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The Most Important Exercise for Rheumatoid Arthritis
Published about 2 months ago • 4 min read
THE JOINT
Your weekly dose of RA wellness
The Movement Edition
Strength Training & Rheumatoid Arthritis
When I was diagnosed with rheumatoid arthritis, the question wasn’t whether I should start exercising.
It was whether I needed to stop lifting weights.
I had been strength training for more than twenty years.
The early months after diagnosis were uncomfortable.
My hands and wrists hurt. Holding dumbbells was painful. Even simple movements like push-ups were difficult.
But I kept training.
Not because I was trying to push through pain. I simply adjusted how I trained. I changed my grip, modified certain exercises, and avoided movements that aggravated my joints.
Over time, I noticed something interesting.
During the weeks I kept up my strength workouts, I felt less stiff. My joints felt more stable. Fatigue was easier to manage.
That experience led me to look more closely at a question many people with rheumatoid arthritis eventually ask:
Should people with RA be lifting weights at all?
The answer turns out to be more encouraging than most people expect.
In This Issue
Why muscle loss happens in RA
What strength training actually means
What research says
How to train safely
Why Strength Training Even Comes Up With RA
Exercise advice for rheumatoid arthritis has changed over the past few decades.
In the past, patients were often told to rest their joints and avoid strenuous activity.
Today we know that complete inactivity can actually make symptoms worse.
One reason is something called rheumatoid cachexia.
In simple terms
Many people with RA slowly lose muscle mass over time.
This happens because of chronic inflammation, fatigue, reduced activity, and sometimes medication effects.
Less muscle means less support around the joints. That can increase fatigue, reduce stability, and make daily tasks harder.
Strength training is one way to counter this process.
Not everyone with RA should start with weights. A better way to think about strength training is as a progression.
A helpful way to think about strength training with RA is to start where your body is and build gradually from there.
What Strength Training Really Means
Strength training simply means working muscles against resistance.
That resistance can come from several sources:
bodyweight exercises
resistance bands
machines
free weights such as dumbbells or barbells
The goal is not extreme workouts. It is to challenge muscles gradually so they remain strong and functional.
What Happens in the Body When You Lift
When muscles work against resistance, they adapt.
At the cellular level, resistance exercise stimulates muscle protein synthesis, which helps maintain or rebuild muscle tissue.
Strength training also improves neuromuscular coordination, which means muscles and nerves communicate more efficiently during movement.
For people with rheumatoid arthritis, stronger muscles can help stabilize joints and distribute mechanical stress more evenly during daily activities.
Resistance training also affects the body beyond muscles.
Moderate resistance training can improve insulin sensitivity, metabolic health, and overall physical function. Those changes can also affect inflammation and energy levels.
What the Research Shows
Research on exercise in rheumatoid arthritis has expanded significantly over the last two decades.
👀
Observational Evidence
better physical function
less disability
improved quality of life
🩺
Clinical Trials
improved muscle strength
improved physical function
reduced fatigue
improved joint stability
🔓
Study Limitations
most studies are small
follow-up periods are often short
exercise programs vary widely
many studies are done under physical therapist supervision
These results are encouraging, but they do not mean every exercise approach is appropriate for every person with RA.
What This Means in Real Life
For many patients, strength training can be a helpful part of a broader management plan.
But it is not a replacement for medical treatment.
Disease-modifying medications remain the primary therapy for controlling immune activity in RA.
Strength training is best thought of as supportive therapy.
It helps maintain muscle, support joint stability, and improve overall function.
Practical Guidance
Who Might Benefit
Strength training may be helpful if you:
experience fatigue or muscle weakness
notice declining physical strength
want to improve joint stability
want to maintain long-term physical function
Who Should Be Cautious
Extra care may be needed if you have:
an active joint flare
significant joint damage
recent surgery
uncontrolled pain
In these cases, working with a physical therapist or clinician can be helpful.
Most people with RA do not start with weights. They start with movement.
If you are unsure where to begin, this progression can help.
SAVE THIS GUIDE
A simple way to progress into strength training with RA
🟢 LEVEL 1: Mobility
Gentle range-of-motion exercises that maintain joint movement and reduce stiffness.
🟡 LEVEL 2: Bodyweight
Sit-to-stands, wall push-ups, or step-ups to build foundational strength.
🟠 LEVEL 3: Resistance Bands
Bands provide controlled resistance with relatively low joint stress.
🔵 LEVEL 4: Machines
Machines guide movement patterns and reduce stabilization demands.
⚫ LEVEL 5: Free Weights
Dumbbells and barbells allow progressive strength development when tolerated.
Progression does not need to be fast.
Many people stay at one level for a long time, depending on comfort and symptoms.
Tips That Make Strength Training Easier on Joints
A few adjustments can make strength training more comfortable:
use a neutral grip when possible
choose thicker handles or grips if holding weights is painful
avoid exercises that aggravate inflamed joints
start with lighter resistance and progress gradually
allow rest days between strength sessions
The goal is consistent training, not maximal effort.
If you want to put this into practice, start simple:
Choose two short strength sessions.
Focus on large muscle groups such as legs, back, and chest.
Keep the intensity moderate.
Pay attention to how your joints feel over the next 24 hours.
Many people notice that gentle strength work actually reduces stiffness.
Bottom Line
Strength training is not a cure for rheumatoid arthritis.
Research suggests it can help maintain muscle, improve function, and support joint stability when done thoughtfully.
For many people with RA, the goal is not intense training. The goal is consistent, sustainable movement that supports long-term health.
Key Points
RA often leads to muscle loss because of inflammation and reduced activity.
Strength training can support joint stability and physical function.
Research suggests resistance training is generally safe when done thoughtfully.
Start with low resistance and progress gradually.
Living with rheumatoid arthritis often means learning how to adapt rather than stop doing the things you value.
Strength training is one example.
The exercises may change, and the weights may change.
But movement itself can still remain part of the routine.
If you found this helpful, feel free to share it with someone navigating rheumatoid arthritis or autoimmune disease.
You can also explore past issues of The Joint for more strategies on nutrition, movement, and managing RA.
Where Traditional Medicine Meets Whole-Body Healing
Stay Informed. Stay Empowered.
Join the Joint Ventures RA newsletter for practical insights on managing Rheumatoid Arthritis with an integrative approach. You'll get expert-backed wellness tips, nutrition guidance, movement strategies, and the latest research—delivered straight to your inbox.
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