Exercise Intolerance: Causes, Signs & How To Overcome It

When it comes to exercising, we are all almost different.

What one person could easily do without much effort may seem extremely hard for you.

Now, does this mean you are exercise intolerant?

Well, in this article, we will be discussing exercise intolerance in detail, you’ll learn what it is and important things you must know about it.

So, let’s dive straight in.


What Is Exercise Intolerance?

Exercise intolerance technically means not being able to tolerate exercising due to some underlying health or physical condition.

Someone with weak muscles will be unable to do a plank compared to someone with strong, well-toned muscles.

Exercise intolerance is not a disease or syndrome but a symptom of a condition. For us to fully understand the concept of exercise, we have to discuss the components of exercise.

What Are The Components Of Exercise?

Exercise has various components. These components are usually assessed to ensure that an individual is physically fit and can also help to point out why someone is intolerant to exercise. These components are:

1. Cardiovascular Endurance

This involves how the body takes in oxygen, how it is absorbed into the body and how it is circulated through the body by the heart and lungs through blood vessels.

For some individuals, running up a flight of stairs makes them breathless. This is either because the body is using up too much oxygen and is not getting enough from the atmosphere or the oxygen carried within the body is not sufficient or the hemoglobin found in the blood to transport oxygen is depleted.

2. Muscle Endurance

When it comes to muscle endurance, ask yourself: “How long can I plank for?”

Muscle endurance is the ability of the muscle to contract against resistance for a particular period of time.

If you try planking for the first time, you might struggle for the first 10 seconds. This means your muscle endurance is poor because your muscles are not contracting long enough against a resistance, which is your body in this case.

People living with musculoskeletal disorders tend to have difficulty contracting some muscles to move which makes them unfit. Muscle endurance also helps the body balance.


3. Muscle strength

How strong are you? Still using our plank scenario, the contracted muscles provide a force to enable stay in the plank position.

The force provided by the muscles is known as muscle strength. The strength in the muscles of your arms and core help you achieve the plank position.

4. Flexibility

How mobile are your joints?

Flexibility is the ability to move the joints of the body easily and freely. Any flexible person also does not have tight muscles.

An easy way to check your flexibility is bending over to touch your toes. If you have to bend your knees before you touch your toes, then you have tight hamstrings.

5. Body Composition

This is the percentage break down of the fat and non-fat (muscle, bone, organs, and water) components of the body. The non-fat component of the body is commonly known as lean mass.

A healthy body composition has a lower percentage of fat and a higher percentage of lean mass.

 What Are The Risk Factors For Exercise Intolerance?

Some of the risk factors are:

1. Genetic Factors

Some medical conditions can be hereditary. Conditions like sickle cell anemia can be passed on from one generation to another.

2. Sedentary lifestyle

Majority of us have jobs that confine us to a table and chair for at least 8 hours in a day. From this position, we go into a car, drive home and then when we get home, we go to bed and the cycle goes over and over again.

The heart and muscles are not working effectively as they are meant to because some muscles are doing more work than the other and the heart is not tasked to strengthen itself. This sedentary lifestyle can later lead to:

  • Poor cardiovascular endurance
  • Poor muscle endurance
  • Poor muscle strength because there will be an imbalance of muscle strength
  • Poor flexibility because the weaker muscles get tighter
  • Poor body composition

3. Bad Diet Habits

Improper eating habits can increase the fat mass of the body and can predispose you to obesity. Food provides the energy needed to exercise and also replaces as energy is being used up. The only way energy can be replaced is when we eat a balanced diet.

4. Smoking

Smoking is the leading cause of most pulmonary and cardiovascular disorders. Your body needs oxygen to exercise but cigarettes contain carbon monoxide that prevents the oxygen from binding to the hemoglobin in the red blood cells. This reduces the amount of oxygen available to the body’s cells.

5. Alcoholism

Excessive intake of alcohol can cause dehydration, which can weaken the body because of inadequate water. It can also affect our balance and coordination as it has a negative effect on our nerve endings. This can affect our exercise performance as well.

 What Causes Exercise Intolerance?


As mentioned earlier, exercise intolerance is a symptom. Medical conditions that offset the components of exercise cause exercise intolerance. Some of these conditions are:

1. Anemia

This is a condition in which there is reduced hemoglobin in the red blood cells. Hemoglobin transports oxygen around the body, which helps to keep our cardiovascular system in check. When reduced, it affects the rate at which our body receives oxygen thereby affecting our cardiovascular endurance.

2. Overexertion

Most people tend to over exercise a lot to get quick results. This puts a lot of stress on the bones and muscles, which compromise the muscular endurance, muscle strength and flexibility components of exercise.

3. Chronic Obstructive Pulmonary Disorder

This is a disorder affecting the lungs in which there is an obstruction of the free flow of oxygen into and out of the lungs. If oxygen inhaled is not effective, the blood will be oxygen deprived and the body will not get enough oxygen.

4. Heart Failure

This is a condition in which the heart does not pump blood effectively. If blood is not pumped effectively, oxygen cannot be transported around the body.

5. Hypertension

This is a condition where there is an increased pressure within the blood vessels. This gives the heart a lot of work to forcefully pump blood through the blood vessels.

6. Fibromyalgia

This is a condition characterized by widespread musculoskeletal pain and fatigue. Exercising may cause more pain and more fatigue.

Other conditions include:

  • Heart diseases
  • Pulmonary diseases like asthma
  • Muscular dystrophy

 How Do I know If I Have Exercise Intolerance?

These signs are not because of the exercises performed but the result of the underlying medical condition and exercises. Ask yourself these questions when looking at the signs mentioned;

  • How many minutes does it take you to do an activity before you feel their effect?”
  • ” Is it a new activity?”
  • ” Is it part of your normal day?”

Look out for the following:

  • Breathlessness
  • Muscle pain
  • Rapid breathing
  • Fatigue
  • Muscle cramps
  • Increase heart rate
  • Cyanosis
  • Muscle weakness
  • Body pains like back pain, chest pain, neck pain

How Do I Overcome Exercise Intolerance?

There are various ways of overcoming exercise intolerance. The main thing is to find out what is causing your exercise intolerance by seeing a doctor and understanding what your condition is all about.

1. Pharmacological Interventions

Depending on the underlying condition, doctors prescribe medications. Medications such as bronchodilators, which help to open up the bronchi in the lungs so you can breathe in enough oxygen, are usually recommended.

2.  Exercise

One of the major ways to overcome exercise intolerance is ironically by exercising.

Here are some things to note when you want to exercise:

1. It is a gradual process. It will take a while for your body to adapt to this new habit. Do not rush yourself. Take your time. Remember no two individuals are the same.

2. Listen to your body. Once you start an exercise regimen and you feel tired, don’t push yourself to do it. Take a break. Your body needs time to rest and gradually build up its endurance and strength.

3. Do not overdo it. If you read the pamphlet that comes with your medication, there’s a section that says, “If you skip a dose, do not make up for the skipped dose but continue like you took the dose”.

The same goes for exercising. Just because you missed the exercise plan 2 days ago does not mean you should combine that exercise plan with the one of today. Carry on like you did the exercise you missed out on.

4. Get someone to supervise you while you exercise. Whoever supervises you will ensure the exercises are done accurately and provide assistance when necessary. The supervisor will also tell you when to stop if any symptom of exercise intolerance tends to appear.

5. Ensure your exercise plan works on every aspect of exercise. A well drawn up exercise plan should target cardiovascular and muscular endurance, flexibility, and muscle strength and body composition.

6. A physiotherapist can help draw out an exercise plan and create realistic goals over a particular time frame to help build you up. I recommend a physiotherapist because they are the movement and exercise experts and they will understand your condition and the impact exercise will have on it.

How Do You Prevent Exercise Intolerance?

In order to prevent exercise intolerance, some lifestyle changes have to be put in place.

  • Reduce your sitting time. Living a sedentary lifestyle is the 4the major cause of developing heart-related disorders. Start an active lifestyle. Try being active for at least 150 minutes a week, which involve aerobics and muscle strengthening exercises.
  • Eat clean. Reduce your salt intake. Have a balanced diet
  • Go for frequent medical check-ups
  • Quit smoking and reduce alcohol intake. Prevention is better than cure.
  • Ensure you get enough sleep so that your body is well rested after a long day.

Are Some Medical Conditions Incompatible With Exercise?

Just like every medication, exercise is contraindicated in some conditions that have exercise intolerance as a symptom. These conditions are:

  • Recent myocardial infarction
  • Pericarditis
  • Acute myocarditis
  • Severe aortic stenosis
  • Unstable arrhythmia
  • Unstable ischemia
  • Resting high blood pressure higher than 200/100mmHg
  • Pulmonary embolism
  • An aortic aneurysm

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Adekanmi Lipede, M.Sc, MPH

Adekanmi Lipede is a licensed physiotherapist with a Master's degree in physical activity and public health from Loughborough University. She joined 25 Doctors in 2018 and is passionate about educating people about the best steps to take when trying to be physically fit or when recovering from a mobility-related condition. For fun, she loves to exercise and read.
Adekanmi Lipede, M.Sc, MPH