Hi,
I find this article interesting. I believe moderate excercise even paced is better than nothing at all. Also, take into consideration your body when it is ill. Do you pace your activities? I would really like to see everyone capable of some activity because it does help with mental clarity. However, we need to remember moderation is essential when stricken with a disease that attacks each individual differently. I praise all of you who can do some sort of movement each day to make yourself feel better.
Many Blessings
Hi mystic,
I agree that it is better for us to work in some movement and activity each day. Better than doing nothing at all. Even if I get worn out, I know that I feel better overall if I do move around and get some physical activity going. That's the way I keep my body pliable which I think is important.
Hi,
I find this article interesting. I believe moderate excercise even paced is better than nothing at all. Also, take into consideration your body when it is ill. Do you pace your activities? I would really like to see everyone capable of some activity because it does help with mental clarity. However, we need to remember moderation is essential when stricken with a disease that attacks each individual differently. I praise all of you who can do some sort of movement each day to make yourself feel better.
Many Blessings
For me, activity is very bad. Each weekday I go to work, I come home with full body pain and painful, swollen hands and feet. I work 40+ hours a week: Monday - Thursday 9 hours and Fridays 4 hours constantly active.
However, I show no signs of swelling (but I still have the pain) on weekends (Saturdays/Sundays) only going to the shopping, church, and lounging.
My doctor says because the RA is active and no under control, the more activity = more physical evidence of the RA; plus, the work stress probably feeds the RA more.
My mother has OA, so exercise for her is great--at 75 with 2 knee joints, she can out manuver me when we go out, because the exercise has loosened her up and gotten her going. Whereas, when I exercise I'm in tears at the pain and increased swelling.
Hi Kathy D,
Aha. You have brought up a good topic. Should we continue to be more active when experiencing active swelling and pain? For me, especially with joints which don't obviously show swelling, if I'm putting off heat, I will definitely rest and not overtax my joints or muscles. To do so can cause further damage. If I am stiff, then gentle movements are good.
But you have a different situation. You are already very active it sounds through your work. Perhaps doing too much. I would think that finding more efficient and ergonomic ways to accomplish tasks would be helpful. And, getting the disease under control is absolutely necessary.
Hope you are able to get some rest in the evenings and on the weekends. Maintaining balance is very important.
Take care,
Lisa
Hi Lisa,
To me, this study seems pretty flawed. I think that there are so many variables that need to be accounted for and a better guidline as to what constitues a good or bad pacer. Hopefully this small study will lead to a larger one, and that in turn will lead to something positive.... But really, I think exercise and activity are like leading a horse to water. You can talk and educate, but if someone doesn't want to do it, they won't.
Ish
Ish,
I tried and tried to find good definitions of what made a "good pacer" or a "bad pacer." Never did find satisfactory explanation.
The study seemed interesting and I think the outcome was mainly aimed at healthcare professionals (not patients). Maybe future studies would better enhance the communication between doctors and patients. That's what we need.
But I know what you mean about the horse and water. I'm guilty of that myself. I may KNOW what is good for me, but that doesn't mean I will do it for myself.
My initial reaction to this study was, quite frankly, negative. So many who live with RA battle lack of understanding of the consequences of doing too much, being encouraged to "work through the pain," as if physical activity could somehow magically make the disease go away. Still, I am aware that activity can go a long way towards maintaining function, so I kept reading and thinking.
I think the point of the study is that the messages given by health professionals can have a profound impact on what happens in a person's life. My take-home message from reading your post was more directed towards those health professionals, telling them to encourage the people they see to be active in a safe way. It's an interesting connection to my post this week about The Arthritis Foundation's new report on environmental and policy strategies to increase physical exercise.
My rheumie told me 2 months ago I am as well as I will ever be again - go have some life. So I went back to kayaking once a week and walking a little on the other days. My primary had absolute kittens when I told him. He said I was straining my long bones too much, that I need to cut my activity by 75%.... I'm back to sitting on the sofa. :-(
Hi Lene,
LOL. I said almost the same thing in the previous comment. I think you're right, the measure here is more about the healthcare professionals than the patients.
My initial reaction was one of "what? you've got to be kidding, right?" Then I tried to understand what was being measured and the meaning behind it.
I hope that the message of "work through the pain" is one which we stop hearing. I don't think that is exactly when is meant when those words are used. We need to have better conversations surrounding how best to care for our bodies.
In my life, there are still days where if I work on the house, or do some other strenuous activity, for 20 minutes, I might need to rest for the remaining 40 minutes of the hour. But if I continue working this way for three hours, I've still accomplished more than if I had done nothing. That seems to be "good pacing" to me.
Laurie - I'm going to disagree with your PCP. Actually, I'm going to suggest that you listen to your rheumatologist, who is an expert in RA and its implications, rather than a PCP.
Your comment reminded me of a conversation I had with one of my neighbors last week. She was diagnosed with RA about six months ago and is on methotrexate. Subsequently, certain numbers in her blood tests went a little weird, indicating that she was more susceptible to infection. Her family doctor was very, very concerned, telling her to be super careful because she was terribly vulnerable to infection, etc., etc. I advised her to talk to her rheumatologist and when she did, he said he wasn't worried, that it was in fact a sign that the meds are working by suppressing the immune system and therefore her RA. Subsequently, her rheumatologist is making an effort to reach out to her family doctor, so the latter understands more about RA and RA treatments.
Obviously, I'm not a doctor, but I wonder if the same thing is happening in your situation. Primary care physicians usually don't know a lot about RA and its effects, so I'd recommend that you double check the information with your rheumatologist. Past recommendations were for people to sit quietly and not move, but this is no longer the case. Now, there's a better understanding of the role physical activity can play in retaining and increasing function and strengthening muscles to provide support for joints (for more on this, see my post on physical therapy). Reducing your activity levelis is the fastest way to lose the ability you have. On the other hand, going kayaking and walking keeps you active, strengthens your muscles and keep your joints mobile. And most of all, it also increases your quality of life. The point of treatment is to get you to a place where you can participate in your family, your work and your community and to live as fully as you want and are able. Call your rheumatologist. I'll bet anything he'll tell you to go get in the kayak.
Thanks everyone for the ideas about trying to strengthen my muscles and my attitude - - that's really what's at stake here is my attitude about HOW to live a successful life with RA. I don't want to sit on the sofa the rest of my life.
I'm always so stunned to read of those with this terrible disease that have to go to work and raise a family - so many kudo's to those folks, learning how to adjust their daily lives around other people and still live with RA.
thanks again.... Laurie
Thanks everyone for the ideas about trying to strengthen my muscles and my attitude - - that's really what's at stake here is my attitude about HOW to live a successful life with RA. I don't want to sit on the sofa the rest of my life.
I'm always so stunned to read of those with this terrible disease that have to go to work and raise a family - so many kudo's to those folks, learning how to adjust their daily lives around other people and still live with RA.
thanks again.... Laurie
you're very welcome, Laurie. You'll get there yourself - it takes time to adjust and to figure it all out. I was thinking about you yesterday. I recommend that when you do talk to your rheumatologist, you ask him for a referral to a physical therapist who can help you put together an exercise program that can strengthen your muscles while being safe for your joints.
keep us posted on your progress, please?
Yeah yeah, I know. I already commented on this. But, it's been rolling around in my brain, so I thought I'd come back and tell you what's on my mind.
This study is like poking a stick at people who have RA. There is such a big difference between RA and OA, and haven't we all been trying to raise that awareness in people? Sure, people with any kind of arthritis need to be active. But there is also the consideration that RA is a take no prisonsers kind of thing that will wreak havoc on you if you annoy it. You can annoy OA as well... but it's ability to kill you or seriously inconvience you can only go just so far.
As for the concept of pacing. Well, that is just an airy fairy idea as far as I can tell. I "paced" myself right into plantar faciitis, achilles tendonitis, and knees that were so annoyed that one or the other would just give out for no apparent reason... except maybe to get a giggle out of watching me get back up. Had this been OA, I sincerely doubt that my pace would've resulted in all this joint and tendon mayhem.
So, I'm sorry if pacing makes people with OA more sedentary. As I said in my first reply, you can't make someone exercise.... but RA is so different, I just don't think there is much of a comparison.
Bottom line for me though is that I don't think these researchers can really draw ANY conclusions until they strictly define "pacing".
*grumble grumble grumble* 
Ish
It's just that, a study. Likely written by folks that DON'T have RA. Take what you can from it and move on.
Laurie,
You're right. It's just one small study, which certainly doesn't define all that there is to know on the subject. That's one reason I found it interesting.
If being aware of this one project helps you in how you approach activity, or helps your doctors in discussing these issues, then it has made a difference. If not, that's fine too. There's so much more to be healthy. ;)
As an aside to this study, I think that perhaps I should start measuring my own activity. For instance, it has taken almost one hour to respond to about 10 comments. I am always surprised how quickly time flies. Maybe if I knew how long it took to do things, I might be able to better pace myself to avoid physical or mental fatigue. Just an outloud thought to myself.
It's a good thought Lisa - I've tried to pay attention to how long it takes me to do things, but I get lost in what I'm doing and forget to notice. If I enjoy life, that's more important than how long.... and this site is one of the hi-lites for me, conversing with others that have auto immune illnesses and how to get along. You've helped me very much in how to set up kitchen/bath for easier ways to get regular daily things done without too much stress on my joints or nerves.... things like that. I'm glad you and Lene are part of my life, and the many that contribute here. Laurie
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I have found that the more active I am the better my mood is , which in turn seems to help me deal with the pain better. I try to exercise as a person without RA but it backfires sometimes. I tried to elevate my fast walking to running, killed my knees . I would say stay active as many days as you can that way when you have a bad day and need to take a break it's not so bad for you.
Hi Candi,
I think you are on to something. Stay as active as you can on good days (well, without causing yourself to flare). Be kind to the knees. Listen to your body.