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Podcast, Rheumer Has It

Rheumer Has It: How to Build Sustainable Exercise Habits With Arthritis

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Summary:

In this episode of Rheumer Has It, Cheryl Crow and Eileen Davidson are joined by Dr. Manny Ester, a researcher in physical activity behavior change, to bust common myths about exercise and arthritis. Dr. Ester explains why any movement counts, especially for people living with rheumatic disease.

Listeners will learn how to reframe movement as something personal, enjoyable, and adaptable, because sustainable behavior change comes from doing what fits your life, not from chasing perfect routines. The biggest benefits come from starting small, not from hitting rigid guidelines like 10,000 steps or 150 minutes per week.  

Episode at a glance:

  • Why movement matters (and what counts): How physical activity supports pain, stiffness, fatigue, mood, and mental health, and why movement doesn’t have to mean gym workouts, strict guidelines, or 10,000 steps to be beneficial.
  • How to move with arthritis – realistically: Practical guidance on starting (or restarting) movement during flares, fatigue, anxiety, or depression, including pacing, rest vs. movement, muscle soreness vs. joint pain, and why short “movement snacks” can be both effective and sustainable.
  • How to make it stick: Building lasting movement habits by keeping them personal, flexible, enjoyable, and supportive, plus a walkthrough of the free, arthritis-friendly Just One Move resource, including flare-friendly options and habit-building tools.

Medical disclaimer: 

All content found onArthritis Life public channels (including Rheumer Has It) was created for generalized informational purposes only. The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment.

Episode Sponsors

Rheum to THRIVE, an online course and support program Cheryl created to help people with rheumatic disease go from overwhelmed, confused and alone to confident, supported and connected. See all the details and join the program or waitlist now! 

Speaker Bios:

Manuel Ester

Manuel Ester is a physical activity specialist with expertise in physical activity for chronic conditions, focusing on helping people create lasting physical activity habits. At the University of Calgary, he works closely with individuals with RA, rheumatologists, and others to improve physical activity support in rheumatology care. Manuel is passionate about the transformative power of movement for all individuals with chronic conditions, which is why he dedicates his time to projects that empower individuals through moving more.  

Eileen Davidson Bio

Eileen Davidson, also known as Chronic Eileen, is a disability and chronic illness advocate from Vancouver BC Canada. Living with a diagnosis of rheumatoid arthritis, she spends a large focus on volunteering and creating awareness around arthritis. With The International Foundation for Autoimmune and Autoinflammatory Arthritis (AiArthritis) Eileen is the Educational Media Assistant. Along with AiArthritis, Eileen is a member of the Arthritis Research Canada patient advisory board, and author with over 100 published articles.

Cheryl Crow

Cheryl is an occupational therapist who has lived with rheumatoid arthritis for over twenty years. Her life passion is helping others with rheumatoid arthritis figure out how to live a full life despite arthritis, by developing tools to navigate physical, emotional and social challenges. She formed the educational company Arthritis Life in 2019 after seeing a huge need for more engaging, accessible, and (dare I say) FUN patient education and self-management resources.

Episode links:

Full Episode Transcript:

[00:00:00] Eileen Davidson: Welcome to Rheumer Has It, the podcast that busts myths, highlights evidence and inspires hope for living better with rheumatic disease. 

[00:00:11] Cheryl Crow: Through plain language interviews with experts, we offer actual knowledge so you can thrive today. 

[00:00:17] Eileen Davidson: My name is Eileen

[00:00:18] Cheryl Crow: And my name is Cheryl. 

[00:00:20] Eileen Davidson: Join us as we bust miss and spotlight evidence.

So I’m really happy today to have Dr. Manny Esther, who is an expert in physical activity behavior change with a PhD in kinesiology. He’s a researcher with Arthritis Research Canada, which is how I’m connected with him as a member of the Arthritis Research Canada Patient Advisory Board. Welcome, Manny.

Can you tell us a little bit about your training and how you came to specialize in physical activity specialist? 

[00:00:48] Dr Manny Ester: Yeah. Thanks so much for having me. I’m really excited to be here and I’ll, I’ll try to keep this brief as I’ve got a little bit of a, a winding career, but essentially when I was doing my undergraduate degree, I was deep in the weeds of doing biology, molecular biology research. But at the same time I was doing a lot of sports and working actually as a certified personal trainer.

So, this idea of exercise and physical activity was always kind of a passion of mine, but I never made the connection until eventually I came to research the impacts of exercise on cancer populations and how to help people with cancer move more and live better. And then that led me then also to do similar work in the rheumatology space, which is why I’m here today.

So basically my expertise, which is where I did my, my PhD, is all about the actual psychology behind how do we build and maintain these healthy habits? And especially we know it’s extra challenging to do this when you’re living with a chronic condition. So how do we actually support people with rheumatoid arthritis, rheumatic conditions, or other chronic conditions to become and stay physically active?

So that’s what I focused my work on. And I think that’s really the, the crux of the matter. It’s not about what are the best exercises you can do, but actually what are the exercises that you’ll actually do day to day? Because we all know it takes a lot of effort and it’s hard work to, to start and maintain those habits.

[00:02:09] Cheryl Crow: Oh my gosh. Touche. Yeah, I a hundred percent agree. As, a patient it’s one thing to know what to do, it’s another thing to actually get yourself to do it. So before we get into the specific myths and misconceptions and stigmas today, we first wanted to give you a chance to just give us an overview of the science behind, how does physical activity, exercise and movement positively impact all forms of arthritis?

[00:02:38] Dr Manny Ester: Yeah, that’s a good, thanks for the question, Cheryl. And I know this this has been an episode to it to itself with Dr. Brian Andonian talking about the inflammation and those responses. And funny enough, actually, my previous research focused on inflammation and physical activity and the immune system in cancer population.

So I know a little bit about that world, but I’ll try to keep it broad and not overlap too much with what what Brian has shared already. So I think broadly,, physical activity can help directly with rheumatic conditions. We know that physical activity in the long term actually and has anti-inflammatory effects and also boosts the immune system.

So we know about certain immune cells and immune responses that can be strengthened through regular physical activity. So in that sense, it can help directly with those rheumatic conditions. And what happens deep inside the body, but also more practically physical activity is one of the most powerful ways to counteract symptoms that people face day to day and actually empower them to yeah, get the most while living with these rheumatic conditions.

So, for example, things like fatigue, pain, and stiffness, all of those, we know physical activity is one of the most powerful ways to counteract those things. For me, I always like to think of physical activity is one of those really helpful tools to help people live, live life to the fullest with rheumatic conditions.

[00:04:01] Cheryl Crow: That’s beautiful. And do you differentiate between physical activity versus exercise versus movement? 

[00:04:10] Dr Manny Ester: Yes. In a technical sense, yes. I don’t think it’s too important, but we can do a quick run through in terms of, yeah, physical activity and exercise are kind of two terms that are often used in the same vein or in the same way, and officially speaking, they mean something slightly different.

So when we talk about physical activity, this talks about any movement in the body that requires energy. So when you’re just sitting here, when I’m moving my arm, that’s physical activity. And then exercise is kind of a smaller piece within physical activity where it’s more structured.

So exercise is when we talk about specific movements that are designed to improve certain aspects of our fitness. Or designed with those specific things in mind and that are performed in a more repetitive structured way. So essentially, exercise is a slightly more specific, more structured aspect of physical activity.

But we know when we use the word exercise, there’s certain kind of connotations around it. So that’s why from a, from a behavioral standpoint, I like to talk about physical activity or movement. And we know from a lot of research too and from talking to. To people like yourselves that there tends to be a more positive response and a more approachable feeling when we talk about physical activity or movement versus talking about exercise.

[00:05:31] Cheryl Crow: That makes a lot of sense. Yeah. A lot of people feel really intimidated by the idea of exercise and kind of, more excited by the idea of, okay, can I increase my physical activity or just move more? So thank you for helping distinguish between those things. Now I’m gonna hand it over to Eileen to go over a myth.

[00:05:49] Eileen Davidson: The whole theme of this podcast is to bust myths and spotlight evidence. Canada has , some evidence about physical activity, including our, the Canadian Physical Activity Guidelines. There is a myth that if you have to follow these guidelines, which are 150 plus minutes of cardio and two days of strength training to get any benefit from physical activity, how would you say that math should be busted? 

[00:06:19] Dr Manny Ester: Yeah, this is a big one. And the physical activity guidelines, whether they’re in Canada and many places in the world, I think the American ones are largely similar to what our Canadian guidelines are, are recommending.

The reason these guidelines are there is to give on a public health population, health level based on all the evidence we have, is to give an understanding of what level may might be helpful for a number of different outcomes and might give us kind of the most, most benefits, I guess, broadly speaking.

If you do more physical activity, you can also get more benefits, but this is a big myth because the biggest benefits actually come from going from zero to one minute or zero to 10 minutes of physical activity and not from going from 140 to 150 minutes of physical activity.

So, the big thing about this to know is that the benefits of physical activity kind of the biggest benefits are at that early stage in getting some movement in, whether that’s cardiovascular related activity, walking, hiking, things like that. Or whether that’s doing a little short body weight strength training or anything like that.

So I think, yeah, this is why it’s a really important thing to realize that while those guidelines give kind of an aspiration that you might want to work towards eventually, you shouldn’t be discouraged in thinking that only if you meet those guidelines are you gonna get benefits from, from physical activity.

So any movement is gonna get you benefits and actually the most benefits or the biggest kind of return, bang for a buck is gonna be in doing a little bit of something if you were previously not doing anything at all.

[00:08:03] Eileen Davidson: That is super motivating for people who want to get started, but just feel like they’re not able to really dive right into it. It’s all about starting small and moving forward. Totally. Yeah. And then would you say the same also applies to the 10,000 steps a day fad as well? 

[00:08:22] Dr Manny Ester: Yeah. So, 10,000 steps a day is, actually, there’s a funny story behind this, and some people might have heard about this, but actually that number and that whole movement around 10,000 steps actually originated from a Japanese marketing campaign that came in the 1960s.

Essentially this was kind of a national campaign that was designed to, yeah, promote movement in Japan and that’s kind of as you can maybe think of 10,000 as kind of a nice round number. It’s a very kind of marketable number, but now there’s so much evidence that shows that much less, much fewer steps in that per day can lead to tons of benefits.

And now I think those, those numbers are still prevalent because those were really successful in terms of promoting physical activity and motivating people. But certainly from 2000, 3000, 4,000 steps a day, you can get lots of benefits and there’s lots and lots of strong evidence showing that.

So it’s definitely a myth. But it’s something that has been very successful in terms of motivating people, at least to some degree, to be physically active. 

[00:09:26] Eileen Davidson: Yes, I agree. It is a great motivation, but is it, reality? I don’t think so. Doing 10,000 steps every day when you’re living with a rheumatic disease is a little unrealistic, especially when we’re in a real big flare or we have medications that day or all sorts of different reasons.

Now thank you so much for answering that. We definitely understand that, physical activity is best to start small and build yourself up and there’s a lot of myths. So Cheryl is going to introduce the next myth to us. 

[00:10:01] Cheryl Crow: Yay. Thank you. Yeah. One of the myths is that in order to get the full benefit of exercise, you have to be in the gym and doing some sort of weightlifting hardcore program, and that’s what “real” exercise is. And everything else is not hardcore enough as we would say.

And I honestly have to say, I used to think this ’cause I was a soccer player and like an athlete and I did do all those things going to the gym and I kind of thought, oh, people doing like jazz exercise or something else, that’s not real exercise.

So I, what would you say to that? 

[00:10:35] Dr Manny Ester: Yeah. Thanks for sharing Cheryl and your own experience. I have to admit to the same thing. I’m also a soccer player, former soccer player. And I used to have those same, same thoughts, but when I got into personal training and got more into the research around kinesiology it’s definitely a myth, I think.

This is actually a, it’s a very prevalent social idea. That’s why we don’t talk about exercise, because exercise has this connotation that it needs to be CrossFit and it needs to be this like sprinting and very high intensity or running a marathon, right? So like all these things are the very extreme forms of physical activity that we see often in media or we see glorified for being these, you know, amazing athletes and things like that.

So often we have that association because that’s what we see and hear about. But it definitely doesn’t have to be that, like I mentioned in the thing around physical activity guidelines, actually doing a little bit of physical activity from no physical activity can be hugely beneficial.

And that doesn’t have to be going to the gym. It doesn’t have to cost you anything. It can be as easy as walking once a day or walking a couple of times a week and doing that with a friend and doing it socially, casually. It doesn’t have to be at a high pace either.

And it’s actually exciting to see the world of exercise science and research in this space more and more start to show how these different forms of physical activity and these more approachable forms of physical activity can actually Yeah lead to huge benefits, both in physical and mental health.

So I, , it’s a really exciting change we’re seeing and we’re hoping that that will also trickle into, how we see and talk about physical activity and not just exercising in media and in social circles.

[00:12:23] Cheryl Crow: I think that’s really reassuring to hear. And whenever I get overwhelmed, I just think to myself, can you do just a little bit more than you did yesterday?

I’ll give it to Eileen for the next misconception.

[00:12:35] Eileen Davidson: I would just like to highlight that I am not a former soccer player, but I am a soccer mom. And after this interview, I am taking my son to his soccer lesson where I walk around for an hour around the track. So there I’m gonna have my movement for the day. Also motivate my son to be involved in sports.

It’s also just finding how you can fit it into your schedule. Especially as a busy parent working, dealing with illness, everything like that, it’s just, you gotta find where it fits in your day as well or even throughout your day.

Okay, so we’re gonna move on to a misconception, and this is one that I think a lot of people assume that we can just go and do, can people with arthritis just go online and follow any Instagram influencer who gives exercise advice? And if you say no to that, tell us a great resource that you know about. 

[00:13:37] Dr Manny Ester: Great question, Eileen. Yeah, there’s definitely a lot of a lot of good and bad information out there, I would say in the social media realm.

So, while you, yeah, generally speaking, I would say pretty much most, a huge majority of what we see around physical activity and exercise is really geared towards younger, healthy adults that don’t have any major physical considerations to deal with.

And that certainly can be dangerous or risky in some ways for people to follow if they are dealing with certain chronic conditions, taking certain medications, having certain injuries or other considerations that have to be taken into account.

I think you can get maybe some inspiration, but you shouldn’t do exactly the same things or think that this is what you need to do to get benefits. And I think this relates to what, what we’ve talked about before already.

So, it’s a really cool tool. It’s one of one of few specific tools that actually tackle this idea of moving well and doing the right movements and, and building those healthy habits while living with a rheumatic conditions. So I think it could be really, really helpful for anyone.

Listen. 

[00:14:48] Eileen Davidson: Absolutely. It is a very helpful website. It’s built by engaging people that live with the condition and with experts in the rheumatology field. So by far, definitely a great resource.

And also one of those resources where you can kind of easily look at an exercise and be able to say, Hmm, I don’t think I can do that, or there’s modification options, so it’s a website that there’s a lot of content on it, and it’s one that you’re gonna definitely need to do a deep dive in, but I highly recommend it because it’s far more reputable, incredible than just following some Instagram influencers random exercise routine.

And every time I do watch those, I watch them because I’m looking for motivation, i’m looking for different exercises, form and things like that. I have almost never seen a full routine that includes exercises, all that I can actually do. There’s many, I’m like, Nope. Can’t do that one. Can’t do one ’cause it’s gonna interfere with my joints. So, very, important to tailor it to how your body is.

[00:15:54] Dr Manny Ester: Yeah, yeah, totally. And it can be, if I can jump in for a sec. Yeah. It can be actually of course, quite demotivating actually, to see these things and then not really know how do I adapt it for myself or to try to follow along, and then you feel really super sore for like five days afterwards and that fatigue spikes and all these different things happen.

Right? So it can actually be demotivating in a way if you try to follow these things, and it doesn’t quite work. And I think in relation to much of the things we’ve talked about in terms of how much physical activity, what does it look like? That’s one of the big aspects that we highlight through the website is actually this idea of what we’ve termed as exercise snacks or movement snacks where it’s 5, 10, 15 minutes.

And it’s straight, straight smack dab in the middle of the website. When you go there and it’s step by step, there’s videos included. And all of those have been, tailored to this idea of can you do it with a rheumatic condition? What exercises, what movements are actually fitting and appropriate?

And that’s something that. Can be really approachable. It changes every day. You come back to the website, it’s something you can do in, in five to 15 minutes. And it’s not this big going to the gym or doing a crazy fitness routine that you see on social media. That’s one of the big things that we’ve taken into consideration for sure.

[00:17:14] Eileen Davidson: That is awesome. I love that. And I am a huge believer in little exercise or physical activity snacks throughout the day because it really helps our joints feel loosened up.

Alright, we are gonna move on to another misconception. And that is some people believe they should always rest when their joints hurt and, related common double misconception is this mixed message. Patients are told to listen to your body, but also told to exercise even when they’re tired or sore. When those signals conflict, it kind of creates a real confusion in us, like, are we supposed to be physically active or are we supposed to be resting?

How much is too much? Kind of thing like that. How do you help patients know when it’s time to rest and when it’s time to move? 

[00:17:58] Dr Manny Ester: . This is a tricky, this is something that I think is, a learning experience where it can be really helpful to first of all speak with people that maybe have had a rheumatic condition for longer than you or have figured out the ups and downs of that.

But it’s definitely whenever you have a new challenge like that, it’s a learning process, right? And I’m sure that both of you and many people out there have experienced kind of this overdoing it or yeah, not really knowing exactly how to approach that.

So, I’ll try to provide kind of some general guidance and then again, go back to this idea that it’s a little bit of a trial and error situation. It’s hard to give general guidance, but in general, I think if you’re feeling what you would kind of classify as mild fatigue or soreness, so not too extreme, you’re able to kind of do your day-to-day activities relatively well that day. Then in those situations, I encourage you to move as much as you can.

Just think about lowering the intensity as needed. So, maybe if you are feeling some mild fatigue, you’re walking instead of running, or you’re doing 10 minutes instead of 20 minutes. Just reducing it slightly. I think that’s kind of step one.

And then if you are experiencing kind of severe fatigue or soreness, and this is maybe something that, you would term as like a seven to 10 out of 10, and it’s really impacting even how you feel in the morning or how you feel throughout the day and what you’re able to do then in those situations, a lot of the time it is actually better to prioritize rest. And do some gentle movement if you’re feeling up for it.

So again, this is up to everyone’s own personal preference, how they experience that pain and fatigue as well, where they experience it. But generally speaking, trying to do some movement like doing some arm circles in a chair, standing up while you’re at work every once in a while, those very simple things can be things you can do even if there’s kind of that severe fatigue or soreness.

And I think in those situations rest is just as important as physical activity. So really prioritizing what I would call high quality rest. So getting extra sleep, getting good nutrition, reducing your stress, and as much as you can in that situation is really important because in those situations, sometimes you require that rest to then get back to a place of that mild fatigue or no fatigue, where then you can, you can start doing more.

So it’s, it’s super difficult for sure and it’s a, a tricky balance, but kind of doing that slow process.

And then with all of that, I think last thing I’ll mention here, ’cause I don’t want it to get too complicated, is, is this idea of listening to your body is super valid and I think the best thing to do is actually the day after, how do you feel? Put a quick note, have a quick reflection. This is what I did, this is how much I did, how hard it was, and this is how I feel. A day after, two days after. And then maybe you start to notice some of those patterns of like, okay, this was a little bit too much because I had five outta 10 fatigue.

I did 45 minutes and then the next three days I just couldn’t do anything. So that’s that process, right? Of self-learning, of understanding. Where does that limit lie? How do you do it in a healthy way? And then I think you can really build that nice positive feedback loop of like, you’re doing what fits for you on the day.

You’re feeling better the next day. You’re building that momentum, regaining energy, things like that. 

[00:21:34] Eileen Davidson: I have one really small follow up question with that. And just to add some clarity because when living with a rheumatic disease and you do start being more physically active, you are going to trigger more fatigue.

But does that fatigue always stick around or does it start eventually to dissipate? 

[00:21:53] Cheryl Crow: Something I know Dr. Kim Steinberger, remember she said that her rule of thumb that I try to remember is two weeks. If you’re start initiating like a new program, like a new strength or, you know, in, in more intense.

Strengthening or cardiovascular exercise to give yourself the understand that there might be like this two week lag of feeling worse before you feel better you. Is that something similar to what you’ve heard, Manny, or do you have a different idea? 

[00:22:18] Dr Manny Ester: Hmm. Yeah, on fatigue. Maybe I’ll make a quick note and then I’ll make a quick note maybe around muscle pain and soreness.

’cause I think that’s also a relevant one. So in terms of fatigue, I think it’s, it’s normal after exertion, especially immediately after you do something difficult. To feel slightly more fatigued and maybe up to kind of like 24 hours later, but. If that fatigue is kind of continuing to keep you down for an extended period of time, that’s really kind of a sign that maybe that you, you did a little bit too much.

Not a sign to necessarily stop all of that activity, but maybe you kind of reenter or restart at a lower level. So, that fatigue, right? It’s this, yeah, you have this negative feedback loop, you’re getting more tired, you’re maybe not sleeping as well, you’re doing less activity. But breaking that is about, yeah, doing those little things and trying to, get out of that loop.

And I think there’s kind of a similar rule of thumb in terms of muscle pain and muscle soreness, and I think there’s a lot of confusion there. Joint pain, what does that look like? And the same thing if you’re doing physical activity, it’s normal to experience some. Kind of surface level muscle pain or muscle soreness.

And this should only last between 24 to 72 hours after a new activity or an increase in load. So if you’re doing more and more, if you experience some mild pain soreness in your muscles within those one to three days, that’s kind of a normal response. But then if you’re having joint pain, or if you’re having.

Muscle soreness that continues three days or longer. This can be a sign of caution that. Either you’re doing the activities in a way that’s actually causing, yeah, damage to your joints or you’re doing them in a way where it’s just overdoing it a little bit and that soreness is just persisting for a really long time.

So, generally speaking, like that’s a good rule of thumb to fall in terms of joint pain, muscle soreness, that kind of thing. 

[00:24:20] Cheryl Crow: Yeah, I think it really helps to understand your own anatomy on some level to be able to visualize it. Like to me. The pain of my joints is very different than muscle pain.

It just, I, it’s in a different location. It feels different. I actually, I don’t know if I’m a freak, but I actually like that feeling of like. Small amount of muscle soreness. Like it makes me feel like accomplished. Like, yeah, my muscles are growing, you know? I don’t know. Do you, do you like that too, Eileen, or am I weird?

[00:24:46] Eileen Davidson: Yeah, I, I like 

to say it burns so good. 

[00:24:49] Cheryl Crow: Yeah, 

burns so good. Like a small, but I definitely have had, I’ll never forget in high school, track and field. The first time I ever did lunges in my life, just like standing lunges, I really overdid it. Like my form I think was not good. I think I actually just like strained both of my, like hip flexors.

I could barely walk for like a week. And there’s a difference. There’s the mild soreness where it’s like, oh yeah,, I’m pushing myself, I’m growing my strength versus, I’ve really overdone it and, but hopefully people will. I, I don’t know. In my personal experience, I mean it, the gains are so quick.

I actually find myself having, as long as I’ve stayed within my kind of just right zone of tolerance for pushing myself, I feel more energy the days that I work out. And I think it, it’s it’s been a really pleasant surprise. I think hopefully other people will feel that too. I know it can be.

Different. Everyone’s different. We always say no one size fits all, but, there all sorts of evidence backs up the improvements if you consistently engage in exercise like the a CR, American College of Rheumatology, integrative Health Guidelines, which I know Eileen was on, one of the patient partners for that, that it’s like the only.

Strongly recommended in integrative health intervention of all, even including occupational therapy it’s like I went to school for two and a half years to become an ot, but it’s like you have to be humble to say like, wow, like it’s actually more effective for people to just consistently exercise than like go to an ot.

[00:26:20] Eileen Davidson: And an OT can 

help us figure out how to pace ourselves and exercise as well. So don’t, that’s fill yourself short. 

[00:26:28] Cheryl Crow: Why not do both? Why not? Yes. ’cause it is re conditionally recommended. It’s just not strongly recommended. Yeah. But, but anyway. Okay. Sorry, we’re so passionate about this. We could talk for nine hours, but the, I do wanna recognize, like, I tend to have anxiety, so we’re gonna go to mental health now, and I do actually find that that exercise helps me with, with anxiety.

Like it kind of helps me feel more centered and grounded. I know, but I think it’s. If you have anxiety, you have I, it feels in my body like excess energy, like nervous energy and I’m, and so it makes sense that I’m like ready to exercise. So I have energy. It’s just sad, bad energy, but it’s like anxious energy.

But I think people who have depression, it’s a uniquely depression and rheumatoid arthritis or inflammatory arthritis, which go together a lot of times it’s a uniquely difficult problem. ’cause you’re just. Feeling mentally and physically exhausted. And now some ladies and the guy are telling you, you gotta go exercise.

Like, I mean, how, do you have any advice for anyone who feels like they’re too tired to even get started? Or how, what are some general ways that you recommend people just get started with a new exercise habit or movement? Habit? 

[00:27:41] Dr Manny Ester: Yeah. This is a, yeah, a really good question, Elle. I probably have a little bit of a long response to this.

That’s okay. This is one of the areas I’m extremely passionate about and I think this is yeah, kind of a starting, starting out is something that people tend to get wrong often, and that’s not on them. On them. That’s actually on our physical activity guidelines and our how media pertains physical activity and all those different factors, and you have this feeling of like.

If I start something, I need to go all out. I need to, like, new year hits January 1st. I’m going to go exercise five days a week and go to the gym and mm-hmm. And all these different things. So I think the biggest piece of very practical advice is start slower than you think, and even once you get to that step, start one step slower than, than that step.

It’s like do, very little because even those very little changes can help kind of break out of that cycle. Or whether it’s negative energy, whether it’s fatigue, whether it’s depressive symptoms, mood, all of those things. And that actually is gonna start this positive wheel rolling, right, and help you break out of it.

So do very little and know that is gonna be beneficial. And really think about how can I do this very gradually. So on day one it’s not doing a run for 60 minutes, it’s getting outside and doing a lap around the block. Even if I don’t feel so great can I try to do something like that? So I think that’s one of the really good practical steps and something that regardless if someone tells it to us, we tend to forget.

And then I think in relation to that as well one of my tricks for physical activity always is do physical activity that doesn’t feel like physical activity or where you’re not thinking about, oh, I’m exercising so hard right now. Right? So there’s ways to do things in a social way if you enjoy social activities.

Go for a walk and chat with people, and then maybe you forget that you’re walking and you’re just chatting with people. Or do something that’s really fun and silly. Put on a song and do a silly dance in your kitchen by yourself. If you don’t wanna be social, but you just want to do something that, that feels like movement, but feels like fun.

One of my favorite activities is actually climbing. So I’m a big rock climber and I think the reason why I’m drawn to it is for those two reasons. First of all, it’s really social and second of all, it’s really fun. I feel like I’m a kid that’s playing and moving and I’m chatting with people and socializing and yeah, the more you can do that, the less you’re thinking about the activity and actually the more you’re actually enjoying.

The process of it, the people you’re with or the environment you’re in, if you’re just walking by yourself outdoors. These kind of things can help us kind of forget about this effort needed and that we’re doing physical activity and get, before you know it, you’re gonna be out for 30 minutes or 45 minutes chatting or, or doing something and having a good time.

Those are some of the things. And I think broadly speaking, I always like to break it down into kind of like. Three relatively simple principles. The first I term as make it your own. So this is about physical activity, needs to be something that’s personal, that’s fit to you and it needs to relate to what is actually important to you.

What might physical activity help you with? Is it. A certain thing like playing with your grandkids. Is it a certain function like walking to the grocery store and getting to bring your own groceries home without having anyone help you? So like relating it, making it your own both in why you’re doing it and in how you’re doing it is number one.

I think the most important thing. And then the other one, the other two is make it social. So like the more you can bring people into your movement team. The more likely people are to stick with those habits. And this doesn’t need to be like someone that always does physical activity with you. It can be just someone maybe in your family that you’re sharing about what you just did that day with.

I think people kind sometimes get hung up on this idea of I have to have a workout buddy or someone that always does activities with you, but your kind of movement team can be much broader than that. It can be your rheumatologist or your rheumatology nurse who you talk about physical activity with.

All those kind of things. So yeah, number two, make it social. Build your team, get support, get people that can keep you accountable. And then number three, I think the most important is make it fun. , Don’t take it too seriously. It doesn’t have to be going to the gym. It doesn’t have to be anything crazy.

Keep it silly like kids are the best example of play and having fun while doing movement and who we can channel some of that. We also know there’s more and more research around this, around actually finding things that you enjoy are gonna make it much more likely for you to stick to those habits.

[00:32:38] Cheryl Crow: That’s beautiful. I’m a big fan of swing dancing and jazz dancing and that’s been so true for me. ’cause it’s social and it’s fun and it’s like a creative expression. So it’s hitting a whole bunch of different for me personally, enjoyable things. I’ve always thought we’ve fun to do like a little arthritis friendly dance class, but I’ll add that to my giant list.

We’re ideas people. We both have long lists of ideas. 

[00:33:04] Eileen Davidson: I love that. I 

just 

wanna touch in that I am. I’m an introvert, so I like to exercise in my own time, in my own piece, but I still like the social aspect and that is, having Cheryl to talk about exercise or other people in the chronic illness community, posting about it on social media, grading content, participating in research.

So it doesn’t necessarily need to be that you have to be, you know, exercising with someone because. For me personally, I need my headphones and my music blaring for it to be fun and my own. Definitely. So yeah, there are other ways to all in the end, just make it your own. I like that.

[00:33:45] Dr Manny Ester: Yeah, exactly. Yeah. It doesn’t have to be a, a social thing for sure. 

[00:33:50] Cheryl Crow: Mm-hmm. 

[00:33:51] Eileen Davidson: Alright, so we are at the end of our interview a lot of great information from you. I feel like getting out and being active right now and a little bit calmer of trying to figure out like how to fit this into my busy schedule.

I know that you touched base on it a little bit previous, but can you share an overview on any of that information about that website that you recommended? Again, even though I was part of it, I want you to talk about it. 

[00:34:21] Dr Manny Ester: Yeah, for sure. So I can, yeah share a little bit about it and I encourage you to explore and, and look at it yourself , and see what fits for you.

So, the website is called Just One move.ca. And as the name implies this, this is all about empowering you to take that first move or to just to do one move. It’s not about doing this crazy routine, it’s about getting started. And then, yeah, when you get to the website we have some really nice practical features.

So like Eileen mentioned, we have a huge amount of content that’s all just arthritis friendly physical activities. So you can go in there. It’s called Our Movement Vault. You can search, you can click on flare as a filter, and it can give you flare friendly activities. You can click on specific joints if you want to focus on those things.

Specific aspects of movements. It can do like balance and gentle movement, all those kind of things. That’s kind of our main big starring piece is this movement vault. So regardless of where you’re at on the day. You’re gonna be greeted with that physical activity snack, and then you’re gonna be able to search through this huge library.

And all the movements again, are arthritis friendly. They’re vetted by experts and by patient partners to be suitable for this. People with rheumatic conditions. So that’s amazing. That’s kind of the first part. And then other parts that we have on there as well is what we call our habit builder. And again, this gets to the idea of it’s really difficult to build and maintain these healthy habits and how do I even get started?

So this is think about it like having an initial conversation with a coach and getting to take those first steps to think about how can I build physical activity into my day to day? So you create this own, you create your own personal action plan of. How are you actually gonna do it? And then that’s really nice ’cause it actually gives you kind of a PDF that you can download, you can share, you can print, put it up on your fridge and you have some kind of thing to keep you accountable and a plan to help you.

So those are kind of two tools. And then the other aspects, we have a community hub as well which essentially just has some nice, really, yeah, I think relatable real life stories from other people living with rheumatic conditions about. What challenges are they facing? How are they making it work?

What makes it difficult? And it’s not just about the successes, it’s also about what challenges are they going through? What do they kind of do on the day to day and how they overcome challenges. So that can be really inspiring. If you’re not quite ready to hit that movement snack, you can go there and just browse some of the stories.

And then the last piece, which I think people are often looking for is actually kind of like an expert tips section. So this is what we called our arthritis toolkit. And the arthritis toolkit essentially has lots of different yeah, research backed expert tips around how do I move well in a flare, how do I move safely and get started with movement while having a rheumatic condition?

All those kind of maybe common questions or concerns you might have. So if you’re coming at it from maybe having a little bit of fear and anxiety around if I do movement or exercise, it’s gonna make my joints worse, or is it gonna cause me to have other problems? You can go to the arthritis toolkit and there’s some really helpful.

Summaries there, and then also links out to other resources and online communities and people that have written about, yeah, physical activity and arthritis. So those are like all the sections and there’s so much more hidden in there, but really encourage you to, to have a look and check it out.

[00:37:53] Eileen Davidson: And I just want to add that it is free and it’s open to anybody in the world, not just Canadians. 

[00:38:00] Dr Manny Ester: Yes. Good ad.

[00:38:01] Cheryl Crow: Awesome. And we will definitely put a link to that in our show notes, which we have on the arthritis Life website. It’s, which is my arthritis life.net. That’ll take you there.

So thank you so much. Do you wanna share in one sentence, what is the most important takeaway message you’d like someone to take from this? 

[00:38:20] Dr Manny Ester: This is a really difficult question. I saw this, I was like, oh no. What is the one sentence, but I’ll try to summarize. So, my, my mantra around movement is always to say that the best movement is the one that you’ll do.

I think that’s the takeaway I want everyone to have, is that it’s not about doing anything crazy. It’s not about doing what other people are doing out there and sharing about. It’s about. Finding movement that works for you, finding your reason why movement matters to you, and then making it fun and or social around that.

So yeah, the best movement is the one you’ll do. And it doesn’t matter how much that is, every movement counts. 

[00:39:02] Cheryl Crow: A hundred percent. That’s great. Thank you so much. 

[00:39:06] Dr Manny Ester: Yes. Thanks so much for having 

me. 

[00:39:07] Eileen Davidson: Yes. Thank you so much for being on here. Wonderful chat with you. And thank you again for listening to another episode of Rumor Has It.

[00:39:16] Cheryl Crow: And as I mentioned earlier, don’t forget to check out the full show notes on the Arthritis Life website, which will also have the full transcript and link to the video of our conversations too. 

[00:39:28] Eileen Davidson: We would also love to hear what you think about this episode. Shoot us an email or comment on our social media accounts.

Thanks so much and bye-bye for now.

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