Training with ... Chronic Health Conditions

Your respose to training differs based on many factors, including your; age, gender, heritage, health, medical conditions, nutrition, recovery, training history, training expectations, socioeconomic status/determinants of health, stressors etc. In fact, how you respond to training will vary from session to session. The more your training is tailored to meet your needs and supports your goals, the more you will get out of it.  

This series, Training with ‘…’, discusses considerations and general strategies for modifying training in situations where doing things differently will allow you to get more out of your training. The first blog looked at training when sick, specifically when you shouldn’t and how to modify training when you do. 

Read the blog here.

Training with … Chronic Health Conditions

Chronic Health Conditions (CHCs) are very common. About half the population will have at least one of the ‘big 8’; arthritis, asthma, back- pain, cancer, cardiovascular disease (CVD), chronic obstructive pulmonary disease (COPD), diabetes or mental illness. These are the most common and contribute the greatest burden on our health care system, but any condition that requires the long-term management of symptoms is classified as a CHC. All have multiple causative and aggravating factors; genetic, traumatic, cognitive, psychosocial, environmental, and lifestyle, making them complex to manage and difficult to live with. While CHCs aren’t immediately life-threatening, they can severely impact Quality of Life (QoL) and shorten life expectancy.

Learn more:

https://www.health.gov.au/health-topics/chronic-conditions/about-chronic-conditions

Common symptoms of Chronic Health Conditions

Of course, different CHC’s will feature different symptoms, and everyone’s experience is unique.  However, due to the long term impact on multiple body systems, it’s common for people with CHCs to experience the following:

• Pain- Pain indicates potential threats to safety and encourages action that promotes health and survival. Unfortunately, when you live with CHC’s you become more sensitive to pain because your body becomes more protective. Those with CHC’s tend to experience pain more intensely and in situations where others don’t. This can make even simple daily tasks challenging.
  

• Fatigue- Feeling tired all the time and having difficulty recruiting energy is common for people with CHCs. This is compounded by chronic pain, disturbed sleep, lifestyle factors, medication/treatments, impaired physical/biological function and the psychosocial burden of living with CHCs.
  

• Autonomic Nervous System (ANS) dysregulation- The Sympathetic Nervous System (SNS) portion of the ANS prepares your body to act when threatened to promote survival. When this system is chronically dominant, such as when your body is more susceptible, the result is reduced rest, recovery, and healing.  Symptoms include stress, poor sleep, impaired cognition, emotional lability, frequent illness, delayed healing, and pain sensitivity.

To Train or Not to Train

Knowing how beneficial exercise is for managing CHCs (and health in general), ‘to train’ should be the default for those with CHCs. However, an ‘all or nothing’ approach to exercise isn’t helpful either. Instead, people with CHCs need to listen to their bodies, be flexible, and practice acceptance. 

When living and training with CHCs, it can be helpful to recognise when:

1. Your symptoms are at baseline. This isn’t an absence of symptoms but reflects a level of good functioning for you, with your usual interventions and supports. You should aim for consistency in your training at these times. ‍
2. Your symptoms are exacerbated (Flare-up). When your symptoms are more severe than usual, you require more support or intervention than average, your function is impacted, and/ or you need to modify your daily activities to manage. You will likely need to modify your training at this time‍
3. You have an acute illness on top of your CHCs. Usually, you will notice a worsening of your symptoms AND additional symptoms related to the acute infection. Usual treatments and interventions may be less effective at managing your symptoms, and you may require additional treatment. It may not be appropriate to train at this time.‍
4. Your symptoms are well managed. CHCs can be well managed with the right combination of medical, lifestyle and/or psychosocial interventions. When you have more resilience, you can slowly increase your training. 
   
   

Intuitive training Vs traditional training models

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The easiest way to adopt a more intuitive approach to your training is to be proactive and flexible. Set goals and develop a plan on how to achieve them but allow for;

1. Schedule slide- Move training around in your day / week / month to train when you are at your peak.
2. Modification- Adjust the loading of your training depending on your symptoms. 
3. Substitute- Replace one training activity for another that better suits your symptoms.
4. Support- If you don’t train, consider finding another way to support your health and wellbeing, such as meditation, massage or connecting with others.‍

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‍Getting the most out of Training with... Chronic Health Conditions‍

• Adopt an intuitive approach to your training.

• Get advice from your specialists and the professionals involved in your management. They can give you informed, individualised recommendations and help you monitor the impact of your training.

• Track your symptoms. Your symptoms will fluctuate based on many things. Consider any symptoms that concern you, including psychosocial symptoms. Objective measures such as sets and reps, heart rate (HR), Blood pressure (BP) and heart rate variability (HRV) are great, but subjective measures such as pain levels, perceived exertion, energy levels, and personal reflections can be valuable too. I’ll post more about this at another time.

• Work with a coach or trainer that has experience working with clients with similar conditions, who listens and helps you modify your training based on how you feel. 

• Talk with others that have similar CHCs to you. While your team’s specific advice and your personal experiences are the most important, you may obtain helpful insights and inspiration from others in similar situations.

• Develop an action plan for when you have a flare-up to limit the number of decisions you have to make at this time. Consider what symptoms indicate that modifying, substituting or supporting your training is better than avoiding or pushing through.

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Next, in this series of Training with..., we will consider training with pain.