Prior to falling ill, fitness was built into my identity, deeply ingrained from my early years. My clearest childhood memories are intertwined with activities like swimming, ballet, and running. I ran and swam for my county and my parents dedicated countless hours each week to chauffeuring me to training sessions and accompanying me to national competitions around the UK. Sport, mainly running, was what I was known for at school. It was something I could consistently count on for kudos and recognition. Unlike Physics and Maths, where I really had to graft to see results, sport came naturally to me. I knew I was good at it.

At the time I became ill, in 2018, I was incredibly health-conscious in both my dietary choices and exercise regimen. Despite my demanding job in a high-security prison, I still carved out time for daily gym workouts and meticulous meal prep, to ensure I was eating clean. I had completed a marathon and two half marathons and was running several times a week on top of gym sessions. In hindsight, my behaviour was obsessive and no doubt contributed to the chronic stress I experienced, which was integral to getting ill. 

However, I turned, almost overnight, from being someone who ran marathons and triathlons, to someone who couldn’t take a shower without needing a nap afterwards.

I still remember the moment when I sat in the doctors surgery being told that the exhaustion I was feeling could last 6+ months, years or even the rest of my life. Looking back, I’m not sure what this doctor thought they were doing by telling a highly anxious, distressed and traumatised 24-year-old this information!

Coming to terms with my new reality proved to be a significant challenge, particularly at the beginning.  In a determined effort to reintroduce some kind of activity into my life, despite the setbacks that arose when I initially overexerted myself, I embarked on a quest to find yoga videos on YouTube. This journey ultimately led me to Pilates videos, and just like that, I stumbled upon my newfound passion.

Pilates is a holistic exercise system that focuses on strengthening the core muscles, improving flexibility, and enhancing overall body awareness. Developed by Joseph Pilates in the early 1900s century, it incorporates a series of controlled movements and breathing techniques to promote physical and mental well-being (Kloubec, 2011).

There are various types of Pilates, including mat and equipment-based, which use machines like the Reformer and Cadillac. Mat Pilates, which involves exercises performed on the floor, is often recommended for beginners and can easily be adapted for those with ME/CFS. Pilates performed on a reformer machine uses spring systems for added resistance, and is one way to increase the intensity of the exercise.

The choice between mat and equipment-based Pilates depends on individual preferences and accessibility. I’m trained in mat Pilates but I enjoy practicing reformer in my own time and plan on training in this discipline in the coming months.

Luckily, Pilates helped me transform my life and attitude towards exercise. Daily practice has done more than just keep me sane and allow me to move without huge relapses – not only does it correct posture, strengthen muscles and increase flexibility, it calms the mind through movement with the breath. Now, I still experience set backs and moments of feeling hopeless, but those don’t last as long or occur as frequently as they used to.

In my opinion, Pilates can be beneficial for ME/CFS sufferers because it offers gentle, low-impact exercises that can help improve muscle strength, flexibility, and posture without exacerbating symptoms. The controlled movements and focus on breathing align well with the needs of individuals with ME/CFS, promoting relaxation and energy and pain management. 

What’s more, Pilates can be used as a base for strength training, meaning if someone has a lot of instability and lack of core control, particularly after a period of inactivity, then they may want to start with Pilates and introduce higher intensity strength training later on when their body starts to adapt and get stronger. After being bed bound, I lost a lot of muscle, and Pilates helped me slowly build back strength and confidence before taking on more strenuous movement.

After practicing Pilates twice a week for about six to eight weeks, you’ll without a doubt start to notice muscle strengthening benefits. Mood-boosting and stress-relieving benefits will appear much sooner, which was my experience. (Vancini et al, 2017) By challenging me to learn the intricacies of each movement and facilitating a deep connection to my own body, I started to regain my sense of self. 

8 Pilates exercises that helped Sophie’s ME/CFS recovery

Although I still experience symptoms daily, in April, four and half years after my diagnosis, I ran a half marathon in 1 hr 44 minutes! I would never have achieved that without the practice of Pilates, which not only transformed my physical health but was also a source of strength and resilience in the face of chronic illness.

Yoga and Pilates, though often grouped together and share similarities, are fundamentally different practices. Yoga is rooted in ancient India and focuses on holistic well-being, integrating breath, movement, meditation, philosophy, and ethics to unite mind, body, and spirit. In contrast, Pilates consists of targeted exercises, performed in repetitions, to improve core strength, flexibility, and posture. Pilates targets smaller muscle groups, providing stability to the trunk (core muscles) and allowing you to complete everyday tasks more easily, as well as lowering your risk of injury.

I think the answer to which one is more beneficial to people with ME/CFS wittles down to personal preference and enjoyment. Both offer physical benefits like balance, strength, and flexibility, as well as mental benefits through breathing techniques and alignment of mind, and body. They are recommended for rehabilitation and are safe and beneficial during pregnancy. 

For me, yoga never quite clicked. I found the postures difficult to hold for long, leading me to frequently divert my attention during a class. In contrast, I found great satisfaction in the mental engagement of Pilates – the pursuit of mastering fresh exercises and learning about their unique physical advantages. What’s more, I felt the benefits quickly.

Yoga, it seems, is more widely offered as a way of graded exercise, but Pilates — once a niche strength, mobility, and recovery technique for dancers — has gone mainstream for a reason and should, in my opinion, be prescribed more for those diagnosed with ME/CFS.

In the first year of having ME/CFS, I did a course at the The Optimum Health Clinic. One of the more instrumental pieces I was given was to perform a quick ‘check in’ whenever I felt my symptoms arising. If ever in a state of overwhelm, stress or anxiety (which I soon realised happened fairly regularly, even if deciding what to buy in a supermarket),  I was told to place my hand on my chest, breathe in for a count of four and breathe out slowly, whilst saying to myself ‘STOP’.

It became to be one of the most powerful tools I had at slowing down, recalibrating and taking stock of my emotions.

Breathing happens to be one of the Pilates principles; a fundamental component of the practices that guides movement. We tend to inhale during the preparatory phase, and exhale during the exertion phase. This helps maintain energy and prevent overexertion,  which can be particularly helpful for ME/CFS sufferers. 

Diaphragmatic (or lateral) breathing, as it’s commonly known as in Pilates can improve oxygen flow, reduce tension, and promote mental clarity. Here is a simple Pilates breathing exercises you can incorporate into your routine to experience its therapeutic effects.

I found that this breath awareness during movement helped me concentrate and connect to my body, and for 20-30 minutes or so, I would entirely forget about ME/CFS.

If this article has sparked your interest and you’re considering giving it a try, that’s fantastic! I would suggest starting with a gradual approach. Begin with just one or two short sessions per week, even if they are as brief as 10-minutes. This approach will enable you to steadily develop your strength and confidence over time, eventually working your way up to hour-long sessions. I understand that it might appear daunting initially, but remember, the key is to simply take that first step.

You could try this series of eight Pilates exercises I used during my recovery or this short guided workout I created.

If you’re keen on starting your Pilates journey in smaller classes or seeking one-on-one guidance to ensure correct posture, form, and muscle engagement, please don’t hesitate to get in touch with me. Larger class sizes may reduce the level of individualised attention, increasing the risk of improper techniques and the potential for injuries or relapse.

Remember, recovery is not a race. Take it at your own speed, within your own means. Your energy will no doubt vary per day, or per hour, and it’s important to listen to those bodily signals.

• 3 gentle stretches to release tension
• 8 Pilates exercises for ME/CFS