Rheumatoid Arthritis – Exercise and DOMS

DOMS = Delayed Onset Muscle Soreness.

For years and years after my RA diagnosis, I struggled to exercise.  Although I typically felt fine during the exercise, 1-3 days later, you’d probably find me bed-ridden for up to 3 days.  I know I’m not the only RA person to feel that way.  I’ve certainly heard a lot of stories!

I started “open gym” or as I like to call it, “exercise therapy” in 2010.  The hospital where I was getting physical therapy just happened to be starting this program, and I was their first patient.  They were taking folks who had trouble exercising due to a medical condition (RA, weight loss surgery, heart conditions, MS, etc…) and helping them come up with an exercise plan they could do and stick to.  It cost $150 for six 1-hour one-on-one sessions.  A major bargain if you ask me!

When I started, I was in terrible shape.  I couldn’t even bend my knees to 90 degrees.  My weight was 185 pounds, and I couldn’t get my knees around the circle to pedal a bike!  I had embarrassingly little strength.  Yet, we started.  My goals were simple: get stronger, be able to alternate my feet going down the stairs, and squat.  As usual, I did fine while there, but within a few days I would be almost unable to walk.  I’d go back, and she’d cut my workout in half, and the same thing would happen.  For several weeks this went on.  But, I was motivated.  I wanted this to work.  The staff there believed in me, and it was flippin’ fantastic to have somebody see how my body revolts, to “get me”, and to keep going with me.  So, I continued.  Eventually, it worked.

The hospital had tons of equipment for me to figure out what I liked.  I tried a variety of exercises while there, but my favorite became a Pilates Reformer.  The hospital had a Reformer, and about a year into the program, my husband and I bought a used one.  I think I liked it because I didn’t have to get up and down from the floor, and it all worked on adjustable spring tension (no impact).  We also did a lot of exercise with no equipment at all, but sometimes that was getting up and down from the floor (not my strength!)

When I wasn’t making the progress I wanted on my knees, my old physical therapist (who helped me with some back/posture issues) came by and recommended talking to my rheumy about having my knees drained.  My rheumy (on the same floor of the hospital) agreed, drained them, and afterwards I immediately went to exercise therapy.  Although my one knee wouldn’t drain, the other did, and they were both injected with a steroid.  Wow!  They measured my knee bend before and after.  I don’t remember the numbers now, but it was an enormous immediate improvement.  It was so good, in fact, that walking to the car afterwards I injured my back.  My posture (which my old physical therapist had been helping me with) suddenly changed with the knee drained, and I had to relearn my appropriate posture all over again.  2 steps forward, 1 step back.

Still, things only went uphill from there!  I lost 12 pounds with exercise, and now have lost 51 pounds total with the Paleo diet.  My range of motion and strength are hugely improved.  And yet….

Here I sit 3 years from when I started.  I was having an awesome week.  I was working on my reformer at home 2 nights ago and was doing so well, I decided to increase the spring tension, making all of my exercises slightly harder.  2 mornings later, I sit here writing this post.  Everything in my body hurts.  I feel like I’ve been hit by a car.  I can barely walk.  It’s a “moving in slow motion” kind of day.  Joints affected are all of those I exercised (my fingers from gripping, my wrists, my knees).

I would love to see some good research on delayed onset muscle soreness and RA.  It’s the only thing that makes sense to me.  Everybody gets DOMS, but why does it seem like I get it so much worse.  And why does it feel like a flare?  It behaves like one, and I often confused it for one, but I don’t think it is.  I suspect in 1-2 more days I’ll be fine, like nothing happened.  In RA world, that’s nothing, but in the real world, that’s a long flippin time.  Glad it’s summer!

Later gators!

– Lori

4 thoughts on “Rheumatoid Arthritis – Exercise and DOMS

  1. Hi,

    I’m looking for research on this as well. I have psoriatic arthritis, it’s similar to RA, the synovial membrane fills with inflammatory cells in both and both are immunological. I have been going off the idea that when you get DOMS it causes the immune system to send out inflammatory cells to the muscles and then afterwards, because our immune systems are on overdrive (overkill if you ask me!), the inflammatory cells attack our joints next. I think most of the patients with diseases like this suffer in silence about it until they are in too much pain to do anything because we just know it’s our own fault for trying to be a warrior! I have noticed as well that it happens less when I am not doing high impact workouts. I was at a gym that did HIIT classes but I really messed up my spine and could barely move for weeks afterward, since then I have been walking and now jogging. It takes longer to burn the same amount of calories I used to but it’s less impact on my body and that means I can do this every single day which is more important to me. I’m glad you found something that works for you most of the time! Good luck!

    • Thank you, Heather! I’m trying to figure out that DOMS thing too. It irks me. For the longest time, I thought it was flat out flaring, but now I don’t believe that’s the case. I love that you can jog! I lost that a long long time ago. Now, there are days when I can remember what it feels like to run, and some days it feels like I could. When I try, I’m always disappointed! I took it off the important list, but maybe some day!

      Take care!


  2. Hi,
    I have RA and get what I would call ‘severe’ DOMS after workouts too. I’ve found that the episodes of DOMS and the severity of it do lessen the more I workout. However if im cominb into a flare the pain will be severe. I also take BCAA’s after workouts (branch chain amino acids) and a magnesium supplement to help with repair.

    So days I can manage to do a modified workout with just body weight when my joint pain is severe, walking can be tough though. I’m trialling using my hiking sticks to take the pressure off my ankles and feet.

    I find the reduction in my fitness after a flare to be really demoralizing. Always that sense of starting back at square one.

    Thanks for your blog

  3. Agreed! The starting over is a pain. It seems like I can never cheat on my exercise, not even skipping 1-2 workouts, as it sends me back too far. I hate having to be so perfect with that.

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