Exercise as treatment for people with chronic fatigue syndrome
People living with chronic fatigue syndrome (CFS) quickly learn that any exertion, whether it’s physical activity or challenging mental problems, has repercussions: They often feel worse in the next few days.
The severe fatigue and other symptoms of chronic fatigue syndrome mean that national recommendations to exercise at least 30 minutes most days of the week simply are not possible for most people with the condition.
“One of the problems is when people talk about exercise, patients say, ‘I can’t exercise, I don’t have the energy, I don’t have the strength,’” says internist Alan Pocinki, MD, a clinical associate professor at George Washington University Medical Center in Washington, D.C.
In fact, Dr. Pocinki says that most of his chronic fatigue syndrome patients have been immobilized by their illness for so long that they are “pretty de-conditioned,” which means that they lack muscle strength and tone. Without muscle strength, even a few minutes on a treadmill can lead to significant joint pain, says Pocinki.
However, by taking it slowly and knowing their fitness limits, chronic fatigue patients can maintain strength and work exercise into their lives.
Building a Fitness Program When You Have Chronic Fatigue
Exercise is important, even if you have chronic fatigue syndrome. In fact, the right kind of exercises can help you keep muscle strength and tone despite severe fatigue.
“Exercise starts with just range of motion and isometric type exercises,” says Pocinki. Then, the key to balancing chronic fatigue and exercise is to take it very, very slowly:
Start at whatever level is right for you. If all you can do is lie in bed, lie flat on your back and do some arm and leg motions to build strength.
Build up gradually. Once you can sit in a chair for a while, pick up a can of soup in each hand and do some light lifts.
Set realistic goals. Once you’ve regained your strength, start aerobic exercises for short periods of time — a few minutes on a treadmill or a walk to the curb and back. Pocinki says to do what you can. For many CFS patients, having the strength for daily tasks is goal enough.
Be disciplined. Whatever you can do, do it regularly. Then you can add to it incrementally, maybe 30 seconds every few days to your walk, for example.
Alternate exercises. Pocinki says the best approach is to mix it up — do some aerobic activity one day and some stretching or toning exercises on the next day.
Don’t overdo it. There will be days when you feel great and are tempted to double your planned exercise time. Resist doing this: A substantial increase in physical activity will trigger worsening chronic fatigue symptoms.
Rest. The Centers for Disease Control and Prevention recommends a 1:3 ratio of time spent exercising to time spent resting. In other words, two minutes of treadmill time needs six minutes of rest.
Exercise is important, but if you have been living with chronic fatigue for some time, you probably know what will lead to severe tiredness and worsening symptoms. Although it’s helpful to have a routine, if there are days when you feel awful or know your body won’t respond well, it’s fine to give yourself a break. And if you try to gradually increase your exercise time only to find your symptoms of chronic fatigue get worse, go back to the level of activity that worked for you.