Psoriatic Arthritis Exercise Mistakes to Avoid -

Although it may be the last thing you feel like doing, staying active is an essential part of managing psoriatic arthritis. Exercising regularly not only helps improve symptoms such as pain and fatigue, but also helps keep your joints flexible and your muscles strong. It can even enhance your overall quality of life.

While the right kinds of exercise can have a strong beneficial effect, exercising the wrong way can actually make psoriatic arthritis worse. So be sure to avoid these common exercise mistakes.

1. You Don’t Work on Muscle Strength

“One of the things to realize, which a lot of people don’t, is the importance of strengthening,” says Chris Kolba, PhD, a physical therapist at The Ohio State University Wexner Medical Center in Columbus.

“Basically, the stronger your muscles are, the better they can absorb shock and control motion,” he explains, “which ultimately minimizes stress on the actual joint.” Some research has found that people with psoriatic arthritis who work strength training into their exercise routine twice a week improve their quality of life and functional fitness, compared with those who don’t do strength training.

It’s important not to start out with too much weight or resistance, Dr. Kolba notes. Instead, begin at an intensity that doesn’t feel too difficult, and do more repetitions of the exercise than you would be able to at a higher weight.

2. You Don’t Get Enough Aerobic Activity

As important as strength training is, it’s equally essential to do aerobic exercise.

If you’ve experienced discomfort in your joints while doing moderate-impact aerobic exercises, such as jogging, you may be tempted to skip cardio altogether, Kolba says. But lower-impact options, such as elliptical machines, stationary bikes, rowing machines, and pool exercises, can boost your health without overstressing your joints.

As an alternative, you can use lighter weights for strength training and do them in a circuit — taking only short, timed pauses between activities — to achieve cardiovascular benefits, he notes.

3. You Focus on High-Impact Exercises

Running and jumping may not be good options if you have psoriatic arthritis, Kolba says, because they can strain your joints and accelerate the inflammatory process.

He notes that the stress you put on your joints equals about double your body weight when walking but five to eight times your body weight when jogging.

“That’s a lot of stress for a joint that’s irritated or inflamed,” Kolba says. “There’s a tremendous amount of force coming up through the legs and into the spine.”

Any type of jumping or rapid form of resistance activity could be even worse for your joints. “Those activities just aren’t going to be tolerable in most people with joint issues,” he says.

But some research has found that high-intensity interval training (HIIT) can be both safe and beneficial for people who have psoriatic arthritis.

So if HIIT is something you’re interested in, consider talking to your doctor or physical therapist about safe ways to incorporate it in your exercise routine.

4. You Don’t Work on Balance

Lack of balance, Kolba says, “is typically what leads to falls, and a lack of strength is typically what prevents you from catching yourself.”

It’s common to lose strength and balance as you age or as an inflammatory condition such as psoriatic arthritis progresses, he notes. But you can take steps to work on improving your strength and balance. This means, to some extent, that you can “minimize the progression of whatever arthritic changes you have,” Kolba says.

Make sure you include balance exercises in your overall workout plan.

Try doing yoga or tai chi along with stretching exercises before a harder workout or on a low-key exercise day.

5. You Skip Warm-Ups

You should never jump right into a tough workout. Instead, get your muscles moving in a more relaxed way for five to 10 minutes, such as by stretching or walking, before you increase the intensity.

Kolba says many of his clients find that warming up and stretching helps eliminate stiffness and soreness. This not only gets your muscles ready for a workout, but also gives you the energy and motivation to exercise in a way that feels satisfying.

6. You Push Through Motion Limitations

When you have joint inflammation, you may not be able to move all of your limbs through the full range of motion.

This is an important consideration when deciding which exercises to do.

Particularly when strength training, finding a range of motion that’s pain free should be your goal, Kolba says. Once you’ve been doing the activity successfully for a while, “You can eventually slowly start to increase the range of motion that you’re able to move the weight through.”

7. You Overexert Yourself

While it may be tempting to give yourself the most rigorous workout possible, this isn’t a good idea if you have an inflammatory condition such as psoriatic arthritis.

“The key is to listen to your joints during exercise,” says Kolba. “And more importantly, how does it feel later?”

While some level of discomfort after a workout is normal, you should never be above a four on a pain scale of zero to 10, he says, “where 10 is going to the hospital and zero is no pain at all.” If you’re experiencing anything above a four, Kolba notes, you risk aggravating inflammation.

8. You Don’t Use Proper Form

Depending on which joints have the most stiffness and pain, you may instinctively change the way your body is positioned during exercises — particularly with strength training. This is especially true for people with shoulder or knee issues, Kolba says.

Using a “faulty movement pattern” can lead to even more muscle and joint issues, he says, so if you have significant joint pain or restricted motion, it’s important to work with a trainer or physical therapist to make sure your form is correct.

If you have trouble using proper form for certain exercises, “We would stay away from those, based on how you felt and what we saw,” Kolba notes.

9. You Don’t Consider Hand Limitations

If you have pain or stiffness in your fingers, it may be more difficult to do any number of strength-training exercises, particularly if it involves free weights.

To use free weights safely, “You have to grip and hold onto them,” Kolba says. If you have hand problems, you may need to stick to very light weights, he notes.

Many exercise machines offer a better alternative, he adds, since the handles can’t be dropped and sometimes require only pushing with the inside of your hand instead of gripping with your fingers. Even machines that involve pulling may not require a full-force grip.

Another good alternative, Kolba says, is using resistance bands, which can be looped around your wrists or hands. This can help you gradually build your grip without straining the joints in your hands.

In any case, he says, you should work on your grip if it’s impaired. “If you ignore it, it eventually gets worse.”

10. You Skip Rest Days

If you’re sore from a workout you did the previous day, you should take it easy, Kolba says. This doesn’t necessarily mean being sedentary. Just don’t push yourself.

“You could definitely take the day off and bring [your pain] down to a two or zero,” he says, adding that just warming up and doing some stretches can also do wonders to help reduce stiffness and soreness.

You may even want to plan a workout routine that alternates between heavier and lighter workouts, Kolba says. For example, do stretching and balancing exercises the day after an aerobic or strength-training routine. Light biking can also be a good way to keep moving on off days, he notes.

Applying heat or ice to sore muscles can help your body recover while you rest. Ice is good immediately following exercise if you’re having joint pain. But heat is better for loosening tight joints and easing sore muscles after a workout.

11. You Don’t Stay Hydrated

“Lots of water” is the way to go, Kolba says, not only when exercising or sweating a lot, but also on rest days.

Aside from replenishing fluids lost during a workout, staying hydrated helps flush toxins from your body, which helps fight inflammation. What’s more, drinking enough water can help keep your joints lubricated.

While you shouldn’t be drinking water in quantities that feel uncomfortable, it’s generally a good idea to drink water frequently throughout the day. When you feel thirsty or notice your mouth is dry, he says, that’s a sign you’re already dehydrated.

Water is key, but the Arthritis Foundation also recommends tea (keep caffeine content in mind though), smoothies, milk, and other beverages to stay hydrated.

12. You Forget the Role Diet Plays

A healthy, balanced diet is good for managing psoriatic arthritis in general, Kolba notes. But when you’re working out, your muscles also need a variety of nutrients to move effectively and grow stronger.

“Cutting out sugar and processed foods and eating high-quality food in general — fruits and vegetables, lean meats — are simple strategies that can help minimize inflammation,” he says.

Maintaining a healthy weight is also important for people with psoriatic arthritis, because a lower body weight puts less pressure on joints. In addition, having obesity can affect how well treatment works, particularly if you’re taking a biologic medication.

If you’re unsure how you should be eating to support your exercise routine and overall health, ask your doctor for a referral to a dietitian or nutritionist.

The Takeaway

When you’re experiencing joint pain and fatigue, exercise may feel like the last thing you want to do. But staying active can actually help keep joints flexible, strengthen muscles, and improve psoriatic arthritis symptoms.
Incorporating a mix of aerobics, strength training, and balance exercises is important for a well-rounded psoriatic arthritis–friendly exercise program. Working with a physical therapist can help you exercise with proper technique and form.
It’s equally important to listen to your body, know your limitations, and rest as needed to avoid aggravating psoriatic arthritis symptoms. And don’t forget to stay hydrated and well-nourished!

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