The 12th Invest in ME Research Conference June, 2017, Part 2
MEMum presents the second article in a series of three about the recent 12th Invest In ME International Conference (IIMEC12) in London.
Discuss the article on the Forums.

Symptoms After Exercise Poll (PEM)

Discussion in 'Post-Exertional Malaise, Fatigue, and Crashes' started by Cort, Jan 20, 2011.


My Top Four Symptoms After Physical Exercise Are

  1. Severe Fatigue

    50 vote(s)
  2. Muscle pain

    35 vote(s)
  3. Fluey Feelings (fever, sore throat, achy muscles, etc.)

    28 vote(s)
  4. Symptoms Upon Standing

    20 vote(s)
  5. Headaches and head pains

    11 vote(s)
  6. Cognitive problems

    38 vote(s)
  7. Gut problems

    7 vote(s)
  8. Muscle weakness

    23 vote(s)
  9. Poor sleep

    19 vote(s)
  10. Poor coordination

    15 vote(s)
Multiple votes are allowed.
  1. SOC

    SOC Senior Member

    Good point. I think it's also interesting, however, to see which symptoms persist even with symptomatic treatment. Maybe there's some core group of untreatable symptoms that provide a clue...

    If we consider the current poll to be symptoms that persist even with treatment, it looks like there's a pretty clear group of 3 that would not necessarily be expected from "typical" overexercising -- severe fatigue, flu-like symptoms, and cognitive problems. However, they sound like pretty common reactions to exercising when you have mono, for example.

    My muscle pain happened in 2 types -- burning pain similar to the lactic acid burn of heavy exercise, and strange, dull joint aches that no OTC pain medication could touch. The first I don't have anymore since I don't push my body anywhere near that hard (as in walking for a whole block) anymore. The second wasn't usually part of the PEM, but more just part of a general flare or relapse. That one is usually handled with Cymbalta + OTC pain medication.

    I wonder if we're all distinguishing an episode of PEM from general flares/relapses. I don't think the distinction was as clear to me when I when I was less ill than it is to me now....
  2. karynwolfe


    United States
    I agree, "Post exertional malaise" is a very poorly defined term. Every sick person feels worse symptoms after exertion. It needs to be better defined, or else it cna't be considered a "core" symptom of M.E. The poor definition of it just lets more people get a misdiagnosis of "CFS."

    When I think "PEM" i think of any type of physical or MENTAL exertion causing severe feelings of weakness and/or sickness, that doesn't strike until 24-48 hours later. The delay should be on the poll, because THAT is a critical piece of what seperates a symptom-flare that any chronically ill person feels after a rough day, from the crash that happens after our type of "PEM."
  3. Cort

    Cort Phoenix Rising Founder

    That's an interesting question in itself because I generally notice the PEM stuff starting pretty quickly. When I exercise I can work myself into a state where I'm feeling pretty good - except that I notice my muscles are tightening up - I feel better for a while - think more clearly for awhile and then within an hour or two or even earlier things start to go wrong with my muscles hurting and feeling hot, tight and contracted. Generally they peak, as you say, 24 or 48 hours later.
  4. Glynis Steele

    Glynis Steele Senior Member

    Newcastle upon Tyne UK
    This probably is not relevant, but I found this abstract regarding d-lactic concentrations before and after exercise.

    Glynis x

    D-lactate concentrations in blood, urine and sweat before and after exercise.
    Kondoh Y, Kawase M, Ohmori S.

    Faculty of Pharmaceutical Sciences, Okayama University, Japan.

    The purpose of this study was to investigate changes in the concentrations of D-lactate, L-lactate, pyruvate and methylglyoxal (MG) in body fluids after exercise. Eight untrained male students and five male students who were boat club members engaged in the exercise. Each subject performed runs of short and long duration. Compared to pre-exercise values plasma concentrations of D-lactate, L-lactate and pyruvate increased after running; in trained men by 3.6, 5.0, 3.4 times after short runs and by 1.5, 4.6, 2.0 times after long runs, and in untrained men by 3.0, 12.0, 1.6 times after short runs and 2.5, 5.6, 1.6 times after long runs, respectively. In all cases, the increase of L-lactate was always higher than that of D-lactate after running. The MG contents in red blood cells decreased markedly after running, especially in the untrained students. After short runs the MG concentration had decreased to 13% in the untrained men and 30% in the trained men, and after long runs the concentration had decreased to 41% in the untrained and 60% in the trained men. The MG in plasma and red blood cells appeared to have been utilized during relatively anaerobic exercise, especially by the untrained subjects. The D-lactate and related substances were also determined in urine, but the concentration of these substances showed no relationship to exercise. The D-lactate concentration in sweat samples tripled after short periods of running but the relative concentration to sodium ion concentration was not altered.(
  5. Marlène

    Marlène Senior Member

    Edegem, Belgium
    Burning chestpain running to the spine and feeling miserable

    They differ from MENTAL exercise by the way ...
  6. glenp

    glenp "and this too shall pass"

    Vancouver Canada suburbs
    High blood pressure after exertion
  7. WillowJ

    WillowJ คภภเє ɠรค๓թєl

    WA, USA
    burning pain in limbs is a near reaction; damp cough is a next-day (and may persist for a while) reaction.

    some of it is hard to distinguish onset because PEM can build up. When I collapse, was it because of what I just did, or what I've been doing that week?
  8. taniaaust1

    taniaaust1 Senior Member

    Sth Australia
    I tend to think of malaise coming under flu like symptoms.

    I had trouble with that poll and couldnt answer it properly as I get more top symptoms and the group of symptoms I get for my top symptoms after exercise, 4 of them dont stand out more then the other 4 I get too..

    as i couldnt put in all 8 equal symptoms I just choose the 4 on that thing which were listed first there. If others are doing this too and cant choose, it may be why fatigue and muscle pain or being rated first and second as they are first and second on the order of the list.

    I also think dizziness should of been listed on that list.. i do get more dizzy on standing after exercise .. but Im also dizzy on laying down after exercise. If you do another poll.. please change the order of the symptoms to see if that changes the responses and also add dizziness.
  9. taniaaust1

    taniaaust1 Senior Member

    Sth Australia
    I just thought of something else missing there.. there was one on this site who used to get mood issues eg depressive eposides after exercise so that is missing too. For this person, I think it was the symptom which bothered him the most after exercise... (I wonder whether mood or depressive issues after exercise are common or not? its not something ive heard many talk about).
  10. Merry

    Merry Senior Member

    Columbus, Ohio, USA
    Thanks, Tanya, for reminding me of this. One sign that I'm doing too much is that my mood starts to sink. If I rest, right away I cheer up.
  11. Cort

    Cort Phoenix Rising Founder

    Another facet of ME/CFS -what mental exercise does....they both burn up energy.......and there is the group that does worse with mental exercise than physical exercise...that is for another poll..
  12. Cort

    Cort Phoenix Rising Founder

    I too get really irritable.

See more popular forum discussions.

Share This Page