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How to Improve Balance in People with Fibromyalgia

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The chronic pain suffered by fibromyalgia patients can make it very trying to exercise regularly. Exercise can exacerbate pain, and who needs that? The problem, however, is that the lack of movement brings about physical weakness, stiffness, less support for the joints, and loss of balance. All of the above can increase chronic pain levels and hinder fibromyalgia recovery.

Loss of balance is especially troubling. People with fibromyalgia need to keep their proprioception (an awareness or sense of where the body is in space) and balance keen, as falling and injury can cause an uptick in chronic pain, and worsen the cycle of weakness, stiffness, and other fibromyalgia symptoms.  

Luckily, maintaining (and even improving) proprioception and balance does not need to be strenuous or painful. There are very gentle exercises that, when done with some regularity, help quite a bit — they may even lower fibromyalgia pain levels over time. 

Loss of Balance in Fibromyalgia Patients

Most fibromyalgia patients experience muscle stiffness, which can increase chronic pain symptoms. In my clients, I’ve found that the stiffer the muscles, the more pain they experience. Stiff muscles are hard and knotted even while at rest — it’s as though the muscle fibers forget how to relax. Some fibromyalgia patients even feel bruised and sore to the touch due to their muscular tension.

Every person carries tension in different areas of the body. It’s a fair guess that wherever you experience pain, your muscles are tight and bound. Tight muscles inhibit proprioception and balance. The steps to improve your balance, then, involve locating your tightest muscles, and begin to loosen them. Here’s how:

1. Work with your tension patterns 

Begin by exploring the sore spots on your body with your hands, ideally while sitting or lying down, so you can relax. Healthy muscle tissue is watery while at rest. In fact, muscles are 79% water! They are not supposed to feel like rocks. 

Think of a baby or a puppy sleeping – their tissue is soft, resilient, and malleable. Hold an image of softness as you explore your own muscle tissue, and deepen your breathing. The imagery, breathing, and gentle touch will help your tension patterns relax. It will also teach you where you need this kind of release the most.

Be sure to include your hips and your legs, especially if you have lower back pain. If an area of the hips or legs is too tight, it can pull on the pelvis and even tilt it slightly off its axis, making lower back pain worse. Take time to explore the sides of your hips, and the backs, sides and fronts of your thighs and calves. Any release you find in these areas will help to right the pelvis and take pressure off the spine. (Of course, you can outsource this practice to a good massage therapist!)

2. Try stretching

Stretching does not work for everyone. For some it increases pain, and in that case, forget it. But for most people, gently stretching your tightest muscles will help them to soften, lengthen and release.

Once you have determined your tight spots, find a good stretch that works for you. Invent one yourself, or look online. 

Remember to keep it gentle! I have my clients grade the intensity of their stretches on a scale from 1-10, with 10 being “I’m dying.” Keep the intensity below a 6 for best results. If you push too far, your muscles will tighten up. Deep breathing helps with stretching as well as massage.

Your body will let you know immediately if a stretch is right for you. Again, I use an intensity scale to help determine this. Grade your pain level before you start, on a scale from 1-10. Stretch gently for a few minutes (it takes at least 90 seconds for muscles to lengthen, which can feel like a long time until you get used to it). Then get up, walk around, and grade your pain again. If the stretch worsened your pain in any way, it’s not the right stretch for you. 

Trust your body as your guide. If stretching works for you, it should leave you feeling lighter — like you can stand up straighter and balance more easily afterward.

3. Retrain the brain to feet connection

Research has shown that balance is determined, in part, by our central nervous system’s (CNS) ability to sense the soles of our feet as they make contact with the ground — and with good reason. We spent most of human evolution walking around on uneven surfaces barefoot. Through most of human history the sensory feedback our CNS gathered from feet to earth contact was important so our feet could feel roots, sharp rocks, unstable surfaces, and anything else that might impede our balance or make forward progress unsafe. Now, however, we have rubber soled shoes that almost eliminate sensory input from the soles of our feet and can limit mobility.

Luckily, due to a concept called neuroplasticity, your brain has the ability to reconnect to the sensory input that your feet provide. This holds true no matter what your age is — it’s never too late to improve your balance. But first, you’ll need to rebuild your capacity to sense the soles of your feet.

Try these gentle exercises to improve your CNS’s ability to integrate the sensory input coming from the soles of your feet and enhance balance. To gain the most benefit, the exercises are best done barefoot.

Start slowly, and again, listen to your body to determine if the exercises are right for you. If they increase fibromyalgia pain, back off. If you have symptoms like dizziness, vertigo, or orthostatic intolerance issues like POTS, these exercises may not not right for your, or you might wish to keep your eyes open for safety as you try them.

  • Standing with eyes closed: To begin this exercise, hold onto something stable (a firm countertop, a dresser, a sink, etc.). If you feel steady, close your eyes and sense the soles of your feet. Move your feet around a bit to feel the pressure on various parts. Then, if you’re able, let go of what you are holding and try to stand without the assistance of your hands.
  • Heel raises with eyes closed: As you progress and feel safe, try raising your heels off the floor. Again, hold something initially, and then let go as you are able. Pro tip: Make sure your weight is mostly over your big toe and your second toe as you lift your heel. Try lifting and lowering your heels in a calf raise while you maintain your balance.
  • Standing on one foot with eyes closed: If you can, lift one foot off the floor and balance on one leg. Hold on to something until you feel safe letting go. Again, remember to put your weight over your big toe. Letting your weight fall to the outside of your foot will throw you off.

As time goes on, and your balance improves, you can incorporate these gentle exercises into daily life. Try brushing your teeth with your eyes closed. Try standing in line at the grocery store eyes closed, or raising and lowering your heels. If your neighbor looks at you funny, don’t worry, you won’t see them!

I have seen great improvements in my clients’ balance over time, repeating variations on these simple exercises once or twice a week. You can invent your own exercises as well. The goal is just to improve your ability to feel your feet — anything that serves that end works. If you are dorky like me, both the exercise invention and practice is a lot of fun, and the improvement in balance is its own reward. 


Shona Curley lives and works in San Francisco. She is co-owner of the studio Hasti Pilates, and creator of the website www.redkitemeditations.com. Shona teaches meditation, bodywork and movement practices for healing Lyme disease, chronic illness and pain.

 

 

References:

Goble DJ, Coxon JP, Van Impe A, et al. Brain Activity during Ankle Proprioceptive Stimulation Predicts Balance Performance in Young and Older Adults. The Journal of Neuroscience. 9 November 2011; 31 (45): 16344-16352. doi: 10.1523/JNEUROSCI.4159-11

Kavounoudias A, Roll R, Roll JP. The plantar sole is a ‘dynamometric map’ for human balance control. Neuroreport. 998 Oct 5; 9(14): 3247-52. doi: 10.1097/00001756-199810050-00021  

 

 

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