Prioritize Disease Stability
Recommend running only when RA is well controlled; avoid initiation during periods of active inflammation or high pain burden.

Use Symptom-Guided Progression
Encourage patients to adjust training based on post-exercise symptoms—pain resolving within 1–2 hours is acceptable; next-day flares warrant load reduction.

Protect Vulnerable Joints
Monitor foot/MTP status closely, consider comorbid osteoarthritis, and use appropriate footwear or orthotics when needed.

Leverage Allied Health and Structured Programs
Support patients with physiotherapy/exercise physiology involvement and accessible graduated programs (e.g., Couch-to-5K, Parkrun).

Align With Patient Goals
Discuss running only when it matches the patient’s interests; clinician experience can help, but individualized, evidence-aware counseling remains key.