Let's talk about how to exercise without pain when you have a chronic illness. This is a topic near-and-dear to my heart because I was diagnosed with a form of vasculitis when I was 14 (and much later with rheumatoid arthritis). But, because I love to move and know the benefits of physical activity on overall well-being, I was determined to find a way to continue moving my body. Most importantly, though, I was determined to find a way to move that didn't leave me feeling worse than when I started.
I recently wrote a post detailing the best -- and worst -- exercises for autoimmune disease and chronic illness. If you're looking for a super nitty gritty, scientific approach to exercise for autoimmune disease and chronic illness, start there! Otherwise, I'll share here what I've learned when it comes to daily tips for exercising with chronic illness but without pain. These tips may also be helpful if you have an autoimmune disease or experience chronic pain, however this is not meant to be advice. ALWAYS be sure to talk with your doctor and team of providers before making any lifestyle or fitness changes.
The years before I was diagnosed with Takayasus Arteritis (and before the onset of any symptoms), I was a competitive swimmer. While I certainly wasn't an "up 'n coming superstar", I had started to think about training for a scholarship to a DI school. Or, at least, this was the path I thought I was walking.
Things started to go off-course when my energy levels plummeted, my hands went numb and blue during practices, I sat out sets shivering on the bench, and I wasn't sleeping throughout the night. My coach (as awesome as he was) thought I was simply lacking motivation. That I wasn't trying and needed to get tougher or push through. At the time, I was frustrated... thinking maybe he was right and I'd lost "my edge". And even now, looking back and after an official diagnosis, I still can't blame him. When you have an "invisible illness" your symptoms aren't tangible.
Getting diagnosed with an autoimmune disease, a form of vasculitis, gave "formality" and answers to my in-the-pool challenges. But internally? I was still frustrated. I wanted to hold onto what "once was". To my life before the diagnosis. To the grueling workouts I could handle without a problem. To the arms that didn't give out before the set was over. Heck, to the arms that didn't get fatigued holding a blower dryer above my head for 5 minutes. I wanted to relive the excitement of winning a race or the confidence that comes with getting faster and stronger each completed lap.
Sure, after my diagnosis, I could still talk about who I used to be in the pool. I could still share my previous times or personal bests. Talk about the conversations my coaches and I used to have about getting into colleges. But honestly? No one cared anymore.
There was nothing visible to see when it came to the difference in how I could move.
I'm starting this post on exercising without pain with this part of my story leading the way... because physical activity has always been important in my life. It has always been an outlet. My way of meditation in motion. So, when I was diagnosed, I wanted to keep it that way. I kept swimming, moving from a long-distance swimmer to a sprinter + letting go of scholarship hopes, and have physically stretched my boundaries ever since.
Here's how I've learned to exercise without pain (or at least while minimizing the chance for an exercise-induced flare) when you're dealing with chronic illness.
(1) MOVE TO FEEL & HEAL AND NOT TO LOSE OR SHAPE.
This might surprise you as the first tip I bring up for exercising with chronic illness and without pain, but it's really important to talk about. Often, we're taught to view exercise as way to lose weight. To tone up. To thin out. To sculpt our bodies. To have abs. But, especially when trying to workout for chronic illness, this isn't helpful and it's not safe. (I go into more detail here.)
You may be shaking your head thinking... "Duh Kel. Of course I'm exercising for my health and not to lose weight. I want to feel better!" And I totally believe you. But even if we're working out 80% for our physical health -- exercising to feel better and alleviate chronic pain -- we still want to eradicate that last 20% of working out to lose weight. It's the most sustainable way to really CHOOSE physical activity that leaves us feeling good.
And that choice? That is EXACTLY what makes exercising with chronic illness and without pain possible for the long-run.
(2) CHOOSE HOW TO MOVE BY CULTIVATING A RELATIONSHIP WITH YOUR BODY.
This sounds cliche, but we have to listen to our bodies -- and choose our workouts accordingly. This is important for both deciding which movements to do in the first place and understanding when to reign it in or pull back.
We have to look for initial warning signs that say we're pushing too hard, moving in a way we can't currently handle, or simply in need of an extra day of rest. Because when you're dealing with symptoms of a chronic illness or when you're trying to heal naturally, you probably do need an extra day or two of rest.
(Does this frustrate you? Me too. Read this.)
We have to ask ourselves... is it worth pushing ourselves -- "to look cool", "to get the fastest time", "to do what everyone else is doing", "because you used to do X", "because so and so does it" -- if we'll experience flares or subsequent symptoms that don't go away for hours, days, or even weeks?
Most likely, the answer is going to be NO. It's not. (Although it's totally okay if for any reason the answer is yes. We get to choose our actions -- and the consequences that may stem from those actions.)
(3) TAKE. IT. SLOW.
I believe that one of the main reasons new exercise programs fail is not because we lack motivation, are too busy, or can't do it.
It's because we try to do too much too soon - and / or without enough nourishment in between. (Or because we pick a movement, or an environment, we hate.)
When exercising with chronic illness, “no pain, no gain” is NOT the goal. Take it slow, listen to your body, and opt to rest even if you don't think you need it.
(4) LEARN PROPER FORM AND TECHNIQUE.
In addition to taking it slow, it's really important to take the time necessary to learn movement basics and proper techniques. This is, of course, a necessity for ALL exercise programs and workouts -- and so exercising with chronic illness is no different. We want to minimize the amount of stress place on the body as a whole... and that includes minimizing the amount of stress placed on the joints.
Working with a personal trainer who understands your specific chronic illness or region of chronic pain (and always under the guidance of your doctor) can be very helpful. A trainer can help you find activities that both stretch your tight muscles and strengthen your weak muscles, so that you can move more easily throughout the day.
(5) WORK THE POWERHOUSE OF THE BODY.
In addition to offering guidance on form and proper training, great personal trainers can also introduce you to exercises that strengthen the "powerhouse muscles". Working these muscles is great because it can reduce pain and inflammation in areas like the back or hips.
In addition, working the powerhouse of the body is important because we generally want exercise in ways that increase our quality of life -- i.e. help us better do the things we already do. In other words, we exercise to improve the efficiency of everyday movement. (Things like carrying groceries, walking our kids to the school bus, cleaning up the yard, etc.) In order to do this, and to live with more ease and less pain, we need to have some amount of body control.
The powerhouse is the key to this control. It's 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.
To work on this powerhouse, and especially this transverse abdomens, practice functional movements and think about “bracing your midsection”, “pulling your naval to your spine”, and “engaging the abdominals and core”. We can improve overall movement efficiency (and ultimately reduce pain and strain on the body) by focusing on this transverse abdomens and other powerhouse muscles.
(6) REMEMBER THE MIND-BODY CONNECTION.
As you start to move your body, one of the most important things you can do is think about each movement as you perform it. Engage your core and focus on the muscles used to perform an activity. The mind-body connection IS important, as the nervous system is the first system to be used during movement.
What does that mean? With almost all new movements, the first adaptation we see is neural. (Remember, exercise is the body adapting to a stress.) Our brains are getting better at communicating with the rest of our bodies, so that our brains can more efficiently tell our joints, muscles, etc. to move.
Take, for example, early strength training gains. These early increases in weight are most likely not from an increase in muscle mass, but rather from more efficient communication between our brains and the muscles performing the lift. The more our brains, muscles, and joints practice good communication, the better the communication. The better the communication, the better our bodies do the activity we are asking them to do.
This is one of the main reasons exercise can be so beneficial for our bodies. Exercise can teach us how to move through life and life's obstacles more efficiently.
(7) MOVE IN ALL THREE PLANES OF MOVEMENT.
We move in 3 dimensions each and every day. Since exercise is foundationally-intended to make activities of daily living (things we do every day) easier, then our workouts should incorporate all 3 dimensions.
These three planes are called frontal, sagittal, and transverse. In general,
Incorporating all three planes of movement will increase our range of motion, better prevent injury, and add overall stability to our bodies. (Again, functional exercises are great for this.) The idea is to work our bodies through all its intended functions (train our body to do what it is supposed to do) and activate our muscles in multiple ways for the most efficient workouts and best results.
(8) BUILD IN (EXTRA) REST + RECOVERY.
Those of us exercising with chronic illness or chronic pain have an extra "ball" in the air. We have an extra variable to take into account.
We are fighting an illness.
We expend more energy more quickly.
We flare up from known and unknown triggers.
Certain "healthy suggestions" simply don't apply to us.
Which means that when it comes to exercising, we simply cannot do what everyone else can do. Or take what traditional trainers tell us to do at face value. Because even really great trainers might not understand what is taking place underneath the surface in our own bodies. If you have an invisible illness, you've probably already experienced this. What we fight daily cannot be seen... and therefore is not often understood NOR remembered.
We have to advocate for ourselves in the gym and build in extra rest and recovery from the start. We have to take into account the amount of stress already placed on the body.
This is a super important nugget right here so listen up!
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 PLUS the amount of stress place on the body from chronic illness PLUS the amount of stress place 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 must be careful - more careful than the "average joe" - 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. Another way is to move every day, but for shorter periods of time. Or, to add meditation to our workouts. We can even 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 -- and build in extra rest + recovery when you're exercising with chronic illness (and wanting to decease pain!).
(9) EXPLORE ALL KINDS OF MOVEMENT.
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.
Even Yoga isn't the only "restorative exercise" we can do.
When navigating how to exercise without pain when you have a chronic illness or an autoimmune disease, open yourself up to new possibilities. After all, exercise is just movement. It's physical activity. It's giving your body the chance to move through full ranges of motion so that it can better handle day-to-day tasks. (And maybe play a bit more than usual.) That's it.
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.
Find movements and physical activities that put your body into the relaxation response. (For me, that's dancing, animal flow, and handstands.) Find workouts that feel gentle and kind to your body... and ones that totally light you up.
Because THIS exploration is how you safely exercise with chronic illness and chronic pain. You let your body, and your JOY, lead the way.
I'd love to hear from you: What are your favorite ways to move??