A 20-Minute Low-Impact Workout for People With Rheumatoid Arthritis

Although rheumatoid arthritis (RA) can cause joint pain and stiffness, it doesn't mean that you need to avoid exercise completely. It would actually be a big disservice to your health if you avoided working out altogether.

Exercising can be safe for people living with RA if you choose safe exercises and listen to your body. Try this 20-minute low-impact workout and learn more about exercising safely with arthritis.

Designed by Kimberly Steinbarger, PT, a physical therapist who specializes in RA and lives with the disease, this 20-minute low-impact workout helps strengthen the muscles around your joints to improve your range of motion. Plus, these exercises are highly functional and mimic many movements in daily life.

First, do the warmup for 5 minutes, then do 3 sets of 8 or fewer reps for building muscle strength. But if your goal is muscle endurance, do 3 sets of 15 or more reps.

"Regardless, people should start where they are at. If they can only do 2 reps, do 2!." Steinbarger says. "The important thing for people with RA is to be able to modify the exercise. If they're having a flare, they might need to tone it down a bit."

Because people with RA tend to have sensitive hands, ankles and feet, it's important to warm up these areas with some stretching before your workout, Steinbarger says.

Repeat the stretches below as needed.

Squats are an excellent exercise for people with RA because they strengthen your quads and glutes, which will help take pressure off your knees and works some ankle mobility. It also helps make it easier to sit down on a chair and stand up, Steinbarger says.

Lateral lunges are a great way to work your body in a different plane of motion while activating your quads, hamstrings and glutes, including the muscles on the sides of your legs, Steinbarger says. Strengthening these major leg muscles is crucial for breaking a fall.

Rows help strengthen your back muscles and improve your posture. In this row variation, Steinbarger ties loops over her wrists instead of holding onto the ends of the resistance band in her hands. Many people with RA may have sensitive fingers, so this is a great alternative that allows you to pull through your wrists instead of your hands.

Although planks are the ultimate core exercise, they may cause some discomfort in the hands and shoulders for people with RA (a forearm plank might be a better choice for some). So crunches are actually a good alternative to working your abdominal muscles, Steinbarger says.

Wall push-ups help take the weight off your hands, which makes them more doable for people with RA while strengthening your shoulders, upper back, arms and core.

It may sound surprising, but it's actually important to keep exercising even if you have arthritis. That's because people with RA have a higher risk of developing heart disease and diabetes, says Kim Marie Huffman, MD, PhD, a rheumatologist, Arthritis Foundation expert and associate professor of medicine at Duke University School of Medicine.

Systemic inflammation from RA not only affects the joints, but it can also spread to the heart, eyes and everything in between.

Case in point: According to a September 2012 meta-analysis in the ‌Annals of the Rheumatic Diseases‌, people with RA are at an increased risk for cardiovascular heart disease by 48 percent compared to the general population.

But by increasing physical activity, people with RA can greatly improve their health and may reduce their risk for heart disease. Moreover, "a number of studies show that exercise actually improves disease activity in patients with RA," Dr. Huffman says.

For instance, a February 2022 research article in ‌BMC Sports Science, Medicine and Rehabilitation‌ found that aerobic exercise can provide some beneficial effects for people with RA, including pain relief, reduced fatigue and joint damage and improved physical function and aerobic capacity.

That said, you may be wondering if there are certain exercises that are off-limits for people with RA. While there are no specific limits, doing low-impact workouts, like walking, cycling, swimming and strength training are best, especially for those who have existing joint damage, Dr. Huffman says.

If a flare-up arises, limit the range of motion and choose a lower-impact version of the exercises.

"It is always good to put joints through their ranges of motion, otherwise, you risk losing mobility — for example, frozen shoulder. If damaged or inflamed, it is strongly recommended to put a joint through range-of-motion exercises and probably a good idea to limit exercises that increase weight on the joints," Dr. Huffman says.

During a flare, you can do isometric exercises, which elicit muscle contraction without joint movement and gentle range-of-motion exercises, Steinbarger says.

Dr. Huffman also advises doing a warmup before your workout to put your joints through proper range of motion and engage your muscles.

"It's ideal to work out later in the day when joints are less stiff. But anything is better than nothing," Dr. Huffman says. "People with RA tend to be a lot less active than the general population. So it's not really about avoiding certain exercises, but finding specific ways to make them safe and being able to advance your skills."