I know it is important to integrate exercise into the therapeutic strategy. My question deals with when and how. I was diagnosed early this year and the mex/folic/prednisone cocktail hasn’t kicked in yet. Hence I’m exhausted and in pain. With such little energy…my question deals with depleting reserves or are they unrelated? Should I begin an exercise routine NOW knowing it can’t zap my reserves or should I refrain until meds kick-in and I’m feeling better? (Who knows how long that could be?!)
Every day I wake up and hope that I will be “back to normal”…what I’m reluctantly coming to understand is that my current state might in fact be my new normal…not very encouraging. I was healthy as a horse then one day I woke up and didn’t feel right and both my elbows hurt…I’ve never been the same.

So I guess my simple question is…do you begin an exercise routine while in the valley of despair or wait until you can feel yourself coming out of the painful haze?
Many thanks to all…we’ve been dealt a hand…it would be easy to fold…I choose to play.

I think you might have answered your own question, Tom: who knows how long it will take until you're feeling better? Do it now.

This isn't the time to start training for a marathon or the weight-lifting competition, but any exercise you can manage will be all to the good. How active were you before The Beast entered your life? If you were pretty much of a couch potato, you'll want to start slowly. Walking has always been my favorite. Some folks love to go to a warm-water therapy pool for an exercise class. Is there an arthritis-specific exercise program nearby?

For me, lack of exercise exacerbates "the valley of despair" like nothing else. Joints that feel awful will loosen up with some- not too much- movement. Overuse may be worse than no use. You will find the balance.

You can begin a gentle exercise program. Even just walking down the end of the block and back can be a good start. You can do this a few times a day, and build up distances and times a day. You can start to do some gentle stretching as well. But this is where "move it or lose it" comes in. Joints that don't move can become unmovable.

Tom I hear you. I have struggled with this myself. I try to walk in a warm pool 1-2 times a week and more oftn when the flare lifts. This keeps me at a baseline that I can increase as the flare ends. I also walk though sometimes it is to doughnuts and coffee or ice cream which am not sure is the best plan. I do have to push myself when I am flaring but only for a bare minimum. When I am feeling better I increase it without really thinking about it. I actually enjoy it when I am better.

Good luck with whatever plan you use. I will keep you in my thoughts and prayers.

When I was at my worst, yoga helped a great deal. I have been doing yoga for years, but I discovered that doing beginner's poses and focusing on mindfulness helped me more than the strenuous stuff. There are a lot of exercises one can do without straining inflamed joints- even just doing range of motion exercises help improve mood and decrease the risk of joint damage.

I agree that you should start some gentle exercise. Today I hurt quite a bit and didn't want to workout, so I promised myself I would at least do a 10 minute ride on the stationary bike and re-evaluate how I felt after 10 minutes. It turned into a 35 minute ride. Just commit to doing some kind of exercise for a short period of time and if you feel up to going longer, do it. If not, at least you did a little.

Miz Que

I have to agree with all of the advice here. The older I get the more apparent it is that movement is essential. I have NO energy unless I exercise, so sometimes I just have to fake it. I do exercise in a warm pool and I try to talk to myself while doing it about what a luxury it is and how it makes me feel better. After a while it feels like the truth. My joints are much more stable when I am regular with my exercise. We have to protect what we have to work with today because there is no guarantee that it will get better and odds are it will get worse.

Hi Tom:

It has been my experience, over the last six months, that beginning an exercise program in the valley of despair can be done and I am so glad I did.

A wee bit about my history, I was dx 2 years ago and was in really awful shape, physically and emotionally and I was in mind numbing pain. I have failed three biologics and getting by on low dose prednisone and methotrexate and pain meds until I can get this monster under some sort of subjection.

Under the advice of my ortho doc, I was advised to undertake 30 minutes of low impact aerobic exercise every other day. For my unique physical challenges, the recumbent bike is perfect and now I am up to 45 minutes at a pretty high resistance rate, every other day. I usually pedal about 7 miles and climb 3400 feet per workout. Believe me when I tell you that 6 months ago, I could barely make it through a trip to the grocery store. Many have had good success with aquatic exercise, too.

If we want to keep moving, we have to keep moving....intentionally. My advice would be to talk to your doctor and get a physical therapist or certified trainer to tailor a program for you. I don't feel all that much better in terms of my pain or symptoms, but I am less anxious and have more stamina and am better able to deal with stress.

I put on my headphones, some great music on Pandora and pedal away and sweat my face off ! I feel great when it is OVER, ha. I work out at the local YMCA. They have a program where they contact your doctor for restrictions and recommendations for an exercise program suited to your specific needs and limitations. I really like going.

I've been including exercise in my daily routine and have found it has really helped overall. Even on days where I feel fatigue, I find if I push through it I end up feeling more energetic after. Last year my mobility was limited due to an increase in flares and over all pain so even just getting in the hot tub and moving around helped. I also started meds last year and it has taken a while to find a combo that would allow me to move more with out flaring.

My current combo seems to be working as I have less daily pain and haven't had a flare in a few months. Now I am hiking almost daily and I find on the days that I'm not active I tend to have more pain (seize up). It can be challenging finding the balance that is right for you, but I have found that moving has been very beneficial for my over all health :-)

Just a word of caution...Be careful. I have been suffering with screaming achilles tendon pain since the beginning of the year(even after prednisone burst x 3) that started after walking slowly on the treadmill with the lowest incline for about 3 days.

Hi Tom,
I was unable to walk when I started treatment as my feet and ankles were very swollen, but I found that just stretching was helpful. I would do a few stretches in the morning. Be patient, I know it feels like you’ll never feel better but you will. Good luck :slight_smile:

Tom, I would strongly advocate for starting a PT program. I was having trouble exercising as I am still in the "gap" and any activity seemed to cause flare-ups. The difference (for me) between trying to do it on my own, and going to PT, was that I feel more confident trying things with the PT watching me, making sure I don't hurt myself and she monitors my condition for flares. I see her twice a week, and it makes a big difference in my stamina, a little difference in strength, and a big mental boost with seeing what I can and cannot do safely. She has told me that arthritis also attacks muscle strength, not just joints, and only a few weeks of inactivity causes weakness that will take months to undue.