Stretch & Movement Programme
ME / CFS Service activity guidelines are not over-ambitious exercise programmes. You will not be advised to 'exercise away your exhaustion', we know that this will only cause you to get worse.
Prolonged rest and inactivity is associated with secondary disability. Bed rest may work for acute illnesses but can cause problems in chronic illness.
- Both activity and rest can be harmful in excess
- Both activity and rest are beneficial in appropriate amounts
- What is appropriate will be different for different people
- What is appropriate may change over time and circumstances.
You, together with the ME / CFS team, will work out what level of activity is appropriate for you. Your personal stretch and movement programme is made up of a series of simple, gentle exercises. Maintaining a planned and paced stretch and movement programme will help produce the best symptom improvements.
In each section you will find resources for home practice diaries. These are extremely important as part of your self-management.
Deconditioning – how it occurs
It hurts to move > muscles weaken and joints
become stiff > move less > it hurts to move
Deconditioning is the normal process of losing fitness, which is associated with decreased levels of activity or exercise. This is a common problem in many long-term illnesses and can also affect healthy individuals whose lifestyle is predominantly sedentary.
- We lose fitness about twice as fast as we gain it.
- Deconditioned, unfit muscles (including postural muscles) get tired more quickly, are painful after very little use and lose strength.
- As we become unfit, infrequent bursts of activity (due to unavoidable demands or occasionally overdoing it) cause aches and pains, which may lead us to avoid activity. This creates a vicious cycle leading to increased disability.
The nature of ME / CFS increases the likelihood of deconditioning. Unpredictable 'good' and 'bad' days lead ME / CFS sufferers into the over-activity – over-rest cycle. This can result in achieving less and less even on better days over time.
- Avoid staying in bed for a large part of the day. This causes deconditioning.
- Avoid overdoing it to catch up or make the most of better days. Plan to do a similar amount of activity and exercise every day.
- Avoid basing your behaviour on how you feel (your symptoms). Instead base what you do on a sensible plan. Start pacing.
- Don’t listen to your body. It is likely that you have been listening too closely to what your body has been saying. In long-term illnesses, not only are your body systems out of kilter, but so are your pain and exhaustion messages.
- Activity pacing and sticking to your personal stretch & movement programme will help you avoid the vicious cycles of over activity /rest yo-yoing and deconditioning.
These techniques will also help you regain control of your activity and gradually increase fitness.
Goal setting to increase your activity
Setting goals can be a good way of setting new targets to achieve and a way of measuring your progress and is an important self-management skill.
Working towards goals will mean that you will have to increase the amount of activity you do, but will also help to break the cycles of ME / CFS.
Goals should be personal - this way they will be important to you and you will be more motivated to try and achieve them.
Writing goals is the first step in achieving them:
- Creates commitment.
- Allows you to see them on paper and revise / update them.
- Makes you more focused.
Goals should be SMART:
Specific: what exactly do you want to achieve?
Measurable: how can you keep track of your progress? When will you know you have achieved your goal?
Achievable: is it possible to successfully achieve your goal?
Rewarding: will reaching this goal give you a sense of enjoyment or achievement?
Time-specific: what is the time-scale for reaching your goal?
See the goals section of home practice to learn about setting goals.