The Best Exercises for Psoriatic Arthritis and Psoriasis
Sweaty skin, itchy plaques, self-consciousness—there are a lot of reasons exercise may end up on the back burner when you have psoriasis. Even more so if you’re also dealing with joint pain, fatigue, and stiffness related to psoriatic arthritis.
But taking steps to prioritize exercise can help improve your overall health and may even positively affect your psoriasis or psoriatic arthritis symptoms.
Why Is Exercise Good for Psoriatic Arthritis and Psoriasis?
While scientific studies about the benefits of exercise for psoriasis and psoriatic arthritis have been rather small or limited, “we know in real-world practice that [exercise] helps,” says Saakshi Khattri, M.D., a board certified dermatologist and rheumatologist and assistant professor of dermatology at the Icahn School of Medicine at Mount Sinai Hospital, in New York City.
Exercise can help you:
- Reduce joint pain and stiffness and improve bone health
- Strengthen muscles
- Maintain joint function
- Reach and maintain a healthy weight
- Improve sleep
- Boost energy
- Improve mood and reduce symptoms of anxiety and depression
- Lower the risk of related health conditions, like heart disease or Type 2 diabetes
- Improve balance and reduce fall risk
- Boost overall health and longevity
- Improve quality of life
Exercises for People with Psoriasis and Psoriatic Arthritis
You can gain the most health benefits by incorporating a variety of activities into your regimen.
Flexibility and Range-of-Motion Exercises
“With psoriatic arthritis, you can have inflammation and stiffness that comes and goes as the disease flares, and oftentimes in the morning, people are feeling stiff and uncomfortable,” says Maura Daly Iversen, a doctor of physical therapy and dean of the College of Health Professions at Sacred Heart University, in Fairfield, Connecticut. “So I often recommend that patients start their morning by doing range-of-motion exercises in bed to move joints through their full range, then continuing with gentle range-of-motion exercises as they're taking a warm shower to help to loosen up the joints.”
Range-of-motion activities include stretches and motions that help get joints moving and prepare them for exercise. For example, yoga and tai chi incorporate range-of-motion stretching, strengthening, and coordination. These activities help keep joints flexible, alleviate stiffness, and improve joint function.
Range-of-motion and flexibility exercises may also help improve balance and body awareness, which is an understanding of how your body is positioned and moving, as well as sensations you’re feeling. Body awareness helps with improving posture, stability, and preventing injury. It may even help with managing chronic pain, according to one study.
Try incorporating gentle stretches or flexibility exercises into your routine most days of the week, and hold each stretch for about 20 seconds. “After 20 seconds, lean into it a little bit more before relaxing,” explains Iversen. “The idea with stretching is to go to the point where you feel some tugging, but no pain, hold it for 20 seconds—you should actually feel your muscles relax—and then stretch a little bit farther.”
“Exercise is very beneficial, not only for addressing the joint issues, such as stiffness and swelling, but it can also improve your cardiovascular health through aerobic exercise and endurance training,” adds Iversen, who is also a spokesperson for the American Physical Therapy Association (APTA). This is especially important, as both psoriasis and psoriatic arthritis can increase your risk of heart disease.
Plus, cardio has been proven to help people manage stress and reduce anxiety and depression.
“Aim for low-impact aerobic physical activity,” says Khatrri. Depending on your fitness level, this may include:
- Brisk walking
- Water aerobics
- Group fitness classes
- Gardening, mowing the lawn, or raking leaves
- Using gym equipment like stationary bikes, treadmills, or elliptical trainers
Strengthening your muscles can provide more support for your joints and reduce stress on the areas that are affected by psoriatic arthritis.
According to Khattri, strength training encompasses a variety of activities, such as:
- Weight training
- Resistance bands
“There are different ways of strength training,” adds Iversen. “You can use light weights and perform multiple reps for a slow-and-steady strength gain. If 30 reps of a lighter weight proves irritating to the joints, you can start with a slightly higher weight and perform 10 or 12 reps.” How much weight (or resistance) you should use can be determined by a strength assessment performed by a physical therapist before you begin your exercise program, she says.
If you have psoriatic arthritis, it’s important to work with a physical therapist who specializes in arthritis before you start a strength-training regimen, adds Iversen. They can prescribe the right amount of weight for you and instruct you on the safest and most beneficial ways to lift it.
6 Tips for Exercising When You Have Psoriatic Disease
General exercise guidelines recommend that adults do at least 30 minutes of moderate exercise five days a week. If you’re already active, aim to stick with your existing workout regimen. But if exercise is new to you, it’s a good idea to seek input from a physical therapist who can help you develop a routine that works for you.
“Someone with arthritis might not be at the moderate level right away, but you can build up to that,” Iversen says. “I might suggest beginning with mild exercise to get your body conditioned so that you don't overstress your muscles and joints, then eventually build up over time.”
1. Choose Timing That Works for You
Many people with psoriatic arthritis find that incorporating movement into their morning routine helps alleviate symptoms like joint stiffness. But that’s not the case for everybody. “Sometimes, it's beneficial to wait to engage in exercise till the late afternoon so that you have a chance for joint stiffness to subside and you feel more comfortable moving around,” Iversen says. Listen to your body, and consider working out at a time of day when you feel you have the most energy.
Others may benefit from breaking up their 30 minutes of activity into smaller chunks throughout the day. “For somebody that is really deconditioned who has psoriatic arthritis, consider exercising 10 minutes in the late morning after muscle stiffness has subsided, 10 minutes in the late afternoon, and then 10 minutes before or after dinner,” explains Iversen.
2. Select Activities Smartly
If the idea of working out in a public setting, like joining the gym, makes you self-conscious, feel free to skip it in favor of activities you’ll actually enjoy. Afternoon walks with the dog? Online classes? Working out with a friend? You’re more likely to stick with your fitness routine if it’s filled with workouts you have fun with.
Be sure to also consider how you’re feeling in the moment. “If you feel like your hands are in a real flare, you might want to think about using a stationary bicycle or elliptical, where you're not using your hands very much,” Iversen says. “Or if you're not quite in a flare, but you're just feeling uncomfortable, you might want to think about water aerobic exercise.”
3. Alternate Between Different Types of Psoriasis-Friendly Exercise
While it’s important to incorporate a mix of range-of-motion, cardio, and strength-training activities, you don’t have to squeeze them all in at once. It actually helps to change things up from day to day. “Alternate the type of exercise you do so you're using different muscle groups and you don't overstrain certain groups of muscles,” Iversen says.
4. Ask About Supportive and Adaptive Devices
“If psoriatic arthritis has progressed and there's joint derangement or changes in the joint alignment, then you may need some additional support,” Iversen says. A physical therapist can help you identify any products or devices that could help you work out more safely and efficiently. This could include proper footwear for a walking regimen, protective gear for safe bike riding, and/or cuff weights to use around your wrists.
5. Dress the Part
Sometimes psoriasis discomfort can get in the way of a workout. Wearing loose-fitting cotton clothing can help prevent irritating psoriatic skin. However, form-fitting, moisture-wicking attire can remove sweat, which can also cause irritation. Experiment to find out which type of clothing makes you feel most comfortable.
6. Listen to Your Body
If you experience soreness or your joints feel worse after exercising, that’s a sign you need to scale back. “It’s important to not stress the joints,” Khattri says. “The idea is to start low and go slow.”
Slowly increasing the intensity can improve your energy levels without excess fatigue and discomfort. It can help to schedule a day of rest in between your workout days.
The American Heart Association recommends at least 30 minutes per day of vigorous exercise. It’s okay to start at your current fitness level and slowly work your way up. For example, if you’re not exercising much, maybe starting with 10 minutes is sufficient; then increase to 15 min, and then to 20 minutes, and so on. That way, your body will adjust, and your endurance will increase. You can also work with a physical therapist to establish the most beneficial exercise plan for you.
And don’t forget to warm up your joints before—and cool down after—your fitness routine. “I think it's really important to take the time to do a true warmup before you exercise, your exercise period, and then a full cooldown so that your heart rate and blood pressure go back to baseline,” explains Iversen.
The bottom line? Start slow, listen to your body, and do what works for you—and you’ll be reaping the health benefits of psoriasis exercises in no time.
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