For people with rheumatoid arthritis (RA), exercise can be hugely beneficial for relieving pain and joint stiffness.

People with RA who exercise may find that they have less pain than those who do not. Exercise can reduce painful symptoms, improve joint function and flexibility, increase range of motion, and boost mood.

It is best to seek medical advice before starting any exercise program and work with a doctor and a physical therapist to develop a tailored exercise plan.

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Photo editing by Lauren Azor; Ashley Corbin-Teich/Getty Images

The following types of exercise may help relieve the pain, joint stiffness, and other symptoms that RA can cause:

1. Stretching

Stretching can help improve flexibility, reduce stiffness, and increase range of motion. Stretching daily is important for relieving RA symptoms.

The ideal stretching routine will be different for each person and depend on which joints are affected and what symptoms occur. However, stretches often involve slowly and gently moving the joints of the knees, hands, and elbows.

A typical stretching routine may consist of:

  • warming up by walking in place or pumping the arms while sitting or standing for 3–5 minutes.
  • holding each stretch for 20–30 seconds before releasing it.
  • repeating each stretch 2–3 times. Using a yoga strap may help people maintain proper form while stretching. If someone does not have a yoga strap, they could use an alternative such as a dog leash.

Some people may find it beneficial to work with a physical therapist who understands RA to learn the correct way to perform the stretches that meet their personal needs.

2. Walking

Walking is a low-impact form of exercise that can help with aerobic conditioning, heart and joint health, and mood.

It is essential to wear proper shoes and stay hydrated, even if the walking is not strenuous. It is often sensible to walk slowly initially and then increase the pace when possible.

A person may want to start a walking routine on flat, even surfaces before progressing to uphill, downhill, or uneven surfaces.

3. Flowing movements, such as tai chi and yoga

Both tai chi and yoga combine deep breathing, flowing movements, gentle poses, and meditation. They increase flexibility, balance, and range of motion while also reducing stress.

A 2013 study of participants with RA who had done group tai chi suggested that tai chi could reduce anxiety and depression while increasing self-motivation and self-esteem.

The participants did tai chi twice a week for 12 weeks.

A 2013 study of women with RA who did Iyengar yoga suggests that this exercise had mood, fatigue, and pain disability benefits. The participants did yoga twice a week for six weeks.

It is possible to find free online videos or apps like Gaia for tai chi or yoga workouts, including some yoga workouts specifically for people with RA. A person should always talk to their doctor before starting a yoga or tai chi practice.

4. Pilates

Pilates is a low-impact activity that can increase flexibility for enhanced joint health.

It can be helpful to do Pilates poses that activate the core muscles and emphasize movements that help with stability. Pilates can be good for overall movement patterns, similar to tai chi and yoga.

People new to Pilates should begin slowly and seek guidance from a certified trainer if possible.

5. Water exercises

Water helps support body weight by minimizing gravity, which means that water exercises do not impact heavily on the joints.

Swimming, water aerobics, and other gentle water exercises can increase flexibility, range of motion, strength, and aerobic conditioning. They can also reduce joint stress and stiffness.

More studies on the benefits of water exercises on RA are needed.

6. Cycling

As RA increases the risk of cardiovascular disease, it is vital to keep the heart as healthy as possible. Cycling can help improve cardiovascular function.

Riding a stationary bike can be a safe way to get the joints moving and improve cardiovascular fitness. A benefit of a stationary bike is that a person can be supervised while riding. A person can also ride their bike outdoors to get fresh air.

In addition to improving aerobic conditioning, cycling can reduce stiffness, increase range of motion and leg strength, and build endurance.

7. Strength training

Strengthening the muscles around the affected joints can help increase strength while reducing pain and other RA symptoms.

Using a resistance band is a way to challenge the body and build muscle over time. A physical therapist who works with people with RA should be able to offer guidance on suitable exercises.

8. Hand exercises

RA can sometimes lead to limited use of the hands. A person with RA may lose their grip strength or find that they are dropping things.

Bending the wrists up and down, slowly curling the fingers, spreading the fingers wide on a table, and squeezing a stress ball can all help increase strength and flexibility in the hands.

9. Gardening

Light gardening can be a beneficial exercise for a person with RA.

People should be gentle with their body, work slowly, and avoid overstraining the muscles and joints.

A person can avoid overstraining by avoiding bending and twisting in ways that can aggravate the lower back. A gardener should make sure to properly hinge at the hips when working in the garden.

The tips below may improve safety and comfort when exercising with RA:

Be consistent

People need to exercise consistently to achieve meaningful results. It is important to keep at it and practice regularly.

A person with RA will benefit from consistent and lifelong aerobic and muscle strengthening exercises.

Some days may be less comfortable than others, but it is possible to adjust the intensity accordingly.

Accessorize for comfort and protection

The following methods can help people exercise more comfortably with less risk of injury and falls:

  • choosing proper shoes that provide the right protection and balance
  • using a slip-resistant yoga mat
  • wearing comfortable clothes that wick sweat away quickly

Seek variety

RA symptoms can vary daily, and they tend to come in waves. People often experience flares and periods of remission.

Doing a variety of exercises and mixing up the daily routine can help people avoid overworking one set of muscles or particular joints.

For example, a person doing morning stretches each day may choose to add strength training twice a week, a water workout once a week, and yoga or tai chi twice a week, symptoms permitting.

This variety should prevent any overuse injuries, which can aggravate symptoms and counter the benefits of the exercise.

Adjust exercises according to symptoms

People can reduce the intensity of an exercise on days when symptoms are more severe. For example, they could place a resistance band around the forearms instead of holding it in the hands.

Alternatively, they can try a different type of exercise or exercise for a shorter time.

On days when cycling or swimming seems too much, switching this type of activity to a leisurely stroll or some stretching will still be beneficial.

Listen to the body

It is important for people with RA to remain as physically active as possible. However, it is equally crucial to avoid discomfort or injuries.

It is vital to choose the right pace and listen to the body. If exercise causes discomfort or a flare, it is best to reduce the session. For example, do 10 minutes instead of 30. People should also take time off when necessary.

Pay attention to small things

Most exercises focus on large muscle groups. It is essential to make time for smaller parts of the body, such as the hands and fingers. It is also important to do small exercises with the toes and feet. Exercises that help with balance, such as yoga, are important also.

Creating a daily routine for these exercises can help.

Work with a physical therapist

Working with a physical therapist who specializes in RA can be helpful in developing a safe and appropriate exercise routine. This collaboration can be particularly beneficial for people with a new RA diagnosis or those who are experiencing a severe flare.

People with RA should avoid strenuous exercise or any exercises that cause pain. These may include high-impact exercises that put excessive strain on the joints.

However, there are no specific exercises that everyone with RA should avoid. Each person is different, and an activity that causes pain for one person may not have the same effect on another person.

What is suitable for someone will depend on their situation and health condition. However, everyone is likely to benefit from paying close attention to their body and working with a doctor or physical therapist for guidance, if possible.

Exercise is usually helpful for people with RA. It offers a range of benefits, which include relieving symptoms, improving joint function, building strength, increasing flexibility, helping daily functioning, improving aerobic fitness, and boosting mood. It can reduce RA flares and make the symptoms of this condition easier to manage.

A person should work with a doctor and physical therapist, if possible, to develop a personalized exercise program for the best possible results.

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