10 Reasons Why Exercise Isn't Always the Answer With Chronic Illness


Chronic illnesses tend to elicit a lot of “advice” from friends, family and acquaintances. After explaining to someone that you have health challenges, it’s not uncommon to get a few pieces of advice in return, like, “You should try cutting out sugar!” or “My friend had that and got so much better after she started meditating!” or, one of the most common suggestions, “You should exercise more!”

Now, to a person who doesn’t have any chronic illnesses, this may seem like a perfectly helpful suggestion. After all, exercise can indeed help reduce your risk of a heart attack, lower your cholesterol and blood pressure, and lower your risk of developing certain conditions like osteoporosis and type 2 diabetes. But — and this may surprise some of these people — exercise is not a “cure all” for every health condition. In fact, for many chronic illnesses, exercise can actually exacerbate symptoms, making the advice to “get more exercise” inappropriate and indicative that you don’t really understand your friend’s illness. There may be certain low-impact exercises they can and should do (and they probably are already doing them under the guidance of a doctor!) but exercise doesn’t exactly “cure” these kinds of illness.

So, to educate friends and loved ones about why exercise is not always a possible solution to health challenges, we asked our Mighty community to share a few symptoms they experience when they exercise. Remember, just because someone doesn’t appear to be getting much exercise, that doesn’t mean they don’t want to — they’re just doing what’s best for their health.

1. Pelvic Pain

Conditions like endometriosis, adenomyosis, uterine fibroids and vulvodynia in women, and inflammatory bowel disease and interstitial cystitis in women and men, can cause pain specifically in the pelvic region which can make any rigorous exercise difficult.

“I have interstitial cystitis. Any physical activity increases my pelvic pain to the point of being unable to walk. I can’t even do 2,000 steps in one day,” April Shoener Kesen said. “It’s difficult to exercise when you can’t use your hips. I never realized that until I got sick.”

“Endometriosis. Pain. I get pain in my legs, pelvis, hips, and back. I’m working slowly but surely with my PT to get an exercise plan that doesn’t leave me exhausted and hurting,” Amelia Hillier said. “We’ve been at this a year and I’ve just now started managing going on daily walks.”

2. Fainting/Passing Out

One of the most common conditions or co-morbidities people with chronic illness experience is dysautonomia, which is a malfunction of the autonomous nervous system (ANS). The ANS regulates heart rate and blood pressure. Two common forms of dysautonomia include postural orthostatic tachycardia syndrome (POTS) and neurocardiogenic syncope, which can cause changes in heart rate and blood pressure that result in fainting or passing out upon standing or being upright for long periods of time.

“I have POTS and any form of cardio causes me to pass out,” Kayleigh Bailess said. “I also get a lot of blood pooling in my feet so standing for extended time frames is impossible. Passing out when exercising is never fun.”

3. Joint Pain and Swelling

Joint pain and swelling is a particularly common symptom among autoimmune diseases like lupus and rheumatoid arthritis, which as you might expect can make movement challenging.

I have rheumatoid arthritis and fibromyalgia. My joints hurt every single day. Sometimes they ‘lock’ when I’m trying to work out,” Kel Williams said. “I also experience constant swelling. What usually happens is I’ll work out once and then have to take the next three to four days off just to recover.”

“I have RA and fibromyalgia. My ankles and feet are almost always swollen so when I walk up a flight or stairs or go to the store I have to pause for breaks to cope with the pain,” said Chris Richards. “I would love to run and do yoga, but with all the pain, stiffness and swelling I have my ankles, wrists, SI joints and knees hurt so much I can’t tolerate it. It puts me in bed for days and the pain is excruciating!”

4. Muscle Pain

Autoimmune diseases, ME/CFS and fibromyalgia (among other conditions) can all cause muscle pain and soreness beyond what a healthy person would experience after a workout. “Pushing through” and exercising anyway may not have any ramifications for a healthy person, but a person with chronic illnesses may still be in pain and exhausted days later.

“I know I have Hashimoto’s, not sure if anything else, but if I work out or do anything really physical the muscle pain I get is beyond debilitating. It’s not the ‘hurts so good’ I used to get from working out; now I am stuck in bed and can barely move. It’s mind boggling to me, I don’t understand it,” Jennifer Saratan said.

5. Easy Susceptibility to Injury

Muscle weakness, fatigue, hypermobility and poor proprioception can lead to easily falling or dislocating a joint, so certain kinds of exercise may not be safe.

“I have fibromyalgia and suspected Ehlers-Danlos syndrome. When I work out, I have to be extremely careful to not go over my threshold and to not do certain things that will injure me. I am extremely susceptible to injury without a traumatic event. I was trying to hold myself up on parallel bars, and I tweaked my thumb. I was in a splint for a week,” Alex Payne said. “If I push myself too hard, I can trigger a fatigue flare. I also can get achy (luckily I’m on good medication so I don’t get pain flares hardly at all).”

6. Heat Intolerance

Several conditions may contribute to heat intolerancehyperthyroidism, which can lead to increased metabolism and higher body temperature; multiple sclerosis, which interrupts nerve signals and can lead to heat intolerance; and dysautonomia, which causes heat intolerance and excessive sweating thanks to abnormal regulation of body temperature. Since exercise raises your body temperature, heat intolerance may be exacerbated.

“I have neurosarcoisosis and I can’t tolerate heat. It’s hard to find exercise because I’m easily overheated. Exercising in a warm pool, walking and cycling is pretty much what I can stand,” Erika Nyström said.

7. Post-Exertional Malaise

A hallmark symptom of chronic fatigue syndrome, post-exertional malaise is characterized by an exacerbation of exhaustion, pain and cognitive difficulties after a period of exertion (though “exertion” doesn’t even have to be intense exercise, it could be an everyday task like showering). A person will feel even worse than they did before the exertion, and it can take days or weeks to feel better.

“My chronic fatigue symptoms, which vary from not even being able to walk to being able to exercise, but it means I’m flat out tired the next day,” Liz Richardson said.

8. Medical Devices

Some illness require medical devices or implants that might cause discomfort when exercising. Your doctor can let you know if you can’t exercise at all, or if there are just certain types of exercise you shouldn’t do and if there are ways to keep the device stable while you move; for example, if you have a catheter or feeding tube.

“Right now I have two kidney stents, one in each kidney. I haven’t been able to go to aquaerobics these past three weeks because I never know when the kidneys are going to cut up and I’m going to have to rush out of the pool to the bathroom, so I’ve been going and I truly hate that I’ve not been able to go!” Joyll Cambridge said.

9. Difficulty Breathing

Asthma, cystic fibrosis, congenital heart disease and even pain from a separate condition like endometriosis can make it difficult to breathe — naturally, exercise can make these symptoms worse.

“I swim and cycle, but if I do anything too fast or to hard, my asthma kicks in. I can’t run at all, both because of asthma and my joint hypermobility syndrome, which means that running even a few steps will almost always result in a price to be paid later…” Peggy Andrews explained.

10. Accessibility Issues

Someone might be able to do a bit of exercise, but if their home or places they would like to exercise (i.e. parks, gyms, downtown areas) are inaccessible, they may not be able to actually participate. If there isn’t a ramp to get into the gym, flat walking paths, or accessible public transportation, you may not be able to work out even if you would like to, or you may be so exhausted from just going about your daily life that extra exercise just isn’t in the cards.

“My building elevator is still being upgraded (since last December) so most days I feel like I’m going to pass out walking up to my place (only second floor) after taking my dog for a walk or carrying groceries up,” Shanleigh Rice said.


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