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Exercise and Chronic Fatigue

Once dismissed as ‘yuppie flu’, chronic fatigue syndrome (CFS) is widely misunderstood and underestimated. Affecting people at different stages of life, there is no specific test to determine if a person is suffering from the condition. Symptoms, however, are often standard across the board, and medical practitioners should be able to determine if an individual is suffering from CFS. Exercise has been shown to benefit chronic fatigue sufferers, so let’s look a little more closely at this disorder, and how physical activity can be used to help alleviate its effects.

What is chronic fatigue?

Affecting up to 3% of the population, chronic fatigue syndrome is characterised by persistent medically unexplained fatigue. Far greater than an average level of fatigue, CFS presents as an unexplained onset, is present for longer than six months and is not relieved by rest. Additionally, sufferers may experience the symptoms listed below. Genetic and environmental factors play a role in the syndrome, and more women than men are affected by it.

Key symptoms of CFS include:

  • Muscular pain and joint pain
  • Poor short-term memory, and difficulty concentrating and finding the right words
  • Headaches
  • Tender, painful lymph nodes
  • Stomach pain and symptoms similar to irritable bowel syndrome (IBS)
  • Sore throat
  • Disturbed sleep and insomnia
  • Sensitivity to light and loud noises
  • Mental health challenges, such as depression, anxiety and panic attacks.

How exercise can help

Treatment of chronic fatigue includes a long-term multidisciplinary approach encompassing education, pharmacotherapy, cognitive behavioural therapy and exercise. Multiple studies have shown that cardio fitness can reduce fatigue, so it’s important to include this in the treatment program. Contrary to the belief held by some sufferers that exercise can exacerbate feelings of fatigue, studies have actually found that exercise can improve symptoms. However, a specific approach must be taken when increasing the amount of exercise a person with CFS undertakes.

Training guidelines for those with chronic fatigue

For some, exercise may provoke anxiety and increase feelings of vulnerability to pain and fatigue, so individuals with CFS should ease their way into a workout program in order to avoid experiencing post-exercise symptoms. It’s a slow process, but can ultimately lead to a vast improvement in the symptoms of chronic fatigue.

When implementing a new exercise program for a client with chronic fatigue, you should:

  • begin at a low level and progress gradually
  • start with short sessions, rather than prolonged bouts
  • prescribe low-to-moderate intensity exercises
  • focus on low impact activities
  • avoid lifting heavy weights
  • avoid eccentric training
  • avoid heart rate exercise, as the client may not be able to reach the required level on some days
  • work harder to motivate the client, without pushing them too far
  • be prepared to adapt sessions in order to accommodate the energy levels of the client on the day.
A person with chronic fatigue syndrome shouldn’t be coaxed or pushed further than their limits within any given session, as this could be dangerous and lead to a long-term relapse. The primary aim is to increase activity to avoid decreasing fitness levels. Over time, this can lead to an improvement in their condition, which can then allow them to work out for longer periods or at higher intensities.

What kinds of exercises should be performed?

The aim is to gradually increase physical activity in the client’s daily routine, so the exercise shouldn’t be over-stimulating or lead to exhaustion. The key thing is for the client to listen to their body and understand what they are capable of on any given day to ensure they are not overtraining. To choose the right activity, some experimentation might be in order. Start your client on some gentle exercises, such as light stretching, yoga, tai chi, walking or light resistance training. Regularly remind your client to listen to their body and to stop exercising before they feel any of their CFS symptoms start to flare up. Their energy and, therefore, activity levels may differ considerably day-to-day: be accepting of this, and do not make assumptions about their abilities based on what they may have recently achieved. Whether through fitness apps and wearable tech, or even an old fashioned diary, it is beneficial for the client to record their activity, as well as how they are feeling. Doing so will enable them to not only track their fitness progress over time, but to note whether improvements in the way they feel and their energy levels correlate with their adherence to exercise.

The role of a Personal Trainer

Whilst training clients suffering from chronic fatigue can be challenging, by exhibiting high levels of patience, understanding and motivation, the Personal Trainer can significantly improve the CFS sufferers’ quality of life. Rather than focusing on making sessions extreme and intense, the Personal Trainer’s role is to guide the client in the promotion of lifelong physical activity and reduce any anxiety around exercise. The opportunity to help a client transform their wellbeing and their relationship to exercise will also be incredibly rewarding for the fitness professional.
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The Australian Institute of Fitness (AIF) is the largest and longest established fitness training organisation in Australia, with dynamic training methods and expert course coaches nationwide - spanning fitness, massage and nutrition. The AIF qualifies more fitness professionals than any other provider in Australia, as well as offering a broad range of continuing education courses (CEC), upskilling resources and partnership programs for existing industry.
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