Do This Countdown of #RAWarrior Workouts for the Win!
Seven days and you’re done! In Week 4 of our daily workout goal, you officially accomplish your fitness streak—and learn ways to keep moving forward.
Picture this: Yourcalendar this month is showing a ton of check-marks, and there are only seven more boxes left to cross off. This is the fourth and final week ofthis Dream Big plan, and by Sunday, you’ll have stuck to your goal of exercising every. Single. Day. This is an incredible streak, and you should be proud of yourself!
How do you feel, #RAWarriors? These small steps are kind of a big deal.
Consider the effect that achieving a month of daily exercise had on your coach for this goal, certified personal trainer Ali DiGiacomo. “I couldn’t walk when I was 20 years old, and now I teach others how to exercise and provide motivation for thousands of people just like you and me,” says DiGiacomo of her journey with rheumatoid arthritis. So how exactly did doing that first workout-a-day challenge inspire her to continue, and to ultimately transform her life?
她说：“我立即沉迷于这种健康和健身的感觉，我想继续做一些有趣的运动，这并不像是一份工作。”“我知道舞蹈会激励我移动，所以我开始在网上观看有关如何跳舞的免费视频（感谢上帝为YouTube！），并尽我所能。每天，即使在我感到痛苦的日子里，跳舞的想法都激发了我起床并移动。”
她的力量在每个一周的时间都提高了，几个月后，她意识到自己可以无痛或僵硬地做下蹲和弓步。那时，Digiacomo加强了一切。她说：“在我不知不觉中，即使耀斑使我退缩，我也能够保持一致，以便走得更长或抬起更多。”“我进步使用了较重的体重，能够完成45分钟的小组健身课程，并且与体育馆的几乎每个人都跟上。”
Inspired? Stick to this Dream Big plan for the next seven days and you might be surprised where the sense of accomplishment—and feeling of fitness—takes you. Let’s go!
第4周：稳定做到这一点
This week, you’ll continue doing the workouts you did inWeek 3，使用相同数量的集合和代表，以及相同的电阻。这种重复是故意的，可以让您每天登录这些胜利，而不会推动身体太快。Digiacomo说：“这个想法是在创建这个新习惯时缓慢而稳定地进步。”“如果您有一天会感到精力充沛，请在步行或有氧运动中选择五分钟。”
Since you’ve now got three weeks of regular exercise under your belt, you might be feeling a little sore, but this likely means you’re working your muscles in new ways.
Digiacomo说：“运动酸痛与耀斑酸痛不同。”“我的RA疼痛在关节中，它从该区域向外辐射。运动酸痛本身就是在肌肉本身，从某种意义上说，我知道自己挑战身体并且变得越来越强壮，更健康。它也会在几天内消失。”
To help alleviate soreness from exercise, add some stretching to your workout that day, choosing moves that target the achy area. For example, if your shoulders are sore, do some gentle arm circles; if your back is sore, do some seated spinal twists.
Digiacomo说：“您也可以进行按摩。”她自己为治疗师定期预约。确实，最近发表的一项研究Complementary Therapies in Clinical Practicefound that Swedish massage—a gentle, relaxing treatment—was effective in reducing pain in those with RA. It also improves blood flow to your joints, helps improve sleep and can even boost your mood, according to research on massage in the journalChronic Pain & Management。
Week 4 Training Plan
If you didn’t use the resistance bands last week, give them a try this week. If you still don’t have any, do the suggested modification instead.
第1天：有氧运动
Take a 25-minute walk.
Tip: If you’re feeling good, see if you can pick up your pace a little bit, or find a route with some very gentle hills to change things up.
Day 2: Strength Training—Upper Body
电阻带拳击
Wrap the band around your upper back and hold the handles at chest level with your palms facing inward, elbows bent. Hold your left hand in place as you extend your right arm and punch straight out in front of you. Return to the start. Continue, alternating sides, for 20 total reps.
提示：您可能需要通过窒息来缩短乐队或将其缠绕在手中以保持到位，同时仍然提供足够的阻力。
Modification: Shadow box without the bands, or hold a pair of water bottles or light dumbbells to increase the intensity. Bottles still too heavy? Pour out some of the water to adjust the weight!
电阻带二头肌卷曲
Stand on one end of the band with both feet and hold the other handle in your right hand. Keep your upper arm close to your side as you bend your right elbow and curl the handle toward your shoulder. Pause briefly then slowly lower to the start. Complete all reps on one side before switching. Do 10 reps each arm.
Tip: Make sure there’s adequate tension in the band; it should feel easy at first, and will be harder as you curl your arm up.
Modification: Continue doing the Air Curl/Extension from第1周and2, or use a pair of water bottles or light dumbbells instead.
Resistance Band Triceps Extension
Choke up on the band and hold it with both hands at chest height, elbows bent. Keep your left hand in place as you extend your right elbow completely. Pause briefly then return to the start. Continue alternating sides, for 20 total reps.
Tip: Focus on squeezing the muscles in the back of your arm to pull the band down.
Modification: Continue doing the Air Curl/Extension from Weeks 1 and 2, or use a pair of water bottles or light dumbbells instead.
Superman Trunk Raise
Lie face-down with your legs together and your arms along your sides. Keep your head neutral (don’t arch it or look up) as you lift your head and shoulders off the mat. Pause and hold for a count of three, then lower to the start.
Tip: Keep your chest in contact with the mat throughout the move to protect your spine.
Day 3: Stretching
Doorway Chest Stretch
Stand sideways inside a door jamb and lift your right arm to shoulder height, elbow bent 90 degrees. Place your arm on the outside of the jamb, then twist slowly to the left until you feel a stretch in your shoulder and chest. Pause for a count of three, then return to the start. Repeat 10 times, then switch sides.
Seated Butterfly Stretch
Sit with the soles of your shoes together and let your knees fall open to the sides. Place your hands on your feet and keep a straight back as you slowly lean forward from your hips as far as you can. Hold for five seconds, then sit back up. Repeat 10 times.
提示：要深入伸展，请将肘部放在膝盖上，同时向前按下。
Knee-to-Chest
面对腿伸出腿。弯曲右膝盖并将其抬起臀部，脚弯曲。双手抓住大腿后面，轻轻地将膝盖拉向胸部。保持10秒钟，然后将腿放回地板上。继续，交替，每条腿10次。
第4天：有氧运动
做有氧运动20分钟。任何低影响的活动，例如步行，跳舞，游泳，骑自行车，瑜伽或太极拳都很棒。
Day 5: Strength Training—Lower Body and Core
支持下蹲
Stand inside a doorframe and grip the front of the jamb at waist height with both hands. Position your feet shoulder-width apart and turn your toes out slightly. Slowly push your hips back then bend your knees and squat as low as you comfortably can. Your heels should stay on the floor throughout the move. Return to the start. Repeat 10 times.
Tip: Use the door jamb to maintain balance and to help you stand back up, if needed.
Seated Resistance Band Leg Press
高高坐在坚固的椅子上，循环右脚下方的乐队。用手掌朝内握住腰部的手柄，在需要时窒息以造成张力。保持脚弯曲，抬起腿，使脚从地板上脱落。从这里开始，伸出腿直到笔直，紧贴乐队。返回开始。在一侧完成10次重复，然后切换。
Tip: The tension on the band will increase as you press your leg away, so make sure you hold it tight with both hands.
修改：没有乐队的动作；腿的重量可能就足够了。
Standing Side Leg Raise
Hold the band of a sturdy chair with both hands and stand with your feet together. Keeping your foot flexed, raise your right leg as high as you can without tipping sideways. Return to the start. Complete 10 reps on one side, then switch.
Tip: Bend your standing knee slightly to maintain balance as you lift and lower your other leg.
Dead Bug
面对膝盖弯曲。用平行于地板的小腿将它们抬起臀部，脚弯曲。将手臂伸向肩膀，然后将下背部压入地板上。慢慢降低一条腿和对面约45度，并短暂停留。返回开始。继续，交替的侧面，总计20次。
Day 6: Cardio
Take a 25-minute walk. Choose a new route, or find one with small hills to boost the challenge.
Day 7: Stretching
站立小牛拉伸
Stand with your hands on the back of a sturdy chair. Take a large step back with your right foot and press your heel onto the ground so your foot is flat. Hold 20 seconds and return to the start. Repeat on the other side.
Tip: Breathe deeply and focus on relaxing the muscles and deepening the stretch.
Seated Hamstring Stretch
Sit with your bum on the edge of a sturdy chair with your feet flat and your back straight. Extend your right leg with your foot flexed. Keeping your back straight, lean forward until you feel a stretch in the back of your leg. Hold here for 20 seconds. Return to the start. Repeat on the other side.
Tip: If your hamstrings are very tight, you might not be able to fold forward much; this is fine. Do what you can and focus on improving your range of motion over time.
手腕卷
Hold both hands in front of you with your elbows bent. Make loose fists with your hands then slowly roll them to the outside for 10 reps. Rest 30 seconds and shake them out, then roll your wrists to the inside for 10 reps. Repeat two times through.
*要观看这些动作的操作视频等等，请查看arthritis.org。
Be a Goal Getter
At the end of this week, you might be asking yourself,下一步是什么？
Digiacomo建议：“将这个挑战用作发射点。”“您可以根据需要再次重复同样的四个星期，也可以尝试一些新事物，例如团体健身课。”
Check in with yourself. What workouts did you love and which weren’t your cup of tea? “For example, if you liked the dancing sessions, try taking a barre class or maybe some Pilates,” says DiGiacomo. “If you liked the stretching, try yoga or tai chi. The more you enjoy what you’re doing, the more likely you will be to continue.”
DiGiacomo credits that simple pleasure principle for helping to pull herself out of a long-ago exercise rut when she was still trying to figure out her best life with rheumatoid arthritis. Even today, she posts videos of herself dancing onsocial media, and uses movement and humor as a way to connect with people and bring awareness to RA. The posts also serve as a sort of high-five for doing exercise. “I celebrate that every day, and you should too!” she says.
Benefits of Massage for RA Patients (1):Complementary Therapies in Clinical Practice。（2022.）“瑞典按摩对类风湿关节炎患者疼痛的影响：一项随机对照试验。”https://pubmed.ncbi.nlm.nih.gov/34953451/
RA患者按摩的好处（2）：Chronic Pain & Management。(2019.) “Hip Pain is Reduced Following Moderate Pressure Massage Therapy.” https://gavinpublishers.com/articles/research-article/Chronic-Pain-Management/hip-pain-is-reduced-following-moderate-pressure-massage-therapy
