Tag Archives: fatigue

Rest and healing

We live in a sleep deprived culture, and most of us do not get enough rest. However, in terms of healing, recovery, managing problems, dealing with the impact of stress on the body and supporting mental health, sleep and rest are essential. People who are ill or in distress tend to need more time to sleep and rest.

Where this gets complicated is if you are dealing with a long term chronic condition. How much rest is a good idea if healing and recovery aren’t going to happen? How much time do you devote to this kind of self care when it’s going to be an everyday issue, and how much do you push through? If you want some kind of life, to be able to work, maintain relationships and take care of your home then you can’t rest all the time, even if your body wants to.

If you rest all the time, you lose muscle tone. Your body becomes weaker and your stamina deteriorates. Most chronic conditions will wear you out and exhaust you, but if you don’t put up a fight to maintain what body strength and stamina you can, you have less to start with each day. People who are largely well will tell you not to exercise when already in pain, but if you are always in pain and it doesn’t go away, when do you exercise? How do you maintain heart health? How much do you push and when do you rest?

There are probably  no experts to consult. It’s possible they exist, but they need to be experts in both your specific condition, and in fitness and wellbeing. Most people working professionally in health and wellness are likely to know less than you do about what might work for your body. They may also think they know more than you do. I have, for example, had to explain to several yoga teachers why yoga is a very bad idea for hypermobile people.  My Tai Chi teacher had not knowingly taught a hypermobile person before and while he was brilliant and supportive, it was a process figuring out what to do with me, and he was not initially able to advise me. Equally, I’ve had health professionals tell me to get more exercise for my mental health with no scope for even having a conversation about how to handle body pain around that.

There are no easy answers here. I’ve written this not to offer answers, but to flag up the shape of the issues. For the person struggling with their body and often surrounded by contradictory and unhelpful advice it can be difficult to trust that you may be the most capable expert where your body is concerned. It may also be an awful discovery, but the odds are there is no one better informed about your body and energy levels and how to manage it than you are. Any advice you get may be valuable, but needs understanding on those terms.

For people who do not live with ongoing pain and fatigue, the issue is of recognising what you might not know. People who are largely well don’t always respond well to invisible illness in others. What you think a person can do and what they can do are not the same things. What a person could do one day isn’t a reliable measure of what they can always do. It takes time and patience to truly support someone with ongoing pain and fatigue issues. Don’t be the person who makes that stuff harder by insisting that you know better, when you might not.

Also don’t be the person who tells someone they must rest and heal and cannot do the things until they are properly well. Some of us will never be properly well, and the decision as to what it is worth hurting for, should be a personal one, and not for anyone else to dictate.


Pain, fatigue and mental health

Pain and fatigue make moving unpleasant. However, if you’re dealing with them for the long haul, you can’t just rest. Too much rest costs you strength, flexibility, other kinds of body health and it also has a mental health impact. Pushing against pain and fatigue to be active can undermine your mental health too. There are no easy answers here, and I think some days there aren’t even any right answers available. You can only do the best you can with what you have. Anyone telling you that some fairly simple thing will magically fix you does not understand the nature of the problem.

When dealing with short term problems, ‘listen to your body’ is good advice. However, when the hurting is long term, and all your body wants to do is avoid pain, this doesn’t work. Modest exercise encourages blood flow which can help with healing. Lymph fluids don’t have any pump to circulate them and they need moving about – which means you have to move about. Muscles get weaker with lack of use, and everything gets harder and hurts more and you circle into even smaller spaces with less scope for living. Keeping moving is hard, figuring out how to do it safely is hard, and not everyone who is a professional in this area reliably knows what is safe for whom. Yoga and mindfulness are not actually good for everyone.

The conclusion I’ve come to is that it may be better to take risks with my body and focus on maintaining my mental health. If I can keep my head together, I can manage the pain and fatigue. If I plunge into depression and anxiety, bodily wellness cannot save me. So, when there’s a tension between different needs, I look most at what will best serve my mental health. There are so many days when listening to my body results in a set of contradictory messages. Bits of me need things that other bits of me will find difficult. I trust my head. In practice, my head is the bit of me that keeps the whole show on the road. If I can focus, if I have willpower to deploy, if I can reason well – I can manage everything else that much better.

It works for me – as well as I think anything can. It may or may not work for anyone else. What you’re dealing with is personal, and probably complicated in its own ways. How you navigate has to be personal, and it has to be based on your needs and priorities. Sometimes, no matter how positive you are, how much you focus on healthy life choices, doing all the right things, sometimes bodies still go wrong and hurt and decline to move much. It may mean you don’t entirely know how to manage some aspect of what you’re dealing with. It may also mean there are things that happen that cannot be managed, they’re just how it goes. When focusing on wellness, it is important to remember that there isn’t always a magic combination that will make you perfectly well, and if your body hurts it is not proof that you’ve failed in some way.

For some people, a change in diet or other lifestyle features can solve a problem – if that’s you, great. But I’ve also watched people trying to find magic bullets for problems and not getting anything to work. I’ve seen that turn into strange, faddish diets that rapidly caused more harm than good. I’ve seen it turn into a fear of doing all kinds of things. If trying to be well is narrowing your life options then it may not be working. Not everything is fixable, and learning to make the best of what you’ve got can be the most helpful and most liberating thing.


Adventures with Ankles

Most of my joints will bend the wrong way(s) under any kind of pressure. It’s only in the last few years that I’ve grasped that this is a thing with considerable implications. It explains much of why I hurt, and why I get tired a lot. The tissues supporting my joints are softer than normal, so everything takes more effort, and I’m more likely to injure myself, including micro-damage. When I was first dealing with fatigue issues in my teens, I’m not sure anyone was aware of this sort of thing. No one asked about my joints.

My ankles are especially bad. I spent my childhood falling over a lot, running was scary and difficult. But, I’ve persisted, kept moving, walked, danced, swam, did what I could with this body and tried not to hurt it too much. I hold pens and chopsticks the ‘wrong’ way to alleviate hand pressure. I hold bows the wrong way, I probably type wrongly as well, but I get by.

A few weeks into learning Tai Chi it became apparent that I couldn’t get the knee and toe positions right for most stances. It’s a small knee bend. My teacher talked a lot about not bending knees the wrong way – clearly used to a lot of older students with dodgy knees. I started exploring what was happening between knees and ankles and realised I was loading the joints badly. Thus started a massive program to re-think how I stand and walk.

My ankles default to rolling outwards in response to any kind of pressure (i.e. being stood up). This probably makes me more likely to fall over, and I suspect it puts pressure on my knees and thighs. One of my hip joints is very loose as it is and often problematic. To correct my ankles I had to get more weight onto the inside of my foot. I focused on my big toes. I did it when practicing Tai Chi, and also when walking, and at first it really hurt, and gradually it’s got easier.

This in turn has got me looking at my toes. I’ve never been a serious wearer of pointy, heeled shoes so my toes aren’t much distorted by that, but they do all roll towards the middle. Getting my weight in the right place has meant training my toes to spread out a bit more. I need to build toe strength! When learning new moves I have to figure out how I’m going to get my ankles to the right place, and this can be tricky with bigger steps, but I’m getting there, and my teacher has been supportive and helpful.

I’ve learned a lot about my body in recent months. I’ve learned things that I wish I’d known when I was a child, struggling with sports lessons. I wish my teachers had known. I wish my doctors had known when I started having fatigue issues. I spent so long with body pain being treated like an over-reaction, fatigue being treated like drama, the poor co-ordination that goes with hypermobility being treated like a personal failing or lack of effort. It’s hard to ask for help when you’ve been convinced that your body is fine and your mind is the problem. I’m getting there now, and it’s changed how I feel about myself and what I do with my body.

I’d internalised so much of that sense of my body issues just meaning that I am a crap person in some way. Having a clear sense of the mechanics has been empowering, and allows me to feel better about myself. I get tired more than the average person because everything takes me more effort. I hurt more because I take more damage. It was never all in my head. And now that I’m dealing with it as a thing happening in my body, I might even be able to improve the situation for myself.