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    Chronic Fatigue Syndrome: Using Graded Exercise to Get More Energy

    Chronic Fatigue Syndrome: Using Graded Exercise to Get More Energy


    You may be thinking, "How can I exercise when I'm so tired I can barely get through the day?" You can do it, as long as you start out very slowly and are careful not to overexert yourself. Most important, it will make you feel better.

    Graded exercise starts out slowly and increases in very small steps. It means that you have a plan for your exercise and you stay with it, even when you're having a good day and feel like doing more. This helps your body make the changes it needs to cope with activity and exercise.

    Studies show that light aerobic exercise, such as walking, helps people who have chronic fatigue syndrome (CFS) feel more energetic and less tired. 1 Maybe you have avoided exercise because you're afraid it will make you feel worse. But the opposite is true. Total rest leaves your body in worse shape. It can also hurt your self-image by making you feel as if you can't do anything for yourself.

    How To

    Work with your doctor to draw up a specific plan for your needs and abilities. But there also are things you can do on your own.

    Walking is an excellent form of aerobic exercise for people who have chronic fatigue syndrome. Other gentle exercises, such as riding a bicycle or stationary bike or swimming, are also good. You need to find a balance so that you are exercising enough to benefit from it but not exercising so much that you become overtired. Here are some things to think about:

    • Adopt a positive attitude toward exercise. Try to put aside your doubts and your worries that it will cause a relapse.
    • Start very slowly. If you have not been very active lately, it is a bad idea to jump into a vigorous exercise program. Start with just a few minutes of very gentle exercise, such as stretching. When you are comfortable with stretching exercises, add very short periods of a mild aerobic activity such as walking or swimming.
    • Increase very gradually. After you know that your body can tolerate this level of exercise over the course of several sessions, increase the length of your exercise session by only 1 minute. Rest often, and build up your exercise intensity a little bit at a time. Try to work up to at least 2½ hours of moderate exercise a week. 2 One way to do this is to be active for at least 10 minutes 3 times a day, 5 days a week.
    • Don't push yourself too hard. You can easily become overtired, which will defeat the purpose of exercise. Sometimes you will not feel the effect of too much exercise until the next day.
    • Take a few days off when you need to. There may be periods of time when stress or other physical activities make exercise too difficult. When this happens, take a little time off. Then try to get back into your exercise routine as soon as possible.
    • Keep track of your exercise on a calendar, or track your progress on a chart.



    1. Reid S, et al. (2011). Chronic fatigue syndrome, search date March 2010. BMJ Clinical Evidence. Available online:
    2. U.S. Department of Health and Human Services (2008). 2008 Physical Activity Guidelines for Americans (ODPHP Publication No. U0036). Washington, DC: U.S. Government Printing Office. Available online:

    Other Works Consulted

    • Togo F, et al. (2010). Sleep is not disrupted by exercise in patients with chronic fatigue syndromes. Medicine and Science in Sports and Exercise, 42(1): 16-22.
    • White PD, et al. (2011). Comparison of adaptive pacing therapy, cognitive behaviour therapy, graded exercise therapy, and specialist medical care for chronic fatigue syndrome (PACE): A randomised trial. Lancet, 377(9768): 823-826.


    By Healthwise Staff
    Anne C. Poinier, MD - Internal Medicine
    Nancy Greenwald, MD - Physical Medicine and Rehabilitation
    Last Revised January 18, 2013

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