Working out with PMR

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.

I find this curious, too, Leeta, but maybe it's because with other conditions that don't involve muscles, we don't think about physical activity.
I had a similar experience to yours. Hit with PMR symptoms big time in Dec '23. Had been working out since my 20's, now in my 70's, doing both strengthening w/free wgts and cardio (usually step). Stopped all activity due to pain in legs and shoulders. Someone described it as "rigor mortis." I agree. Also developed Baker's cysts.
In about 8 mos, the legs got better. I was thrilled and astounded. Shoulders still an issue but improving greatly. Never took steroids. I don't know what will happen now, but we'll see. I'm just grateful. Started walking for 1/2 hr this summer every other day and strengthening work in between.
I did notice my overall cholesterol number shot up right after I'd ceased exercising for about 6 months.
I owe my life in many ways to working out. It has had disadvantages too, for sure, but the good greatly outweighs the bad.
I want to have an ultrasound done of my shoulders to see how much I can/should be doing. Do have torn rotator cuffs, but worse in dominant shoulder. Last US showed surgery not needed....yet.
Unfortunately, just as I was getting up to speed, I decided to do a step routine for the first time in over a year and fell off.
Broke my wrist, so in a cast now and very upset. Really setting me back again.
I have about 2 more wks to go and it's been really tough. But....onward!
May you stay in full remission for the rest of your long and healthy life!!

I’m 62 years young and have worked out since my early 30’s. I do 45 mins cardio on my Peloton cycle and weights or Pilates classes after…4 days a week.
I was diagnosed with PMR in July of 2020 and have yet to successfully taper below 5mg, without the pain returning. Most recently in October of 24, I was down to 2.5mg and very liveable discomfort….until I began having pain in my right clavicle. I thought initially I had injured it, but I never had any recollection of doing so. After seeing my primary care, she said to give it another 6 weeks and stop doing weights and Pilates. It became worse during this time period and spread to my left side as well. I continued to only do my cardio, but no improvement. I was using a heating pad all day and finally decided in January to go back up to 10 mg on my prednisone. By day 3, I was seeing improvement and on day 5 it was all but gone.
I made an appointment to see my Rheumatologist, as I needed a refill on my steroids and she said it wasn’t my PMR? I had read online, that it’s not as common, to present in the clavicle…but it can. She still said no, and wants me to begin Kevzara, which I’m very opposed to. I’ve never had anything but normal markers, and Kevzara studies don’t show it working on people with normal inflammation markers. For now she has refilled my prednisone. I began to taper down from 10mg last week and guess what, my clavicle area is slowly beginning to have discomfort. I’m going to taper slowly, and hope it is a tolerable discomfort as I do.
I’m not going to stop working out, as it’s what keeps me mentally happy. I don’t really experience that much extra soreness from doing so.
What I will mention, is back n Fall of 2021, my Rheumatologist said that she has never seen so many cases of PMR in her career, since we all began vaccinating against Covid. I wonder if they are looking into that?
Thank you all for your support!❤️

That is very interesting.

I'm so sorry about this issue with your clavicle. Have you had an ultrasound or MRI? I would definitely recommend your requesting one or both. The US can detect inflammation, injury, etc. It's worth it to know what's going on so you can move forward and got off steroids.
From what I'm reading, and I try to go for trustworthy sources, PMR can present in the clavicle.
I don't know a thing about Kevzara except I have seen it mentioned out here along with Actemra.

Very much hope you continue working out but not pushing too hard. Take care.