Why Lyme Disease and Exercise Deserve a Second Look

In my clinical practice, I’ve worked with patients who could barely walk across the room—let alone exercise. But I’ve also seen those same patients regain strength, mobility, and hope when we introduced the right kind of movement at the right time.

When Lyme disease is part of the picture, the body often deals with fluctuating energy, joint pain, muscle weakness, and sometimes nervous system sensitivity. That means exercise isn’t about “pushing through,” but instead about listening carefully to your limits and honoring what your body can handle on any given day.

Exercise can be a powerful tool for recovery. But for people with Lyme disease, especially those dealing with chronic symptoms, it’s often misunderstood — and mistimed.

Let’s talk about how to approach Lyme disease and exercise.

Start With This: Not Everyone Can Exercise (Yet)

Before we dive into recommendations, let’s be clear: If you’re in the middle of a flare, struggling to walk, or reacting to medications, you may not be ready for exercise. That’s okay. Pushing through can backfire, leading to post-exertional malaise, symptom flares, or even setbacks in your treatment plan.

Instead, we focus on pacing, stabilization, and symptom control first. Then, as you improve, we gently reintroduce movement.

5 Gentle Ways to Reintroduce Movement in Lyme Recovery

1. Start Where You Are—Even If That’s in Bed

If walking to the mailbox feels impossible, start with stretching in bed or doing ankle pumps. Restorative movement, like diaphragmatic breathing or light stretching, still counts. And it often lays the foundation for more.

2. Focus on Frequency, Not Intensity

Forget “no pain, no gain.” In Lyme recovery, consistency beats intensity. Try a few minutes of movement, once or twice a day, and build from there. Even two minutes of chair yoga or standing stretches can help retrain your nervous system.

3. Support the Autonomic Nervous System

Patients with POTS or dysautonomia often struggle with standing or exercise intolerance. I often recommend starting with recumbent movement, like pedaling on a floor bike while seated or doing gentle core work while lying down.

4. Treat the Infection and Watch for Improvements

In my practice, I’ve had patients who couldn’t exercise at all until we treated underlying infections — especially Babesia, which causes air hunger, night sweats, and post-exertional fatigue. Once their treatment took hold, they were surprised to find they could walk, stretch, and move again.

5. Track Symptoms, Not Just Progress

If you try a new activity and feel worse the next day, scale back. It’s not failure. It’s feedback. A symptom journal can help you spot patterns and fine-tune your movement plan.

Barriers That Keep Patients From Exercising

Many patients want to exercise but they’re held back by one or more of the following:

• Pain (musculoskeletal, neuropathic, or joint-related)

• Fatigue that feels crushing and unpredictable

• Fear of relapse or post-exertional malaise

• Vertigo, dizziness, or lightheadedness

• Heart palpitations or exercise-induced tachycardia

• Air hunger or shortness of breath

• Depression, hopelessness, or trauma from past flares

• Stigma: “If I can walk, people think I’m not really sick.”

Recognizing these barriers is the first step toward overcoming them. We don’t ignore them—we work with them.

A Patient’s Story: “I Was Afraid to Move Again”

One of my patients had been bedridden for months. She feared any activity might bring back her worst symptoms. We started with leg slides in bed, then progressed to sitting stretches, and eventually to short walks in her home. Six months later, she could walk around the block with her child and smiled when she told me, “It feels like I have a life again.”

Final Thoughts: Lyme Disease and Exercise Can Coexist

If you’ve been told to “just exercise” your way out of Lyme disease, I’m here to say: It’s more nuanced than that.

Yes, movement can be medicine but only when guided by clinical judgment, patient readiness, and individualized care.

Here’s what I tell my patients:

1. 1. Start small.
   2. Listen to your body.
   3. Stop if it sets you back.

And when it works? Celebrate the progress — no matter how tiny.

References

• Supervised Resistance Exercise for Patients with Persistent Symptoms of Lyme Disease

• Lyme Recovery Takes More Than Just Rest

• Lyme Disease Prevention, Tick Removal, & Health and Wellness Tips