Fitness Friday: Working Out With RA

The last few months have been relatively fitness-less for me.  In March I was diagnosed with Rheumatoid Arthritis (RA).  In a nutshell, RA is an autoimmune disease in which your body thinks the connective tissue in your joints is foreign or harmful and begins attacking it.  The result is swelling and painful joints and, frequently, lots and lots of fatigue.

In educating myself about RA, I've been pleased to read so many stories of athletes keeping up with an ambitious training schedule despite their RA.  It gives me hope that, once my rheumatologist and I find a treatment combination that works for me (in conjunction with making permanent my Paleo lifestyle), I'll be back to running or P90X or another new challenge.

In the meantime, it has been frustrating to keep moving (which RA patients are told is important both to maintain mobility as well as to avoid weight gain, which further stresses the joints) while perpetually exhausted and in (sometimes excruciating) pain. Particularly as a relatively active, young person (I'll be 35 later this year), and even though you know I'm not opposed to modifying, it has been difficult to find exercise guides that don't go too easy: a lot of "exercise for arthritis" resources are geared toward the elderly.

All of this is why I'm sharing today some of the exercises I've found helpful and do-able lately and some tips and tricks that are working for me.  I'm by no means a medical doctor, so listen to your own body and talk to your doctor before you dive in.  My hope in sharing is that there will be something helpful out there for the next thirty-something (or twenty-something or forty-something) who is out searching for ways to stay fit and have fun while waiting to get their RA under control.

WARM UP!
I mean this in both a literal and workout sense.  RA joints are better with heat.  Ideally, as an RA patient, I'd work out at about 2 p.m. when I'd been awake and moving long enough to be warm naturally, but before fatigue from the day set in.  Realistically though, 5:30 a.m. is still where its at in my world.  If I wake up especially stiff, I will run my hands in the hottest water I can stand or use warm compresses to get my joints moving.

It also helps to gently stretch before diving into a workout.  This five-minute routine from Tara Stiles is enough to get me going without cutting too much into my workout time.



GEAR UP!
Good shoes are important for anyone and everyone when it comes to exercise.  But they're critical when your feet and ankles are tender.  Be open to the idea of having more than one pair, too - not just a running shoe and a training shoe, but different sizes depending on where you are with inflammation.  I keep both 9.5 and 10 on hand.  Oh, and when you find one you love (it took me 7) buy multiples! The big brands love to change their styles every year and you don't want to have to test drive every time you need shoes.

I've also been experimenting with wrist wraps to give me a little extra support for yoga, planks and (modified) push-ups.  I've been using them for about a week now and I notice a positive difference, especially in the duration I'm able to stay on my wrists.

GET YOUR SWEAT ON!
I'm assuming if you're reading this, you have a pretty good fitness base and, like me, you still want a good sweat and burn but you're temporarily limited by pain and inflammation.  With that in mind, here are some of my favorite workouts lately.

Jessica Smith's Low Impact HIIT - When you want to move beyond walking and get your heart rate up, this is a great cardio segment that doesn't involve any jumping at all!  While its not full-length, try doing it multiple times between weight segments as a sort of DIY circuit.



Tone It Up's Bikini Body 2 - There isn't anything magical about this workout in particular - but the reason it works for me is that, unlike a lot of strength circuits, it doesn't involve getting up and down and up and down from the floor (something my wrists, knees and ankles are pretty whiny about lately): the warm-up and first circuit (which is done twice) is done standing; and the second circuit (also done twice) is done on a flat back on the floor.  Because it is high-rep (about 15 repetitions per exercise), I can get some muscle burn going with a relatively light weight (helpful when my fingers can't close tightly enough to safely use a heavier dumbbell).



Barre3 Standing Slim DVD - This workout is my go-to when I feel like I can't possibly manage anything else.  Barre workouts in general are billed as being good for folks with joint difficulties because they are (as a group) low impact.  The problem comes in (for me) with the amount of work that takes place in plank - bearing weight on the wrists.  As the name of this workout implies, the entire routine is done standing with little or no weight-bearing on the hands.  If you're pinched for pennies (who wouldn't be if Celebrex is part of your early treatment!) and don't want to splurge on the DVD version, the original YouTube version is also good.  Just be warned that there are some wall push-ups in the beginning that put minimal pressure on the wrists and shoulders.



When you get frustrated (and if you don't, please tell me what you're doing, because I still do!), remember, it's only temporary.  Unlike so many diseases and chronic illnesses RA is controllable (yay!).  As my rheumatologist reminded me, the jogging stroller will still be there for me once we get things under control.

If you've battled RA, what tips or favorite routines would you suggest to someone just starting their journey?