Exercise Flares - tips on prevention and symptom control?

[Jen75]

So… most of us get exercise or “overdo” Flares.

When we don’t have effective meds, they can be the result of something as simple as driving to work and getting stuck in a traffic jam, cooking a meal, hanging out the washing, or mowing the lawn (actually even with effective meds, mowing the lawn still does me in!).

i know that when a healthy person exercises their muscles to the limit, inflammation kicks in to help heal and make them stronger. But it’s local. Things are stiff and sore in the morning, but it’s not body-wide, and doesn’t take 2 hours to get going!

For me, if I go too hard, the inflammation kicks off a flare - systemic, body-wide, fatigue, low grade fevers, the whole kit and caboodle.

I’m really fortunate at the moment, that I can do most day to day things without triggering this. And…

I’m taking advantage of that, to do things I haven’t done in years I’m finally riding horses again!

It’s fantastic, and I’m very lucky (thanks Humira ). But obviously, when you bring an animal with its own mind into the equation, where you can’t just hit the off button, and letting go would be purely dangerous, pacing (which I highly advocate in most situations), has its limitations.

At the moment, my version of pacing is only to go riding every fortnight, hopefully I’ll slowly increase.

So… what are your strategies both to prevent these sorts of overdo Flares, and help minimize the symptoms?

[Cynthia]

Awesome thread thanks! I’m still trying to learn… I’d love to know if you guys can “feel it coming” and be able to know when to stop before you’re already way over the line?.. and how you know…

[Jen75]

Hmm, 6 years after I felt like a truck hit me, I can, sometimes, just feel it coming. Often I miss it.

My simplest example IS mowing the lawn… I just recently moved into a place with a big lawn. The first time, I mowed it in one day. Boy, was I punished. Stupidly, I did it again, thinking it was “just me”.

Well of course it was just me! But doing it the same way again wasn’t going to fix that! (and it didn’t).

Next time, I mowed the front one day, and the back next.

The back is twice as big as the front - still too much.

Now, I split it up into three.

I’m a slow learner, but I get there.

And, eventually, I have learnt to see it coming. When I start holding my breath - I realized that is how my body tries to push through discomfort - I know I need to reassess.

Not necessarily stop - perhaps I just need to breathe, pay attention to my body, and know that stopping time might be soon. That signal gives me time to make a plan to stop - ok, I’ll mow to there. Or I’ll trot once more around the ring, or if I’m on a walk turn for home (whether I’m a mile away, or a block - same principal works for me).

I’ve learnt that if I listen better to my body, it actually shouts pretty loudly at me. I was always so fit, and the change so sudden, it took a big adjustment. But interestingly, it’s made me better at some things.

Particularly when it’s hot (40 deg C plus) in the fieald, I do the morning in the field, and the afternoon on the computer. At the start, my clients seemed a bit miffed and compared me to other consultants who worked in the field all day.

Now, they appreciate that I create methodical, well documented reports on my field work with a robust explanation of my interpretation. In an employment category with around 50% of people unemployed or underemployed, I have to say no to new work.

I’m not going to say it is easy or rainbows and unicorns, but pacing has made my whole life better.

If you can stop and listen to your body, you will find your own signals. For me, it’s breath holding if I’m doing something physical, or, if I’m in the office, I look like I have a headache. Today I drove into a clients office - a 1.5 hour drive. I’d normally stay till the end of the day to make the drive in and out worth it. But by about 1.30, my brain was slower than my PsA normal, and at two, I saw myself in the mirror in the toilets, I looked like I had a terrible headache. I made my preparations to leave, and told the client I had an appointment to go to.

And, before my meds kicked in, I held my breath MOST of the time. I looked like a had a terribly headache MOST of the time. But subjectively, in hindsight, there were some times worse than others. I won’t kick myself for not saying no, or taking a rest then - I was still learning, but I’m happy to do it now.

What do others find their body signals are? As well as prevention and treatment, how do you know you are overdoing it?

[Poo_therapy]

Completely fascinating. I too hold my breath and only realise after, why I was holding my breath. For me always the worst thing to do is be stuck in doing something when I can’t change or stop being so stuck. For instance the very worst thing for me is being stuck sitting on an uncomfortable chair. That can be a car seat, a train seat, a chair in my employer’s office at my work station or the very worst of all a chair at a conference or meeting where just standing up and moving about makes people think the very worst of you. Other beds rather than my own can do that to me too. They’re something like a form of all night water boarding type of torture for me.

Other things abit like your lawn mowing experience is deciding this is the walk with the dog I’m doing - always a circuit in the woods for me. And then I realise I’ve been far too ambitious today but I’m stuck as the way back is just as long as the way forward. Eventually I manage to hobble back to the car, feeling utterly defeated and useless. I’m getting better at that one though as I now do circuits with extra loops for when it’s just a great day and I can walk just as far as I desire.

It takes effort and also shedloads of imagination to really learn how to pace effectively, without always beating yourself up about the times when desire to do more or overambition ends up making you feel like you’re just a total failure.

This is a fascinating topic @Jen75 - just fascinating. Thank you.

[debruble]

I am relatively new to PSa. I was also diagnosed with Lyme Disease within the same year. There are times I’m not sure which I’m dealing with. I had associated just the pain and swollen joints and fingers as PSa and all the yuck as Lyme. This site is helping me understand more about this disease. My flares start as an overall weakness in my limbs, particularly my arms. If I am able I sit and put my legs up. If I’m in a situation that that is not possible I try to fade in to the background. I try and remove all stress from my thinking. I guess I do a mental sit down and put my legs up. I too look like I have a bad headache. Which I have seen as a blessing because people tend to not hover and question a person with a bad headache. Thank you for posting.

[Cynthia]

How do you look when you have a headache? I get a red and flushed face like I’m hot but I’m actually cold… people always ask if I’m hot before I realise and I have headaches then but also a lot of pain… is that what you guys mean too?

[Jen75]

Being a bit of an oldie, I get a forrowed brow with plenty of wrinkles - basically looks to other people like a combination of me being constantly concerned about something and a bit washed out (so I often go a bit pale) all at the same time.

I actually only occasionally get a real headache to go with it - it must just be my “pain expression” that other people associate with headaches

[tamac]

I got to the point that when got stuck in traffic going to work in the morning and it took me an hour to get there I had to grab my pants to left my leg up and and start it getting out of my truck. My hips and knees would hurt so much I couldn’t more my legs.

When I told my doctor that this week he said no more of the Otezla, I had to change. I’ll be starting Enbrel in a few days.