Why “Just Do Some Exercise” Misses the Point for a Lot of People

Exercise is medicine. You've probably heard that phrase. It shows up in public health messaging, in GP waiting rooms, in well-intentioned advice from people who want to help.

It's not wrong, exactly. There is strong evidence for exercise as a meaningful intervention across a wide range of conditions. The problem isn't the principle — it's the assumption that getting from "not exercising" to "exercising" is simply a matter of motivation, access, or time.

For people with chronic conditions, it often isn't.

When the standard advice doesn't land

“Just do some exercise” assumes a fairly uneventful relationship between effort and outcome. You do the thing, your body responds, you feel better over time. The feedback loop is relatively predictable.

For someone navigating persistent pain and fatigue, that feedback loop can be genuinely unreliable. Effort doesn't always produce the expected result. Sometimes it produces a significant worsening of symptoms — not because they did it wrong, but because their system responded the way their system responds. That's not a psychological barrier. It's physiology, and it deserves to be treated as such.

Post-exertional symptom exacerbation is real. Autonomic instability is real. Pain systems that have become sensitised over years of mismanagement don't respond the way a deconditioned but otherwise healthy body responds to an exercise programme. Applying standard progressive exercise logic to a system operating under those conditions doesn't just fail to help — it can actively erode trust in movement, deepen avoidance, and confirm the belief that exercise isn't for people like them. 

The dosing problem

Exercise dosing is genuinely complex for this population. The right amount on the right day, with the right kind of load and the right recovery built around it, can build capacity meaningfully over time. The wrong amount — even a modest excess — can trigger a crash that sets progress back weeks.

Standard exercise advice doesn't come with that nuance. Neither do most group fitness programmes. And most healthcare providers, even well-meaning ones, haven't had specific training in working with conditions like hypermobility spectrum disorders, dysautonomia, or complex chronic pain.

That knowledge gap has consequences. People are told to exercise, experience a worsening of symptoms, and conclude that exercise is harmful. Then they're told the problem is their mindset. The cycle compounds.

What good exercise support looks like for a complex body

It starts with actually understanding the presentation. Not applying a standard protocol or a generic fatigue management programme, but understanding the specific mechanisms at play for this person, right now.

It includes dosing that accounts for total load — not just what happens in the session, but what else the person is managing in that week. It includes clear communication about what to expect, what to watch for, and what to do if things spike. It includes a team who knows how to differentiate between a normal response to load and a signal that something needs to change.

It also includes being honest when in-person sessions, or any formal exercise setting, aren't the right starting point — and having a pathway that can begin where the person actually is.

At AOK Keep Moving, that's the work. Not prescribing exercise to people and hoping for the best. Actually building the capacity to move, in a way that fits the body doing the moving.

If you've been told to exercise and felt worse, and you're not sure what to do with that — that's a conversation worth having. Book an initial session and let's work out what actually makes sense for you.