Trust me, I know how to use this machine

How stigma and other concerns can add complications to exercising with a physical disability.

In a previous blog, I discussed the added complications for exercising for neurodivergent people (specifically those with ADHD). Now, I want to look at the same situation for someone with a physical disability.

Imagine this scenario:

It is a Tuesday morning and you have to be at work or class by 10 AM. Normally you have to go in by 9:00, so the temptation to sleep in is strong. You turn on your phone and the weather app says that it is 36º F and raining. Last night, you told yourself that you would go to the gym in the morning before work for 30 minutes. The gym is a 15 minute drive away, so if you want to be able to shower before work, you will need to leave home at 8:45. You finally pull yourself out of bed at 7:15 and everything else runs smoothly from there.

This is a hypothetical morning for a hypothetical person who is not disabled. This person still has their individual concerns and needs, as all people do, but for the purposes of this thought experiment, I hope you will humor me with these generalizations.

Additional Concerns for Chronically Ill People

Now imagine that you have Chronic Pain or some other chronic physical condition. In addition to the normal struggles most people face when dragging themselves out of bed when it is rainy and gross outside, there are now additional concerns. For many people with chronic pain or joint conditions, rain is the enemy. While the science of how increases in humidity and rain cause pain in joints is not fully understood, there is significant evidence supporting the connection between weather and pain (Smedslund and Hagen 2012; Dixon et al. 2019). Depending on the person, a rainy or very humid day could leave someone with joint pain in so much pain that they can barely handle standing, or even sitting, for periods of time. Going to the gym and exercising is therefore out of the question for that day (and likely for the next few days as they recover from the increase in pain).

For a person with certain types of heart conditions, it may take them at least 5 minutes to simply get from laying down to standing. Other people may have strength or stretching exercises they have to do before they can stand up. These are all barriers that exist before a person even gets out of bed; from there, the barriers don’t stop. To learn more about managing energy with a chronic physical condition, see my blog on the Spoon Theory.

Barriers to Going to a Gym

In addition to the normal mobility concerns that people with physical disabilities face in their everyday lives, going to the gym can bring a new set of obstacles. Below are examples of complications physically disabled people may face in going to a gym. These are not exclusive to this population, but they are likely more extreme, especially when they start adding up.

Social/Mental:

• Not being able to go alone (either for mobility or Anxiety reasons)

• Stigma of entering gym with a mobility device

• Anxiety of not knowing how to work the machines (this is especially stressful when everyone is watching you, like is the case for people with visible disabilities)

• Fitting exercise into the schedule around doctor’s appointments

• Trauma from previous bad experiences when working out in public

Physical:

• Only being able to do certain exercises without causing pain

• The process of trying to learn what works for you is more complicated

• Recovery times between exercise sessions are often longer, so you may only be able to go 2-3 times a month

• Might be in too much pain from day-to-day movement to do a full exercise session

• Might have to wait a period of time before or after taking meds

• The lack of accessibility in most gyms may stop you from even getting in the door

This is by no means a comprehensive list. It only provides a sample of the many complications physically disabled people face when attending gyms. Each person has a unique mixture of these barriers depending on their health needs and personal situation.

Personal Experience

Many people feel like everyone is watching them when they are working out in a gym, but when you have a visible physical disability, it is not just a feeling. When I enter the gym with my cane, many people stop to watch me—and they aren’t subtle. Before I became physically disabled, I was able to use the machines wrong without people feeling the need to correct me. But now that I have a cane, people feel the need to step in.

The sole reason that I go to the gym is to use the elliptical machine. Ellipticals work really well for me because I don’t have to pick my feet up, which minimizes impact pressure and the need to support my weight on one leg like with walking and running. I know it looks weird to see a person walk into the gym using a cane and then get on an elliptical and “run,” and if I wasn’t the one doing it, I might also be confused, but physical disabilities are complicated. It sometimes doesn’t make sense when one thing that should be difficult doesn’t cause pain but something that should be simple is extremely painful. However, just because it doesn’t make sense does not mean that it isn’t valid. To learn more about my experience as an ambulatory mobility aid used, see my blog titled “Standing Up.”

Activity Recommendations for a Healthy Lifestyle

It is recommended that adults exercise for at least 30 minutes per day at least three days per week. However, these recommendations were not created with people with chronic health/mobility conditions in mind. Exercising three times a week may be completely unfathomable to an individual who struggles to even find the energy to clean the house. They may have to decide between exercising and cleaning, cooking, showering, doing laundry, or other such chores and when it comes down to it, exercising is often the first activity to be forgotten. It is not a simple matter of making time for exercising, but rather about having the energy to exercise.

It is important that I clarify that energy in this context doesn’t refer to coming home after a long day and just wanting to lay down. It is a physical and mental exhaustion that can bring a person to tears at the thought of having to stand or move at all. To learn more about the extra complications chronically ill people face when it comes to managing energy, click here to read my blog on the Spoon Theory.

What I have learned as a physically disabled person is that any exercise is worth it. I simply cannot meet the physical activity recommendations, but I can’t let that stop me from doing any exercise.

Even though I enjoy using the elliptical, I have decided that it is only worth me trying to go to the gym around twice a month. I don’t want to put too much pressure on myself and cause my health to suffer from aggravating my chronic illnesses. However, to compensate for how seldom I am able to make it to the gym, I have developed an exercise routine that I can complete in my bedroom. YouTube is a great source for finding workouts for people of all activity levels, whether you are barely a beginner or an expert. It has allowed me to monitor my health while I exercise and take breaks whenever I need, and I don’t have to worry about the social expectations that come from being physically disabled in a gym.

Still, even though I am able to exercise in my room away from the stigma and judgment present in gyms, I still usually can’t meet the activity recommendations because of my pain concerns. We can come up with mechanisms for getting around uncomfortable environments, but when it comes down to it, we are still physically disabled and therefore cannot be expected to hold ourselves to the same standards as able-bodied people. And that’s okay. Being physically disabled is nothing to be ashamed of. We may be different, but that does not make us lesser.

Sources:

Smedslund, Geir, and Kare Birger Hagen. 2011. “Does Rain Really Cause Pain? A Systematic Review of the Associations between Weather Factors and Severity of Pain in People with Rheumatoid Arthritis.” European Journal of Pain 15 (1): 5–10. https://doi.org/10.1016/j.ejpain.2010.05.003.

Dixon, William G., Anna L. Beukenhorst, Belay B. Yimer, Louise Cook, Antonio Gasparrini, Tal El-Hay, Bruce Hellman, et al. 2019. “How the Weather Affects the Pain of Citizen Scientists Using a Smartphone App.” Npj Digital Medicine 2 (1): 105. https://doi.org/10.1038/s41746-019-0180-3.