Exercise with ME is going to look very different to the exercise you used to do before becoming ill. For many people the word movement rather than exercise is probably more appropriate. Hardcore HIIT sessions and long runs or bike rides are off the table. Instead it is about gentle, restorative movement, things that make you feel better rather than worse.

PEM or post exertional malaise is when your symptoms become worse after exertion, also referred to as a crash. It is really important you avoid this. If the movement or exercise you are doing is causing you to crash then you are doing too much. You need to reduce the intensity or the duration of the activity, or possibly both.

I always start by doing less than I feel I am capable of. Beginning with something you think will be really easy ensures you are unlikely to crash and will help you build confidence in your body’s ability. Over time you can gradually increase your activity. Dr Meg Anderson shares some great advice in this video about how to manage PEM and how to safely increase your level of exercise.

It can be challenging to find exercises suitable for people with ME/CFS. Even “beginner” videos on YouTube often look too intense for those with chronic fatigue syndrome.

To solve this problem I have linked up with three qualified instructors who all have or had ME/CFS themselves. They fully understand exercise for chronic fatigue syndrome needs to be gentle and slow paced.

Below are four videos of different styles of exercise, each with a different intensity level, so hopefully you can find one which is suitable for your level of functionality.

Ideal for those who are moderate to severe or for people who are apprehensive about introducing exercise. These gentle movements are all done while lying down on your bed. The video ends with a 10 minute relaxing meditation.

Teacher Shannon is a certified yoga instructor who has ME/CFS. She has developed her own style of accessible and gentle yoga, designed to be adaptable for people with chronic fatigue syndrome. Her online yoga studio, Nourish Therapeutic Yoga, specialises in spoonie yoga and grades all classes by spoon level.

This video is a 2 spoon class. If you want something easier or more challenging then Shannon has a large variety of live and prerecorded classes ranging from 1 to 4 spoons you can try. She has also run several free classes in conjunction with ME Action. 

Using a series of controlled movements and breathing techniques Pilates offers gentle, low-impact exercises that can help improve muscle strength, flexibility, and posture.

Sophie Reynolds found Pilates exercises to be crucial to her recovery from chronic fatigue syndrome. After being bed bound, she had lost a lot of muscle. Pilates helped her slowly build back strength and confidence before taking on more strenuous movement. It was so instrumental in her recovery Sophie trained to become a Pilates instructor.

This video is a mix of lying and seated exercises, suitable for mild to moderate ME/CFS. If you enjoy it she also runs free live classes on her instagram

These simple stretches are a great way to introduce gentle movement for anyone with mild to moderate ME/CFS. Designed to be easy to follow, they can help improve flexibility and ease stiffness.

Suzanne is a certified personal trainer who has battled with chronic fatigue syndrome and fibromyalgia for over a decade. Conventional exercise made her fatigue and pain worse, so she developed the Cocolime Fitness approach using a range of low to no impact movements at a moderate to low intensity. 

If you are looking for guided support on exercise and movement she has a selection of exercise programs for chronic fatigue syndrome available on her website.

These strengthening exercises are designed for people with mild chronic fatigue syndrome and can all be done seated or lying down. They focus on gently building strength without overexertion. 

The use of light weights is optional. If you would like to include them, Suzanne recommends starting with 2lbs and gradually increasing up to 12lbs, but only if it feels manageable for you.

As mentioned above, Suzanne has had ME/CFS and fibromyalgia for over a decade. She created Cocolime Fitness to help people like herself, people who are looking for real workouts that help them get into shape without making them crash. She has a wide variety of workouts available through her website including weight training, bodyweight toning, cardio, dance, pilates and stretching.

While it may seem like a daunting task to introduce movement to your routine it can produce huge benefits. The most important thing is to listen to your body and only do what it feels capable of. Everyone has different levels of pain and fatigue so make sure you modify moves for your bodies needs. It is ok to stop part way through a workout or skip moves which are too difficult.

Remember, progress with ME/CFS doesn’t come from pushing harder. Be kind to yourself, start small and build up slowly. Little by little, movement can start to feel good again.

• 8 Pilates exercises for ME/CFS
• 3 stretches to release tension in your upper body
• Risks of Graded Exercise Therapy by ME Action
• Post exertional malaise research review by ME Association