Episode 31 – Can strength training help IA?

Debbie: Hello and welcome to Inflammatory with Debbie.

Katy: and Katy

Debbie: This week we’re delighted to be joined by Matt Brown, who’s a physiotherapist and strength training coach. He’s passionate about helping people live fuller, healthier lives through movement, strength and confidence. Hi Matt.

Matt: Hi, how are you?

Debbie: I’m very well, thank you. Thank you so much for joining us today. So, we’re going to be exploring how strength training can benefit people living with inflammatory arthritis from an understanding of us from a physio’s perspective as well. But Matt, first of all, can you just give us a bit of a background around yourself and how you got into physio?

Matt: Yeah, of course. So, I’ve a qualified physio for just over a year. And before that was a personal trainer slash strength conditioning coach for about a decade. So, I’ve worked in various different environments with every single different person from every walk of life over that time. And really in the last four to five years, I’ve started working a lot more with folks with persistent pain, long-term health conditions and things of that nature. And that really just started to help me develop a real passion for the rehab side of things and supporting people that have maybe slightly greater challenges than the average person in the general population and helping people find a way to exercise that supports them around their various different health challenges and their symptoms and getting a lot of reward from that really. Physiotherapy as a profession was just a natural progression from that really.

Katy: That sounds really interesting. So, it was it that people came to have strength training with you that had got some of these conditions or did you go out and essentially look for them?

Matt: Yeah, I think I was in one particular personal training space and because I maybe had slightly more qualifications on the strength and conditioning side than maybe some of the other coaches in that gym at the time, anybody that was, for lack of a better term, a little bit complicated or maybe just was a little bit, had various different challenges when it came to exercise prescription and coaching that maybe some of other coaches were struggling with, I would sort of be brought in to assist with that really. And I think it just really made me realise how misunderstood and kind of underserved so many people are when it comes to an awareness and acknowledgement of long-term health conditions and some pain and how those two things interact and how they can create various challenges for people when they’re trying to make these lifestyle changes and improve their health. So, it just became a little bit of a passion and an obsession really of just going down all of the rabbit holes and just trying to get as much knowledge as possible really. And the great thing about personal training as well is you know you’re just working with one person at a time you know you’re not necessarily working with a specific condition or a specific population of people so I think that’s probably given me a real appreciation of how differently people can present symptom wise with various different conditions as well and it’s very much just about meeting someone where they’re at. Because some people can live fairly well and without too many challenges with certain conditions, other people, it can be much more of a struggle.

Debbie: Can you just tell us a bit more about strength training and what that generally means? Because I think sometimes all these buzzwords for in like exercise people are like, I’ve heard of it, but I don’t actually know what it is.

Matt: Yeah, yeah, that was one of the things that we covered actually. So, I worked alongside Katy on a master’s thesis that delved into a lot of this around kind of an understanding of strength training and what it means to people, specifically those living with rheumatoid arthritis. And that was one of the things that came up really, wasn’t it?

Katy: yes

Matt: was just a real confusion on what the word strength actually means. it can mean you know, various different things to different people, I suppose. I think I would probably define it as any kind of exercise that’s intense enough to actually create the physical adaptation of strength, if that makes sense. So, something that tangibly helps your muscles, tendons, bones to be able to withstand more, more stress, essentially. And that can be done with, a variety of different piece of equipment, can be done with your own body weight, it can be done in so many different environments. I think part of the confusion sometimes is there’s a little bit of a discrepancy between or a misunderstanding between the word resistance training and strength training as well. So, when people hear resistance training, I think they immediately think, well, that needs to be done in a gym. But our own body can be resistance as well. Depending on the exercise and the type of positions and muscle groups that we’re trying to target it can be defined quite broadly. But I think anything that’s not improving muscle mass, improving bone density, improving how much force somebody can produce with their muscles, it’s probably not… I wouldn’t necessarily constitute it as strength training or define it as strength training.

Debbie: That’s really useful. Thank you.

Katy: And how have you found your, I guess your background in being a personal trainer? How has that helped you when it comes to the work you do as a physiotherapist?

Matt: Yeah, I think it’s, I think it’s helped a lot in terms of the communication side of things, probably mostly and being able to build relationships and rapport with people. I think when you, when you deal with something like strength training or trying to support somebody to make that a bit more of a consistent part of their lifestyle, if they don’t trust you and they don’t like you, it’s going to be very difficult to kind of sell it. I think particularly if someone’s maybe had a negative experience of that kind of exercise in the past. And I think for those with various health conditions as well, have had either direct negative experiences, or they’ve perhaps been told by other people that it’s, you know, all strength training, all intense exercises, just inherently bad and negative and just to avoid it really. So, I think the communication side of things and probably getting people on side and building that trust. it’s definitely something that coaching gives you.

Debbie: Yes. When you were a personal trainer, did you ever come across people with inflammatory arthritis, especially in a younger age group? Because what we find is people then are like, I didn’t realize inflammatory arthritis can happen in that age group. I thought it was for the older people. I just wonder what your thoughts were on that.

Matt Brown: Yeah, not really, you but I think I suspect over the years, and I think this is the case in a health and fitness setting, and I think it’s a case in a more of a clinical environment as well. The amount of people that come through with quote unquote common run of the mill musculoskeletal complaints. You know, you have to question how many of those actually ended up having an underlying systemic condition, whether it was missed at the time or it’s still not diagnosed now. We know that that’s a massive problem. So I suspect there was probably a fair few that nobody had any idea about at the time, which is real shame, isn’t it? And that’s something that I know there’s a lot of work being done in the research and in clinical practice to try to create much more awareness of these conditions and how they can kind of manifest, particularly in the early stages.

Katy: Yeah. And how do you think we as patients suffering with these conditions? Because something that I found really tricky when I was first diagnosed was actually explaining to people like personal trainers, people helping out in the gym, what the condition was, how I needed extra support. So I think people would look at me and not think that there was anything wrong. And then trying to explain to them that no, can’t. I can’t get my wrists to 90, so I can’t do a press up, need an alternative. I found really hard to kind of get that understanding from them.

Matt: Yeah, It’s really tricky, isn’t it? And I think a lot of it is the owners, I think, has to be placed on the professional themselves to develop that knowledge base as well. And there’s more and more resources becoming available for health professionals and health care professionals to try to develop a bit more awareness and appreciation for, how things can manifest for people symptom wise and how that impacts exercise. That was one of the things that came through from the as well, actually, from the research project was a lot of people feeling just completely alienated in gym and fitness environments. And that was definitely a common theme that came through, not feeling like their symptoms are being understood or believed or appreciated, particularly with the more, non-visible ones, fatigue and pain. The thing I would prioritise would probably be finding environments that you feel safe and supported in. And there are plenty of fitness professionals out there that will take the time to really understand your past medical history and understand you and how that personally affects you. But yes, it can sometimes be difficult to seek them out, I’m not going to lie. So I think it’s just shopping around and really trying to advocate for yourself in those spaces as well. Not necessarily jumping straight into a fitness regime or a personal training contract before you really understand the person and trust them.

Debbie: Because I just I just thinking, you know, flipping that on its side, though, is actually, when you become a personal trainer, is there anything in that education side about all these MSK conditions about invisible illnesses, such as inflammatory arthritis, because we know it’s so important to do some sort of exercise. But people that, you know, feel very hesitant about going to say a PT or to a gym. They feel quite anxious anyway. And then having to explain that to someone who doesn’t know anything about it. was just thinking, obviously then from a charity side, is there something we could do? And do you think there should be something done on the educational side for those PTs?

Matt: Yeah, think it’s to answer your initial question, the answer is unfortunately no. Well, there’s absolutely gaps when it comes to awareness of so many musculoskeletal conditions, so many systemic conditions. And I think, unfortunately, there’s been a trend within the health and fitness industry towards professionals gravitating towards clients with short-term goals around fat loss and improving their aesthetics. And I think there does really need to be a shift away from that towards actually. If you’re an exercise professional, your main clientele should be folks that don’t necessarily find exercise as easy to access and as easy to engage in as regularly as maybe somebody else. And I think that’s just a huge gap at the moment in terms of the way that professionals are trained coming into the industry. And then the things that are offered to them from a continuous professional development perspective. And that is something that I’m quite passionate about.

trying to create more and more of in the future really is that awareness of a variety of different health conditions and things that as a personal trainer is unavoidable, you’re going to see it. So are you going to be able to support that person when they walk through the door or are going to have to just turn them away because you don’t have the skill set to be able to support them?

Katy: Takes me back. On the aesthetics part, I used a personal trainer when I was about to get married. But that personal trainer really didn’t understand some of, the things I just couldn’t do. I think he just thought I was being a bit lazy as much as I kind of tried to explain. So there is that lack of understanding from say, PT’s, but I think it also can sometimes be some of the healthcare professionals not thinking that we can actually do activity. there’s a sort of, a bit of a gap, isn’t there, between healthcare professionals maybe promoting the fact that we should be doing physical activity, maybe strength training to protect around the joints that are affected. And then also, if you then go down that road, you may be not finding the people that understand. So, it’s a bit of a two-pronged approach, isn’t it?

Matt: Yeah, absolutely. think the stereotype is the consultant or sometimes unfortunately the physio and people that are on the clinical side of the picture and maybe not proactive enough in encouraging and supporting people to make exercise work for them. But then you’ve got the perhaps the fitness professionals on the other side who are so just gung-ho and no, just crack on, we’re fine and don’t appreciate the modifications and the tweaks and the adjustments that need to be made. So, I think you’re absolutely bang on there. They’re somewhere in the middle, isn’t they, which is a lovely middle ground for folks.

Debbie: I think everyone should sounds like everyone should go to you because you seem to know understand the conditions But you’ve been you’ve been the PT and now obviously you’re physiotherapist as well. What do you really like about being a physio?

Matt: I think what’s great about being a physio is that you can much more readily support folks that probably need it more. I think oftentimes people that attend physiotherapy practices and physiotherapy clinics are those that are struggling more with symptoms, whether that be pain, stiffness, chronic persistent fatigue, things like that. So, I think it provides you with a really good opportunity to see more people that are maybe more on the symptomatic end and are struggling to make movement and activity work for them in their lifestyle. I do think that there are downsides with that though because although we do get a decent amount of time with patients, you are then somewhat limited. Whereas in a personal trainer context, you generally see people lot more and you can spend more time with them. So, this has been like the existential dilemma for me at the moment is like, where do I place myself? Do I go more towards the PT or do I go more towards the physio? And I think both settings have got their pros and cons. I think the absolute ideal scenario would probably be people on the clinical side that are a little bit more knowledgeable about the conditions themselves and how they can impact somebody. But then a referral network of exercise professionals that have enough knowledge and enough understanding of conditions to be able to appreciate how exercise needs to be modified. But, you know, we’re not necessarily expecting them to have clinical knowledge to the extent like a physio or a consultant or someone like that would have. So, yeah, I think the issue is, I think sometimes you can struggle to actually know where to send and refer people to and where is going to be the best fit for them. But certainly in a physio context you can really support people to make a lot of change with the way that you prescribe exercise and your recommendations in that setting definitely

Katy: Yeah. And we’ve spoken before on the podcast around, trying to be 1% better every day, every week, every month, every year in what you’re doing. And obviously with these, group of diseases, it’s quite fluctuating. What do you think people could do to maybe start embedding more strength or resistance training into their everyday?

Matt:  I think one of the things that comes through quite strongly from the research when it comes to strength exercise specifically or resistance training is how little of it you actually need to do for it to be quite beneficial. So, we’ve got studies showing that, even just two to three sets of a particular strength exercise, whether it be, body weight, lower body, upper body exercises, or even just free weight based exercises can be really beneficial for improving strength, muscle mass, bone density, which are all, regardless of whether you’re living with a long-term health condition or not, these are real public health imperatives really. Everybody should be trying to incorporate strength training into their routine. But I think for folks that have fluctuating symptoms and aren’t necessarily going to be able to exercise in the same way that maybe somebody else can on a regular basis, just understanding that something is so much better than nothing and even just being able to do a little bit of something if it’s five, 10 minutes, if it’s even less than that, it’s still going to at least maintain things like strength and muscle mass. And it’s difficult to, I suppose, specific guidance beyond that because, everybody’s symptoms are going to present slightly or slightly differently and probably as well when certain people are in a flare, they might actually respond very differently to exercise. Some people might get actually a positive benefit from performing more exercise whereas other people, it would just exacerbate the problem. So, I think you have to, as a person living with these conditions, it’s understanding how exercise impacts you, depending on whether you’re in a better or worse spot with symptoms at any given time, I suppose.

Debbie: Yeah, I think that’s a really good tip though what you said though Matt is doing some things better than nothing even if it is five minutes because I must admit my hands have been flaring recently and the extra fatigue that that hits it’s just like Five minutes of do exercise really but actually it would because I know exercise does benefit me I feel so much better afterwards, but it’s that initial thought of my gosh. But then I suppose it’s realizing that if my hands are flaring I can, I think, we’ve mentioned it before, we can go for a walk, we can do things So there may be then strength training I could do for my legs, which makes my mental health feel better as well. But as you say, everyone is different and every journey is very different. But, it’s great that you have that understanding. I think, I think lots of PTs out there really should.

Katy: Yeah. And I guess everybody has their own piece of the pie, don’t they? Everybody will maybe look to go down a slightly different route with their training.

Matt: I thought I’m you know, more than anyone I wish more of our industry I suppose I don’t necessarily identify with it as much anymore because I’ve moved into physio. But the fitness industry in general like I wish more people were interested in focusing a little bit more on this side of their professional development because I think from a public health perspective it would just, you know, for people that can afford private exercise coaching it would just transform.

Katy: Well, it all helps the NHS. Yeah. It’d mean less people were having to go to the NHS because they’d be healthier.

Matt: Absolutely. Yeah, it has the ability to have a real positive effect on public health. And like you say, massively take the strain off the NHS, which then opens up doors for people that are on long waiting lists at the moment that can’t be seen. No.

Katy: Yeah, so it’s that kind of public private how it can partner to benefit everybody.

Matt: Yeah, absolutely. I think with exercise as well, it’s any, particularly strength training or I suppose any exercise, but, know, if you do a take a lower body strength exercise, for example, it’s going to be having a local effect on the muscles around your lower body. But I think it’s important to always remember that it’s also going to have a systemic effect as well. So even if you’re doing a set of bodyweight squats or sit-to stand, it’s going to have an effect on your cardiovascular system, it’s going to have an effect on your immune system. So, I think it’s working around where location where your symptoms are and doing what you can with your other body parts. I think that’s a really nice way of thinking about it actually and just doing enough so you still feel like you’ve done something I suppose and like I said based on the research that can be something as small as a couple of sets five to ten minutes.

Debbie: We’ll have to put this research in our show notes, by the way, because I think it’d be really useful for everyone to know. And there is evidence out there, which I think most people know this anyway, but sometimes people do just need that bit of evidence to say, no, actually this will help you and this will benefit you, because I know sometimes even for me, it can be so hard, as I said before, just lying there thinking, I’m in so much pain, I’m in flaring, I really don’t want to be doing anything. But it’s trying to get your mindset changed as well to know, as you said Matt so well, something is better than nothing.

Katy: Yeah, and it’s that kind of remembering last time you did it, you felt better and building those mind connections that if you do something, you’ll feel better over the next few days.

Matt:  I suppose that’s where understanding yourself and keeping a diary and understanding maybe how your symptoms are impacted by certain different activities at different times is you can make that informed decision then. It may well be the case that resting is the priority and the most important thing for you that day. But I think where possible, if you’re able to, and you feel strongly that you’re going to have at least somewhat of a positive effects on your symptoms on the other side or even if you feel like it’s not going to exacerbate your symptoms I think it’s worth giving it a go definitely.

Katy: And you can always stop, can’t you? You can start and then go, no, this is terrible. I’ll stop.

Debbie: What you also could do is get your friends and family involved though. You know, because when my daughter was diagnosed with juvenile idiopathic arthritis, my other daughter was diagnosed with hypermobility. So, she had different joint problems, but the physio exercises they were given were identical. And actually them both doing it together, it really did help. And we know the benefits of exercising together. So, get your friends and family on board as well.

Katy: Yeah. And actually if you kind of buddy up with a friend and say, can do it, you can do it virtually, can’t you? You can set up a Zoom or something. You don’t actually physically have to go to the same place as that person, but you can, agree to do something at the same time.

Debbie: But Matt, I just want to say thank you so much for your time. I do just have one last question for you. If you could give one piece of advice to someone living with inflammatory arthritis who’s hesitant to start strength training, what would it be?

Matt: I think I would probably go back to the research and just say that we have really good studies now to show that exercises of any kind, particularly higher intensity exercises as well, not only have they been shown to improve quality of life and in some cases improve symptoms, but also don’t have any negative effects on things like disease progression. So I think from a reassurance perspective, it’s because that’s one of the things that I come up against quite a lot when it comes to hesitancy is concerns and worry about symptoms getting worse, but then also what that means for making things worse beyond that point more longer term. And so it would probably be just the reassurance that even in a situation where symptoms are slightly exacerbated, I suppose that’s more information that you’ve overdone it and you need to tailor and tweak things but it doesn’t necessarily have longer term consequences than that if that makes sense and then as I’ve always liked go back to what we’ve said before which is start small you know it really doesn’t have to be a huge huge commitment any kind of exercise if it’s little and often if it’s little and infrequent at first if you can just find a certain form and type of daily and weekly activity that works for you in your lifestyle and you find that your symptoms are fairly stable whilst performing it, amazing. And then you can potentially start to increase and progress it over time from there really. But there’s no rush, there really isn’t any rush because I think a lot of people are pointing to the physical activity guidelines now a lot around much aerobic exercise we need to be doing, how much strength training we need to be doing and I think a lot of the time for those with various challenges in front of them when it comes to exercise that’s quite daunting because it is a lot it’s a lot for anybody but it’s just it’s just knowing that you’re still going to get loads of benefits if you do one third of that one eighth of that one tenth of that

Debbie: That’s been a really, really interesting conversation. So thank you so much, Matt, for your time. Is there any way that people can get maybe in contact with you? Are you on Instagram

Matt: Yep. So, I’m on Instagram, Matt Brown underscore physio. that’s probably the best place to me.

Debbie: Excellent, yeah we’ll put that in our show notes as well. I just want to say thank you again Matt, it’s been really really insightful. Yeah lots of conversation for us to take forward Katy I think as well, especially on the educational piece. But thank you so much that all the research and everything will be in our show notes. Don’t forget we are on YouTube now where you can actually watch our episodes. We’re also on Instagram, Facebook, Blue Sky and LinkedIn so please do like, follow, comment, it all helps with the analytics and please rate and follow the podcast wherever you get your podcasts from. But until next week, it’s goodbye.

Katy: Goodbye.

Inflammatory! Episode: Can Strength Training Help IA?

Hosts: Debbie & Katy
Guest: Matt Brown (Physiotherapist & Strength Coach)

Episode Overview

In this week’s episode of Inflammatory!, Debbie and Katy are joined by Matt Brown, a physiotherapist and strength training coach, to explore how strength training can benefit people living with inflammatory arthritis (IA).

Matt brings a decade of experience as a personal trainer and strength & conditioning coach, now combined with his clinical expertise in physiotherapy. Together, they unpack common myths, explore practical tips, and discuss the research behind strength and resistance training for people managing pain, fatigue, and mobility challenges.

Key Topics Discussed

• Matt’s Journey: From personal training to physiotherapy and his passion for helping people with long-term conditions.
• What Is Strength Training? Understanding what “strength” really means and how it differs from “resistance training.”
• Exercise & IA: How people with inflammatory arthritis can safely engage in strength training and why it can improve overall health, bone density, and confidence.
• Bridging the Gap: The disconnect between personal trainers and healthcare professionals when it comes to chronic conditions and how education and awareness can close that gap.
• Practical Advice:
  • Start small, even 5–10 minutes of activity can help.
  • Focus on something over nothing, every bit of movement matters.
  • Modify exercises to suit your symptoms and energy levels.
  • Track your response to activity to understand your body’s patterns.
  • Find trusted, supportive fitness professionals who understand chronic illness.
• The Mental Health Link: How movement can support mood and motivation during flares.
• Systemic Benefits: Strength training not only supports joints and muscles, but also improves cardiovascular and immune health.

Key Takeaways from Matt Brown

“Something is always better than nothing. Even a few minutes of movement can maintain strength and improve wellbeing.”

Connect with Matt Brown

• Instagram: @mattbrown_physio

Evidence & Resources

Matt and Katy’s research on understanding strength training in rheumatoid arthritis is discussed in this episode. Link here

Connect with Inflammatory!

Follow us for more conversations on living well with inflammatory arthritis and related conditions:

• YouTube: Watch full video episodes
• Instagram / Facebook / LinkedIn / BlueSky: @InflammatoryPodcast
• Don’t forget to follow, rate, and review the show wherever you get your podcasts, it helps others find us!

Listen If You’re Interested In:

• Living with inflammatory arthritis
• Safe ways to exercise with chronic pain
• Understanding strength & resistance training
• Bridging healthcare and fitness
• Mindset and motivation for long-term conditions

Disclaimer: Debbie and Katy are not medical professionals. They share personal experiences of living with IA to build connection and community. The podcast is for informational purposes only and is not intended to replace professional medical advice. We talk about our personal health journeys and the podcast is not intended to provide professional medical advice, diagnosis, or treatment. We are not medical professionals and in no way claim to be medically trained. The podcast does not take responsibility for any losses, damages, or liabilities that may arise from the use of the podcast. The podcast does not assume responsibility for the accuracy of third-party content. For more information, head to https://inflammatoryarthritis.org/