Fatigue symptoms and the complex conditions they’re associated with are fast becoming one of the more common presentations our Exercise Physiologists are faced with in the return-to-work space. At Specialised Health, we’ve been helping people navigate fatigue-related barriers long before they became well-known during the COVID (and now long-COVID) era. Our fixed-fee fatigue management program “Bounce” has been a cornerstone of our work for years—and for good reason. Exercise Physiology for fatigue management is here to stay.
Fatigue can stem from a wide range of medical conditions, each with its own underlying causes and unique challenges. And while the symptom may be the same, our approach is anything but one-size-fits-all.
A Closer Look at Fatigue Across Conditions
Fatigue shows up in many forms—and at Specialised Health, we see it across a broad spectrum of health conditions. While no two people experience it the same way, some patterns emerge. The conditions we work with vary, but some of the most common include:
Chronic Fatigue Syndrome / Post-Viral Fatigue (including Long COVID)
For these clients, the focus is all about pacing and load management. And it’s important to note that “load” doesn’t just mean exercise—it can include basic daily tasks, cognitive effort, chores, and even social interaction. In conditions like Chronic Fatigue Syndrome or post-viral fatigue, many systems in the body are often dysregulated, and traditional exercise can actually worsen symptoms if not carefully managed. That’s why our approach prioritises understanding the individual’s total load. We monitor heart rate variability, track energy patterns, and help clients recognise their own “energy envelope.” Pacing strategies become the foundation—helping clients balance activity and rest, while slowly and sustainably building tolerance over time.
Cancer-Related Fatigue
Fatigue in cancer survivors is multifactorial—driven by treatment, deconditioning, sleep disruption, and more. Here, the goal is to gently restore physical function, while also working to prevent muscle wastage and improve quality of life. Education, energy budgeting, and exercise intensity modulation play a big role.
Mental Health Conditions (including Depression, Anxiety, PTSD)
For mental health clients, fatigue is often tied to dysregulation of the autonomic nervous system (ANS). While CFS and some mental health conditions might call for nervous system downregulation, some mental health-related fatigue benefits from upregulation. Think breathwork, movement exposure, and structured activation—using exercise to shift physiology, improve motivation, and promote resilience. Heart rate variability monitoring and pacing strategies can also be powerful here.
Fibromyalgia & Chronic Pain Conditions
Pain-related fatigue is more than just feeling tired from being in pain. It’s the result of a constantly activated nervous system—one that’s on high alert, scanning for threats, managing discomfort, and often interfering with sleep and recovery. This heightened state, known as hypervigilance, can be exhausting in itself. Our role is to help calm the system first, supporting the body’s energy regulation by working with—not against—the nervous system. From there, we guide clients through re-learning that movement can be safe, slowly integrating activity in a way that reduces fear, builds confidence, and supports energy restoration. Education around pain science is key—because when people understand what’s happening in their body, the load they’re carrying often feels a little lighter.
Sleep Disorders
When sleep is a root cause, we bring physiology back into focus—using movement and structured routines to support circadian rhythm, manage arousal levels, and help the body relearn how to rest. These programs often include education around sleep hygiene, and consistent tracking of sleep metrics can be invaluable.
Our Approach: Individualised, Data-Informed, Purpose-Driven
What sets Specialised Health apart is our deep understanding of fatigue and our ability to adapt our programming based on the condition at hand. We don’t just hand over a list of exercises—we teach clients to listen to their body, track meaningful data, and make choices that support recovery. Our Bounce Program sets us apart in the fatigue management space – and the results are speaking for themselves!
Whether it’s:
- Using biofeedback like HRV, RPE, and symptom tracking to scale back on harder days and guide activity levels in real-time
- Integrating nervous system regulation strategies (like breathwork, mobility, or gentle movement) to help manage flare-ups and support recovery
- Implementing graded loading to gently bridge the gap between current capacity and future goals—meeting clients where they’re at, and building from there
… We treat fatigue not just as a symptom, but as a puzzle to be solved—with clinical insight, empathy, and science-backed tools.
Fatigue is complex, but recovery is possible—and Exercise Physiology has a big role to play.
Author: Tessa Nielsen
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