Working out with PMR
I'm a newbie to PMR and glad I found this forum. I have so many questions. I'm around the corner from 69 years old and was diagnosed on Dec 17, 2024. For months I kept thinking, I'm not stretching enough, I need to whip this by working out a little harder. My inner Rocky Balboa has always kept me in reasonably good shape through other geezerly challenges. Before tapering I was feeling great but now it seems whenever I have a great workout, later that day the pain ratchets up. My wife tells me to moderate but that's not in my psyche. Am I damaging things more by enjoying a good hard workout? Should I back down? Will I be sorry I push too hard?
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I was 69 when PMR started. I too worked out. I have lifted weights since high school. I have managed to build considerable strength but at 69 was finding my max workouts were gradually getting a little less. PMR is not considered a muscle wasting disease although inactivity can be. I started on a every day workout when PMR hit. There were days that I could not even lift the bar. This became much easier with prednisone. During the taper I just kept going. Some days were not easy. I switched to more of workout routine that incorporated every muscle group each day. This was more of 3 sets of warmup. I added weight as my strength increased. I believe this helped me get off steroids in 6 months. I think the exercise is critical to helping eliminate the inflammation. I cant say what your pushing to hard is. I know there will be days when it might be dangerous due to risk of muscle damage. Just take your own pace. Prednisone has a half life of 3 hours. It stays in your system about 10. Your body is going to feel the fatigue of tapering. Particularly later in the day. I used Dexamethasone which has a much longer half life. My advice is keep working out. Take your better days when you get them. Watch your diet on prednisone and rest when you need to. Coming out the other end will put you in a better much place. I am 73 now. I kept my every day workouts. Some strength returned but its not my 69 strength. I am happy these days to try and maintain what I have.
I'm 71 and have GCA and PMR. I started on 60 mg prednisone last July and added weekly Actemra injections in August. I'm currently at 9 mg prednisone. I've been a runner for almost 50 years, and I stretch and lift weights (nothing very heavy) every other day. There was a point in my prednisone taper where I was straining muscles in my legs without doing anything out of the ordinary or anything strenuous. One strain was bad enough to bleed internally. It healed up ok though. I stopped running completely for a while because I was afraid I might do permanent damage. That was when I was tapering down between 20 and 10 mgs a day. I restarted jogging again recently, and it seems to be going ok. Also I don't think I've lost any strength since I started treatment.
I've read that prednisone can be hard on your muscles. With me it seemed to make them less elastic or weaker. But hopefully I've gotten past that as I have continued to taper. Working out is good, but you just need to be careful and avoid strains. And as @tuckerp says take plenty of rest as needed.
I am a Physical therapist...9 mo history...managing this without prednisone...must take a daily dose of Diclofenac. I take a ton of supplements addressing inflammation, detox, and rebuilding the microbiome. Prior to PMR, I worked out every day in some way...walking 9 or 18 holes of golf, weight lifting, walking several miles, elliptical, bike, or swimming. For a period of time, I had to stop everything. Weaker I became. Slowly I am getting myself back. It is hard to get back the strength I had prior to all of this. I have found the greatest success with lots aerobic on the bike or elliptical for anywhere from 20- 4o minutes. My body likes HEAT....sauna, salt water baths, and steam room. Modified weight lifting is manageable after that on most days. Cannot do the weights I did beforehand. Shoulders are the worse. Squats I do, but it is often difficult to discern if I've made myself the normal muscle sore, or PMR sore. Every day is different. My advice...do not quit exercise. It is the most important part of the healing process, or you will simply get weaker. There is no question this disorder makes you weak....grip, gluts, shoulders, etc...You have to combat that with strength training as much as your body allows. I too have found if I do too much, I will be more painful. As I've gotten better, I can do more and more. Hang in there.
One thing that helped me get through my 2 occurrences of PMR was to keep a daily log of my level of pain when I got up and the dose of prednisone for that day. It also helped to note my level of activity and reinforced when I needed to be a little more moderate with my exercise. Like others have mentioned, exercise does play a part in getting through the PMR journey.
Before PMR, I was riding my bike for some good distances, two or three hours out on the road, a hard hour + on my indoor trainer. My stamina has gotten knocked back with this condition: I can’t generate the watts I used to, and I haven’t been able to ride with my usual Saturday group. I’ve become aware of a lower limit where pushing myself feels more like injury than training.
But my PMR seems to be subsiding after a year, and I’m feeling stronger again! Hoping to join that group ride again this spring. I agree with the others that exercise is critical, but you do need to be aware of your limits.
One last observation I’ve had reading comments in this forum: so many of us come from very active lives, and great fitness, into this unfortunate condition. I haven’t seen any studies, but I do find it curious.
I was diagnosed with PMR Dec. of 2023. My exercise mainly consists of walking and hiking. I did my best to go my typical 40-50 miles week during the entire ordeal. I always felt better alter a hike. I tried adding some resistance training recently and damn did that make me sore. I found it very difficult to tell the difference between the muscle soreness from the remmants from PMR/pred taper and the resistance training. My understanding is vascular inflammation is what leads to muscle pain. You would think that by increasing blood flow to those muscles during exercise should help speed up getting off prednisone but I really don't know. I am down to 1 mg pred/day and stopping the resistance training for now. I'll pick it back up once I'm totally off the pred, which I hope will be very soon.