Exercises with Rheumatoid Arthritis and Scoliosis

[handy]

Hi Coach,

Firstly, I would like to apologize for this lengthy question, and also I am sorry as I am not even sure if this is the appropriate site to ask it (I mean as a whole site, not just the wrong sub forum) , but you are the authority in gaining muscles and strength, so I came here.

Secondly, my personal information:

Age: 29 years
Sex: Male
Weight: 47kg or about 104lbs
height: 165cm or 5'4"
Squat max or current working weight and reps: None
Bench press: None
Deadlift: None
Press: None
Power clean: None
Chinups max reps or added weight x reps: None
General description of training history: Just running 8km or about 5 miles every other day at a medium to low pace and playing football (soccer) once a week for about 90 minutes
Any special diet and whether you are currently gaining or losing weight: No special diets but I keep the types of food I eat at minimum as my stomach isn't very fond of food, I am underweight and trying to gain
Major goals and concerns (If you are trying to do anything other than get stronger in the five barbell lifts above this is particularly important.): Gaining weight preferably between 15-20kg


With all the above information, I would like to add that I also have severe hypothyroidism, which is supposed to make people overweight, but that didn't happen to me, Also as the title says I have Rheumatoid Arthritis and scoliosis (Cobb angle about 60 degrees).

I have spoken with my Rheumatologist and he said any type of exercises with weights is a big no for me, as it would speed the process in which the Rheumatoid destroys my joints and the only thing he allowed me to do is running

Are there any exercises that might be beneficial to me without using weights? I mean exercises that will help me build muscles and gain strength.

Again, sorry if this is not the correct site or place to ask this question, I asked so many trainers and coaches but they all said we can't help you without using weights, I got desperate, and I would totally understand if it is the same case here as I see this is a site for barbell users


Thanks in advance,

[David Clark]

I'm amazed that your rheumatologist thinks weight training would be hard on your joints but running is not. While I don't suffer from any of the conditions described in your post my experience has been that running hammers my joints much more than squats and deadlifts.

[melody]

You are a 30 year old man who weighs as much as a 12 year old girl and runs 5 miles a day. I wonder why you feel like shit. Your rheumatologist might be wrong. Or you might want to ask at a different website. Everyone here will tell you to eat cheeseburgers and squat.

[Kyle Schuant]

Your rheumatologist gives different advice to one who sends me his patients to train, and advice which contradicts research findings - that properly-performed and sensibly-progressed resistance training reduces the frequency and severity of flareups of RA.

I suggest you seek a second opinion.

As for the scoliosis, we'd have to see you move to judge what you can do. But the basic movements of squatting, pushing, pulling, hingeing at the hips and doing loaded carries are movements which people do in everyday life in any case, so if those movements will hurt you then you're fucked no matter what. You'll already do these movements, the only question is which particular version you can do today, and how fast you can progress it.

[handy]

I'm amazed that your rheumatologist thinks weight training would be hard on your joints but running is not. While I don't suffer from any of the conditions described in your post my experience has been that running hammers my joints much more than squats and deadlifts.

Yeah that didn't make sense to me, but I actually tried it a few times with minimum weights and in each time the next morning I experienced much more stiffness in my joints, if I just went for a jog I would feel less stiffness overall

You are a 30 year old man who weighs as much as a 12 year old girl and runs 5 miles a day. I wonder why you feel like shit. Your rheumatologist might be wrong. Or you might want to ask at a different website. Everyone here will tell you to eat cheeseburgers and squat.

Well, I know I am fucked up genetically, I am a bit short with small bones, my weight is of a 12 year old girl and my arms are like the arms of a 10 year old boy

I tried eating cheeseburgers and pizza and whatnot, and I mean lots of it, but it didn't do anything for me, after 6 months my weight was 50kg

Your rheumatologist gives different advice to one who sends me his patients to train, and advice which contradicts research findings - that properly-performed and sensibly-progressed resistance training reduces the frequency and severity of flareups of RA.

I suggest you seek a second opinion.

As for the scoliosis, we'd have to see you move to judge what you can do. But the basic movements of squatting, pushing, pulling, hingeing at the hips and doing loaded carries are movements which people do in everyday life in any case, so if those movements will hurt you then you're fucked no matter what. You'll already do these movements, the only question is which particular version you can do today, and how fast you can progress it.

You mean you've people with Rheumatoid Arthritis whom their rheumatologist send them to train with weights?

I have an appointment with another rheumatologist coming up in a couple of weeks.

Can you please provide me with some of the researches you mentioned? I'd love to print them and show it to my current rheumatologist, might benefit other patients also.

As for the scoliosis I intend to use a pull up bar in hopes that I get a bit of correction

[Kyle Schuant]

YYou mean you've people with Rheumatoid Arthritis whom their rheumatologist send them to train with weights?

Yes. And osteoarthritis.

All those I've trained have got less pain.

Most have to start with something less than the empty bar, using dumbbells etc. But that's not because of the arthritis, it's because most people who get arthritis are in their 60s, and they've been sedentary their entire adult lives - 40 years or more. So they're very weak. Of course, the joint pain makes them avoid physical activity, which makes them weaker than other people in their 60s. Vicious spiral.

Most don't stick with it, not because of medical advice, but because it's fucking hard. This applies to everyone regardless of health conditions. This shit is hard.

Can you please provide me with some of the researches you mentioned? I'd love to print them and show it to my current rheumatologist, might benefit other patients also.

There are zillions. For example,

One - "Resistance exercise in RA is safe, and the improvement in most outcomes was statistically significant and possibly clinically relevant for RA disability."
Two - "High-intensity strength training in RA patients with varying levels of disease activity and joint damage had a large, significant effect on strength, and led to improvements in pain and function, with additive patient benefits beyond the effect of their infliximab use."
Three - "Low load resistive muscle training increased functional capacity as reported by patients and is a clinically safe form of exercise in functional class II and III RA."
Four - "Regular dynamic strength training combined with endurance-type physical activities improves muscle strength and physical function, but not BMD, in patients with early RA, without detrimental effects on disease activity"
Five, a review of other studies - "The results indicate that exercise leads to unchanged or reduced self-reported pain and joint tenderness for patients with rheumatoid arthritis. Further studies are needed in order to demonstrate to what extent and how different kinds of exercise influence pain and joint tenderness in rheumatoid arthritis patients."

Some studies show no change in pain etc as a result of resistance training; most show an improvement. I would suggest those showing no change weren't very good programmes, but this is an issue with exercise science generally, not specific to studies on chronic health conditions. But the least you can hope for is that you remain in pain, but in pain and stronger, instead of in pain and weaker. More likely, you'll have less pain and be stronger.

I have NEVER seen a study showing a worsening of pain long-term in people with rheumatoid or osteoarthritis who do correctly-performed resistance training. Not a single one. Nada. If your doctor has one, ask him to show you it and you can share it with us.

I would be interested in the supposed mechanism of injury to the joint which eventuates from resistance training but not running. Why is it that dropping your 47kg of bodyweight onto your ankles and knees at the rate of 100-150 thumps per minute for an hour 3-4 times a week - thus, 18,000-27,000 thumps weekly - is harmless, but squatting (to begin with) the 20kg empty bar for 3-6 sets of 5 some 3 times a week for a total of 45-90 more moderate thumps would be horrendously dangerous.

[mrflibble]

Yeah that didn't make sense to me, but I actually tried it a few times with minimum weights and in each time the next morning I experienced much more stiffness in my joints, if I just went for a jog I would feel less stiffness overall

How many times? Most likely you have insufficient experience with lifting to be able to tell the difference between the normal soreness/tightness every newbie experiences after their first sessions, and any similar signs and symptoms of your RA.

I tried eating cheeseburgers and pizza and whatnot, and I mean lots of it, but it didn't do anything for me, after 6 months my weight was 50kg

And what did you conclude from this?

[Larissa]

I have RA. My rheumatologist told me "High reps, low weights, don't lift anything over five pounds." A quick trip to Google Scholar and a couple of hours searching through Medline told me that the research was on my side, not hers.

Rheumatologists, like most doctors, are great in their area of expertise, but their area of expertise is not usually exercise medicine. Don't be content to take their word for something outside their area of expertise; RA is very much a use-it-or-lose-it disease, and failure to build up strength is going to cost you enormously in the long run. Look up "rheumatoid cachexia," check the clinical literature, and re-evaluate.

[handy]

Yes. And osteoarthritis.

All those I've trained have got less pain.

Most have to start with something less than the empty bar, using dumbbells etc. But that's not because of the arthritis, it's because most people who get arthritis are in their 60s, and they've been sedentary their entire adult lives - 40 years or more. So they're very weak. Of course, the joint pain makes them avoid physical activity, which makes them weaker than other people in their 60s. Vicious spiral.

Most don't stick with it, not because of medical advice, but because it's fucking hard. This applies to everyone regardless of health conditions. This shit is hard.


There are zillions. For example,

One - "Resistance exercise in RA is safe, and the improvement in most outcomes was statistically significant and possibly clinically relevant for RA disability."
Two - "High-intensity strength training in RA patients with varying levels of disease activity and joint damage had a large, significant effect on strength, and led to improvements in pain and function, with additive patient benefits beyond the effect of their infliximab use."
Three - "Low load resistive muscle training increased functional capacity as reported by patients and is a clinically safe form of exercise in functional class II and III RA."
Four - "Regular dynamic strength training combined with endurance-type physical activities improves muscle strength and physical function, but not BMD, in patients with early RA, without detrimental effects on disease activity"
Five, a review of other studies - "The results indicate that exercise leads to unchanged or reduced self-reported pain and joint tenderness for patients with rheumatoid arthritis. Further studies are needed in order to demonstrate to what extent and how different kinds of exercise influence pain and joint tenderness in rheumatoid arthritis patients."

Some studies show no change in pain etc as a result of resistance training; most show an improvement. I would suggest those showing no change weren't very good programmes, but this is an issue with exercise science generally, not specific to studies on chronic health conditions. But the least you can hope for is that you remain in pain, but in pain and stronger, instead of in pain and weaker. More likely, you'll have less pain and be stronger.

I have NEVER seen a study showing a worsening of pain long-term in people with rheumatoid or osteoarthritis who do correctly-performed resistance training. Not a single one. Nada. If your doctor has one, ask him to show you it and you can share it with us.

I would be interested in the supposed mechanism of injury to the joint which eventuates from resistance training but not running. Why is it that dropping your 47kg of bodyweight onto your ankles and knees at the rate of 100-150 thumps per minute for an hour 3-4 times a week - thus, 18,000-27,000 thumps weekly - is harmless, but squatting (to begin with) the 20kg empty bar for 3-6 sets of 5 some 3 times a week for a total of 45-90 more moderate thumps would be horrendously dangerous.

Wow,I can't thank you enough, I have printed a couple and will take them to my rheumatologist today.

I am not planning on becoming a muscular man or have the body of bodybuilders, I just want to gain weight and have a bit extra of strength.

It didn't make sense to me that lifting will affect my joints far worse than running or playing football, that's why I came here where I knew I'll find some insightful information.

How many times? Most likely you have insufficient experience with lifting to be able to tell the difference between the normal soreness/tightness every newbie experiences after their first sessions, and any similar signs and symptoms of your RA.



And what did you conclude from this?

I tried lifting a 10kg bar for about 50 times in total in 10 days, it might be normal soreness or tightness accompanied by RA pain.

Well, I thought it might be that I have some conditions that cause malabsorption, but I had tests done and nothing out of order appeared

I have RA. My rheumatologist told me "High reps, low weights, don't lift anything over five pounds." A quick trip to Google Scholar and a couple of hours searching through Medline told me that the research was on my side, not hers.

Rheumatologists, like most doctors, are great in their area of expertise, but their area of expertise is not usually exercise medicine. Don't be content to take their word for something outside their area of expertise; RA is very much a use-it-or-lose-it disease, and failure to build up strength is going to cost you enormously in the long run. Look up "rheumatoid cachexia," check the clinical literature, and re-evaluate.

May I ask how old you are?

My mother has rheumatoid cachexia, she had RA for more than 35 years, that's what made me want to exercise and endure the pain in the beginning

Exactly.

OP, you might have been eating shitty food and not gained much weight, but that doesn't mean much in the absence of strength training. To my uninformed brain, you just seem to be catabolic. Someone with RA would more than likely benefit in being anabolic.

Here's what I would do (but I'm a moron):

Stop running.

Get another opinion.

Do your own research (Kyle has started you on both the research and getting another opinion).

Fix your diet so that you are eating a lot of protein.

Lift heavy things.

There might be something else going on here. I'm suspect of the test levels of a grown man that is of your stature. An endocrinologist may also be of help.

Yeah I have been reading on exercises for the past 2 days, thanks to Kyle, it did open my eye.

My diet currently contains lots of protein.

I went to many endocrinologists they all agreed that it is probably I had insufficient growth hormone during puberty, but I am way beyond the time limit to fix it now unfortunately, as said before, I know I am fucked up genetically

[Kyle Schuant]

I know I am fucked up genetically

Irrelevant.

It's not about becoming someone else, it's about becoming a better version of yourself.

We all have limits. But these invariably turn out to be higher than we commonly suppose. Every single person I've ever trained has said, "I wish I'd started this when I was younger." 65 year olds say it, 23 year olds say it.

You won't become Lou Ferrigno. Who gives a shit? You'll become better than you are now. You don't have to be 47kg and weak. You don't have to get more and more lopsided as you age. You don't have to have joints in pain, with no prospect but more pain over the years. You can be a better version of yourself.

Don't bother with seeing this doofus again, if he got through the 8-10 YEARS it takes to become a rheumatologist without ever ONCE hearing how resistance training helps with the condition, he is obviously a closed-minded idiot. Follow his advice for now, but get a second opinion. This will be a better opinion which you can then follow instead.