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RA and Osteoporosis: Exercising for Bone Health

It's an unfortunate fact of life at menopause: your risk for osteoporosis goes up. If you take corticosteroid medications for your RA, you have even more reason to be concerned about your bones. Although corticosteroids fight inflammation that threatens your joints, they can also cause bone loss. The good news is that regular exercise and other treatments can help counter the bone-damaging effects of menopause and steroids.

How Exercise Helps Bones

Just as your muscles grow stronger when you use them, your bones grow stronger with exercise.The best exercises for building bone are weight-bearing exercises, or those that make your muscles work against gravity.

High-impact exercises or some movements might harm damaged joints, so it's best to always ask your doctor or a physical therapist about the right exercise for you. Water exercise, for example, is a favorite with many people with RA. And although it takes pressure off sore joints and can help increase flexibility and minimize pain, water exercise doesn't help build bone. That doesn't mean you should stop water exercise if you like it -- just that you'll need to add some other exercise for stronger bones.

You may want to try these exercises to strengthen bone:

Walking. Walking is easy and cheap. A regular walking program can help strengthen the bones of your hips, which are especially vulnerable if you fall. You can walk in any weather -- whether you hit the high school track or your local mall -- and you don't need any special equipment aside from comfortable clothes and good, supportive pair of walking shoes. To get the most benefits, you'll need to walk about 30 minutes each day. But you don't have to do all 30 at once. Three 10-minute walks work just as well.

Strength or resistance training. With some guidance, strength training is a safe way you can help prevent osteoporosis or stop it from getting worse. You can do strength training exercises with free weights, weight machines, or elastic exercise bands. Strength training doesn't have to be expensive -- if you can't join a gym, use inexpensive weights or bands from a discount store. Even soup cans from your own cupboard will work. Aim to do strength-training exercises two to three days per week. Like walking, these exercises can be spread throughout the day. A physical therapist or trainer with experience working with RA can get you started.

Yoga. Although some women with RA love yoga because it helps relieve stiffness and tension, some yoga postures can also help your bones. In one study, researchers found that yoga appeared to slow bone loss in women 50 to 60 who practiced high-impact yoga three times a week. If you're interested in trying yoga, talk to your physical therapist or find an instructor who has experience teaching people with arthritis. Once you know the postures, you can practice at home. 

Stationary cycles and elliptical machines. If you decide to join a gym, look for one with exercise bicycles and elliptical machines. If your back and hips are affected by RA, a recumbent bike – where you're in a reclining position, with your weight spread over your back and buttocks – may be easier than an upright model. And the elliptical trainer gives a good workout while being easy on the knees. Mix up these exercises with walking and other exercises.

Beyond Strong Bones

By building stronger bones, exercise can help you reduce your risk of fractures. But that's not all exercise does. It strengthens muscles that support the joints, improves cardiovascular fitness, relieves pain, improves sleep, reduces depression, and improves balance and coordination.

WebMD Medical Reference

Reviewed by David Zelman, MD on March 18, 2013

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