28th January 2017. For many of us, exercise might not be the most fun thing to do in the world, but we do it anyway. Sure, we may feel a little sore the next day, or tired in the evening after a heavy workout, but the body bounces back quickly in response to fitness activities. After all, we're trying to improve our health, right? Unfortunately, for many people, this isn't their reality. Instead, each day is a constant battle against fatigue, exhaustion, muscle aches, and a litany of other pains and complaints. This condition is what is often called chronic fatigue system, also known as CFS or by its medical name, "myalgic encephalomyelitis." Treating ME/CFS disorders poses a challenge for many doctors. There is currently no known cause for the condition, though some theories exist. Likewise, there is no cure ? CFS is often a lifelong condition that even defies classification. There is debate over whether it is a neurological or a muscular disorder. The World Health Organisation, for example, lists it as a neurological problem. Thus, many of the treatments for CFS centre around CBT, also known as cognitive behavioural therapy. In other words, a therapist will try to help a patient condition their mind to fight back against perceptions or feelings of fatigue.

The establishment approach to treatment

Is this the best way to approach treatment? Again, there is uncertainty here as well. However, one only needs some common sense to imagine the deleterious effects a lack of exercise can have on a chronic fatigue syndrome sufferer. Is there a place for training in treatment programs for this condition? There is an unfortunate lack of evidence for efficacy in current medical literature, but a popular approach is something called "graded exercise." Some minor benefits have been recorded in studies of CFS sufferers. Let's look at what that actually is, what the state of research in this area is, and whether or not chronic fatigue sufferers should actually try to engage in more exercise.

Graded exercise and what the science says

One needs only to look at the name to get a sense of what GET entails. It's not "graded" in the sense that you're going to receive a score on how well you exercise; instead, it's all about beginning at a relatively low level of activity. From there, you work your way up to higher levels of activity as you improve your ability. Ideally, this is done very slowly and over an extended period. CFS sufferers can have difficulty with even a moderate level of exercise, so beginning at a basic level is imperative. We'll discuss ways you can approach GET on your own shortly. Several studies have been undertaken to see what benefits GET can have for those dealing with chronic fatigue. Unfortunately, the results of those studies are both somewhat inconclusive and quite controversial. For example, a foundational study called PACE that evaluated graded exercise therapy against CBT and other more mind-focused treatments contain many flaws in its methodology. Its results, therefore, remain in question despite follow-up studies. These studies found that while GET could help some sufferers experience a degree of recovery, it was nearly just as effective as cognitive behavioural therapies. Though some patient advocates state that GET can actually worsen CFS, there is as yet a lack of evidence in that direction. It, therefore, seems as though some of those with chronic fatigue can benefit, and it is an avenue that is at least worth exploring. Benefits in areas such as sleep quality and overall feelings of wellness have been observed, though its actual long-term effects on fatigue symptoms is less apparent. It's essential that more medical research must be carried out to understand the potential benefits of GET. In the meantime, you may still want to consider ways to become more active.

Take it slow, make it steady

The fundamental reason to try exercising through your chronic fatigue is that it provides you with a chance to give your body a tune-up. Some research, conducted by scientists at the University of Florida in the United States, indicates that CFS may be caused by over-active neurons in the brain transmitting fatigue signals in excess of what's normal. By trying to work through the challenges placed in front of you positively, it's possible you may give your body the tools it needs to fight back. At the very least, if you can develop some better cardiovascular fitness or improve your endurance levels moderately, a better quality of life could follow. With that in mind, what are some ways you can approach exercise without overdoing it right from the start? The key initially is to set reasonable limits for yourself, even if they seem low. Pacing yourself and undertaking graded exercise need not necessarily be done under expensive supervision. Gauging what you can handle and working to improve where that threshold lies is more important. Try keeping a "symptom diary" for each day in which you note down the severity of your symptoms, perhaps on a scale of 1 through 10. Your goal should be to find the level of activity and exercise that does not cause a worsening of your symptoms in the days that follow. Riding a bicycle at a leisurely pace or going for a daily walk are ideal ways to begin slowly. This way, you can assess what works best and leaves you feeling comfortable. Even yoga can be an activity that helps you, as it boosts flexibility and includes components that focus on breathing exercises. As you practice these activities, you'll slowly come to understand more deeply your body's capabilities. Keep your routine consistent, unless you overdo it ? remember that rest is a highly important part of this process for CFS sufferers.

What about when you want to do more?

With this method, you may begin to see some results. You should at least feel more comfortable moving about more often rather than staying at home much of the time. While highly intensive activities, like long-distance running or swimming, might not end up on your agenda, creating a "new normal" level of activity is an excellent step towards feeling better. It's also worth considering the benefits of behavioural therapy at this stage. While you don't unnecessarily need to head to a therapist, you can use positive thinking and reinforcement to keep you motivated when the idea of going for your walk is totally unappealing. Set goals for yourself, even if they are very small. Taking tiny steps is better than none at all! Try to increase the amount of activity in which you engage gradually. Try to pick out a few basic exercises that you can switch between during the week. If you do yoga for a day or two, for example, go for a nice walk the next day. If you still feel good the next day, maybe a short bike ride is in order. Consistency, and fighting back against the mental urge to give in to exhaustion, will be core parts of your strategy. Overcoming your fatigue isn't necessarily going to be easy; the disagreement and uncertain results present in many of the current studies make that clear enough. However, that doesn't mean CFS needs to rule your life. By resolving to beat it, you've already won the first major battle. Depression and anxiety are common symptoms of CFS; experiencing the world you've been missing out on can help with that. Strengthening your body and learning to manage better your fatigue are pleasant side effects.

Carefully assess the approach that's right for you

If it seems like it's a little confusing to sort out the truth about chronic fatigue and exercise, don't worry ? you aren't alone. The scientific and medical communities continue to struggle with not just the causes of chronic fatigue syndromes, but the best methods for treating them as well. It's important to stress that graded exercise doesn't work for everyone. However, if you contend with CFS daily, seeking relief with the therapies currently available is worth trying. Even if you just get out of the house and begin to walk around your neighbourhood a bit more, you may see some positive benefits. As always, though, it's important to discuss these topics with your doctor before making any significant changes in your lifestyle.