#RheumAthlete Training Q&A

Since returning to the gym at the beginning of May, I’ve been meaning to write more here about how I’ve been progressing in my training since coming back from knee surgery in February. But then May was absolute chaos with looking for a new job, traveling for work, traveling for advocacy, and just trying to get back into my training routine. And while I’d still like to resurrect my training journals at some point, lately I’ve been getting a lot of questions about my training via social media, and I decided that tackling some of those is as good a start as any.

What is your workout schedule? How do you balance exercising with rest?

My workout schedule is constantly changing and evolving based on my body’s needs, pain levels, disease activity, treatment side effects, etc. And even though I had a rock solid weekly routine before this last surgery, that’s been tossed out the window since. I’m not running AT ALL, and I’m not even back on the elliptical yet. I also haven’t progressed to adding squats or lunges or any real leg day routine back yet. Instead, I’m reshaping my training to focus more on low-impact endurance training which means a lot more time outdoors on my new bike, and working up the guts to get in the pool and start swimming soon… My training today looks nothing like it did six months ago, and I’m working hard to adjust to new limitations. This means that my schedule is changing every week while I work to find the perfect combination – and to balance that with enjoying my summer!

What about rest? Rest is the easy part as I’ve worked to really dial in on the messages my body is sending me. Today I was “scheduled” to train before work, but intense knee and SI joint pain prevented me from doing so. I went to bed early, slept in (for me) a little, and hope to get back on schedule tomorrow. Some weeks I need more rest than others which is frustrating, but one workout does not make or break my progress, and so I look at rest as an integral part of my long term goals.

How do you still train when you’re flaring? How do you motivate yourself to train when you’re in pain?

I don’t train when I’m flaring or when I’m in a high disease activity state. A flare is your body’s way of raising the red flag, and for me that means rest. I will say, however, that because laying down for extended periods of time often exacerbates my back pain, I do try to do gentle stretches every day that I’m flaring. I have an extra thick and squishy exercise mat that and I’ll start by simply lying flat on that and working through some breathing exercises before anything else. From there I try to do some of my PT exercises from surgery and work up to some gentle yoga poses.

Other days when I’m having a high pain day, but I’m not actually flaring, it’s a little harder to make the call of whether or not to train. In my experience, nine out of ten times when I choose to train despite pain, I do feel better afterward. I’m a firm believer in “motion is lotion,” and it’s rare that I ever feel worse after moving. That said, just because I train on a high pain day, doesn’t mean I train as scheduled. It might just mean a walk with the dog or riding the stationary bike at home – it doesn’t always mean a full workout, and that’s OK. Every day that I’m able to move is a good day.

When you don’t train for a while, does it affect your RA? How so? Is it hard to get back to training after taking time off?

Without a doubt, prolonged breaks from exercise affect my RA and pain levels – especially my back pain. I’ve grown to consider exercise a critical part of my disease management and it really helps me cope with the emotional toll that my disease takes. Even after twenty-two years, I still struggle with feeling like I have a lack of control over my life because of my arthritis. Exercise helps me feel like I’m exerting at least some control, and I rely on that feeling as an outlet for any stress and frustration I’m feeling. Stress is BY FAR the biggest disease trigger for me, and exercising helps me manage stress and mitigate that trigger.

I rarely take an extended break from training that isn’t a direct result of my health, and so I’m usually anxious to get back to training as soon as I’m feeling better. That part has never been an issue for me. If my motivation does falter (I don’t exactly love my 5AM wake ups), I try to remind myself of how quickly this can all change – how quickly this disease can take away the things I love in the blink of an eye. So it’s important to me to do those things for as long as possible.

Does your training ever trigger flares? How do you avoid that?

I can say with a fair amount of certainty that my training has never been a direct contributor to a flare. Do I have increased joint pain as a result of training? Yes – my knees and my wrists bear the brunt of that, but I believe the benefits for me far outweigh that pain. And, like I said, stress is a HUGE flare trigger for me, and exercise helps me to relieve stress. But if you’re concerned that exercise could trigger a flare for you, you should discuss this with your rheumatologist before starting any exercise program.

 What food do you eat to help you train?

As I discussed in a recent post, I struggle with a history of disordered eating which means I have to be really careful not to get too prescriptive with my diet. Food and cooking are a huge passion of mine, and, as much as I try hard to eat in line with my training goals, it’s also important to me to leave room in my life to enjoy food. So I operate by the 80/20 rule: 80% of what I eat is good, clean food and 20% of my diet is reserved for treats and enjoyment. I will never be the person out to eat with friends logging menu options into an app to see what fits my macros. If that works for you – awesome! But flexible dieting/intuitive eating supports my training goals while allowing me to enjoy the things that I love.

(Side note: I’m being intentionally vague about my diet here. There are many different schools of thought about how diet can be used as a tool in treating RA, and, while I know what works for me, I want to be clear that I in no way know what works for everyone – nor would I want anyone to expect that following my specific diet would yield similar results in their condition. Like exercise, I encourage everyone to talk to their rheumatologists and other providers before exploring any diet as a treatment for their disease.)

Do you use any type of supplements while you’re training?

I’m of the opinion that too often arthritis patients are told to take supplements like calcium and Vitamin D without any testing to see if they are actually deficient in these nutrients. My rheumatologist referred me to a nutritionist and I’ve had lab work done to establish micronutrient deficiencies. The vitamins and supplements I do take are based on these tests with every effort being made to offset deficiencies with diet first and foremost. I do take additional performance supplements (protein powder, MCT oil, etc.), but only after discussing these additions with my nutritionist. Am I being intentionally vague again? YUP! Not only do I only know what works best for me, the supplements I do take address more than just arthritis – pericarditis, high blood pressure, osteoporosis, low bone density, etc. Please talk to your doctor before adding any sort of supplement! There’s definitely so much as too much of a good thing when it comes to certain vitamins, and, believe it or not, some of them can even have adverse reactions with different types of medication!

Alright, let’s wrap this up!

Getting back to training since surgery in February has been HARD. It’s been frustrating. And it’s been more than a little humbling at times. But then a friend will say to me something as simple as, “you’re a natural athlete. Once you start working at it, developing your swim technique will come naturally.” And I’m reminded that, more than anything else in the world, I want people to see me as an athlete for as long as I am able.

Sixhips&counting is provided for general informational purposes only and represents my personal experiences. The opinions expressed here are mine and not those of any advertiser, company, affiliate or group. I do my best to provide accurate information, but please understand that I am not a medical doctor or expert in the field. Please do not consider my opinions as substitutes for sound professional or medical advice.

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