Virtual Treatment for ME/CFS Patients

This program is delivered virtually and is available to all residents of Ontario, British Columbia or Alberta.

What is ME/CFS?

Myalgic Encephalomyelitis (ME), often referred to as Chronic Fatigue Syndrome (CFS), is a complex biological illness that affects multiple systems in the body. It isn’t just “feeling tired”, rather it is a significant, life-altering reduction in your body’s ability to produce and use energy.

For many, ME/CFS is triggered by a viral or bacterial infection (such as Epstein-Barr, COVID-19, or Lyme). Even after the initial infection is gone, the body’s immune and nervous systems stay on high alert, leaving the person in a state of chronic exhaustion with physical crashes.

Why Does ME/CFS Happen?

Research shows that ME/CFS is not a result of deconditioning or “laziness”. Instead, it involves a cellular and neurological shift:

• Energy Production Struggles:  Think of your cells as having a faulty charging system. Even with rest, your “internal batteries” (mitochondria) struggle to create energy as quickly as you use it. When you push too hard, your system enters an emergency “power-save” mode, which results in a crash.
• Nervous System “Overdrive”:  Your nervous system manages things you don’t think about, like heart rate and digestion. In these conditions, it gets stuck in “high alert” (fight or flight). This is why you may feel completely exhausted but also “jittery” or unable to relax—a feeling often described as being “wired but tired.”
• Sensory Overload:  The immune cells in your brain can become over-sensitive. This can lead to brain fog, making it hard to process information or find words. It also lowers your “sensory filter,” so normal inputs like light and sound feel overwhelming or even painful.

Common Signs and Symptoms of ME/CFS

The hallmark of ME/CFS is Post-Exertional Malaise (PEM); a “crash” or worsening of symptoms that happens after even minor physical or mental effort.

How our ME/CFS Assessment Works

We understand that just getting to an appointment can be exhausting. Our assessment can be done at the pace that you prefer, can be broken down into shorter sessions and can be a phone call instead of video call. The main components of an assessment for ME/CFS rehabilitation include:

• The “Trigger” History:  We look at when your symptoms started and identify your specific “triggers” for a crash.
• PEM Screening:  We use validated tools to confirm if you are experiencing Post-Exertional Malaise, which helps us differentiate ME/CFS from other types of chronic fatigue.
• Active Stand Test:  We monitor your heart rate and blood pressure while you move from lying to standing to see how your nervous system handles gravity.
• Wearable Setup:  If you have a wearable device, we analyze your data together to find your current “Energy Envelope.”

Our Approach to ME/CFS Management

In the past, patients with ME/CFS were often told to “push through” their fatigue. We now know that “pushing through” can actually be harmful. Our focus is on guiding you through pacing to avoid PEM and stabilize symptoms.

• The Science of Pacing:  We teach you how to balance activity and rest to avoid the “Boom and Bust” cycle (doing too much on a good day and crashing for three days after).
• Heart Rate Monitoring:  We may use wearable technology to identify your “anaerobic threshold”—a heart rate limit that, if stayed below, can prevent your body from crashing.
• Calming the Nervous System:  We use gentle breathing and positioning techniques to shift your nervous system from “survival mode” into “recovery mode.”

Using Technology to Guide Your Recovery

One of the most powerful tools in modern ME/CFS rehabilitation is biometric data monitoring. By using wearable devices (like an Apple Watch, Garmin, or Oura Ring), we can take some of the guesswork out of rehabilitation.

• Heart Rate Variability (HRV):  This measures the tiny variations between your heartbeats. A high HRV usually means your nervous system has good balance between the two branches, while a low HRV can be an early warning signal that a crash (PEM) is coming.
• Resting Heart Rate (RHR):  We track your baseline heart rate. If your morning RHR is higher than usual, it’s a sign that your body hasn’t recovered from the day before, and you need to prioritize rest.
• Heart Rate Threshold Tracking:  We help you identify your “ceiling”, which is a specific heart rate (often just 15–20 beats above your resting rate but this can vary person to person) that you should stay below to prevent your body from switching to “emergency power” and crashing.

A Team Approach to Recovery

Because ME/CFS can affect an individual’s life significantly, management often requires a “team of experts” working together. At Cornerstone, we use an interdisciplinary model to ensure no part of your health is overlooked.

• Physiotherapy:  Your Physiotherapist will work with you to stabilize your system and stop the cycle of exhaustion. Through energy management, we teach you how to move your body safely using pacing and heart-rate-guided activity. Our goal is to keep you moving in ways that support your recovery rather than draining your limited battery.
• Occupational Therapy (OT):  OTs are the experts in functional energy. They help you modify your home or workspace, manage brain fog through cognitive pacing, and find ways to perform daily tasks (like cooking or showering) with less effort.
• Registered Dietetics:  Nutrition plays a massive role in managing inflammation and fueling your mitochondria. Our dietitians help you identify “trigger foods” and design an anti-inflammatory eating plan to support your energy levels.

Our Clinical Advisory Team

Dr. Todd Davenport
Physical Therapist, Professor and Researcher
Read their bio here

Frequently Asked Questions

Is This Program Right For You?

• Does a short walk or a long phone call leave you feeling “wiped out” a day or two later?
• Do you feel “wired but tired” and exhausted but unable to get restful sleep?
• Do you have to choose between doing the dishes or taking a shower because you don’t have the energy for both?
• Do you experience “brain fog” that makes it hard to follow a simple conversation?

If these experiences sound familiar, we can help you find a path toward stability and a more predictable quality of life.

ME/CFS Resources

Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) and Long COVID