Overwhelming research evidence shows that aerobic exercise helps reduce the effects of rheumatoid arthritis. It can improve heart and lung health and help keep RA symptoms in check. The key is to do aerobic exercise regularly and safely.

Improving Heart and Lung Health with RA

Rheumatoid arthritis increases the risk of developing heart and lung disease. That risk can be decreased with regular aerobic exercise.

In Latin, aerobic means “with oxygen.” Aerobic exercise requires the body to take in and use oxygen at a higher rate than normal—breathing is more labored and the heart beats faster. Aerobic exercise strengthens the heart and lungs, which reduces the risk of disease and helps the body use oxygen more efficiently.

Creating an Aerobic Exercise Habit with RA

To get the most benefit from aerobic exercise, make it part of a routine. Medical experts recommend getting at least 150 minutes of moderate aerobic exercise or 75 minutes of intense aerobic exercise per week. 1 How much physical activity do adults need? Centers for Disease Control and Prevention. Last reviewed October 7, 2020. Accessed October 4, 2021. https://www.cdc.gov/physicalactivity/basics/adults/index.htm

It is okay to mix-and-match intense and moderate exercise. For example, a person may swim laps a couple of times a week for intense exercise and take a brisk walk every day for moderate exercise.

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Examples of aerobic workouts include:

  • Walking is the most commonly recommended aerobic activity because it does not require training or start-up costs. Brisk walking—as opposed to a casual stroll—is best for raising the heart rate. For an even bigger challenge, try hiking. If it is too painful to walk on land, try walking in water.
  • Biking is a terrific low-impact aerobic exercise. For an intense indoor cycling workout, try spin classes. If neck or wrist pain is a problem, try a recumbent bicycle.
  • Elliptical and stair-climbers machines, found at most gyms, can help get the heart rate up. If using these machines is causes joint pain, consider walking or jogging in the water.
  • Aerobic classes designed to get the heart rate up are offered by many gyms. A low-impact class with an experienced instructor is ideal.
  • Swimming and water aerobics are often recommended because being in the water takes pressure off weight-bearing joints.
  • Dancing is a fun option for those who do not like traditional workouts.
  • Any other physical activity that gets the heart rate up, whether it is playing badminton, doing Zumba, or taking the stairs instead of the elevator.

While it is normal for arthritic joints to feel a little uncomfortable during certain movements, avoid movements that trigger sharp pain or cause moderate to severe pain, especially after exercising is finished (pain after exercise should not be worse than before exercise). If taking an exercise class, ask the instructor to recommend ways to modify exercises that cause pain.

See Ways to Get Exercise When You Have Arthritis

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Avoiding Joint Damage During Exercise

While most exercises are good for joints, people who have rheumatoid arthritis may want to avoid activities that raise the risk of joint damage. In general, risky exercises are ones that:

  • Trigger sharp pain or cause moderate to severe pain
  • Are considered high-impact, such as jumping and jogging
  • Involve a lot of sudden starting, stopping, and pivoting, such as basketball or soccer
  • Have a high risk of falling down and getting injured, such as downhill skiing

Occasionally, a patient and doctor may weigh the pros and cons and decide a risky physical activity is okay if RA is under control. For example, a lifelong downhill skier may decide to ski easy runs, or a trained runner may include jogging in a larger cross-training plan.

Aquatic exercise is a great option for a low-impact workout that is safer for joints.

See Hydrotherapy for Arthritis

Dr. Catherine Lutsey is a Doctor of Physical Therapy at the Shirley Ryan AbilityLab. She has practiced as a physical therapist for more than a decade, and her specialties include the spine, sports injuries, and arthritis.

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