Exercise intolerance
Exercise intolerance is a condition where the patient
A patient is any recipient of healthcare services. The patient is most often ill or injured and in need of treatment by a physician, advanced practice registered nurse, veterinarian, or other health care provider....

 is unable to do physical exercise
Physical exercise
Physical exercise is any bodily activity that enhances or maintains physical fitness and overall health and wellness. It is performed for various reasons including strengthening muscles and the cardiovascular system, honing athletic skills, weight loss or maintenance, as well as for the purpose of...

 at the level or for the duration that would be expected of someone in his or her general physical
Physical may refer to:*Body, the physical structure of an organism**Human body, the physical structure of a human*Physical abuse, abuse involving contact intended to cause feelings of intimidation, injury, or other physical suffering or bodily harm...

condition, or experiences unusually severe post-exercise pain
Pain is an unpleasant sensation often caused by intense or damaging stimuli such as stubbing a toe, burning a finger, putting iodine on a cut, and bumping the "funny bone."...

, fatigue, or other negative effects. Exercise intolerance is not a disease
A disease is an abnormal condition affecting the body of an organism. It is often construed to be a medical condition associated with specific symptoms and signs. It may be caused by external factors, such as infectious disease, or it may be caused by internal dysfunctions, such as autoimmune...

 or syndrome
In medicine and psychology, a syndrome is the association of several clinically recognizable features, signs , symptoms , phenomena or characteristics that often occur together, so that the presence of one or more features alerts the physician to the possible presence of the others...

 in and of itself, but a symptom
A symptom is a departure from normal function or feeling which is noticed by a patient, indicating the presence of disease or abnormality...


Since there are many possible specific reasons why exercise could be inhibited, this is a rather slippery term. For instance, the patient may experience unusual breathlessness (dyspnea
Dyspnea , shortness of breath , or air hunger, is the subjective symptom of breathlessness.It is a normal symptom of heavy exertion but becomes pathological if it occurs in unexpected situations...

), muscle pain (myalgia
Myalgia means "muscle pain" and is a symptom of many diseases and disorders. The most common causes are the overuse or over-stretching of a muscle or group of muscles. Myalgia without a traumatic history is often due to viral infections...

), or increasing muscle weakness while exercising, or may, after exercise, experience severe headache
A headache or cephalalgia is pain anywhere in the region of the head or neck. It can be a symptom of a number of different conditions of the head and neck. The brain tissue itself is not sensitive to pain because it lacks pain receptors. Rather, the pain is caused by disturbance of the...

, nausea
Nausea , is a sensation of unease and discomfort in the upper stomach with an involuntary urge to vomit. It often, but not always, precedes vomiting...

, dizziness
Dizziness refers to an impairment in spatial perception and stability. The term is somewhat imprecise. It can be used to mean vertigo, presyncope, disequilibrium, or a non-specific feeling such as giddiness or foolishness....

 or extreme fatigue. In most cases, the specific reason that exercise is not tolerated is of considerable significance when trying to isolate the cause down to a specific disease.


Exercise intolerance is primarily found in cardiorespiratory disorders. It is also a common symptom in chronic fatigue syndrome
Chronic fatigue syndrome
Chronic fatigue syndrome is the most common name used to designate a significantly debilitating medical disorder or group of disorders generally defined by persistent fatigue accompanied by other specific symptoms for a minimum of six months, not due to ongoing exertion, not substantially...

. Several heart conditions, such as a cardiac arrhythmia (abnormal heart rate or rhythm) or an aortic valve insufficiency, if severe enough can cause activity problems such as shortness of breath and/or exercise intolerance. People with acute back pain from an injury or chronic back pain (e.g., from a degenerative condition) may also experience exercise limitations due to muscle spasms or limited range of spinal motion. Overtraining
Overtraining is a physical, behavioral, and emotional condition that occurs when the volume and intensity of an individual's exercise exceeds their recovery capacity. They cease making progress, and can even begin to lose strength and fitness...

 and (undiagnosed) anaemia can also cause the intolerance.


Exercise is key for many heart and back patients, and a variety of specific exercise techniques are available for both groups. Some exercise specialists are trained in modifications specific to these patients.


Certain conditions in particular exist where exercise, particularly rehabilitation, may be contraindicated, including:
  • decompensated heart failure
  • recent myocardial infarction
    Myocardial infarction
    Myocardial infarction or acute myocardial infarction , commonly known as a heart attack, results from the interruption of blood supply to a part of the heart, causing heart cells to die...

  • hypertrophic cardiomyopathy or cardiomyopathy from recent myocarditis
  • active or suspected myocarditis or pericarditis
  • low left ventricular ejection fraction
  • severe aortic stenosis
  • unstable ischemia
  • unstable arrythmia
  • irregular or resting pulse greater than 100 bpm
  • resting systolic blood pressure >200 mm Hg or resting diastolic blood pressure >110 mm Hg
  • severe pulmonary hypertension
  • severe chronic fatigue syndrome
  • suspected or known dissecting aneurysm
  • recent systemic or pulmonary embolus
  • pneumothorax and haemoptysis
  • thrombophlebitis

Other conditions may also preclude exercising under certain conditions. Passive physiotherapy can in some instances be an alternative for some patients unable to safely self-power.
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