Did you race back to the gym as soon as they reopened, or are you one of the hundreds of women who have sacked it off in favour of spending time outdoors? I was definitely in the first camp – but not for the reason most were keen to return to the weights room.

I didn’t just have to pause my fitness regime for a few months; thanks to an auto-immune condition, my weight training programme has been paused for years.

At the end of 2019, after months of living with debilitating exhaustion and metabolic changes, I was diagnosed with auto-immune thyroid disease. While waiting on test results and medical answers, I worked out – baffled at how tired my body felt. Despite that fatigue, the gym remained my happy place where I felt accomplished.

After receiving my first diagnosis, I paused my workout regime in order to get used to new medication. By May 2020, my symptoms had settled and I was able to head out for a lockdown run. Pounding the pavement on a sunny day, the sense of freedom that comes from running filled me with joy and on returning home, I shared a post on social media about my fitness breakthrough – relieved that my exercise hiatus was over. 

Devastatingly, a fortnight after returning to running, my ankles swelled up like balloons. Before long, my hips, wrists and knees all became inflamed and excruciatingly painful. Even getting out of bed to place a foot on the floor sent a sharp pain splintering through my body. I couldn’t get shoes on over my swollen feet.

My GP quickly realised that this flare-up was being caused by auto-immune activity once more and diagnosed something called reactive arthritis. The condition required a course of steroids and under specialist supervision, I spent the next few months on medication suppressing my misfiring immune system. 

Frustrated and defeated, the swelling subsided slowly. For months, doing minimal exercise left me feeling completely floored and walking my dog felt like agony. At a time when it seemed like everyone on Instagram was (understandably) sharing their couch to 5k achievements, my body physically couldn’t handle that kind of high-impact exercise. Doing squats or light weights aggravated my joints to such a degree that even some yoga stretches hurt. I felt frightened and alone in an unpredictable body serving up seemingly random symptoms. 

A year on and my inflammation and auto-immune disease had both come under control. The bone-aching exhaustion subsided, as did the relentless pain. To celebrate, I signed back up to the gym as soon as restrictions were lifted in April. After months of dreaming about pain-free movement, I was finally able to exercise. 

I still can’t do anything that puts too much pressure on my joints without experiencing pain. As such, I’ve had to experiment to find suitable exercises – made infinitely easier by working with an amazing PT who has guided me to move better. We’ve adjusted exercises and weights, ruled out certain machines and signposted those I’m compatible with. 

My workouts may not look like other people’s and that has led to some awkward conversations. Last week, a fellow gym member joked that my warmup is unusually long; I hadn’t been warming up but actually doing my full workout. I know that my sessions may seem mellow to others, which is why I took no offense at the comment. I was so thankful to be in that space, doing what exercise I could that it didn’t matter how I looked to anyone else.  

Having finally accepted that at any stage I may need to pause or alter my regime again, I’ve been able to concentrate on the joy that comes from moving my body rather than getting too caught up in results or external metrics. I know that when I flare again, I will need rest. I’ll be exhausted, in pain and just getting up the stairs could be a struggle. 

After six weeks of being able to exercise, I’ve increased my weight-bearing exercises, returned to my cross-trainer workouts and can use certain resistance machines again. Because of these experiences, I’ve learned to recognise my body saying “enough now”. It’s that acceptance that has helped me to appreciate fitness even more.

While working out with a chronic health condition may come with certain limitations, it also instills a steely determination. Because of that, I’ll continue moving as and when I can and enjoying every rep.

Ease yourself in

“If you have had a period away from regular exercise due to illness, it is really important to gradually build up the time and intensity of exercise you are doing when you return,” says GP and BBC Breakfast regular Dr Rachel Ward. “You may feel disheartened at times if you find your physical goals challenging due to a chronic condition,” she adds. “However, it is so important to understand that any exercise has a positive physical health impact but also whatever you do, there are significant mental health benefits that make it so worthwhile.”

Keep a diary

“Recording the type and duration of exercise alongside symptoms associated directly and 24 hours afterward can help establish both healthy and unhelpful patterns,” advises Miriam Daurat, chartered physiotherapist and pain management specialist with Our Health Hub. While that may be one of the harder things to persevere with, Daurant says, “these can then be discussed with your healthcare provider as needed.”

Make adaptations

“If a stretch hurts past a certain point, ease off until you can still feel a stretch but there is no longer pain. Stretch within this pain-free range and every week try to push a little further,” advises Daurant. “This will help you to safely improve your flexibility.” Explain to trainers (where necessary) the limitations you may be working with and if doing group sessions “inform the person running your classes so that they are aware and can adapt activities safely for your benefit.”

Seek support

There’s specialist guidance out there, Dr Ward says. “If you are keen to start exercising but are unclear what is best for you and your overall health, there are many GP exercise referral schemes available for people with chronic conditions.” As a part of this, “you will be signposted to a fitness team who understand your health needs and can advise you where to start and how to progress safely.”

Don’t fight a flare-up

Above all else, Dr Ward emphasises the need to spot the signs of being overworked. “It is important to understand cycles and recognise when your body needs rest,” she explains. “You may not need to stop exercising completely during these times but a change in the intensity and type of exercise may be beneficial.” Daurant agrees, adding: “This comes with time,and will evolve in response to any changes in your condition and physical fitness levels.” 

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