A psoriatic arthritis (PsA) flare-up can sometimes be enough to make me want to crawl into bed and forget about heading to the gym. But I find that I’m always better for it when I’m able to work through the inflammation and joint pain in a smart manner.
When considering the best exercises for psoriatic arthritis pain, it’s less about the specific exercise than about the characteristics of the exercise and how it can maximize joint performance while minimizing joint pain in the affected area.
My psoriatic arthritis pain moves around my body quite frequently, which has made it hard to establish a hard and fast workout routine. Understanding that I have to work with my body, rather than against it, was key to my staying active even throughout the worst flares.
In fact, according to Christopher F. Raynor, MD, an orthopedic surgeon at University of Ottawa Sports Medicine, ideal exercises can and should change based on your current pain. However, every routine should include movement that helps develop and maintain a full range of motion of the particular joint being exercised (especially if it tends to give you trouble).
In addition, exercises should promote and maintain adequate strength of the muscles that surround the affected joint so that when you do experience a flare-up, the surrounding area can help compensate for the pain and make regular movement easier.
“The exercises should allow the development of strength throughout the full range of motion of the joint to maximize the mobility of the joint,” says Raynor. “In weight-bearing joints such as the knees, hips, and ankles, the exercises should minimize the amount of impact utilized.”
“This is not to say that impact exercises should be avoided completely but rather that care should be taken to avoid unnecessary impact in the setting of preexisting injury or degenerative changes,” he adds.
I’ve found that the key is to tailor my workouts to what my body needs — even if some days I’d rather be going for a run than just sticking to strength training or yoga.
Doing too much at once could be counterproductive, whereas working around my pain with these joint-friendly exercises has actually resulted in less painful flare-ups and a much more comprehensive fitness routine.
The first few hours of the day are always hard when you have joint pain, but I’ve found that a consistent stretching routine is one of the easiest (most pain-free) ways to loosen up stiff joints without putting too much pressure on them.
I recently started doing a 5-minute morning yoga practice as soon as I wake up to help eliminate my morning joint pain as quickly as possible, and it works wonders.
Yoga can be a great exercise for anyone with joint problems, as it helps foster more flexibility while gently strengthening muscles throughout the body. The Arthritis Foundation also urges those with joint pain to practice yoga regularly, as it has been proven to lower stress in people with chronic pain.
I tend to look to classes that aim to reduce overall inflammation, like hot yoga, but avoid anything that involves strenuous balance-focused poses that might put unnecessary stress on my joints.
I love taking a mat Pilates class when my ankles and toes are flaring but I’m still craving a more intense workout. I typically follow a low impact online class (my favorite is BBFIT by Bailey Brown), but there are lots of low impact Pilates classes available at most local gyms if you prefer a sense of community.
Your local gym might not advertise that classes are PsA-friendly, but they’ll know which classes or flows will be the least challenging for tender joints.
Because it involves intense cardio, high intensity interval training (HIIT) isn’t going to be your best bet if you have regular joint pain in your ankles or knees. But it’s a great way to get off the ground and give your hands and elbows a break.
Many HIIT workouts can be done fully standing without using your hands, but you’ll want to be aware of any repetitive jumping or running if you have any inflammation in your knees or ankles. I always wear shoes with added support and skip any excessive jumping, even if my ankles are feeling fine that day.
Biking can provide an excellent workout without putting too much pressure on your joints, especially if you invest in some padded cycling shorts.
I like to pull out my stationary bike whenever my elbows or shoulders are inflamed. It’s also a great option for giving your feet and ankles a break from load-bearing workouts.
The only problem with cycling is that it’s important not to overdo things, as this could cause even more damage than when you started out. Take it slow and don’t overtrain — even if you’re going at a leisurely pace.
Abdominal pain and a decline in performance are possible signs of overtraining. I’ve found that a good general rule is to stick to 45-minute workouts no more than 3 times per week.
I love foam rolling after a particularly sweaty workout, but it’s also great to practice during a psoriatic arthritis flare for some instant relief from tightness and limited mobility.
“Perhaps the best thing that foam rolling does for the muscles is to free them to do their jobs,” explains Joy Puleo, PMA-CPT, founder of Body Wise Connection, a nonprofit that helps women with chronic pain restore physical self-awareness through Pilates-based movements.
“By releasing the bound or rigid tissues, the muscles and surrounding tissues around joints have access to greater range of motion,” Puleo says.
As Puleo explains, muscles are surrounded and supported by connective tissue called fascia. This tissue is part of the three-dimensional webbing that helps hold us together.
When this tissue loses its elasticity or becomes rigid or tight, the muscles within it will be affected. When connective tissue gets bound, tight, or rigid, important nutrients, hydration, blood flow, and circulation can be restricted.
According to Puleo, rolling is an active way to break up some of the mechanical tightness of the connective tissue, which may help increase circulation, increase hydration and nourishment to tissues, release tension, increase proprioception and joint range of motion, and help reduce pain in the body.
Whether it’s a full-body HIIT workout or simply allowing my body to lean into the benefits of a couple minutes of gentle foam rolling or yoga during a particularly bad flare-up, taking the time to move in whatever capacity my joints allow has given me a newfound sense of control over my disease.
It has also helped me foster a healthier relationship with fitness, which not only helps reduce pain and inflammation but also does wonders for my mental health and overall wellness.
Kaitlyn McInnis is an international travel and lifestyle writer based in Montreal, Quebec. Her work has appeared in Travel + Leisure, Forbes, The Points Guy, Tatler Asia, and many other consumer and trade publications around the world. You can usually find her reading or writing from a hotel lobby or on Instagram.