ARTHRITIS
INFORMATION SHEET
Exercise and RA
This sheet has been written for people with rheumatoid arthritis (RA) to provide extra
tips about exercise. It includes general information about what types of exercise are
recommended and what to do during a ‘flare’ of your arthritis. This sheet does not
provide individual exercises or programs.
Is exercise recommended for RA?
Exercise is an important part of managing RA. People
with RA who exercise have:
• higher levels of fitness
• better muscle strength and size
• greater ability to do daily tasks
• improved mood and emotional wellbeing.
Exercise can also help you maintain a healthy body
weight and improve the health of your heart and blood
vessels. Some types of exercise may also help improve
the strength of your bones and reduce your risk of
osteoporosis (thinning of the bones).
But I’m scared of doing more harm than good.
Many people with RA are anxious about exercising.
This may be due to fear of causing damage to the joints
or the presence of pain. However research shows that
people with RA can participate in regular, appropriate
exercise without causing joint damage or worsening of
symptoms. Everyone’s fitness levels and limitations will
be different so start with activities that suit you. While
some people with arthritis will find a five kilometre
walk easy, others may find walking around the block
difficult enough when starting. If you have damage
to the larger joints in your legs, such as your hips or
knees, it is generally recommended to avoid activities
that put excessive force on those joints (for example,
running and jumping). Talk to your rheumatologist
(arthritis specialist) to find out if there are activities that
you should avoid. You may also find it helpful to ask a
physiotherapist for advice on exercising safely.
What types of exercise could I try?
muscles a bit harder or causes you to ‘puff’ a little,
without increasing your pain or other symptoms, will
be beneficial. Choose activities that you enjoy and are
convenient. Activities that are particularly useful include:
• Water exercise: Many people with RA prefer exercising
in water. The buoyancy of the water takes pressure off
painful joints and you may find you can move more
freely than you can on land. Warm water can also be
soothing for sore muscles and stiff joints. If you are
fairly fit, you could swim laps or join a water aerobics
class at your local pool. If you are less fit and have
access to a warm water pool, you may be able to join
a water exercise class. There may be suitable classes at
local pools or at hydrotherapy pools (heated to around
34 degrees), usually found at hospitals, community
health and rehabilitation centres or physiotherapy
clinics. If you are new to exercise or your RA is
limiting your ability to exercise, you may find it useful
to have one-on-one hydrotherapy sessions with a
physiotherapist. Talk to your doctor or contact local
hospitals and community health centres to find a
physiotherapist who offers hydrotherapy sessions.
You can also search for an aquatic physiotherapist in
your area on the Australian Physiotherapy Association
website www.physiotherapy.asn.au
• Strength training: Muscle weakness is very common
in RA. A combination of pain, fatigue (tiredness) and
the disease itself often leads to weakening and wasting
of the muscles. This can make it even more tiring to
do your normal daily activities. Research has shown
that muscle weakness in RA can be prevented and
even reversed by strength training. Strength training
There are many activities that are safe and effective
for people with RA. Any activity that works your
For your local Arthritis Office:
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involves working your muscles a little harder than you
do in normal life. You do this by working with hand
weights, leg weights, gym machines, resistance bands
or even just your own body weight (for example,
doing push-ups). The key to successful strength
training is to:
- start with supervision from a qualified health or
exercise professional who understands RA
- learn the right way to do the exercises and how
much resistance to add to prevent injury
- keep challenging your muscles by doing different
exercises and using more resistance.
Strength training may also improve the strength of your
bones and help prevent a condition called osteoporosis.
Ask about strength training at your local community
health centre, physiotherapy clinic or gym.
What about during a ‘flare’?
During a ‘flare’ it is usually recommended to rest the
affected joint(s). You should still gently move the
affected joint(s) as far as is comfortable several times
a day as this may help prevent stiffness. However you
should not apply any force or resistance to the affected
area. For example, if your wrist is affected, do not
use any weights or resistance bands with that arm. If
you are feeling otherwise well, you can still do some
gentle exercise for the rest of your body. Talk to your
rheumatologist for more information.
Safety tips
• Check with your doctor or rheumatologist before
starting an exercise program.
• If possible, see a physiotherapist or exercise
physiologist for advice about specific exercises. They
can suggest safe exercises tailored to your condition and
make sure you are doing your exercises correctly so you
don’t cause an injury.
• Always build slowly. When you first start, do less
than you think you will be able to manage. If you
cope well, do a little bit more next time and keep
building gradually.
• Always start your exercise by doing some gentle
movements to prepare your muscles and joints for the
activity. This will help prevent pain and injury. You
may find it useful to use heat packs or warm showers
before activity to loosen up stiff joints and muscles.
• Never place your joints under excessive pressure or
unsafe positions that can increase your risk of injury.
Wherever possible, learn exercises from a qualified
health professional and exercise under supervision.
CONTACT YOUR LOCAL ARTHRITIS OFFICE FOR
MORE INFORMATION SHEETS ON ARTHRITIS.
Exercise is safe and beneficial for people with RA.
Talk to your healthcare team before you get started.
For more information:
To find a physiotherapist, talk to your doctor, see the Australian
Physiotherapy Association website at www.physiotherapy.asn.au
or look under ‘Physiotherapist’ in the Yellow Pages.
To find an exercise physiologist, talk to your doctor, contact the
Australian Association for Exercise and Sports Science on
(07) 3856 5622 or use the ‘find an exercise physiologist’ feature
at www.aaess.com.au
Books Millar, A Lynn 2003, Action plan for arthritis: Your guide to
pain free movement, Human Kinetics, Champaign, IL.
Nelson, Miriam E et al 2002, Strong women and men beat arthritis,
Lothian, Port Melbourne.
Walk with ease: Your guide to walking for better health, improved fitness
and less pain 2003, Arthritis Foundation of America,
Atlanta, GA.
Source: A full list of the references used to compile this sheet is available from your local Arthritis Office
The Australian General Practice Network, Australian Physiotherapy Association, Australian Practice Nurses Association, Pharmaceutical Society of Australia and Royal
Australian College of General Practitioners contributed to the development of this information sheet. The Australian Government has provided funding to support this project.
Your local Arthritis Office has information, education and support for people with arthritis
Freecall 1800 011 041 www.arthritisaustralia.com.au
Disclaimer: This sheet is published by Arthritis Australia for information purposes only and should not be used in place of medical advice. © Copyright Arthritis Australia 2007.
ARTHRITIS
INFORMATION SHEET
Physical activity
This sheet has been written to provide general information about exercise for people
with arthritis. It also includes guidelines as to what types and how much exercise to
do and general safety tips. This sheet does not provide individual exercises or specific
advice for each type of arthritis.
Is physical activity good for arthritis?
Research has found that regular exercise is one of the
most effective treatments for arthritis. It can help to:
Improve: mobility and flexibility of joints, muscle
strength, posture and balance.
Decrease: pain, fatigue (tiredness), muscle tension
and stress.
Just as importantly, physical activity will improve your
overall health. It can improve the fitness of your heart
and lungs, increase bone strength, reduce body weight
and reduce the risk of conditions such as diabetes. It also
improves your sleep, energy levels and mental wellbeing.
Who should exercise?
Everyone with or without arthritis should be doing
regular, appropriate exercise. The important thing is
to choose the activities that best suit your condition,
health and lifestyle.
What types of exercise should I do?
Before you start to exercise it is important to ask your
doctor and healthcare team to help you develop a
suitable program and choose the best activities for you.
Everyone’s fitness level and limitations will be different
so start with activities that suit you. While some
people with arthritis will find a five kilometre walk
comfortable, others may find walking around the block
difficult enough when starting. Generally you will need
to do a mix of:
• flexibility: to maintain or improve the mobility of
your joints and muscles. Examples include moving the
joint as far as it can, muscle stretches and yoga.
• muscle strengthening: to support and take pressure
off sore joints, strengthen bones and improve balance.
For your local Arthritis Office:
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An example is using weights or resistance bands.
• fitness: to improve the health of your heart and
lungs. These activities usually use the larger muscles
in the body, rather than exercising a specific area, and
may make you ‘puff’ a little. Examples include brisk
walking, cycling and swimming.
There isn’t just one particular exercise or activity that
is recommended for all people with arthritis. Choose
an activity that you enjoy and that is convenient for
you to do. Low-impact exercises, with less weight
or force going through your joints, are usually most
comfortable. Examples of low-impact activities include:
• walking
• exercising in water, such as hydrotherapy (with a
physiotherapist), swimming or water exercise classes
• strength training
• tai chi
• yoga and pilates
• cycling
• dancing.
How much should I do?
All Australian adults should be aiming to do at least
30 minutes of activity on most days of the week. You
can do 30 minutes continuously or combine several
10 to 15 minute sessions throughout the day. If you
have arthritis and you have not exercised for a while,
you may need to start with shorter sessions then build
slowly. Talk to your doctor or a physiotherapist about
getting started to help you avoid an injury or over-doing
it. Don’t forget that activities such as gardening, playing
with pets or taking the stairs rather than the lift can also
count as exercise.
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How will I know if I’ve done too much?
It can be hard to predict how your body will cope with
a new activity. The most important thing to do is to
listen to your body. A general guide is the ‘two hour
pain rule’ – if you have extra or unusual pain for more
than two hours after exercising, you’ve done too much.
Next time you exercise, slow down or do less.
Should I exercise through pain?
You should stop exercising if it is causing you unusual
pain or increases your pain beyond what is normal for
you. Exercising through this type of pain may lead to
injury or worsening of your arthritis symptoms. (Note,
many people with arthritis have some amount of pain
all the time. This is not a reason to avoid exercise. You
should only stop if you notice extra or unusual pain
while you are exercising).
When is the best time to exercise?
It doesn’t matter when you exercise, as long as you do.
If possible, try to exercise when:
• you have least pain
• you are least stiff
• you are least tired, and
• your medicines are having the most effect (ask
your doctor or pharmacist about how to time your
medicines with exercise if possible. This may help to
make your exercise session more comfortable).
Safety tips
• Talk to your doctor and/or health professional before
starting an exercise program. A physiotherapist or
exercise physiologist can suggest safe exercises and
make sure you are doing your exercises correctly to
prevent an injury.
• You may need more rest and less exercise during
a ‘flare’, a period of increased pain and stiffness.
Do not vigorously exercise a joint that is red, hot,
swollen or painful.
• Always build slowly. When you first start, do less than
you think you will be able to manage. If you cope
well, do a little bit more next time and keep building
gradually.
• Always start your exercise with some gentle
movements to warm up your body and your joints.
This can help prevent pain and injury during exercise.
• Cool down at the end of your session with some
gentle movements and stretches. This can help prevent
muscle pain and stiffness the next day.
CONTACT YOUR LOCAL ARTHRITIS OFFICE FOR
MORE INFORMATION SHEETS ON ARTHRITIS.
Exercise is one of the best treatments for arthritis.
Talk to your healthcare team before you get started.
For more information:
To find a physiotherapist, talk to your doctor, see the Australian
Physiotherapy Association website at www.physiotherapy.asn.au or
look under ‘Physiotherapist’ in the Yellow Pages.
To find an exercise physiologist, talk to your doctor, contact the Australian
Association for Exercise and Sports Science on (07) 3856 5622 or use the
‘find an exercise physiologist’ feature at www.aaess.com.au
Books Millar, A Lynn 2003, Action plan for arthritis: Your guide to
pain free movement, Human Kinetics, Champaign, IL.
Nelson, Miriam E et al 2002, Strong women and men beat arthritis,
Lothian, Port Melbourne.
Walk with ease: Your guide to walking for better health, improved fitness
and less pain 2003, Arthritis Foundation of America, Atlanta, GA.
Websites Australian Government’s National Physical Activity
Guidelines are available at www.health.gov.au (look under the
‘For consumers’ section)
Source: A full list of the references used to compile this sheet is available from your local Arthritis Office
The Australian General Practice Network, Australian Physiotherapy Association, Australian Practice Nurses Association, Pharmaceutical Society of Australia and Royal
Australian College of General Practitioners contributed to the development of this information sheet. The Australian Government has provided funding to support this project.
Your local Arthritis Office has information, education and support for people with arthritis
Freecall 1800 011 041 www.arthritisaustralia.com.au
Disclaimer: This sheet is published by Arthritis Australia for information purposes only and should not be used in place of medical advice. © Copyright Arthritis Australia 2007.
ARTHRITIS
INFORMATION SHEET
Saving energy
This sheet has been written to inform people with arthritis about ways to deal with
fatigue (tiredness) and conserve their energy. It also provides general information about
ways to make daily tasks easier and take pressure off joints affected by arthritis. Sources
of further information are also included.
What is fatigue?
Fatigue is a feeling of both physical and mental
tiredness. It is often described as exhaustion or a lack of
energy, and can make everyday tasks seem impossible.
Many people with arthritis experience fatigue, no
matter what they have been doing or how much sleep
they get. There are many possible causes of fatigue,
including the disease activity, pain (which can also affect
sleep), certain medicines, muscle weakness and wasting,
or depression.
How can I manage fatigue?
The good news is that there are ways you can deal
with fatigue:
• Talk to your doctor. Make sure you let your doctor
know if your fatigue does not improve, or is made
worse by your arthritis medicines. Sometimes small
changes in treatment can make major differences in
how you feel.
• Exercise. Exercise is one of the best things you can
do to combat fatigue. Exercise can help strengthen
muscles and increase your fitness. Within a few
months, you should feel an increase in strength and
energy and be able to do more without getting as
tired. The key to a successful exercise program is
to begin gradually, listen to your body and build
slowly. For more information see the Physical activity
sheet. You may also find it helpful to get advice
from a physiotherapist (see the Working with your
healthcare team sheet for information on seeing a
physiotherapist).
• Learn ways to get a good night’s sleep.
- If pain is interfering with your sleep, talk to your
doctor or see the Dealing with pain information
sheet to learn ways to manage pain.
For your local Arthritis Office:
1800 011 041 www.arthritisaustralia.com.au
- Limit caffeinated drinks to five or less per day, and
avoid these types of drinks after dinner.
- Try different relaxation techniques until you find
one that works for you. For example, you could
visualise a restful scene or focus on your breathing.
• Acknowledge your feelings and seek support. It
is natural to feel scared, frustrated, sad and angry
at times. During these times your most important
allies can be your friends and family members. Enlist
their help and understanding. Educate those close to
you about fatigue being a part of your arthritis, and
explain to them the ‘ups’ and ‘downs’ you experience.
See the Arthritis and emotions information sheet.
Conserve your energy and protect your joints
You can also learn ways to save your energy and protect
your joints during daily tasks. These tips may also help
you cope with fatigue, or reduce its impact on your life:
• Pace yourself. Carefully plan and organise your
activities so you make the most of your energy. Here
are some simple tips to help you pace your activities:
- Try to plan your day so that you can alternate
periods of activity with periods of rest.
- When you know you have a large task to do, such
as preparing a meal or cleaning a room, plan ahead
and break the job into smaller tasks. Then work on
completing the tasks one at a time, and follow each
with a rest break.
- Try to prioritise jobs. Do the hardest jobs when you
are feeling your best.
- Take advantage of ‘good days’ to do the things you
may have been putting off. Remember not to overdo
it on these days as it could result in pain and fatigue
the following days.
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- Simplify tasks. For example, buy pre-cut vegetables
and meat to make cooking simpler. Find out about
appliances that can make tasks easier (see below).
- If you are having a bad day, be ready to change your
plans and not force yourself to work through pain.
- Ask for help when you need it.
• Learn about equipment that can make daily tasks
easier. There are many appliances that can make your
daily activities simpler and less tiring. These appliances
aim to protect your joints by reducing the effort you
have to put in. Examples include:
- ergonomic knives to make cutting and slicing easier
- adapted cutlery and cooking utensils to allow easy
gripping
- equipment to help with opening jars or bottles, and
turning on taps
- equipment to make dressing and showering easier
(such as long-handled sponges and shoe horns for
reaching your feet)
- trolleys (rather than carrying shopping bags in
your hands).
You can find more information about these types of
equipment at an Independent Living Centre. These
centres have a wide range of tools and equipment on
display. You can get advice, including where to purchase
equipment, in person or over the phone. Occupational
therapists are also available at the centres to provide
advice about equipment. You may need to make an
appointment, and may be charged a fee, to see an
occupational therapist.
• See an occupational therapist. An occupational
therapist (OT) can show you ways to simplify tasks
and advise you on suitable aids and equipment. You
will need a referral from your doctor to see an OT
in the public system (such as at a community health
centre). These services are usually free or low cost. You
can consult a private OT at any time without a referral
from your doctor. Find a local OT at the Australian
Association of Occupational Therapists website
www.ausot.com.au or look under ‘Occupational
therapist’ in the Yellow Pages.
CONTACT YOUR LOCAL ARTHRITIS OFFICE FOR
MORE INFORMATION SHEETS ON ARTHRITIS.
There are ways to manage fatigue.
Learn how to conserve your energy and make daily tasks easier.
For more information:
Independent Living Centres are located in each capital city.
See www.ilcaustralia.org or call 1300 885 886 to find your closest centre and
more information. If you’re in the ACT call (02) 6205 1900) or in Tasmania call
(03) 6334 5899. (Note, the Independent Living Centre is called LifeTec in QLD).
To find an occupational therapist, talk to your doctor, see the Australian
Association of Occupational Therapists website www.ausot.com.au or look
under ‘Occupational Therapist’ in the Yellow Pages.
To find a physiotherapist, talk to your doctor, see the Australian
Physiotherapy Association website at www.physiotherapy.asn.au or look under
‘Physiotherapist’ in the Yellow Pages.
Books Mansberg, Ginni & Thomson, Anne 2006, Why am I so tired?: How
to put the fuel back in your tank, Michelle Anderson Publishing, South Yarra.
Thomas, Jill 2006, Revive: How to overcome fatigue naturally, Penguin,
Ringwood.
Williams, Xandria 1996, Fatigue: The secrets of getting your energy back,
Vermilion, London.
Websites National Sleep Foundation (US) www.sleepfoundation.org
Source: A full list of the references used to compile this sheet is available from your local Arthritis Office
The Australian General Practice Network, Australian Physiotherapy Association, Australian Practice Nurses Association, Pharmaceutical Society of Australia and Royal
Australian College of General Practitioners contributed to the development of this information sheet. The Australian Government has provided funding to support this project.
Your local Arthritis Office has information, education and support for people with arthritis
Freecall 1800 011 041 www.arthritisaustralia.com.au
Disclaimer: This sheet is published by Arthritis Australia for information purposes only and should not be used in place of medical advice. © Copyright Arthritis Australia 2007.