How to Begin Working Out With a Chronic Illness

How to exercise with a chronic illness

Verywell / Theresa Chiechi

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If you are living with a chronic illness, exercise may be the last thing on your mind. Whether it is pain, exhaustion, or a low mood, motivating yourself to get moving can be a challenge in itself. What's more, a recent study on living with a chronic disease found that those suffering experienced a negative shift in their quality of life.

It, therefore, may be of no surprise that chronic diseases are one of the most costly health conditions in the U.S. Plus, almost half of the population experiences at least one type of illness, with the risk increasing by age.

"Chronic illnesses typically persist longer than one year, require ongoing medical treatment, interfere with daily activities or limit exercise tolerance," explains seven-time book author Erika Schwartz, MD, a recognized internist specializing in disease prevention. "Those most at risk for chronic disease are people over the age of 65, obese individuals, tobacco users, those with poor nutrition, lack of exercise and genetic predisposition." 

Laura DeCesaris, DC, MSACN, IFMCP

A chronic illness can affect one’s activities of daily living like running errands or getting dressed, and sometimes requires ongoing medical care and evaluation.

— Laura DeCesaris, DC, MSACN, IFMCP

Examples include type 2 diabetes, arthritis, autoimmune disease (like Hashimoto’s disease or lupus), as well as asthma, and heart disease, says Laura DeCesaris, DC, MSACN, IFMCP, a functional medicine-trained health strategist and health and performance consulting coach.

"A chronic illness generally refers to an illness that lasts for a long time, often a year or more, and can affect one’s activities of daily living like running errands or getting dressed, and sometimes requires ongoing medical care and evaluation," says Dr. DeCesaris.

Beyond the most obvious symptoms, Dr. DeCesaris says invisible symptoms such as fatigue and pain can affect many.

"This can make it challenging to not only diagnose these illnesses but also to form effective treatment plans as symptoms vary widely between patients," she says.

Should You Exercise With A Chronic Illness?

When even simple tasks can test your day-to-day living, exercise may seem like an impossibility. However, it has its benefits. Dr. Schwartz recommends exercise for those with chronic illness but advises keeping in mind limitations.

Erika Schwartz, MD

In cases of chronic illness, exercise may improve the condition by boosting the immune system, releasing endorphins, elevating mood, increasing circulation, lowering blood pressure, and reducing stress.

— Erika Schwartz, MD

"In cases of chronic illness, exercise may improve the condition by boosting the immune system, releasing endorphins, elevating mood, increasing circulation, lowering blood pressure, and reducing stress," Dr. Schwartz says.

But, knowing your limits and learning to accept them is another layer. And if you are dealing with a flare-up, which can cause inflammation and symptoms preventing you from a high-energy workout, you can opt for a movement that includes walking a pet, partaking in a gentle yoga class, and even some forms of dancing, says Dr. DeCesaris.

"Talking to your doctor and/or hiring a certified personal trainer for more intense workouts [especially when you’re just starting out], can be useful," says Dr. DeCesaris.

Professionals will be able to guide you to develop a suitable routine that can help prevent injury by taking you through and explaining the workouts in detail.

Benefits of Exercise

  • Reduces stiffness in the joints: According to Dr. DeCesaris, exercise helps with lymphatic flow and circulation. This is partly due to an increase of synovial fluid which lubricates joints, naturally brought on by exercise. She adds that strength training also can help promote healthy joint mobility and decrease joint pain.
  • Impacts health risks: Those with heart disease markers, like high cholesterol and high blood pressure, might see a reduced risk in more severe events of heart attacks and stroke by incorporating moderate-intensity aerobic exercise, explains Dr. DeCasaris.
  • Improves mood: This benefit is especially true for those dealing with mood disorders. Regular exercise has been shown to improve not only mental outlook but also positively impact symptoms that can often accompany chronic conditions like depression, pain, insomnia, and anxiety.

Considerations to Starting Exercise

Before attempting an exercise program of any sort, start by considering your fitness level. This is especially important for anyone with a chronic illness who may encounter issues with exercise due to a lack of endurance.

"Starting slow is important [because] someone with chronic illness may become dizzy, weak, or confused while initially exercising, which is why it's important to have a companion close by," says Dr. Schwartz.

It is, therefore, advisable to ease into exercise with your duration and frequency in order to limit added stresses on the body and avoid burnout. Exercise can play a tremendous role in uplifting your mood, easing depression, and sharpening your cognitive functioning.

Another issue she mentions is a lack of patience due to slower progress. For example, a person suffering from arthritis may find discomfort in repetitive motions, meaning a hike in reps or weight load is off the table. Such a scenario serves as a reminder to progress at your own speed for your personal journey.

Prepare for the Unpredictable

"It can be really frustrating to suffer from fatigue and low energy and trying to muster up the strength exercise, which also makes it difficult to stick to any sort of a routine," outlines Dr. DeCasaris.

With this day-to-day unpredictability, take a flexible approach to exercise, subbing in a gentle stretch session if an aerobics class requires too much energy, or even opting for a strength routine in place of pilates if you feel a burst of energy. Rather than adhering to a rigid schedule, match your workouts to your daily mood.

Address any Anxiety

While it is normal to experience some level of soreness when you start to work out, a person with chronic illness may have heightened anxiety when it comes to working out, says Dr. DeCasaris. This is where a support network helps.

Whether you ask a friend, therapist, or personal trainer, having someone in your corner can help ease your concerns. Remember, exercise has the ability to divert your attention away from what is causing an anxious spell by changing up your brain chemistry and releasing feel-good hormones such as serotonin.

Learn What Works for You

Many chronic illnesses come with aches and pains and it can feel difficult to navigate an exercise routine when everything hurts, Dr. DeCasaris adds. Take notes on what exercises reduce or diminish pain altogether and focus on the workouts that not only work for you but motivate you. Research has found that exercise deemed enjoyable is one of the strongest motivators to sticking to a regular workout schedule.

First Steps Into Exercise

An exercise program must be completely customized and unique to the individual's needs, cautions Dr. Schwartz. She also suggests creating the groundwork with breathing exercises to reduce stress, increase lung capacity, and circulate more oxygen to your brain and other vital organs. Other first steps:

  • Start slow: "If you’re just figuring out what an exercise routine for you might look like, the last thing you want to do is worsen your symptoms by going too hard on day one," warns Dr. DeCasaris. Instead, she recommends starting with some gentle stretching and walking, before adding in more intense workouts such as weight training.
  • Be flexible: As mentioned above, being prepared for the unpredictable is helpful advice when starting out exercise with a chronic illness. Don't get too attached to a daily goal or strict workout schedule Dr. DeCasaris says. Instead, listen to and honor what your body is saying so you can tailor your exercise choice accordingly.
  • Discuss symptoms with your doctor: Specific signs can indicate you may need to reduce the intensity of a workout or that your body requires more recovery. Dr. DeCasaris says discussing what symptoms to be aware of can help you exercise smarter.
  • Hire a professional trainer or coach: A qualified fitness coach can help you set sensible goals, teach you valuable skills, and plan a suitable program for you. This expert knowledge is important for both your physical safety and support during workouts.

A Word From Verywell

If you have been diagnosed with a chronic illness, you may be wondering if exercise is right for you. While there are a number of benefits to exercising—even for those with chronic illnesses—it is important to talk to a healthcare provider to determine if exercise is right for you.

They also can advise you on what would work best for your situation and what you should avoid. And if you need help developing an exercise regimen, consider talking with a certified personal trainer.

8 Sources
Verywell Fit uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Benkel I, Arnby M, Molander U. Living with a chronic disease: A quantitative study of the views of patients with a chronic disease on the change in their life situationSAGE Open Medicine. 2020;8:2050312120910350. doi:10.1177/2050312120910350

  2. Raghupathi W, Raghupathi V. An empirical study of chronic diseases in the united states: a visual analytics approach to public healthInt J Environ Res Public Health. 2018;15(3):431. doi:10.3390/ijerph15030431

  3. Gordon R, Bloxham S. A systematic review of the effects of exercise and physical activity on non-specific chronic low back painHealthcare. 2016;4(2):22. doi:10.3390/healthcare4020022

  4. Cleveland Clinic. Living with a chronic disease? 4 best tips for exercising. Updated March 7, 2017.

  5. American Council On Exercise. How to work with clients who have chronic conditions. Updated April 17, 2017.

  6. Harvard Health. Can exercise help treat anxiety?

  7. Gjestvang C, Abrahamsen F, Stensrud T, Haakstad LAH. What makes individuals stick to their exercise regime? A one-year follow-up study among novice exercisers in a fitness club settingFront Psychol. 2021;0. doi:10.3389/fpsyg.2021.638928

  8. American Council On Exercise. How to work with clients who have chronic conditions.