Why am I so tired all the time?

As a tutor, I come across many people during the week. Many come for fun, but many others come because they are struggling and are looking for a way to manage their pain. “Pilates” is often quoted by Dr’s (thank you!) as a good way to deal with pain – and this is because it targets both mental and physical health in its workouts. You will often see Pilates listed under a “Mind & Body” heading, and that is because it helps you to relax, as well as strengthen your body. I am not sure if it is because the NHS is under pressure, but I am seeing more and more people come to me with chronic fatigue and looking for Pilates to help. The good news is, that it does.

First, let us look at what “chronic fatigue” is. Anything listed as “chronic” tends to be hanging around for more than 6 weeks. It may be due to Covid, or injury, or even stress. The symptoms tend to be, tiredness and unrefreshing sleep, a constant sore throat, muscle pain without reason, short term memory problems such as difficulty concentrating or remembering things, a new pattern of headache’s, joint pain, exceptional tiredness after exercise, and tenderness in the body. Most of this tiredness is not relieved by rest. If you think you have these, then please go to the GP for sound medical advice. If you think you have general tiredness and lack of energy, then have a look at some of the ways exercise can help.

"Feeling tired” often means that many people do not seek treatment, some because they are not aware that they can do, not sure what help they will get, and so will keep going in the hope that they get well on their own. This might affect both your work, or school life, your relationships, and make you feel down. If you think that you have some of these, then there are things that you can do to help overcome long term fatigue. Number one, please take things easy. This type of fatigue is not a normal everyday tiredness, and pushing through can prolong your symptoms. Be gentle and kind and learn to take small steps to fitness. The good news is that mild aerobic exercise has been shown to be of benefit for those with chronic fatigue. The key is not to think of this as training, and try to keep a lower heart rate.

To work out your heart rate zone, it is well worth using the “Karvonen Formula” . If you know your resting heart rate, use that, if not, then use 70. Find your maximum heart rate by subtracting your age from 220. Then you need to work out at 40% of your maximum to find the heart rate level you should be working at for optimum results. The formula looks like this:

Target Heart Rate Intensity Zone = ((max HR − resting HR) × %Intensity) + resting HR

But luckily, the internet is full of sites that can do this calculation for you – so use them, and write your numbers down!

Aim to start with short 5-minute walks at 40%MTHR (max training heart rate) and slowly build up to 30 minutes as you start to feel better.

CBT is often used for people with chronic fatigue, as much like chronic pain (which you all know I suffered from), dealing with the psychology of “protecting” the body from possible pain can sometimes reduce our world, make us avoid exercise and not help us deal with moving on with it.

Chronic pain for me was a big headbang, and it took me a while to get over it, so I really understand the link between thinking “if I am tired, I should not exercise as it will make me more tired”. But, science say, small daily walks (especially in nature) where you keep your heart rate low will help you both physically and mentally.

It is going to be of no surprise to hear that Pilates has also been shown to be effective in helping with chronic fatigue -- it has been shown to reduce anxiety and depression and aid a more restful sleep. The deep breathing techniques and the way that Pilates allows you to be in a more relaxed state can help to overcome some of the anxiety around fatigue. Learning to stretch and release muscle aids a more restful sleep. Steady practice and routine will enhance your self-confidence as you become a “master” of the exercises.

You can slow Pilates down to suit you and do short bursts to allow time to do the exercise and then rest. I like to offer a 3-pronged approach to this with a mobility, the exercise, a stretch and then repeat. Rather than follow a more standard, 10 min warm up , 30 min workout, stretch at the end of the session - so short bursts with plenty of rest.

If you think you have more serious symptoms rather than post-viral fatigue, general fatigue, menopausal fatigue, then please go to your dr and get the help you need. Exercise is of great value, but it is one element of healing, so explore them all.

I wish you much luck with your recovery – take care xx