Physical Support

Following being in the Intensive Care unit, you may find that day to day tasks you previously completed without thinking are now quite challenging and come with symptoms of extreme tiredness (fatigue).

This page aims to reassure you this is very normal and with help from your Physiotherapist, family and other members of the multidisciplinary team (MDT) we will support you in your rehabilitation journey and help you achieve your goals.

Muscle weakness following critical illness, in summary, is secondary to being exposed to a period of bed rest/immobility due to being medically unwell, in combination with damage to your muscles from the illness itself. It is important to note these symptoms will improve but this may take a long period of time. Unfortunately, it is difficult to put a specific time scale on recovery as everyone responds at different rates as it is dependent on a multitude of factors such as your age, previous fitness levels and length of illness.

We want to emphasise that you may not experience the problems described here, but if you do suffer from any of them, we hope that you will find this advice helpful.

Common Physical Experiences

Extreme tiredness, fatigue and weakness
Reduced physical ability
Reduced appetite
A loss of independence
Loss of interest in sex
Physical aches and pains
Becoming more breathless or more tired doing a given activity than before the period of critical illness

Exercise and Mobility on the Wards

Going to the ward is a big step on the way to getting better and going home, and it is quite normal to feel apprehensive. You can rebuild your muscles to what they were before and in some cases even better. However, do not be alarmed if it takes you weeks or even months to return to normal.

Your Physiotherapist will have started rehabilitation as soon as safely possible on ICU, and this will continue on the wards. Unless you are fully independent and mobile when you leave ICU, physiotherapists will continue to work with you on the wards; they will devise a rehabilitation plan that will include exercises to rebuild strength and fitness that you do with them and some that you can do by yourself. If you would like some additional exercises to complete outside of Physiotherapy sessions and haven’t been given any please highlight this to a Physiotherapist, ward staff or the RaCI team and we will provide a plan to meet your needs.

Fatigue is also very common following critical illness, and needs to be managed to help aid your recovery. It is common to have ‘good days’ and ‘bad days’ with fatigue, and our aim is to help you self-identify these days to prevent inactivity or over activity. A technique we recommend using to support this is writing an activity diary and also following the 3 P’s; Pacing, Prioritisation and Planning. If you would like further information on this please see our ICU Fatigue management leaflet.

Important Points about Exercise.

Do not try to do too much too soon. This could make you feel over tired and disheartened.
If you have a bad day try not to get disheartened, everyone feels like that at some point.
Always warm up and cool down before and after exercise.
If you feel unwell reduce your normal level of exercise until you feel well again.
Listen to your body – if it is craving rest or peace and quiet, this is probably exactly what it needs.

You should stop exercising and rest if you experience any of the following:

Severe chest pains.
Increased chest tightness.
Dizziness or feeling faint.
Much more breathlessness than you experienced the last time you exercised.
Joint or muscle pain. If these symptoms persist, inform a healthcare professional or contact your G.P immediately. If the symptoms settle in 2-3 minutes, do not continue with the exercise but contact your GP or the RaCI Team for advice going forwards.