If you’re a current or aspiring runner living with psoriatic arthritis (PsA), you may wonder how this type of high-impact exercise might affect your condition. Running does offer many health benefits — but it can also worsen PsA symptoms, like pain and joint damage.

Fortunately, you might not need to hang up your running shoes just yet. By making some modifications to your gear, stride, and routine, you may be able to continue reaping the many benefits of running.

How Psoriatic Arthritis Symptoms Affect Your Ability To Run

Psoriatic arthritis is a type of inflammatory arthritis that affects some people living with psoriasis, a condition in which the immune system attacks healthy tissues in the body. Researchers aren’t exactly sure why people with psoriasis — characterized by symptoms like patches of scaly skin — develop this form of arthritis.

Psoriatic arthritis symptoms vary from person to person but can include pain, reduced range of motion, and joint swelling — particularly in the fingers, toes, knees, and ankles. These symptoms can all interfere with running comfortably. Some people with PsA also experience fatigue, which can make it difficult to maintain the energy and endurance needed for running.

In more advanced cases, PsA can cause joint damage and deformities or loss of joint mobility, which can make running even more difficult.

Additionally, some types of psoriasis may affect the feet, causing symptoms that can interfere with running, including blisterlike pustules (sores), dactylitis (swollen toes), and inflammation.

How Running Can Affect Psoriatic Arthritis Symptoms

Studies show that for people with PsA, physical activity can also reduce pain and fatigue, improve mood, help you maintain a healthy weight, and improve your overall quality of life. However, given that running is a high-impact activity, it may not be the best choice for everyone with psoriatic arthritis.

“It’s recommended that people living with PsA try low-impact exercise (walking, yoga, and swimming) instead of high-impact exercise (running),” according to the National Psoriasis Foundation.

However, some health experts say running can be safe for some people with PsA. Dr. Joshua Bilsborrow, an instructor of rheumatology at Yale School of Medicine, told Self magazine that running may be OK for people whose PsA symptoms are well controlled. It’s important to talk to your doctor before taking up this activity, though.

Running brings potential risks and benefits if you’re living with PsA. If the road, trails, track, or treadmill is calling to you, consider these eight tips for running with PsA.

1. Consult a Doctor or Physical Therapist First

Check in with a health care provider before starting or resuming a running regimen. They can provide guidance based on your specific diagnosis and symptoms, including recommending support devices (discussed more below), tips, and modifications to prevent worsening symptoms.

Depending on your symptoms, they might suggest a more joint-friendly form of exercise, such as swimming, cycling, or walking. “If you have been diagnosed with plantar fasciitis or bone spurs in the heel, you should get this inflammation under control before running for exercise,” according to the Arthritis Foundation.

2. Start With the Right Footwear

If you’re living with psoriatic arthritis, choosing the right shoes can be essential to your health and well-being. Over time, ill-fitting shoes can damage your feet and worsen your PsA symptoms. Finding the right shoes is all the more important if you’re engaging in a high-impact physical activity like running.

When shopping for shoes, select a pair that fit your feet well and accommodate any symptoms you may have, like swelling, flat arches, or sausage toes.

Consider buying your shoes at a physical store instead of online to be certain you get the right size. The shoes should be comfortable and fit well when you put them on. If one of your feet is larger than the other, go with a shoe size that accommodates the bigger foot and use an insole to make the other fit properly.

Additionally, choose a pair that strikes the right balance between cushy and supportive. The best shoes have a stable sole that doesn’t bend easily, a forefoot rocker to take pressure off of the big toe joint, and a good heel counter, according to Dr. Najwa Javed, a podiatrist with Silicon Valley Podiatry Group.

Here are more tips for finding the best shoes for psoriatic arthritis.

3. Try Orthotics or Other Devices for Extra Support

Depending on your symptoms and affected joints, you may benefit from a knee, back, ankle, or wrist brace or other supportive devices, according to the Arthritis Foundation. Consult your doctor or physical therapist for recommendations.

4. Warm Up and Cool Down

Warming up before a run can loosen your joints, helping to prevent injuries, and boost blood flow to your muscles, reducing the risk of rips, tears, or twists. A 10-minute warmup walk (or other type of light exercise) can increase your blood flow, improve muscle performance, and improve oxygen efficiency — that is, help your muscles get the oxygen they need when you’re on your run.

After warming up and before running, take some time to stretch your muscles. Cooling down with more walking or light stretching after a run can help prevent post-run muscle soreness and aid recovery.

Learn some guided stretching techniques and exercises for joint pain.

5. Watch Your Form

Using proper form as you run reduces stress on your joints and decreases your risk of injury.

The Arthritis Foundation recommends the following tips:

• Hold your head high and gaze 30 to 40 feet in front of you.
• Relax your jaw, neck, and shoulders. Hunching your shoulders can increase tension as you run.
• Keep your wrists loose, and relax your hands.
• Bend your elbows at around 90 degrees, and keep them close to your sides as your arms swing forward and backward.
• Don’t lift your knees too high.
• Make sure your foot aligns with your knee as it lands.
• Try to land on your midfoot instead of your forefoot or heel.
• Keep your trunk erect rather than bending forward at your hips or waist.
• Use a short, quick stride.
• Maintain a comfortable, easy pace.
• Run lightly rather than pounding the ground.

6. Run on Softer Surfaces

Some surfaces are easier than others on runners’ joints.

“The surface you run on plays a major role in determining the impact on your body and how much repetitive microdamage may be done to your bones and joints over time,” according to Dr. David Kovacevic, an orthopedic sports medicine specialist at Palisades Medical Center in North Bergen, New Jersey.

Some of the best surfaces to run on are:

• Flat grass — Grass has the least impact on your legs, bones, and joints, according to health experts.
• Dirt, gravel, and woodland trails — Like grass, these softer surfaces reduce strain on bones and knees.
• Synthetic track — Generally made from recycled rubber tires, this type of surface is more forgiving than asphalt or concrete.
• Treadmills — Treadmills provide a consistently smooth surface, though the hardness varies among machines.

If you don’t have access to the surfaces listed above and must choose between the sidewalk and the road, go with the latter. Asphalt is less hard than concrete, which delivers more shock to your legs than any other surface, according to Runner’s World.

7. Add Strength Training to Your Workout

Strengthening exercises can support your running regimen by improving joint stability and body alignment and reducing your risk of injury. Incorporate exercises that target muscles around the affected joints, such as your feet, ankles, knees, and hips. Also target your core — your abdominal, back, and pelvic muscles.

Muscle-strengthening workouts include:

• Resistance training with weights or resistance bands
• Elliptical machine routines
• Water aerobics
• Yoga, tai chi, or Pilates

It’s a good idea to talk with your doctor or physical therapist before adopting a muscle-building exercise program, just as with running. You’ll want to make sure you’re using the proper technique to avoid injury.

8. Don’t Ignore Pain

Pay attention to your body before and while you run, especially during a flare-up when your symptoms are worse. Avoid running at times of the day when you experience the most inflammation, pain, and stiffness. If you start feeling significant pain, don’t push through it — stop running. Having to pause may be frustrating, but ignoring minor pain or injury can lead to more severe problems.

Notify your doctor or physical therapist if you start experiencing pain during your workouts to determine the cause and a treatment.

MyPsoriasisTeam Members Share Experiences With Running and Exercise

MyPsoriasisTeam members have shared their experiences with running, alternatives to running, and exercise in general.

When one member asked if anyone on the site was a runner, another replied, “Yes, yes, and yes. I walk, jog, run and am signed up for the Cowtown Half Marathon. I use a training plan. You could find one on the internet that suits you. Best wishes. You CAN do it!”

Other members shared that they had to stop running but have found new exercise routines. “I’ve been biking and doing yoga,” one member wrote. “My legs are pretty weak right now after not using them for the last year. The swelling and pain were so bad I could barely walk.”

“I was able to invest in a Hydrow, a rowing machine. It has been a godsend,” wrote another member. “I used to be a runner but have almost completely given that up at this point.”

Other members have shared tips for recovering from workouts. “I noticed lukewarm or cooler showers rather than hot showers help avoid more inflammation and irritation,” one wrote.

Another member stressed the importance of listening to your body. “You know your body better than anyone else, so take care of it by listening to it. Rest, recoup, in your own way and time. Don’t give up,” they urged. “Much later, in time, look back to see how far you’ve come.”

Talk With Others Who Understand

MyPsoriasisTeam is the social network for people with psoriatic arthritis and psoriasis and their loved ones. Here, more than 116,000 members come together to share their stories, ask and offer advice, and discuss life with PsA.

Are you a current or past runner living with PsA? What experiences or tips could you share with others? Let us know in the comments below, or start a conversation on your Activities page.