I wish I had a cool diagnosis story for my autoimmune disease like Pesto does. But I was so young when I first found out that I had juvenile rheumatoid arthritis, I don’t remember not having it. I was first diagnosed when I was two, and although I’ve had long remissions, it’s always been a part of my life.
The good news about RA is that its diagnosis is not necessarily a death sentence for your running. While for many years any rheumatologist would laugh if you asked if you could run with RA, studies now show that high-intensity exercise can actually be beneficial; it improves mood, decreases stress, and improves bone density. However, it’s a complicated disease, so while many with RA can run, not everyone can. I’ll explain below.
As an adult with RA, when I moved to Texas in 2006, the warm weather and drier air helped me manage my symptoms and I was able to go off medications. This lasted until 2012, when I was parenting a two year-old and a newborn, who had the nasty habit of waking up every hour on the hour around the clock. I noticed that my ankles were swollen and achy but I assumed it was due to lack of sleep and generally being two seconds from losing my shit at any moment.
When my youngest turned six months old, I woke up with a high fever, all-over achiness, and super stiff and swollen joints. I couldn’t bend my elbows to pick up my kids or bend my knees to walk to my kids’ rooms at night. I quickly figured out that I was having a flare, and went about the work of finding a rheumatologist and getting on medication. I’ve been on medicine daily ever since and have been much more proactive at managing my disease.
What is Rheumatoid Arthritis?
Rheumatoid Arthritis is different from Osteoarthritis in that RA is caused by an autoimmune disorder. While RA primarily affects the lining of your joints, it can also affect skin, lungs, eyes and heart. The swelling and pain from RA can eventually cause joint deformity. My RA primarily affects my ankles, elbows, knees, neck and wrists. My elbows have been affected to the point that they barely bend, and I had my right elbow replaced in 2004 (this is a pretty drastic solution and knowing what I know now, I would never recommend it!).
For years, I managed my symptoms with prescription or over-the-counter anti-inflammatories. After my most recent flare, I switched to a biologic medicine. Mine is called Enbrel. A biologic is a medicine that you inject into your bloodstream because the bacteria in your stomach will destroy it. It helps manage the joint pain and inflammation, but it also slows the progression of the disease, which is crucial. I regret all the years I allowed the disease to spread. There are some side effects. Enbrel is not compatabile with breastfeeding, for example, and I had to stop immediately which was no picnic, but I can say unequivocally that it’s been a lifesaver for me.
I also take a pill called methotrexate that works with Enbrel to slow disease progression, and folic acid to minimize nausea and GI distress from the methotrexate. That sounds like a lot, but most of the time, I only really think about my RA on the days when I take my medicine.
Additionally, like Pesto mentioned in her post about the autoimmune disease Lupus, rheumatologists suggest cutting out gluten to mitigate symptoms of RA, but I would honestly rather take my medicine than give up bread. Vitamin D has also been shown to help manage RA symptoms, as well as reducing stress.
Running with RA
As I said in the intro, rheumatologists now often recommend exercise to improve the quality of life for their RA patients. But here’s the kicker: running is only beneficial if it does not strain the joints affected by RA. That means if your RA is flaring in your knees, ankles, or hips, running might not be feasible for you.
Personally, I’ve clung to the advice I received from my rheumatologist when I was a kid. He told me that as long as I could stand the pain, I could keep participating in the activities I love. My current rheumatologist has only told me not to run during a flare. Since I can barely walk to the bathroom during a flare, I’ve never been tempted to run anyway.
Over the years, I’ve learned a lot about running with RA. Here are my top five tips. **These tips come from my experiences only, so please consult with your doctor before heeding any of this advice!**
1. See a Physical Therapist.
Get a quick form check and check out the range of motion on your ankles and knees. You may have one joint that has a more limited range of motion than the other, which could cause compensation issues in other areas. I dropped out of the Houston marathon in 2015 due to a hamstring issue that stemmed from limited range of motion in my left ankle.
2. Listen to your body.
For real though. I know we as runners hear that all the time, but it’s important for RA patients to back off when we’re starting to feel symptoms so that they don’t turn into a flare.
3. Be proactive about disease progression.
If you have RA, even without a flare, talk to your doctor about being on some sort of treatment to prevent further joint damage.
4. Be careful about mornings.
Joint pain and stiffness is often worse in the mornings. If that’s true for you, don’t leap out of bed and expect to be able to knock out a tempo run. You may need to schedule your run for later in the day or give yourself time to wake up and loosen up.
5. Enjoy it while it lasts.
This advice may not be popular or easy to hear, but it’s honest. I feel really good now and rarely think about my RA, but I know that may not last forever. I may have flares again, or my RA might remain at a level that doesn’t allow me to run anymore. Will I be happy about that? Of course not! But realizing that right now running is a gift has allowed me to enjoy it while I can. And I’m already scheming about what I’ll do when I can’t run anymore. (Return to swimming? Crossfit? Become a yoga-holic? Who knows!)
Do you have RA and run? Any other tips?