Exercising might be the last thing you want to do — or feel able to do — if you’re experiencing aches and pains from psoriatic arthritis. But the fact is, cutting back on physical activity can lead to stiff joints and muscle weakness and make your symptoms worse.
“It’s a vicious cycle,” says Shailendra Singh, MD, a rheumatologist at Unity Health in Searcy, Arkansas, and board member of the Arkansas Rheumatology Association. “People who are hurting may avoid physical activity, but that’s what can help improve symptoms like pain and swelling so that you can move better.”
Exercise is also important because psoriatic arthritis can increase your risk of other health conditions, such as cardiovascular disease, diabetes, and obesity (which can put additional stress on your joints), according to the National Psoriasis Foundation (NPF). Regular physical activity can help lower your risk of developing these problems.
And, according to the American College of Rheumatology, people living with arthritis who exercise regularly experience less pain, have more energy, sleep better, and function better day-to-day.
“Exercise helps us produce natural painkillers called endorphins, which can be beneficial in chronic pain management,” says Dr. Singh.
If you experience a flare or have pain that prevents you from exercising, talk to your doctor about ways to manage your pain so that you can be physically active, says Singh. “Exercise in conjunction with other treatment is an important part of psoriatic arthritis management,” he says.
Smart Exercises for Psoriatic Arthritis
Once your doctor gives you the green light to get moving, work with a physical therapist — preferably one who has experience working with people who have arthritis — and start slow. Remember not to overdo it, and to listen to your body, says Nilanjana Bose, MD, rheumatologist at Lonestar Rheumatology in Houston. Some exercises to try that are particularly good for psoriatic arthritis include:
Swimming
Why It’s Good for Psoriatic Arthritis
Swimming is one of the best exercises for people who have psoriatic arthritis because it helps you strengthen your muscles and maintain flexibility without having to put any weight-bearing pressure on your joints. In swimming and other water-based exercise programs, you can build muscle strength without putting too much stress on your hips, knees, or spine, according to the NPF.
Tips for Swimming With Psoriatic Arthritis
If your shoulders or upper body are particularly affected by psoriatic arthritis or you can’t swim, you can still get the benefits of water therapy by walking in the pool (try walking forward, backward, and sideways in waist-deep water). “Join a gym or the Y and find a water therapy class or instructor,” says Dr. Bose.
You might also try to find a heated pool, since warm water can improve blood flow and help reduce inflammation and reduce tightness and stiffness of muscles and tendons, says Singh.
Safety Tips
If you don’t have good motion of the spine or have other upper-body issues, swimming might not be the best option, says Singh. Your doctor may advise other types of hydrotherapy.
If you have open or cracked skin, which can occur with psoriasis, avoid the water until you’re healed. “Your skin is your main line of defense against infection,” says Singh.
And don’t forget to take breaks and drink water; you may be working out in water rather than dry heat, but you still need to hydrate!
Walking
Why It’s Good for Psoriatic Arthritis
Walking is easy to do and is great for building muscle and maintaining flexibility in your joints. It’s also a weight-bearing exercise, which means it helps strengthen bones, and is great for weight loss. “Studies have shown that weight reduction leads to faster improvement in disease activity in people who have psoriatic arthritis,” says Singh.
Tips for Walking With Psoriatic Arthritis
The NPF recommends starting with short walks, about 10 minutes each, then gradually increasing to a half hour and then an hour. Wear comfortable shoes with good support and use gel shoe inserts to reduce stress on your feet, ankles, and knees, especially if you have stiffness or pain in those areas.
Safety Tips
Be sure to stay in well-lit areas and avoid uneven ground to reduce your risk of falling, says Bose. And don’t walk on steep slopes, which can put too much pressure on tendons, adds Singh.
Finally, don’t overdo it when it comes to walking. “Too much walking can be hard on the knees, ankles, hips, and feet,” says Bose.
Elliptical Machine
Why It’s Good for Psoriatic Arthritis
It’s a low-impact cardiovascular exercise that’s great for all joints, says Bose. You can adjust the intensity of the machine so that the settings work for your individual needs.
Tips for Using the Elliptical With Psoriatic Arthritis
Start slowly and gradually increase the speed and resistance of the machine, says Singh. You can also try not using the handles to help build up your core muscles, but if balance is an issue for you, stick with using the handles. And as with other workouts, be sure to take breaks as needed and stay hydrated.
Safety Tip
Consult with a certified trainer or physical therapist to make sure you’re maintaining proper posture and performing movements correctly to prevent strain on your back or feet.
Strength Training
Why It’s Good for Psoriatic Arthritis
Strength training can involve working out with free weights, machines, or resistance bands to help you build and maintain muscle mass and strength. Strong muscles help reduce stress on your joints and contribute to better overall function in people with many forms of arthritis, according to the ACR.
And according to the Bone Health and Osteoporosis Foundation, strength-training exercises can also help build and maintain bone density. This is important for individuals who have psoriatic arthritis, because research has shown that some people living with the condition may be at increased risk for osteopenia and osteoporosis, says Bose.
Tips for Strength Training With Psoriatic Arthritis
If you’re new to strength training, you may want to work with a personal trainer who can help develop a routine that’s tailored to you. “It’s best to have a trainer who specializes in psoriatic arthritis,” says Bose. If strength training isn’t done correctly and safely, there can be a chance of injury to muscles, tendons, or joints.
Safety Tip
If you’re experiencing a flare, avoid weight training, says Singh. “It can lead to damage to the joint if it’s inflamed,” says Singh.
Stationary Bike
Why It’s Good for Psoriatic Arthritis
Cycling is a good cardiovascular workout that’s fairly low-impact, says Bose.
Tips for Biking With Psoriatic Arthritis
Start by doing 10 to 15 minutes a day and be sure to take breaks, stretch, and cool down, Bose suggests.
Safety Tip
You should check with your doctor before getting on a bike if you have any foot pain. Inflammation of the feet and ankles that restricts movement is common in people who have psoriatic arthritis. If you’re experiencing pain and swelling in your ankles, heels, or other areas of your lower extremities, biking might not be recommended for you, says Singh.
Yoga
Why It’s Good for Psoriatic Arthritis
In yoga, you use controlled movements, stretching, and deep breathing to strengthen muscles, improve range of motion, while also gaining a feeling of relaxation. “It can increase flexibility and stretch muscles, and has a strong mind-body component,” says Bose. “It has been shown to reduce stress, which plays a big role in any disease process.”
While there isn’t a lot of solid evidence that yoga can help psoriatic arthritis specifically, research has shown that it can be beneficial for people who have osteoarthritis or rheumatoid arthritis (RA).
One research review found that yoga may be effective for improving pain, movement, and stiffness in people who have knee osteoarthritis. Another review found that yoga may help improve physical function and disease activity in people who have RA.
Tips for Doing Yoga With Psoriatic Arthritis
Yoga poses run the gamut from fairly easy ones that most people can do, to more advanced ones that require significant strength and flexibility.
For many individuals who have psoriatic arthritis, “gentle” yoga classes or classes geared toward people who have arthritis may be most appropriate.
In class, share any information about poses you should avoid or other limitations with your certified yoga therapist or teacher.
Safety Tips
Find a good yoga therapist. “With yoga, it’s important to have an instructor for your practice,” says Singh. “Incorrect posture in yoga can harm rather than help.” Look for a practitioner who is affiliated with a hospital or healthcare center or find someone who is affiliated with the International Association of Yoga Therapists.
The Arthritis Foundation recommends talking to your doctor before starting yoga to ensure that it’s right for you and to discuss any modifications that may be necessary for you to do it safely. They also advise listening to your body and avoiding poses that cause pain or discomfort in your joints.
Tai Chi
Why It’s Good for Psoriatic Arthritis
Tai chi is a centuries-old mind-body practice involving gentle movements and postures that can be modified to be done while walking, standing, or sitting. These slow and gentle movements are performed with a mindfulness toward mental focus, breathing, and relaxation. According to the National Center for Complementary and Integrative Health (NCCIH), research shows that practicing tai chi may help reduce stress and anxiety, improve balance, and ease back pain.
While research on tai chi and psoriatic arthritis is limited, a meta-analysis of seven tai chi trials found that a 12-week course of tai chi may be helpful in improving arthritis symptoms and physical function in people with osteoarthritis.
Another more recent review of 11 studies showed that tai chi, when used safely and in tandem with other treatment, can help improve posture control, balance, and walking ability in older adults who have knee osteoarthritis.
In short, tai chi potentially offers a myriad of benefits for individuals who have psoriatic arthritis with few downsides. “It promotes flexibility, strengthens and stretches muscles, and gives you mind-body benefits,” says Singh.
Tips for Doing Tai Chi With Psoriatic Arthritis
As you practice slow and controlled movements, be mindful of your breathing and relaxation. Follow a program developed for people with arthritis to avoid any moves that could hurt your joints, the Arthritis Foundation suggests.
Safety Tips
According to the NCCIH, tai chi is a relatively safe practice with little risk for serious injury. That said, tai chi instructors are not required to be licensed, and the practice isn’t regulated by state or federal authorities, so you may want to ask your healthcare provider or local hospital to recommend a tai chi teacher. And be sure to tell your doctor about this or any other exercise you incorporate into your psoriatic arthritis management.
Should You Exercise if You Have Flares?
The answer is yes, but carefully and while working with your doctor. Depending on what areas of your body are affected and how much pain and inflammation you’re experiencing, certain exercises may be better than others. Work with your doctor to manage your pain and come up with a plan to get you back to being physically active as much as possible.
Above all, it’s essential that you keep moving, and don’t stop once you feel better. “I have patients who say, ‘I was doing well, so I stopped exercising,’” says Singh. “But if you do that, you will lose the benefit you gained.” Bottom line: “It’s important to remember that exercise is preventive; it’s not treatment,” says Singh.
Samir Dalvi, MD
Medical Reviewer
Samir Dalvi, MD, is a board-certified rheumatologist. He has over 14 years of experience in caring for patients with rheumatologic diseases, including osteoarthritis, rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, lupus, and gout.
Katherine Lee
Author
Katherine Lee is a writer and editor who specializes in health, science, and parenting content. She has written for Verywell, where she covered school-age parenting, and worked as an editor at Parenting and Working Mother magazines. She has written and edited numerous articles and essays on science, parenting, and children's health and development for What to Expect, the American Association for the Advancement of Sciences, the American Psychological Association, and Newsweek, among others