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  • Liz Hoobchaak

Exercising with an Autoimmune Disorder: A Balancing Act

Regular exercise can be one of the most effective things we can do for our health, especially for those living with an autoimmune disease. Many people avoid exercising as it is sometimes difficult to find the motivation and energy to be active when you are not feeling well. This is very understandable given the day-to-day changes in symptoms and energy levels that come with managing an autoimmune condition.


Although different autoimmune diseases affect different parts of the body, the main thing they all have in common is inflammation.They both cause inflammation and are exacerbated by inflammation. Many individuals struggle with joint and muscle pain, as well as overwhelming fatigue that sometimes makes it hard to get through the day. Regular exercise can be a tool to help you manage this pain and fatigue, but it is a balancing act.


An exercise program for someone with an autoimmune condition should support health and healing while also preventing further inflammation. Exercise does indeed induce a small amount of inflammation over the short term, however, it has been shown to cause a vast improvement in chronic inflammation over time. This can have a profound impact on the symptoms of many autoimmune disorders.


It can be confusing to know how to exercise safely to maximize its benefits without going too far to induce a flare-up of symptoms. This article will give you some tips and ideas for helping you get started on an exercise routine and to help determine the best activity type and level for your body.


Benefits of Exercise for Autoimmune Disorders

For many people with an autoimmune disease, moderate, regular and low-impact exercise can be of tremendous benefit to helping manage the condition and improve quality of life. To understand how, let’s look at the physiology of exercise and how it impacts the human body. Exercise is defined as any movement that makes your muscles work and requires your body to burn calories. Exercise affects every major body system and organ in the body including the cardiovascular, pulmonary, muscular, integumentary and immune system.


The body’s response to exercise varies greatly depending on factors that are related to your personal health and related to the specific exercise being performed. Regular exercise has many general benefits that improve nearly every aspect of your health:

  • Produces anti-inflammatory compounds, such as endorphins which are natural pain killers

  • Improves circulation which helps bring much needed oxygen and nutrients to all your body’s tissues

  • Provides antioxidant protection and increased blood flow which can protect your skin and delay signs of aging

  • Facilitates detoxification and removes debris through your liver and kidneys

  • Helps reduce inflammation throughout the body

  • Helps build strong muscles and bones and may help prevent osteoporosis

  • Produces chemicals that enhance brain function and can lessen the common symptoms of “brain-fog”

  • Helps you relax and achieve better sleep quality

  • It can boost physical energy levels and can help combat depression and anxiety

Best Types of Exercises for those with Autoimmunity

Walking, cycling, swimming and/or water exercise classes, yoga, pilates and light weight training are great low-impact activities that are easier on your joints. Even activities such as dancing can be a great way to get in some cardio exercise and move your body. These low impact activities move each joint through the available range of motion without causing pain. This gentle movement helps to lubricate the joint surface, prevent stiffness and encourages deep breathing which can be helpful for pain management.


Cardiovascular, flexibility and strengthening exercises are all very important for maintaining optimal functioning of our bodies. If you have been fairly inactive, start slowly with some walking and light stretching. Slowly build up to doing some light strength training as your body can tolerate. The goal is to be able to incorporate all three of these types of exercise into your routine several times a week. Here are some simple tips to incorporate these exercises into your daily exercise regime.


Yoga / Flexibility Exercises

If you have been fairly inactive due to your symptoms, yoga and flexibility exercises are a great starting point. Yoga is relatively low impact but can also increase muscle strength and stamina. Yoga incorporates gentle whole body stretches. Many stretches can be done lying down on your bed if it is difficult to get to floor level. You can also consider chair yoga in a seated position.


These flexibility exercises can help you have full range of motion in your joints so they can function optimally which will lead to reduced risk of falls. The internet is a great place to find some simple videos of yoga instruction for beginners. Just start slow and ease into the stretches to see how your body responds.


Walking

Walking is also a great starting point because it is great cardiovascular exercise, but not intense enough to stimulate stress hormones, so it is less likely to cause an exercise induced flare-up of symptoms. Begin by walking on level surfaces at a pace that is comfortable for you. Begin with a 5 minute warm-up then gradually increase the speed until you are walking briskly and you feel your heart rate rise a bit. Aim to reach a pace where you are breathing harder than normal, but you can still carry on a conversation.


Keep a log of how many minutes you are able to keep up this pace. Bring your pace back down for a cool down to let your heart rate decrease back to resting rate. Each week, add an additional 2-3 minutes to your walking time until you are able to maintain that pace for 30-45 minutes for 4-5 days a week. If you can tolerate this walking program for 8-10 weeks without an exacerbation of symptoms, you can progress your walking further by walking on a slight incline or by slowly increasing your speed.


Strength Training

Weight training has been shown to have many benefits on our body to help us live a longer and healthier life. It improves muscle health which causes lasting improvements in our functional capacity and reductions of inflammation. Activating your muscles by doing light strengthening can also relieve pressure on joints leading to reduction in knee, hip, shoulder and back pain.


Remember to start slow when you are introducing weights. I would recommend starting with lighter weights and higher repetitions. Slowly work your way up to help minimize stress on the joint. Start with doing 2-3 sets of 10 or 12 reps at a very comfortable low weight. Over time when it starts to feel easier, increase the weight by 1-2 lbs. The last few repetitions of a set should feel slightly challenging but make sure you are keeping your correct posture and not compensating by using bad body mechanics.


Strength Training can also be done without any equipment. There are many great body weight resisted exercises that can be challenging enough to help improve muscle and core strength. Squats, lunges, push-ups and planks are examples of great strengthening exercises that can be done anywhere and don’t require any equipment.


When it comes to strength training, if you are unsure of where to start or what exercises to do, I would recommend consulting with a Physical Therapist. They will be able to assess your areas of weakness, give you some personalized tips on the best starting point to ensure you are using the correct form to decrease risk of injury.


Important Tips to Help Make Exercise Part of your Daily Routine

1. Find an exercise that is fun and enjoyable. Exercising should be a positive experience which will enhance the health benefits. Find an exercise partner with similar goals who can go walking with you and support you on your health journey. Consider a small group class for added socialization which could help with exercise motivation. Seek out some fun low impact classes at a local center that you can do at your own pace. Even dancing counts as cardio exercise and can help improve your stamina and balance.


2. Go at your own pace. Exercise does not need to be all or nothing. If your goal is 30 minutes of walking a day, it is ok to break that time up into smaller chunks of time so it can be less intimidating. Aim for 10 minutes of walking, 3 times a day if that is more manageable.


3. Listen to your Body. It is important to pay attention to your body and tolerance levels to exercise. If you are feeling really run-down and finding it hard to get out of bed, it is okay to keep your activity level to a minimum. Consider some simple stretching on those days. It is important to heed your body's changing needs and tolerance levels.


4. Capitalize on the days when you are feeling good. Use your better days to

challenge yourself a bit more than normal. Add in an extra few minutes of a particular exercise or aim to do a few additional repetitions of a strengthening exercise. Just don’t go overboard so you don’t become fatigued.


5. Give your body the fuel that it needs. Part of a healthy lifestyle is to consider an anti-inflammatory diet. In general, increasing your fruit and vegetable consumption, drinking enough fresh water, and adding healthy Omega 3 essential fatty acids into your diet will help immensely. Foods to avoid include gluten, lactose, refined sugar, processed foods, especially meats and alcohol. Consider consulting with a nutritionist to see if there are any diet changes you should make to help you achieve an overall healthier lifestyle and help better manage your autoimmune condition.


6. Keep a journal of your daily activities. Keep track of the length and type of exercise you did, what you ate and how you felt. You may start to see some patterns emerge to help you figure out when you feel the best and have the most energy. This will help guide you to determine what level of exercise is best for your body.


Starting a regular exercise program can be hard, especially when you are dealing with an autoimmune condition. Remember that improving your health and functioning through exercise should be considered a marathon, not a sprint. Make sure to take the time to figure out what exercise and what intensity is best for you, set realistic goals for yourself and celebrate your progress.


Written by: Liz Hoobchaak, PT, DPT, CNPT, CAHNS


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