Rebuilding Strength: The Best Exercises for Long COVID and CFS Recovery

For individuals managing long COVID or Chronic Fatigue Syndrome (CFS), exercise presents unique challenges. What may seem manageable one day can trigger post-exertional malaise (PEM) the next, even if the effort was minimal and seemingly within limits. This often leads to confusion about the appropriate type and intensity of movement during different stages of recovery.

The issue is not the individual, but rather the unpredictable nature of these conditions. Both long COVID and CFS make it difficult to gauge how the body will respond to physical exertion. However, with the right approach, it is possible to rebuild exercise tolerance and use movement as a tool for recovery, rather than a trigger for setbacks.

The core problem lies in the exercise strategies often recommended. Most workout plans are designed for healthy bodies capable of handling standard levels of exertion, which makes them unsuitable for those dealing with conditions like long COVID or CFS. Even Graded Exercise Therapy (GET) lacks the necessary flexibility for most people with these conditions.

In this article, we will explore why compound strength exercises may exacerbate symptoms and present an alternative solution for gradually rebuilding strength—one that is specifically designed to support recovery and avoid overexertion.

Compound movements: The No-Go exercises for Long COVID and CFS

First, it’s important to define what a compound exercise is. These are multi-joint movements that engage several muscle groups simultaneously, such as squats, deadlifts, and bench presses. While effective for building overall strength, they place significant demands on the body’s energy systems.

For individuals with long COVID or Chronic Fatigue Syndrome (CFS), the ability to generate sufficient energy is severely impaired. Growing scientific evidence suggests that mitochondrial dysfunction is a key factor behind the debilitating fatigue experienced in these conditions. Mitochondria, the energy-producing structures in cells, do not function optimally, leading to faster onset of fatigue compared to individuals without these issues.

A 2021 study by Pretorius et al., published by The Institute for Functional Medicine, highlighted how mitochondrial impairment plays a significant role in the fatigue and post-exertional malaise (PEM) common in long COVID.

Similarly, research by Tompkins et al. ​(SpringerLink) found that individuals with CFS experience a marked reduction in cellular energy production, contributing to rapid muscle fatigue.

Further evidence from my personal experience reinforces this. In a research study conducted by UCL’s Long COVID clinic, my blood samples were analyzed to assess mitochondrial function before and after a power walking exercise. I was fifteen months into long COVID and my mitochondrial function was notably lower compared to the control group.

When considering the high energy demands of compound exercises, it becomes evident why individuals with long COVID or CFS often experience significant crashes after traditional strength workouts. While PEM is a complex condition with multiple contributing factors, it is clear that compound exercises should be avoided during the symptomatic phase. PEM is far more than simple tiredness—it’s an overwhelming fatigue that can last for days, and compound exercises risk exacerbating this by pushing the body’s already-compromised energy systems beyond their capacity.

Rebuilding Mitochondria with long covid

The good news is that mitochondrial function can be restored through the right approach to exercise. Contrary to what might seem intuitive, complete rest is not the solution for improving energy levels or aiding recovery in long COVID or Chronic Fatigue Syndrome (CFS). Instead, carefully structured movement can help restore mitochondrial health without triggering post-exertional malaise (PEM).

Research shows that gentle, low-intensity physical activity can stimulate mitochondrial biogenesis—the process by which new mitochondria are created. According to a study by Safdar et al., moderate, controlled exercise can upregulate genes responsible for mitochondrial production, increasing the number of mitochondria in muscle cells and improving overall energy efficiency. The critical factor is engaging in the appropriate type of exercise—movement that encourages mitochondrial repair without overtaxing the body’s limited energy reserves.

For those with long COVID or CFS, the focus must be on striking a balance: delivering a consistent but manageable level of physical stimulus to promote mitochondrial recovery without overwhelming the body. Complete inactivity, as studies ​on chronic fatigue syndrome have shown, may actually exacerbate mitochondrial dysfunction over time, leading to further muscle deconditioning and reduced mitochondrial efficiency. This deconditioning can make long-term recovery even more difficult.

The challenge lies in finding the right dose of movement and the correct types of exercise for each stage of recovery. Gradually increasing physical activity in a controlled manner allows the body to rebuild strength while supporting the recovery of mitochondrial function. This approach helps avoid PEM and ensures that exercise serves as a tool for healing rather than a source of further setbacks.

The Right Strength Exercises for Long COVID or CFS

When it comes to exercise for those with long COVID or Chronic Fatigue Syndrome (CFS), isolation exercises offer a more effective alternative to compound movements.

Here’s why:

Lower Energy Demand: Isolation exercises target one muscle group at a time, unlike compound exercises that engage multiple muscle groups simultaneously. This significantly reduces the amount of energy required to complete each movement—a critical factor for individuals with limited energy reserves.

Reduced Complexity for Neurological Symptoms: Many people with long COVID or CFS experience neurological symptoms such as dizziness, brain fog, or balance issues. Compound exercises, which demand coordination across multiple muscles and joints, can exacerbate these symptoms by overwhelming both the body and the mind. Isolation exercises are simpler, reducing cognitive load while still providing the essential benefits of movement.

Better Control and Volume Monitoring: With isolation exercises, movements are smaller and more controlled, making it easier to gauge the amount of energy being expended. This helps in maintaining the delicate balance between exercising and conserving energy, minimizing the risk of triggering post-exertional malaise (PEM).

Why Isolation Exercises Alone Aren’t Enough for Long COVID

While isolation exercises are generally safer for individuals with long COVID and Chronic Fatigue Syndrome (CFS), many standard isolation exercises may require some form of external resistance—such as weights or resistance bands. For example, a tricep pull-down typically necessitates resistance to be effective. However, for those recovering from long COVID or CFS, adding external resistance can be too taxing on already limited energy reserves, underscoring the need for a different approach.

This is where the Baseline Movement program within The Baseline Club becomes essential. The program focuses on what I call muscle activation exercises—specific isolation movements designed to be performed using only bodyweight. This means you won't encounter energy-demanding exercises like bicep curls that depend on external resistance. Instead, the exercises are carefully selected to target crucial muscle groups such as the core, glutes, and back. These muscles are vital for posture and injury prevention but can be activated without requiring significant energy expenditure.

Key features that differentiate the isolation or muscle activation exercises within the Baseline Club program include:

Low Impact: These exercises engage muscles gently and efficiently without the need for weights or resistance bands. Many can be performed from the floor or a seated position, further conserving energy and aiding in the management of conditions like Postural Orthostatic Tachycardia Syndrome (PoTS).

Energy Efficiency: The selected movements activate critical muscle groups while minimizing energy output, making them particularly suitable for recovery.

Functional Focus: The exercises emphasize maintaining good posture and preventing injury as strength is gradually rebuilt. This is especially crucial for those who have experienced immobility or reduced mobility over time.

Overall, the program is designed to help individuals maintain muscle function and progress safely while respecting the limits imposed by their conditions during recovery.

Muscle activation exercises represent just one core component of the Baseline Formula, which members explore through a concise video course.

Additional components cover dosage principles—ensuring the right balance of exercise—and a system of predictable progressions.

For those interested in learning more, we offer a 7-day money-back guarantee. This allows potential members to sign up, access all content, receive support through the app, and even try out a workout.

Additionally, the membership is affordably priced with no contract, eliminating barriers to access.

To Sum Up

Navigating exercise with long COVID or Chronic Fatigue Syndrome (CFS) can be challenging, but it is essential for re-building resilience in your muscles as you recover.

While isolation exercises provide a safer alternative to compound movements, they must be approached thoughtfully to maximize benefits without overexertion. The Baseline Movement program focuses on muscle activation exercises that support mitochondrial function, enhance strength, and promote overall well-being.

By emphasizing low-impact, energy-efficient movements, individuals can gradually rebuild their strength and improve their quality of life. Remember, the journey to recovery is unique for each person; prioritizing appropriate exercise will pave the way for sustainable progress.

For those seeking a supportive framework, the Baseline Club offers accessible resources and expert guidance with 121 support to navigate this path effectively.

P.S. When you are ready. Here are two ways I can help you:

The Baseline Club. Affordable monthly coaching, to help you perform deliberate movement consistently and safely build back your exercise tolerance, keeping your muscles and joints healthy as you heal from long COVID or chronic illness. Learn more.

90 Day The Rebound Method. A unique reconditioning program for those no longer experiencing PEM and are ready to train back. You'll build back better than before with rock solid foundations, recover your exercise confidence and prevent injury. Take a closer look.