You know you should lift weights to make your muscles stronger and reduce your fatigue. But if you have rheumatoid arthritis (RA), you may be worried that strength training might be bad for your joints, or even make pain worse.
Experts say that if you have RA, strength training is something you should fully embrace, not back away from. “Exercise is a great anti-inflammatory,” says Gustavo Carbone, MD, a rheumatologist in Savannah, Georgia. ”People with RA constantly ask me about natural things they can take, he says. “Exercise, including strength training, is the best natural thing there is.”
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Strength Training — Big Benefits for People With RA
Strength or resistance training — exercise to increase muscular strength — protects bone health and muscle mass, boosts energy levels and mood, and increases resting metabolism so weight stays off easier. This kind of training can involve weight lifting or using forms of resistance — bands, weights, your own body against the force of gravity — to strengthen your muscles.
According to Mayo Clinic, regular strength training also aids people as they age, making falls less likely, everyday activities easier, and, along with aerobic exercise, may even improve thinking and learning skills.
In fact, a review of the benefits of exercise for people with RA in the Journal of Aging Research concluded that exercise training is so valuable for improving function without exacerbating disease activity that “all RA patients should be encouraged to include … resistance exercise training as part of routine care.”
Strength training is especially important for people with RA because it helps to stabilize the joints, explains Scott Haak, a physical therapist at Mayo Clinic in Jacksonville, Florida. “Part of the consequence of RA and joint erosion can be ligamentous laxity, which inherently decreases the stability of joints. Working small muscles can be beneficial with stabilizing joints and improving function,” he says.
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Working Out to Help, Not Hurt, RA Symptoms
Some people with RA worry that strength training, weight lifting, and other exercise might be detrimental. Research published in Sports Medicine, for instance, found that people with the condition often say that “pain and fatigue” are barriers to working out — even as they recognize that regular exercise will diminish these symptoms.
Working out does not seem to harm the joints. CreakyJoints, an advocacy and support organization for people with arthritis, notes that weight lifting reduces joint pain and stiffness. They cite a study in which people with early stage RA did strength training exercises twice a week for two years and improved muscle strength by up to 59 percent; this group experienced greater reductions in inflammation, pain, morning stiffness, and disease activity compared with patients who only did range-of-motion exercises.
Additionally, a review of research published in the journal Medicine in April 2021 found that resistance exercise significantly decreased disease activity.
Get Expert Advice From a Physical Therapist
Once your doctor says you can exercise, it’s best to get a referral to a physical therapist (PT), who can show you how to work around your condition. While you don’t want to lift weights with joints that are flaring, Genie Lieberman, an occupational therapist and director of the Gloria Drummond Physical Rehabilitation Institute at the Boca Raton Regional Hospital in Florida, says you can still strength train muscles in other body parts during that time.
Need more inspiration? Research points to ways to help make your exercises more effective and more enjoyable:
Lift Less Weight and Still Get Results
You may think you have to lift mega-sized dumbbells to get results from strength training. And it’s true that if you want to look like Serena Williams, you will need very heavy weights.
But a small yet important study published in Life Sciences showed that when people lift light weights and focus their minds as if they are contracting their muscles for a heavier load, they significantly improve muscle strength. Interestingly, people lifting the same light weights while watching an entertaining video (and therefore not concentrating on their muscles) didn’t see the same gains. “High-effort” exercise done with light weights can be safe and effective, the study authors concluded, for people who can’t lift heavier weights.
You Don’t Have to Go It Alone
People often avoid weight training because they think it’s boring. But a review published in the British Journal of Sports Medicine looked at some reasons people avoid strength training and offered suggestions to combat them.
The researchers found, for example, that planning a workout in advance increases the odds that you’ll do it. So does enlisting the encouragement of family and friends. (You might even ask them to go to the gym or to lift weights at home with you, which will benefit them, too.) The authors also suggest finding ways to make the exercises enjoyable, such as listening to upbeat music or working out with a PT or trainer you like.
A review of research published in September 2022 in The American Journal of Lifestyle Medicine recommends being active with a friend or joining an exercise class to stay motivated. Researchers also note that goal setting, planning, and knowing the benefits of strength training can help keep you on track.
Make Workouts Work for You
Sometimes people gain strength while working out at a physical therapist’s office, but can’t translate that into exercising at home. That’s why Hong Kong researchers explored the effects of adherence to an exercise program that was tailor-made for a small group of participants with knee arthritis. In an article in Clinical Interventions in Aging, they described their method, which proved effective in boosting adherence and health outcomes in this pilot program.
They found that it’s better for the PT to teach you exercises that are done while sitting or standing rather than lying down. They also found it helps to ensure that you understand all the steps involved in each exercise so you can do them later; study authors provided both in-class demonstrations and handed out posters and pamphlets with pictures and descriptions of each move.
It also helps to tailor workouts to your body. For instance, if you experience morning stiffness, plan to exercise later in the day, note the researchers in The American Journal of Lifestyle Medicine review, modify uncomfortable movements, and add activities that improve flexibility.
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Soreness Doesn’t Have to Stop You
While doing strength training, it’s important to listen to your body, Lieberman cautions. After you exercise, if you feel pain that is severe or lasts more than an hour, talk to your PT or trainer about modifying specific exercises for the next time. Muscle soreness may be normal but joint pain during or after exercise is not and you shouldn’t push through joint pain.
But don’t let soreness be a reason to stop, since all effective strength training makes you feel sore. “Any exercise done when a person is not conditioned is going to hurt for a while — not just people with RA, but everyone,” Dr. Carbone says.
