CFS and exercise
Includes: Why exercise with CFS/ME can be dangerous

What is post exertional malaise?

CFS and exercise in the normal sense of the word don't mix well.

POST EXERTIONAL MALAISE (PEM) or post exertional fatigue is the official term for the aggravation of CFS symptoms that follows exercise.

Post exertional fatigue is a key symptom in the diagnosis of ME or CFS (Myalgic Encephalomyelitis or Chronic Fatigue Syndrome).

In fact an alternative name for the illness is Systemic Exercise Intolerance Disorder (SEID).

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For those of us living with CFS, particular those who love to exercise, it can be deeply upsetting not to be able to engage in  exercise and feel one's body moving freely.

In a world where we regard exercise as healthy and necessary, the dangers of exercise can be one of the hardest symptoms for a family member, friend or professional to understand.

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Contents for CFS and Exercise

Scroll down for items on this page or click on the links for a further CFS/ME article.

Find the level of CFS exercise which is right for you

Gentle exercise for Chronic Fatigue Syndrome

Quotes from Doctors about the dangers of exercise and Chronic Fatigue Syndrome or ME

A further article shares Research into ME / CFS and exercise and the following information.

Or click for an article which advises you on alternating rest and activity. Pacing allows you to maximise the movement and functioning available to you.

Find the level of CFS exercise which is right for you

CFS and exercise can be combined.

When you live with CFS/ME think of EXERCISE  as a level of movement and activity which you can carry out sustainably without aggravating the symptoms.

This may not look like exercise to yourself or other people, but please give yourself credit for doing what you can.

It is common  - if not universal - to get annoyed with yourself when your activity levels are affected by living with chronic illness.

Be gentle on yourself.
You are a unique person.
You have unique character traits.
You are living with an illness which is manifesting in a unique way in your body.

Experiment gently to find a level of CFS exercise which is right for you.

At a level of severe CFS or severe ME (Myalgic Encephalomyelitis) your exercise level may be to be propped up three times a day to be fed a meal - this was how it was for me for many years.
With the illness, mild CFS or mild ME, it might mean going for a 20 minute walk each day.
You are the only one living in your body 24 hours a day.
You are the best expert on yourself.
You will work it out.

My advice for Chronic Fatigue Syndrome is to pace and switch with aim of finding a sustainable level of activity for you.
Click through on the last link for the definition of pace and the definition of switch.


Gentle exercise for Chronic Fatigue Syndrome

If you are looking for gentle CFS exercise, I recommend Qigong which I do each day.
Qigong also serves as a potential form of alternative healing.


"Like pharmaceutical therapies, prescribing exercise as therapy, an activity that is gaining in acceptance throughout the medical community, must be predicated on understanding the risks and benefits of exercise as thoroughly as possible."
Journal of Applied Physiology 2007; 103: 700-709
Dangerous exercise: lessons learned from dysregulated inflammatory responses to physical activity Cooper DM at Al

"The most important thing about exercise is not to have patients [with ME or CFS] do aerobic exercise.
I believe that even progressive aerobic exercise is counter-productive. If you have a defect in mitochondrial function and you push the mitochondria by exercise, you kill the DNA"
Dr Cheney, International Congress of Bioenergetic Medicine, Lecture 5th to 7th February 1999

Doctor Cheney invites patients to "move within the limits of your illness".
On the subject of graded exercise he says:
"the whole idea that you can take a disease like this and exercise your way to health is foolishness.
It is insane."

"From the medico-legal point of view, health professionals who prescribe exercise programs must do so with just as much caution as would be taken with medication."
British Journal of Nursing, volume 15, number 12, 2006, pp 662-669, Doctor Charles Shepherd, medical adviser, ME Association

“It has now been shown the calibrated exercise on a bicycle ergometer on two consecutive days indicates clear differences in muscle metabolism between ME/CFS patients and healthy but sedentary, i.e. deconditioned controls.
In the ME/CFS patients, the “anaerobic threshold” lowers on the second exercise day, whereas it increases in the controls.
(Appendix: Snell et al, Doctor's quote on CFS and exercise)

“In badly affected patients the effect of an extremely low anaerobic threshold is severe exercise-intolerance which manifests as profound exhaustion, even with the minimal effort of getting out of bed, or such activities as eating and swallowing, or talking for short periods.

In many instances, enforced exercise renders the ME/CFS sufferer exhausted and bedbound for prolonged periods.”
Doctor William Weir, a synopsis of ME/CFS, article for the Newsletter of the 25% ME group, 2019, Issue number 47.


“Management primarily consists of advice to avoid both inactivity and overactivity, to keep active within the individual patients (often meagre) limits and to maintain a non-stressful daily agenda – “pacing”.”

What activity is possible should be kept below the patient's anaerobic threshold at all times.”

Dr William Weir, a synopsis of ME/CFS, article for the Newsletter of the 25% ME group, 2019, Issue number 47.

“The observation that exercise lowers the anaerobic threshold in ME/CFS patients has been repeated in more than one academic centre.
It is also supported by study of biopsied muscle from ME/CFS patients and healthy controls.
Repeated electrical stimulation of isolated muscle cells from ME/CFS patients in vitro reveals impairments of metabolism which are not seen in healthy controls.”
(Appendix: Brown at al)

Move to TOP

Click here for research into the potential danger of exercise for #PWME  (People with ME)
The article ME and exercise
includes the following:

  • CFS and Exercise: People with CFS/ME report their findings
  • CFS and Exercise: Why can't people with CFS exercise normally?
  • Post exertional fatigue found in people with ME
  • The Benefits of Short Bursts of Exercise
  • Cognitive Behavioural Therapy and CFS
  • The PACE trial

› Exercise can be dangerous for people with chronic fatigue syndrome

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