Training/exercise when you have a condition that causes extreme levels of fatigue isn’t really discussed enough, though it’s something that many, many people struggle with. So, I’m going to share some of my experiences and how I’ve adapted what I do over the years to cope, and hopefully if have similar experiences it will spark a few ideas that you can use yourself.
I like to think I am, but in reality, I have an extremely frustrating autoimmune disorder that routinely likes to kick my ass, and the medication I have to take also brings a buttload of “fun” symptoms too.
My Autoimmune Disorder & Me
I end up severely dehydrated, extremely sore, self-conscious, angry, upset, very irritable and could basically sleep all day every day. Any movement hurts me, a gentle breeze hurts my face, and if I sweat at all it feels like acid being pushed through my skin from the inside. Despite feeling extreme itchiness, if I scratch, I get intense pain – and when I’m sleeping, I scratch so much that I have to peel my clothes off my cuts in the morning when I get up.
Creams that are used to treat skin inflammation cause my skin to worsen, only oral medications like the corticosteroid Prednisone will calm it, by helping to suppress my immune system. I’ve also been on immunosuppressant medications like Cyclosporine and Methotrexate – which are typically given to transplant patients to stop their immune systems from rejecting organs. These severe medications bring all kinds of fun side effects, like heart palpitations, extreme sweating, tingling fingers, and my personal favorite: relentless weight gain!
It doesn’t lend itself to high intensity interval training very well I can tell you that much.
Resting Causes More Fatigue
You can get stuck believing if you aren’t sweating or pushing yourself, then you aren’t “exercising”, often leading to complete inaction and “what’s the point” thinking – but that couldn’t be further from the truth. Remember that I can’t let myself sweat during a flare up? Yet I had to keep moving.
Over the years I’ve built up habits that keep me physically active – and mentally sane – during a flare up. Here’s a few examples:
Day to Day
Doing a bit of mobility work as soon as I get up. I’d do this when I’m feeling good anyway, but during a flare up I just alter the movements, regress them to easier versions if I need to, and do them much slower. I focus on calming myself down as my stress levels would be through the roof.
Breathing is very underrated as a “training” element. As I move, stretch, or even if I’m out and about, I would pause in certain positions, and use deep breaths to try and relax some of the tension I’m feeling in my muscles. I breathe in deeply for 5+ seconds through my nose and do long slow exhales, which really helps with my energy levels. You sometimes don’t realise how much tension you’re holding in your body and how tired that alone can make you.
Drinking a tonne of water helps me specifically when my skin is literally drying itself out but staying well hydrated is also a well-known “energy booster”. Yes, I have to pee at an almost alarming rate, but the benefits outweigh the interruptions!
Simply by keeping up these three things I’ve maintained most of my flexibility and kept on top of as much as I can control.
At the Gym
Where possible I still go to the gym, but I don’t force myself to do a “normal” session – because trust me that just leads to frustration, disappointment, and pain. Instead, I’ve learned to accept there are temporary adjustments I need to make.
I take many, many rests. Partly this is to avoid the burning sweat pain, but it’s also to prevent myself from tiring out an already fatigued body & mind. Slowgress is Progress – doing something with lots of rest is better than doing nothing because you have no energy.
The movements I use will generally be lighter and more focused on quality movement rather than pushing myself. Depending on how bad my skin is (i.e., how much the skin in my joints is ripping) I’ll sometimes reduce the range of motion, so instead of Deep Split Squats I’ll do normal lunges.
I’ll generally stick to lower rep ranges around 5-10 reps and switch exercises frequently, helping me avoid getting frustrated at how tired I’m getting (when I “shouldn’t be”).
How I Adjust a Training Session
An example superset I’d do when I’m feeling ok is:
During a flare up I might adapt that to:
20x Lunges (no weight)
1 minute rest
1x Slow Negative Pull Up
2 minute rest
Depending on how rubbish I feel, that 2 minute rest can turn into a 5 minute rest as the sets go on.
Intense and very sweaty…
You Might Surprise Yourself
Though it’s easy for me to say all this, it can take a lot of mental effort to get myself to do even an adjusted training session.
The thing that keeps pushing me is reminding myself: I feel like rubbish anyway, so I may as well feel like rubbish while doing something. You can really surprise yourself when you feel like you can barely get out of bed to what you can manage when you just start moving a little.
Hopefully you find something useful from this blog and get some takeaways from it!
Remember that just because you’re not sweating or pushing your limits, it doesn’t mean you’re not training. Everything that you do, no matter how half-hearted it feels, is still beneficial and 1000 times better than nothing at all.