ME/CFS and Exercise

By Karen Lee Richards

While aerobic exercise is beneficial for many chronic illnesses, ME/CFS (also known as chronic fatigue syndrome) is not one of them.  In fact, a key symptom of ME/CFS is post-exertional malaise, which is an exacerbation of symptoms following any kind of exertion (physical or mental) that usually begins 12 to 48 hours after the exertion and lasts for several days or even weeks.

Although aerobic exercise is not recommended, neither is strict bed rest and a complete avoidance of any kind of activity.  Dr. Charles Lapp, well-known ME/CFS researcher and clinician, recommends a balance of light activity with frequent bed rest breaks.  He suggests that ME/CFS patients think of exercise as movement.  It's important to move as much as you're able to avoid deconditioning.  If you can't get out of bed most of the time, gentle stretches or walking to the kitchen for a glass of water may be all you can handle.

The Push-Crash Cycle

Unfortunately, many people – including many doctors – don't really understand the enormous negative  impact too much exertion can have on someone with ME/CFS so they continue to encourage them to exercise without giving them appropriate guidelines.  This tends to lead to a “push-crash” cycle.  Patients do too much then crash.  After resting for several days/weeks, they begin to feel a little better, do too much then crash again, and so on.  It's a vicious, never-ending cycle.  If you find yourself caught up in the push-crash cycle, it's best to limit yourself to doing only what is absolutely necessary, such as personal hygiene and other essential tasks, until you have stabilized.

Beginning to Move

Two important movements Dr. Lapp recommends for ME/CFS patients that can be very helpful for easing pain and increasing energy are postural assistance and deep breathing.

Postural Assistance – Pain and muscle spasms tend to contribute to a rounded-shoulders, head-forward type of posture that only serves to increase the likelihood of headaches, neck and shoulder pain and shallow breathing.  It's good for ME/CFS patients to stretch their muscles several times a day.  If possible, consult with a physical therapist who can teach you gentle stretches that you're able to do, including stretches that can be done from a sitting position

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