What are the most effective exercises for reducing pain and improving joint function in people with rheumatoid arthritis? Discover the top 9 exercises recommended by experts to manage RA symptoms.

Stretching: Improving Flexibility and Range of Motion

Stretching can be highly beneficial for people with rheumatoid arthritis (RA). It can help improve flexibility, reduce stiffness, and increase range of motion in affected joints. The ideal stretching routine will vary depending on which joints are involved and the individual’s symptoms. A typical RA stretching routine may include:

• Warming up with 3-5 minutes of light movement like walking in place or arm pumping
• Holding each stretch for 20-30 seconds, repeating 2-3 times
• Focusing on stretching the knees, hands, and elbows gently and slowly
• Using a yoga strap to maintain proper form if needed

Consistent stretching can be an effective way to manage RA pain and joint stiffness.

Walking: Low-Impact Aerobic Exercise

Walking is a low-impact exercise that can provide numerous benefits for people with RA. It can help with aerobic conditioning, heart health, joint health, and improved mood. When starting a walking routine, it’s important to:

• Wear proper supportive shoes
• Stay hydrated
• Begin slowly and gradually increase pace as tolerated

Walking is a great option for RA patients looking to stay active while minimizing joint stress.

Flowing Movements: Tai Chi and Yoga

Tai chi and yoga combine deep breathing, flowing movements, gentle poses, and meditation. These mind-body practices can be highly beneficial for people with RA by:

• Increasing flexibility, balance, and range of motion
• Reducing stress and improving mood

It’s important for RA patients to consult with their doctor before starting a new tai chi or yoga practice to ensure it is safe and appropriate for their individual needs.

Pilates: Strengthening the Core

Pilates is a low-impact activity that can increase flexibility and joint health. Pilates poses that activate the core muscles and emphasize movements to improve stability can be particularly helpful for RA patients. For those new to Pilates, it’s best to start slowly and seek guidance from a certified instructor.

Water Exercises: Relieving Joint Stress

Water-based exercises like swimming, water aerobics, and other gentle water activities can be highly beneficial for people with RA. The buoyancy of water helps support the body’s weight, minimizing stress on the joints. Water exercises can:

• Increase flexibility, range of motion, strength, and aerobic fitness
• Reduce joint stiffness and pain

These forms of hydrotherapy are often recommended for RA patients looking to stay active while minimizing joint impact.

Cycling: Improving Cardiovascular Health

Cycling, including stationary bike riding, can be a great option for RA patients. It can help improve cardiovascular function, which is important as RA increases the risk of heart disease. Stationary cycling allows for exercise in a controlled environment, which can be beneficial for RA patients.

Strength Training: Building Muscle Support

Strengthening the muscles around affected joints can help increase strength, reduce pain, and improve other RA symptoms. Resistance band exercises are a safe and effective way for RA patients to build muscle over time. It’s best to work with a physical therapist to develop an appropriate strength training routine.

Hand Exercises: Improving Grip Strength

RA can sometimes lead to limited use and decreased strength in the hands and wrists. Specific hand exercises can help increase flexibility and grip strength, such as:

• Bending the wrists up and down
• Slowly curling the fingers
• Spreading the fingers wide on a table
• Squeezing a stress ball

Incorporating hand exercises into a regular routine can help RA patients maintain dexterity and function in their hands.

Low-Stress Activities: Gardening and More

In addition to the more structured exercises, low-stress activities like light gardening can also benefit people with RA. When engaging in these types of activities, it’s important to avoid excessive bending, twisting, or other movements that could aggravate RA symptoms. Focusing on proper body mechanics, such as hinging at the hips, can help make these activities more manageable for RA patients.

Regardless of the specific exercises chosen, consistency is key for RA patients. Incorporating a combination of aerobic, strength, and flexibility exercises into a lifelong routine can help manage pain, improve joint function, and enhance overall quality of life.

Tips and what to avoid

For people with rheumatoid arthritis (RA), exercise can be hugely beneficial for relieving pain and joint stiffness. Exercises can include walking, yoga, Pilates, water exercises, and more.

People with RA who exercise may experience less pain than those who do not. Exercise can reduce painful symptoms, improve joint function and flexibility, increase range of motion, and boost mood.

It is best to seek medical advice before starting any exercise program and work with a doctor and a physical therapist to develop a tailored exercise plan.

The following types of exercise may help relieve the pain, joint stiffness, swelling, and other symptoms that RA can cause:

1. Stretching

According to the Arthritis Foundation, stretching can help improve flexibility, reduce stiffness, and increase range of motion.

The ideal stretching routine will differ for each person and depend on which joints are affected and their symptoms. Typically, stretches involve moving the joints of the knees, hands, and elbows gently and slowly.

A typical stretching routine may consist of the following:

• Warming up by walking on the spot or pumping the arms while sitting or standing for 3–5 minutes.
• Holding each stretch for 20–30 seconds before releasing it.
• Repeating each stretch 2–3 times. Using a yoga strap might help people maintain proper form while stretching.

Learn more about stretching routines.

2. Walking

Walking is a low impact exercise that can help with aerobic conditioning, heart and joint health, and mood.

It is essential to wear proper shoes and stay hydrated, even if the walking is not strenuous. Start walking slowly initially and then increase the pace when possible.

Learn more about the benefits of walking.

3. Flowing movements, such as tai chi and yoga

Both tai chi and yoga combine deep breathing, flowing movements, gentle poses, and meditation. They increase flexibility, balance, and range of motion while also reducing stress.

It is possible to find free online videos or apps for tai chi or yoga workouts, including some yoga workouts specifically for people with RA. A person should always talk with their doctor before starting a yoga or tai chi practice.

Learn more about yoga.

4. Pilates

Pilates is a low impact activity that can increase flexibility for enhanced joint health.

Doing Pilates poses that activate the core muscles and emphasize movements that help with stability can be helpful. Pilates can be good for overall movement patterns, similar to tai chi and yoga.

If possible, people new to Pilates should begin slowly and seek guidance from a certified trainer.

Learn how to do more exercises for the core.

5. Water exercises

Water helps support body weight by minimizing gravity, which means that water exercises do not impact heavily on the joints.

Swimming, water aerobics, and other gentle water exercises can increase flexibility, range of motion, strength, and aerobic conditioning. People often refer to these as forms of hydrotherapy. They can also reduce joint stress and stiffness.

Learn more about hydrotherapy.

6. Cycling

As RA increases the risk of cardiovascular disease, keeping the heart as healthy as possible is vital. Cycling can help improve cardiovascular function.

Riding a stationary bike can be a safe way to get the joints moving and improve cardiovascular fitness. A benefit of a stationary bike is that a person can exercise in a controlled environment and under supervision if necessary. A person can also ride their bike outdoors to get fresh air.

Discover more about the benefits of cycling.

7. Strength training

Strengthening the muscles around the affected joints can help increase strength while reducing pain and other RA symptoms.

Using a resistance band is a way to challenge the body and build muscle over time. A physical therapist who works with people with RA should be able to offer guidance on suitable exercises.

Learn more about strength training.

8. Hand exercises

RA can sometimes lead to limited use of the hands and wrists. A person with RA may lose grip strength or find that they are dropping things.

Bending the wrists up and down, slowly curling the fingers, spreading the fingers wide on a table, and squeezing a stress ball can all help increase strength and flexibility in the hands.

Discover 8 hand exercises for arthritis relief.

9. Gardening and other activities

Low stress activities, such as light gardening, can benefit a person with RA. A person can avoid overstraining by avoiding bending and twisting in ways that can aggravate the lower back. A gardener should hinge at the hips when working in the garden.

Learn how RA affects the hips.

The tips below may improve safety and comfort when exercising with RA:

• Be consistent: It is important to exercise consistently to achieve meaningful results. A person with RA will benefit from consistent and lifelong aerobic and muscle-strengthening exercises.
• Seek variety: Doing a variety of exercises and mixing up the daily routine can help people avoid overworking one set of muscles or particular joints.
• Listen to the body: It is important for people with RA to remain as physically active as possible. However, it is equally crucial to avoid discomfort or injuries. People can reduce exercise intensity on days when symptoms are more severe.
• Use the right equipment: Padded yoga mats, supportive footwear and clothing, and resistance bands can help people exercise more comfortably.
• Work with a physical therapist: Working with a physical therapist specializing in RA can help develop a safe and appropriate exercise routine.

Learn more about physical therapy for RA.

Below are some FAQ relating to RA and exercise.

What exercises should be avoided with RA?

People with RA should avoid strenuous exercise or any exercises that cause pain. However, RA is different for everybody, and there are no specific exercises that everyone with RA should avoid. For example, a person with RA in their hands might not be able to exercise in the same way as someone with RA in their feet.

Learn what exercises to avoid with hip RA.

What activities worsen RA?

High impact exercises that involve twisting or compressing joints may worsen RA symptoms if a person does not perform them correctly. Working with a professional to ensure proper form and starting slowly at low intensity can help a person build safe high intensity performance.

Learn more about physical therapy and how it can help with RA.

Does exercise reduce inflammation in RA?

Exercise can reduce inflammation in RA, lessen pain symptoms and improve flexibility.

Learn more about joint inflammation.

Can exercise reverse RA?

Exercise cannot reverse RA, but it can help people to manage symptoms and improve joint health.

Learn about other natural remedies for RA.

Exercise is usually helpful for people with RA. It offers various benefits, including relieving symptoms, improving joint function, building strength, increasing flexibility, helping daily functioning, improving aerobic fitness, and boosting mood. It can reduce RA flares and make the symptoms of this condition easier to manage.

If possible, a person should work with a doctor and physical therapist to develop a personalized exercise program for the best possible results.

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Rheumatoid Arthritis (RA) Exercises Joint-Friendly Fitness Routines

Medically Reviewed by Dany Paul Baby, MD on June 26, 2022

It’s true: Exercise can help you feel better when you have rheumatoid arthritis. If you sit on the sidelines, you’ll lose flexibility. Instead, get up and move to loosen up stiff joints, build muscle, and boost your fitness. In time, you’ll feel stronger with less fatigue. If you’re not active now, see your doctor first, so you know what activities are best for you.

Choose exercises like stair climbing, walking, dancing, and low-impact cardio machines, like the elliptical trainer. They’re better for you than activities that put stress on your joints, like running or playing basketball.

To do: Exercise a few minutes each day, at first. Add more time as you can. Keep a moderate pace and work out for 30 to 60 minutes most days each week. 

Do resistance exercises two to three times a week for stronger muscles, which will give your joints more support. You’ll burn more calories, too. 

To do: Use elastic bands, free weights, or machines for resistance. Ask the trainer at your local fitness center, or your physical therapist, to show you how to do each move.

Swim your way to better fitness without straining your joints. The water feels good, too!

To do: Begin slowly with a few minutes in a heated pool. Use a kickboard when you first start to get used to moving in the water. Gradually build to a goal of swimming 30 minutes at a time.

RA makes heart disease more likely. That’s all the more reason to exercise. It will make your heart stronger, cut your blood pressure, and improve your cholesterol level. 

There’s another perk, too. Since your condition puts you at risk for bone loss, weight-bearing exercise like walking, dancing, and climbing stairs helps prevent osteoporosis.

For these exercises, you tense the muscle, and then relax it. If someone was watching you, they wouldn’t see you move at all. This kind of workout may be a better option if strength training makes your joints hurt.

To do: With your arms at chest level, press the palms of your hands together as hard as you can. Hold for 5 seconds and then rest for the same amount of time. Do 5 repetitions. Slowly build up to holding the press for 10 to 15 seconds at a time. If it makes your joints hurt, ask a trainer to show you another type of isometric chest exercise.

To do: Stand with your back against a wall and your arms at your sides. With your elbows straight, push your arms back toward the wall. Hold for 5 seconds and then rest. Repeat 10 times. If it hurts your joints, ask a trainer to show you another isometric shoulder exercise.

It strengthens muscles that support your knees.

To do: Sit on the floor or a bed with one leg straight and the other bent. Then tighten the thigh muscles of your straight leg as hard as you can and count to six. Relax, and then repeat. Do it with the opposite leg, gradually increasing up to five, then 10, then 15 repetitions, twice a day with each leg. If it hurts your joints, ask a trainer to show you another isometric thigh exercise.

You’ll move better if you make it part of your routine. Use moist heat or warm baths before and after stretching exercises to ease your pain and stiffness. Warm up first with light aerobic exercise, such as walking for 10 minutes. Hold stretches for 30 seconds without bouncing or jerking. It should feel good. Keep it gentle, not intense.  

Tip: Use a towel to bridge the distance between your hands if you can’t comfortably connect them.

To do: First, make a fist. Then, open and extend your fingers as straight as possible. Repeat this exercise, gradually increasing up to 20 times, twice a day. To make it harder, squeeze a foam or sponge ball about the size of a tennis ball, then release and extend your fingers. 

To do: First, sit at a table or desk. With your left forearm on the table, let your left hand hang over the edge. Use your right hand to grab the fingers of your left hand and bend your left hand at the wrist, slowly moving it up and then down as far as possible without pain. Repeat with the opposite hand. Increase up to 20 repetitions, twice a day.

To do: With your arm extended, parallel to the floor, position your palm face up. Use your opposite hand to grab hold of the fingers, and pull the palm of the extended hand toward the floor. Hold for 30 seconds. Now, do the same exercise, except this time turn your palm face down. Use the opposite hand to push the top of your extended fingers and hand down toward the floor. Hold for 30 seconds.

To do: Sit or lie on your back on the floor or on a bed, feet slightly apart. With your legs and knees straight, turn your knees in toward each other and touch the toes of your feet together. Hold for 5 seconds. Now turn your legs and knees out, and hold for 5 seconds. Repeat this, gradually increasing up to five, 10, and then 20 repetitions, twice a day.

To do: Face a wall and place your palms flat on it, one foot forward, and one foot back. Leave your heels on the floor and lean forward. You’ll feel a gentle pull in the calf of your back leg and the Achilles tendon at the back of the ankle. Hold for 30 seconds. Do three repetitions. Then reverse the position of your legs and repeat. 

It’s great for your range of motion, flexibility, and balance. It’s also meditative and peaceful, so it’s a good way to relax. The Arthritis Foundation has videos and DVDs that can show you how to do it.

When you jog, run, or play tennis on hard pavement, it can put too much stress on your joints. Lifting heavy weights may also not be the best form of exercise for you. Want a more intense workout? Talk with your doctor first to see what’s OK for you to try.

Pace yourself. When your symptoms flare up, you may need a little downtime. This doesn’t mean bed rest, unless your doctor recommends it. When you stay off your feet too much, your muscles get weak and your joint pain can get worse.

They can tailor your workout plan to meet your needs. Tell them about your RA and any limits you have. There are often ways to adjust an exercise so it’s OK for you to do. 

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REFERENCES:

American College of Rheumatology web site.
American College of Rheumatology, Subcommittee on Rheumatoid Arthritis Guidelines. American Rheumatism Association, 2002.
American Physical Therapy Association web site.
Arthritis Foundation web site.
Asia Pacific Family Medicine.
Ruddy, S., Harris, E.D., Sledge, C.B., Kelley, W.N., eds. Kelley’s Textbook of Rheumatology. 7th ed. Saunders, 2005.
McIlwain, H.H.; Bruce, D.F.  The Super Aspirin Cure for Arthritis. Bantam, 1999.
McIlwain, H.H.; Bruce, D.F. Diet for a Pain-Free Life. Marlowe, 2007.
McIlwain, H.H.; Bruce, D.F. Pain-Free Arthritis. Holt, 2003.
National Institute of Arthritis and Musculoskeletal and Skin Diseases web site.
Riemsma, R.P., Kirwan, J.R., Taal, E., Rasker, J.J. Cochrane Database of Systematic Reviews, 2003.

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Exercise for rheumatoid arthritis | Hello

In rheumatoid arthritis, the disease affects small joints, gradually spreading its harmful effect to larger ones. In the process, the inner surface of the articular bag and cartilage tissue are destroyed. Most often, the disease affects women and teenagers, as well as people who are regularly exposed to physical activity. By resorting to exercise therapy for rheumatoid arthritis (exercise therapy), you can ease the symptoms and improve well-being. Treatment of the spine and joints is prescribed by exercise therapy doctors, orthopedists or rheumatologists. The program is compiled taking into account the patient’s condition, his physical capabilities and existing contraindications.

What does exercise therapy do

Due to therapeutic exercises, rheumatoid arthritis maintains joint mobility. With a decrease in activity, muscle tissue atrophies, blood circulation slows down, and edema develops. At the same time, body weight increases. This is important because being overweight interferes with movement and puts more stress on your joints.

Thanks to the exercises, muscle and connective tissues, tendons are strengthened. As a result, the risk of injury is reduced. Simultaneously, during exercise, muscle relaxation occurs, and in rheumatoid arthritis, this helps prevent pain and accelerates regeneration processes.

Classes have a positive effect on the processes of metabolism and oxygen absorption, weight is reduced. But exercise therapy for rheumatism is contraindicated if the disease is in an advanced stage, and also when:

• inflammation in the internal organs and the cardiovascular system is detected;
• the acute stage of a chronic disease has begun;
• infection has occurred;
• there is intoxication of the body;
• infection develops;
• have heart or lung failure;
• suffering from fever;
• the temperature has risen;
• a hernia appeared;
• diagnosed with cancer.

Physical activity in rheumatoid arthritis should be regular and feasible. It is necessary to perform the exercises three times a day: in the morning, in the afternoon and before bedtime. At the same time, you should try to evenly distribute the load, equally working with both right and left limbs. Breathing should be measured, deep, and the load should be increased gradually, taking into account well-being.

Caring for the hands

Hand exercises for rheumatoid arthritis include exercises for fingers, wrists, shoulders and elbows. Classes begin with the development of the wrists, gradually rising up:

1. Stretch your arms forward. Turn open palms in different directions.
2. Close fists and repeat turns.
3. Sit down at the table. Place open palms on it. Now you need to raise your fingers up so that everything that is below the interdigital spaces lies motionless on the table.
4. Press palms together (as if in prayer) and raise to the level of the face. Put your elbows on the table. Then you need to slowly spread them, while the fingers should still touch each other.
5. Squeeze an expander, a special ball or an anti-stress toy in the palm of your hand.

To develop the elbow joints, it is necessary to bend and then raise the arms so that the hands are down and the elbows are at shoulder level. Now you need to reduce and breed the shoulder blades. Then you need to go to the wall, lean on it with your elbows and start push-ups.

Physical exercises for rheumatoid arthritis to develop the shoulder girdle include classic movements. First you just need to take turns raising and lowering your shoulders. After that, you need to make circular movements back and forth with them. To stretch from behind, behind the back at waist level, you need to interlock your fingers into the lock and lift them up, bringing the shoulder blades together.

Footwork

Orthopedists have developed a standard set of exercise therapy exercises for the lower extremities in rheumatoid arthritis. There are also proprietary methods. The classic exercises are as follows:

1. Tighten your toes and relax them.
2. Stand up straight and roll from heel to toe and back.
3. Rise on your toes and try to stay in this position for 1-2 minutes.
4. Place small objects on the floor and then try to pick them up. The exercise can be done both sitting and standing.
5. Rotate the foot, raise and lower it. You can also sit down.
6. Lie on the floor and do a “bike” with your hips up and your feet imitating the motion of the pedals.
7. Still lying on the floor, stretch out your arms and legs. Then you need to slowly bring the left heel to the buttocks, and then raise the leg so that the knee touches the chest. Repeat the movement on the right side.
8. Lying on your back, bend your knees and spread them to the maximum distance.
9. The exercise is similar to the previous one, but is performed with outstretched legs.

It is very useful to walk barefoot on the ground or grass as often as possible. Periodically, it is desirable to make swing movements: just stand up straight and stretch your legs, and then make wide swings with one limb, then the other.

Emphasis on the knees

Very effective exercises for rheumatoid arthritis of the knee joint, developed by Dr. S.M. Bubnovsky. The main goals of the complex he proposes are to activate the blood supply in the knee area, stimulate the production of synovial fluid, and strengthen the ligaments and muscles. Also in the process, the spinal column is strengthened, due to which the pressure of body weight on the knees is reduced. The complex proposed by the doctor consists of only three exercises:

1. Lie down on the floor and roll over onto your back. Then, in turn, raise one leg, then the other, bending it at the knee. Fix the limb at the top point for 1 minute. Legs should always be lowered slowly. While one limb is up, the other should lie on the floor. Repeat the movement 10 times. Hands can be extended along the body or placed on the stomach.
2. Same starting position. It is necessary to raise the pelvis with support on the feet and outstretched arms. You should get a “bridge” with the legs as bent as possible. Next, you need to stand like this for at least 1 minute and gently lower yourself. Exercise is done 15 times.
3. Lie on your back with your arms and legs extended. Then slowly bring one knee to the nose, then the other. You can help yourself with your hands, pull yourself up with your head. Do 10 sets for each leg.

To practice Bubnovsky on the floor, you need to prepare a soft surface. You can work on an orthopedic mattress. The complex cannot be called easy to perform, but the result of the classes appears quite quickly.

Summary

Exercise therapy does not cure rheumatoid arthritis. In severe situations, the pain will not go away, and you still have to go for surgery. But the body prepared by exercises recovers faster and easier. In the initial stage of the disease, classes will help to maintain joint mobility for longer and lead a full-fledged lifestyle.

What kind of exercises can help with rheumatoid arthritis?

Exercise may help people with rheumatoid arthritis feel better. If you lead a sedentary lifestyle, you will lose flexibility, and joint mobility will decrease. Instead, move more to develop joints, build muscle, and improve your fitness.

Individuals with rheumatoid arthritis should opt for physical activities such as stair climbing, walking, dancing, and low-impact cardio (elliptical trainer). Such types of physical activity are more preferable for rheumatoid arthritis than high-impact exercises on the joints, such as running or playing basketball.

Exercise should begin with a few minutes a day, gradually increasing the load. It is better to do it at a moderate pace, gradually increasing the duration of the workout to 30-60 minutes 3-4 days a week.

To strengthen the muscles, it is advisable to perform weight-bearing exercises 2-3 times a week. Strong muscles will give your joints extra support.

Swimming is also helpful. Water helps to unload and not unnecessarily strain the joints. Start with a few minutes of swimming in the heated pool at a slow pace. Gradually increase your exercise time to 30 minutes.

Rheumatoid arthritis is one of the risk factors for developing heart disease. This is another reason for cardio training. This will make the heart stronger, help lower blood pressure and normalize blood cholesterol levels.

In addition, patients with rheumatoid arthritis are susceptible to bone loss, and activities such as walking, dancing, and climbing stairs help prevent osteoporosis.

Try isometric exercises, in which the contraction of the muscle causes only its tension.