HITT me with your best thoughts - auto immune edition
March 13, 2018 6:20 AM   Subscribe

I've got some auto immune issues, and I'm female, fat and 40. I'm a mutt mixture of European and north american ancestries, but I look and pass for white instead of light brownish and have the typical redhead's pain tolerance and issues with pain meds not doing much. No label on the auto immune except now (12 years in?) I'm on daily gabapentin for generalized pain. But I've got to work out more.

Overweight by at least 60 pounds, trying to do a DIY HITT workout similar to Orange Theory. I found a few suggestions online, and started last week by doing treadmill walking and fast walking (if I were a horse it'd be a canter, not a run). I measured my pulse and got it up to 140ish now and then. That night and the next day I felt terrible, took NSAIDs to help. Every muscle in my body was on fire and throbbing like I was in a flare, and it took me a couple of days to recover.

The next time I went to the gym, I exercised before hand, walking a mile in about an hour, then spent an alternating half hour in the pool doing upper body work. I did not feel like every muscle was on fire, and my leg and upper body muscles were nice and sore from a decent work out. I was still a little "on fire" but not as much.

Yesterday was a third gym day. I needed to do some yard work, so I did it. Took a break and went inside to rehydrate when my lips got slimy (dehydration) and then skipped all the machines at the gym and alternated the pool and the hot tub, doing arm work in the pool and torso twists (legs and back were covered from yard work).

Today, I hurt in my legs and back and arms and it feels great! Like before I was sick. Nothing was "on fire" like it hurts where my muscles are connected to my ligaments to my bones everywhere. Just sore spots and fine spots and feels great.

So do I need to skip HITT training, or should I ease into it more slowly than my treadmill workout of "5 minutes walking at low incline/5 min walking a lot faster at a slight incline"?
posted by anonymous to Health & Fitness (10 answers total) 1 user marked this as a favorite
I am not a doctor, and your background is different enough from mine (active male in my 20s) that you should probably talk to your doctor about this to be safe. But from your description this sounds a lot like Delayed Onset Muscle Soreness, or DOMS. DOMS is an absolutely normal part of exercise - it happens to almost everyone, and it’s caused by your body adapting to a new stress you’re putting on it. I’ve been working out for years and I still get minor cases of it when I do an exercise I haven’t done in a while.

The good news is now your body is adjusted; odds are this won’t happen again unless you drastically increase the intensity of your workout or try something entirely new, and even then it won’t be as bad as the first time. Meanwhile, if it does happen again, Advil and warm baths should help a lot.
posted by Itaxpica at 6:41 AM on March 13

(Hit post too soon, I was gonna post the Wikipedia article for DOMS for some added context. The part especially about feeling it where the muscles connect to ligaments is classic DOMS in my experience)
posted by Itaxpica at 6:44 AM on March 13

I guess it depends on why you want to do HIIT workouts. If it's because you find the intervals fun and motivating, sure, try easing into it more gradually and see if it makes a difference to how you feel. If it's because you think they're more effective for weight loss, but you like other types of workouts just as well or better, then do the other workouts instead. Any edge HIIT might have (and I don't think the evidence is there for general fitness or weightloss) will be cancelled out if they're unpleasant and demotivating for you.
posted by Kriesa at 6:47 AM on March 13 [3 favorites]

Kriesa has an excellent point. The most effective form of exercise is the one that you actually do. If HIIT has side-effects that cause you to not want to do it, maybe you should find something else. Anything that gets you breathing hard and increases your caloric output will help you lose weight and get fitter.
posted by Anticipation Of A New Lover's Arrival, The at 6:58 AM on March 13 [4 favorites]

IANA health care professional I have poorly diagnosed autoimmune issues, specifically inflammation, so I feel you. I get inflammation from too much exercise and it can sideline me so I lose progress. If you can work with a physical therapist even briefly, they may be able to help understand the process better. When you exercise, esp. hard, your muscles produce chemicals that may be causing the extra misery. I am not an expert, so I recommend finding one.

In my case I recently got a fitbit (flex, an early basic version, on sale cheap at Marshall's) and it's helping me add activity to my everyday life, and is rewarding when I exercise. Stress causes your body to make corticosteroids, so meditation helps with inflammatory illness. I am also trying out vagus nerve stimulation for inflammation, and made dietary changes that seem to help.

It takes a ton of effort to start an ambitious, or any, exercise program when you have little energy and plenty of pain. Yay, you!
posted by theora55 at 7:16 AM on March 13 [1 favorite]

I am here to advocate for taking things *extremely* slowly as you develop your new and awesome exercise routine. This is for a few reasons: first, feeling like death after you work out is demotivating. Second, you want to avoid overuse strain and injuries, which are remarkably easy to accomplish when you start a new exercise thing and as you get older.

So, for the first month or so, take it easier than you feel like doing until you figure out what works for you and what doesn't, and maybe skip the HITT for now. HITT is a really intense approach to exercise even for people who are already in shape, so give yourself some time to build up a base level of activity and then give it another try. Go with what you like and with what doesn't set you on fire! Theora55's suggestion to see if you can work with a physical therapist is an excellent one.

I say all this as someone who got back into regular exercise at a *cough* middle-age-ish stage of life. I was SHOCKED at how much longer it took my body to adjust to regular activity than I was expecting, and I didn't have autoimmune issues to contend with.
posted by Hellgirl at 7:31 AM on March 13 [2 favorites]

I have an autoimmune condition and I cannot do exercise of that intensity any more at all - it absolutely causes a flare. What I do instead is a) powerlifting, which I can do quite heavy and they don't cause the same problem and b) gentle walking, which I can do a lot of if I'm careful. I'm actually in better shape than I've been for a long time, although my cardio is not where I'd like it to be, because intense cardio just isn't worth it any more.
posted by restless_nomad at 7:41 AM on March 13 [3 favorites]

I have an autoimmune disease and am overweight and in my early 40s, but am in decent shape. My body cannot handle intense exercise. I took a spin class for the first time about a month ago and am only now feeling back to my normal again. I can hike or walk or bike ride at a moderate pace for as long as I want to without many problems. Although, I hiked a 14er in June and ended up with a migraine and was sick for about a month after, so that was too much.

Bottom line is you don't need to do HIIT to be fit. Find an exercise routine that works for you and doesn't make you sick.
posted by BooneTheCowboyToy at 8:17 AM on March 13 [3 favorites]

Oh, OW. I know exactly what that kind of overdoing it does to me, and I'm in very much similar circumstances, with the high pain tolerance and low effectiveness of any sort of pain meds. (And an utter unwillingness to take anything strong enough to impair me.) It's all too easy for me to not notice or ignore pain until I've done so much more than I should it takes me days to recover.

This isn't something to be doing in that intensity and length unless your doctor ok'd it. And if your doctor ok'd it, and you described it in detail, I'd reconsider whether or not this doctor actually "believes" in your autoimmune disorder, or if he/she is of the "it's all in your head" line of thought.

Gradual increases of low impact exercise to hopefully prevent triggering flares that make you stop. Consistency and ability to continue day after day will get your further in the long run. Heck, I work on my feet in a often BUSY environment, and I've been able to get back up to working 10-12 hour shifts without it destroying me, but it's even that's taken some time to adjust. (And after 3 in a row of those, I still need a recovery day where I'm pretty low-energy/high pain before I think about anything requiring much movement. But hey, I can work three long days now! That's a win right there.)
posted by stormyteal at 8:26 AM on March 13

A lot of autoimmune conditions feature an increased, long-lasting lactic acid build-up post-exercise; like the others above, I can't exercise intensely anymore. (And for me, any weight loss is directly tied to diet, not activity level. I try to reduce inflammation via diet, too.) I think you should skip the treadmill-based HIIT and keep working out in the pool, as it's easier on your joints.
posted by Iris Gambol at 3:59 PM on March 13 [1 favorite]

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