Rheumatoid Arthritis Support Group
Rheumatoid arthritis is a chronic, inflammatory, multisystem, autoimmune disorder. It is a disabling and painful condition which can lead to substantial loss of mobility due to pain and joint destruction. The disease is also systemic in that it often also affects many extra-articular tissues throughout the body including the skin, blood vessels, heart, lungs, and...
Because of an issue not related to RA, my family doctor and I agreed that I should do a round of physical therapy. Since I was going anyway, he also agreed to write a second scrip for therapy for my RA-swollen hands. (The actual scrip was necessary for insurance purposes.) The problems with my hands are certainly not overwhelming at this point, other than the fact that they're MY hands, and I'm sure most of you understand what I mean.
The physical therapist has turned out to be a fantastic ally in my RA journey. Perhaps I was especially lucky since her sister has RA, so she gets it. Like most PT's I've met, her approach is knowlegable and practical. Like many of you, especially new posters, I've wondered if I should exercise / work when I hurt. If I don't, will I lose mobility and gain more weight, which is a post-menopausal issue for me? If I do, will I risk injuring joints further?
We talked about those concerns in depth, and her honesty was refreshing. I will not detail her suggestions for me because we are all different, and the advice she gave me may not be applicable to others. But as a result of my sessions with her, I have a better understanding of RA in general, I have a better ability to assess what's going on in my own body at the moment, I have some pre-emptive exercises to strengthen muscles that I will appreciate more if I have further deterioration, I have a few simple things to do to maintain mobility, I have a few things I can do once a week or so that might give me some advance notice if I'm beginning to lose mobility. I have a better sense of when to push a little and when to back off. My rheumatologist is wonderful - it's not like she's been negligent or hasn't answered my questions. But a physical therapist just looks through a different lens.
Our copay is very high and I forgot to become independently wealthy (it's always on the to-do list but never gets done) so I let her know upfront that I wouldn't be able to do too many sessions. I told her I definitely have skin in this game and I'd be very faithful about following her recommendations - I didn't need to pay to have someone watch me do reps at the PT office that I could do at home. She agreed that I could use my phone to take a video of her demonstrating the various stretches and things she suggested so I'd be sure to get things right, and we're going to touch base once a month or so for a bit, which fits my budget.
I have learned over and over again in my pre-RA life that pre-emptive physical therapy is critical, perhaps expecially for people like me who are not naturally athletic or graceful. If you can make it happen, I'd strongly encourage anyone on the RA train to find a good PT before you get to a critical point. It also feels good to know I'm taking a pro-active step. Good luck to all!
But what DMARDS are you on?
I've always said that movement is most important when you have RA. Many of us understand that but don't know exactly what to do or how to do it or how much..... And that's why a PT is great.
Along those lines, an occupational therapist can also be of great help, I understand.
Nice going, Katie.
I chart everything I do, so I can see the gaps and be more consistent. It's great to have a good set of personalized exercises, but you have to do them for them to be useful. Just talking about myself right now.
I hesitate to describe the exercises I've been prescribed in too much detail, only because the PT had the skills to assess my starting point, and yours would be different. I'm sure there's things she did not suggest because they'd be too much for me right now. But I can tell you about one or two that anyone can do to their own comfort level.
She asked me to hold my hand palm up as if I'm holding an apple, with my fingers cupped. Wrap a rubber band around the outside of your fingers, and gently open your fingers and bring them back to the starting point (expanding the band as you go). A lot of our daily activities use the opposing muscles, the ones you'd use if you were squeezing a ball. This helps the other ones, since you're applying pressure in the other direction. The strength of the rubber band determines the difficulty.
She gave me clothespin and told me to pinch it open between my thumb and forefinger. Easy. Then the thumb and middle finger. Sure. Thumb and ring finger? Not so good. Thumb and pinkie? Oh, crap. If I had been able to do this really easily, she said I could have added a rubber band around the clothespin to make it harder. I really like this exercise, because I can keep a clothespin by my comfy chair and do this while I'm watching the news.
And here's my favorite - this explains why I love PT's. In the last few years, I've become just a bit stooped. (Probably not RA related, I have some spine issues). I told the PT that I find it difficult to be mindful of this. If you were to ask me at any moment if I'm standing up straight, I'd say yes, because this feels normal to me now. But when I see photographs, I realize that oh, I'm slightly stooped forward, So how, I asked, can I work on this if I'm not aware of it? Her answer was simple, inexpensive, and effective: wear a lanyard. (Or a long scarf or long necklace.) If it lays flat against your chest, you're standing up straight. If it's swinging freely, you're leaning. I've been doing this for a week now and I can't tell you how many times i've caught myself leaning forward.
Now, I need to add that this young woman is very lithe and I've got significant boobage, which threw things off somewhat, but you just adjust to your own self. Stand against a wall and straighten yourself up and see where that lanyard is, and that's your goal. Adjust the length of it if necessary.
There's a muscle in my hip that's atrophied slightly because of my spine problem. It's affected my ability to do leg lifts when I'm lying on one side. Her suggestion was to put a can of tunafish on the floor in the kitchen and while I'm fixing dinner, bat it around like a hockey puck with the outside of my foot on that side. Later, I can try something a little bit heavier. Understand that this particular problem has by now involved x-rays and a nerve conduction test and an MRI.........but we're making it better with a can of tunafish.
Sorry this is getting so long. Just one more thing. I'm finding it very, very difficult to answer when my rheumatologist asks how I'm feeling. I was brought up to be functional and not whine and so on, and this inward reflection business is new to me. There's still a part of my brain that believes that if I just don't think about this, it will be easier. But at the same time, I know that I need to be vigilant, and self-assess, so that we can be sure I'm on the right meds. So, the PT gave me some checkpoints, like this simple one: touch the tip of your thumb to the top of each finger on that hand, one at a time. In my situation, it's really, really easy to objectively say if that's working or not. For me (not necessarily for others) this is something I can do quickly, measure objectively, and chart. So far, it looks like the 2nd-5th days after my weekly dose of MTX are better than days 1, 6 and 7. Seems like that's going to be good information to take back to the rheumatologist in a few weeks.
How lucky we are to have great PT's. Mine instilled the belief that no matter what I've got to keep moving.
we have a pt on this board. the guy from NY where the hell has he been? has like everyone left but nighshades?
i get the most out of the home stretches, the hot water arthritis pool, muscle building on a circuit - more than I do at PT, now. but I am thrilled you are enjoying. @katie significant boobage - oh for pete's sake you crack me up as usual Katie. you are a fresh voice of non whinage and non curmudegonage on this board.
depot
They are so random. I will start walking then my inner thigh gives out..?? I will get up from my desk at work and my feet feel like needles are in them. I will staple something and my hand gets a huge cramp and won't relax for a while.
So strange...
I say that because years before I found my wonderful PT Jennifer, I'd had knee surgery and was sent to PT before the stitches came out. I told the PT that I had RA and that I had to go slowly othersie I'd have a lot of inflammation. She kept pushing me and I finally said I was done. As I walked out I overheard her telling someone that I was lazy. On top of that, by nighttime two of my stitches popped open from the inflammation.
My orth surgeon hit the ceiling and I was later told that he raked the PT group owner over the coals.
So ask the PT: "How many RA patients have you successfully treated?"
Usually your rheumatologist's office has a group that they feel comfortable with.
I'm glad you have a trusted ally helping you. Very important. Keep the trust, for good or for bad.
I have had numerous PT experiences, and I'm sorry to say that I can't say that I've ever had a really good one. Some 20+ years ago, I had shoulder issues, found a doctor who gave me a choice of PT, acupuncture and massage. At this point in my life, I know very well I have rortor cuff tears, hich have scarred over badly, but at the time, I tried each therapy in succession. The PT was disaster, the acupuncture, which moved beyond shoulders, to address pain in feet and legs that developed as time passed, and which workd very well, up to the point where it basically quit working. Then, I dscovered massage, became a junkie and, ultimately, a trained and licensed therapist.
A post mortem on that expeience reveals that with massage therapy (lots of it), extreme dietary change and HUGE exercise changes brought be back to PLUS.
Years (I accidentally mistyped "Tears") later, I developed RA, which first manifested in my shoulders. My doctor suggested a form of PT called the Bowen Method (bust), so I tried massage, and that was disaster. After RA was under control, I was able to enjoy massage again, BTW.
PT has been another experience. I've had a knee replacement and a great toe MTO joint fusion, due to OA, but PT has been little help. Learn the exercise that are offered, but know your body, and what's best for you.
If you trust your PT, then forget anything I've said, except, pay attention and know your body.
Good luck