Q: I am really tired of having people tell me about how exercise is good, and no exercise is bad. I was a runner before ME/CFS & FM, but now trying to do what I love is a disaster. How can I rise from total potato status without a flare?
A: Exercise is a touchy subject for ME/CFS and fibromyalgia patients. Since post-exertional malaise (extreme, prolonged exhaustion and a worsening of symptoms following physical exertion) is a key symptom of ME/CFS, most patients balk at the suggestion of exercise. And for FM patients, when it hurts to move, the idea of exercising seems unfathomable – yet multiple studies have shown that exercise is an important component of any FM treatment plan.
Part of the problem is that most people think of exercise as jogging, aerobics and other strenuous activities.
ME/CFS and FM specialist Dr. Charles Lapp suggests redefining “exercise” for these patients. Perhaps a better word would be “movement.” He says the main thing is to avoid strict bed rest, which causes deconditioning, which in turn makes symptoms worse.
Important ME/CFS & FM “exercise” tips:
• Move your body as much as you are able – even if it’s just walking to the kitchen for a glass of water.
• Deep breathing exercises – learning to breathe from the lower part of the diaphragm – are essential. Shallow breathing increases neck and shoulder pain and can cause chest tightness, shortness of breath and spasms in the postural muscles. Deep breathing eases tension and improves the circulation of oxygen in your body. Dr. William Collinge offers an excellent explanation of how to use deep breathing to relax (scroll down to "Using the Breath").
• Stretch your muscles periodically throughout the day. Begin slowly with seated stretches. After several weeks, if you are able, progress to standing stretches. [See the Arthritis foundation’s short videos demonstrating seven simple stretches.]
• When you first begin any new type of exercise, think in terms of seconds, not minutes. Depending on the severity of your illness, start with as little as 30 seconds and build up very gradually (i.e., spend several weeks at each level).
• Take frequent rest breaks. The CDC recommends that ME/CFS patients rest three minutes for each minute of exercise. Once you’ve moved into strength training or cardiovascular exercise, it’s a good idea to only exercise every other day, allowing yourself a day of rest between workouts.
• Break up your exercise sessions. Five three-minute sessions are much better for ME/CFS patients than one fifteen-minute session.
• For those who are able to tolerate a longer period of exertion, water exercise may be a good option. Water’s buoyancy decreases the effects of gravity, displacing 85 percent of your weight. As a result, it takes less effort to move because you don’t have to support your whole weight. Also, immersion in water promotes relaxation, reduces muscle fatigue and lessens pain perception.
To read more about physical activity and stretching for fibromyalg patients, see “Planning Your Exercise Regimen,” by Claudia Craig Marek, Medical Assistant to FM specialist R. Paul St Amand, MD.]
Note: This information has not been evaluated by the FDA. It is general and is not meant to prevent, diagnose, treat or cure any illness, condition or disease. It is very important that you make no change in your healthcare plan or health support regimen without researching and reviewing it in collaboration with your professional healthcare team.