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Managing Chronic Fatigue

The question coming in today is from a guy asking for his name to be withheld.



So, we’ll call him Bob.


For no reason other than that’s the first name that popped into my head.



Bob writes:


“Morning Dave,



It's a question & health condition I've battled with over the years so it's hard to admit it sometimes. When I was into barbell training (before chronic back pain took over and then covid, I stopped going to gyms and got the TRX and some KBs for home workouts) I remember reading in Wendler's Forever 531 the phrase something like "don't be that person, Mr Adrenal Fatigus" and that stuck with me and hurt a bit! We can't all be beasts. That said I saw massive gains from 531.



I don't utilise HRV. I remember your post and have looked briefly at it in the past but never properly looked into it. I'll go back :)



Probably also worth saying that my training is casual. I'm not looking to be a beast. I'm looking to be averagely strong for my size (around 11.5 stone, 5'7), the byproduct of muscle for aesthetics, but move as well as I can. Hence I don't completely miss the barbells and do prefer the approach now with lots more rotation and function in my training. That's not to say I wouldn't love to put a heavy weight on my back again and squat it, or a monster deadlift for my size. I was proud of those lifts and those numbers but for now my world favours the home training approach.



Look forward to the response!


Cheers


Bob”



There’s a lot to unpack in that, but the crux of the email revolves around chronic fatigue.



Anything “chronic” is a nightmare.


Fatigue doubles down on that, so Bob, I feel you mate, and i hope you find a way out of this.



But what shines through first and foremost is that attitude that I always talk about.

Bob has that attitude.

Bob isn’t going to lie down and accept his fate, Bob is a fighter and will keep fighting.



This is the way.



The trick is fight smart.



Chronic Fatigue can be caused by a range of issues, for example ( and this is not exclusive):


viral infections, such as glandular fever


bacterial infections, such as pneumonia


problems with the immune system


a hormone imbalance


your genes – ME/CFS seems to be more common in some families



Getting to the bottom of the actual cause can be difficult, and potentially impossible.


So we’re looking at management.



Bob mentions HRV.


Several emails ago I told you that HRV probably isn’t going to help you, but this is a situation where it just may.



HRV is the variance in the rhythm of the heart rate. A heart rate of 60 beats per minute isn’t 1 beat per second.

It’s a beat at 58 seconds, the next at 65 seconds, the next at 62 seconds, the next at 57 and so on.

It may average out at 1 per second, but it varies. The more it varies, the more parasympathetic you are, the less, the more sympathetic.


Most apps give you a daily readiness score, a prediction of what you can expect of yourself today. And also a score out of 100 which is your actual HRV number.



The readiness score is handy for letting you know how well you are recovering from whatever stresses you’re placing on yourself, including training.

The HRV score out of 100 gives you a longer term view to see if changes you are making are helping or not.



In Bob’s case, on days where fatigue is high, the readiness score will be low so he can adjust training to suit. The score may also change leading up to a crash in energy levels so may help predict and prevent crashes.



The trend then shows if any dietary changes, any nighttime pre sleep routine changes, any work or relationship changes, changes in CO2 tolerance and of course, changes in training load/style are making a difference.



Interpreting HRV takes a bit of learning, but in this case I feel it may be useful, especially over the longer term.



As for training.


5/3/1 is one of my favourite general strength programs, but if no longer using a gym, it’s not suitable.

The value of 5/3/1 comes in it’s inherent flexibility.


The last set of each session is x+

Where x = the minimum number of reps required, but there is no maximum, you do as many as good form allows.

The assistance work is also somewhat optional.


So you can literally go in, warm up, load the bar and be leaving again inside of 20 minutes.


Or you can stay and work for a full hour if time and energy allow.



It is a simple progressive program that is meant to feel somewhat easy most of the time.



Take that mentality into a home based workout and you are golden.


Some days you go hard, other days you go, well, less hard.



Arranging the training can be done many ways.

Push, Pull, Hinge, Squat

Strength, Endurance, Power


Kettlebell, Bodyweight, Outside



It depends on your wants and needs.


And with chronic fatigue, those needs may simply be getting something done.



If you get a Green on HRV, train hard that day, go all in.

If you get an Amber, reduce the volume right down. It’s far easier to recover from intensity than it is duration. So less sets. Maybe only one heavy set of relatively low reps. Everything else easy

If you get a Red, consider still getting n something, even if it is just a walk.



Why one heavy set?

Even a 3x3 heavy?



Sometimes it “resets” us. Sometimes a short acute stimulus to the nervous system kicks in the recovery processes we need. It tips us over into Parasympathetic, which if we then fuel up and get some good sleep while managing stress, may leave us feeling great the next day.



It’s a balancing act.



Life always is, but dealing with chronic illness makes finding that balance just that little bit harder.



HRV may help tracking


Improving cardio vascular fitness and CO2 tolerance may help


Dietary changes may help (talk to our Seb)

Building and maintaining muscle mass may help



And if you want mine or Sebs help, just reach out.





--

Regards


Dave Hedges

www.DaveHedges.net

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