Gym training

Welcome @goraneklund, You might find it helpful to read through the following related discussions where members have asked similar questions about PMR and exercise:
-- PMR Case Study with Remaining Questions as of 09-04-2025
https://connect.mayoclinic.org/discussion/pmr-case-study-with-remaining-questions-as-of-09-04-2025/
-- Muscle Weakness with PMR, can I resume working with weights?
https://connect.mayoclinic.org/discussion/weakness-1/
Here's a fairly small research study that also might be helpful.
-- POS0445 THE IMPACT OF REGULAR PHYSICAL EXERCISE AND NUTRITIONAL COUNSELLING ON BODY COMPOSITION AND DISEASE ACTIVITY IN POLYMYALGIA RHEUMATICA PATIENTS TREATED WITH ORAL OR INTRAMUSCULAR GLUCOCORTICOIDS: A PROSPECTIVE MONOCENTRIC STUDY IN SLOVENIA: https://www.sciencedirect.com/science/article/abs/pii/S0003496724155938

I'm 83 and my second flare up of PMR has been in remission for close to 7 years now. I struggle daily with muscle loss due to mobility issues but I still try to get in 30 to 45 minutes daily of various exercises. Both times my PMR was active I had to be careful not to overdo any kind of physical activity or my PMR pain would be much worse the next day. It was kind of a balancing act for me because exercise does help the recovery, just not too much. Just my thoughts as a patient.

Has your rheumatologist offered any thoughts or suggestions for exercise and building strength?

I've been in remission since 2022 and have worked out routinely before and after I got PMR in 2021. Since I only experienced pain while laying in bed, I was able to continue my pilates, swimming, yoga, and dancing throughout this, but I did notice that whenever I tried to increase my hand weights from 4 lbs. to 5 lbs., I would experience pain in my shoulders. I once had to start a small dose of prednisone to relieve the pain for a few days. This has happened twice to me! And it wasn't just sore muscles from lactic acid.

@janiceem
Thanks. I have just completed three weeks of cortisone treatment and haven’t noticed any pain in any muscles after gym training. I reduced the weights by about 25% to begin with and have stayed there. Maybe the pain will come back after I reduce the cortisone dose, now 30 mg per day. Thank for taking time to answer!

I'm a 69 year old male and have worked out 3-5 times per week since I was 16. I lift (not powerlifting, but lifting significant weights - bench, curls, lat pulldowns, triceps work, etc., etc., mixed in with leg workouts). My point? I have worked out pretty hard my entire life, including 45 minutes of hard cardio 5 times per week.

PMR disrupted everything. I was in so much muscular/joint pain that I simply couldn't lift heavy weights. Stationary bike was okay. But everything else hurt. Bad. I went on prednisone (20 MG per day) about four months ago. Night and day. I'm back to my old self. One more thing: Pre-prednisone, my muscles simply didn't respond. I never got "pumped." Now, I feel a little bit of the old "swole" quality. Don't get me wrong - I'm not Arnold Schwarzenegger. But you get the idea. It's nice to feel you muscles say, "Good work."

Two additional points/questions: (1) If I miss a dose, I feel it the next day. Also, I have switched things a bit: 15 MB in the morning. 5 MG with dinner. That seems to help the morning hand soreness that is a constant for me.
(2) Has anyone had a little bit of hand "shakiness" from the prednisone? I'm talking about minimal shakiness - the kind you might have after a third straight cup of black coffee (which I do NOT do).

Any comments will help me on my journey.

My training experience is very much like yours. 50 plus years of weightlifting combined with endurance sports, running, cross country skiing, orienteering, cycling. Since starting on predisolon I also miss the ”pump”. I have usually very easy to get the pump in my biceps but now it is gone. I also get a bit speeded after 30 mg prednisone in the morning. Not an uncomfortable feeling. Full of eager to start the day. I don’t think I would consider taking the pills later in the day since that would completely ruin my sleep. I do take Imovane (don’t know what it called in the US, a kind of benzo) before I go to bed but still have a hard time falling asleep and wake up too early. My Garmin clock complains evvery morning.

After one year on prednisone, which I am finally off thanks to Kevzara, my hands are not shaky so much as weak. I notice I drop small objects unexpectedly. I attribute this new reality to the fact that prednisone weakens muscles, which is also true for my legs and thighs. In general, my muscles are far weaker now than before I started prednisone.

@mjdcl57 I used to get shakey at higher doses of Prednisone. I'm at 5 mg now and don't have that problem.

@mjdcl57
Yes hand shakiness when above 15mg/day of Prednisine.
Hand pain every morning when I wake up..
I exercise and stretch my hands every day, and the rest of my body. But hands several times a day.

I have the standard PMR symptoms of course, but like many people I have a few not so typical pain, like hands and wrist.

Pre-Prednisine I could still get swole and do one hour cardio on a treadmill.
PMR mostly hit me in the hips. Crippled me actually, and that is when I decided I needed help and went to my PCP.
From 40mg/day in November 2025, then Kevzara starting in January 2026, at 30 mg/day. Today, I’m down to 2.5 mg/day of Prednisone.

I measure my PMR, by how my hips are feeling….especially sitting and when driving.

I do one hour of cardio 5-6 days/week followed by the same weights routine you described above and a lot of stretching. My daily workout takes 2+ hours. Truthfully, more like 3 hours/day.
I look forward to the swole and it really helps my lower back pain and shoulder rotator cuffs (a tear on both.)
Resistance exercising helps my shoulders, knees and lower back so much that it’s almost unbelievable.
It works me.

I eat food like it’s ammunition. My diet is strict. Like it or not, taste doesn’t matter, it’s a matter of what my body needs that takes priority.

Most doctors say exercise but gently.
But, I don’t. I look at it this way: the more times per day I can get blood to circulate carrying fresh oxygen, nutrients and medicines to every cell, and remove waste from every cell, then the faster and better I will heal.
Intense exercise does that for me.

Sleep, is critical. Eight hours/daily is a must, that’s when healing happens. (I had to take sleeping pills when I was on the higher doses of Prednisone.) Now, only as necessary.

I’m 69. PMR crippled me. Barely could get out of bed. Struggled to get off the toilet. Had to use a walker at home, but had to use a cane to see my PCP, because I couldn’t load a walker into my car and could barely drive to him.

I’m getting better every day.

Don’t feel alone. We all need support. Best wishes.

Randy

@stonewheel
Thanks for this, Randy! I too find that powering through the pain, no matter how bad, makes me feel better. The workouts are essential to my physical and psychological well-being. My workouts, like yours, are 2-3 hours. As I said, cardio, stretching, lifting, core work. Lots of water, too, of course.

A sauna after the workout seems to do worlds of good.

It's interesting how, when I was pre-prednisone, I simply couldn't get swole/pumped. Now that (pleasant) experience has come back.

One last thing I've taken up: I go to epsom salt immersion baths 1 to 2 times per month. Really seems to help, though the effects only last a day or a day and a half.

Thanks again! I really appreciate your comments and input.

Best to you!
Michael

@goraneklund

Just a comment about the sleep. I know what you mean. I'm sleeping okay, but have to take an Ambien or half a lorazepam to quiet things down. I don't like taking such things, but ...

I'm pretty lucky: prednisone has been a wonder drug for me, though I do notice some lower GI issues (I have more frequent bowel movements). Nothing awful, though.

Thanks again. This is such a tricky, sneaky, and weird affliction.

MC