By Karen Lee Richards*
Numerous studies done over many years have repeatedly found that exercise helps reduce fibromyalgia pain and fatigue and improve overall quality of life. But because of that pain and fatigue, many FM patients find it difficult to even think about exercising. However, with the right approach, it is possible for people with FM to develop a successful exercise plan.
The saying “perception is reality” can be very true when it comes to exercising with FM. Many people associate the word “exercise” with a strenuous workout of some kind – like an aerobics class or jogging – which would be way too much for many FM patients. If you perceive exercise to be very strenuous (and therefore painful), you’re more likely to avoid it in reality.
That negative connotation to the word exercise is why health coach and FM survivor Sue Ingebretson prefers to use words like “body movement” or “fitness activity” rather than exercise. FM researcher and clinician Dr. Charles Lapp agrees and says that the word “movement” is a much better description of what FM patients should be doing.
Start Slowly… Very Slowly
If you have fibromyalgia, it is essential that you begin any new fitness activity slowly and increase your activity gradually. Remember, the key word is movement. The most important thing is to start moving at least a little more than you are now.
Why is movement so important? Because inactivity, whether sitting or lying down, will increase your pain. This is best illustrated by the fact that most people with FM have a lot of stiffness and pain when they first get up in the morning. That’s simply from being in bed and inactive for several hours through the night. While the nighttime stiffening can’t really be avoided, you can reduce daytime pain and stiffness by moving your body as often as possible – even if it’s just to stand up and stretch for a minute or walk to another room and back.
Set aside any preconceived ideas you may have about how much movement (or exercise) you should do and for how long you should do it. If you are largely bedridden or spend most of the day seated, just walking to the mailbox may be all you can handle at first. On the other hand, if you’re already fairly active, you may be able to do more for a longer period of time.
When deciding what type of fitness activity to do, the most important thing is to choose something you enjoy. You’re much more likely to stick with it if you enjoy what you’re doing. Try to find a variety of activities you like so you can vary your routines. Click the next button to discover some fitness activities that research studies and other Fibromyalgia patients have found to be effective and fibro-friendly.
Stretching improves overall circulation, muscle and joint health – which are all beneficial to people with fibromyalgia.
Water exercise is an excellent choice for fibromyalgia sufferers because of the natural resistance and buoyancy.
Walking helps move more oxygen and nutrients to your muscles. Short bursts of walking are more feasible for people with fibromyalgia and the health benefits are the same as one long session.
The postures, meditation and most importantly, breathing can all help reduce the symptoms of chronic pain.
Tai Chi is a gentle exercise that focuses on breathing and mental focus while doing slow movements.
Pilates is beneficial because the repetitions can be done in short, slow spurts. Also, there are many modifications that can be made for most positions.
Qiqong promotes flexibility, balance, and a sense of wellbeing.
Use light weights to increase muscle strength. Stronger muscles take a little more time to fatigue.
Overall, low impact aerobics improve circulation, muscle and joint health. Low-impact aerobics is often done in a group setting, which may also be a supportive and positive environment.
Set Goals that Are Right for YOU
Most fitness plans – even those designed especially for FM – describe workouts that last from 30 minutes to an hour. Although that might be ideal, many people with FM are not going to be able to workout for that long at first.
Don’t allow yourself to feel like you have to keep up with a plan like that right away. Only you know the severity of your illness and what you are able to do. Evaluate where you are now and how much movement you get in an ordinary day. Decide how much you think you can add without triggering a flare.
Don’t feel guilty or discouraged if you’re only able to workout for two minutes at a time. Remember, that’s two minutes longer than you did yesterday. After a few days, you can add another minute; then in a few more days, another minute. You get the idea. If you have a flare, drop back to your previous level for a while longer. The important thing is to be patient with yourself and don’t give up.
It’s probably going to be a matter of trial and error to find what works best for you. For people with FM, there is often a very narrow window that constitutes the right amount of exercise. Too much will increase your pain, but too little will add to your pain as well. So don’t push yourself until you’re exhausted or in severe pain. Stop while you feel like you could still do a little more. Also, it may work better for you to exercise every other day, allowing yourself a day of rest in between.
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Choosing the Right Fitness Program
Keeping your expectations and ultimate workout goals in mind, here are a few tips from Sue Ingebretson for choosing a program that’s right for you:
- Choose classes or DVDs that are either specifically for those with fibromyalgia, arthritis, or limited mobility, or ones that make accommodations for these challenges.
- At all times, pace yourself. Begin any new fitness routine gently.
- Respect your own physical and fitness level limits. Adjust as needed to the moves you see on the DVD or in a class.
- To prevent injury, remember to use proper body mechanics as you move. Pay attention to your posture (spinal alignment), breathing (don’t hold your breath!), and overall body form.
- Select a variety of programs and/or DVDs. Try new things often and continuously add to your list of programs that you like.
- Give a new routine enough time to see if it will work for your needs. You don’t have to love it. Falling in “like” with a program is just fine… and it takes time.
- If your gym class or DVD fitness instructor sports a crew cut, wears army boots, blows a whistle, and says that everyone is “namby-pamby,” you may wish to select something else.
Movements to Avoid
According to Dr. Sharon Clark of Oregon Health & Sciences University and the Fibromyalgia Information Foundation, people with FM should avoid movements that cause muscles to contract and lengthen at the same time. She refers to this as eccentric work. Some examples of eccentric work include:
- Anything that raises your arms over your head, such as drying your hair or putting things into cupboards.
- Vacuuming, mopping, making beds.
- Putting dishes into a dishwasher or clothes into a clothes dryer.
- Walking down steps or downhill.
Of course, you may not be able to avoid all of these movements in your daily life, but try to minimize them as much as possible. Any exercise or activity that involves similar movements should also be avoided.
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* Karen Lee Richards is ProHealth’s Editor-in-Chief. A fibromyalgia patient herself, she co-founded the nonprofit organization now known as the National Fibromyalgia Association (NFA) and served as its vice-president for eight years. She was also the executive editor of Fibromyalgia AWARE, the very first full-color, glossy magazine devoted to FM and other invisible illnesses. After leaving the NFA, Karen served as the Guide to Fibromyalgia and Chronic Fatigue Syndrome for the New York Times website About.com, and then for eight years as the Chronic Pain Health Guide for The HealthCentral Network.
Exercise Advice from the Fibromyalgia Information Foundation
Includes information about several good fibro-friendly workouts as well as exercise DVDs available.
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