• PhysiosforME

We respond to a letter promoting exercise for Long Covid

On 11 March 2021 a letter was published in the Guardian encouraging the use of graded exercise for Long Covid patients. This letter was strongly opposed by ME Charities, Long Covid advocates, and both ME and Long Covid patients alike, due to the inaccuracies and potentially damaging advice.

Physios for ME teamed up with Long COVID Physio to write a response to the Guardian. However, a response by Dr Charles Shepherd of the ME Association was published, and we are pleased that this important information has been made public.

We would like to share our own letter here:

"We write with concern at the letter published 11 March, as we believe it is inaccurate and may lead to patient harm.

We are Physios For ME and Long COVID Physio, Physiotherapists specialising in ME/CFS and Physiotherapists living with Long COVID, both globally advocating for safe and effective rehabilitation.

As Physiotherapists we are leading advocates for therapeutic exercise and are specialists in delivering exercise-based rehabilitation. Therefore when we caution against the use of exercise, it is pertinent to take note.

The letter encourages people with Long COVID to try graded exercise because “there are no studies to show [it] is detrimental”. While research in this area is relatively new, one study has reported 86% of 3,762 people with Long COVID relapsed due to exertional activities such as exercise. NICE have cautioned against the use of graded exercise therapy for people recovering from COVID-19.

The letter states “graded exercise therapy is an effective treatment for chronic fatigue syndrome.” This ignores the NICE review from November 2020 which describes evidence for graded exercise therapy as “low or very low quality”, with revised guidelines (to be published April 2021) advising against the use of graded exercise therapy for people with ME/CFS.

There is objective evidence of the adverse physiological effects of exercise on people with ME/CFS and qualitative research has demonstrated that over 80% of people with ME/CFS have cited graded exercise as a cause for the deterioration of their condition.

The aim is to prevent patient harm by identifying those who develop these abnormal physiological responses to exercise, and the best way to do this is for clinicians to expand their knowledge of “post exertional malaise” so that interventions are appropriate."

701 views0 comments

Recent Posts

See All

Physios for ME at the World Physiotherapy Congress

This year’s World Physiotherapy Congress ran between 9th and 11th April 2021 and we were thrilled to have two poster presentations accepted. The Congress brings together global perspectives showcasing

Physios for ME and Long Covid Physio

On Saturday 6 Feb 2021, Physios for ME had the pleasure of (virtually) meeting “Long Covid Physio”, a global peer support and advocacy group for physiotherapists and support workers living with Long C

Research update - delays and wins

We posted a quick update about our research project before Christmas and indicated that recruitment had already been delayed due to the pandemic. Unfortunately as lockdowns continue, it looks like we

  • Facebook
  • Twitter

Physios for ME

© 2020 by Physios for ME

Proudly created with

The information provided on this website is meant to inform and signpost helpful resources. Any treatment for a person with ME should always be individualised, monitored and constantly evaluated


We want to link with physiotherapists or people with ME.

Whether you need advice, resources or just to share your story. 

Contact us at 

This site was designed with the
website builder. Create your website today.
Start Now