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ME / Chronic Fatigue Syndrome Treatment - Exercise


Exercise is a touchy subject for ME/CFS patients. Since post-exertional malaise (extreme, prolonged exhaustion and a worsening of symptoms following physical exertion) is a key symptom of ME/CFS, most patients balk at the suggestion of exercise. Part of the problem is that most people think of exercise as jogging, aerobics and other strenuous activities.

ME/CFS specialist Dr. Charles Lapp suggests redefining “exercise” for ME/CFS patients. Perhaps a better word would be “movement.” He says the main thing is to avoid strict bed rest, which causes deconditioning, which in turn makes symptoms worse.

Important ME/CFS “exercise” tips:
  • Move your body as much as you are able – even if it’s just walking to the kitchen for a glass of water.

  • Deep breathing exercises – learning to breathe from the lower part of the diaphragm – are essential. Shallow breathing increases neck and shoulder pain and can cause chest tightness, shortness of breath and spasms in the postural muscles. Deep breathing eases tension and improves the circulation of oxygen in your body.

  • Stretch your muscles periodically throughout the day. Begin slowly with seated stretches. After several weeks, if you are able, progress to standing stretches.

  • When you first begin any new type of exercise, think in terms of seconds, not minutes. Depending on the severity of your illness, start with as little as 30 seconds and build up very gradually (i.e., spend several weeks at each level.

  • Take frequent rest breaks. The CDC recommends that ME/CFS patients rest three minutes for each minute of exercise. Once you’ve moved into strength training or cardiovascular exercise, it’s a good idea to only exercise every other day, allowing yourself a day of rest between workouts.

  • Break up your exercise sessions. Five three-minute sessions are much better for ME/CFS patients than one fifteen-minute session.

  • For those who are able to tolerate a longer period of exertion, water exercise may be a good option. Water’s buoyancy decreases the effects of gravity, displacing 85 percent of your weight. As a result, it takes less effort to move because you don’t have to support your whole weight. Also, immersion in water promotes relaxation, reduces muscle fatigue and lessens pain perception.


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