Exercise and Lupus.

Exercise & Lupus

What is Lupus?

Systemic lupus erythematosus (SLE), or lupus, is a chronic illness of the immune system, a condition in which the immune system mistakenly attacks normal, healthy tissues including the skin, joints, kidneys and lining of the heart and lungs, causing ongoing inflammation and pain. Lupus can be well managed through a healthy lifestyle and most of the time individuals with lupus can live a relatively ‘normal’ and healthy life. Lupus is associated with periods of ‘flares’ and remission. ‘Lupus Flares’ can be triggered by UV rays from the sun, hormones, viral infections, and stress. Symptoms can range from mild to severe and can include joint pain, fatigue, skin rashes, headaches, and organ damage. Symptoms can come and go, and it's often hard to know when and how lupus will strike. When the disease gets worse and symptoms develop, it's called a flare.

Due to the unpredictability and seriousness of this disease, people with lupus often face a difficult problem about the question of EXERCISE?.

“Can I exercise?? What kind of exercise can I do?? And how much can I do”??

Regular exercise, in general, can reduce stress, keep your heart & lungs healthy, improve muscle strength and joint support, prevent osteoporosis and increase joint range of motion. It’s especially important for people with lupus because it helps reduce stress as well as manage symptoms such as fatigue, joint pain and chronic inflammation. Since many people with lupus experience muscle and joint pain on top of intense fatigue, low-impact activities like walking, cycling, swimming, yoga, dancing, water aerobics and Pilates are all good choices for activities. However, everyone with Lupus is different, and so they need to become an expert of their own body. A good rule of thumb is not to do too much, but not to do too little. As with many other aspects of living with lupus, moderation is the key to success. People with lupus should plan their exercise appropriately and seek expert advice from their specialists and GP’s and an Exercise Physiologist. Exercise is good for people with Lupus, but unsupervised exercise or too much exercise, too fast, can harm their health. It is important that the whole health care team work collaboratively with the individual to provide a safe individualised exercise program that will help manage the disease and maximise their quality of life.

How can an Exercise Physiologist help with this population?

An Exercise Physiologist is a health professional who is trained to prescribe evidence based exercise to general populations AND to clinical populations who have any form of chronic disease and/or pain of a musculoskeletal, neurological, cardiopulmonary and/or metabolic nature (such as Osteoporosis, Multiple Sclerosis, Lupus, Hypertension, Diabetes and more). An Exercise physiologist can educate, inspire and empower people with Lupus to take control of their health through exercise. An Exercise physiologist will be able to work collaboratively with the whole health care team and provide an individualised exercise program that will assist the individual in both their recovery & management of the disease, help prevent ‘flares’ from occurring and maximise their quality of life. An EP will provide initial and follow up assessments and prescribe the appropriate frequency, intensity, type and time of exercise for the individual, as well as make appropriate modifications dependant on the symptoms of the individual. This is important because recommendations and modifications of exercise for the general population are not the same as for people with lupus.

Top tips for exercising with Lupus

Listen to your body. Exercise when your symptoms are minimal. It is important for to be an expert of your own body and know what you can tolerate. If your body is not feeling up for it, then rest is the key.

Plan your exercise appropriately. Try and perform exercise on a day/time when you know you can get an adequate rest afterwards. Physical stress and exhaustion can trigger flares so it is important to ensure your body is getting a good recovery. Fatigue can be a problem for people with lupus, so it’s important to pace yourself during exercise. It’s okay to take breaks and rest accordingly, but don’t give up altogether.

Vary your exercise. Try & get a complete range of exercises into your weekly routine to ensure you are utilising all systems effectively. Using different muscle groups and various body systems on different days can help your full body get a regular workout without overdoing it on one particular day. i.e. Cardiorespiratory (walking, bike, swimming) for good heart & lunge health, Strength (weights, hip walking) for good muscle & bone health, Mobility (yoga, stretching) for joint range of motion, & joint support, and Relaxation (mediation, rest) for stress & overall wellbeing.

Think carefully when exercising outdoors. Avoid outdoor exercise in the sun (particularly during high UV time from 11am-4pm in summer) because sunlight can trigger flares. Cover up by wearing a hat, long-sleeved shirts, and long pants, and use sunscreens with a sun protection factor of at least 15 if you walk/run or bike outdoors.

Start gradually and build up slowly. Starting with too much or increasing too quickly can bring on symptoms. Use the 10% rule to gauge how much to increase, that is, increase the duration and intensity of your workout by 10% per week. For example, increase by one minute if you walk for 10 minutes. Again, remember that each day may feel afferent for you so again it is important to read your body and have adjustments made accordingly.

Summary

Lupus can be well managed and most of the time individuals with lupus can live a relatively ‘normal’ and healthy life. “Lupus Flares” may be associated with a variety of triggers and symptoms and so it is important that the whole health care team works closely with the individual to manage their symptoms and minimise the risk of flares. Between these flares the individual may feel well and be symptom free but it is important that they continue to listen to their body and to have close communication with their health care team.

Living with this disease myself and being an Exercise Physiologist I have equip myself with extensive knowledge about the disease to be able to manage my condition and maximise my quality of life. The four keys to my recovery have been appropriate and structured exercise, proper nutrition, limiting stress by having a good work/life balance and overall having a positive mental attitude.