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Day: April 1, 2026

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Not All Post-Exertional Malaise (PEM) Is the Same_Anna Marsh
Exercise & PEM

Not All Post-Exertional Malaise (PEM) Is the Same

If you live with an energy limiting condition such as Chronic Fatigue Syndrome, Long Covid, Post-Viral Fatigue or an autoimmune condition you have probably experienced post-exertional malaise. When you’re in it, a crash can feel just like any other crash and you also just assume that whatever you are experiencing is what others experience too. But…

Not all post-exertional malaise (PEM) is the same.

And if we treat all crashes as identical, we can end up applying a good strategy to the wrong situation. This can be ineffective at best and stall progress over time.

In clinical practice, there are often three distinct physiological patterns behind what people label as “PEM.”

Understanding the difference can reduce fear and offer important insight into what type of support the body needs.

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Join the nurturing Resilience Membership for just £39/month

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Nurturing Resilience offers you the opportunity to address both, to whatever degree you need. By supporting your nervous system and physical health, you can build more resilience in your system. And with more resilience comes greater capacity to live life with less crashes, flares and setbacks!