exercise?

[jwichmann]

I'm wondering if daily exercise (50 min at the gym) could be making me stuck at 12.5 mg?

I've tried several slow tapers but only made it from 20 mg to 12.5 mg in the last 9 months.

Any ideas?

[SnazzyD]

Well, it could simply be that your current autoimmune activity would be at this level exercise or not as you are only about 7 months in.

Stress can keep that fire stoked and what that is depends on the person. It might be other things in your life aren’t helping. I was very fit before my GCA diagnosis but had to be really careful with exercise once on Pred. Yes I had higher doses, but others have found their joints, tendons and muscles don’t tolerate hard and repetitive strain. I had tendonitis that appeared below 10mg somewhere that stuck around for 18 months or so and it wasn’t apparent the was a problem brewing until then. Perhaps what you think is a flare is due to delayed onset muscle soreness (a couple of days later) or damage brewing. Certainly I ‘d be wary of daily 50 min sessions because your musculoskeletal system isn’t getting a chance to repair because it is no longer operating under normal circumstances.

[jwichmann in reply to SnazzyD]

So helpful - thank you

[PMRpro Ambassador]

Very much depends really. What sort of effects are you putting down to being PMR as you reduce the dose? Personally I'd say that 2x25min with a day rest between gym days would be better. The rest periods are equally as important as the exercise ones - it doesn't necessarily mean do nothing but use different sets of muscles on consecutive days.

[jwichmann]

Similar PMR symptoms of sore hips and shoulder mostly - I have arthritis in those places too.

Good idea to pace the gym and maybe walk the other days. Thank you!

[PMRpro Ambassador in reply to jwichmann]

That suggests to me that maybe you have PMR that is causing bursitis and soft tissue inflammation around those areas, It isn't fully under control and the exercise movements is exacerbating the inflammation, especially if you are doing repetitive movements - that will also apply to walking for hips. Maybe try aquafit or walking in the pool which will relieve the stress on joints. I think cutting down for a while and changing the routines would probably help.

[jwichmann in reply to PMRpro]

Thank you . I think you’re right.

[DorsetLady PMRGCAuk volunteer]

What exercises are you doing? If it’s repetitive circuit training type, and doing them every day then you are not giving your PMR/Pred affected muscles a chance to recover

Have a look at this -

healthunlocked.com/pmrgcauk...

and plenty of related posts now you’ve asked the question.

And how `are you trying to taper .. could be too big a reaction each time - like 2,5mg a time - if so, try 1mg a time.

[jwichmann]

Great Articles! I will print them out. Doing mostly cardio and stretch but maybe less is more. Tapering at 1mg already so maybe down to .5. Very helpful - thank you.

[GrandmaPirate]

Daily exercise is for sure good. If you can do some indoorrowing there, you may feel a benefit after a while. I bought myself an indoorrowing machine (not too sofisticated but efficient) at the beginning of Covid after my fitness closed and my rheumy told me that it was the best investment ever. I was able to reduce very slowly prednisolone to 1mg/day. From 20 mg to 1mg took me 2 years. I am now already 1 year on 1 mg/day and that is fine. On weekdays I do also in the morning about 50 minutes of pilates. It really helpt in my case.

[Polygolfer]

I also exercise a lot and we all know that your body will complain if you over do it. So I agree with the suggestion to pace yourself, alternating on the type of exercises you do daily (walk/cardio/weights) exception made perhaps to moderate stretching, but more importantly give yourself rest days, your muscles, tendons, joints etc all need time to recover and regroup. If normal pain killers like ibuprofen and naproxen ease your pain then it is possible that it’s osteoarthritis or just fatigue and over exertion. Those meds would not help if it’s pmr.

[Gimme]

Great advice already about not overdoing it. Exercise (of the right kind) is supposed to be good for us, but we do need to take care, so I would give yourself a bit more rest between any high impact activities. No reason that I can see not to keep up the daily stretching as this will help circulation and keep you mobile. Just take extra care with posture and to do any stretches correctly and not over stretch joints. You could swap some of your high impact sessions with pool work. A lot of us with PMR have commented that we find swimming or exercising in the pool soothing. I have no idea if this is backed up clinically, but my feeling is that being in cool water helps the inflammation for me. Also, what do you do when you are not at the gym? Allow yourself some time to recharge your batteries and recover after and don't go mad with household chores, or whatever else it is that you spend your time doing.