Best 5 Exercises for Chronic Fatigue Syndrome

Chronic fatigue syndrome (CFS, or ME/CFS) is a chronic condition that affects multiple systems in the human body. It is also known as myalgic encephalomyelitis (ME), typically it is characterised by severe fatigue, cognitive dysfunction, insomnia and post-exercise fatigue/nausea.

Often it can become undiagnosed for a number of years due to complexities around the nature of the condition, confusion regarding diagnosis and a lack of investigations that can confirm it. Let’s put it like this, it’s not a condition you can get diagnosed from a scan or a blood test. CFS is a biological dysfunction and not a psychological one and the exact causation is still not fully understood. CFS is often seen around the ages of 40-70 years of age and women suffer from it more often than men.

Interestingly, long covid and ME/CFS seem to be quite closely related. They both appear to potentially be caused by a virus, and the symptoms are very similar. The main symptom is severe fatigue.

The mechanisms leading to chronic fatigue syndrome are not well understood, but it is believed to be caused by a combination of factors, including genetics, environmental factors, viral infections, hormonal imbalances, and stress. Some experts suggest that the condition may be triggered by a viral infection, such as Epstein-Barr virus, but this has not been proven.

Although chronic fatigue syndrome can affect anyone, regardless of age, gender or fitness level, it is most commonly seen in athletes who engage in long duration high intensity sports, such as long-distance running, cycling, and triathlons. Athletes who participate in theses sports are more likely to experience the condition due to the high physical and mental demands planed on their bodies. Another common characteristic that we see at Surrey Physio is that it tends to affect high-performers, especially highly-strung people.

Symptoms vary from person to person but typically include persistent fatigue, weakness, muscle pain, headaches, joint pain, sleep disturbances, and cognitive difficulties such as memory loss and difficulty concentrating. Often people describe abrupt fatigue and flu like symptoms. Patients also complain of cognitive decline with slowed mental processing speed, impaired learning ability, processing new information, memory decline, decreased attention span and poor multitasking ability. It is not unusual to display symptoms of uncontrolled anxiety, panic attacks and impaired social ability.

Often a diagnosis derives from clinical examination after ruling out other possible causes. The diagnosis can be challenging as there is no definitive test for the condition. Instead, a diagnosis is typically made based on the presence of a specific set of symptoms, including severe fatigue that has lasted for at least six months, cognitive impairment, sleep disturbances, and post exertional malaise (a worsening of symptoms after physical or mental exertion). Further symptoms include headaches, muscle aches and pains, pain in multiple joints, sore throat, tender lymph nodes and insomnia.

Despite ongoing research into the causes of CFS, there is currently no cure for the condition. However, there are several treatments available that can help to alleviate symptoms and improve quality of life. These include medications to manage pain, sleep, and other symptoms, as well as cognitive behavioral therapy (CBT) and graded exercise therapy. The current medical model does not give the solution.

In our experience at Surrey Physio (and we have some of the top therapists in the UK working with us), we believe that where the medical model cannot help, holistic therapy can. As physios and osteopaths, we always look at the body holistically to work out what might be contributing to people’s chronicity. In many cases the body has been hammered, and the real key lies in building up the immune system. We can talk to you about ways to do this.

Physiotherapy is also an important part of the treatment of CFS, it can improve physical function, reduce pain and increase overall well-being. At Surrey Physio we offer treatments like graded exercise therapy and advice on pacing. The combination of CBT and graded exercise therapy has been shown to improve patient outcomes. At Surrey Physio we have trained physiotherapist in CBT who can also develop personalised exercise programs to include graded exercise therapy. Along with this we also provide manual therapy such as massage and stretching, to relive muscle tension and improve range of motion.

When it comes to exercising, start very very slowly and proceed very very gently. It is very easy to overdo it, and that can cause a backward step. We have developed 5 simple exercises we think may help you if you think you may have CFS:

Deep Breathing Technique Sitting

Sit upright with good posture. Place one hand on your stomach. Take a deep breath in, and push your belly (and your hand) outwards. Try and keep the movement of your chest to a minimum, so you concentrate on the deep breathing. Relax your neck and shoulders as you breathe. This will help you to use your diaphragm, the main inspiratory muscle. Repeat 20 mindful deep focused breaths per day.

Quarter wall squat

Open your legs slightly wider than shoulder width, stand with your back resting against a wall, and bend your knees to the 1/4 squat position. You can either go up and down, or keep a sustained hold. Make sure you keep the middle of your knee-cap in line with the middle toes of your foot. Repeat ten reps.

How to Improve Lower abdominal strength

Lie flat on your back, with your knees bent, and hand under your lower back. Lift one leg so your knee is pointing towards the ceiling. Contract your deep abdominal muscles by drawing your belly button towards the floor, and flattening your back against your hand. Hold the pressure against your hand while you lower the leg to the floor, and back to the start position. Do not let the back arch. Try to breathe normally throughout the exercise. This is a lower abdominal and deep core strengthening exercise. Repeat 5 reps.

How to do a Half Lunge

Take a step forwards, and bend your front knee a little as your back knee drops towards the floor. Always keep good alignment: your knee should stay over the 2nd ray of your foot, and never let your knee drop inwards. Only go as far as feels comfortable and do not go into a full lunge position. This is a lower limb strengthening exercise. Repeat five times each side.

Marching Climb a Rope

Stand upright with good posture, next to a wall or table just in case you need support. March on the spot. Keep your knees up, and using your arms, imagine you are pulling a rope downwards from the ceiling. Try to stay in exactly the same spot throughout your march. This exercise is good for knee mobility, endurance, balance and co-ordination. Repeat for 30 seconds.

Surrey Physio is a leading physiotherapy clinic that can help with people who are experiencing ME/CFS. Our team of experienced physiotherapists and osteopaths can make a difference in your life. We provide a holistic approach and use evidence-based treatments to manage conditions. If you feel you have chronic fatigue syndrome please contact us as soon as possible. Often this is the quickest way of seeing a health professional.

(Therapists, osteopaths, sports therapists, chiropractors reading this page… if you love the exercises here, then please check out the amazing exercise prescription tool You can sign up for a free 14-day trial, and it’s affordable to buy, with pricing starting from £11.23 per month.

If you would like to read more interesting information, Rehab My Patient has written a good article here:

If you are a patient suffering with ME/CFS, please call us to discuss your case further. Don’t book first, but speak to our team first so we can direct you to the best person. Surrey Physio have an amazing team of therapists to help you recover. Call us on 0208 685 6930 or click the link at the top to book online.)