Post Exercise Fatigue

[MamaTrain]

Hello,

I haven't been on here in a while and I'm sure this has been brought up in some way, shape or form before but does exercise fatigue get better with continued exercise? Every time I exercise I am usually VERY tired the next day and most times I have some sort of episode in the middle of the night and I know it's from the exercise because it only happens when I exercise. Your thoughts are greatly appreciated!

KC

[Katybug]

Mine has not gotten better over time but I think mine is a result of MCAS not my POTS. Exercise seems to trigger me. I exercise the best I can anyway because my actual exercise endurance is getting better...it just the aftermath that's not improving.

[westernmass]

My dr's were ADAMANT to me that over-exercising would be worse for me than under-exercising. I was started at 10 mins/day, recumbent bike, for 6 days, the one day off, then add 3 mins... So week two would be 13 mins...

I have hit a few blocks with this and listen to my body. For some reason 16 mins was killing me so I went back to 13 until it felt right. Now 25 mins is killing me so I've gone back a step. I can't do 6 days in a row, so I try every other.

The point is to slowly build strength and recondition, not get into the cycle of pushing too hard followed by relapse followed by pushing to hard again.

[futurehope]

Mine has not gotten better over time but I think mine is a result of MCAS not my POTS. Exercise seems to trigger me. I exercise the best I can anyway because my actual exercise endurance is getting better...it just the aftermath that's not improving.

I agree with this. My exercise endurance is better. My underlying condition is still there (POTS, MCAS).

[Chaos]

http://www.iacfsme.org/Portals/0/pdf/CFSandtheExcerciseConundrum.pdf

Good to see you back here! We've missed you! Here's a link to a paper on exercise in CFS but since you're talking about PEM it seems like this would be helpful for you since that's a major issue in that patient population as well.

[boymommy3]

I just started exercising this week. 3 days on the treadmill doing a walk/jog taking about 20 minuets. I had a terrible night last night and wondered if it had anything to do with exercising. I do know that during my exercise times my hr got high really really fast. After a very light jog for 90 seconds my hr was 171. That happened the other two nights I exercised as well but not quite as high. Also, the very minuet I stop I get crazy dizzy for a little bit.

[Relax86]

I usually have an exaggerated fatigue response to exercise and my post ex fatigue lasts longer than it used to (pre POTs). But the payoff is usually more days feeling closer to normal. That's just me - some of the forum people feel worse when they over do it. I actually feel a little better but it's a pay off of possibly a night of surges, and a day of having more breathing/lightheaded issues to get those extra good days. It's worth it to me at this point. Just hoping to stay away from my next flare.

[futurehope]

I agree with Relax86. In the past, as I began my exercise regimen, I have put up with surges, fatigue, etc. But, my conclusion is that I am willing to endure these reactions because overall, I am in a better place to enjoy everyday life. I have decided that in my case, the exercise has given me enough positive reinforcement to continue...and so, I ignore my less than stellar response to exercise in order to gain the benefit of increased ability to enjoy life.

[Ashelton80]

I have the exact same experience as futurehope and Relax86. It can be rough for the first few weeks, but in the end it's worth it. Just have to make it over the "hump" in my case to get to the good days.

[Chaos]

Wish I could say I'd had the same experience as the others. Most recently, I worked my way up gradually to walking 4 miles a day in 53 minutes and was doing that regularly for over 2 months,4-5 days a week plus doing some yoga. I even tried adding in some intervals to see if that would help. (They didn't. They REALLY triggered a lot of symptoms.) I kept feeling worse and worse, having more and more fatigue along with other symptom increases, being able to do less functional activities around the house and now I'm in the midst of the worst relapse I've had in a long time. I don't think it was the exercise that caused the relapse but it did contribute to it. (A virus with subsequent infection really took me out.) Despite my best efforts I do not feel like I ever "got over the hump" despite continuing to push thru it in the hopes that exercise was going to be "best treatment" out there for my POTS symptoms.

Don't get me wrong. I think exercise is important and still try to do whatever I can, although what I can do now is extremely minimal. I think lying in bed is the WORST thing you can do. But, for me personally, as much as I WANT exercise to be the cure for this....it hasn't been and has in fact made my situation worse when I've tried to approach it with my normal rehab mindset.

For those who find that they can push thru and get good outcomes, I am SO happy for you. I'm jealous too.

[volo]

Your experience, chaos, reminds me of my own. My concussion symptoms morphed into POTS symptoms (there's overlap if you aren't tracking heart rate). After 3 months, I thought daily walking was one ingredient to recovering from the concussion. I was surprised my heart rate was so high, but it wasn't that extreme (about 120) so I continued on. I never thought to check my HR while simply standing still. But after a couple weeks of walking, starting with 15 minute walks and having worked up to 30 minutes, my heart rate starting going all over, up to 180 just waking at a modest pace, and my symptoms got much worse. I ended up in bed for a couple weeks, feeling so ill and weak. The only thing that kept me out of ER is that I had already been there twice and both times they said it was anxiety.

Whether the walking was too much or I was going to get much worse in any case, I don't know.

[Ashelton80]

The one thing in common from people who seem to talk about not doing well with exercise tend to be the ones trying to do upright things like walking, jogging, elliptical etc. I NEVER work out standing up. Everything is always on a recumbent bike or rower and as far as weights and strength training its the same. Flat on my back, planks, on all fours etc.

[Katybug]

I use the recumbent bike but I still experience the post exertin fatigue. No matter...like I said I still do it. I'm up to an hour now (yay for me!). I choose an hour long TV show each night and pedal away. The TV keeps my mind off the symptoms that crop up and the joint pain (Eds) . I know this sounds vain but I am so tired of the weight I've gained from the medicine and inactivity that I've just decided that I'm gonna do the hour as I might be sick on any given day anyway.

[Chaos]

The one thing in common from people who seem to talk about not doing well with exercise tend to be the ones trying to do upright things like walking, jogging, elliptical etc. I NEVER work out standing up. Everything is always on a recumbent bike or rower and as far as weights and strength training its the same. Flat on my back, planks, on all fours etc.

That's interesting. I have seen a lot of people who have done well with the walking and running as well, but it's an interesting observation that you've made.

I was swimming this summer and had similar issues with increased symptoms as I increased my exercise. I had 2 of my docs who follow me for POTS say they thought I needed to be doing upright exercise and swimming wasn't adequate for reconditioning the ANS- that I needed to be challenging my system by being upright and making the muscle pump work in that position. One specifically said swimming was ok to start with, as a transitional thing when you hadn't been doing much, but then you needed to move on to upright exercise and specifically said walking.

Have tried a recumbent bike (several versions) but for some reason they kill my knees.

[Dizzysillyak]

I tried exercise routines many times and while my muscles got stronger and I could do more

I had chronic pem. I pushed myself thinking my chronic pem would stop but never did.

Fwiw,

I was egged on to push myself by exercise enthusiast who thought I'd hit the same wall they

did. I completely understand that this makes sense to those who've never experienced pem.

My symptoms of chronic pem were muddled thinking including obsesssing about exercising and

lack of coordination when trying to perform tasks like writing or chopping veggies. And feeling

exhausted all the time.

I've yet to find a solution for pem but my experiences are limitted by my finances. Tc .. D

Ps. Exercising when completely supine helped me too but even that didn't stop the pem.

My circulation is only good when I'm completely supine, partial doesn't help so recumbent bikes

don't work for me.