Immunological Arthritis & Methotrexate/Immunosuppressants?

[billy1edwards]

Anyone else lucky enough to have an immunological or rheumatological arthritis like psoriatic arthritis (which I have) or ankylosing spondylitis (similar to psoriatic) and have been training while on methotrexate? MTX has been used to treat rheumatoid arthritis and its kind for decades, so I hear.

I manage well enough with the disease but when I continued to get worse despite cleaning up the diet (no diary, processed carbs, etc.) and trying every vitamin and natural thing the internet suggested, my doc talked me into an immunosuppressant, of which methotrexate sounded the least scary and the one that has been on the market the longest.

Anyone have experience with similar issues and immunosuppressants? I would very much like to hear from someone who either has similar problems or trained someone with similar problems. Doc seems to think MTX will not hinder my progress. It should lower my immune response which caused my body to attack proteins in my joints and leaving painful pockets of inflammation in its wake.

Anyway, thanks for any input.

[stef]

Have a look at this video and you might start with searching the forums.

[tiny&mighty]

I have RA and cannot take MTX. So far my flares mostly affect my fingers, eyes and ankles. Over time, I have learned some tricks to manage the condition and its impact on my job and life, but even on a good day, it is always sitting in some of my fingers. I have also had some success mitigating sudden, aggressive flare-ups with short-term, low-dose prednisone. As much as I hate having RA, I would describe myself as a quite fortunate RA patient.

Though I cannot answer your question, I find that Starting Strength has been helping. I do not know why or how, but my RA has been less aggressive since I started this program about a year ago. It is like my body is so busy keeping up with the SRA cycle that it cannot be bothered to deploy the heavy artillery to attack itself. Completely anecdotal, but this has been my experience and one of my many motivations to keep training.

Also, Starting Strength has enabled me to keep disability at bay. Of course I am never going to perform as well as I would without RA, but I am still a much more capable person than most women my age and size. So my only advice would be to keep training.

[billy1edwards]

This video is what convinced me a year or so ago I could start to train! Thanks for the reminder.

Prednisone is a huge blessing-for sure. I wish there was more people on immunosuppressants training, but they are a relatively new class of drugs. I agree training has drastically improved my condition. I believe it’s psychological in that I’m not sitting around being depressed about being fat and sick anymore.

I do want to ask-how do you cope with DLs and chins? I have to do these alone on their own day at the end of the week because my fingers are destroyed for a couple days (swollen, very sore, inflamed). I use straps for both. Any advice as someone with RA in the phalanges to a guy with PsA in the phalanges??

[tiny&mighty]

I do want to ask-how do you cope with DLs and chins? I have to do these alone on their own day at the end of the week because my fingers are destroyed for a couple days (swollen, very sore, inflamed). I use straps for both. Any advice as someone with RA in the phalanges to a guy with PsA in the phalanges??

As a rule, I never train early in the day, and always ensure my hands are warm and that my finger joints are loose before I get started.

Chin ups

I use this padded bar, which is more comfortable.

Padded bar.jpg

If a finger joint is particularly sensitive, I line it up with one of those dents to further alleviate the pressure.

I step on something to grab the bar properly rather than jump and deal with the "impact" on my joints.

I use a monkey grip (all fingers around the bar, including the thumbs). I find it distributes the pressure on the joints more evenly.


Deadlift

This is going to sound weird, but I warm up my deadlift bar (more on this bar below) with a radiant heater. My RA loves heat; I experience more joint pain if the bar is cold.

I use the monkey grip during warm-up sets for the reason noted above.

For the work sets (two triples), I use an alternate grip because I am not strong enough to use the double overhand or monkey grip, and I cannot use the hook grip (fingers are too short, and thumb joints are currently inflamed). I supinate one hand for the first set, and the other hand for the second set, so that both hands experienced a limited amount of overhand and underhand pressure, rather than twice the pressure on the exact same inflamed spots.

Right now, the pressure is more painful on the supinated hand (because my pinky fingers are also inflamed). So I supinate the “worst” (most painful) hand during the first set. I find this makes the second set more tolerable. A while back, it was the opposite. My ring and index finger joints were inflamed, so the overhand grip was more painful and aggravating. Same principle though: I would pronate the “worst” hand during the first set, and supinate it during the second set.

I bought a women’s bar for the deadlift (but use a standard barbell for the other SS lifts). This is probably the best decision I have made during my NLP. Upon reaching about 145 lbs on the deadlift, my grip strength was not keeping up. I figured that a smaller bar would be easier to hold, and the circumference of a women’s bar is about 1 cm shorter than that of a standard barbell. It is indeed a lot easier to hold (still not using straps at 220 lbs), but most importantly, I find it much gentler on my joints (probably because my fingers are less extended?). Try it. I wish I had made this switch before.

Finally, my last tip is another weird one, but it works wonders for me. My RA-affected joints love heat. After a workout, especially after a deadlift workout, I take a hot bath pretty much right away, while still “warm” from the workout. It cannot wait until I have cooled off and a shower does not do the trick. After a 15-20 minutes hot bath taken during that post-workout window, my joints feel almost like they did before the workout (instead of feeling worse for days like they did before I discovered this trick).

[billy1edwards]

Fascinating... I respond well to heat (known to nearly fall asleep at sink w hands in hot water) but never would’ve thought to do this POST workout... great idea. Too bad I did my chins and DLs last night and am already paying for it! I’m going to definitely use your ideas ASAP.

I wonder if anyone else has anything good or bad to say about using a woman’s bar for a DL as opposed to straps?

I have recently started the old sock of rice thing the old folks use, and it feels good. No idea if it actually helps other than mentally.

Thanks again Tiny and mighty. Those are great ideas!!

[tiny&mighty]

I’m going to definitely use your ideas ASAP.

Please let me know whether any of these help. I would be curious to find out. Maybe I am just lucky (or weird)?

And since you seem very open minded, here is my weirdest tip (though unrelated to barbell training):

When I go to bed, I hold a roll of gaze in each hand to keep my fingers folded about halfway between a fist and a flat extension. Then I wear a wool sock to keep this all in place. On a very bad day, I throw a hand warmer in there (Little Hotties) as well. Not sexy, I know. But on a bad day, doing this allows me to regain full range of motion within 20 minutes from waking up (because range of motion is not as limited to begin with). Otherwise, it takes well over an hour, even with our beloved sink ritual. I have also noticed that the better my fingers feel first thing in the morning, the better they will feel throughout that day.