by Jack Croxall

Two months ago I wrote about a subject that causes a lot of controversy in the invisible illness community: whether or not CFS and ME are the same thing. This month it’s on to another somewhat contentious issue, the question of graded exercise therapy (GET).

In case you haven’t heard of it, graded exercise therapy is a physical therapy which aims to gradually increase a patient’s activity until they regain a healthy level of mobility. In theory it sounds reasonable; upping your activity in small increments similar to how a weightlifter might train to increase the maximum weight they can lift. But whilst it sounds good in theory, and there are some people who report that GET works, I’ve noticed it gaining serious criticism lately.

So, let’s start with my personal experience of GET. When I was first diagnosed with CFS, the doctor who diagnosed me prescribed some drugs and supplements, along with GET. I was to start with the exertion I could manage (literally walking for about a minute before having to lie down completely flat for hours), do it every day and then try and increase my walking time marginally each week.

Eventually, I was told, I should be able to regain 80% of the physical capability I had before I was ill. This was all good news, and so, like a good patient, I did as I was told, but only to begin with. It didn’t take long for me to realise that GET wasn’t going to work for me, at least not in the form I’d been undertaking it in. Whenever I tried to increase my exertions, I would feel dreadful. Pain, cramps, crashes, the lot. And it wasn’t just after exercise that I felt bad. Whilst I was exercising, especially when I forced myself past my threshold, it never felt right. You have to listen to your body, it will tell you when you’re doing something stupid.

So, I stopped GET. But, I felt uneasy about it. Everything else my doctor had me doing seemed to be helping, and I didn’t want to just give up on something that might see me improve further. On top of that, I felt the other end of the extreme (lying flat all day unless it was strictly necessary) probably wouldn’t be a good idea either. It was time to experiment.

I tried various different kinds and different amounts of exercise, and it soon became clear what I could manage without bringing on a crash. Now, this is just my personal experience so I’m not saying the following will work for everyone, but gentle stretching most days (touch toes, rotate arms and neck etc) with a slow walk on sunny days (good for vitamin D and morale) is what has made the most difference for me exercise-wise. I’m still way, way below 80% of what I used to be, but that’s the exercise regime that feels right both during and after.

And I think I know why it feels right. I’m exercising within my available envelope of energy: the daily level of activity my body can cope with. I could go into the science here (look up mitochondrial malfunction in CFS/ME patients if that’s what you’re interested in) but I always prefer to keep things simple if I can. So: healing requires energy and, if you spend all of your available energy pushing yourself outside of your envelope, then there’s no energy left for your body to fix itself with. On top of that, I’ve found my envelope has gotten bigger from my gentle walks and stretching anyway, without the need for me to push through the pain barrier like many interpretations of GET imply is necessary. In a way I’m kind of undertaking an altered GET – the right thing for me. But what about you? Do you have any experience of GET? Was it beneficial or problematic for you? Let me know in the comments section or on Twitter!

Jack Croxall is an author/blogger living in Nottinghamshire, UK. He posts for Allies Everywhere monthly.

Twitter: https://twitter.com/JackCroxall

Site/blog: http://jackcroxall.co.uk

Books: https://www.amazon.com/Jack-Croxall/e/B00BBX48NK

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Photos by: Bruno Nascimento Jesper Aggergaard Toa Heftiba