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What are energy-limiting conditions?

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A core concept for disability inclusion policy and practice

Energy Limiting Conditions (ELCs) describe a form of disability where energy production itself is impaired – limiting the amount, pace and reliability of activity a person can sustain over time.

This page introduces the concept of Energy Limiting Conditions (ELCs), a framework that originated in disability-led research and lived experience. It is intended for researchers, policy-makers and equality, diversity and inclusion (EDI/DEI) professionals seeking more accurate ways to understand disability, participation and support.

What are Energy Limiting Conditions?

Energy Limiting Conditions (ELCs) are an umbrella term for conditions in which fatigue and energy impairment are common and significantly limit activity and participation.

Unlike impairments that primarily affect a specific function (such as vision or mobility), ELCs limit the total amount of activity a person can do, and the pace and consistency with which they can do it. This includes physical, cognitive, emotional and sensory functions.

With ELCs, disability is best understood over time – across a day, a week or longer – rather than in a single moment.

A defining feature of ELCs is that exertion carries risk. Activity can trigger worsening of symptoms, sometimes delayed, commonly referred to as “payback” or post‑exertional symptom exacerbation. This means that tasks which appear manageable in the moment may result in short‑term collapse or longer‑term deterioration.

Key features commonly associated with ELCs include:

  • Severely limited and finite energy
  • Cognitive fatigue and dysfunction (e.g. processing speed, memory, executive function
  • Fluctuating or episodic symptoms
  • Delayed consequences of exertion
  • Co‑occurring symptoms such as pain, sensory sensitivity, dizziness or nausea

Because energy impairment affects multiple systems at once, ELCs often cut across conventional disability categories.

Who is included under the ELC umbrella?

ELC is not a diagnostic or medical category. It does not describe the cause of a condition, but its functional impact on daily life and work.

For this reason, there is no definitive list of conditions that qualify as ELCs. Inclusion depends on how a person is affected, not the name of their diagnosis.

UK Government data on impairment and disability reveal that just over 1 in 3 (or ~6 million) disabled people report ‘impairment of stamina, breathing or fatigue’,[1] a concept closely related to ELC.

The term ELC is widely used by people with conditions where exertion intolerance is a hallmark feature, such as:

  • Myalgic Encephalomyelitis / Chronic Fatigue Syndrome (ME/CFS)
  • Long Covid and other infection-associated chronic conditions

It also applies to many other conditions where fatigue or energy impairment is among the most disabling aspects, including:

  • Neurological conditions (e.g. multiple sclerosis)
  • Autoimmune conditions (e.g. lupus)
  • Musculoskeletal conditions (e.g. fibromyalgia, Ehlers‑Danlos syndromes)
  • Respiratory and cardiological conditions (e.g. COPD)
  • Gastrointestinal conditions (e.g. Crohn’s disease)
  • Cancer and the long‑term effects of treatments such as chemotherapy

Energy impairment is also widely reported by people who are neurodivergent and by people experiencing mental distress, and these experiences often co‑occur with physical illness.

Focusing on impact rather than diagnosis makes ELCs particularly useful for policy, employment and inclusion contexts.

The impact of ELCs on work and daily living

ELCs restrict mental as well as physical activity. Cognitive fatigue – including difficulties with concentration, memory and communication – is often under‑recognised, despite being highly disabling in education and knowledge‑based work.

Most ELCs are fluctuating conditions, meaning that capacity can vary unpredictably from day to day, or even within a single day. This makes rigid systems of assessment, attendance and productivity poorly suited to capturing support needs.

Most ELCs are a form of non-visible, or invisible disability. This means, like the majority of impairments and health conditions, they are not immediately apparent to others.

What distintinguises ELCs from many other forms of non-visible impairment is that fatigue and energy impairment are generally medically invisible. They are poorly understood, can’t be verified by standard clinical tests. As a consequence, people with ELCs typically experience delayed, uncertain or contested diagnosis.

As a result, people with ELCs frequently experience disbelief, trivialisation and invalidation. Fatigue is often treated as a minor or universal experience, rather than a serious and limiting form of impairment.

Disbelief is not a side issue – it is a structural barrier that shapes disclosure, access to support and long‑term participation.

These dynamics make it harder for people with ELCs to:

  • Identify as disabled and claim disability rights
  • Disclose support needs safely
  • Access reasonable adjustments
  • Sustain work or study without risking deterioration

Understanding ELCs as a legitimate and common form of disability is therefore essential for effective policy, inclusive workplace design and equality practice.

Where did the concept of ELCs originate?

The concept of Energy Limiting Conditions emerged from emancipatory, disability‑led research, most notably through the Chronic Illness Inclusion Project. [2]

Participants in this research explicitly called for new impairment concepts that better reflected their lived experience and disability identity. They rejected the term “fatigue” as trivialising and inadequate, and articulated energy impairment as a more accurate description of their constraints.

ELCs were developed as a rights‑based, experience‑led framework, intended to support self‑advocacy and improve understanding in policy, employment and social contexts.

[1] Department for Work and Pensions (2025).Family Resources Survey: financial year 2023 to 2024. GOV.UK. https://www.gov.uk/government/statistics/family-resources-survey-financial-year-2023-to-2024 (accessed January 2026).

[2] See Catherine Hale, Dr Anna Ruddock and Ana Bê. Introducing “Energy Limiting Conditions”: The Emergence and Evolution of a New Impairment Concept. International Journal of Disability and Social Justice. 2025. Vol. 5(2):136-158. DOI: 10.13169/intljofdissocjus.5.2.0001

and

C. Hale, J. Lyus, S. Benstead, A. Ruddock, E. Odell, Energy Impairment and Disability Inclusion: towards an advocacy movement for energy limiting chronic illness, (2024). doi:10.31219/osf.io/xwjuh.

Cite as: Hale, C. (2026). What are Energy Limiting Conditions (ELCs)? Disability Insight. Available at: https://disabilityinsight.co.uk/about/what-are-energy-limiting-conditions/

© 2026 Catherine Hale.

This article and the original terminology it contains are the intellectual property of the author. No part of this work may be reproduced, adapted, or used for commercial purposes without prior written permission.