Q Postviral fatigue syndrome. Is there anyone else out there who's had this and what did they do about it? The symptoms are tiredness all the time, sleep disturbance, joint and muscle pain, exercise intolerance.
Kit,
Dr Kim says:
Post-viral fatigue syndrome, chronic fatigue syndrome, infectious mononucleosis and myalgic encephalitis are all terms used to describe a condition that is characterised by severe fatigue, muscular aches and sleep disturbance.
These symptoms were initially recognised as a syndrome in the 1980s but, despite considerable research into the condition, the cause unfortunately remains poorly understood. Many people experience a cold or flu like illness before the onset of the more severe symptoms so it is thought that the syndrome may be caused by a viral infection. Ebstein Barr virus is one of the implicated ones but there are loads of others out there! Also, many people with the syndrome have been found to have changes with the immune system, which also suggests an infective agent is the likely cause.
The illness itself can have a devastating impact on people's life, work and sport, which should not be underestimated. On top of this, doubts about the cause, duration and treatment of the illness can compound the surrounding uncertainties and be even more demoralising!
Thankfully, the illness is relatively rare (I know that won't provide much relief for you Kit!) effecting less than 2% of the general adult population and mostly effecting 20-50 yr olds. However, many an elite sportsman or woman have been effected, including road cyclist David Millar.
So what can you do?
You will be pleased to hear, one of the most beneficial methods of treatment is exercise! And, conversely, prolonged rest will not do you any favours. However, before you dive back into things full tilt, this definitely has to be done in the right way.
The first rule is slowly, slowly, catchy monkey.
If you immediately try to return to training at the same level you were at before the illness you are going to run into trouble. Fatigue and muscle aches will prevent you from maintaining your previous training pace, which can destroy your self-esteem, fill you with a feeling of loss of control and lead to frequent interruptions in training…which will just perpetuate the vicious cycle.
The good news (for cyclists and other endurance athletes) is that endurance or aerobic level training is just the right thing to be doing. You must set realistic goals though and try to maintain a steadily graded exercise programme. You may have to cut back dramatically on training time initially, maybe aiming for just 20-30 minutes 3 times week. Your heart rate may be raised for the training effort you are used to, but it is important to reduce your workload to keep in your aerobic zone (even if this means using tiny gears) and keep sessions short. Then as you can tolerate this gradually increase it. Longer rides of 2 hrs plus are out for the initial period and I'd be cautious about how much you do on a warm weather training camp (aside from enjoying the sunshine).
Unfortunately, there are no hard or fast rules about how much exercise to do and over what period of time, mainly because the illness can affect people in different ways and different people have varied levels of fitness to start off with. But don't worry about gradually increasing things even over several months or one year.
Other things that you may want try, include:
- Relaxation therapy or learning relaxation techniques and giving yourself regular time intervals to use them
- Flexibility training or working regular stretching into your training programme
- Trying to reset your sleep pattern (easier said than done!)
- Evening primrose oil, which some people have found effective and others have found no use at all.
Finally, anxiety and depression are both seen in people with chronic fatigue syndrome. This is not surprising given the impact it can have on a day-to-day level. If you think your mood is being adversely affected then you should see your doctor for further advice. This is a serious point.
To summarise, take your time in getting back into it, try some of the other methods to supplement your training and remember to keep a long-term view in mind, no matter how frustrating this may be in the here and now.
DISCLAIMER: Advice and information is provided via SheCycles.com Clinic on a free of charge basis as a supportive service to women in sport. It should not replace the use of your General Practitioner for medical problems.
Kit
