Best Exercises for Rheumatoid Arthritis: A Complete Guide to Safe Movement

Living with rheumatoid arthritis (RA) can make the idea of exercise seem daunting or even counterintuitive. When your joints are painful and stiff, the last thing you might want to do is move them. However, regular physical activity is one of the most powerful tools available for managing RA symptoms and improving your overall quality of life.

This comprehensive guide explores how exercise benefits people with rheumatoid arthritis, which types of activities are most helpful, and how to start an exercise routine safely. Whether you’re newly diagnosed or have been managing RA for years, understanding the role of physical activity in your treatment plan can make a significant difference in your daily life.

Why Exercise Matters for Rheumatoid Arthritis

Exercise offers numerous benefits for people with rheumatoid arthritis that extend far beyond what many medications can provide. Understanding these benefits can help motivate you to incorporate regular physical activity into your routine.

Reduces Pain and Stiffness

Contrary to what you might expect, appropriate exercise actually helps reduce joint pain and stiffness rather than worsening it. Physical activity increases blood flow to your joints, delivering nutrients and oxygen that promote healing. Movement also helps maintain the cartilage in your joints by keeping them lubricated with synovial fluid.

Builds Muscle Strength

Rheumatoid arthritis accelerates the natural loss of muscle mass that occurs with aging. Strong muscles provide better support for your joints, reducing stress on them and potentially decreasing pain. Strength training can help counteract this muscle loss and protect your joints from further damage.

Improves Flexibility and Range of Motion

Joint stiffness is a hallmark symptom of RA, particularly in the morning or after periods of inactivity. Regular stretching and flexibility exercises help maintain your joint range of motion, making daily activities easier and reducing the risk of permanent joint deformities.

Enhances Cardiovascular Health

People with rheumatoid arthritis have an elevated risk of heart disease. Aerobic exercise strengthens your heart and lungs, improves circulation, and helps manage cardiovascular risk factors such as high blood pressure and cholesterol levels.

Prevents Bone Loss

Both RA itself and certain medications used to treat it can contribute to osteoporosis, a condition characterized by weak, brittle bones. Weight-bearing exercises help maintain bone density and reduce the risk of fractures.

Reduces Fatigue

While it might seem counterintuitive, regular exercise actually combats the persistent fatigue that many people with RA experience. Physical activity boosts energy levels and improves sleep quality.

Supports Mental Health

Living with a chronic condition like rheumatoid arthritis can take a toll on your mental wellbeing. Exercise releases endorphins, natural mood-boosters that can help reduce depression and anxiety while improving overall emotional health.

Types of Exercises for Rheumatoid Arthritis

A well-rounded exercise program for rheumatoid arthritis should include several different types of activities, each serving a specific purpose in managing your condition.

Range-of-Motion Exercises

Also called flexibility exercises or stretches, these movements take your joints through their full span of motion. Range-of-motion exercises help reduce stiffness, maintain joint function, and prevent loss of mobility.

Examples include:

• Gentle neck rotations and tilts
• Shoulder rolls and arm circles
• Wrist circles and finger stretches
• Ankle rotations and toe points
• Knee bends and hip rotations

These exercises should be performed daily, ideally in the morning to combat morning stiffness, and can be done without any special equipment.

Strengthening Exercises

Building and maintaining muscle strength is crucial for protecting your joints and maintaining function. Strengthening exercises can be done using your body weight, resistance bands, or light weights.

Effective strengthening exercises include:

• Wall push-ups for upper body strength
• Chair stands for leg strength
• Leg raises while sitting or lying down
• Resistance band exercises for arms and legs
• Gentle core exercises like modified planks

Aim to perform strengthening exercises two to three times per week, allowing rest days between sessions for muscle recovery.

Aerobic Exercises

Also known as cardiovascular or endurance exercises, these activities get your heart pumping and improve overall fitness. For people with RA, low-impact aerobic exercises are typically the best choice.

Low-impact aerobic options include:

• Walking at a comfortable pace
• Swimming and water aerobics
• Cycling on a stationary or regular bike
• Elliptical machine workouts
• Dancing at a gentle to moderate pace
• Tai chi and gentle yoga

Try to accumulate at least 150 minutes of moderate-intensity aerobic activity per week, which can be broken down into manageable sessions such as 30 minutes five times per week.

Water-Based Exercises

Exercising in water deserves special mention for people with rheumatoid arthritis. The buoyancy of water supports your body weight, reducing stress on your joints while still providing resistance for strengthening.

Benefits of water exercise include:

• Reduced joint stress and pain during movement
• Warm water can help relax muscles and ease stiffness
• Natural resistance for strengthening without weights
• Lower risk of injury compared to land-based exercises
• Improved balance and coordination in a safe environment

Many community centers and gyms offer water aerobics classes specifically designed for people with arthritis.

Getting Started with Exercise

Beginning an exercise program when you have rheumatoid arthritis requires careful planning and patience. Here are essential steps to help you start safely and successfully.

Consult Your Healthcare Team

Before starting any new exercise program, discuss your plans with your doctor or rheumatologist. They can provide personalized recommendations based on your disease activity, joint damage, and overall health status. You might also benefit from working with a physical therapist who specializes in arthritis to develop a customized exercise plan.

Start Slowly and Progress Gradually

If you’re new to exercise or returning after a break, start with short sessions of five to ten minutes and gradually increase duration and intensity as your body adapts. Pushing too hard too soon can lead to increased pain and discouragement.

Listen to Your Body

It’s normal to feel some mild discomfort when starting an exercise program, but sharp pain is a warning sign. Learn to distinguish between the temporary discomfort of using muscles differently and pain that signals you should stop or modify an activity.

Warm Up and Cool Down

Always begin exercise sessions with a five to ten-minute warm-up of gentle movement to prepare your joints and muscles. Similarly, end with a cool-down period that includes stretching to prevent stiffness.

Modify During Flare-Ups

During periods of increased disease activity or joint flare-ups, you may need to reduce exercise intensity or focus primarily on gentle range-of-motion exercises. Don’t stop moving entirely unless advised by your doctor, as complete rest can lead to increased stiffness.

Use Proper Equipment

Invest in supportive, well-cushioned athletic shoes appropriate for your chosen activity. Consider using assistive devices like braces or splints if recommended by your healthcare provider. Ensure any exercise equipment you use is properly adjusted to your body.

Safety Tips and Precautions

Exercising with rheumatoid arthritis requires attention to certain safety considerations to maximize benefits while minimizing risks.

Recognize Warning Signs

Stop exercising and consult your doctor if you experience:

• Sharp, severe, or increasing joint pain
• Unusual or persistent swelling in joints
• Chest pain or shortness of breath
• Dizziness or lightheadedness
• Pain that persists more than two hours after exercise

Protect Your Joints

Apply these joint protection principles during exercise:

• Use larger, stronger joints when possible (for example, carry a bag over your shoulder rather than in your hand)
• Avoid positions that stress your joints in the direction of deformity
• Change positions frequently to avoid staying in one position too long
• Respect pain and avoid activities that cause lasting discomfort
• Use assistive devices when helpful rather than struggling without them

Time Your Exercise Appropriately

Many people with RA find they have more energy and less stiffness at certain times of day. Experiment to find when exercise feels best for you. Some people prefer exercising after taking their medications or after a warm shower when joints are less stiff.

Stay Hydrated

Drink plenty of water before, during, and after exercise to maintain hydration, especially during water-based activities where you might not notice how much you’re sweating.

Exercises to Avoid or Modify

While exercise is generally beneficial for rheumatoid arthritis, certain activities may need to be avoided or modified depending on your condition severity and which joints are affected.

High-Impact Activities

If you have significant joint damage, particularly in your hips, knees, or ankles, high-impact exercises may cause additional harm. Activities that typically need caution or avoidance include:

• Running or jogging on hard surfaces
• Jumping activities and plyometrics
• High-impact aerobics
• Contact sports

These can often be replaced with low-impact alternatives that provide similar benefits without the joint stress.

Repetitive Gripping Activities

If your hands and wrists are affected by RA, activities requiring prolonged or forceful gripping may exacerbate symptoms. This includes:

• Heavy weight lifting with traditional dumbbells
• Racquet sports requiring a tight grip
• Rock climbing

Consider using larger, padded grips or exploring alternative exercises that don’t stress these joints.

Activities That Worsen Your Specific Symptoms

Pay attention to how different activities affect your body. An exercise that works well for one person with RA might not suit another. If a particular movement consistently causes increased pain or swelling, discuss alternatives with your healthcare provider or physical therapist.

Creating a Sustainable Exercise Routine

The most effective exercise program is one you’ll stick with long-term. Here are strategies to help you maintain consistency.

Set Realistic Goals

Establish achievable short-term and long-term goals that motivate you without overwhelming you. Goals might include walking for 15 minutes three times per week, attending two water aerobics classes weekly, or performing daily range-of-motion exercises.

Find Activities You Enjoy

You’re much more likely to stick with exercise if you actually enjoy it. Experiment with different activities to find what appeals to you. Consider the social aspect too – exercising with friends or in a class can provide motivation and support.

Track Your Progress

Keep a simple log of your exercise activities and how you feel before and after. This can help you identify patterns, celebrate progress, and stay motivated. You might notice that regular exercise leads to fewer flare-ups, less morning stiffness, or improved mood.

Build Exercise Into Your Daily Routine

Make physical activity a regular part of your schedule rather than something you fit in when convenient. Consider it as important as taking your medications – a vital component of managing your condition.

Seek Support

Join an arthritis exercise class, find an exercise buddy, or work with a physical therapist. Having support and accountability can help you maintain your commitment to regular physical activity.

Additional Lifestyle Considerations

Exercise works best as part of a comprehensive approach to managing rheumatoid arthritis.

Balance Activity and Rest

While regular exercise is important, so is adequate rest. Learn to pace yourself, alternating periods of activity with rest. This is especially crucial during flare-ups.

Maintain a Healthy Weight

Carrying excess weight puts additional stress on your joints, particularly weight-bearing joints like knees and hips. Exercise combined with a nutritious diet can help you maintain a healthy weight, further reducing joint stress.

Apply Heat and Cold Therapy

Using heat before exercise can help relax muscles and reduce stiffness, making movement easier. Cold therapy after exercise can help reduce inflammation and pain. Consult with your healthcare provider about incorporating these therapies into your routine.

Follow Your Treatment Plan

Exercise complements but doesn’t replace medical treatment for rheumatoid arthritis. Continue taking any prescribed medications as directed and maintain regular appointments with your healthcare provider. If you’re considering any changes to your treatment plan, including the addition of supplements or alternative therapies, discuss these with your doctor first.

When to Seek Professional Guidance

While many people with rheumatoid arthritis can safely begin a gentle exercise program on their own, professional guidance can be invaluable in certain situations.

Physical Therapy

A physical therapist who specializes in arthritis can assess your specific needs, teach you proper exercise techniques, and develop a personalized program that addresses your particular challenges. They can also provide education on joint protection strategies and recommend assistive devices if needed.

Occupational Therapy

An occupational therapist can help you find ways to perform daily activities more easily and with less joint stress, complementing your exercise program by making everyday movement less painful.

Certified Exercise Professionals

Consider working with a certified personal trainer who has experience with clients with chronic conditions. They can ensure you’re using proper form, provide motivation, and help you progress safely.

The Bottom Line

Exercise is one of the most effective tools available for managing rheumatoid arthritis symptoms and maintaining quality of life. Far from worsening your condition, appropriate physical activity can reduce pain, improve function, boost mood, and protect your overall health.

The key is finding the right balance of activities that challenge your body without overwhelming your joints. Start slowly, listen to your body, and don’t hesitate to seek professional guidance. Remember that some exercise is always better than none – even gentle range-of-motion exercises performed regularly can make a meaningful difference in how you feel.

By making exercise a consistent part of your rheumatoid arthritis management plan, you’re taking an active role in your health and investing in your long-term wellbeing. With patience, persistence, and the right approach, you can develop an exercise routine that helps you feel stronger, more flexible, and better able to enjoy the activities that matter most to you.