Graded Exercise Therapy (GET)



Graded Exercise Therapy (GET) is commonly recommended to people with Chronic Pain and Fatigue like me.  Following standard exercise recommendation is not real good, as it can lead to pain and fatigue flares. Doing no exercise is not good either, it can lead to physical deconditioning, poor circulation related  paresthesia  (nerve dysfunction and tingling), muscle spasm and increased aches and pains.  So what is the answer?  Like always it is PACING,  pacing exercise is known as Graded Exercise Therapy (GET).  For some people  


Exercise has many benenfits.  Not only can it make you stronger physically, but it can also turn down volume on pain and help your body and mind cope better and recover from stressors quicker. If able, it is best to follow standard exercise recommendations.  If unable due to pain, fatigue, injury, de-conditioning,  Graded  Exercise is usually recommended. 

Graded exercise therapy (GET) is something that can sometimes lead to miraculous results if you persist with it, even when hard, and causing some discomfort.  As shown in the video about Arthur’s GET exercise journey.

 Graded Exercise Therapy is now a pretty standard recommendation for people experiencing chronic pain and fatigue Syndromes (CSS).   It helps to keep you moving, and reduces complications linked to poor physical strength and de-conditioning. When it comes to GET the most important thing to remember is to pace within your own individual activity limits, and increase the amount of activity you do as your health improves. If you have a physical injury, or chronic fatigue syndrome, it can help to work with a physiotherapist with a good understanding of GET.

For people with  chronic fatigue syndrome  Graded Exercise Therapy is recommended for people with mild to moderate CFS, but there is still some debate about whether it should be recommended to people with more severe CFS,  where even small amounts of physical activity may  cause malaise, pain and fatigue flares!

Graded Exercise Therapy

From the CFS Toolkit:

Activity pacing

Activity pacing is recommended for many people with CFS. Pacing refers to taking activities such as doing laundry or shopping, and breaking it into small manageable tasks with rest breaks in between. Activities should be spread evenly throughout the day and should not make symptoms worse. If activities or exercises are not spread out, a “push – crash” cycle will occur. “Push – crash” cycle is when a person does too much all at once, crashes, rests, starts to feel better and does too much once again.

Graded exercise therapy

  • Graded activity and exercise is defined as starting from a very low, basic level of exercise and/or activity and gradually increasing it to a level where people can go about their daily life. NOTE: the level of activity may not be the same as before the CFS diagnosis.
  • People that have done no exercise or activity for a long period of time and feel very weak should only do a basic activity (ex: stretching, walking, or biking for a few minutes). They should not feel tired after the activity. If the activity does induce tiredness, it should be lessened.
  • If any of the symptoms of CFS get worse after adding activity, people should return to the last level of activity where they felt comfortable.
  • Lifting light weights and stretching can help some people with CFS feel better. People can start with using their body weight (for example, raising their arms) and gradually increase to wall push ups, modified chair dips, and toe raises. Strengthening activity should precede aerobic activity.
  • Very ill people who are housebound or bedbound can start with working on picking up and grasping objects. Activity should be increased until the person can handle activities of daily living such as getting up, dressing, moving around the house and brushing teeth. Having CFS does not mean that a person should avoid these activities, but instead means they should go slowly when starting a new activity.





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