Fitness Balls for Rheumatoid Arthritis–Friendly Workouts: What to Know

Most people with RA need to improve their stability, balance, and core strength. A fitness ball can help you work on all 3 fitness factors.

woman using exercise ball
Exercise balls are ideal for home-based workouts of various intensities.iStock

You might know it as an exercise or fitness ball, a balance ball, a physio ball, or a Swiss ball. Whatever you call it, this simple, air-filled object makes a great addition to a?home workout, especially for people with rheumatoid arthritis (RA).

Stability balls actually got their start among physical therapists (PTs) in Europe (hence the “Swiss ball” nickname), and when they first found use in the United States in the 1980s, they were typically located in physical therapy centers. Only later did the balls find a place in gyms, yoga and Pilates studios, and people’s homes. Stability balls range in size, but they typically measure two to three feet across and are filled with air.

RELATED: How to Exercise With Rheumatoid Arthritis

What Makes a Fitness Ball Helpful for People With RA?

Because they’re like very strong balloons, the balls create a slightly unstable surface, which causes you to engage more muscles when you work out. “One of the reasons the ball is especially good for people with RA is you strengthen the small muscles that help stabilize the joints just by trying to keep yourself balanced,” says Scott Haak, DPT, a physical therapist at the Mayo Clinic in Jacksonville, Florida.

Lightweight and versatile, fitness balls can be a great start to a home gym. Not much research has been done on the balls, especially among nonathletes, but a few small studies point to their benefits.

In one study, 60 people with ankylosing spondylitis who performed a series of exercises on a ball twice a week for four months improved muscle strength and walking performance more than a control group.

In another study of 60 people with?fibromyalgia, strengthening exercises with a Swiss ball were found to improve pain, quality of life, and muscle strength, when compared with stretching exercises.

And research found that 36 healthy young adults doing balancing exercises on a Swiss ball improved both their static and dynamic balance.

Work With a Physical Therapist

As with any exercise program, consult with your physician before starting. It’s also a good idea to work with a physical therapist (PT) at first. The PT will assess your physical conditioning, balance, and joint damage and help you come up with a customized exercise program. A physician will refer you to a PT, and most health insurance plans cover some PT sessions.

RELATED: Physical Therapy to Ease Chronic Pain

How Steady and Stable Are You?

You and your PT will need to determine whether your muscles give you enough balance for sitting on a stability ball. In the assessment, you sit in the center of the ball and slightly lift one foot off the floor. If you can’t stay stable or are too nervous about falling, skip exercises that involve this position. You can still do moves where you lie on your abdomen on the ball (see below), since this position requires less balance.

Where to Find a Stability or Fitness Ball

Stability balls are not expensive. Most sold by Amazon, Dick’s Sporting Goods, and Target, for example, range from $15 to $45. Many sporting goods stores and discount department stores sell these balls. The size you need depends on your height, and the balls are labeled accordingly; a midsize, 25.6-inch (65 centimeter) ball is good for anyone from 5'4" to 5'11". When you’re sitting on the ball, your hips should be at about the same level as your knees.

Stores typically sell balls that are deflated, so if you don’t already have an electric pump (such as for an air mattress) or a bicycle pump, you may want to borrow or buy one, since the small, handheld pump that often comes with the balls may be hard to use when you have RA. You’ll have to periodically top off the air to keep the ball firm.

RELATED: Rheumatoid Arthritis: Top Tips for Effective Strength Training

How to Get Started With an Exercise Ball

Wear comfortable or workout clothing; you can wear sneakers or exercise in your bare feet, whichever you prefer.

Set up the ball on carpeted flooring, a no-slip rug, or a yoga mat. Dr. Haak suggests beginning in a hallway or a doorway so you'll be near a wall you can use for support until you feel secure.

Stability balls are popular because they are so versatile. You can use them for a wide variety of exercises and a number of different positions.

Position 1: Sit on the Fitness Ball

Getting on and off the ball is exercise in itself because you have to engage your abdomen, or core, notes Haak.

To do this, stand with the ball on the floor slightly behind your legs, with your feet hip-distance apart. Tighten your abdominal muscles and begin to bend your knees. Reach one hand to touch the top of the ball to stabilize it as you sit. Keep your bottom firmly in the center of the ball, with your feet flat on the floor. This position is good for doing basic arm and hand exercises (wrist circles, biceps curls). It’s also good for working the core because you’re engaging those muscles to maintain balance.

Beginner Fitness Ball Move: Leg Marches

Sit up straight and tighten your abdomen. Lift your left foot two to three inches. Hold for a few seconds, then return your foot to the floor. Switch sides. Repeat 10 times.

To dismount, tighten your abdomen as you place your hands on the ball next to your hips, engaging your core as you stand.

Position 2: Chest on the Fitness Ball

“I like patients to do shoulder movements while lying on the ball,” Haak says. “It’s better than being on the floor, because you have more range of motion in your arms and it engages your shoulder blade muscles more.” Try this shoulder blade tug, Haak suggests, to strengthen the muscles that keep posture aligned.

Beginner Fitness Ball Move: Shoulder Blade Tug

Facing the ball, bend and bring your knees to the floor. Place your hands on the ball as you roll forward slowly, so your chest moves forward as your knees lift off the floor. Stop when your abdomen and lower chest are on the ball. Keep your feet on the floor.

Remove your hands. Slide your arms toward your hips, with your palms facing down, and pull your shoulder blades toward each other. Hold for a few seconds and release.

Repeat four or five times.

To dismount, place your hands firmly on the ball, push your hips back over your feet, and stand.

Position 3: Back on the Fitness Ball

This is a good position to work core muscles, since you have more range of motion than when you lie on the floor. To begin, sit on the ball. (See position 1.) Place your hands on the ball at your hips and lean back slowly. When you're steady, walk your feet forward until your back rests on the ball. Keeping your feet on the floor, push down on your heels to keep your hips up; use your ab muscles to keep your head and torso in line.

Beginner Fitness Ball Move: Leg Raises

With your back on the ball, tighten your abs and raise one foot 2 to 3 inches off the floor. (Go slightly higher if you have good balance.) Hold for a few seconds, lower your foot, and switch sides. Repeat 10 times.

To dismount, return to a seated position like this: Tighten your core, tuck your chin toward your chest, and raise your torso as you walk your feet toward the ball. To stand, tighten your abdomen as you place your hands on the ball next to your hips and pull up into a standing position.

Position 4: Feet on the Fitness Ball

In addition to working the leg muscles, exercising with your feet on the stability ball also forces you to stabilize your core, Haak says. Lie on your back. Bend your knees and place the ball on the floor behind your buttocks. Lift your heels onto the ball.

Beginner Fitness Ball Move: Bridging

You can choose to do this exercise with your knees flexed at 90 degrees or, pushing the ball away from you, with knees straight.

Keep your spine straight. Engage your abdominal muscles and tighten your glutes, hamstrings, and calves as you lift your hips off the floor a little (without arching your back). Hold a few seconds, then return your hips to the floor. Repeat five times.

To dismount, roll the ball away from you and return to a sitting, then standing, position.

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  • Cardoso de Souza M et al. Swiss Ball Exercises Improve Muscle Strength and Walking Performance in Ankylosing Spondylitis: A Randomized Controlled Trial. Revista Brasileira de Reumatologia.?January 2017.
  • Arakaki JS et al. Strengthening Exercises Using Swiss Ball Improve Pain, Health Status, Quality of Life and Muscle Strength in Patients With Fibromyalgia: A Randomized Controlled Trial. Reumatismo. April 2021.
  • Yu W et al. The Effect of Ball Exercise on the Balance Ability of Young Adults. Journal of Physical Therapy Science. December 2017.
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