GLA:D program with polymyalgia ?

[redruth123]

Hi All, Hoping for some advice.

I am about to start the GLA: D exercise program for hip arthritis. Apparently it is quite challenging. My question is - is the GLA: D exercise program detrimental to the body if you still have PMR? . Does anyone have any experience? I've tried searching on HealthUnlocked but didn't find results.

Background is that my current Rheumo declared all the aches and pains I was experiencing as I got lower and lower on Pred (being pushed by him) and finally to zero were now arthritic and not PMR. However true PMR signs and symptoms did re-surface after zero pred after some months, and it's not fully controlled. He will only prescribe 2.5mg of pred, rather than the 5 that I need. The GLA: D practitioner doesn't seem to think that PMR will be an issue. Thank you in advance for any thoughts or experiences.

(Ps have had to put a space before the "D" because without it the post came up with emoji faces !!)

[DorsetLady PMRGCAuk volunteer]

Hi,

Just had a look at this- and it seems to be something quite new and not I’ve not heard of it in UK - so have linked info for anyone else interested.

As you say , some exercises do look quite challenging even though it is aimed at older patients. Two sessions a week might be a bit much initially, so think you might need to build up a bit beforehand depending on your current fitness/and activity.

Provided you feel confident, and the GLA: D practitioner understands about your PMR, then give it a go.

gladinternational.org/glad-...

gladaustralia.com.au/wp-con...

As for Rheumy, I think he’s making assumptions that PMR is completely gone…but you’ll have to see.

Please do let us know how you get on.

[redruth123 in reply to DorsetLady]

Thanks so much DorsetLady. And thanks for adding links for others. I didn't mean to be obscure...thought I'd remembered seeing other people on this group commenting about Gla;D so assumed it was worldwide. Will report in after trying the progam......

[DorsetLady PMRGCAuk volunteer in reply to redruth123]

It may be worldwide, just haven’t seen it mentioned on here -and it’s not obscure. Lots of us have OA … in fact I may try some of the exercises.. already do Pilates and other stuff..

[PMRpro Ambassador]

Never heard of it but just been reading some of the documentation. It is possibly similar in part to the Nuffield gym stuff that has been talked about but not having done it I don't really know although I do know that that tends to vary from course leader to course leader and this looks more standardised.

They seem to emphasise individual adjustment which is good. But there is some stuff there I could never do "homework" for - using an ergometer which is about the quickest way to cause back pain for me, the pelvic tilt (I'd never get up again!) and the step work without hand rails.

But if the physio is good - it looks good. However - like DL, I think your rheumy is making an assumption that I suspect is not correct and if the PMR is still active you may struggle without enough pred but you will have to try to find out.

[redruth123 in reply to PMRpro]

Thanks PMRpro. Yes, giving it a go will be the only barometer for how it can be both physically challenging yet still designed for older arthritic folk. (??) The process will be "interesting" if nothing else.

[PMRpro Ambassador in reply to redruth123]

Feedback would be good - I couldn't find anything about the level of "fitness" they are expecting and sometimes they can be a bit unrealistic about other aspects. How many of us have cardiac issues? I would love to do the cardiac rehab programme locally - but the rheumy issues mean the physios advise against it. Needs a bit of lateral thinking sometimes!!

[DorsetLady PMRGCAuk volunteer in reply to redruth123]

Yes but muscles surrounding arthritic joints arent affected in the sane way as PMR affected muscles are.

[redruth123 in reply to PMRpro]

Thanks very much PMRpro, it will be "interesting" to see how challenging exercise is also designed for arthritic older folk (???). Giving it a go will be the only way I guess. As for rheumy, he appears to be an older- style practitioner who regards pred as the devil's work, whereas I prefer to think of it as white gold. I believe he would rather prescribe very low dose pred even if it means symptoms are somewhat bothersome. Seeing him again in late August so we shall see.

[PMRpro Ambassador in reply to redruth123]

That suggests he doesn't understand PMR in the first place. If you give a patient an inadequate dose of pred then you might as well give them none - if there is left-over inflammation it will just build up over time until sooner or later you are back where you started. That is our dripping tap analogy - which arguably the top PMR rheumy in the UK thinks is a brilliant way of describing it. Enough - or don't bother at all.

[redruth123 in reply to PMRpro]

Will have to be very insistent with him in that case, or find a new rheumy. ( Or find a better GP who will prescribe for me). I strongly suspect he doesnt keep up with the latest thinking all that much, and wouldnt have heard of the dripping tap analogy. Just wish the marvellous Dr C.O, was still available. You originally recommended her to me and I saw her for quite a while till she stopped private practice. During the tapering process I asked this current rheumy's advice about potential adrenal shock/insufficiency. He said "We'll worry about that if it happens".. omg.

[PMRpro Ambassador in reply to redruth123]

Bit late when you are in ICU!!!

Actually, I doubt many will have come across the dripping tap - unless they follow us!! Which is unlikely ...

[S4ndy]

Just be aware that should PMR inflammation still be present in your body then any exercise may cause muscles to tire easily and recovery after exercise to take longer.

Your Physio should take this into account and should recommend less reps with longer recovery time between sessions.

My cousin has just been through a hip replacement after trying everything including physio over the last 2 years. The only thing I think she was glad of was that the exercises her physio had given her meant that her muscles were stronger when she had the op and she therefore recovered quicker.

Hope it all works out for you.

[redruth123 in reply to S4ndy]

Thanks for your advice S4ndy. I also feel encouraged for the longer term, when a hip replacement will (most likely) become inevitable, so thanks again.