I have a confession that might raise eyebrows or invite ridicule: I find most exercise plans and pre-designed programs for fitness and wellness to be not all that useful. Regardless of the rigor and time invested in creating that “perfect” exercise plan, I find a majority of them collecting proverbial dust in the bottom of that proverbial gym back or under a pair of unused walking shoes.  

As someone with two doctorate degrees, one in physical therapy and the other in health sciences, exercise and physical wellness are at the core of my life’s work. I help people move and exercise for a living and I am an endurance athlete myself — and yet, I often find that the best exercise programs aren’t the ones we meticulously design but the ones that resonate with individual needs, preferences, and enjoyments. 

Me and My Exercise-Resistant Mom

My mom, who happens to be the best person to have ever walked the Earth, hates to exercise. She hates going to the gym, gets a sunburn and thus doesn’t like outdoor exercise, isn’t tech savvy and feels overwhelmed with streaming fitness class options. In general, she identifies as “someone who just doesn’t exercise.”  

Over the course of my nearly 20-year career, my mother has heard it all. I have painstakingly designed programs tailored for her specific needs using the latest research and technology to date. I have made modifications and delivered detailed lecture presentations to educate her on the importance of weight-bearing exercise, resistance training, cardiovascular health, and optimal yoga practices. I have also spent hours sharing the latest nutritional advice or the niftiest new meditation neuro-acoustic software. Like a dog with a bone, I have yet to let go.  

It’s important to tell you, dear reader, that my mom still puts up with me. She even loves me, if you can imagine. But it’s also time for me to tell you that precisely zero of my programing has been successful.  

After 20 years of me presenting her with the latest and greatest in exercise physiology, not a bit of it has stuck. During family gatherings, my family still brings the mashed potatoes and I still bring the uncomfortable questions about exercise. 

This Missing Exercise Ingredient: Enjoyment

I encounter a similar dynamic with my patients. They have the desire to improve and feel healthier, and I provide them with a delightfully effective program to achieve those goals. However, more often than not, they struggle to follow through. When they come for their next appointment, they face the dreaded question: “How have your exercises been going?” Their reactions are telling — nervous eye shifts, shrugged shoulders, fidgeting hands, and uncomfortable giggling.  

These patients, like my mother, share a common trait. Perhaps you can relate. Regardless of their motivation or well-intentioned principles, they simply will not stick to a program they don’t enjoy. It doesn’t matter how perfectly designed the program is from a biomechanical standpoint; if they don’t enjoy it or it doesn’t feel good for them, chances are they won’t continue with it. Plain and simple. 

Please know that I am not sharing this perspective from a position of superiority. In fact, I astonish myself and my own health care providers but how non-compliant I can be with my own program. Believe me, I’m not kidding. Just like my patients, I too won’t stick to a program if I don’t enjoy it.  

Finding Exercise Success

My mom currently embraces regular exercise — three times a week — but I had nothing to do with it. My efforts didn’t finally pay off. And, nope, I didn’t finally get through to her. Instead, she found success, just like my patients do by finding an enjoyable exercise routine.  

Her routine involves taking classes with a friend and making new friends along the way. It has become a social activity that happens to include some weight training and chair exercises. It has become something she loves and looks forward to. I often hear stories of her progress in resistance training or how much fun she and her dog had on their recent walk. 

Similarly, my patients find success when I help them discover activities they enjoy while still meeting the necessary objectives.  

As for me, I exercise because I am obnoxiously cheerful in the morning. I like seeing people give me side-eye when I do a dance break between sets. The common factor — it works when we love doing it and find immediate benefit. 

So, for now, let go of what you “should” be doing or the “perfect” routine for you, and think about something you genuinely enjoy doing that involves movement. It can be any kind of movement. That, my friends, is your perfect exercise program for now. 

Tips to Determine if You’ll Enjoy an Exercise

• Try it out: Experiment with various exercises or activities to find what piques your interest and brings you joy. 
• Listen to your body: Pay attention to how your body feels during and after exercise. If it leaves you feeling energized and fulfilled, it’s a good sign. 
• Make it social: Engage in group activities or classes where you can connect with like-minded individuals. 
• Mix it up: Keep your routine diverse and explore different types of exercises to prevent boredom and maintain excitement. 
• Set realistic goals: Ensure that your exercise goals align with your personal preferences and values, making them more enjoyable and meaningful. 

Be a More Proactive Patient with ArthritisPower

ArthritisPower is a patient-led, patient-centered research registry for joint, bone, and inflammatory skin conditions. You can participate in voluntary research studies about your health conditions and use the app to track your symptoms, disease activity, and medications — and share with your doctor. Learn more and sign up here.

“You have a fatty liver.” Well, that stung like a yellow jacket. A new diagnosis is hard enough, but one with fatty in the title felt harsh. The gastrointestinal doctor (GI) explained that with nonalcoholic fatty liver disease (NAFLD), there is excess fat in the liver. My ALT (Alanine Aminotransferase) and AST (Aspartate Aminotransferase) levels were elevated. I felt it coming. He was building up to those two words I didn’t want to hear.  

Looking me squarely in the eyes over his face mask, he gave the directive: “Lose weight.”

It’s probably good that he didn’t see my smirk under my face mask. “The biopsy of intestinal tissue we took during your colonoscopy shows you have microscopic colitis,” he added. Two diagnoses in one appointment? Jackpot! I got my co-pay’s worth of new ailments at this visit.  

Microscopic colitis is an inflammation of the large intestine that is identified by looking at intestinal tissues through a microscope. The exact cause of my microscopic colitis is not known, but it could be from having autoimmune diseases, my food sensitivities, medications, a virus, or even a combination of those.  

This was a lot to unpack. I contacted my rheumatologist about the liver levels because I suspected he might want me to stop my weekly injections of methotrexate (which can be tough on the liver). My rheumatologist advised decreasing my dosage but warned against stopping it entirely. 

What We Eat Can Impact Inflammation

My GI doctor suggested I stick to a diet of bland foods like apple sauce, rice, and non-fibrous foods for a while. I had already been eating gluten-free and dairy-free due to my extreme food intolerances, and I tried to stick to anti-inflammatory foods.  

I wondered what other dietary changes would now be necessary. The doctor reminded me that just because one is eating a diet without gluten or dairy does not mean it’s necessarily healthy. With all the new gluten-free products available at the grocery store, it can be far too easy to succumb to the gravitational force of the processed foods aisle.  

According to the American College of Gastroenterology, the most effective treatment for fatty liver involves “changes in how you eat and live including weight loss, increasing your exercise, eating a balanced diet, and avoiding alcohol.” All of these changes can help with both fatty liver and managing the symptoms of microscopic colitis.

Other foods and beverages I now eat in moderation and avoid during a microscopic colitis flare-up include:  

• Those with a high volume of sugar or artificial sweeteners 
• Raw fruits and vegetables 
• Caffeine 
• High-fiber foods like beans and nuts 
• Foods that are spicy, fried, or fatty 

There are other health benefits to losing weight if you are overweight. People like me with rheumatoid arthritis are 50 percent more likely to develop cardiovascular disease compared to the general population. 

Being Proactive About Your Health 

It can be scary to think about all the possible complications an autoimmune condition might create. Having already had a scare with pulmonary embolisms several years ago, I knew I needed to be mindful of my symptoms and share them with my rheumatologist and specialty doctors if necessary.  

Here are a few ways that I try to stay proactive about my treatment plan to avoid an unwanted trip to the emergency room. 

• Stay on schedule with prescribed medications and tell your doctor about side effects if you experience them. 
• Exercise in moderation. Too much exertion at once could knock you down for days. Daily low-impact exercises and stretching are easier on the joints and can make an enormous difference in how you feel. 
• Talk with your doctor about healthy lifestyle changes. My primary care provider connected me with a free weight-loss coach I hope to meet with soon.  

Hard Work Pays Off 

I lost weight, and six months later, we checked my liver levels once again. My ALT and AST levels were normal and they’ve stayed normal through today.  

There are four key factors that led to shedding the 40 pounds I’ve lost so far. I consulted my primary care doctor, rheumatologist, and gastroenterologist before making these diet and exercise changes. 

1. I walk at least three miles, four to five days per week.  
2. I use intermittent fasting, which means I do not eat after 7 pm and resume eating at 10:30 am. 
3. I follow the FODMAP diet most days to keep inflammation down and avoid flares. 
4. I try to avoid the aisle of cookies and crackers, but the force is strong with that one. 

It’s not going perfectly, but if I deviate from my health plan, I know tomorrow is a new day and I’ll feel better when I get back on track. My personal goal is to lose another 40 pounds, which I had gained when I had to take steroids for a long time. 

The pressure to lose weight was intense for me nine months ago when I got the double diagnosis. I knew that I couldn’t possibly be alone in this feeling, so I reached out to friends for support. I’m especially thankful for my family and close buddies for lifting me up and acknowledging my efforts to eat well and exercise regularly.  

If you want to lose weight, don’t just blindly pick one of the hundreds of weight-loss plans out there, talk with your doctor about a diet and exercise plan that is right for you, along with any obstacles you are facing and how your current medications may be impacted.  

Be a More Proactive Patient with ArthritisPower

ArthritisPower is a patient-led, patient-centered research registry for joint, bone, and inflammatory skin conditions. You can participate in voluntary research studies about your health conditions and use the app to track your symptoms, disease activity, and medications — and share with your doctor. Learn more and sign up here.

The American College of Rheumatology (ACR) strongly recommends consistent exercise for people with rheumatoid arthritis over no exercise and conditionally recommends aerobic, aquatic, resistance, and mind-body exercises. These recommendations are found in the first-ever ACR Guideline for Exercise, Rehabilitation, Diet, and Additional Integrative Interventions for Rheumatoid Arthritis. 

This likely doesn’t come as a surprise with numerous studies demonstrating the benefits of exercise for those of us with RA, as well as other types of inflammatory arthritis. Exercise has been found to reduce stress, fatigue, brain fog, inflammation, and body fat.  

But how do you know which type of exercise is best? And what about frequency, intensity, and duration? ACR has not formally defined this criteria, but instead, recommends that exercise should be tailored to each patient based on their:  

• Disease trajectory 
• Capabilities 
• Access 
• Other health conditions 

In other words, there is not one best exercise for all and it’s up to you to find what works for you. To help get you inspired to incorporate movement into your overall treatment plan, we’ve asked several people with inflammatory to share their routines.  

There’s Not One Best Exercise for All

The following people are all living with inflammatory arthritis  — but how and when they exercise varies immensely.  

Sara’s Routine: Fitness Classes 5-6 Days Weekly

Sara King-Dowling attributes sticking to a routine exercise program as a key factor in keeping her ankylosing spondylitis (AS) symptoms at bay. Her routine consists of attending group fitness classes five to six days each week. These classes incorporate a variety of cardio and resistance-based exercises targeting the whole body to improve endurance and strength.  

The workouts change every day, but some common movements include:  

• Romanian deadlifts 
• Kettlebell swings 
• Chest presses 
• Cycling 
• Jumping jacks 
• Burpees 

Exercise is a vital component of Sara’s wellness plan, and she recently documented her success in a Patient Perspectives poster for the American College of Rheumatology (ACR) convergence 2022 entitled “Exercise as a Supportive Treatment for my Ankylosing Spondylitis.”

If your exercise routine does not include much cardio or strength-training, you are not alone. Even people with similar conditions have their own unique set of attributes, including fatigue and pain levels, muscle strength, flexibility, stamina, and disability, which may hinder certain types of exercise.  

Elisa’s Routine: Hiking, Water Therapy, Stretching

Like many, Elisa Comer’s exercise routine changes based on good and bad days with RA. Her favorite activity: hiking an easy trail. Other exercises in her rotation include: 

• Warm water therapy 
• Stretching 
• Using gentle resistance bands 
• Floor exercises with a firm foam roller (to ease her back pain) 

Ashley’s Routine: Dance Class, Strength-training, Swimming, Walking

Ashley Newton was once a distance runner, obsessed with beating her best time, longest distance, and number of competitive events. Before being diagnosed with RA, her goal was centered on cardio, weight management, and personal growth.  

Today her routine changes based on how her body and joints feel.   

On good days, Ashley enjoys: 

• Hip-hop dance class 
• Barre with modified moves 
• Strength-training with light free weights 
• Swimming  
• Walking (for more than 30 minutes at varying speeds) 

When her body is not feeling as well, her activity includes: 

• Short walks at a slower speed 
• Gentle stretching with deep breathing 
• Physical therapy (PT) exercises 
• Walk laps in the pool 

 Adapting to New Forms of Exercise

Lauren Scholl’s career as a personal trainer requires her to bend over and pick up weights as she demonstrates exercises. A reverse lunge, for example, involves stepping back and bending the toes. “There are days where I can’t do it. I can’t demo that for someone,” she shares on the Psoriatic Arthritis Club Podcast.  

Lauren’s psoriatic arthritis symptoms make it challenging to demonstrate exercises for clients like she did in the past, so she demonstrates using her words. “I’ve tried to learn ways to work around it, I’ve changed my training style,” Lauren explains.  

For Lauren, like so many others with inflammatory arthritis, it’s about finding a good balance. “If I am flaring, it is hard, and I have to like, really listen to my body and know what I can handle.”

Find What Works for You

In the past, my own exercise level varies based on how I feel and my schedule — but the new ACR guidelines have redirected me toward more consistent exercise.  

When I feel unmotivated to exercise, I remember how great I feel after a good walk. If I step outside and walk around my neighborhood or on a path at the park, my energy level increases while my fatigue level decreases. On some days, I can hike on rough terrain up and down hills and other days I can only walk on paved surfaces on flat ground.  

It’s important to keep in mind that each person is unique. Even if we have similar conditions, there will always be differences between us all. A person’s pain and fatigue levels may be different and they may feel pain in a different part of the body. Since we can’t generalize how each person feels and reacts to treatment, we can’t generalize how each person should engage in exercise.  

When I see someone with a chronic condition on social media showing how they ran a marathon or participated in Zumba classes, I cheer them on, but I avoid comparing myself to them because everybody is different.  

Getting Started with Arthritis-Friendly Exercise

A good first step is talking to your doctor about your desire to exercise — and how you can approach movement without overtaxing your joints. In the meantime, here are some patient recommendations for getting back into a daily exercise routine. 

• Work with a physical therapist. A PT can help you choose exercises that do not cause additional pain or damage. 
• Think slow and steady. Do a few minutes of low-impact exercise and then lengthen the duration and intensity as your body becomes accustomed to the movement.   
• Consider arthritis-friendly aids. Wearing hand, wrist, or back braces or applying kinesiology tape prior to exercise can help support the joints and muscles.  
• Find the fun. Do something you love to do like biking, walking, stretching, tai chi, yoga, or swimming. Get more ideas on how to make exercise with arthritis easier. 

Be a More Proactive Patient with ArthritisPower

ArthritisPower is a patient-led, patient-centered research registry for joint, bone, and inflammatory skin conditions. You can participate in voluntary research studies about your health conditions and use the app to track your symptoms, disease activity, and medications — and share with your doctor. Learn more and sign up here.

New Year’s resolutions are hard when you live with an unpredictable chronic illness. Resolutions often require you to make a regular commitment to change, which just sometimes isn’t feasible when you live in chronic pain, have fatigue days, or are busy with doctor appointments. Resolutions also can become expensive, for example, if you decide to buy a gym membership or change your diet and need to buy certain foods. People living with chronic illness are already facing high medical costs through copayments and often cannot afford to invest more into their overall health — whether it be through time or money. 

At CreakyJoints and the Global Healthy Living Foundation, we understand the struggle patients go through around this time of year, and the guilt that often accompanies the inability to keep up with New Year’s resolutions. That’s why we hosted a virtual event “New Year’s Resolutions: Chronic Illness Edition” where we came together as a community on Zoom to start making small healthy changes together and create resolutions in our own chronic-illness friendly way. 

We invited New York City-based physical therapist Chad Woodard, PhD, DPT, to help us bring movement into our daily lives with a few simple stretches. You can use these stretches alone or to prepare your body for exercise. Think about “how can I prepare in the way I want to move,” says Dr. Woodward. “This way, if you have a better foundation then you are more likely to stick to the resolution.” 

Starting Simple

Adding a few simple stretches to your day is a great way to start moving safely — and from here you can build up to other types of movement you want to do on a regular basis.  

Before starting an exercise program, it’s best to talk to your doctor about your capabilities and which types of physical activity are best for your body, preferences, and lifestyle. And once you get approval, don’t do anything that hurts — ease into the movements gently, says Dr. Woodard.  

Neck Stretch

This stretch is good for the muscles in the neck called scalenes and certicangoid mastoid, says Dr. Woodard. You may feel the stretch in the front part of the neck or the back. 

• Bring one ear to the shoulder.  
• Slowly turn your head to look at the ceiling, keeping your shoulders down and away from your ears. 
• Tilt your head back a bit and roll it a little. Play around with the angle that feels good for you.  
• Come out of the stretch, go nice and slowly.  
• Repeat on the other side. 

Middle-Low Part Spine Stretch

Dr. Woodard explains that this is targeted to the thoracic vertebrae and lumbar vertebrae all the way to the pelvis. If you have spinal arthritis or disc issues, do this at a level that is comfortable for you. 

• Stand up, with your right leg in front of your left leg. If balance is an issue for you, stand near something you can balance on like a kitchen counter or wall.  
• Twist slowly so your chest is facing toward the right.  
• Turn your head to look toward the left. Like ringing out a towel, says Dr. Woodard.  
• Stay as far as you think you can go; you should not feel any sharp pains.  
• Switch feet and repeat movements on the other side. 

“And smile,” says Dr. Woodard. “It’s good to smile while you stretch.” 

For more stretches from Dr. Woodard, visit the CreakyJoints YouTube page: 

• Hand Exercises for Arthritis 
• Morning Exercises for Arthritis (Knee and Back Pain) 
• Neck Stretches & Exercises for Arthritis 
• Mindfulness Breathing Exercises for Arthritis and Back Pain

Not Sure What’s Causing Your Pain? 

Check out PainSpot, our pain locator tool. Answer a few simple questions about what hurts and discover possible conditions that could be causing it. Start your PainSpot quiz. 

 

People with arthritis are often advised to stay active, as exercise has been proven to ease pain and improve mobility. But knowing which exercises — and how many of them — to do can be a challenge. This is especially true during the COVID-19 pandemic, where social distancing and shutdowns have forced people to work out on their own rather than with a class, trainer, or physical therapist.

But a new study suggests virtual training programs might be just as effective as in-person training when it comes to managing osteoarthritis (OA) pain.

The study, which was published in the journal JAMA Network Open, recruited 105 people with osteoarthritis from an existing database and split them into two groups. One group was advised to continue with their usual care, which included exercises approved by their general practitioner and physiotherapist; the other was assigned to a six-week exercise and educational program that was delivered via a smartphone app.

The program guided users through daily exercises designed to improve their leg strength and core stability. It also asked participants to rate the complexity and difficulty of each exercise, and automatically adjusted moves based on this feedback before the next virtual session. Users received daily emails, smartphone notifications or asynchronous (not in realtime) chat messages encouraging them to stick with the program. Participants were also provided educational sessions that covered the basics of osteoarthritis and its treatment, as well as tips for self-managing symptoms and maintaining a healthy lifestyle.

Participants were assessed when the study began and when it ended six weeks later through a series of questionnaires about osteoarthritis symptoms and physical tests that measure lower extremity strength, balance, and mobility.

The findings showed that app users fared better than the control group in a number of areas. To start, they reported lower pain and stiffness scores, as well as higher physical function scores, than those in the control group. Participants who used the app also improved more significantly on two common physical functioning tests — the sit-to-stand tests and timed up-and-go tests — than those who did not.

• The sit-to-stand test, which assesses lower extremity strength, requires patients to go from sitting to standing (and vice versa) in an armless folding chair with their back straight and their arms across the chest.
• The timed up-and-go test, which asses functional mobility, requires patients to stand from a chair, walk to a line 10 feet away, walk back to the chair, and sit down.

“In this randomized clinical trial, we found that an internet-based first-line knee osteoarthritis management program was superior to routine self-managed care,” the authors wrote. “The effect sizes attained with the internet-based program used in this study are comparable with or greater than those presented in systematic reviews of face-to-face exercise programs.^”

Whether these benefits are a direct result of the specific exercises or the motivational messages is not clear. What is clear, however, is that guided exercise helps, and an app or tailored digital program may be just as effective as in-person treatment.

Not Sure What’s Causing Your Pain?

Check out PainSpot, our pain locator tool. Answer a few simple questions about what hurts and discover possible conditions that could be causing it. Start your PainSpot quiz.

Lack of physical activity is a known risk factor for osteoporosis, or severe bone thinning that puts you at risk for dangerous and painful fractures. Now a large study suggests that how active you are when you’re young can make all the difference in reducing your risk. It found that teens who spent the most time doing moderate to vigorous exercise were significantly less likely to have low bone mineral density by their mid-twenties.

The study, which was published in the journal JAMA Network Open, followed 2,569 people from age 12 to age 25. Researchers monitored the activity level of each participant by having them wear an accelerometer for a full week when the study began and again for a full week at age 14, 16, and 25. Participants also had bone density scans when they were around age 25.

According to the findings, “more time spent in moderate- to vigorous-intensity physical activity in adolescence was associated with greater hip bone mineral density at age 25 years,” the authors wrote. Intensity was a key factor: Teens who did plenty of light physical activity did not have a reduced risk of lower bone density in their twenties.

The authors also noted that “bursts” of high-impact activity — such as jumping rope, jogging, or playing tennis — were beneficial. That makes sense, as high-impact and weight-bearing activities stimulate cells called osteoblasts.

“Peak bone mass occurs in young adulthood and is considered to be a marker of the risk of fracture and osteoporosis in later life,” lead study author Ahmed Elhakeem, PhD, told Healio Rheumatology. “The results highlight adolescence as a potentially important period for bone development through high intensity exercise, which could benefit future bone health and prevent osteoporosis in later life.”

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If you have lupus, an autoimmune condition that can affect many of the body’s organs and systems, it’s important to do whatever you can to protect your physical and mental health. Now, new research shows that even a small amount of physical activity can make a big difference.

A study published in the journal Arthritis Care & Research found that lupus patients who don’t engage in physical activity have triple the risk of developing depression as more active patients. Even small amounts of light exercise can help protect you from depression. “Any physical activity/exercise is better than nothing,” says study coauthor Patricia Katz, PhD, Professor of Medicine and Health Policy at the University of California San Francisco.

Lupus patients, who often have to cope with pain, fatigue, and various limitations, are especially prone to feeling depressed. Up to half of people with systemic lupus erythematosus (SLE) will experience this mood disorder at some point in their lives, compared to 17 percent of the general U.S. population.

Researchers at the University of California San Francisco noted that physical inactivity increases the odds of depression among Americans in general, and decided to investigate whether lack of exercise might also contribute to this problem among lupus patients.

To measure “inactivity,” the study authors asked if study participants agreed with the statement: “I rarely or never do physical activities.” They chose to focus on physical inactivity rather than activity because research has shown that people tend to exaggerate how much exercise they do.

For depression, the researchers relied on a well-validated test called the Patient Health Questionnaire, depression scale. People who showed signs of depression at the beginning of the two-year study were excluded, but those with a history of depression (26 percent of participants) were able to participate in the study.

The 225 participants in the study were drawn from the California Lupus Epidemiology Study, which has tracked individuals with SLE in San Francisco County since 2015. To ensure ethnic diversity, interviews were conducted in English, Spanish, Mandarin and Cantonese, resulting in a mix of participants that was 35 percent Asian, 30 percent white, 22 percent Hispanic, 10 percent African American, and 2 percent other or unspecified.

The vast majority of the study subjects (88 percent) were women. The mean age of participants was 45, and they had been diagnosed with lupus, on average, about 17 years earlier.

About 16 percent of the participants experienced one or more episodes of depression during the 26-month study period. While patients who were male or white had a statistically significant higher risk of becoming depressed, by far the strongest predictor of depression was being sedentary.

Some patients did not exercise anywhere near the conventionally recommended amounts but did engage in some amount of “regular light activity,” such as, perhaps, walking their dogs around a short block twice a day. Even these people had a significantly lower risk of depression compared to the sedentary individuals in the study.

If you’re interested in logging more active time, walking is often the simplest way to start. “It is easy to scale both in intensity and time/distance,” says Dr. Katz. She also advises trying to sit less throughout the day. For example, you could walk around your home while talking on the phone or set a reminder on your phone to get up move briefly every hour or two — say, walk to the kitchen to get a glass of water.

What about getting physical activity during a lupus disease flare? Lupus, like many autoimmune conditions, tends to ebb and flow, with certain periods where the disease is very active and causing a lot of symptoms and other times when it is not as active or debilitating.

“In these situations, it may be better to take it easy,” says Dr. Katz. “It’s important, though, not to fall into the trap of not exercising because of fatigue.  Regular physical activity can actually help reduce fatigue.”

Track Your Lupus Symptoms with ArthritisPower

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You’ve likely been spending more time in your home than usual for most of 2020, especially if you live with an underlying condition like arthritis. Research shows that rheumatic disease patients have been isolating more strictly than the general public during the COVID-19 pandemic.

Unfortunately, this may also lead to less time getting physical activity, which can take a big toll on your health when you’re already prone to joint pain and stiffness and fatigue.

The majority of arthritis patients reported reduced levels of physical activity — and many reported lower energy levels and worsening symptoms — in a 12-week survey of 264 people with inflammatory arthritis (such as rheumatoid arthritis, psoriatic arthritis, or ankylosing spondylitis) that’s part of an ongoing study from the University of East Anglia.

 “Symptoms such as pain flare-ups and stiffness were in many cases put down to reduced activity and exercise,” lead researcher Alex MacGregor said in a statement.

Being inactive can lead to a vicious cycle. When you’re inactive, it may cause your arthritis symptoms to get worse and also lead to weight gain. That extra weight, in turn, can put more pressure on the joints of the body and spine.

“It’s difficult during this time when a lot of people are stuck at home or quarantined,” says Joseph Bax, DO, Pain Management and Rehabilitation Specialist in the Department of Orthopedics at Mount Sinai in New York. “However, there are some simple things you can still do at home to help slow down the progression of arthritis.”

There’s no need for jumping jacks or even splurging on fitness equipment for a home gym. Here are seven simple ways you can get moving more throughout the day.

 1. Add stretching to your routine

You likely already know how important stretching is for soothing your arthritis symptoms. It’s also a good way to get blood flowing when you’re inside all day. When you don’t move as much, your joints are less likely to maintain their full range of motion. With time, the surrounding muscles can shorten and make it more difficult to keep moving, per Harvard Medical Health Publishing.

“Simple things, such as stretching to maintain the range of motion in your joints and to make sure they don’t get stiff, are very helpful,” says Dr. Bax. “When you are going through a full range of motion, you want to make sure the muscles that move those joints are properly warmed up. Stretching is a way to accomplish that.”

Schedule time into your day when you can stretch with less pain. For instance, if your joints are stiffest in the morning, try stretching after lunch or before bed instead. A hot shower or bath can help relax stiff joints before you stretch. To get started, try these gentle stretches for arthritis.

2. Pace around when you’re on the phone

If you need to take phone calls for work or get stuck on hold with a customer service agent, try not to sit still. Walk around your house, take a stroll in your yard, or go upstairs and back down again.

“Every time I’m on the phone, I pace around,” says Lynn Ludmer, MD, Medical Director of Rheumatology at Mercy Medical Center in Baltimore. “That can add up to 3,000 steps during a phone call.”

If you find a lot of your communication has switched to video conferencing like Zoom or similar programs, ask friends or colleagues if they wouldn’t mind sometimes switching to audio-only if video isn’t necessary.

3. Clean a small section of your home

Whether you have an ambitious project on your to-do list (like reorganizing your closet) or are simply trying to keep your home tidy, cleaning up bit by bit every day can help you stay active — and prevent you from overexerting yourself and causing injury from doing too much at once.

“Have a goal in mind, and remember that it’s okay to take a break and do more the next day,” says Dr. Bax. “You don’t want to overdo it, because the next thing you know you may have done too much and you’re going to be in pain.”

All kinds of physical activity (even cleaning!) can burn calories, get your blood pumping, and strengthen muscles. A 150-pound person can burn about 150 calories per hour by doing household chores, per the American Cancer Society. That said, even five minutes of cleaning at a time can add up. Here are 10 surprising household items you can use to make tidying up with arthritis less painful.

4. Set a timer when you’re working

If you’re working at home during COVID-19, you may find yourself rolling out of bed and going straight to the couch or your desk with your laptop.

“The next thing you know, the day gets away from you and you’ve been sitting for hours,” says Dr. Bax. “If you set a timer for every hour to get up and walk around, you can break that cycle and taking a walking break becomes more of a routine.”

You might even consider investing in a standing desk if it’s possible for you. Then you can step in place as you work to keep moving, adds Dr. Ludmer.

5. Take gentle workout classes online

There’s no shortage of workout videos available on YouTube or other sites, including those that are gentle and just five to 10 minutes — making them perfect to do during quick work breaks or while you have dinner in the oven. Take a calming yoga class or learn a few functional exercises.

Exercise is crucial for everyone, and particularly if you have arthritis. It will increase your flexibility and strength, combat fatigue, and reduce your joint pain. Even moderate exercise can reduce arthritis symptoms, per the Mayo Clinic.

Depending on what type of exercise your doctor has approved, you might search for YouTube videos with keywords like “low-impact workout” or “joint-friendly workout.” Videos with these keywords typically avoid jumping and other movements that are more strenuous on your joints. The Australia-based physical therapy clinic BJC Health also offers several videos tailored to those with rheumatic disease.

We also asked CreakyJoints members for recommendations for arthritis-friendly online workouts. Here are some favorites:

• FitnessBlender.com (“Many of their workouts are very gentle and modifications are given,” says Cathy K. on Facebook.)
• Do Yoga with Me (“Loads of free classes and great instructors,” says @Kat_Hopps on Twitter.)
• Jane Fonda walking cardio workouts on YouTube (“Walking Cardio Level 1 and Level 2 are manageable and can be adapted,” suggests @Newsfnd on Twitter.)
• Yoga with Adrienne
• Ask Doctor Jo

Take it slow, and if needed, use heat before you begin to relax your joints and muscles. You can also apply ice afterward if the activity causes joint swelling, according to the Mayo Clinic.

Of course, it’s always important to talk to your doctor before starting a new exercise regimen or trying heat or ice treatment.

Here’s how you can prepare for a rheumatology telehealth visit during the coronavirus pandemic.

6. Walk around during commercials

Commercials — remember those? These built-in breaks are perfect for moving around. Instead of fast-forwarding or sitting through commercials, walk around the living room or go refill your bottle of water.

“You don’t have to go far, and even walking in place works,” says Dr. Ludmer.

Of course, when you’re enjoying a Netflix marathon, you’ll have to be conscious of scheduling breaks or setting a timer to remind yourself to get up and move. If you’re drinking plenty of water, frequent bathroom breaks will also remind you to get up regularly.

7. Wear a pedometer

You may have stashed your pedometer away at the beginning of the pandemic, or even stopped checking your phone’s step counter. But having a record of how much you’re moving each day may surprise you and encourage you to get up for breaks more often.

“You have to be cognizant of how much you’re exercising, and one of the ways to do that is either by using your cell phone or a pedometer to see how many steps you take,” says Dr. Ludmer. “Steps are really easy to do at home, and they can be done at any time.”

Not Sure What’s Causing Your Pain?

Check out PainSpot, our pain locator tool. Answer a few simple questions about what hurts and discover possible conditions that could be causing it. Start your PainSpot quiz.

Smoking is linked to the onset of rheumatoid arthritis, especially in people who have smoked for decades. However, the health benefits of a particular diet may help lower the risk in people who have ever smoked.

In a new French study published in the journal Arthritis & Rheumatology, researchers evaluated the data of more than 60,000 women for particular environmental factors and prevalence of chronic disease. While following a Mediterranean diet was not associated with a lower risk of rheumatoid arthritis overall, high adherence to the diet did lower the risk for those who had ever smoked.

Most of the women involved in the study were born between 1925 and 1950, and recruited in 1990. They answered questionnaires every other year about health and lifestyle concerns, plus disease diagnoses such as rheumatoid arthritis.

Of the participants, 13.2 percent reported current smoking and 33.2 percent reported formerly smoking. Adherence to a Mediterranean-style diet was low in 29.2 percent of participants, medium in 45.2 percent of participants, and high in 25.5 percent of participants.

The only specific food that was linked to a lower risk of rheumatoid arthritis was fish: A moderate consumption of 9 to 25 grams per day resulted in lower RA risk than eating less than 9 grams per day. The researchers didn’t find a difference in risk for the high consumption of any food group.

“The Mediterranean diet has been reported to be associated with significant reduction of non-communicable diseases,” note the researchers. “Our results suggest that adherence to the Mediterranean diet could reduce the high risk of rheumatoid arthritis among ever-smoking women.”

You’re likely familiar with the mainstays of the Mediterranean diet: This plant-heavy eating pattern, similar to the cuisine of countries along the Mediterranean Sea, features plenty of foods like fruits and vegetables, potatoes, whole grains, beans, nuts, seeds and extra virgin olive oil, per the Cleveland Clinic.

It includes only moderate amounts of lean poultry, fish, seafood, dairy, and eggs — and very few fried food, sweets, red meats, and white flour products.

The Mediterranean diet has been linked to several other long-term benefits. For instance, it was found to reduce the risk of major cardiovascular events over five years by 30 percent compared to a regular low-fat diet in a 2018 study published in The New England Journal of Medicine.

Because the Mediterranean diet features foods rich in antioxidants, it may counterbalance some of the damaging oxidant effects caused by smoking — therefore reducing the risk of rheumatoid arthritis associated with smoking, note the researchers of the new study.

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Check out PainSpot, our pain locator tool. Answer a few simple questions about what hurts and discover possible conditions that could be causing it. Start your PainSpot quiz.

Whether you’re planning to take a road trip this summer or you have a long regular commute to work, you know driving for long periods can be tough on your muscles and joints. This is especially true if you live with arthritis.

When you drive, you’re in a prolonged static position, which can cause stiffness and discomfort — particularly in your knees, shoulders, and low back. However, stretching before, during, and after your drive can have a significant impact in how you feel.

“If you have arthritis, you need to change positions or take a break and stretch out a little bit regularly,” says Leada Malek, PT, a licensed physical therapist in San Francisco, California. “Stretching relieves the sensation of tightness in the muscles. That tightness can otherwise increase compression on your joints, leading to stiffness and achiness.”

Think about how long you can typically drive before your arthritis symptoms start to worsen —  and make a conscious effort to take breaks before that point (in other words, don’t wait for pain to appear before you stretch). If your joints begin to ache after 40 minutes, aim to take a break every 30 minutes if possible.

The following physical therapist-approved stretches can help you feel comfortable as you drive by gently stretching your muscles from head to toe. Unless you’re a passenger, be sure to park before you start stretching, so you can stay safe and focused on the road while driving.

Neck and Shoulders Stretches

Shoulder Shrug

Raise your shoulders toward your ears, then shrug down to release them. Next, inch them back by bringing your shoulder blades together. That’s one rep; do 10 to 15 reps.

“That’s inherently going to relieve tension in the neck, without compressing it,” says Malek. “If you have arthritis, it’s important to stretch your muscles without cranking on the joints that are aching.”

Prevent the Pain

Remember, your shoulders shouldn’t be elevated throughout your drive, because it can contribute to neck pain and tightness. Make sure your steering wheel isn’t too high, but at a level that allows your shoulders to remain relaxed while you drive.

To avoid inadvertently contributing to neck pain, rotate with your upper and lower back to make up for any limitations in your neck’s range of motion while you’re reversing the car or checking blind spots, advises the Cleveland Clinic. Try to park in ways that don’t require you to back up, if possible.

Cross-Body Stretch

Reach your right arm across your body to the left. Hold your right arm with your left arm for 30 to 60 seconds. Repeat with the opposite arm.

“This gentle, small tug stretches the back of your shoulders,” says Malek.

Prevent the Pain

To minimize the stress on your joints when driving, keep your hands below the “3 o’clock” and “9 o’clock” positions on the steering wheel, suggests the Mayo Clinic.

Lower Back and Mid-Back

Cat/Cow 

Place your arms on the top of your steering wheel. Arch your back, and then collapse to curve forward. That’s one rep; do 10 to 15 reps.

“By having your arms on the wheel, you’ll feel a stretch through your upper back, too,” says Malek. “It’s a nice way to get a little bit of movement in the spine without having to leave the car.”

Prevent the Pain 

When you set out on a long drive, increase the lumbar support in your car seat if possible, or add a small pillow along the natural curve in your low back.

“This helps distribute the pressure along the back and hips a little more evenly,” says Malek. “Otherwise, you can get compression on the nerves and discs in your back.”

Also adjust the chair so it’s elevated (your hips should be slightly higher than your knees) and leaning backward slightly at a 110-degree angle. This is the position of least pressure for the discs in your back, adds Malek.

Hips

Hip Flexor Stretch

Stand with your left foot about 12 inches in front of your right foot. Tuck your tailbone beneath you and slightly shift your weight forward over the left leg while keeping both feet pointed forward and your front leg slightly bent. Tighten your right glute and hold this position for 30 to 60 seconds. That’s one rep; do two to three reps total on each side. (This video shows how to do this stretch.)

“I would definitely do this in the middle of your drive to stretch those hip flexor muscles,” says Malek. “You get a stretch automatically without needing to enter a full lunge, which is helpful if you have arthritis.”

Prevent the Pain 

On your next drive, slide the car seat forward so you have a slight bend in your knee when you’re using the gas pedal and brake pedal.

“A lot of people with arthritis in their back may have lumbar radiculopathy, and with that comes tingling down the sciatic nerve,” says Malek. “When your seat is a little closer to the pedals, that slight bend in the knee is more comfortable for the nerve.”

Try to get into and exit the car without twisting your back and hips. For instance, face away from inside of the car when getting in and then swivel in to face the steering wheel, per the Cleveland Clinic. To get out, swivel to face away before stepping out.

Legs

Calf Stretch

Place your hands against the outside of your car and stand with your left foot about 12 inches in front of your right foot. Lean forward by shifting your weight onto the left leg but try to keep the right heel against the ground and both feet pointed forward. You should feel the stretch in your upper calf.

Next, slightly bend your right knee to stretch the lower part of your calf. Hold for 30 to 60 seconds. That’s one rep; do two reps. (This video shows how to do this stretch.)

“There are two parts of the calf muscle, and you stretch the upper part with a straight knee and the lower part with a bent knee,” says Malek.

Feet

Tennis Ball Roll

Take your shoes off and roll each foot over a tennis ball for two to three minutes as a gentle massage (it’s easiest to do this while sitting). Here are more genius ways to use a tennis ball to to ease arthritis pain.

Prevent the Pain

“I would also utilize cruise control when possible,” says Malek. When safe to use, cruise control can help you avoid flexing your foot for a prolonged period of time.

Not Sure What’s Causing Your Pain?

Check out PainSpot, our pain locator tool. Answer a few simple questions about what hurts and discover possible conditions that could be causing it. Start your PainSpot quiz.