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Ask the Expert: Rebekah Wallach, Physical Therapist, Answers Your Questions About Exercising with Lupus

People in spin class

Q1. What should a physical therapist and patient be aware of? What should they look out for? Also, if you are recovering from an attack to the heart and dealing with shortness of breath, will cardio be hurtful or harmful?

A physical therapist and a patient with lupus must consider many things before beginning an exercise program:

  1. Patients should consult with a doctor before initiating any exercise program.
  2. Patients and therapists should be familiar with lupus medications and side effects.
  3. Therapists should be informed of all symptoms related to your lupus.
  4. Therapists should know your exercise history and tolerance.
  5. Your therapist will perform a thorough evaluation including your medical history, strength, range of motion, endurance, flexibility, functional status and balance. Your program will be tailored to the results of the evaluation.

What to look out for:

  1. Exercise should be pain free.
  2. Never work to or through fatigue or shortness of breath.
  3. Do not exercise during an acute flare up.
  4. Avoid high impact activities, such as running or jumping, to protect your joints.

I cannot advise a patient recovering from a heart attack. The exercise program should be prescribed and closely monitored by their cardiologist. No one should exercise through shortness of breath.

Q2. I often experience fatigue- would exercising make my fatigue worse or are their exercises I can do to relieve my fatigue?

Studies show that patients with lupus who perform cardiovascular exercise (walking, swimming, biking) 30-60 minutes three times a week for 12 weeks had reduction in fatigue. However, be sure not to exercise to fatigue and not during flare-ups. Consult with your physician before starting an exercise program.

Q3. I have a lot of joint pain and muscle stiffness- are there any exercises I can do to help with the pain and stiffness?

Gentle exercises like stationary bike, swimming and range of motion exercises often decrease joint stiffness and pain. High impact or high resistance exercises may increase complaints of joint pain. Speak with your physician before starting an exercise program.

Q4. What kind of exercise routine would you suggest for people with lupus? How often and how long should they workout?

Once medically cleared and stable from lupus symptoms, follow the general guidelines below for strength and cardiovascular endurance (consult your physician or physical therapist). Work up to these guidelines as tolerated:

To improve cardiovascular endurance: Warm up 5-10 minutes; perform 30 minutes of moderate level activity such as walking, biking or swimming; then cool down 5-10 minutes at least 3 times per week.

To increase muscular strength, power and endurance: Warm up first for 10 minutes. Then perform large muscle group resistance exercises of moderate resistance, with 8-12 repetitions for 1-3 sets, three times per week.

Q5. I like to be outdoors but the sun causes my lupus to flare. What kind of activities can I do outside?

Walking, swimming and biking are good exercises for the outdoors. Try to workout early in the morning or later in the evening when the sun is not as strong. During the summer and hotter season, find alternate exercise activities indoors. Consult with your physician before you start an exercise program.

Next week, Dr. Edward Craig, orthopedic surgeon, will answer your questions on shoulder pain. Write your questions below or email socialmedicontact@hss.edu.

Topics: Rheumatology
The information provided in this blog by HSS and our affiliated physicians is for general informational and educational purposes, and should not be considered medical advice for any individual problem you may have. This information is not a substitute for the professional judgment of a qualified health care provider who is familiar with the unique facts about your condition and medical history. You should always consult your health care provider prior to starting any new treatment, or terminating or changing any ongoing treatment. Every post on this blog is the opinion of the author and may not reflect the official position of HSS. Please contact us if we can be helpful in answering any questions or to arrange for a visit or consult.