How to Start Working Out
Chronic Illness + Working Out
Many years ago it was thought that exercising with MS (or other chronic illnesses) was a big no-no, but now we know better…
Exercise and moving your body plays an important role in living a healthier and happier life with MS. Now if you have MS or another illness you may be thinking, ‘that’s great but I’m tired AF and there is no way I can exercise’ or maybe the words ‘fuck off I feel like I’m heavier than concrete and my body is stiff and in pain’ come to mind.
Well, I get it. I get the fatigue, the pain, the spasticity, the balance issues, the heat intolerance, the emotional struggles. I get it all.
And don’t get me wrong, it’s a lot. But, before you give up on the idea of working out, I have a question for you…
What is your idea of exercise?
Is it pushing yourself to the brink of physical exhaustion? Is it the ‘no pain, no gain’ mentality? Is it punishment for what you have eaten? Or is it any of the many, many other toxic fitness beliefs that constantly infiltrate our lives?
Those types of ideas turn exercise into a chore. This shifts it from something fun you GET to do for your body and mind to something you HAVE to do whether you want to or not. It also turns the idea of moving your body into something that is right or wrong - you have to do it a particular way (or like how someone else does it) to do it right. Otherwise, you’re wrong or not good enough, which breeds judgement and shame. All of which have no place in your movement practice.
Exercise and moving your body should be something that is fun and works for you and YOUR body. It shouldn’t be exhausting, punishing or something you dread. That means it can be whatever movement, for however long and however often as YOU want.
So now reflect back on your answer to the question ‘What is your idea of exercise?’ and think about how can you broaden your idea of exercise to empower you. This will help you be more compassionate and flexible in the moment.
For example, today I feel like a big pile of poop - symptoms are high and just getting ready was a whole thing. Originally I was planning on doing a short strength training workout, but upon waking I realized that wasn’t going to happen. Instead of beating myself up or bumming out, I practiced some good ‘ol self compassion and flexibility. I reminded myself that I exercise because I want to minimize stress and strengthen the mind-muscle connection. To that point, it would be more stressful to try to push through and fight my body when it clearly isn’t up to strength training today. So, I adjusted. I chose to do some light stretches in bed. Of course it is not what I want to do, but it is what my body needed. After doing them I consciously made the choice to celebrate myself for listening to my body and doing what it needed. That would not be possible if my idea of exercise was different. If I had a rigid belief of what exercise had to be, I would have shamed myself for not being able to stick with my workout schedule, which could easily spiral (and has spiraled in the past) to giving up exercising entirely.
Reframing your mindset around exercise can take time, but it’s imperative to creating a sustainable workout routine that will flow with the inevitable ups and downs of living with chronic illness.
Step-by-Step Guide to Beginning a Movement Practice
*I’m calling it a movement practice instead of exercise because that is more accurate imo. Moving your body is a lifelong practice that’s always evolving and I like how ‘Movement Practice’ embodies that idea.
Step #1 - Get Curious
First and foremost think about your goals. What do you want to achieve with moving more?
These can vary widely, but here are some examples:
Improved balance
Better coordination
Better mind-muscle connection and body awareness
Increased strength
Improved mobility
Increased Flexibility
Less Pain
More energy
Less stress
More endurance or stamina
Improve grip strength
Take a moment and think about what you hope to achieve by moving more on a consistent basis.
I am going to use my journey as an example throughout these steps, so you can see how to apply it for yourself. When I chose to start a movement practice my goals were: improve balance and strength, minimize stress, have more energy, less pain and just feel better overall. Those were my guiding lights throughout the journey.
Next, think about activities you like to do. If you are going to commit to moving your body more, it MUST be something you enjoy otherwise there is no way in hell you are going to stick with it long term.
Examples of types of movement and what they can help with to help get your wheels turning on how you can apply it to yourself.
Aerobic activities (swimming, running, walking, anything that gets your heart rate up) - Improves endurance, stamina and heart health (ex. you can walk longer without getting tired or out of breath)
Strength Training (bodyweight exercises or using equipment like resistance bands, free weights, machines, etc) - Improves strength, alleviates stress and depending on the exercise it can also improve balance, coordination, power and overall function, body awareness and strengthen joints and bones
High Intensity Interval Training (HIIT) - this entails doing an activity at a high intensity for a period of time, then low intensity for a period of time and alternating back and forth. It can be done with aerobic activities or strength training. Personally it’s one of my faves because it keeps me interested and entertained. Plus it’s way easier to go hard for a short burst of 20 sec of a high intensity exercise when you know rest for 40 secs is right around the corner. Interval times range and so you can customize it to work for you.
Stretching (static or dynamic) - Improves flexibility and mobility and reduces muscle tightness, alleviates stress
Balance (static or dynamic) - Exercises that challenge and ultimately improve your stability either when in one position (static) or when moving (dynamic)
Coordination (conditioning or strength training exercises) - improves mind muscle connection and body awareness which can translate to better hand eye coordination or less tripping when walking
Speed/Power - improves speed, overall quickness and agility
Daily Activities - errands, chores, walking to get the mail, anything that you do day to day that requires activity, it all counts!
To continue on with my own example…After writing out my goals I thought about what I liked to do. Running was a hard no. Swimming was too much work (washing my hair is a production, etc). Zumba, Barre or other dance related activities were a pass for me. Spinning classes always held my attention and I found enjoyable. I also liked strength training and restorative yoga.
Once I had my list I compared it to my goals - spinning, strength training and restorative yoga had all or some of the benefits that I was searching for with my goals. Spinning and restorative yoga could help relieve stress, strength training could improve balance and strength and accomplish my other goals as well.
Step #2 - Get Planning
You know your goals, you know what activities you enjoy, next up is to come up with a plan.
How often will you move your body? For how long? Where (home or gym or outside)?
Think about what is realistic and know that nothing is set in stone and you can always switch up your plan if needed!
While you are thinking of a plan keep the following in mind:
Start Small - It is WAY easier to under do it one day and come back and do more the next time vs overdoing it and being out for a few days or longer. Also, if you start small and accomplish what you set out to do, it builds trust in yourself and further empowers you. A good rule of thumb is that you should feel back to baseline 2 hours after your movement practice, if it takes longer you may want to consider cutting back a bit.
Be Flexible - When creating a plan, remember it is a *tentative* plan. Keep in mind nothing is perfect and some days may not go according to plan and that is okay. The key is staying consistent over the long term. Skipping a day or a week won’t matter years down the road, what DOES matter is consistency and doing what you can when you can.
Be Compassionate - There is no world where you can not do something for a long time then start back at it and be great at it. Chill out, enjoy the journey and celebrate the small wins by focusing on what you can do - its WAY more fun this way.
Be Patient - Good things take time. If you are impatient like me, progress will take longer than you want. That is normal. This is where focusing on what you can do can help. If your overall goal is to improve your balance but you focus on how much you fall during the exercises, you’ll be discouraged. Instead focus on the times you do maintain balance (even if its really short) and celebrate those to further encourage you.
To continue with my own example…I know myself and I don’t do well with a super strict plan. The rebel in me just says ‘fuck you’ and does the opposite of what the plan says. I also struggle with being motivated. So, I kept my plan loose and focused on taking classes to hold me accountable and keep me motivated. I planned go to 3 workout classes a week - ideally a mix of spinning, strength training and yoga. While at class my goal was to do it as best as I could, focus on form and not compare myself to others. Some days getting to classes was easier said than done, but knowing how good I would feel after helped. And, focusing on form and what I could do kept my mind plenty busy so I couldn’t even compare myself to others if I wanted to.
A note on road blocks:
Exercising with chronic illness is like doing anything else with chronic illness, there is an added layer of difficulty. After you come up with a plan it can be helpful to imagine possible roadblocks and work arounds so you aren’t caught off guard if they happen.
If you are heat intolerant, plan to have cold water to drink, grab a cooling accessories (headband with ice packs anyone?), try swimming to stay cool and get aerobic activity.
If you are tired or not used to activity for long periods, break it up into short bursts. Try 5-10 minutes in the AM, 5-10 minutes midday and 5-10 minutes in the PM.
If it is hard to stay motivated, enroll a friend to help hold you accountable or try remembering your why for moving or the benefits of doing so.
If you aren’t sure if your body is up for moving one day b/c you feel kind of crappy, try for 5 minutes and then re-evaluate and stop if you need.
Remember, its all about flexibility and being okay with making adjustments. No one is grading you, there is no ‘right’ way, set your ego aside and do what works for you and be proud of yourself for that.
Step #3 - Try it Out
Try out your plan and make adjustments as needed.
Don’t judge yourself if you really overshot what you thought you could do and had to stop earlier than you wanted (I do it all the time). Instead, just be pumped you are committing to yourself and your health and celebrate what you were able to do!
There is no such thing as a failure if you are trying - even when you fail you learn something. Use those times to your advantage, make adjustments and continue trial and error until you find the magic recipe that works for you.
To continue with my own example…Eventually my legs started to hate spinning - it was just too much. I had no choice but to be flexible and adapt. Of course it was hard not to judge myself or grieve that unwelcome shift in ability, but during a particularly emotional moment I asked myself ‘is this helping?’ My whole goal with starting a movement practice was to feel better, and focusing on how I couldn’t spin was doing the opposite of that. I then had to make a choice, do I want to continue down a path that I know isn’t good for me and continue wallowing in my grief, or do I want to make the conscious choice to do something else and reap similar benefits to spinning without being too hard on my legs. I chose the latter, focused on strength training, and incorporated aerobic or higher intensity exercises but in VERY short bursts (like 40 seconds instead of a 40 minute class). That way I was able to enjoy the benefits I was getting from spinning but in a way that worked for me and my heavy ass legs. :)
TO CLOSE
While I can’t tell you an exact workout plan to do, my hope is that these steps help you find something that works for you. After all, YOU know yourself best.
Remember to be patient, starting a movement practice will take experimenting, but you will never know what works and what doesn’t if you don’t try.
And finally, if you don’t know back in January I had the worst relapse I have had in over a decade. Prior to the relapse I was already struggling to keep up with any type of movement practice and the relapse was the final straw. I didn’t do much moving (aka moved between the couch and my bed) for about 5 weeks. During this time, although it was short in the whole scheme of things, I became extremely de-conditioned. So much so that my first trip out, which was going to target and taking a lap around the store, was BEYOND exhausting. So how the fuck did I get back? After grieving, going through all the emotional turmoil, and accepting where I was I started with a physical therapist that specializes in MS. I did very basic exercises about 3 times a week for a month. These exercises included sitting upright and lifting one leg at a time and kicking it out, bodyweight glute bridges, sitting upright and slowly leaning back to work my abs and a handful of other exercises to get used to moving my body again. Also during that month I would try to do a 10-15 minute walk once a week.
Then, as I started to feel more stable in and reconnected to my body, I did those exercises 3 times per week and added a few to the roster. I upped walking to 20-25 mins a week. After about a month of that I added more, but it all was dependent on how my body felt. I did this consistently and slowly built up to the point where now almost 7 months later I am about 60-70% of the way back to baseline. I’m sharing this story because it takes a LONG time and it is often frustrating, but if I would have stopped whenever a challenge arose I would still be struggling walking through target. Keeping my overall goal in mind, listening to my body and doing what I could when I could consistently, is what got me closer to where I want to be. And let’s be honest, the time is going to pass regardless - if you want to change you have to change your mindset and behaviors and comfortably challenge yourself because nothing changes if nothing changes.
Additional Resources
If you want to do additional reading here are some other articles I have written (or collaborated on) that you may find helpful -
