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If you have psoriatic arthritis, regular exercise can help keep your joints flexible and keep the muscles around them strong. It may sound counterintuitive, but certain types of exercise can help relieve psoriatic arthritis-related pain and improve quality of life.

Exercise with psoriatic arthritis doesn’t have to be strenuous — there are plenty of low-impact exercises that are just as beneficial. The most important thing is to not stop exercising completely. “Lack of activity can actually cause more progression of pain than exercise,” said Audrey Lynn Millar, PT, PhD, FACSM, chair of the department of physical therapy at Winston-Salem State University in North Carolina.

And people with psoriatic arthritis don’t necessarily need to avoid any types of exercise. Some types of exercises that can work for them include:

  • Aerobic. These are exercises that get your heart rate up and can be as simple as walking, biking, or swimming.
  • Strength training. When you strength train, you are using either weights or your own body weight to work specific muscles throughout the body. When strength training, it’s important to project joints that are easily triggered by a lot of motion and pressure.
  • Range of motion. These exercises focus specifically on joints and improving their function, and on keeping your flexibility and strength intact.
  • Balance. These can help you stay steady on your feet, particularly in older adults. Pilates classes are a good way to practice balance exercises, such as standing on one foot.

“In general, aerobic and resistance training have been shown to provide the best relief,” Dr. Millar says. “Flexibility is also useful, and is related more to function than pain relief.”

Once you know what type of exercise you want to focus on, it’s important to protect your joints while you’re working out. It’s easy to trigger an inflammation episode by overworking your joints. Here are six tips to make exercise less stressful and more beneficial for your joints:

1. Make sure exercises won’t aggravate your joints. If your knee joints are painful, it’s probably not a good idea to be running marathons or doing lunges at the gym. Knowing what joints are easily triggered by being overused is important when making the best exercise plan for psoriatic arthritis.

For example, if your finger and wrist joints are acting up, it’s a good idea to focus on lower body or abdominal exercises such as squats, crunches, or leg presses. A personal trainer or physical therapist can help you find exercises that will keep your joints as safe and comfortable as possible.

Even if you’re trying to avoid triggering pain in your joints, there will likely be times when your body is just not up to any exercise. It’s important to listen to your body and know when it needs to rest. Talk to your doctor about the best exercises for you.

2. Do water workouts. One of the best ways for people with psoriatic arthritis to get exercise is in the water. Working out in a pool can increase your heart rate without putting stress on your joints. The buoyancy of the water supports the weight of your body. When immersed to the waist, your body bears just 50 percent of its weight and when water is up to the neck, your body bears just 10 percent of its total weight, according to the Cleveland Clinic. And if the pool is heated, it may also provide some relief to aching joints.

“Water exercises can be a good place to start for people with psoriatic arthritis,”  Millar says. There are many types of water aerobics classes available. Usually pool water doesn’t irritate skin symptoms associated with psoriatic arthritis, but chlorine can dry out the skin.

3. Incorporate mind-body exercises. While keeping your body active is important, incorporating some mental health exercises can also be beneficial if you have psoriatic arthritis. In particular, yoga and tai chi offer stretching and other gentle movements that can help coordination and balance as well as relax your state of mind. When led by an instructor, these practices can help you focus on deep breathing and clearing your mind, which could also be a stress reliever. A study published in 2010 in the journal Pain found that a two-hour yoga and meditation session once a week helped reduce pain and fatigue in women with fibromyalgia, another chronic pain condition.

4. Consider strength training. It may seem counterintuitive to put stress on your joints by lifting weights, but it’s not necessarily off limits. The stronger the muscles surrounding your joints are, the better they can support your inflamed joints.

Isometric exercises, in which the angle of your joint and your muscle length don’t change during the movement, are good strength-training options for people with psoriatic arthritis. This type of exercise includes planks, wall sits, and doing squats while holding weights. Deadlifts, where you lift a weight from the ground up to your hips, can also be beneficial as long as the weights used aren’t too taxing to the joints.

But avoid lifting a heavy amount or doing too much strength training. “More rigorous exercise, especially strong resistance exercises, may be detrimental to actively inflamed or severely damaged joints,” says Reynold Karr, MD, a rheumatologist at the University of Washington in Seattle.

5. Stretch in the morning. Often people with psoriatic arthritis find that their joints are stiff and aching in the morning because they’ve been immobile during sleep. Doing some simple stretches before you get out of bed can both help relieve joint pain and get your muscles moving.

“For pain associated with prior joint damage, regular stretching and gentle range of motion and resistance exercises can help preserve adjacent muscle strength to help reduce stress on the involved joint,” Dr. Karr says.

6. See a trainer or a physical therapist. If you’re concerned about how exercise may affect your psoriatic arthritis, it may be best to consult with a personal trainer or physical therapist. He or she can create and tailor a workout plan around the joints that cause problems for you while also ensuring you’re getting a good workout. In some instances, you may be able to find a personal trainer who specializes in working with people dealing with chronic pain issues such as psoriatic arthritis.

“A personal trainer or physical therapist can help identify which supporting muscles may need improvements in strength, and can identify if a person with psoriatic arthritis may need splinting to provide joint stability during exercise,” Millar says. “He or she can also use certain methods to help decrease pain so the person is more likely to attempt the activities and stick with them.”