Let’s be honest, any physical activity let alone exercising is a challenge when you have adrenal fatigue or chronic fatigue syndrome! Yet it is possible to benefit from many movement and mindfulness practices when you understand your needs and your current abilities.
The first thing that is important to remember, and I’m not the first one to point this out – exercises are NOT a form of treatment! However, nourishing your body through safe and enjoyable physical activity and rest is a pathway to improving your symptoms (in addition to taking care of your diet, changing daily routine and much more).
It is possible that right now you are not ready for any physical activity, strenuous or not – that’s totally fine. Give yourself time, listen to what your body asks for, you will know when you are ready to start.
But if you feel that you would like to add some gentle movement and soft exercises to your daily routine, carry on reading!
Things to remember before you start
Learn to tune into your body’s needs. It is crucial to the whole recovery process, not just when it comes to exercising. The ability to tune into yourself and discern what is causing you stress or worsening of your symptoms is what will help you to choose the right activity for you, but also know when to stop, when it’s enough and when you just need to rest. Body awareness exercises are perfect for that – Peter Levine’s body scan is one of my favourites.
Don’t compare yourself to others and be patient with yourself. Remember, things that work for one person with the same physical condition, may not work for you. We are all different due to our body structure, lifestyle, past injuries etc. It can be disheartening sometimes to see others doing things you were able to do in the past. Try not to compare yourself (although it’s a tendency we all have). The same goes for following other people’s advice, even if it comes from teachers or trainers. Even though they have the expertise and knowledge, they may not be aware of the particular limitations YOU are dealing with. Don’t assume that one or the other pose or exercise is right for you just because it is suitable for beginners. Equally, if a specific form of exercise works wonders for one person with chronic fatigue (like Yin Yoga does for me), it may not work for you, or it may not work for you on certain days. That’s perfectly ok!
Recovery is not a linear process. There can be days when you feel strong and active enough to extend your physical routines and can feel some progress, and then there may be days when you experience a crash that makes your stay at home or in bed for days or weeks. Learn to adjust and don’t be afraid to start from level 0 after you have experienced a crash. Be patient.
Pacing and staying within your “energy envelope” applies as much to everyday life as it does to exercising. Check in with yourself, how much energy do you have today? Does this activity give you energy or depletes it? How long can you do it so that you don’t run out of energy and aggravate your symptoms? (Read about pacing on Phoenix Rising website)
Find joy in small things. You may wonder why is it so difficult to stick to exercising even when you feel that you are ready for it? Very often we associate exercises with effort, sweating, discipline… All of those things that probably made you feel good and energised in the past, or gave you a sense of achievement. But this attitude will not serve you when you are dealing with a condition like chronic fatigue or adrenal fatigue. Your body’s response to physical exertion is very different from the one of a healthy person, therefore, your approach to exercising would need to change. This time it’s not about strong will power and pushing yourself, but about finding an enjoyable activity and appreciating the little things that you can do. Trust yourself and your body and don’t despair if you think you can’t stick to it. Your body has its own rhythm and recovery pattern, it may have a lot of ups and downs, but it’s never wrong. Let the feeling of curiosity and joy be your guide.
Choosing the right activity
Now let’s get more practical!
Be mindful of the severity of your symptoms. When it comes to starting an exercise program, Dr Kristina Downing-Orr in her book Beating Chronic Fatigue suggests to determine your base-rate abilities first. She distinguishes a total of 11 levels: from no sign of ill health and very mild symptoms to very severe symptoms and being totally disabled. Understanding your base-rate helps you determine what you realistically can do, track the improvement and adjust the level of the activity accordingly.
Either way, consult your doctor or physical therapist to get a personalised advice on what kind of activity is more suitable for you considering your current condition and symptoms, past illnesses, injuries etc.
Relaxation techniques. Breathing techniques, tension and release exercises, self-massage, mindfulness meditations etc. aim to regulate your nervous system, help you relax and can aid hugely in your daily life, but also when you exercise. You can try them separately or incorporate them into your physical routine as you alternate activity with rest.
Pick and choose based on your abilities. I completely agree that with chronic fatigue “every physical activity counts as exercise” . On your good days you may want to do a more active (but safe) form of exercise, but if on some days you don’t feel as strong, switch to a gentler one.
Supine/ prone exercises – can be done in bed:
- Chair yoga and seated Qigong
Gentle standing exercises, most of which can be also done sitting down:
Alternatives (just but be mindful of the distance and duration of your practice):
Strength exercises (These exercises are more suitable for people with light symptoms of adrenal and chronic fatigue as they focus on building muscle strength and you will feel more exertion while doing them. Consult your doctor first!):
Advice for bedbound disabled patients from Dr Kristina Downing-Orr:
“Your muscles will no doubt be very weak and deconditioned, so you need to begin slowly. Start with simple exercises like flexing and relaxing your feet. If you feel up to it, you can also squeeze and release the muscles around your knees and hips. You can carry out these simple exercises at several points throughout the day. Once you feel a little stronger, you can try sitting up in bed for a minute, then slowly, even if it is just by an
General safety guidelines for any type of activity
Start slowly/ warm-up. When your muscles are stiff, start slowly and don’t go too deep into the poses if you are doing yoga or stretches. If the exercises you chose include movement, allow some time to warm up and increase the range of motion gradually.
Know your limits and your own edge. In Yin Yoga there’s a concept of finding your own edge. What it means is that when you get into a pose, you don’t go beyond your physical limits, adding just enough tension to benefit from the pose, but avoiding pain and extreme discomfort. This concept can be applied to any physical activity that you do.
Don’t be afraid to stop. Watch your symptoms (dizziness, nausea, increased weakness) especially if you have decided to join a group class. As Emma from Not Just Tired writes: “If you start a class and find some of the exercises are too much for you, don’t be afraid to sit them out. In fact, you really must do so! Some instructors may not be aware of your condition or how to manage this – and even if they do, you will very likely know more than them!” 
Alternate physical activity and rest  Incorporate rest in between poses or movement sequences. If you are doing yoga, add Savasana (the resting pose) in between. If you have gone out for a walk, stop and rest, resume only when you feel ready. “By working in short bursts with long periods of rest in between, you may find you’re able to do more without triggering post-exertional malaise.” 
As someone who suffered from chronic fatigue and who struggled to do any exercises, I understand how frustrating it is not to be able to do most of the things you used to do in the past, yet wanting to find a way to feel good your own body instead of forcing yourself to exercise. Before I developed chronic fatigue, I had been working as a professional dancer and a teacher, but as my symptoms were gradually getting worse, I found that Yin Yoga (a static form of yoga that would have made me cringe in the past) was the only type of exercises I was capable of doing, and the only activity I was actually looking forward to. It didn’t make me heal from chronic fatigue, but it helped me overcome my strong resistance to any form of strenuous movement and gradually made me feel more connected to myself. This allowed me to slowly start adding more demanding exercises to my daily routine when I was ready for that.
I believe in the innate wisdom of the body and I’m convinced that paying close attention to it can uncover a lot of unhealthy patterns that made the body weak. Coming back to the body is like rediscovering a compass to healing and a more conscious life.