Lupus and Exercise

“An object in motion tends to stay in motion. An object at rest tends to stay at rest.” - Newton’s First Law

If you live with lupus, you know that chronic pain and fatigue are two of the most common lupus symptoms. They also happen to be two of the most common hindrances to staying physically active. Research has proven that physically active individuals are overall healthier, have improved mental health, and live longer than those who are inactive.

But what if you are living with a chronic illness like lupus? Is this true for us as well?

Yes. It is especially true. However, being newly diagnosed with lupus (and the multiple overlap illnesses that follow suit) is one of the most common reasons people give for limiting physical activity in their daily life. Unfortunately, Inactivity + lupus can lead to a variety of health risks, including weak and atrophied muscles, poor balance, increased inflammation, decreased circulation, and cardiovascular disease (which as we all know is the number one cause of death among SLE patients).

As a patient, there can be confusion about what type of exercise is beneficial and what exercise should be avoided if you have lupus, RA, osteoarthritis, or other musculoskeletal complications. This blog will hopefully provide you with some clarity and a step that will start you in motion... to incorporate appropriate exercise into your life.

“Strengthening your muscles helps prevent joint weakening and damage,” - Diane Kamen, MD, source LFA

Different Types of Exercise:

Before we delve into recommendations, let's talk about the different levels of exercise. These include: therapeutic/rehabilitative, recreational/leisure, and competitive/elite.

• Therapeutic exercises are exercises prescribed by doctors or other health professionals that are recommended to address specific joints or body parts affected by lupus or another medical issue. This type of exercise program is often a necessary first step for individuals who are recovering from surgery, have restricted joint motion or muscle strength, have been sedentary, or are experiencing joint, muscle, or nerve pain. This type of exercise is therapeutic in nature, and usually does not lend itself to weight loss or substantial muscle gain.

• Recreational or leisure activities are types of exercise that range from swimming, to walking, golfing, skiing, jogging, dancing, and running. Recreational exercises should be safe and manageable for wherever you are in your health journey. Finding the right recreational activity should be dependent on what joints are affected and if the level of risk of injury is low. For example, if you have a slipped thoracic disc, probably not the best time to take up golfing. However, if you had knee surgery and your doctor doesn’t want you bearing a lot of weight on your joints, swimming is perfect! Sometimes, participating in therapeutic AND recreational activities might be the best combo for you if you are dealing with lupus joint/muscle involvement, but are looking for more calorie burn.

• Competitive or elite are activities that are performed at higher intensities, that require a lot of training and skill. Some of these activities include marathon running, CrossFit, and bodybuilding. The American College of Rheumatology guidelines for systemic diseases such as juvenile rheumatoid arthritis, psoriatic arthritis, rheumatoid arthritis and SLE include joint health and proper exercise as one of the mainstays of treatment for these conditions; however, as a general rule, exercising at this level is not recommended for individuals with inflammatory arthritis or with joint problems. They suggest if you have mild or early arthritis and wish to continue exercising at this level, to talk to your rheumatologist or a physical therapist who has experience in arthritis and lupus and knowledge of the specific sport.

What are the best exercises for people with lupus:

Let’s be clear, exercise is not a “one size fits all” situation. Every person living with lupus is unique, so your fitness level and preferences should reflect that as well. Exercise should be safe, but it should also be enjoyable. If you don’t enjoy bike riding (me) then don’t go out and buy yourself a PendletonⓇ. However, if you like to dance (me) then try putting some fun music on and have a dance party in your garage.

Here are some great suggestions if you have lupus:

• Dancing: Top memory experts AND rheumatologists believe one of the best forms of exercise for lupus is dancing! Dancing has been scientifically proven to not only improve energy levels but cognitive dysfunction as well! As I mentioned above, this is my TOP PICK for exercise!

• Swimming: Doctors love swimming because it hits all the important exercise categories! It is aerobic, strengthening, and helps with joint stability and range of motion! Swimming helps build strong muscles because of the resistance in the water, and it also can help reduce bone loss related to inactivity, chronic inflammation, and even certain medications like prednisone.

• Walking: "Being physically active helps prevent fatigue, a major symptom of lupus," says Amita Bishnoi, MD, a rheumatologist who treats lupus patients at Henry Ford Hospital in Detroit. Studies have shown that lupus patients who participate in a daily aerobic exercise like walking, are able to reduce their level of fatigue and have more energy throughout the day. Walking is preferred to many lupus patients over jogging because there is less shock absorption on the joints. Lupus tip: make sure you wear a hat and apply ample sunscreen if you are walking outside during the sunny days of the year to protect yourself from photosensitivity.

• Pilates: Pilates focuses on the core muscles that affect one's posture, which help keep the body balanced, and are essential to providing support for the spine. “Pilates can benefit someone who has lupus by enabling the person to experience greater and more expansive mobility in her joints while not exhausting her,” says Gia Marakas, a classically trained, certified Pilates instructor in Los Angeles. Pilates is usually offered in varying levels of difficulty, so start slow and steady!

• Yoga: What is good for your mind, body, and soul? YOGA! And before you think it is

just about stretching...think again! Yoga takes incredible strength, balance, and coordination. Infused with classical philosophies of India, yoga uses meditation, exercise, and breathing practices to improve overall health and mindfulness. “The immediate benefit of yoga is an awareness of your body,” says Mary Scudella, an experienced registered yoga teacher and founder of OmYogaMom.com.

Whatever you choose, start small and simple. Being overly ambitious is one way to stress yourself out and take the fun out of incorporating sport into your daily life.

Barriers to getting started:

• Will people think I’m cured if they see me being physically active? This is something we never talk about. But, let’s go there. Public opinion can be Public Enemy No. 1 that stops you from becoming or staying physically active if you live with lupus. People ALREADY have a hard time understanding an “invisible illness” like lupus. What will they think if they see you or learn that you are (ominous chord) WORKING OUT?!? Here’s the bottom line. You have one life to live. And you cannot squander it trying to make other people understand your life. As Taylor Swift says, “The haters are gonna hate.” This is true. People are going to say what they are going to say. And don’t you dare feel guilty about taking care of yourself. If they ask, hit them with the facts. Exercise is life-enhancing and life-saving.

• Am I going to make myself more sick if I work out? Based on studies by the NIH not likely! Studies have shown that patients with low physical capacity were less physically active, exercised less and had more pain and depressive symptoms than those that reported a high capacity. In another study, the effects of an exercise training program on lupus cells were assessed in response to exercise in women with SLE and women without SLE. After a 12-week aerobic exercise program, there was a noticeable difference in some individuals, which revealed that exercise benefits the immune system and does not trigger inflammation in lupus, even if the individual is going through a flare-up. That being said, obviously you know your body best and it is important to listen to your body's signals.

• If I cannot afford a gym, how am I going to get in shape? You can build a stronger body and have more energy—no gear required! Low-impact exercises are effective and are less stressful on the body and can be done from the convenience of your own home! Here are some great exercises to try, that won’t cost you a thing. Confession… I don’t have a gym membership. I dance, stretch, and strengthen… in my dusty old garage. It is free and just fine.

Additional Tips:

In order for you to choose an exercise routine that will be sustainable, here are some recommendations:

• Find something you love and make it yours.

“Begin by really thinking about the things you enjoy — nature, group settings, playing sports, quiet time, or being challenged. Then look for activities that meet one or more of your criteria,” Kristen Dieffenbach, PhD

• Have a long-term goal that is important, but praise yourself for the mini victories as well!

• Put it on your calendar.

• Team up with a buddy!

• Break up your exercise into shorter spurts.

• Don't beat yourself up if you miss a day or two or three.

• Rock what you've got NOW. Don't wait to be proud of yourself until you have lost a certain amount of pounds. Remind yourself that your value is NOT in a number on a scale.

I want to close with a reminder:

Exercise is just as important for your emotional health as it is for your physical health. It increases serotonin levels, leading to improved energy, and mental state. It is also the only thing scientifically proven to help lessen lupus fatigue.

Something as simple as walking for 15–20 minutes a day can have a major impact, not only in preserving physical function, but also in improving overall health. So try it, you may even like it. Heck, you may even love it.

Written By:

Kelli Roseta

**All resources provided by this blog are for informational purposes only, not to replace the advice of a medical professional. Kelli encourages you to always contact your medical provider with any specific questions or concerns regarding your illness. All intellectual property and content on this site and in this blog is owned by morethanlupus.com. This includes materials protected by copyright, trademark, or patent laws. Copyright, More Than Lupus 2021.

Sources:

https://www.rheumatology.org/I-Am-A/Patient-Caregiver/Diseases-Conditions/Living-Well-with-Rheumatic-Disease/Exercise-and-Arthritis

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5461882/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3964608/

June 2021