How to Get Motivated to Exercise When You’re Not Feeling Your Best
Cheryl G. has suffered from psoriasis and psoriatic arthritis her entire life. After having three kids and settling into what she calls “an inactive lifestyle,” her flares worsened and became more frequent. Finally, after her weight ballooned and her joints stiffened even more, she knew she had to do something before permanent damage set in. So she started exercising. “I make myself do something active every day, even through the pain,” she says.
Multiple studies show that exercise is crucial to the long-term health of psoriasis and psoriatic arthritis patients, who are at an increased risk of cardiovascular disease, diabetes, mental health issues, and more. Plus, inflammation can weaken muscles and cause joint stiffness. “Movement is essential to the homeostasis of the body and the mind,” says Joanna Nobbe, a physical therapist in New York City who works with many chronically ill patients. “This is true for everybody, whether you have a rheumatic condition or not. Physical activity is a nonnegotiable need for every human.”
Even though it can hurt to move when you have psoriatic arthritis, exercise actually lessens psoriatic pain in the long run by strengthening muscles. So, the last thing you want to be is sedentary. “We really have to push ourselves to ‘use it or lose it’ with this bloody disease,” Kim W. laments.
It’s so valid to feel like the last thing on earth you want to do is work out when you’re feeling fatigued, in pain, or having a skin flare-up. “I really struggle with this and need to find a way to include fitness in my life,” says Amy D. “I used to walk 6,000 steps a day, plus walk all day at work. Now, I am overweight and struggle to just get out of a chair.”
Allow Yourself to Grieve Temporarily
When you feel like you’re at the point of no return, how can you possibly get back on that horse—or stationary bike? First, stop beating yourself up. “Give yourself some grace and understand that it’s not you being lazy or difficult or unmotivated,” explains Maryland-based licensed therapist and life coach S. Tia Brown. “It's a real-life challenge physically and emotionally. We have to give ourselves permission to feel down about that.”
It’s really a grieving process. After going through it, it’s time to kick-start your heart with a real plan of action. “You must say to yourself, ‘How am I going to deal with this? On my knees or on my feet?’”
Find Your Exercise Happy Place(s)
During the times you are feeling healthy, happy, and mobile, Brown suggests taking note of the things that keep you in that space. It could be a ritual, like a morning walk, or eating certain foods, or hanging out with friends. Then post that list on your refrigerator, bathroom mirror, computer, or any other place where you’ll see it a lot. “Those notes will help you when you’re in your downtime,” Brown explains.
She also recommends looking at inspirational images or listening to music that pumps you up. Brown listens to Kendrick Lamar and Eminem songs because they remind her of happy times when she danced at clubs in college. Cheryl G. watches superhero movies. “If the actors in those movies can get into shape, so can I,” she says. “I won’t look like that specifically, but I like that mindset and can-do/must-do attitude to keep motivated.”
Follow Your Passions
Once you feel the drive, just get moving any way you can. “Number one, do what you enjoy,” says Nobbe. “Research shows that there's really not one modality of exercise. What most consistently has the best results is following what you enjoy.” There’s no reason to be scared. “Understand that movement is not harmful. Trust your body that that movement is inherently healthy and nutritious and beneficial. Start from an optimistic positive mindset.”
Kim W.’s feet and lungs are so bad right now, it’s tempting for her to curl up in a ball on the couch sometimes. “But I’ve got to keep going,” she says. So, she plays golf, her favorite sport, as many times a week as she can. She takes a cart “but just getting out of the house, moving around and socializing makes it all worth while.”
Adapt and Modify
It’s important to accept your limitations. So, if your right foot hurts, don’t do something that hurts your right foot—maybe work on your core instead. You might not be able to do everything in an exercise or yoga class and that’s perfectly fine. “It’s heartbreaking to feel like a part of your body isn't functioning, but to make that productive and positive, you can spin it to, ‘Well, 97 percent of my body still works really well,’” Nobbe points out. “Take what feels good today and move it. And that actually might lead you to do more than you thought you could.
“The first few times I tried to exercise were nightmares,” admits Chancy F. “Eventually, I was able to get past that wall, and now, I have built up to being able to use a stationary bike and lift weights. This doesn't mean there aren't setbacks or days when I can’t, but I'm so much better than I was in the pain department.”
Joanna S. completed a marathon three years ago but knows she’s not able to do another one because the recovery is “too brutal.” Instead, she opts for yoga and stationary bike rides. “I do exercise most days because I feel worse if I don’t.”
Denise V. can also no longer run long distances. But she can do strength training, PiYo, stretching and walking instead. For Angela Z., jumping is out for now. “At one point, I was a wreck and could barely walk around the block or climb into my car,” she says. Now, she does Barre, Pilates, strength training, swimming, walking, and cycling. “Lots of physio [therapy], persistence, and PsA medication got me to where I am today.”
Let your limitations guide you to the exercise you are able to do. “If you love running and jumping but can’t do it anymore,” Nobbe says, “find something that gives you that same rush, that same pleasure, that same fun.”
Have a Workout Buddy
Both Nobbe and Brown recommend working out with at least one other person, whether that’s making a gym date with a friend, taking a group exercise class or hiring a personal trainer. “I have a trainer that works with me to find things to do to get stronger and healthier,” Arin P. says. “It’s making a huge difference.”
Brown says make sure your accountability partner is neither too harsh nor too coddling. “Someone that will hold you accountable in a way that feels loving and good.”
Cheryl G. found a like-minded group of people who love the gym, and are positive and supportive. “We stay in touch with each other about when we’re going. No guilt, no stress, just ‘I’m going, are you?’ ‘Need a lift?’ ‘See you there!’ It seems to build momentum.”
Start Small and Work Your Way Up
When you feel mentally ready to start moving, “start slow and build flow,” Nobbe advises. “Especially if it’s a new diagnosis, if you're coming back to exercise after a long time, or if you've had a big setback. Don't expect to be where you were before.”
“Two years ago, I was in a wheelchair,” Kay L. says. “My doctor told me to walk in waist-deep water. When I began, I could only walk 50 steps. I began taking Humira, lost 50 pounds and now walk 5,000 steps a day on land. Small beginnings make huge progress.”
If you’re unsure what exercise is right for you, Nobbe notes that the American Heart Association recommends 150 minutes of cardio per week (30 minutes per day, five times per week), while she recommends adding three more hours of strength training the “major muscle groups.”
“Cardio is essential and especially helpful for rheumatic conditions,” Nobbe points out. “It maintains cardiovascular health and helps prevent atherosclerotic (artery-related) conditions and heart disease. It’s anti-inflammatory and it helps with mental health. It can help flush out all toxins that can contribute to pain. It gets your whole system circulating, your blood flowing and your metabolism fired up.”
Cardio can be brisk walking, the elliptical, stair climbers, biking, dancing, running, HIIT classes, even the rowing machine. “It’s super low-impact but a great workout,” raves Ariane S.
Cynthia S. takes aquatic arthritis classes up to three times per week, though the chlorine can sting for some with cracked skin. “I shower immediately after the class and then slather on goat’s milk lotion, so I don't seem to have any issues,” she adds.
Eden B. has become a fourth-degree black belt in karate, even though she’s had a hip replacement, her right hand has poor mobility, and her toes are clawed. “It’s adaptive karate, at times, but I make it work. I have to wear dojo shoes so the pain is manageable in my feet. On bad days, I do home exercise or seated exercise. On the worst days, I do bed exercises.”
Rachel H. loves boxing now but also feels it’s “vital” to add strength training, CrossFit in her case. “Otherwise, my flares are a lot worse and longer lasting. I’m determined to not let this disease win, although, on bad days, it seems impossible. Just got to do what I can, when I can, and pray it doesn’t get much worse.”
Strength is essential to function, Nobbe insists. You cannot live a healthy, vibrant, vital life if you can't get up and down from a chair, if you can't go up a flight of stairs, or lift your child or grandchild. It can spiral out of control. If you think it hurts to move, you don’t move; then, all of a sudden, you really can’t move at all and you get very weak. “All of a sudden, the pain really accelerates and the function really declines. With chronic pain, it seems like the last thing you want to do is pick up a weight, but it's crucial. You have to have a strong body to get around.”
Work on Strength
There’s a lot of misinformation about what strength training is and that it’s harmful, she adds. You won’t get “huge” Arnold muscles from lifting weights. You don’t have to pick up an Olympic barbell and throw it over your head tomorrow. Strength training could mean core work, yoga, kettlebells, medicine balls, sandbags, resistance bands, and squats. “The workout needs to fit the person,” says Nobbe.
The physical benefit of strength training is obvious, but the psychological benefit is that you will feel like Superwoman or Superman. “You really feel the vitality of your body,” Nobbe says. “It's like, ‘Wow! If I can do this, what else can I do?’ It's very empowering.”
Take It Day by Day
Use your body’s ebbs and flows to help you decide what exercise you’re going to do each day. If your pain levels are pretty low and you’re not in a flare, maybe that’s the day to go to the weight room. But, if you’re sore from the last workout, or if you're having more pain than usual, that might be the day to get in the pool and do some laps, or get on the bike and flush out those toxins. “Listen to your body, and kind of cross-train, in order to optimize.”
Suzy H. works out with weights twice a week with a trainer, uses the elliptical machine twice per week, and uses the treadmill twice per week. She walks her dogs every morning and she gardens. “I had to work up to this. Some days, it’s hard and I have fatigue issues. Overall, I have found the more I work out, the better I feel. I still have pain, but it’s reduced. I have greater range of motion and a cheerier attitude.”
Eden B. agrees: “I feel you have to keep moving, no matter how little, to stop from getting stiffer, which leads to more pain.” She adds, “Keep doing what little you can and build it up, warriors! The only thing that stops me is me.”
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