How to Approach Physical Activity in CFS & Long COVID Recovery

Finding Balance in Activity and Rest

Recovering from chronic fatigue syndrome (CFS) or long COVID requires a careful balance between activity and rest. Many people hear the advice to “rest as much as possible” or, on the other hand, to “push through and build resilience.” The truth is somewhere in the middle. Overexertion can lead to crashes, but too much rest can also slow down progress.

The nervous system thrives on balance—not extremes. If you’ve been pushing too hard, it’s important to pull back, but if you’ve become overly cautious and rest too much, it may be time to gently increase activity. The key is to listen to your body and make small, sustainable adjustments.

Avoiding the Over-Rest Trap

Rest is important, but excessive resting—especially lying down throughout the day—can send signals to your body that reinforce the fatigue cycle. If your daily capacity is relatively high (for example, you can work part-time or go to school), then lying down frequently may not be necessary. Instead, try sitting in a reclined position or simply resting without completely lying flat.

For those who are housebound or mostly couch-bound, lying down may still be necessary. However, if your capacity improves, consider reducing your time lying down gradually. Aligning your rest with your current ability level can help your body adjust and prevent deconditioning.

How to Expand Activity Without Crashing

One of the biggest challenges in recovery is knowing how much to increase activity without overdoing it. Here are some key strategies:

• Increase Activity Gradually – Instead of suddenly jumping from 30 minutes of walking to 35 minutes, try breaking it up into two shorter walks (e.g., two 17-minute walks instead of one long walk). This helps your nervous system adapt without overwhelming it.
• Avoid Extreme Rest After Activity – If you finish a walk or another form of movement, avoid immediately lying down. Instead, stay upright, move around gently, or sit before resting. This helps signal to your body that movement is safe.
• Monitor Symptoms, Not Just Comfort – If you only increase activity when you feel completely symptom-free, you may be waiting too long. Instead, expand gently when symptoms are uncomfortable but still manageable. If symptoms become overwhelming, scale back slightly and try again later.

The Role of Body Language and Posture

Your body posture plays a significant role in how your nervous system responds to activity. If you do something active, such as walking or stretching, and immediately collapse onto the couch afterward, it reinforces a cycle of extremes. Instead, aim for smooth transitions—move from standing to sitting before lying down, or take a moment to adjust after activity.

Additionally, pay attention to how quickly you perform tasks. Rushing through activities like brushing your teeth, eating, or drinking water can signal stress to the body. Instead, try to maintain a normal, relaxed pace throughout daily tasks.

Managing “Good Days” Wisely

It’s common to have days when you feel better and suddenly feel motivated to do everything at once. However, this can lead to a crash. The brain tends to overshoot expectations on good days, making you feel like you can handle more than you actually can.

A good rule of thumb is to listen to your body, but only follow about 60–70% of the energy your brain thinks you have. The remaining 30–40% may be adrenaline, which can lead to setbacks if overused.

Final Thoughts

Recovery from CFS and long COVID isn’t about doing nothing, nor is it about pushing through at all costs. Finding a middle ground—where you gently increase activity while avoiding extremes—can help retrain your nervous system and build stamina over time.