Rheumatoid Arthritis: Try Strength Training as Part of Treatment

You know you should lift weights to make your muscles stronger and reduce your fatigue. But if you’re like most Americans, you just don’t do it. And if you haverheumatoid arthritis (RA), you may be worried thatstrength trainingmight be bad for your joints, or evenmake pain worse.

Strength Training: It's All Natural

Experts say that if you haveRA, strength training is something you should fully embrace, not back away from. “Exercise is a great anti-inflammatory,” saysGustavo Carbone, MD, arheumatologistat the University of Miami Health System on Coral Gables, Florida.People with RAconstantly ask me aboutnatural things they can take, he says. “Exercise, including strength training, is the best natural thing there is.”

Strength training is especially important forpeople with RAbecause it helps to stabilize the joints, explainsScott Haak, a physical therapist at the Mayo Clinic in Jacksonville, Florida. “Part of the consequence of RA and joint erosion can be ligamentous laxity, which inherently decreases the stability of joints. Working small muscles can be beneficial with stabilizing joints and improving function,” he says.

Strength Training Is Beneficial for People With RA

Thebenefits of strength training, which is using any size weights to improve muscle strength, are vast for everyone. These exercises protect bone health and muscle mass, boost energy levels and mood, and increase resting metabolism so weight stays off easier.According to the Mayo Clinic, regular strength training also aids people as they age, making falls less likely, everyday activities easier, and, along withaerobic exercise, may even improve thinking and learning skills.

In fact, areview of the benefits of exercise for people with RA in theJournal of Aging Researchconcluded that exercise training is so valuable for improving function without exacerbating disease activity that “all RA patients should be encouraged to include … resistance exercise training as part of routine care.”

Some People With RA Have Concerns About Joint Pain and Fatigue

Some people with RA worry that strength training and other exercise might be detrimental.Research published in July 2015 inSports Medicine, for instance, found that people with the condition often say that “pain and fatigue” are barriers toworking out— even as they also recognize that doing it regularly with diminish these symptoms of their disease.

Working out also does not seem to harm the joints. Apilot studyof eight individuals with stable courses of RA, published inMusculokeletal Care, found that performing lower-body resistance exercises, along with aerobics, for 30 minutes does not result in changes to joint health, as measured by serum cartilage oligomeric matrix protein (sCOMP) and knee joint synovial inflammation.

Ask About Physical Therapy

Once your doctor says you can exercise, it’s best to get a referral to a physical therapist (PT), who can show you how work around your condition. While you don’t want to lift weights with joints that are flaring, Genie Lieberman, an occupational therapist and director of theGloria Drummond Physical Rehabilitation Institute在博卡拉顿波卡拉顿地区医院Florida, says you can still strength train muscles in other body parts during that time.

Need moreinspiration? Several recent studies point to ways to help make your exercises more effective and more enjoyable:

1. You Can Lift Less Weight

Most people think you have to lift mega-sized dumbbells to get results from strength training. And it’s true that if you want to look like Serena Williams, you will need very heavy weights.

Focus on What You Are Lifting, and You Can Use Lighter Weights

Buta small but important study published in June 2017 inLife Sciencesshowed that when people lift light weights and focus their minds as if they are contracting their muscles for a heavier load, they significantly improve muscle strength. Interestingly, people lifting the same light weights while watching an entertaining video (and therefore not concentrating on their muscles) didn’t see the same gains. The authors concluded that such “high-effort” exercise done with light weights can be safe and effective for people with health conditions that preclude their lifting heavier weights.

2. You Don't Have to Go It Alone

People often avoid weight training because they think it's boring. Buta review published in April 2017 in the British Journal of Sports Medicinelooked at some reasons people avoid strength training and offered suggestions to combat them.

Hatch a Workout Plan and Add Friends

The researchers found, for example, that planning a workout in advance increases the odds that you'll do so. So does enlisting the encouragement of family and friends. (You might even ask them to go to the gym or tolift weights at home with you, which will benefit them, too.) The authors also suggest finding ways to make the exercises enjoyable, such as listening to upbeat music orworking outwith a PT or trainer you like.

3. You Can Make Workouts Work for You

Sometimes people gain strength while working out at a physical therapist’s office, but they can’t translate that into exercising at home. That’s why Hong Kong researchers explored the effects of adherence to an exercise program that was tailor-made for a small group of participants with knee arthritis. In a2016 article inClinical Interventions in Aging, they described their method, which proved effective in boosting adherence and health outcomes in this pilot program.

Which Moves Are Most Doable for You?

They found that it’s better for the PT to teach you exercises that are done while sitting or standing rather than lying down. That way, you can do your resistance exercises at home while watching TV. They also found it helps to ensure that you understand all the steps involved in each exercise so you can do them later; study authors provided both in-class demonstrations and handed out posters and pamphlets with pictures and descriptions of each move.

4. Soreness Doesn't Have to Stop You

While doing strength training, it’s important to listen to your body, Lieberman cautions.After you exercise, if you feel painthat is severe or lasts more than an hour, talk to your PT or trainer about modifying specific exercises for the next time.

But don’t letsorenessbe a reason to stop, since all effective strength training makes you feel sore. “Any exercise done when a person is not conditioned is going to hurt for a while — not just people with RA, but everyone,” Dr. Carbone says.