Physios for M.E.
The members of Physios for ME are physiotherapists, and we support exercise in general wholeheartedly.
When it comes to Myalgic Encephalomyelitis there are known contraindications to exercise that all physiotherapists must be aware of.
The table below compares normal physiological responses to exercise, with those found in people with ME.
This table is taken from the International Consensus Primer, which includes references and more comprehensive details:
Making matters worse are doctors who trivialize long-term COVID patients seeking help. Many have been told that stress and anxiety are hampering their recovery and are advised to push through their illness and exercise, even though mild exertion can trigger a return of symptoms or cause further cardiac and pulmonary complications.
Paul Garner, an infectious disease professor in the Liverpool School of Tropical Medicine, makes the distinction between those still suffering from the later manifestations of the disease versus those who are experiencing symptom exacerbation after pushing too hard.
In a blog published in the British Journal of Medicine, Garner writes, “I suspect people recovering at home and their doctors…do not realize it may be exertion—both mental and physical—that is causing their symptoms to return. Without instituting careful pacing, people suffer, and their recovery is delayed.”
It is important to understand the range of potential complications that can arise in post-viral conditions. Standard rehabilitation approaches (i.e., graded exercise) may be harmful and worsen prospects for recovery in the subset of long-haulers who experience symptom exacerbation after physical and cognitive activity.