Exercise plays a major role in the rehab and pain-management protocols of people who reel under rheumatoid arthritis (RA). It also helps them manage their bodyweight, a key variable to keep under control while managing the condition.
However, RA limits the type of exercise a person can do. Any high-impact activity is a no-no because of the vulnerability of the joints. Swimming, which impacts the joints less but is still a great cardio as well as toning exercise, can be their best option.
Rheumatoid arthritis is an autoimmune condition which affects the joints, causing stiffness and inflammation. This is because the immune system mistakenly starts attacking the healthy cells and tissues of the joints.
Benefits of Exercise in Rheumatoid Arthritis, a paper by Peter Maddison et.al., concludes that exercise improves the overall functions in those suffering from RA and comes with no proven detrimental effects. The paper recommends some form of aerobic and resistance training as part of the care routine.
People with rheumatoid arthritis need not look beyond swimming, a full-body exercise that comes loaded with cardiovascular benefits. Swimming is also a great exercise for muscle toning.
Rheumatoid arthritis and exercise — the right approach
“Damage in rheumatoid arthritis corresponds to duration of the untreated disease,” says Dr Shweta Singhai, consultant rheumatologist at Sakra World Hospital, Bengaluru. “The longer the duration of inflammation, the more is the damage.”
Whenever pain and inflammation are high, the person should stick to exercises with a simple range of motion — flexion and extension of elbows, wrists and knees, or raising arms above shoulder level or squeezing a smiley ball.
“The golden rule is to listen to the body,” adds Dr Singhai. “Once it [inflammation due to the condition] is in control, those with RA can do any exercise [like] any other person. And in chronic deforming RA, low-impact exercises such as swimming, water aerobics and walking can be done.”
Swimming and rheumatoid arthritis
“Swimming is a low-impact exercise and is considered one of the best exercises for RA, osteoarthritis and for recovery after knee-replacement surgery,” says Dr Singhai. “The buoyancy of water reduces the impact on the joints along with reducing muscle stiffness and pain, increasing flexibility of joints and improving cardiovascular fitness.”
RA affects the heart by causing pericarditis (inflammation of the heart lining). In serious cases, this results in pericardial effusion where fluid collects in the lining of the heart, compressing it and hampering its functioning.
Those with long-standing rheumatoid arthritis have a high risk of cardiovascular events like heart attack or paralytic attack. Swimming improves cardiovascular fitness and decreases this risk.
Precautions and intensity of the swim
Deformities are not seen during the early stages of the onset of RA, but they may develop if treatment is delayed. In such a scenario, care should be taken before doing any form of exercise, including swimming. The cervical spine can also get affected in rheumatoid arthritis. So, it is important to consult a rheumatologist and a neurologist before planning any exercise regimen.
When starting swimming, you should keep the intensity light and only gradually increase the level. Once the condition is under control, and the person has been following a systematic training routine, advanced level swimming is also possible.
- Swimming, being easy on the joints, can be taken up as an exercise routine by those with rheumatoid arthritis.
- Swimming improves cardiovascular health, reducing the risk of cardiac issues among those with RA.
- Those who have deformity or issues in the cervical spine should always consult a rheumatologist and a neurologist before planning an exercise routine.