Andrea Wool is a certified personal trainer and nutritional therapy practitioner. After traditional gym training led her to experience alternating cycles of wellness and crushing fatigue, she designed a personal fitness program to support her own healing.

Andrea eventually received diagnoses of fibromyalgia and multiple autoimmune diseases. She started Autoimmune Strong to help people with autoimmune conditions like psoriasis create individualized fitness programs.

She spoke with Healthline about how people with psoriasis can develop and stick with a fitness program and addressed the common fears many have.

This interview has been edited for brevity, length, and clarity.

Fitness trainer Andrea Wool of Autoimmune Strong stands in doorway smilingShare on Pinterest
Photography courtesy of Andrea Wool

As people living with an autoimmune disease like psoriasis, our bodies don’t work the same as others. We’re under stress because our immune system is going slightly haywire.

A lot of fitness advice that we get is, “Push really hard — no pain, no gain.” For people with an autoimmune disease, this can make exercise a stressor. There’s a balance — a tightrope that we need to walk.

Exercise can actually decrease psoriasis. But if you exercise too hard, you can overdo it. Psoriasis is aggravated by stress. When there’s a flare-up and the skin gets raw and uncomfortable, that’s an indication that your immune activity is really heightened.

The bottom line is you have to find the “Goldilocks Principle.” You need that sweet spot of not too much, but not too little. Just right.

We have a level of tolerance that our bodies can handle. If you do too much exercise, you may get into an area of intolerance. That’s when people say, “I can’t exercise. Exercise isn’t for me.”

But exercise doesn’t have to look a certain way to be effective. There are multiple ways you can think about exercise.

If you have psoriasis, you absolutely can do high-intensity exercise, as long as your body can tolerate it. You have to listen to your body. If you’re dealing with psoriasis symptoms when you’re doing high-intensity exercise, then that high-intensity exercise is probably more than your body can tolerate.

There’s a difference between cardio and strength work. Strength work may be high-intensity, but cardio work relies on a cortisol output, which means your adrenaline rushes. That high adrenaline output can be very stressful and lead you very quickly into that intolerance level.

Strength work doesn’t flip that switch into intolerance as easily. You can also make strength work lower in intensity and build over time.

If someone is experiencing a flare-up of psoriasis, I recommend dialing down from high- to low-intensity exercise and also from cardio to strength training. Often, people need strength work to create a foundation of properly developed muscles. Then they can add cardio back in after the muscles are more capable of handling that strain.

First, start to journal. This increases your awareness into how your exercise may be affecting your flare-ups.

The next part is to reduce exercise, then replace it. When you’re reducing, you’re scaling back exercise, so prioritize some rest.

During this time of recovery, I recommend working on tension release and strength work. You may have tight overactive muscles and tight underactive muscles, and they can pull together to create:

  • imbalances in posture
  • inflammation
  • pain
  • discomfort

If you reduce the tension on those tight overactive muscles, it may bring relief. Things that can be really helpful include:

  • foam rolling
  • massage therapy
  • stretching

A lot of people stop there once they get the relief they need. But tight muscles often come back if you haven’t strengthened them. So, simultaneously, you have to release the overactive muscles and strengthen the underactive muscles.

Building strength and rebalancing posture are important parts of recovery. It really is about finding your Goldilocks spot. Take these steps just a little bit at a time, and as your body recovers, you can do more.

It’s very normal and common for people to be scared of exercising. Our fear sensation feels like a red, flashing warning: It didn’t go well the last time, so it won’t go well this time.

The best way to deal with that sensation is to recognize that it’s happening and to start with exercise in tiny little bits. You’ll start showing your body that it’s not so scary after all.

The first exercise I teach is abdominal bracing. It’s a core exercise. You can literally do it anywhere. It trains the deep core muscles. Then you add some exercise on top of it. Eventually you get to a place where you can do a lot.

I would ask that person to look inward and ask where the drive is coming from. It’s usually one of two places.

First, many of us have been taught that exercise is weight management. If that’s the motivation, despite the fact that the psoriasis is being triggered, maybe that isn’t what’s healthy for you.

I encourage focusing on getting the psoriasis to feel better, then focusing on weight loss.

Second, some people love the adrenaline rush from exercise. I am an ex-marathon runner. I loved to see how far I could push myself and how fast I could run. I really had to come to terms with the fact that it wasn’t serving me.

No matter what the reasoning is, ultimately the recommendation I give is to see if you can scale back. I know that can be very scary, but it may be worth it to see what happens.

Absolutely, but it can be a little tricky. You may have raw patches on your skin that are sensitive to touch. Foam rolling may require that you put pressure on those areas.

You can start by foam rolling the areas of the body that aren’t affected by psoriasis.

Another option is to lessen the amount of pressure that you put on areas with psoriasis. There are different ways you can use the foam rolling tools to put just a light amount of pressure on those spots in the beginning.

A third method is to use a compression sleeve or sock and put on a lot of moisturizer underneath it. This way, the skin gets a lot of moisture and the foam roller is not directly on the skin with psoriasis.

Consider exercising outside of the traditional confines of the “no pain, no gain” way of thinking. Instead, do little bits of exercise throughout the day that help your body come into balance. Think about exercise for restorative purposes.

Start small and know that this process takes time. As long as you keep going and you focus on those health benefits, that’s going to serve you best in the long run.

If you’re struggling with exercise, know that you don’t have to do it alone. There are millions of people out there who are dealing with these same issues. There’s a community out there who can relate and support you.