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Breaking Down Safe and Effective Exercises for Lupus

“Exercise is as important to living as eating and sleeping.” - Don Thomas, Jr. M.D., author of The Lupus Encyclopedia

We recently premiered our latest educational event, "Lupus Fatigue and Weight Management featuring Dr. Don Thomas, Jr. M.D. and patient advocate and fitness professional, Ashley Nicole. The event's goal was to break down how having a healthy BMI, good nutritional habits, and appropriate exercise have been scientifically proven to decrease lupus fatigue and many other avoidable issues. Our hope was to encourage and motivate the lupus and RA community to become aware of their bodies and honor them by taking small steps to improve daily habits.

It is not a secret that cardiovascular disease is the number one cause of death in lupus patients. Though this primarily involves heart attacks and strokes, blood pressure issues, diabetes, and high cholesterol are also highly problematic and can affect your cardiovascular and kidney health.

That is why in addition to the event, we thought we would provide a brief breakdown of the types of appropriate and necessary exercises for those with lupus and give easy-to-follow tutorials that you can incorporate as part of your wellness journey.

The benefits of safe and effective exercises not only include weight control but also can decrease blood clots, decrease bad cholesterol, increase good cholesterol, lower blood sugar, improve lung function, help maintain healthy blood pressure, increases muscle mass, help bone density, improve sleep, reduce anxiety and depression, help with pain associated with joint stiffness and muscle cramps, help your lymphatic system, and even help your gut! (As Dr. Thomas pointed out during the virtual event, your gut is the largest immune system organ!)

Types of Exercise:

Before we continue with the breakdown, it is important to note that there is no “one size fits all” exercise routine for all lupus and RA patients. It is best to speak to your doctor and seek counsel from educated professionals before starting or changing your exercise routine to avoid injury or unnecessary stress on your body.


Aerobic exercise involves physical activity that increases your breathing and heart rate to fuel your body with oxygen-rich blood. Aerobic exercise helps strengthen your heart muscle, improves your lung function, and increases circulation, and healthy blood flow throughout your body.

  • Amount per week: 150 minutes weekly, broken down to 20-30 minutes a day, three times a week to maximize the benefits like improving heart health and circulation.

Types of low-impact aerobic exercise: walking on a flat surface, gardening, light swimming, light housework, tai chi, and chair yoga.

Types of moderate aerobic exercise: dancing (btw top memory experts AND rheumatologists believe one of the best forms of exercise for lupus is dancing! Dancing has been scientifically proven to not only improve energy levels but cognitive dysfunction as well!) walking on an incline, hiking, swim aerobics, Pilates, and active yoga.

Types of high-impact aerobic exercise: jogging, running, sprinting, HIT training, stair climbing, jumping rope, swimming laps, and intense cycling.

Here is a great low-impact 20-minute workout!


If you have not been active for a while, it might be best to start slowly and gradually increase exercise intensity, duration, and frequency. Try dividing your workouts into 10-minute sessions to help your heart, lungs, and muscles acclimate. It will also help make exercise more doable and achievable.

Also, it is important to note on days when you are having treatment (Benlysta infusion, methotrexate shots, etc.) or having blood drawn or kidney testing that you skip or pair down your exercise routine because it can affect the way you feel and even alter your test result (checking a urine protein to creatinine ratio is one of the most important labs to screen for LN and exercising too hard before can give a false positive result (exercise induced proteinuria).

Strength Training:

While aerobic exercise is important for general health and healthy weight management, it isn't the only type of exercise that can help you reduce your BMI (body mass index). Strength training enables you to preserve the muscle you have and increase your muscle mass; this is important for several reasons. Some lupus and RA medications, like corticosteroids, can actually eat away at muscle and replace it with fat, and since muscle is more active than fat, the less muscle you have, the fewer calories you will burn. That means the more muscle you have, the more energy you will have! A pound of muscle can burn anywhere from 10 to 20 calories daily, while a pound of fat burns only 2 to 5 calories daily.

Strength training can build lean muscle tissue, strengthen bones and connective tissue, keep your body strong and injury-free, and can boost your metabolism. The good thing is that it can be done just as effectively at home as it can be done in the gym.

  • Amount per week: ⅔ times per week. Aim to do 12-15 sets of each strengthening exercise for a 20–30-minute session.

  • Types of strength training:

Body weight. You can do many exercises with little or no equipment. Try pushups, pullups, planks, lunges, and squats.

Resistance tubing. Resistance tubing is inexpensive, lightweight tubing that provides resistance when stretched. You can choose from many types of resistance tubes in nearly any sporting goods store or online.

Free weights. Barbells and dumbbells are classic strength training tools. You can use soup cans if you don't have weights at home. Other options can include using medicine balls or kettlebells.

Weight machines. Most fitness centers offer various resistance machines. You can invest in weight machines for use at home, too.

Cable suspension training. Cable suspension training is another option to try. In cable suspension training, you suspend part of your body — such as your legs — while doing bodyweight training such as push-ups or planks.

Check out this video with 9 strength training exercises specifically for people with joint pain!


Working on various muscle groups is essential to prevent strength imbalances that can lead to instability, decreased flexibility and falls. However, if something is painful…stop. You may need to consider trying a lower weight or trying it again in a few days. Also, before beginning strength training, consider warming up your body with a quick walk or another aerobic activity for five or 10 minutes. Cold muscles are more prone to injury than are warm muscles.

Many people, especially women, avoid strength training because they think they'll gain weight or get bulky. However, lean muscle mass naturally diminishes with age and body fat percentage will increase over time if something isn’t done to replace the lost lean muscle.

Flexibility and stretching exercises:

Stretching exercises can help increase your flexibility, improve the range of motion in your joints, promote recovery, prevent injury, and help you unwind.

Stretching is one of the most overlooked elements of a full-body workout, even though it has many benefits, including stress relief, mindfulness, and soreness reduction.

Flexibility and stretching exercises can target all the body's major muscles, including chronically tight ones, like the chest, shoulders, back, arms, hips, and legs.

  • Amount per week: Daily if you can! The American College of Sports Medicine recommends stretching each major muscle group at least twice a week for 60 seconds per exercise.

Check out these stretching videos by RA and Lupus Warrior Ashley Nicole!

Balance and Core exercises:

Your core is the central part of your body. It includes your pelvis, lower back, stomach and hips. Core exercises train the muscles in your core to work in harmony. Strong core muscles make it easier to do most physical activities and improve your balance and stability.

Balance is your ability to control your body in space, distributing your weight evenly in a way that allows you to remain upright. Balance is divided into two types: static and dynamic.

Dynamic balance is the ability to move outside the body’s base of support while maintaining posture control.

Static balance is the ability to maintain the body’s center of mass within its base of support

  • Amount per week: Balance exercises can be done every day or as many days as you like and as often as you like. Preferably, older adults at risk of falls should do balance training 3 or more days a week. However, balance training is good for all ages!

  • Examples of balance exercises: heel to toe walking, tree pose, posture practice with a book on your head, balancing on one foot, working with a balance board or BOSU.

Check out these core strengthening exercises from our favorite PT Pro’s "Bob and Brad!"

Common Questions About Lupus and Exercise:

  • Will people think I’m cured if they see me being physically active? This is something we never talk about. But, let’s go there. Public opinion can be Public Enemy No. 1 that stops you from becoming or staying physically active if you live with lupus. People ALREADY have a hard time understanding an “invisible illness” like lupus. What will they think if they see you or learn that you are (ominous chord) WORKING OUT?!? Here’s the bottom line. You have one life to live. And you cannot squander it trying to make other people understand your life. As Taylor Swift says, “The haters are gonna hate.” This is true. People are going to say what they are going to say. And don’t you dare feel guilty about taking care of yourself. If they ask, hit them with the facts. Exercise is life-enhancing and lifesaving.

  • Am I going to make myself sicker if I work out? Based on studies by the NIH not likely! Studies have shown that patients with low physical capacity were less physically active, exercised less and had more pain and depressive symptoms than those that reported a high capacity. In another study, the effects of an exercise training program on lupus cells were assessed in response to exercise in women with SLE and women without SLE. After a 12-week aerobic exercise program, there was a noticeable difference in some individuals, which revealed that exercise benefits the immune system and does not trigger inflammation in lupus, even if the individual is going through a flare-up. That being said, obviously you know your body best and it is important to listen to your body's signals.

  • If I cannot afford a gym, how am I going to get in shape? You can build a stronger body and have more energy—no gear required! Low-impact exercises are effective and are less stressful on the body and can be done from the convenience of your own home! Here are some great exercises to try, that won’t cost you a thing. Confession… I don’t have a gym membership. I dance, stretch, and strengthen… in my dusty old garage. It is free and just fine.


If you haven’t watched our recent educational video, “Lupus Fatigue and Weight Management,” please click on the link below. Dr. Thomas and Ashley Nicole do an extraordinary job of talking about the importance of taking care of the one body you have.

Remember, living up to some unattainable beauty standard isn't the goal. The goal is not to feel more valuable because of a number on a scale, either. The goal is to rock what you’ve got and feel your best…even with lupus.

Commit to your body in positive ways and surround yourself with friends and family who support, respect and encourage you along your health journey as well.

Written By:

Kelli (Casas) Roseta


**All resources provided by this blog are for informational purposes only, not to replace the advice of a medical professional. Kelli encourages you to always contact your medical provider with any specific questions or concerns regarding your illness. All intellectual property and content on this site and in this blog is owned by This includes materials protected by copyright, trademark, or patent laws. Copyright, More Than Lupus 2023.

May 2023

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