Exercise is essential for healthy joints, especially for people with rheumatoid arthritis (RA). This chronic autoimmune condition causes pain, swelling, and stiffness in the joints and can also affect other parts of the body. While it may seem counterintuitive to keep moving when your joints are in pain or inflamed, regular exercise as part of an RA treatment plan can actually help decrease symptoms and improve overall physical function.
This article provides an overview of the types of exercise that are recommended for people with RA and offers tips on how to keep your joints safe while staying active.
Does Exercise Help the Symptoms of RA?
Exercise has been proven to lower inflammation throughout the body, reduce pain, enhance joint flexibility, and boost range of motion for people with RA.
Research confirms the many benefits of physical activity for RA, including:
According to the Centers for Disease Control and Prevention (CDC), being physically active may help adults with arthritis reduce painful symptoms and increase overall function by roughly 40%.
Talk to a Healthcare Provider
Some people with severe joint damage or movement limitations from RA may be unable to perform certain types of exercise or physical activity. Always check with a healthcare provider first to see if there are any activities that are off limits before starting an exercise routine.
Best Exercises for RA
Experts recommend incorporating a mix of exercises into an RA fitness plan.
While specific exercise routines will vary by person, several types of low-impact exercises are safe for RA and can successfully elevate the heart rate, challenge the muscles, and improve strength and mobility, while still protecting the joints.
Stretching the muscles of the body is important for maintaining normal joint movement and relieving the stiffness that often comes with RA. It also helps contribute to better posture and can lower the chances of injuring a joint or muscle while exercising.
For people with RA, experts often suggest stretching at least five days per week. Simple stretches around the affected joints can be done seated or standing by gently holding the muscles in a position for up to 20 seconds before releasing.
Keep in mind that stretching in the morning can help loosen up RA morning stiffness, while stretching in the evening can help relax and release tension.
Walking is a popular low-impact exercise that’s gentle on the joints, while still beneficial for the heart, muscles, and mood. It’s an activity that helps build strength, maintain joint flexibility, and reduce the risk of osteoporosis (weak or brittle bones).
While walking can take place in a park, gym, or neighborhood, you can also get your steps in from other activities, such as mowing the lawn or golfing.
For people with RA, it’s good to start slowly and increase your pace and distance safely over time. In addition, wearing supportive athletic shoes will help avoid pressure on the knee and ankle joints.
Whether it’s a casual swim or a water aerobics class, exercising in the water is a great addition to any RA exercise routine. This is because being in the water supports your body weight, putting less stress on the joints while still allowing for free movement.
An added bonus is the natural resistance of water that helps work the heart and other muscles in the body, building up strength without the added pressure.
Exercising in warm water is known to help reduce joint stiffness and pain, which is especially helpful for people with RA and other forms of arthritis.
Water-Based Exercise Programs
If a local YMCA is accessible to you, consider asking if the facility offers the Arthritis Foundation’s Aquatic Program. This program provides instruction on a variety of water-based exercises to help increase physical activity among adults with arthritis. Note that it’s not mandatory to know how to swim in order to participate in the program.
The hands are commonly affected body parts in people with RA. This can result in painful, inflamed joints and sometimes hand deformity, damage, or loss of function. Making it a point to stretch and exercise your hands, wrists, and fingers can help increase strength and mobility while preventing further joint damage.
Hand exercises don’t need to be a time-consuming part of your overall exercise routine. Experts recommend doing daily, simple stretches for a few minutes, like bending wrists in an upward and downward motion, spreading fingers wide, and slowly making a fist one finger at a time.
Yoga and Pilates
Mind-body coordination activities like yoga and Pilates combine intentional breathing, stretching, fluid movement, and static poses, all of which potentially can benefit joint flexibility, mobility, and range of motion.
Yoga has been shown to provide physical and psychological benefits for people with RA, helping reduce inflammation and pain while also contributing to a positive mental outlook.
Pilates offers additional health benefits for people with arthritis that are similar to aerobic exercise. Using carefully crafted and low-impact movements to lengthen the muscles of the body can also help relieve sore joints and improve posture.
Yoga or Pilates sessions can be done a few times a week, for as little as 10 minutes to a full hour. Because these exercise activities involve some coordination and muscle memory, you might consider starting out with an in-person or virtual fitness class before trying these moves on your own. Certified instructors will be able to help tailor or modify any poses that are not RA-friendly.
Strength training exercises can have major benefits for people with RA. Strengthening the muscles surrounding the joints helps protect and stabilize them, decreasing pain and making movement easier.
Some examples of strength training exercises include:
- Using free weights
- Weight machines
- Resistance bands
- Bodyweight exercises
While many types of exercise work the muscles, it’s still essential to isolate strength training activities for at least two to three days a week. Experts usually recommend starting with three sets of a movement of your choice, with 12 repetitions per set. If your joints allow, you can gradually increase the weight, resistance, or repetitions over time to improve strength.
Low-Impact Aerobic Exercise
Low-impact aerobic exercise, like biking, dancing, brisk walking, or light jogging, helps boost the heart and cardiovascular system. These exercises engage the body’s larger muscle groups while getting the heart rate going and loosening up the joints. In turn, this can help people with RA boost their cardiovascular fitness, control weight, and perhaps improve brain health.
Achieving a target heart rate (the number of times your heart beats in one minute) typically is the goal of an aerobic workout. As you work out more intensely, your heart beats faster and your body burns more calories.
Beginners might consider aiming to bring their heart rate up for 30 minutes per day at least three times a week. Keep in mind that this can also be split up into smaller increments of 10 minutes over the course of the day.
Exercises to Avoid
People with RA and other forms of arthritis should always discuss their exercise plans with a healthcare provider. Any exercises that force a joint beyond its normal range of motion usually are off-limits, as these movements can aggravate RA symptoms.
Unless it’s cleared by your healthcare provider, this means it’s typically best for RA patients to avoid high-impact, strenuous exercises such as:
- Heavy weight lifting
- Competitive sports
The types of exercises that a healthcare provider recommends or approves for someone will RA will vary by person depending on factors such as:
- Affected joints
- Joint stability
- Inflammation levels
- History of joint replacement surgery or other procedures
- Other existing health conditions
How to Create an Exercise Plan
The best exercise program is one that you enjoy doing. First, discuss exercise goals with a healthcare provider. Next, take a closer look at exercise options and plan out the activities that you’d like to try.
Here are the weekly exercise guidelines recommended by the CDC for most adults with RA and other forms of arthritis:
- 150 minutes of moderate-intensity aerobic exercise: This might include a water aerobics class, biking on ground level, or taking a brisk walk.
- 75 minutes of vigorous-intensity aerobic exercise: Examples include swimming laps, biking on a hilly terrain, or playing tennis.
For beginners, this may mean starting out with two 10-minute exercise sessions per week, then building up to five 30-minute sessions weekly. If this seems daunting, just focus on being as active as you can. Getting some physical activity in is better than getting none.
Don’t forget that daily activities (such as vacuuming, gardening, cleaning the house, or walking the dog) can count toward your movement goals.
Tips on Protecting Your Joints
Because RA is an inflammatory condition that affects the joints, it’s usually best to stick with low-impact and joint-friendly exercises to avoid worsening symptoms.
To help protect your joints, check with a healthcare provider first, then:
- Start gradually: Beginning with 10 minutes a day of light exercise and increasing that amount over time is a good way to introduce your joints to movement.
- Don’t overdo it: Too much activity can aggravate or worsen symptoms. Listen to your body, and don’t be afraid to modify movements to your abilities that day.
- Be as consistent as possible: Daily physical movement adds up. Skipping exercise days here or there is fine (particularly if you’re experiencing an RA flare and are experiencing worsening symptoms) but a consistent routine is most beneficial to your body and your joints.
When to Call a Healthcare Provider
A certain amount of soreness or discomfort is expected after exercising, but any lingering or severe pain may be a sign of an injury or injection. Call a healthcare provider or seek immediate medical care if you experience:
- Pain or swelling that is severe or does not get better with rest
- Pain that causes you to limp
- Joints that feel hot to the touch or appear red
Getting regular exercise as part of an RA treatment plan can help decrease symptoms like joint pain, inflammation, and stiffness. Low-impact physical activities like stretching, water aerobics, yoga, and strength training are recommended, while high-impact activities that are hard on the joints like running or jumping typically should be avoided.
Research shows that routine exercise is a safe and effective way for people with RA to improve muscle strength, flexibility, sleep quality, energy levels, and overall physical function.
A Word From Verywell
Finding the motivation to exercise on a regular basis can be difficult, particularly if you’re also dealing with a painful condition like RA. Just remember that exercise routines are not one-size-fits-all plans, and don’t let physical limitations discourage you from movement. As long as you focus on staying as active as your body allows, you’ll be on the right track to better long-term health outcomes and overall quality of life.
Frequently Asked Questions
Should I exercise during an RA flare?
It’s usually best to stop exercising during an RA flare (a period in which symptoms intensify). Resting your body is important during a flare to help decrease joint pain, inflammation, and swelling. If you still feel like being active, check with a healthcare provider first to see if gentle movement or light stretches are appropriate for your individual situation.
How much exercise is too much with RA?
Each person’s experience with RA and exercise is different. But most experts agree that if exercise causes lasting pain past the point of typical discomfort or soreness, it’s likely too strenuous. Listen to your body and talk to a healthcare provider if you notice unusual or persistent fatigue, joint swelling, pain, or weakness following exercise.
Can I jog with RA?
People with RA are encouraged to participate in exercise that is safe and appropriate for them (and their joints). If light jogging does not cause you additional pain or inflammation, it may be an activity that’s cleared by your healthcare provider.