12 Aug Strength Training for Inflammatory Conditions
I firmly believe that quality strength training is an absolute must for ALL populations. This view is generally supported by anecdotal evidence and an ever-growing body of research. However, there’s one population group where the benefits of strength training are not as well researched – those experiencing inflammatory conditions.
While the benefits of strength training for mechanical arthritic conditions (like osteoarthritis) are more well-known, the benefits for those with inflammatory conditions, like rheumatoid arthritis, are somewhat limited.
Having coached many clients with inflammatory-based conditions, I wanted to delve deeper and educate others on just how important strength training is for this population.
So, what is inflammation?
Your immune system is designed to fight off viruses, bacteria, and infection. Inflammation is one of the body’s natural defenses against these invaders, and is also a key process involved in adaptation to training stress.
Sometimes, though, your immune cells attack your body by mistake or in excess relative to the given stimulus to the body
What are inflammatory disorders?
Inflammatory disorders occur when the immune system attacks the body’s own cells or tissue. Essentially, the body triggers an inflammatory response without any invaders being present. This causes an imbalance in cytokine profiles. Cytokines are molecules that aid cell-to-cell communication in immune responses. They stimulate the movement of cells towards sites of inflammation, infection and trauma.
Some examples of inflammatory disorders include psoriatic arthritis, rheumatoid arthritis, gout, coeliac disease and ankylosing spondylitis.
Symptoms vary, but often include localised inflammation, pain and stiffness. Additionally, people may experience states of severe fatigue, challenges in maintaining full time employment, withdrawal and isolation from socialisation, depression and anxiety.
So, how can exercise help?
Before moving on, I must state that these conditions MUST be managed with medication under the guidance of your GP and specialists. I am merely going to comment on the role that strength training can play when it comes to managing these conditions.
Common issues and how strength training can help
Many inflammatory disorders have large crossovers in their symptoms. These are some of the more common issues associated with these conditions, and how strength training can play a key part in management
1. Inflammation and pain
Strength training promotes better anti-inflammatory profile balance and physical performance simultaneously. It increases the production of anti-inflammatory cytokine IL-10, which is key for a positive inflammatory profile.
2. Medication side effects
Medication plays a key role in the management of inflammatory conditions. The most common types of drugs used are Non-Steroidal Anti-Inflammatory Drugs (NSAIDS). These drugs can have many side effects, but I’m going to focus on their negative impact on tissue remodelling.
Several studies have demonstrated that the use of NSAIDs may lead to reduced tensile strength of tendons, which increases your risk of injury. Clinical evidence also indicates that NSAID therapy can impair bone fracture healing and tendon-to-bone healing.
So, what does strength training do?
Strength training increases the tendons ability to absorb and utilise tensile forces. It also increases the strength of the muscles surrounding the tendons and joints. This reduces injury risk and increases performance, not just in sporting pursuits but in life.
3. Joint and bone degeneration
There is greater risk of joint degeneration for those with inflammatory conditions. Strength training provides appropriate stressors to the skeletal system. This stimulates the body to increase bone density and significantly slows the decline in bone and joint health that comes with chronic inflammation and the natural processes of ageing.
4. Muscle wastage
With pain, fatigue and withdrawal from physical activity comes increased rates of sarcopenia (muscle wastage). While this does happen naturally as we age, lack of strength training and other disease factors significantly increases the rate of muscle loss. Strength training helps increase and maintain muscle strength across the life span. One study focusing on patients with rheumatoid arthritis found that high-intensity strength training increased muscle strength with no negative effect on disease activity or pain.
Fatigue is a disabling symptom of inflammatory diseases. It often hits hard for sufferers during flare ups. Strength training can significantly counteract these symptoms and improve self-reported fatigue and health. It does this by improving the bodies tolerance to load and the forces of gravity. This means that simple day to day tasks become that much less stressful for your body, thus conserving energy stores.
6. Isolation from socialising & mental well-being
With pain, fatigue and other challenges associated with inflammatory disease can come a range of mental health problems. These are just as important as the physical ones already mentioned. Socialisation, autonomy, self-mastery & self-efficacy all play critical roles in positive mental health, and these can be stripped away for those managing inflammatory conditions. Strength training provides everyone, not just this population group, the opportunity meet these needs.
What About When I Have a Flare Up?
Unfortunately, there still will be occasions when you have flare ups. But the stronger and healthier you are, the less severe, frequent and overwhelming your flare ups will be. Removing yourself completely from strength training won’t help you in the long term.
Getting the right advice
I can’t overstress the importance of getting the right advice. Talking to an allied health professional, like an exercise physiologist or exercise scientist is a great place to start. It’s important to work with someone who understands your symptoms, monitors your fatigue and tailors your exercise program accordingly. The sooner you get back to moving, the better you will feel.
Written By David Smith. David is an Accredited Exercise Scientist and the Co-founder and Head Performance Coach at Absolute Health & Performance. He has 15+ years’ experience both in Australia and internationally in professional sports, multidisciplinary sports medicine centres and fitness centres.