A new year always seems like an opportunity for new beginnings. This year I’ve decided to try to get through the backlog of books I’ve been meaning to read, but for a lot of people a new year means a new vow to be more active. Everyone knows that exercise and activity is good for us, but that doesn’t mean that it is easy to fit into our day. We all have our own individualities and realities that affect what we do and how much we do it. While some things are common to everyone, like juggling multiple commitments, people have a health condition like arthritis, symptoms like pain and stiffness play a part as well.
For most people, a healthy day means a good balance of different types of exercise and physical activity, the right level of sleep and rest, and limiting screen time and sedentary behaviour. To help people stay on track, the Canadian Society of Exercise Physiology developed the 24 Hour Movement Guidelines (https://csepguidelines.ca/). Do you feel that you are meeting them? (To be honest, I could probably use a little less screen time…)
In Canada, where I live, just less than half of children, youth, and adults meet the recommended physical activity guidelines. While the reasons for that can vary, people who report feeling confident in their abilities and supported in participating in activity tend to have higher levels of physical activity in comparison to those who don’t. (1)
People with arthritis often tell me that they feel stiffer and less capable of performing some movements and activities in comparison to their peers. Some studies have shown that even with low or no signs of inflammation, people who have had arthritis in their joints can be stiffer and use their joints differently than those who haven’t when doing things such as walking and jumping. (2,3) These changes in movement can in turn affect how well people perform and feel when being active – and if activity doesn’t make you feel good, physically or mentally, then it can really take a toll on how confident you feel.
When confidence in activity takes a hit, it’s normal to be worried about starting something new. If this sounds like you, a conversation with your medical team about your goal of increasing activity can be a great place to start. Making sure your medications and management strategies support your goal of being active can help you start off on the right foot. Physiotherapists and occupational therapists can also help you prepare for activity by offering suggestions to strengthen and support areas that are weaker or don’t move as well. Feeling prepared and ready for the road ahead with your team’s support can build confidence and set you up for success.
Once you’re ready to get started the next step is to choose your activity. If you’re not sure what to try, activities such as pilates, cardio-kickboxing, and water-based exercise all have studies showing that they help reduce inflammation and help people with arthritis move and function better overall. (4) That being said, explore your interests! The best exercise or activity is the one that you’re motivated to do. Swimming is low impact and a great way to strengthen, sure, but if you hate getting your hair wet and struggle to stay afloat it may not be the right activity for you. Whether it’s a sport or an activity like biking, skating, going to the gym, following exercise videos at home, or any combination of things, the important part is to get moving in a way that is meaningful to you.
But what about if your interests include activities such as rugby, hockey, or other “high impact” sports? Can these still be an option if you have arthritis? I would argue yes, but maybe with some compromises. When going through a flare, higher impact activities can sometimes make you feel worse rather than better; if you have joint damage, sometimes extra stress on these areas can lead to increased pain. The goal of activity is to make you feel better, not worse, so if you’re feeling constant pain or are discouraged about what you are doing, it could be a sign you may want to consider a change.
A change doesn’t necessarily mean cutting an activity out completely though - this is where the compromise comes in. There could be ways to modify or tweak what you are doing to make it a better fit for you. For some this might mean stopping competitive sport and focusing on having fun through a recreational group. Some people move into coaching or leadership roles where they still get to be involved and practice skills, but with plenty of opportunity for rest and breaks as needed. Maybe there’s certain drills or techniques you avoid while fully participating in others. There’s lots of possibilities out there waiting to be discovered!
If you’re new to activity there’s ways to make it more likely you’ll stick to it – joining a group, having an “accountabilibuddy”, purposefully planning activity into your day, and tracking your progress are all ways to motivate and support yourself. You can also lessen barriers by having backup plans for what you might change or do differently if things go sideways, like you can’t get to that yoga class because of the snow, or your knee is sore and it’s hard to go for a run.
Remember that this is a journey – there will be ups, downs, and everything in between, but any step in the right direction is a step forward. Start small and work up – running a marathon doesn’t happen with one day of training, but that first five minute walk still means you are closer than you were the day before.
While my new year’s goal requires a little more sitting, I’m also going to do my best to track my progress and plan my day in a healthy way. Let’s get things moving!
Kuntze G, Nesbitt C, Nettel-Aguirre A, et al. Gait Adaptations in Youth With Juvenile Idiopathic Arthritis. Arthritis Care Res. 2020;72(7):917-924.
Kuntze G, Nettel-Aguirre A, Brooks J, et al. Vertical Drop Jump Performance in Youth with Juvenile Idiopathic Arthritis. Arthritis Care Res. 2021;73(7):955-963.
Cavallo S, Brousseau L, Toupin-April, K, et al. Ottawa Panel Evidence-Based Clinical Practice Guidelines for Structured Physical Activity in the Management of Juvenile Idiopathic Arthritis. Arch Phys Med Rehabil. 2017;98:1018-1041.