Hi everyone, I find this site so useful. I was wondering what impact you think exercise has on PMR. I exercise every morning for about 40 minutes, gentle stretches and I find they relieve my early morning stiffness. Weather permitting my husband and I walk for about an hour, again we don’t push it, quite brisk but certainly not power walking. This worked really well for me until I started reducing my pred and my aches have returned. I now find the stretches more challenging and the walk more tiring but I still feel the buzz I get from exercise and being outside is worth the effort. I have noticed a number of posts advising lots of rest and I wondered if I am wise persisting with my regime I appreciate many of you are suffering and I am extremely lucky to be able to exercise so please forgive me if this appears trivial
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El
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Elor
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Hello. Both Pred and PMR make the muscles and tendons less tolerant to exercise, often with a delayed reaction. However, it is essential to maintain as much functionality as possible. So yes rest, but do what you can and be totally lead by what your body says. You may also find it’ll fluctuate with phases of good and not so good times. Yes, you’ll hear of those who work out regularly and those who can’t lift a finger but you have to find your happy medium for now.
I had GCA only and found all I could do was walk as my upper body became so weak. Then at much lower doses my Achilles’ tendons have decided to be upset so walking like I did on higher doses is less easy which seems a bit cruel now I have more energy and general strength.
The advice for rest is perhaps more directed at the problem of fatigue which is made far worse by overdoing it.
I too found that carefully selected exercise helped the stiffness but never the pain during the 5 years I had PMR without pred - not out of choice, I simply wasn't diagnosed and it wasn't for lack of trying. I did an hour of aquafit most mornings, after which I could move enough to do Pilates and Iyengha yoga, both heavily adapted to accommodate the muscle and joint pain (due to bursitis). However, walking was not really an option - because of the pain and bursitis which was worsened by the action. If I couldn;t drive somewhere so the walk was short - I couldn't go.
For most people, PMR also limits the amount of exercise they can manage - those who were very fit and diagnosed quickly tend to be able to manage more. But even that isn't a given - Skinnyjonny here was a firefighter and training for Himalyan expeditions and a marathon when he developed PMR which confined him to a wheelchair. It took 18 months of very careful rehab, starting with hydrotherapy, to be able to run 5km again.
The pred only manages the inflammation - it does nothing to change the actual underlying disease process and so your muscles remain intolerant of acute exercise, much as would be the case during a illness/infection such as flu. You can do exercise - but it is a very individual thing and you tend to have to "retrain", starting with a small amount and building up VERY slowly. Sometimes you can do more at higher doses of pred - most people who work require more pred. But you have to listen to your body: if you do a level of exercise that leaves you feeling OK the next day - not the same day, developing DOMS is a significant measure - that is a sign you can try a few mins more (and I mean a few mins) next time. If the level leaves you with delayed onset muscle soreness (DOMS) you did a bit too much, go back a level, train at that for a couple of weeks and then try again.
You will get there - it will just take rather longer. How long no-one can say though.
Having read this again, this is very helpful , thanks again
It's just a case of not over doing it for you. Stretching for me is done everyday but I can only do a short walk every other day. If I try and do 2 in a row the 3rd day is when delayed onset muscle soreness strikes. If you think about it your muscles are not always getting the full charge of blood so micro tears can't heal as quickly. While ever you can do the walking, do so. Perhaps just do a test of doing a week every other day... Or 60mins/30mins and see if the stiffness and soreness is reduced. Even if I can't walk I often drive into the countryside and just walk to my favourite seats.
At the beginning, with the fear of osteoporosis very high on my list, I used to have a long walk every day, often over a hill, and had no problems. But later, especially when I got down to the 4 mg level, I found it was harder to have the single long walk and used to go out a couple of times a day for shorter walks instead. For a while I even felt like I was walking through water it was so hard to move, and even though that stage is long over I find I often can't walk as fast as I used to. I always maintained my (rather mild) physio and yoga exercises and took up tai chi and Nordic walking. The Nordic walking uses more energy than regular walking and we were told to start by walking only 15 minutes a day three times a week. So, long story short, maintain your total level of physical activity but maybe modify the timing a bit so you have recovery time built in.
I really like the sound of your sensible regime but your body is telling you different. I wonder if a day or two of something gentler when you taper might suit you better - like a bob about in a swimming pool or Pilates at the right level. Then resume when your body has adjusted.
I will assumes that you did not change your exercise routine simultaneously when you dropped the dose. ...
Then if your walks and stretches didn't give you problem before you reduced the dose, my opinion is that exercise is not a problem, but you may have reduced the dose too much too soon. This will bring back your pain regardless of exercise. If it were me, I would go back to previous dose that you had no pain while walking, etc and see if it helps. If it does, you have the answer.
Thanks for your response. You’re right, I haven’t changed my exercise routine. I am going to go back up to 10 mg where I was pain free and taper slowly. My pains started up again albeit bearable when I reduced to 9mg but since I reduced to 8mg three weeks ago my aches get worse after exercise. Spoke to the rheumatologist yesterday and she recommended Pilates as well as upping the dosage
prior to diagnosis I jogged about 30 miles a week....post diagnosis I walk 25-30 miles a week albeit average a 16-17 minute mile as attempts at jogging results in my hips and upper legs "screaming". I know I am blessed to be able to do this as so many of my fellow PMR sufferers are not. I am 4 months in this journey and am slowly accepting the fact I have to listen to my body and make necessary adjustments accordingly.
Thanks for responding. I’ve never been a jogger but I love to walk. I was diagnosed in August and have continued to exercise as I did before. I was totally pain free practically immediately after starting pred 15 mg My pain only returned when I dropped from 10 mg to 9 and recently to 8mg
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