Anyone can develop rheumatoid arthritis (RA), but it most commonly crops up in people who are in their 60s, according to the Centers for Disease Control and Prevention. (Women are also about twice as likely to have it as men.) If you have rheumatoid arthritis, eating a healthy diet can ease inflammation levels, while doing low-impact aerobics, strength training, and stretching can help prevent stiff joints, build muscle, improve endurance, and benefit your heart, bones, and mood.
Of course, when joints are inflamed, you need to take it easy. Listen to your body. "If it feels good to just walk in the water, then by all means go ahead, but you do not push through RA pain," says Daniele Anderson, a personal and adaptive trainer at Advocate Good Shepherd Hospital in Barrington, Illinois. "It's your body's way of telling you to stop." Work with your doctor to find the right exercise for you, and consult him or her about when you should skip it due to symptoms.
Who it's good for: People who want to build leg muscles.
Tips: Sitting in a normal-height chair, stand up, and sit down, but don't just plop down. Focus on controlling the motion, using your arms to assist you if needed. Try doing 10 to 15 reps. If that's too easy, try a lower-height chair. Too difficult? Find a higher-height chair. "As your legs get strong, you can control that motion more with your legs and less with your arms," says Lesley Hlad, a doctor of physical therapy in the arthritis rehabilitation service at Duke University's Center for Living in Durham, North Carolina.
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Who it's good for: Almost everyone can benefit, even people with tender, swollen joints.
Tips: Yoga packs two great benefits for people with RA. Using deep relaxation techniques, like yoga Nidra, promotes a healthy immune system and helps reduce joint inflammation. Plus, gentle stretching is great for maintaining mobility and movement. "Avoid power yoga, hot yoga and flow (also known as Vinyasa yoga), which can increase internal heat and put excessive pressure on the joints," cautions certified yoga specialist Robin Rothenberg of Essential Yoga Therapy in Fall City, Washington.
Who it's good for: Almost everyone, unless walking is too painful.
Tips: Walking is a great bone-strengthening and aerobic activity. The American College of Sports Medicine recommends that most people exercise at a moderate-to-hard intensity level — 60% to 85% of your maximum heart rate — three to five days a week and working up to a 30-minute session, but also notes that your regimen can be modified based on your physical abilities. You'll build endurance if you walk longer, but it's okay to do 10 minutes at a time, says Hlad.
Who it's good for: RA patients who want stronger muscles.
Tips: Pilates is good for stabilizing your joints and strengthening the muscles that support your joints, explains Tresa Sauer, a personal trainer at the YWCA of Minneapolis. Try the "shoulder bridge." Lay on your back, bend your knees and place your arms along each side of your body. Exhale through pursed lips as you contract the abdominals and lift your pelvis. (Don't arch your back or overflex your knees.) Inhale through the nose and hold the position. Exhale to lower your pelvis back to the ground and repeat the exercise.
Who it's good for: People who have significant joint pain.
Tips: In a lap pool (usually 4-feet deep), walk from one side of the pool to the other at a brisk pace. If you work out in a health center with an underwater treadmill, your trainer can adjust the speed of the exercise. The buoyancy of the water relieves pressure on your joints. Consider exercising using a water jogging belt. It suspends you above the pool floor so you can move without putting any pressure on your hips, knees or ankles, says Ann Rosenstein, a Lakeville, Minnesota, fitness professional and author of Water Exercises for Rheumatoid Arthritis.
Who it's good for: Anyone with RA, as long as you don't overdo it.
Tips: You can stretch sitting in a chair, if that helps. And you can use a Stretch-Out Strap, a nylon strap with built-in loops for your hands and feet. Try this: Place the ball of your foot through a loop, grasp each end of the strap with your hands, and straighten your leg. Lift your leg, gently pulling on the straps. You're not reaching your toes, you're taking the strap and pulling up, so you're still getting a hamstring stretch, says exercise physiologist Stefanie Fleming, of OSF Saint Anthony Medical Center, in Rockford, Illinois.
Who it's good for: People looking for a low-impact exercise.
Tips: "Sun-style" (pronounced SOON-style) tai chi involves slow, smooth movements that strengthen the body, reduce pain and improve mobility. In general, don't practice tai chi longer than the amount of time you can walk comfortably, advises Paul Lam, a family physician and director of the Tai Chi for Health Institute in Australia. Twenty to 40 minutes per day is a good average for most people with RA, he says.
Who it's good for: Anyone, as long as you know your limits.
Tips: Start by doing bicep curls with light hand weights, no more than 2 to 5 lbs., and build your endurance over time by adding weight and sets. Stronger muscles help you perform daily activities. If the heaviest thing you pick up is a gallon of milk, "you want to be lifting about 8-lb weights as your goal," says Anderson. You can do this in the water — hold foam dumbbells in each hand, pull down, and let the weights slowly float up to work your arms, shoulders, chest, and back.
Who it's good for: Anyone with feet or ankle problems.
Tips: Whether you're riding outdoors or sitting on an upright or recumbent exercise bike, cycling avoids the pounding of high-impact aerobic activities, but still packs great cardiovascular benefits. It also strengthens the quads. Try cycling for 10 minutes at a time. Build up to 30 to 40 minutes two to three times a week.
Who it's good for: People with pain in their fingers and hands.
Tips: Spread your fingers as wide as they can go, then make a fist, and repeat that stretching and squeezing motion. If you're in the water, open and close your hands underwater, or try squeezing a foam ball. Let it absorb the water before squeezing it out again.
Who it's good for: People who want to sweat without hurting their joints.
Tips: What makes Zumba, the Latin-inspired dance fitness craze, different from high-impact aerobics classes? It burns calories without jarring your joints, explains exercise physiologist Caryn Locke of Caryn's Studio in Waite Park, Minnesota. "A lot of it is just the fluidity of the movements," say Locke, who was diagnosed with RA in April 2010. If you're just starting out, ease into it because you'll be using all the muscles in your body and you don't want to overdo it. Taking twice-weekly classes will help you learn the choreography.
Who it's good for: Anyone desiring better balance, improved posture, a stronger core.
Tips: Standing tall or sitting up straight in a chair, imagine a spring is lifting you from above, suggests Tess Franklin, exercise physiologist at OSF Saint Anthony Medical Center in Rockford, Illinois, who teaches this Chinese exercise. Close your eyes and take deep, relaxed breaths in through your nose and out from your mouth. Place your hands on your stomach and focus on moving your diaphragm in and out with each breath. Concentrate on strengthening the core muscles of your abdomen to maintain your balance and posture.
Who it's good for: People who have good balance and exercise endurance.
Tips: Riding an elliptical machine is not for the exercise novice. It's ideal for people in good cardiovascular condition who want a higher-intensity, no-impact challenge. Start at a constant ramp height and constant resistance and make adjustments as you get stronger. Or choose a pre-set cross-training program. Adding arm movements will amp up the cardiovascular benefit.
Who it's good for: Anyone who enjoys recreational exercise.
Tips: Gardening burns calories and boosts pleasure-enhancing endorphins, easing depression that can be associated with RA, says Anderson. But you need to pace yourself. If you've got RA in your wrists, you're asking for a flare-up if you dig and dig for hours at a time.
Who it's good for: People who are game for a more challenging core workout who don't have serious wrist or ankle issues.
Tips: With suspension training, you leverage your own body weight from straps hanging from an anchor point. Place your feet in the stirrups and hold your body up with your hands or resting flat on your forearms. Holding a plank position works muscles in the abdomen, back and shoulders. Work up to a 30-second hold with a 20-second rest between reps.
Three-way hip exercises
Who it's good for: People with weak hip muscles.
Tips: 1. Face the kitchen sink and hold on. Alternate bringing each knee up like you're marching in place. This will work muscles in the front of your hips.
2. Keep your toes facing forward. Raise a leg out to the side and back to work the outer thighs and glutes. Alternate legs.
3. Face forward; extend a leg out behind you until it's a few inches off the ground. Hold and lower slowly, then switch legs. This works your butt and lower back. Why the kitchen sink? It's something sturdy to hold onto in case you lose your balance, says Hlad.
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