my muscle tolerance. I was doing pilates and will start again as it did help.

PMRproAmbassador in reply to Mitziecat

I credit Pilates and Bowen therapy with keeping me reasonably mobile and upright for the first 5 years of PMR when I wasn't diagnosed and so not on pred.


I went for my first swim this week and loved it but had to relax for a while afterwards. Swimming and aqua aerobics are very good as the water aids you and lets you have a good workout. Think about it! Good luck

Mitziecat in reply to Hidden

Thank you. I haven’t been swimming for awhile but will give it a try.

PMRproAmbassador in reply to Mitziecat

I couldn't swim - the shoulders objected too much. In aquafit you are upright and jumping about like any other class.

Hidden in reply to Mitziecat

Hope you enjoy it and find it beneficial


Hell, if I could do it, I would! Listen to your body.... mine still screams if I walk up a steep hill, or more than a flight of stairs!

Not sure how happy "she'll" be this upcoming week when I start training on the new (used) exsercise bike! 🚴 I plan to start getting my knee strengthened! First physio appt on Monday! 😬

Mitziecat in reply to Hidden

😀. Good luck with the exercise and physio.

Hidden in reply to Mitziecat


I have the same dilemma before PMR I was going to a gym class twice a week and Pilates, PRe diagnosis I couldn’t even manage Pilates then have been scared to try anything other than walking, last week I rejoined the gym and have done Pilates and Aquatone so far I am contemplating trying some higher impact classes but worried about damaging muscles. I am currently on 15mg of Prednisolone but have a doctors appointment this week and think my dose will be lowered and maybe I feel more pain as I’m currently almost pain free due to the Prednisolone. Well done to you for having the courage to try a class.

I’ve just had my second anniversary of PMR diagnosis and am hovering around 10/9mg. Started at 20 after a few months trying to establish what was wrong with me. Was crippled! Went from running 3 times a week, Pilates and dog walking and golf in the summer to just walking. I was delighted I could do that! Prednisolone was a miracle cure and I tried running again that summer. As I’d reduced too quickly on GPs advice all the pains returned and I couldn’t do any Pilates and never even considered running. Very frustrating!

You’ve had a faster more successful reduction so hopefully are still strong enough. I definitely feel weaker. I have kept moving so do feel my general fitness is relatively good. I live in a hilly area so any dog walking is a workout. Now back at Pilates and started yoga. Definitely feel so much weaker than 2 years ago but just delighted I can do something as it was so much part of my previous life. I do miss all the running girls chat we had so now we have to meet in evenings and drink wine and eat instead! 😂 Not as healthy but very therapeutic for me. I’ve now managed a few rounds of golf (foursomes so I’m not hitting every shot) and have loved it too.

I say go for it but be sensible! The sense of being normal again is thrilling. Listen to your body though and don’t be pushing through the pain barrier to get fit, think of any exercise as maintenance and rebuilding strength.

Mitziecat in reply to Lochy

Thanks for your advice Lochy. When you have a dog it makes you do some walking and that is good. I have to stop making excuses and get on with it in a sensible way. I am still working & use it as an excuse when feeling tired.

Keep up your exercise and I hope that you soon regain your previous fitness.

70 years old man, 3 1/2 years PMR, now on Methotrexate since 3 months ago, feeling very much better and started reducing pred from necessary 10mg by DSNS. Had several bad flares trying to reduce even slowly over last 2 years, everything got very bad. Very life changing.

In my first year I felt pretty normal and went back to my Circuits class, using hand weights & bands etc. I had always been quite competitive there. Carried a load of chairs upstairs for my Brass Band, which hurt quite a lot, etc etc. After a year I fell in the shower and snapped both spinatus tendons in my shoulder. (Massive rotator cuff tear). Orthoped surgeon said it was acute damage on top of chronic, most likely due to being on steroids which softens tendons, and trying to stitch together would be like stitching tissue paper. He knew much more about PMR than either GP or Rheumy seemed to, and understood my need for the pred. Ruptured achilles tendons is on the Pred list of side-effects.

So be careful with your joints, best not to do anything high-impact or high weight. You can’t tell until you damage something irreversibly. Physio exercises have helped restore good function but no strength above shoulder level.

Really want to get rid of wretched pred, my skin is so thin my arms are covered in red bruises and cuts from the slightest brush with a bush in the garden!

PS even after every test and scan in the book, GP still doesn’t seem to believe in PMR and has had no advice to give. “You’re not getting any younger you know, must expect a few aches and pains......”!!!! If only he knew. Impact on my life AND THAT OF MY WIFE has been huge.

Mitziecat in reply to Roltuba

Hi Roltuba.

Sounds like you have had a very tough time and I hope it changes for you. I will be careful as I stopped doing any heavy weights before my diagnosis due to the history of a fractured shoulder. I worry about the effect if the medication on my achillies tendon and that is another reason that I have been scared of resuming any running. However, I will try but will do the suggested walk and then run for a few minutes to see how it goes.

Thank you for your imput nad encouragement.

bunnymom in reply to Roltuba

Yes pmr is absolutely life changing for both. I just retired at 62. Couldn't do it.

Exercise is good for body and mind. I have stress fractures in both feet and can do weight training and low impact Zumba.i have metal plates in my sneakers. At times, I simply walk way too much. The Dr. said it’s fine. I would push yourself starting gradually and increasing. Muscle has memory and trust yourself to know when to stop.

Mitziecat in reply to Sandy1947

Thank you Sandy1947. Hopefully my muscle will have some memory😀. I will build up gradually but difficult not to push the boundaries at times. Exercise helps my physical and mental health. I find the most depressing thing about pmr is not physically doing what you want to. It is taken for granted when fit and well but I will certainly appreciate it if I get back to a decent level of fitness.

Hi been diagnosed PMR 28 months ago,did lots of exercise classes prior to this,actually I thought the pain from PMR was due to exercising,any way it wasn’t I take 8 mgms of pred daily am trying to taper slowly.The only exercise I do now is yoga and lots of walking.Can do 10 miles a day with my Border Collie Hollie. Good luck with whatever exercise you choose to do I’m sure you will know what is best for you.

Mitziecat in reply to Pieater67

Hi Pieater67

I also confused initial pain as too much exercise. It is excellent that you walk for so many miles but dog walking helps. I am trying to do more walking as it all helps. Thanks for your reply and encouragement.

I have GCA, PMR, doctor said the same thing. I was an avid swimmer. Since diagnosis, I can do a gentle walk for 20-30 minutes. If I do too much, I can barely get from the couch to the kitchen. I usually do not feel the ill effects until the next day. I hiked a strenuous hour uphill and downhill with a friend. I felt fantastic!! Next 4 days felt like I was dying. Everyone is different, so start gently and gradually increase if you can. Take care and good luck on your journey.

Mitziecat in reply to Dream21

Thank you Dream21. I think I worry about the after effects if I do too much & possibility of causing a flare. However, I know if I increase my exercise I will feel better. Wishing you luck also on your health journey.

When I first started on Pred it was so miraculous that I had got my mobility back I went a bit overboard on exercise particularly swimming. I used to rattle off the lengths but then didn't have the strength to pull myself out of the pool. Well all I know is that now my shoulders are totally wrecked and I'm sure it's because I overdid things in the early days, I didn't realise I was damaging them. I now just do gentle exercises like easy yoga and short walks around the park and if I swim it's more like doggy paddle or swimming on my back or aquaerobics rather than front crawl. If I overdo things I seem to get a flare the next day and am really tired for days or weeks, so I try and pace myself. It's frustrating, I want to do more and be 'normal' again but that's how it is and I have to be patient for the moment.

Thank you for the advice tangocharlie. As you say,patience is key and required to avoid any damage. Good luck with your health journey.

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