Chronic Fatigue Syndrome 

What is Chronic Fatigue Syndrome?

Chronic Fatigue Syndrome (CFS) is a complex, long-term condition that significantly impacts multiple systems in the body, including the nervous, immune, cardiovascular, and digestive systems. It is classified as an energy-limiting chronic illness (ECLI), meaning the body does not produce enough energy at a cellular level. This is comparable to a battery that never fully charges and quickly depletes.

While the exact cause of CFS is unknown, it may be triggered by infections, anaesthesia, immunisations, or trauma such as car accidents. For some individuals, CFS develops gradually over months or even years.

Common Symptoms 

CFS presents with a variety of symptoms, with Post-Exertional Malaise (PEM) being the most prominent. PEM occurs when even minimal physical or mental activity causes a worsening of symptoms, often delayed by 24–48 hours and lasting for several days. 

Other common symptoms include:

Exercise and Chronic Fatigue Syndrome

CFS is an energy-limiting condition, meaning the body has difficulty producing sufficient energy at a cellular level. This results in rapid fatigue and restricts the amount of physical activity a person can undertake daily.

Although exercise cannot cure CFS, a carefully tailored program can improve functional strength, cardiovascular fitness, and overall well-being. The key is a highly individualised approach that considers the fluctuating nature of symptoms and energy levels.

Exercise programs for individuals with CFS must be approached cautiously. Overexertion can trigger PEM, so flexibility and gradual progression in intensity are essential. With proper guidance, patients can incorporate exercise safely into their routine, improving their ability to manage daily challenges and enhancing long-term health.

Benefits of exercising include

• Increased blood plasma and red blood cells: Enhances oxygen transportation throughout the body.
• Combats deconditioning: Addresses one of the key contributors to symptom worsening.
• Improves circulation: Supports better blood flow, reducing blood pooling and dizziness.
• Boosts cardiovascular health: Helps alleviate tachycardia (rapid heart rate) symptoms.
• Increases muscle mass: Assists in raising blood pressure, improving circulation, and overall stability.
• Enhances sympathetic nervous system tolerance: Aids in managing stress responses, such as increased heart rate, sweating, and shakiness.
• Improves gravity tolerance: Reduces symptom onset when transitioning between positions.

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How Can an Exercise Physiologist Help with Chronic Fatigue Syndrome?

Coast Sport’s Accredited Exercise Physiologist’s (AEP) play a critical role in managing CFS. Taking a holistic approach, our AEP’s can create a personalised exercise plan tailored to your specific needs and help identify and manage potential symptom triggers.

What an AEP can help with:

• Recognising triggers: Identifying factors such as allergens, temperature, emotional stress, cognitive load, dehydration, diet, and sleep issues that exacerbate symptoms.
• Developing pacing strategies: Learning to manage energy levels through pacing, including balancing “good” and “bad” days, breaking activity into manageable tasks, and using tools like heart rate monitors or activity diaries.
• Lifestyle management: Conserving energy through strategies such as using assistive devices (e.g., shower chairs or stools in the kitchen) or managing work and study demands.

Additional support includes:

• Education about CFS and its effects on the body.
• Strategies to address brain fog and improve cognitive function.
• Sleep management techniques and stress reduction strategies, such as mindfulness and relaxation exercises.
• Goal setting and planning a gradual return to activities such as work or school.
• Addressing specific concerns, such as the impact of the menstrual cycle on energy levels in women.

With the expertise of an AEP, you’ll receive support to manage CFS symptoms effectively, improve your quality of life, and find a sustainable balance between activity and rest.

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Frequently asked questions

Is it safe for me to exercise?

Yes, exercise can be safe and beneficial for people with CFS  but it must be approached carefully. The key is to start very slowly, focusing on low-intensity activities that won’t overwhelm your energy systems. Exercise can help improve functional strength, cardiovascular health, and overall well-being, but it’s crucial to listen to your body and avoid overexertion. 

How can I avoid triggering Post-Exertional Malaise (PEM) during exercise?

To avoid PEM, pacing is essential. You’ll need to start with very small, manageable bouts of activity and pay close attention to how your body responds. A key strategy is to stay within your energy envelope, meaning you should aim to do only as much exercise as your body can handle without triggering a flare-up. Using tools like an activity diary or heart rate monitor can help you track your exertion levels and avoid pushing too hard. We’ll also monitor your symptoms regularly and adjust the intensity of the exercises as needed.

How can I manage my energy for daily activities while also including exercise?

Energy conservation is crucial. You’ll want to balance physical, cognitive, and emotional tasks throughout the day. We can build strategies into your exercise plan that allow you to take frequent rest breaks, rotate between light physical activities and cognitive tasks, and use energy-saving tools (e.g., a shower chair or stool in the kitchen). We will help you prioritise essential tasks and structure into your day so you can incorporate movement without overwhelming your body.

What should I do if I experience a flare-up after exercise?

If you experience a flare-up after exercise, it’s important to rest and allow your body to recover fully. During a flare-up, focus on gentle self-care, including hydration, nutrition, and stress management techniques. We will provide you with strategies for managing flare-ups, including how to adjust your exercise routine, prioritise rest, and reintroduce activity gradually. If flare-ups become frequent, we’ll reassess your program and adjust it accordingly.

Can exercise help with other symptoms like sleep disturbances, pain, or stress?

Yes, regular, gentle exercise can help improve sleep quality, reduce pain, and alleviate stress. Low-intensity activities like clinical pilates or walking can promote relaxation and help regulate sleep patterns.  Exercise can also improve circulation and reduce muscle stiffness and pain. Furthermore, exercise can stimulate the production of endorphins, which are natural mood boosters that help reduce anxiety and stress.