Running with a Chronic Illness Ep. 1: The Physiological Impact of Exercise on Your Health and Vice Versa

Hello, my name is Pav and I live and run with two and a half chronic illnesses:

  1. II-degree AV block/Wenckebach Phenomenon,
  2. Endometriosis, and
  3. Adenomyosis.

I’ll get into the nitty gritty of these conditions later on, along with explaining why I consider these three conditions to be only two and a half. For now, let’s explore the general implications of being active while living with a long-term or incurable health condition.

Written and edited by Pavlína Marek


(Disclaimer: I’m not a health care professional. The following information is compiled from peer-reviewed research and personal experience. Always listen to your body and check with your healthcare provider before starting a new exercise regime.)

While research confirms that an active lifestyle lowers one’s chances of premature death and chronic illness (Warburton et al., 2006), many athletes find themselves on the short end of the stick, developing a disease despite their best efforts to stay happy and healthy. Even though participants in all kinds of sports have to navigate the intricacies of living and being active with a chronic illness, I will mostly focus on running as I, too, have officially entered the ranks of runners with a chronic disease.

Running with a chronic illness presents a unique set of challenges that can impact both the body and mind. For many chronically ill runners, balancing the desire to stay active with the limitations imposed by their condition requires a nuanced understanding of their own health. Navigating these hurdles is not just about physical endurance; it involves addressing the psychological demands as well.

Understanding the physiological aspects is crucial, as chronic illnesses often lead to complications that can limit physical capabilities, necessitating tailored exercise regimens. Equally important is recognizing the psychological impact, since managing a chronic illness can be mentally taxing. This dual awareness helps in crafting effective strategies to maintain motivation and pursue running without compromising health.

In this article, you’ll learn about:

  • The physiological implications of running while managing a chronic illness.
  • Benefits of exercise in regard to chronic diseases
  • Overcoming physical barriers.
  • Practical guidelines to support your physical journey as a chronically ill runner.

Next week, we’ll focus on:

  • The psychological implications of running with a chronic disease and its connections to mental health.
  • Effective coping mechanisms to help you navigate your path as a runner with chronic illness.
  • The importance of building a robust support system.

In this series, I will also share personal experiences with navigating pain, medical emergencies, and medicine management during both training and racing, focusing mainly on endurance events. And while my experience may differ wildly from yours, I hope that this exploration sets the stage for embracing both body and mind in your personal running journey.

The Physiology of Running with a Chronic Illness

Living with a chronic illness presents unique physiological challenges, influencing the body’s ability to engage in physical activities such as running. Conditions such as arthritis, asthma, diabetes, heart disease, cancer, and dementia impose limitations that vary widely among individuals. Each condition affects the body differently—arthritis may cause joint pain and stiffness; asthma can lead to breathing difficulties; diabetes requires careful monitoring of blood sugar levels.

Exercise and its Physiological Impact

Exercise can have varying effects on people with chronic illnesses, and understanding these effects requires careful consideration of the specific condition involved. According to a review by Pedersen and Saltin (2015) in the Scandinavian Journal of Medicine & Science in Sports, exercise is beneficial for patients with chronic diseases, improving both physical and mental health outcomes.

Regular physical activity has also been shown to enhance immune function and reduce inflammation, as noted in a study by Gleeson et al. (2011) Moderate exercise can therefore help improve immune surveillance and reduce infection risk, which is particularly important for chronically ill individuals.

Furthermore, an article by Warburton et al. (2006) in CMAJ outlines how aerobic exercise can lead to metabolic adaptations that improve cardiovascular health even in those with chronic conditions such as heart disease or diabetes. This comprehensive body of research underscores the critical role of exercise in managing chronic illness and optimizing overall health.

Sample Complications and Limitations:

  • Arthritis: Joint inflammation and pain.
  • Asthma: Respiratory challenges during intense exercise.
  • Diabetes: Necessity for blood sugar management.
  • Heart Disease: Limits on cardiovascular exertion.
  • Multiple Sclerosis: Neurological symptoms affecting balance, coordination, and fatigue levels. (Meet Sagirah, a MS marathoner.)
  • Endometriosis and Adenomyosis: Pelvic pain and heavy menstrual bleeding affecting mobility and exercise capacity.
  • Dementia: Cognitive challenges affecting coordination.

Underlying chronic illness and associated medication use can also increase the chance of cramping during or after runs (Schwellnus et al., 2018). These complications often require additional planning when engaging in physical activity, particularly in high-impact exercises like running.

Exercise Benefits for Chronic Illness Management

Despite these challenges, regular exercise plays a critical role in managing chronic illnesses. Engaging in physical activities not only improves cardiovascular health but also enhances mental well-being, leading to an improved quality of life. Research shows that exercise can reduce symptoms, improve mobility, and boost mood for those with chronic conditions (Warburton et al., 2006).

Benefits Include:

  • Enhanced cardiovascular health.
  • Improved muscle strength and flexibility.
  • Better mental health, reducing feelings of depression and anxiety.
  • Increased energy levels and reduced fatigue.

Overcoming Physical Barriers

Establishing realistic goals is crucial for chronically ill individuals who wish to incorporate (or keep) running into their lifestyle. Gradually increasing intensity allows the body to adapt safely while minimizing the risk of injury. Tailored programs focus on accommodating specific needs through low-impact activities:

  • Walking: A gentle introduction to cardiovascular exercise.
  • Swimming: Provides full-body workouts with minimal joint strain.
  • Cycling: Enhances leg strength and endurance without high impact.

These alternatives offer similar benefits to running while reducing stress on vulnerable areas. They’re also a great form of cross-training and perfect substitute exercises for days when your condition prevents you from doing what you love.

On top of these, yoga can also do a lot of good. While it doesn’t substitute for running as well as the above-mentioned exercises, it’s the perfect choice for days when you want to exercise even though simply getting out of bed was/is already too much. (Yoga with Adrienne is a YouTube channel where you can find yoga sessions specifically for when you’re sick.)

Types of Exercises Suitable for Chronically Ill Runners

Even with your condition, you can probably incorporate all three main types of exercise into your life. (Don’t forget to always discuss specific exercises and their possible impact or appropriateness with your doctor. Always listen to your body.)

  1. Aerobic Exercises (e.g., Running): Boosts heart health and endurance.
  2. Strength Training: Builds muscle mass, supporting joint stability and overall strength.
  3. Flexibility Exercises (e.g., Yoga): Increases range of motion and reduces stiffness.

Specific Approaches and Exercise Impact for Select Conditions

Certain chronic illnesses require more specific exercise considerations for added benefits. People with chronic illnesses often lack specific guidelines for navigating their health issues in regard to sports (Hunt et al., 2018). It can be challenging to find guidance, especially if your condition is a more limiting one. The following is in no way a complete guide; use the links provided, search on the internet, and ask your healthcare provider for more detailed guidelines should you need them.

Brief Approach Overview:

  • Cancer: Moderate exercise during and after treatment can reduce fatigue, depression, and anxiety, improve the quality of life, and even enhance treatment outcomes for certain types of cancer. (National Cancer Institute, 2019).
  • Multiple Sclerosis: Regular physical activity helps maintain mobility, balance, and muscle strength while managing fatigue symptoms (National Multiple Sclerosis Society, 2021, 2024).
  • Endometriosis and Adenomyosis: At the moment, literature is “inconclusive” as to the positive impacts of exercise on endometriosis symptoms (Bonocher et al., 2014). However, low-impact exercises and pelvic floor workouts could help manage lower-level pain.
  • Dementia: Regular physical activity may help slow cognitive decline and improve mood and social engagement (Teri et al, 2008)
  • Arthritis: Low-impact aerobic exercises combined with strength training reduce joint strain while building supportive muscles (American College of Rheumatology, 2023). Regular exercise also lowers pain amounts (American College of Rheumatology, 2023)
  • Asthma: Daily aerobic activities help increase blood flow to your lungs and lung capacity. Proper belly-breathing techniques can help manage symptoms. Stop exercise immediately and use a quick-relief inhaler if you begin to struggle. (American Lung Association).
  • Diabetes: Regular exercise can assist with the management of blood glucose levels, improve insulin action and blood pressure, lower cardiovascular risk, and improve the quality of life. It can also prevent or delay type 2 diabetes (Colberg et al., 2010).
  • Heart Disease: When it comes to heart disease, “slow and steady wins the race (American Heart Association, 2020).” Moderate-intensity activities monitored by healthcare professionals ensure safety (American Heart Association). “Accumulating evidence suggests resistance training is a safe and effective approach for improving cardiovascular health in adults with and without cardiovascular disease (Paluch et al., 2023).”

Tailoring fitness regimens to individual needs maximizes benefits while minimizing risks.

Please refer to linked research and websites for more information. Discuss appropriate exercises with your healthcare provider if you’re unsure about your specific condition. Always listen to your body and stop if you feel unwell.

Make sure you stay safe during workouts:

  1. Consult Healthcare Providers: Discuss any exercise plans with your doctor or physiotherapist before starting.
  2. Start Slow: Begin with low-intensity exercises and gradually increase as tolerated.
  3. Monitor Symptoms: Keep track of how you feel during workouts; stop if you experience pain or discomfort.
  4. Stay Hydrated & Nourished: Proper hydration and nutrition support energy levels during activities.

Consultation with Professionals & Summary

The importance of consulting healthcare providers cannot be overstated. Professionals offer valuable insights into managing exercise within the context of chronic illness.

They provide personalized advice tailored to individual conditions, making adjustments as necessary based on progress or medical changes.

Understanding both physiological constraints and potential benefits can empower you as you navigate your fitness journey. Engaging strategically in physical activity can enrich your life by fostering resilience and promoting mental health, which we’ll focus on in our next foray into the world of running with a chronic disease.

Next Episode: The Psychological Impact of Chronic Illness on Running and Vice Versa

Following:

  • The Science Behind and Personal Experiences with Running with Heart Disease, Endometriosis, and Adenomyosis
  • Pre-Surgery Preparations, Post-Surgery Recovery, and Return to Running

Citations:

American Heart Association News. “Slow and Steady Wins the Race When It Comes to Heart-Healthy Exercise.” Heart.Org, American Heart Association, 2 June 2022, www.heart.org/en/news/2020/02/26/slow-and-steady-wins-the-race-when-it-comes-to-heart-healthy-exercise.

“Asthma and Exercise.” Asthma and Exercise | American Lung Association, American Lung Association, 23 Oct. 2024, www.lung.org/lung-health-diseases/lung-disease-lookup/asthma/managing-asthma/asthma-and-exercise.

Bonocher, Camila M, et al. “Endometriosis and Physical Exercises: A Systematic Review.” Reproductive Biology and Endocrinology : RB&E, U.S. National Library of Medicine, 6 Jan. 2014, pmc.ncbi.nlm.nih.gov/articles/PMC3895811/.

Colberg, Sheri A, et al. “Exercise and Type 2 Diabetes: The American College of Sports Medicine and the American Diabetes Association: Joint Position Statement Executive Summary.” American Diabetes Association, 1 Dec. 2010, diabetesjournals.org/care/article/33/12/2692/39226/Exercise-and-Type-2-DiabetesThe-American-College.

Crow, Cheryl. “Finding the Right Exercise Plan with Rheumatic Disease.” Finding the Right Exercise Plan with Rheumatic Disease, American College of Rheumatology, 25 Apr. 2023, rheumatology.org/patient-blog/finding-the-right-exercise-plan-with-rheumatic-disease.

Gleeson, Michael, et al. “(PDF) the Anti-Inflammatory Effects of Exercise: Mechanisms and Implications for the Prevention and Treatment of Disease.” ResearchGate, Aug. 2011, www.researchgate.net/publication/51548683_The_anti-inflammatory_effects_of_exercise_Mechanisms_and_
implications_for_the_prevention_and_treatment_of_disease.

Hunt, Emily R, et al. “Being Physically Active through Chronic Illness: Life Experiences of People with Arthritis.” Taylor & Francis Online, Qualitative Research in Sport, Exercise and Health, 9 Apr. 2019, www.tandfonline.com/doi/full/10.1080/2159676X.2019.1601637.

NCI Staff. “Prescribing Exercise as Cancer Treatment.” Prescribing Exercise as Cancer Treatment – NCI, 12 Nov. 2019, www.cancer.gov/news-events/cancer-currents-blog/2019/cancer-survivors-exercise-guidelines-schmitz.

Citations:

Paluch, Amanda E, et al. “Resistance Exercise Training in Individuals With and Without Cardiovascular Disease: 2023 Update: A Scientific Statement From the American Heart Association.” AHAIASA Journals, Circulation, 7 Dec. 2023, www.ahajournals.org/doi/10.1161/CIR.0000000000001189.

Patz, Aviva. “Empowering People Affected by MS to Live Their Best Lives.” National Multiple Sclerosis Society, 2 Mar. 2021, www.nationalmssociety.org/news-and-magazine/momentum-magazine/research-and-science/exercise-boosts-brainpower.

Pendersen, B K, et al. “Exercise as Medicine – Evidence for Prescribing Exercise as Therapy in 26 Different Chronic Diseases – Pedersen – 2015 – Scandinavian Journal of Medicine & Science in Sports – Wiley Online Library.” Scandinavian Journal of Medicine & Science in Sports, 25 Nov. 2015, onlinelibrary.wiley.com/doi/full/10.1111/sms.12581.

Schwellnus, Martin P, et al. “Underlying Chronic Disease, Medication Use, History of… : Clinical Journal of Sport Medicine.” Clinical Journal of Sport Medicine, May 2018, journals.lww.com/cjsportsmed/abstract/2018/05000/underlying_
chronic_disease,_medication_use,.8.aspx.

Teri, Linda, et al. “Exercise Interventions for Dementia and Cognitive Impairment: The Seattle Protocols.” The Journal of Nutrition, Health & Aging, U.S. National Library of Medicine, 2008, pmc.ncbi.nlm.nih.gov/articles/PMC2518041/.

Warburton, Darren E R, et al. “Health Benefits of Physical Activity: The Evidence | Cmaj.” Canadian Medical Association Journal, 14 Mar. 2006, www.cmaj.ca/content/174/6/801.

Warburton, Darren E R, et al. “Health Benefits of Physical Activity: The Evidence.” CMAJ : Canadian Medical Association Journal = Journal de l’Association Medicale Canadienne, U.S. National Library of Medicine, 14 Mar. 2006, pubmed.ncbi.nlm.nih.gov/16534088/.

Yang, Howard, et al. “Exercise & Arthritis.” Exercise & Arthritis, American College of Rheumatology, Apr. 2023, rheumatology.org/exercise-and-arthritis.

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