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I am a 31 yr old male who has CFS for 3 years. I have managed (although in less quaility and quantity than before) to still exercise.

I am a keen runner, and run for a running club who is still when fit able to run/race on the local race circuit.

I feel due to my ME/CFS I am not able to train at high intensity as it leaves me too exhausted. I can run slowly

It may sound stupid but I can run on good days and am sofa bound on others. I am running the Great North Run in 5 weeks, and have run a marathon this year

Is there any advice available on improving exercise for someone like me so that I can get back to somewhere near my pre-CFS/ME state

As a fellow runner (and self-confessed running geek!) I empathise with much of what you say, yet we need to be safe and measured with how you exert yourself.

Evidence shows that most elite athletes have an associative running strategy that is valuable for all of us to learn from, but in particular someone suffering from ME/CFS.

Most new runners and many club runners use dissociative strategies when running. That is, they attempt to distract themselves with the use of music, or mantras and so on. This helps to lessen the awareness of any pain or fatigue being encountered while running. There are many such structured methodologies for capitalising upon this and using dissociation. However, I'd suggest that anyone suffering from CFS/ME refrain from such methods and develop the opposite - an associative running strategy.

It does not have to be constant during the run, but can involve a basic mindfulness of how you are feeling physically, or it can involve a full-blown, specific cognitive strategy that helps you tune in to how you are at the time. The main reason I think this would help you is because many runners are far more capable than they realise with their exertions - it is only usually exceptional (some may say crazy) athletes such as the Brownlee brothers who can push themselves to the real limit of what their brain is telling them. But we are all more capable of going faster.

With CFS/ME, this is very risky and if you are hoping to push yourself further, then having an accurate gauge of how to know your ongoing limits will benefit you greatly. it will ensure that if you push yourself, you do so safely and get to know your body's limitations more accurately. I am happy to email you a link to such a specific associative strategy if you think it would be useful to you.

This is probably not directly what you were after, a sports specialist or physiotherapist would probably be better suited to advising you about physiological ways to advance your running safely to the levels you were once at.

Best wishes, Adam

Dear rungeek82

Ahhh - the clue is in the name!

It sounds like you are having considerable fluctuations in your symptoms which need to be stabilised first, before you build up again. This could mean reducing to gain this stability, then moving up again.

There's not a quick answer to this, but yes - you can continue to gently explore the limits of your performance once you have got a bit more consistent.

This is something that a physiotherapist or exercise physiologist would be ideally placed to help you with - but they would need to have experience in CFS/ME otherwise the programme could be inappropriate for you and risk going too far, too soon.

A number of people working with us have returned to running, but an equal number have decided that the running they were doing was not serving their health very well, or the way they were doing it was not something to go back to.

It is of course possible that you may not get back to the full performance that you once had, but unless you gently explore the limits (with professional guidance) you'll never know what's possible.

Thank you for getting in touch (subsequently) too - I have sent the link to you via PM as you requested. Let me know how you get on.