Temporary Weakness After Exercise

[William Palmer]

Same happens with me on my elliptical. I can manage ten minutes. If I try for much more, my walking is labored for an hour or so. Same happens when I mow the lawn–it’s very hard for me now after 15-20 minutes. I take breaks and do what I can. I haven’t found anything to be done for this issue. But if I go to town to shop for groceries, I make sure I exercise when I get back. Otherwise, my walking will become very labored in town. Fatigue sets in fast. Realizing this has helped me not ruin my trips into town.

[Bruce Van Camp]

Thanks for the response William.

 

[Dr. Barry Seiller]

Kevin and Bruce and any others MALE OR FEMALE who have experienced the same problem of weakness on a  delayed basis after exercise should have a stress test performed.

Dr. Barry

[David Blacker]

Just a correction, it was Dan, not Dr Ahlskog himself, who brought up the “ burning through” L-dopa suggestion with exercise.

 

looking through the other replies it’s clear that we need a much more organized and expert, individualized approach to the prescription of exercise in PD

Last year, the Parkinson’s foundation put out a fabulous table summarizing recommendations for PD exercise across a wide variety of exercise formats including aerobic, strength, balance and flexibility; with suggested duration and intensity.

Exercise is so valuable for PD, and for other neurological conditions ( cognitive decline, stroke) that we really should develop “exercise neurology” as a subspecialty. I see this as potentially being of huge benefit

 

David Blacker

neurologist with PD ( and insomnia!!)

 

[Kevin McGuinness]

1. Hi Bruce.  I do the treadmill everyday for 30 minutes at 3 mph.  I experience the same post exercise symptoms you described.
   I go home and sit for awhile but still have some residual weak feeling in my legs throughout the day.  I enjoy the treadmill and i just accept what follows.

[Bruce Van Camp]

Thanks for responding Kevin. Just hoping that someone may know what may help with the issue.

[Clive Varejes]

Hi all,

Yes, I do find that after gym & cycling I do feel ‘weak’ as well.

I’ve been told by my neuro that it is actually fatigue, and that is fairly common. It’s not that you want to go and sleep, but you feel  totally ‘nackered’ for lack of a better term, for an hour or so.

[Daniel Novak]

Several MDS now acknowledge that we burn through our meds when we exercise. That means, in my case, that my burn rate out paces my absorption rate [getting LDopa from mouth thru gut through blood-brain  barrier].

Add to that my PD exertion penalty of approx 20% and oxygen transfer penalties of 10% and I should be excited to do what we do!

Ask your MDS if you can try boosting  )) your meds before your primary workouts with a quick acting hit  of your medication. Beware of saying you saw this on the internet…. and some docs vehemently oppose extra ldopa due to old beliefs.. Say you read it in New Parkinson’s Disease Treatment Book : Partnering with Your Doctor to Get the Most from Your Medications
by ,, J. Eric Ahlskog at the Mayo Clinic

[Denise]

My husband always feels as though he’s burned through his medicine much faster when he does the stair master. He believes the lack of dopamine is what makes him feel tired or weaker. He always views it as a wearing off each morning, expedited by exercise.

[Charles H Levin]

Interesting … I’m not having that issue … I do about 35-40 mins on my elliptical, 30 of those minutes at 80-85 percent of my max heart rate … I monitor with an Apple Watch …

What I have noticed after my workout is that my tremor is more pronounced and I can barely type for about 30 minutes… which is frustrating …

I get fatigued on occasion, but it always seems to be on days when I didn’t get enough sleep … In general, my energy is still great and I plan on hiking the west coast of Ireland in August …

My case is a rather odd one … I developed an action tremor (diagnosed as Essential Tremor) in 2007 … It didn’t change until early 2019, when it was clearly a resting tremor … I was also developing some slowness for about six months before that (bradykinesia) but, like so many parkies, I had no idea what was happening until my diagnosis in June 2019 …

My docs call it benign tremulous parkinsonism … the word “benign” is a bit misleading … it means it’s moving at an “exceedingly slow pace” … How rare or frequent this is depends on the doc you’re talking to …

Thanks, Daniel Novak, for mentioning that book … I will check it out … BTW: I just finished Jon Palfreman’s “Brain Storms,” which was very good …

[Daniel Novak]

Charles, your hiking trip sounds exciting!

I suggest that your experience of added tremor and reduced typing is due to a lower level of dopamine in the brain after your workout, in other words, the same issue at a better level than ‘us guys’ with PD for 10+ years, 15+ in my case. Of course, normal fatigue and muscle weakness also affect; most normal folks after a good workout.

[Denise]

When my husband first started to exercise, after diagnosis, he would tremor excessively for the first three months. It appeared that once he got fit, the tremors subsided. Now, recently he had a brain bleed post-op to Part A of DBS Surgery (the unfortunate 1%), and so his exercise program was greatly interrupted. (Its taken him several months to recover all his deficits.) Four months later, he is back to his stairmaster exercise, and once again, the extreme tremoring started until he once again, reached that level of “being fit” once more.

[Alan M]

As a matter of fact, I have this same experience, Bruce.  I purchased a treadmill last September and started in earnest.  But after a couple of months of treading, I noticed a similar response, that I termed “weak in the knees”.   Both my knees were operated on (due to my earlier career ‘bush bashing’) so I attributed this noticeable weakening to bad joints.  It actually got me worried enough that I stopped treading recently.

Now that I read the responses your astute post has elicited, I’m beginning to wonder if many PwP struggle like this?

[Louis Comitini]

Good Day From Montreal Canada :-)—I take my Levo/Carb at 7 a.m. and start working out around 8ish for an hour or so, Stretch 15 minutes/ Treadmill-1/2 hour ( a few minutes in between of a slow jog)/Biking 10 minutes/elliptical 5 to 10 minutes/rowing 5 minutes/ and YES after that I feel a little tired and the legs are usually weak afterwards.  So I usually go listen the radio for a half hour take a shower and eat some fruits and a then a fruit-Shake, wait a half hour then at 10 I take another pill at 10 and if I also get a good night sleep I start the day.  That is when I have a good day! 🙂

58 almost 59 – Been diagnosed since August 2018 — 3 1/2 years, but as most of us had it for at least 2 to 5 years prior. No tremors yet but have most of the other symptoms, Gait issues, Anxiety, fatigue, sleep issues, swallowing at times.  It could be worse, so I try to stay positive and feel fortunate and have what I have and try to deal the best I can!

Louis Comitini

 

[Daniel Novak]

Louis, thanks for sharing.  It sounds as if you are part of the 30% of PwP that do not present tremor as a major symptom.

[David Blacker]

Hi Bruce

A few things.

You should probably get a thorough review by your neurologist or internist to ensure there is not another cause for your leg weakness such as poor circulation or spinal canal narrowing.

More L-dopa may be needed; great to see Eric Ahklkog chipping into this discussion ; his books are a “must read” and his views on exercise are progressive and world leading

Finally, input from an exercise physiologist to tailor and vary your training program should help ; slogging   Out the same distance on a treadmill all the time will lead to initial improvement, a plateau and then decline . Athletes don’t train like that, nor should we with PD; they have quiet weeks and variation- get good advice from an exercise physiologist and it can help a lot

best wishes

David Blacker

neurologist with PD

 

 

 

 

 

[Bruce Van Camp]

Thanks to all of you who posted comments. I’ve got some good ideas to go with now.