Moving Through It: How Exercise Supports People Living with Chronic Illness

Living with a chronic illness often means waking up already exhausted. Fatigue, joint pain, brain fog, inflammation, and muscle stiffness can make even basic tasks feel draining. It’s not simply tiredness—it’s a body and mind weighed down by an invisible load. Understandably, the idea of exercise can feel completely out of reach, or even counterproductive. When you’re in pain or depleted, movement is often the last thing you feel capable of.

Yet ironically, not moving can also make things worse. Muscles decondition, joints stiffen, sleep gets disrupted, and mood declines. Over time, this inactivity loop can deepen symptoms—and leave people feeling even further from themselves.

But there’s good news: starting to move again—even a little—can help break that cycle. Regular, gentle exercise can support you to feel as good as your condition allows physically, improve mood, reduce inflammation, and—perhaps most importantly—restore a sense of agency in your own body. In some conditions, there is evidence that exercise can even reduce the severity or biological activity of the illness itself.

Reframing Exercise: From Performance to Permission

Mainstream messages about fitness often promote “pushing through” or striving for performance. But therapeutic movement is different. It’s about learning to move in ways that support, not strain, your body—and honour the reality of chronic symptoms.

This shift from performance to permission allows space for exercise to become something nourishing. Whether it’s five minutes of stretching, a short walk, or aquatic therapy, the goal is sustainable movement that feels achievable—not punishing.

The Evidence: What Research Shows

1. Chronic Pain and Fibromyalgia

People with fibromyalgia and chronic pain often experience widespread sensitivity, poor sleep, and fatigue. Despite this, regular aerobic exercise has been shown to reduce symptoms over time.

A meta-analysis of randomised trials found that aerobic exercise (2–3x/week, 20–40 min) led to moderate improvements in pain, fatigue, and physical function in people with fibromyalgia.

(Häuser et al., 2010)

Exercise may also reduce pain-related biological activity, such as levels of substance P and pro-inflammatory cytokines.

(Busch et al., 2011)

Benefit:

Reduces pain sensitivity and inflammation; improves energy, function, and quality of life.

2. Autoimmune Conditions (e.g. RA, Lupus)

In autoimmune conditions, the immune system mistakenly attacks the body’s tissues, leading to inflammation, fatigue, and tissue damage. Exercise not only supports joint mobility and cardiovascular health, but may lower systemic inflammation and improve immune function.

Exercise has been shown to reduce inflammatory markers like CRP and TNF-α, improve joint function, and increase aerobic capacity in people with RA and lupus.

(Cooney et al., 2011; Kettunen & Kujala, 2020)

Recommended:

2–3 times/week, 30–60 minutes, combining aerobic and resistance-based movement at a tolerable intensity.

Benefit:

Reduces inflammation, protects joint and heart health, and may positively influence disease activity.

3. Irritable Bowel Syndrome (IBS)

IBS is a functional gastrointestinal condition often marked by abdominal pain, bloating, constipation, diarrhoea, or fluctuating bowel patterns. While causes are complex, regular physical activity is shown to improve symptoms by regulating digestion, reducing stress, and improving autonomic balance.

Randomised trials show that moderate exercise (e.g. walking, yoga, cycling) improves IBS symptoms and quality of life.

(Johannesson et al., 2011; Daley et al., 2008)

Exercise may influence the gut–brain axis, calming the nervous system and improving vagal tone—which plays a key role in digestion and stress response.

🔁ecommended:

20–30 minutes, 3–5 times per week. Low to moderate intensity; regularity is more important than intensity.

Benefit:

Reduces abdominal pain, bloating, and bowel irregularity. Supports digestive health and stress resilience.

4. Mental Health and Cognitive Function

Chronic illness often affects mood and cognition—bringing depression, anxiety, and brain fog. Exercise enhances emotional regulation, improves sleep, and increases clarity and attention.

Meta-analyses confirm that exercise significantly reduces depressive symptoms and anxiety in adults with chronic physical illnesses.

(Kelley & Kelley, 2018)

Regular movement improves memory, executive functioning, and mental stamina.

(Baird et al., 2012)

Recommended:

20–30 minutes, 3 times per week. Activities like walking, swimming, or tai chi are especially effective.

Benefit:

Improves emotional resilience, cognitive clarity, and psychological wellbeing.

Other Chronic Conditions Helped by Exercise

In addition to the above, research supports movement as a key component in managing:

• Type 2 diabetes: Enhances insulin sensitivity and glycaemic control. Weight loss may occur but is not required for metabolic benefit.

• Osteoarthritis: Reduces joint stiffness and supports long-term mobility

• Cardiovascular disease: Lowers blood pressure, strengthens heart function

• Cancer recovery: Reduces treatment-related fatigue and improves quality of life

• Long COVID: Gentle, paced movement can support strength recovery when introduced carefully

Social and Emotional Benefits of Movement

Chronic illness can lead to deep isolation—due to fatigue, mobility limitations, or the sense that others “don’t get it.” Engaging in movement—especially in gentle group settings like yoga or aquatic therapy—can offer connection and validation. Even light social interaction during classes or walks can ease loneliness and build a sense of belonging.

Movement in natural environments also enhances mental wellbeing. Studies show that walking in green spaces improves mood, reduces stress hormones like cortisol, and boosts emotional recovery.

“Green exercise” has been shown to significantly reduce symptoms of depression and enhance overall wellbeing, even after brief exposure.

(Barton & Pretty, 2010)

Whether it’s walking with a friend, joining a class, or being in nature, movement can be a way back into the world.

Gentle Movement Practices to Consider

• Short, self-paced walking (indoor or outdoor)

• Restorative or chair-based yoga

• Aquatic therapy or swimming

• Tai chi or qi gong

• Seated or lying stretches

• Low-weight resistance or band work

The Role of Pacing and Self-Compassion

One of the most vital skills for exercising with chronic illness is pacing. Avoiding the “boom and bust” cycle means learning to move just enough—then rest. Tools like energy diaries, heart rate monitors, and the “spoon theory” can help.

But above all, compassion matters. There is no need to strive, compete, or measure progress by anyone else’s standard. The only goal is to do what your body can manage today—with kindness and consistency.

Final Thoughts

Exercise isn’t just about feeling better—it can help the body function better. In many chronic conditions, movement:

• Reduces pain

• Lowers inflammation

• Improves immune regulation

• Boosts mood and cognition

• Eases fatigue

• Builds social connection

• Reinforces trust in the body

When approached gently and intentionally, exercise can help you reconnect with your body, your strength, and your life—not despite your illness, but alongside it.

References

Häuser W, Klose P, Langhorst J, et al. (2010). Efficacy of different types of aerobic exercise in fibromyalgia syndrome: A systematic review.

Busch AJ et al. (2011). Exercise therapy for fibromyalgia syndrome.

Daley AJ et al. (2008). Exercise therapy in the management of irritable bowel syndrome: a systematic review. Gut.

Larun L et al. (2019). Exercise therapy for chronic fatigue syndrome. Cochrane Review.

NICE (2021). Myalgic encephalomyelitis (or encephalopathy)/chronic fatigue syndrome: diagnosis and management.

CDC (2023). ME/CFS Treatment Guidelines.

Cooney JK et al. (2011). Benefits of exercise in rheumatoid arthritis. Rheumatology.

Kettunen JA, Kujala UM. (2020). Exercise and immune regulation in systemic autoimmune diseases.

Johannesson E et al. (2011). Physical activity improves symptoms in irritable bowel syndrome: a randomized controlled trial. Am J Gastroenterol.

Kelley GA, Kelley KS. (2018). Exercise and depression in adults with chronic illness.

Baird CL et al. (2012). Physical activity and cognitive function in long-term illness.

Barton J, Pretty J. (2010). What is the best dose of nature and green exercise for improving mental health?