We appreciate that a lot of individuals steer well clear of running, for fear of pain, injury, or an exacerbation of any niggles they may have. For those running with Rheumatoid Arthritis (RA), we understand that there will likely be even more apprehension.
Joint pain, swelling and fatigue can certainly impact motivation to exercise at the best of times, and we appreciate that the thought of running might not be an appealing one when these symptoms occur.
We understand that running is not everyone’s cup of tea (nor does it need to be), however we have noticed that a number of our clients have ruled out the idea of even trying to run based on fear, or based on common misconceptions about joint pain and running. We hope this blog can help dispel some of these misconceptions and give you some confidence either way.
Running is a great way to improve the function of the heart, lungs and the rest of our cardiovascular system. It is well accepted that running regularly (like other types of aerobic exercise) can improve the overall capacity of the lungs and heart, meaning that the potential of what your body can achieve is a lot greater…and as an added bonus- it doesn’t cost you an expensive gym membership! Having a stronger heart and lungs, and a stronger muscular system (which can both be achieved through gradually built up and consistent running) can also impact your immune system in a positive way. It can mean that your body is more effective at fighting off infections, and better equipped to manage any RA flares you might experience. Like the rest of the population, those with RA can achieve a number of health benefits from regularly running, however the type/speed/amount of running needs to be appropriate to the individual (more on that later) Check out one of Sarah's previous blogs for some more pros and cons of running.
So what are the risks?
Let's quickly refresh how RA affects the body and how it might respond to an exercise such as running. RA is an inflammatory condition which can effect numerous joints. Pain, swelling and stiffness are common complaints, with both big and small joints being affected. Left untreated, RA can cause joint erosion and deformity. Thankfully, the medications available to treat this condition are much better than 20 years ago. There is also a strong push to help people get diagnosed EARLY, in order to prevent long term joint damage and health complications.
So with that being said, it is important to recognise that running is an activity which is both weight bearing and repetitive in nature. So there is a risk of developing niggles and/or grumbly joints, especially if one starts and progresses too quickly! Running on stiff and/or unstable joints can also be problematic, especially if it has been a while since you have run or exercised regularly. An additional point is that joints that are already sore, swollen or inflamed (like what you might feel when in a RA flare) are also not going to respond well to running. So if one of your joints is already stiff and sore, then heading out for a tough challenging run is not going to be the best idea. Moderate to vigorous exercise should be avoided during these times, and instead replaced with low impact activities. Improving your lower limb mechanics (if necessary) and getting yourself nice and strong can assist in managing some of the risks outlined above. It would also be appropriate to consider the activity and running history of the individual!
Still keen to start?
First and foremost, we recommend working with a trained health professional who can help you navigate your running journey. A thorough assessment looking at both your biomechanics and running style should always form the basis of a tailored approach to upping your activity levels. We can't encourage this enough!
However, here are some principles that often help in the initial phase of commencing some running.
1.) Start SLOW and SMALL
I use the same approach for any of my clients who are keen to start running. We never truly know how your body is going to respond, so it makes sense to start out in small doses. Using 1 minute intervals of jogging (as slow as you need!) teamed with 1-2 minute intervals of walking is a good example. Repeating this over 15-20min might be plenty for your first go. Both intervals can be reduced or adapted to suit your needs. The idea is to stop well before you experience any pain or discomfort. Our muscles and tendons love getting stronger in small, incremental steps..try and remember this as you get started!
2.) Spread the exercise love around
Even if you are loving your runs, its a great idea to balance your runs with other types of exercise. I'm a big fan of not putting all of your exercise eggs in the one basket. Stretching, swimming or even some strengthening exercises can all be built up gradually to form part of a well balanced exercise regime. A balanced program can share the exercise love amongst a range of different joints, tendons and muscles, whilst also keeping you interested. We also strongly suggest doing some regular strength training, as one way of trying to navigate the risks listed above. If we can improve the strength of the muscles around your joints, they will be better equipped to manage the loads associated with running.
3.) Every runner needs a toolbox
For me, my running toolbox includes a good running plan, appropriate and comfortable shoes, and the occasional remedial massage to keep my legs nice and supple. For yourself, it might be similar! But we generally recommend a running plan as an essential ingredient so that you are equipped to build things up safely. In addition to the above, if you do pull up a little stiff and sore after a run, then having some trusted strategies on standby can help you manage things effectively. For some that might mean a nice warm bath, for others using a heat pack or spikey ball might do the trick!
Our final tip is to keep your Rheumatologist and health care team informed of your plans! They will also be able to guide you with this decision, and help you understand any specific risks specific to your body and situation, and help work out strategies to manage your health in the best possible way.