Your first contacts need to be with your client’s physician and physical therapist to be certain that she has medical clearance, and for you to get some guidelines regarding activities/exercises she should and should not perform. Because RA has a wide range of physiological and functional impact, a safe, effective program for her may differ from another client with RA. One environment that seems to be broadly appropriate is to have your client perform ROM and light resistance exercises following medical clearance, against the resistance of water in an arthritis pool (temp >90 degrees F.)
RA can manifest itself very differently in people, and you always have to be aware of the possibility of flare-ups. I require in the case of RA a physician’s approval. Clients with this diagnosis often had physical therapy, and I am usually asking for copies of the exercises that they had been doing and use those as a starting point.
However, it is important to still do your own assessment. People who deal with chronic conditions like RA often begin to compensate, thus creating muscular imbalance problems in the body that are only secondary to RA. Even though pain in the hands is usually RA, the hip pain does not have to be. But the physician or PT may be able to shed light on that.
Depending on the severity, the exercise recommendations can be just aquatic exercises. They can also progress to light resistance training. Bands are often less intimidating and are also easier to negotiate with pain in the hands because you can have her wrap it around her hands. Flexibility is a must for RA. If you can, try to find some information about MELT. I have many people in my classes who have benefited greatly from this modality. I believe there is a MELT instructor in Hawaii.
Sorry, there is not a list of ‘good exercises for RA’ because it still depends entirely on the person you are dealing with.
Hi Patience. I had a client with JRA who was a varsity basketball player. I totally agree that you MUST work with your client in conjunction with her physician to make sure that you are working as a team to avoid or minimize flare-ups.
I’m going to take a different tact in answering your question by shedding some light on exercises that you probably ‘shouldn’t’ do in training your client. I’d be extremely careful, if not completely eliminating plyometric exercise from your clients workouts. That type of pounding is generally not good for this condition and could exacerbate flare-ups and pain.
With my client, we worked through this issue in a slow, methodical and safe way because of the necessity of doing this type of training for a basketball athlete. However, we did it with a vigilant eye on her body’s reaction to this type of training, monitored it closely and progressed her very slowly, and as others have alluded to here, every patient/client is different so I would highly advise working with your client’s physician.
Good luck! Above all, work with your client’s treating physician, and follow his/her guidance on how to work with your client (hmmm, did I already say this??? 🙂 I guess I think that’s very important here 🙂
Although I am neither a physician or a personal trainer, I do have a loved one who has RA and she does experience pain in her hips and hands as well.
I do agree with the above comments in regarding seeking physician clearance and etc…
However, just from her experience with these specific pain points, her most comfortable form of exercise and stretching is in warm water.
I wish you and your client well.
Hello Patience Thompson,
I agree that doctors’ clearance is vital and getting pictures of past therapy to continue training is very helpful.
The warm pool is usually the best for RA, 86-90 degrees. If the person fears water, try them in a warm bathtub. Be careful of flare ups letting pain decide the intensity and decision to strength train. The range of motion and flexibility should be done daily.
Balance and fall prevention to avoid falling on painful joints and improve confidence.
Yes, it is also worth looking into MELT.
NAPS 2 B Fit