Returning to activity

Pain is a common factor that prevents people wanting to exercise, however evidence shows that exercise is best for long-term outcomes of pain and function.

The key is to start slow, find exercises that are manageable, and things that do not cause a significant flare up of your symptoms. Progression should also be small and gradual, in order to monitor the impact on your symptoms.

The key to managing fatigue is balance- too little activity will lead to deconditioning however too much exercise will exacerbate your symptoms. Finding the right balance of activity and exercise can help keep us healthier and reduce the risk of losing muscle strength and fitness.

Some tiredness after exercise is normal, however if you find that after exercise that you are excessively tired the
next day, this is a sign you have done too much and should reduce your exercise or activity slightly.

This is a worsening of your symptoms that maybe felt up to 72 hours after an increase in activity and exercise. The importance of pacing is crucial in managing this, giving your body time to rest and recharge in between your activities

Palpitations can be caused by a number of factors, including dysautonomia, emotions and psychological triggers, some medications, hormone changes, heart conditions, other medical conditions.

In many cases they are not dangerous, but if you have not had this investigated you should see your GP for further advice. They may be able to screen for conditions that may require further treatment such as atrial fibrillation.

You can have palpitations even with a normal ECG. These are not always dangerous and should not prevent you from exercising, and can even improve with better conditioning. If
you have any concerns please see your GP.

Some people will experience symptoms from prolonged periods of standing, such as dizziness or palpitations. These can be caused from a condition that affects the autonomic nervous system, causing a significantly increased heart rate on positional change.

Some adjustments to exercise choice can be beneficial; try selecting recumbent (lying down or leaning back) exercises to begin with such as rowing, recumbent bike,
Pilates, resistance band exercises and over time, you can gradually incorporate more upright and standing exercises as tolerated. Ensuring good hydration is also important.

There can be many causes of chest pains, many of which are not a risk to you.
However, if you are experiencing regular chest pains and have not had this
investigated, you should see your GP prior to commencing exercise.

If you have had
this investigated, you can be assured it is safe to exercise. Most of the time this pain will be due to weakness of the breathing muscles and surrounding soft tissue.

• Yoga
• Stretches
• Pilates
• Tai Chi
• Walking

• Brisk walking
• Jogging
• Swimming
• Cycling and exercise bike
• Swimming

• Body weight exercises
• Hand weight exercises
• Resistance bands exercises
• Resistance machines