Whole-body and energy
ME/CFS: staying inside the envelope
NICE no longer recommends programmes of fixed incremental increases in activity. Energy management, led by the person, replaced them.
Created by Lee Albert, NMT · 8 August 2026
This isn’t a workout to push through. It watches how your body responds and adjusts as it goes.
“Vinys is the only practice that asks what I have first, and builds from that.” Karen W. · ME/CFS
Before you start
This is a condition that needs a clinician who knows it. If you have not been assessed, or if symptoms are worsening, that assessment comes before any exercise plan, including this one.
Ready to stop guessing? Let your answers narrow the choices and shape your first session.
Start your first sessionWhat it is
ME/CFS is a long-term condition whose defining feature is post-exertional malaise: a disproportionate worsening of symptoms after activity, often delayed by a day or more, and out of all proportion to what was done. That delay is what makes it so difficult to manage by feel, and it is the reason approaches that work in other conditions can be actively harmful here. The activity that counts is not only physical; cognitive, emotional and social effort all draw on the same budget.
How it behaves day to day
Fatigue that is not relieved by rest, worsening after exertion that may not arrive until the next day, unrefreshing sleep, and difficulty with concentration. Many people describe an energy envelope, a level of activity they can sustain, with a crash following whenever they exceed it.
What tends to feed it
- Pushing through symptoms to finish something
- A good day used up entirely, with the cost arriving later
- Cognitive and emotional load, which draws on the same budget as physical activity
- Fixed programmes that increase activity on a schedule rather than on capacity
What the research recommends
NICE guideline NG206 changed the position here substantially. It no longer recommends programmes involving fixed incremental increases in physical activity, such as graded exercise therapy. What it recommends instead is energy management: a self-management strategy led by the person, covering all types of activity including cognitive, physical, emotional and social. People should be advised to stay within their energy limit and not push through symptoms in order to complete tasks, in order to reduce the risk of post-exertional malaise. Activity is alternated and varied, broken into small chunks, and balanced with regular rest. Physical activity programmes are available for people who want to progress, but they follow the person's capacity rather than a schedule.
Sources
- 1NICE NG206, myalgic encephalomyelitis / chronic fatigue syndrome (2021)
Programmes of fixed incremental increases in physical activity are no longer recommended; energy management, person-led and covering all activity types, is the recommendation, staying within energy limits and not pushing through symptoms.
Where Vinys is different
- Vinys has no fixed progression. Nothing in the app increases your session because a week has passed, which is precisely the mechanism NG206 stopped recommending.
- The session is rebuilt from how you report the day, every day, so a low day produces a genuinely low-demand session rather than the same one with encouragement.
- Zero movement is a complete, valid choice on any day. It is not logged as a skipped or incomplete session, because completing a sequence is not the aim.
- There is no streak pressure and no class to keep up with, because the incentive to push through is the risk here.
- Vinys is honest about the limit: an app cannot manage an energy envelope for you. It can make sure it never asks you for more than you said you had.
A short session to try
- 1
Extended exhale breathing, or nothing at all · Optional, a few minutes
One example at the lowest cost. Skipping it entirely is just as valid a choice for today.
- 2
Cat-cow, small range · As many slow rounds as feel available, or none
One example of a familiar, low-cost movement, shown for comparison rather than as a target to reach.
- 3
Downward dog, chair supported · A few breaths, only on a day with more room
A higher-cost example shown alongside the others. Choosing it is not progress, and skipping it is not a setback.
These are examples at different costs, not a sequence to complete. There is no reward for the higher-cost option and no penalty for choosing none of them. Judge the choice by how the next day or two goes, not by how the session felt at the time; a crash later means it was too much, whatever it looked like on the day.
That session was written for everyone with this condition. Yours would be built around your answers.
Start your first sessionMovements often used for this
Breath · 180 to 300 seconds
Extended Exhale Breathing
Longer exhales deeply activate your body's calming response, reducing physiological arousal and pain sensitivity: particularly helpful for highly irritable or sensitive conditions.
Spinal Mobility · 60 to 90 seconds
Cat-Cow: Small Range
Gentle spinal mobility in a small, safe range helps maintain fluid movement in the spine and reduce stiffness without placing excessive load on sensitive structures.
Upper Limb Weight Bearing · 60 to 90 seconds
Downward Dog: Chair Supported
The most accessible version: a chair supports your hands, removing deep flexion demands and making this stretch gentle enough for sensitive knees, ankles, and shoulders.
Breath · 60 to 75 seconds
Arriving with the Breath
A gentle, guided arrival that simply invites you to notice your breath without changing it: the calmest possible way to begin.
Restorative · 120 to 180 seconds
Banana Pose
A deeply restorative supine side-body stretch that releases tension along your entire lateral line, from your outer hip through your side ribs and waist.
Breath · 180 to 300 seconds
Bhramari: Humming Bee Breath
The gentle vibration of humming during exhale stimulates your vagus nerve, creating a powerful calming effect that reduces stress and soothes your nervous system.
Restorative · 120 to 180 seconds
Broken Wing
A prone shoulder stretch that passively opens your posterior shoulder capsule, releasing the tightness that restricts internal rotation and contributes to rounded posture.
Restorative · 120 to 240 seconds
Butterfly
A gentle, grounding pose that opens your inner thighs and deep hip rotators with minimal joint loading, allowing long passive holds that gradually release fascial tension.
Restorative · 60 to 300 seconds
Child's Pose: Chair Facing Back
A fully seated rest: sit facing the back of a chair, fold forward, and rest your arms and forehead on the backrest. No floor needed; all the calming benefits of Child's Pose from a chair.
Restorative · 120 to 180 seconds
Deer Pose
An asymmetrical seated pose that simultaneously works internal and external hip rotation, improving the balanced rotational mobility your pelvis needs for comfortable movement.
Breath · 180 to 300 seconds
Diaphragmatic Breathing: Dirga Pranayama
Slow belly breathing activates your parasympathetic nervous system, helping to reduce pain sensitivity and calm your body before or after movement.
Breath · 70 to 90 seconds
Following the Movement of the Breath
A slightly more detailed breath-awareness opening that helps you notice exactly where and how your breath moves: good preparation right before breath-led movement.
Sessions for this lean on the breath and restorative families in the library. These are the ones most likely to appear, not a prescription: your own session is built from your answers on the day.
Common questions
Is graded exercise therapy still recommended?
No. NICE NG206 no longer recommends programmes involving fixed incremental increases in physical activity, and recommends person-led energy management instead.
Should I exercise at all?
That is genuinely individual and belongs with your clinician. NG206 does describe physical activity programmes for people who want to progress, but they follow capacity rather than a schedule.
Does Vinys increase my sessions over time?
Not on a schedule. Sessions are built from what you report on the day, and there is no automatic weekly progression.
This is the version everyone gets. Yours is different.
Start your first sessionAlso called chronic fatigue syndrome, myalgic encephalomyelitis, ME, CFS. Movements are drawn from the clinically authored Vinys library, and the guidance above is sourced to the publications listed. This page is general movement information, not medical advice, and it is not a diagnosis. How the method works.