Fitness with rheumatism

In this fact sheet we discuss the what, why and how about this theme. Why is strength training recommended for people with rheumatism?

• Anti-inflammatory: Various forms of rheumatism are related to high levels of inflammation in the body and joints. Strength training has an anti-inflammatory effect in rheumatism and especially has an inhibitory effect on the breakdown of cartilage, in some cases even visible on an X-ray.
• Pain reducing: Strength training and physical activities reduce pain. This is probably due to the anti-inflammatory effect.
• Fewer physical complaints: Research shows that people with rheumatism who exercise weekly generally have less rheumatism but also fewer other physical complaints than people with rheumatism who do not exercise.
• More positive mindset: Exercise and muscle training contributes to a more positive mindset and therefore has a preventive effect against depressive complaints.
• Less tired: People with rheumatism often suffer from chronic fatigue, a problem that is much less common in people with rheumatism who regularly exercise and do muscle training.
• More hand strength: People with rheumatoid arthritis often experience pain and stiffness in the hands, which means they can exert significantly less force with their fingers. Strength training improves the strength that people with rheumatism can exert with their hands, which promotes independence.

Several studies have shown that strength training does not worsen rheumatic complaints, but actually relieves them. It is important that resistance is built up slowly and that execution is more important than building up resistance.

Points of attention for fitness training with rheumatism

• Always increase the intensity of fitness training slowly, for example starting at 50% of max. heart rate, 40% of the heart rate reserve according to Karvonen or 40% of the Wmax (maximum work capacity).
• Preferably use 2 to 3 training sessions to determine the starting level with a number of standard exercise forms.
• It is possible that this intensity may feel heavy for people with rheumatism, but safety and increasing resilience are the first priority.
• When using beta blockers, train at 11-13 on the RPE scale.
• As load capacity increases, exercise duration and intensity can be increased.
• Interval training is seen as a suitable form of training, for example intervals of 30-45 seconds at 80-85% of the max. heart rate (14-15 RPE), alternating with 2 minutes of rest, 4 to 8 intervals.
  NOTE: Always build up very gradually! The principle is: intensive without exhaustion.

Points of attention for strength training with rheumatism

• Even with strength training, always increase the intensity slowly.
• For example, start with 2 series of 6-12 repetitions at 40-50% of the 1 RM.
• Then first increase the number of series to 3 and then build up the intensity/resistance to 80 of the 1 RM.
• However, it is preferable to use 2 to 3 training sessions to determine the starting level with a number of standard exercise forms.
• Train all major muscle groups such as legs, chest, back, shoulders, abdomen and arms.
• Start with closed chain exercises (feet/hands fixed) if you have difficulty with balance or balance problems, and then progress to free exercises.
• Allow at least 72 hours of rest between training sessions (per muscle group).

LIFESTYLE ADVICE FOR PEOPLE WITH RHEUMA

Staying active is essential if you have rheumatism. Not only exercise, twice a week, but also daily, or preferably every part of the day, an exercise session of 10 to 30 minutes, such as walking or cycling.

Other lifestyle factors that can reduce complaints are:

• Eat less simple and refined sugar.
• As little juice, soft drinks and products with sugar or honey as possible.
• Achieve and maintain a healthy weight.
• Quit smoking.
• Reduce elevated blood pressure.
• Reduce high cholesterol levels in the blood.
• De-stress, take moments of relaxation every day.
• Eat enough calcareous products.
• Limit or better yet no alcohol.
• Not too much red meat and organ meat.
• Drink 2 to 3 liters of water or green tea per day.
• Consume sufficient low-fat dairy products.
• Get at least 8 hours of sleep.

Rheumatism Netherlands recommends regularly eating oily fish, which is good for your heart and blood vessels. It is also good to pay attention to your vitamin D intake.