New Study Reveals Challenges of Exercise with RA

A study recently published in The Journal of Physiology sheds light on challenges experienced by rheumatoid arthritis (RA) patients when they exercise.

Researchers studied physical responses to exercise (mean arterial pressure, heart rate, and muscle sympathetic nerve activity followed by post-exercise ischemia) in a group of 33 post-menopausal women diagnosed with RA and a control group of 10.

The exercises were a protocol of isometric knee extension exercises.

Measured responses to exercise

The RA patients experienced greater measured responses to the exercises compared to the control group. These responses were also associated with multiple cytokines (both pro- and anti-inflammatory) and pain.¹

The researchers also wrote that the results support the idea that  an abnormal reflex control of circulation may be what causes the worse cardiovascular response to exercise and increased cardiovascular risk for RA patients.¹

How the nervous system reacts to muscle changes

The results indicated that the nervous system may be overreacting to even small changes in the muscles.¹

Basically, the study found additional evidence that people with RA have an easier-to-activate sympathetic nervous system (the part that keeps people on high alert, like the fight-or-flight response).

Increased overall risk of heart issues

This means that people with RA experience a higher risk for elevated blood pressure and heart rate, increasing the overall risk of cardiovascular issues.¹

While exercise is important for health even for people with RA, it also raises blood pressure and heart rate.

This may help explain why exercise can be more fatiguing for people with RA, as the study found a greater response.¹

Exercise has always been harder for me

While it was a small study focused on a certain group of people with RA and only certain exercises, it resonates with me.

Ever since I can remember, exercise has been harder for me — and not just because of joint deformities, limited range of motion, and pain (although they also play a role).

Easily exhausted in a short amount of time

On a really bad RA day, sometimes just getting up can be exhausting! When it comes to exercise, I can get easily exhausted in a short amount of time.

Yet, I am well aware that regular exercise helps to manage my RA symptoms and maintain my strength. It is sort of terrible that exercise may feel awful in the short term but is necessary for the long term.

In addition to the other challenges of exercise (mental strength, endurance, finding an achievable method, etc), the strong negative physical response to exercise can be a huge impediment to doing it regularly.

Find what works best for you

A good health team will listen, understand, and advise patients with RA on these challenges and help them to find options to try.

I really do think that we need to try different things and figure out what kind of exercise will work for us personally. It’s got to be something we enjoy enough to return to regularly or be able to tolerate to form a regular habit.

In my case, I find aquatic exercises both fun and soothing. I am usually eager to get into the pool! However, it is the case that I cannot usually get there every day for various reasons.

So, on non-pool days, I have an exercise stepper machine I use. I can’t say I enjoy it, but if I put on the timer and a good TV show then I can motivate myself to get through it. Previously, I have also enjoyed a combination of yoga and stretching.

Are some exercises better for people with RA?

Future research may find that certain exercises are better for people with RA.

I am guessing exercise that puts less stress on the body (such as aquatics or slow stretching) may be both beneficial and physically easier for RA patients.

I’m not giving in

While it’s disheartening to see the results of this study and how hard it illustrates exercise for people with RA is, it also helps to verify what I know has been true for me.

Although discouraging, it’s good to know there are real physical reasons why exercise is so challenging when living with RA.

Not exercising means worse outcomes for my health

I’m not giving in though! I’m going to keep working on exercise even though it is a challenge, because I know not exercising would be even worse for my long-term health.

I’m also going to keep watching this kind of research in the hopes of better mitigating the challenges of life with RA.