One of the many activities curtailed by having an adverse reaction to fluoroquinolone is physical exercise.  Whether you were an athlete prior to your FQ ADR or you were a sedentary individual, exercise can play an important role in your post floxed life, enhancing it and helping the body with the healing process.

I am not going to extol the general virtues of exercise since by now everyone should know that exercise benefits the body in many different ways and information on this subject is easily researched.  I will however extol the virtues of exercise for the floxed individual. 

After our reactions, many FQ sufferers become quite health conscious. Paying attention to drugs that are taken, foods that are consumed, and working hard on keeping what we have left of our bodies in good working order. Regardless of the type of FQ reaction that you have, you are going to have collateral damage. The amount of collateral damage obviously varies from victim to victim depending on numerous factors.   However, for most FQ sufferers there comes a point in their reaction timeline when they choose to start integrating a physical exercise regimen into their road back.  I think that there are numerous reasons why we, as FQ sufferers, should start exercising when we are physically capable.  In the next few paragraphs I will elaborate on a few areas where I think exercise benefits the FQ sufferer in particular.

Exercise has numerous positive effects on cognitive function and neurological function.  Most FQ sufferers have at least some neurological damage that can manifest itself in numerous different ways.  Exercise has been shown to improve cognitive function by helping the hippocampus in the brain and improve synaptic responses.  It does this by increasing cell proliferation or turnover rate of nerve cells by increasing growth factors that create new nerve cells. Exercise also increases blood flow through the brain which increases the amount of oxygen the brain receives. 

Moderate exercise helps the immune system. Studies have shown that moderate exercise can reduce the amount of upper respiratory infections and reduce bodily inflammation. In addition, Exercise can help regulate adrenal output by helping reduce the level of cortisol buildup in the body.  Excess cortisol can lead to numerous health problems.  One problem faced by some FQ sufferers is adrenal gland malfunction.

Three questions that are often asked after one suffers from an ADR to the fluoroquinolones are: when do I start exercising, what type of exercises do I do, and how often?  When, is obviously a hard question to answer.   Two years into my reaction my joints still felt like they were held together by rubber bands and that too much exertion would cause damage.  It was not until I was at 32 months out that I decided to begin an exercise regimen.  For each sufferer, the answer to “when” question differs according to their reaction.  I know some floxies that were exercising three months after their reaction (obviously not a very severe reaction physically) and I know some who have not started five years after their reaction.  This decision is such a personal one and must be left to the individual and how they feel.  I believe that rushing to exercise too soon can cause severe damage.

 What type of exercise to do is also a hard question to answer but there is some helpful information garnered from other floxies who have started an exercise program.  Most FQ sufferers cannot tolerate impact exercise for quite some time, if ever, after their reaction.  I was very physically fit prior to my reaction and now almost three and a half years out I cannot tolerate any impact exercise whatsoever, that includes even walking for very far.  What I can tolerate is a no impact adjustable resistance exercise.  My exercise of choice is stationary bicycling. I purchased a very nice recumbent exercise bike with adjustable resistance that can be changed while bicycling and a built in cardio monitor.  I am able to adjust the resistance depending on how my legs feel that day and give myself a good aerobic workout.
The exercise bike allows me to work my ankle, knee and hip joints and well as the muscles associated with these joints. To benefit the rest of my body I do light resistance exercises to my arms and shoulder joints.  These consist of pulling, pushing, lifting, and curl exercises while a helper puts variable light pressure on the joints.   I can direct the helper to put more or less pressure on the joints depending on how they feel.  One final exercise I do is some mild sit-ups to keep the back limber.

Some floxies prefer to exercise in the swimming pool, and this can be very beneficial especially if it is a heated pool.  I have however had some floxies say that swimming still puts too much resistance on knee and shoulder joints.

Talking about exercising for floxies would not be complete without talking about pain.  I never realized the body could experience so many different kinds of pains at so many different levels.  Early on in my reaction deciphering the different pains was very hard to do.   Only after time did I learn what pains to pay attention to and what pains to ignore.  I had to learn that the “headache” like pains that I get in my joints, were not serious, and did not affect my exercises at all.  Then there are the phantom pains of neuropathy that come and go and with me are completely unrelated to exertion. If I get sharper pains in the tendons, I know that I have to back off the exercise and cool the tendon down.   I do this by putting an ice pack on the offending tendon after exercise. On an important note, exercise for the most part lowers my overall pain levels.  On average if I am not able to exercise for three days or more, my pain levels in usually increase.

This leads to me to the question of “how often?” In my life pre-floxing I would do intense aerobics every day, I now find that it takes me much longer to recoup even from moderate to mild exercise.  Because of this I prefer to exercise every other day and sometimes two days between sessions if I am not feeling up to it or I over did it.

One final note and that is what I call the paradoxical effect of insomnia.  Several floxies that I have talked to about exercise have reported that exercise sessions can worsen insomnia.  I have found this to be true in my case.  I speculate that this is caused by adrenal malfunction but I do not know for sure.  I have found that I can lessen the impact on insomnia if I exercise early in the day and consciously try to keep stress levels that day to a minimum and avoid too much sugar intake.  Overall, I believe that the benefits of exercise outweigh the negatives.