The name is fictional and some details have been changed to protect privacy. Published with the patient’s consent.

There comes a moment, in many chronic illnesses, when the body no longer feels like our own. Gestures that used to be automatic — standing up from a chair, going downstairs, getting dressed while standing — become small undertakings to be approached with caution. And, often, with fear.

Anna, 67, has lived for years with psoriatic arthritis, an autoimmune disease that affects the joints, alongside other conditions that make her clinical picture complex. When she came to see me, the pain in her knees going downstairs was intense, her left thigh hurt without a predictable reason, and bending forward — even just to sweep or wash the floor — had become difficult.

But what struck me most at the beginning was not a number or a measurement: it was the fear of movement. Anna had stopped bending her knees properly and squatting, for fear of hurting herself. It is an entirely understandable mechanism — when a movement hurts, the body learns to avoid it. The problem is that, over time, the less you move, the stiffer you become.

A journey that began before me

Anna’s story, however, does not begin in a rehab gym. It begins years ago, with a diagnosis that came after difficult months:

The symptoms were strong night-time pain in my legs, morning stiffness, and as soon as I woke up I struggled to get on my feet and walk.

The medication pathway was not straightforward: Anna struggled to tolerate treatment, with significant side effects. Together with her doctor she then reviewed her care plan, and it was medical advice that steered her towards a path she now recognises as a turning point: movement.

She started with swimming. Then she joined a pilates class. And she tells it herself:

The beginning was not easy; my body felt locked, every muscle hurt. More than once I wanted to give it all up, but I kept going.

That sentence, to me, is the heart of everything. Because starting to move again when every gesture costs effort is not about heroic willpower: it is about consistency, starting slowly and not giving up after the first hard days.

Starting again from movement

When Anna came to me, the goal was not to “make the disease disappear” — psoriatic arthritis is a chronic condition managed over time, together with the medical team. The goal was to restore her confidence in her movements and improve what limited her every day.

We worked gradually on:

  • leg strength and control, to give stability back to knees and hips and ease the fear of bending;
  • knee mobility, gradually recovering range of motion;
  • the back, with exercises that allowed her to bend forward without pain;
  • balance and arm strength, for the gestures of everyday life.

Nothing spectacular: simple exercises, repeated session after session, adapted to good days and less good ones (because in chronic illness the off days are part of the journey, and they need to be accounted for without discouragement).

Where she is today

The results, week after week, showed up in concrete gestures. Today Anna:

  • gets dressed while standing, putting on trousers one leg at a time like anyone else — before she had to sit down, or use her hands to lift her leg;
  • does household chores bending forward (sweeping, washing the floor) with much less back pain;
  • goes up and down stairs more easily, and has stopped holding the handrail;
  • notices her arms are stronger — even in pilates she performs the exercises better;
  • managed a full day out visiting a city without major discomfort;
  • feels, overall, less stiff and more upright, with less pain and more freedom of movement.

And progress continues, even in the smallest details. In one of the most recent sessions, during balance exercises, we noticed she can now push a little through her toes to stand up — a tiny gesture that, until recently, she could not manage. That is how this path works: small steps that, lined up one after another, change an entire day.

There are off days too, of course. Sometimes, after doing a bit too much, her knees make themselves felt again. But it is no longer a reason to stop: it is simply part of the journey.

In her own words:

Today, a year on, I can say that physical activity has changed my lifestyle. I feel less stiff and my movements have improved.

What Anna’s story teaches us

Movement is not an enemy to fear, even — and perhaps especially — when living with a rheumatic disease. On the contrary: appropriate, guided and gradual physical activity is an integral part of care, alongside (never instead of) the medical pathway.

Anna’s story is not the story of a miraculous cure. It is the far more precious story of someone who took back her everyday life one gesture at a time, with patience and consistency. And that, every day, is the most beautiful part of my work.

This account describes a personal journey and is not medical advice. Any therapeutic choice — including any decision about medication — should always be discussed and agreed with your specialist. The physical activity described was part of a care pathway supervised by healthcare professionals.

Living with a rheumatic disease and want to get moving again safely? Get in touch — let’s build a pathway tailored to you together.