When Working Out Doesn’t Work Out

Living with rheumatoid arthritis is a constant balancing act, and one of the many aspects to balance is getting enough exercise and enough rest. Unfortunately, due to the pain of arthritis getting enough rest can sometimes be easier than getting enough exercise. Doctors agree that exercise is an important component of RA self-care, and that the right amount of exercise can greatly improve overall health function, as it can increase range of motion and strengthen the muscles surrounding our joints, providing more stable support. However, exercising can be a challenge. Even without a condition such as RA, many Americans struggle to establish a regular exercise routine, as we tend to drive to our destinations rather than walk or bike, and we tend to work long hours and lead go-go-go lives, leaving little time for exercise. Perhaps the biggest factor is the difficulty that humans have in initiating change. An object in motion tends to stay in motion, and an object at rest tends to stay at rest. People can be very similar. I know runners who lament going a day without their “runner’s high” if they have to skip a workout. And for others who aren’t in the habit of exercising, finding the motivation and energy to start something new can be daunting.

This is all the more the case for people with RA. On top of all those issues, rheumatoid arthritis can cause fatigue, which requires even more motivation to overcome. RA also causes pain, so just the thought of working out might seem unbearable for some. Yet, over time regular exercise should increase energy and thwart off some of the fatigue, and improve other symptoms such as pain.

Personally, I have found it very difficult to maintain a daily exercise routine, and rather seem to have an exercise “cycle” with several phases. There is an “active” phase where I’m able to exercise two-four times a week. Yoga, swimming, and walking are my workouts of choice, as they all are low impact on my joints. There have been times in my life when I’m able to maintain in the “active” phase for months on end. During those times, I can attest that exercise does indeed help my RA. I have more energy and less pain and swelling. Yet, while exercise causes significant improvement in my symptoms, it is not a cure, and inevitably a flare will hit, which derails my workout routine.

“Flare” is another phase of my cycle, which is obviously the least active. When I’m in a flare I’m doing well if I even get any stretching in. Sometimes I’m in so much pain that I do little more than lie in bed with a heating pad. However, as the flare subsides to more bearable symptoms, I enter the next phase of my cycle, which I’ll call “trying to exercise.”

In the past few years, I’ve found that I spend most of my time in the “trying to exercise” phase.   While it’s always been tough for me to transition from the “flare” phase back to the “active” phase, becoming a mom nearly five years ago has made it that much more challenging to carve out the time to exercise. I might exercise once and then let another two or three weeks go by before exercising again. Frustrated with myself, I decided that perhaps rather than try to workout for 30 or more minutes at a time, I should settle for 10 minutes each morning, before my little ones wake up. I started with a few yoga poses, some crunches and leg lifts, a “plank” (basically you position your body as if you were going to do a push up, but hold still in the position for anywhere from 30-90 seconds), and in an effort to get my heart rate up just a bit, some jumping jacks. Each time I did this, I found that it helped me wake up, that I had more energy throughout the day, and that I felt like I had more spring in my step. Success breeds success, and feeling better was excellent motivation to do my 10-minute workout more and more frequently, until I was doing it every morning. I was finally approaching re-entry to the “active” phase. That is, until my knees started hurting.

Generally if only one of my joints is bothering me, it will be a wrist, hip, or sacroiliac joint (I’m leaving my fingers and toes out of this, as they always hurt to some degree). My knees, shoulders, elbows, and ankles usually don’t hurt unless other joints are also inflamed. Therefore, when my knees started hurting in isolation, I figured it was something I was doing, rather than my fickle RA being extra fickle. My immediate thought was that it was probably the jumping jacks, since they are high impact. So I gave them up and continued with the other components of my mini-workout. Yet the pain persisted. Then I realized that it was actually the plank that was the culprit. Again, the plank is a position where one’s body is totally still (how can you get lower impact than motionless?), yet it turned out the plank was wreaking havoc on my knees. Once I stopped doing the plank, my knees got better, and I eventually incorporated my jumping jacks back in without any issues.

Rheumatoid arthritis is so hard to understand, and impossible to predict. Activities that I suspect may cause pain can turn out to be problem-free, whereas my body sometimes protests to activities that should be easy. It is hard to make anything routine when my body can go into revolt at a moment’s notice, and exercise is no exception.

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