I was the "active one" growing up.
The athlete and competitive swimmer.
I swam year-around starting at the age of 8 and loved the long, grueling events like the 200-meter butterfly, 400-meter Individual Medley, and 1650-meter freestyle.
I was prepared to swim year around through middle school, and high school, and right up to a Division I scholarship.
This was the path I thought I was on. Until I struggled to finish two laps in a practice let alone an entire 400-m event.
What felt like overnight, my energy levels plummeted, my hands went numb and blue during sets, and I sat out practices shivering on the bench.
Everyone thought I was lacking motivation. That I wasn't trying hard enough and needed to get tougher or push through. Even I started to wonder... Am I losing my edge? Do I need a good kick in the rear? Where the heck did my motivation go?
Turns out, at the age of 14, I was about to be diagnosed with an autoimmune disease named Takayasu's Arteritis (TAK), a rare form of vasculitis that involves inflammation in the walls of the largest arteries in the body: the aorta and its main branches.
In a few short months, my capacity for physical work (i.e. exercise) changed drastically. And with it went many of the plans I had for my future.
After a lot of time away from the pool, I realized I could swap the 400-meter IM for a 50-meter backstroke inside the Medley Relay. I could give up the 200-meter butterfly in exchange for a 100-meter sprint. I let go of the dream for a scholarship -- and started looking at an entirely new set of schools to attend.
I made changes in the pool because I couldn't physically handle the same events. I thought this was a necessary after-effect of TAK -- I didn't realize that exercise could be a potential trigger itself.
I didn't realize until years later that there's a sweet spot between exercising too much, too often, and too intensely (and experiencing an exercise-induced flare as a result) and exercising too little or too inconsistently (and missing out on the benefits of physical activity).
Here's what I've learned about navigating this balance and exercising safely with autoimmune disease. (This is to be used for informational and educational purposes only. Always talk with your doctor before making any fitness or lifestyle changes!)
4 TOOLS TO SAFELY EXERCISE WITH AUTOIMMUNE DISEASE
(1) CULTIVATE A RELATIONSHIP WITH YOUR BODY.
It sounds cliche, but this has been the most important piece of the puzzle for me when it comes to safely exercising with illness (and without exercise-induced flares).
It's so important to listen to our bodies -- and choose our workouts accordingly. We have to ask: Is it worth pushing myself -- "to look good", "to get the fastest time", "to do what everyone else is doing", "because I used to do X" -- when I may experience flares or symptoms that don't go away for hours, days, or even weeks?
Usually, the answer is no. It's not. (Although it's totally okay if for some reason the answer is yes. We get to choose our actions here -- and the consequences that may stem from those actions.)
It's great to mentally push ourselves to work out -- especially because physical activity is good for the body and can help our symptoms -- but we must physically respect our boundaries. (No pain no gain is NOT the goal here.)
Now, I say this with a ton of love and grace because I AM that girl who actually loves to workout. So, for me, having to purposefully skip the gym -- even when I want to go? Having to hold myself back, even when I want to set a personal record? Having to stop, grab a sip of water, wait on the sidelines, and pause in between rounds EVEN WHEN I don't "need it"?
I don't necessarily enjoy this. Especially because often no one really understands why I scale a movement, hold myself back, take an extra minute to rest, or choose a walk around the block instead of a run. It can be really hard to "reign it in" in a world that screams more is always better.
But, the truth is, working out with an autoimmune disease or chronic illness is not about seeing how hard we can push day in and day out. It's about finding that sweet spot and allowing our bodies -- the ones doing the hard work of keeping us alive despite the cards we were dealt -- to tell us when to move and when to hold back.
(2) WORK THE POWERHOUSE OF THE BODY.
If you're new to working out, or you've recently been diagnosed with an autoimmune disease, talk to your doctor and consider hiring a personal trainer who specializes in working with people who have your condition.
In addition to offering guidance on form and proper training, great personal trainers can also introduce you to exercises that strengthen the powerhouse muscles of the body.
The powerhouse is the group of muscles in the center of the body, specifically, the abdomen, lower back, hips and butt, also known as “the core”. An important piece of this powerhouse is called the transverse abdominis, or the "internal weight belt" that connects our spine and pelvis. Working these muscles is really great because it can reduce pain and inflammation in areas like the back and hips.
Plus, working the powerhouse of the body helps us better do the things we already do. In other words, these exercises help improve the efficiency of everyday movement. (Things like carrying groceries, walking our kids to the school bus, cleaning up the yard, etc.)
To work on this powerhouse, and especially this transverse abdominis, it's helpful to practice functional movements during your workouts -- and to think about “bracing your midsection”, “pulling your naval to your spine”, and “contracting the core from the front, back, and both sides all at once". The more we perform functional exercises (exercises that use multiple muscles and are designed to improve activities of daily living), the more we use our transverse abdominis and the stronger it becomes.
We can improve overall movement efficiency (and ultimately reduce pain and strain on the body) by focusing on this transverse abdominis and other powerhouse muscles.
(3) BUILD IN (ADDITIONAL) REST + RECOVERY.
When you have an "invisible illness", such as an autoimmune disease, your symptoms aren't tangible. They aren't easily seen or understood. Getting diagnosed with TAK might have given "formality" and answers to my in-the-pool struggles, but the challenges were just beginning.
Because there was nothing visible to see when it came to the difference in how I could move, I had to learn how to advocate for myself -- and build in extra rest and recovery from the start.
This is super important nugget right here!
The amount of stress our body is under is the TOTAL sum of stress in our lives. (P. 159 The Paleo Approach.) Which means we need to add the amount of stress placed on the body from working out (yep, exercise is a stress!) PLUS the amount of stress placed on the body from chronic illness PLUS the amount of stress placed on the body from daily life PLUS any stress placed on the body from life transitions or difficult seasons.
That can be a lot of stress, right?!
Since stress can lead to inflammation in the body, and inflammation is related to chronic illness, we want to be careful to NOT add so much additional stress that we take ourselves out of short-term stress (which by itself can improve the immune system) and into chronic stress (which has a significant effect on the immune system and chronic illness).
One way to do this is to actively schedule in rest and relaxation.
To move every day but for shorter periods of time. To add meditation to our workouts. To spend time in nature while we move. And make sure we get a full night's sleep.
There are loads of ways to decrease stress -- but the key is making sure we build in that extra rest + recovery from the start.
(4) EXPLORE ALL KINDS OF MOVEMENT.
Exercise can help us better cope with the triggers of daily life and relieve mental stress. It can be a form of meditation in motion.
However, as you can see, exercise becomes a potential problem when autoimmune disease and chronic illness are thrown into the mix. We don't yet have surefire answers in regards to which movements are helpful -- and which cause worsening of symptoms. It seems to depend on the type of illness we're experiencing, the stress already present in our lives, our current work capacity, or fitness level, and much more. We're left wondering for ourselves how often to exercise and, even more, which exercises to do.
This is where a little exploration & experimentation comes into play.
Running on a treadmill is not the only way to get a good workout. (In fact, it might not be the best way at all. I break down some of my favorite ways to exercise for autoimmune disease and chronic illness in this post here.)
Crossfit isn't the only way.
HIIT workouts aren't the only good workouts.
Yoga isn't the only "restorative exercise" we can do.
When learning how to safely exercise with autoimmune disease, open yourself up to new possibilities.
If you like dancing, have you tried the NIA Technique?
If running puts too much pressure on your joints, have you tried swimming?
If you like strength training, have you tried Animal Flow?
If nature is your happy place, have you tried a guided walk?
If it hurts to stand, have you tried chair Yoga or chair dancing?
KEEP EXPLORING UNTIL YOU FIND SOMETHING YOU LOVE. AND SOMETHING YOUR BODY LOVES, TOO.
Because THIS exploration is how you safely exercise with autoimmune disease. You let your body, and your JOY, lead the way!
If this post resonates with you, but you're still not sure where to start, check out The Wellness Boulevard. With access to workout videos, meditations, guided walks, expert-taught classes, and other curated resources, The Wellness Boulevard is your one-stop shop for feeling good, healing naturally, and living a life without restriction.