a body-mind approach to chronic illness
exercise routine
specifically for fibromyalgia
When people ask what fibromyalgia is they are usually given a long list of the main symptoms. These include pain, fatigue, stiffness, sleeplessness, fogginess, depression, and anxiety.
While this list gives us an overall picture of fibromyalgia it doesn’t really describe the essence of the disease. Fibromyalgia is a disease of many symptoms and these symptoms vary considerably from person to person.
There are however two words that capture the essence of fibromyalgia and they are “sensitivity” and “stiffness.” People with fibromyalgia tend to be very sensitive chemicals, light, noises, and especially to pain. They are also described as very stiff and maybe even a bit “uptight.” Stiff joints, tight muscles, and slightly uptight in their behavior.
In Fibromyalgia: Simple Relief Through Movement, Stacy Bigelow explains that the key to managing the pain of fibromyalgia is regular and gentle movement. Most exercise programs are very strenuous and result in rebound pain. Bigelow developed a five step sequence that starts light and gradually intensifies. I’ve added breathing as an additional step.
1. Restorative sleep so your body can repair damaged muscles.
2. Activity or movement to condition your body for exercise.
3. Breath work to maximize the benefits of exercise.
4. Stretching to losen those stiff and painful muscles.
5. Aerobic exercise to get the blood flowing.
6. Muscle training to become fit because fit bodies have less pain.
When you exercise you create microscopic tears in your muscles called micro traumas. During sleep your body secretes growth hormones, which repair these tiny tears, making your muscles stronger.
People with fibromyalgia often suffer from rebound pain after exercising and usually need long periods of rest before they are ready to exercise again.
If the quality of your sleep is good your body is better able to repair itself, thus reducing rebound pain. Go to the sleep page to read about ways to help you sleep better.
two. activity and movement
Do at least 60 minutes of activity every day. Activity are not the same as exercise. Bigelow defines activity as any movement where you are on your feet for a minute or more. This may include walking the dog, doing chores, or gardening.
One of the best ways to ease the pain of fibromyalgia is regular exercise but if you were to suddenly start doing rigorous exercise you would definitely suffer the consequences.
The key is to start slowly and gently and then progressively work up to a more challenging regimen.
Regular daily activity is the foundation of managing fibromyalgia. It is most effective when done along with mild, regular aerobic exercise. But activity without exercise is better than exercise without activity.
First let’s define activity. Any kind of movement where you are on your feet for more than a minute. So walking to the kitchen to get a glass of water doesn’t count. But standing at the sink doing the dishes does. Use your discretion though, because you can be active without standing: gardening for instance.
In your first week you want to measure the amount of activity you engage in daily. The easiest way to do this is to jot down the type of activity and the time you spent doing it and then adding up the total amount of time at the end of the day. Once you’ve observed how active you are you can start making changes.
Aim to do the gentle movement where the risk triggering pain is minimal. Make sure to listen to your body for any clues of pain or discomfort. Try a wide range of activities to find out what you like doing. They will be a fair amount of trial and error at first before you settle into a routine.
If you have some cash to spare you might consider getting a full body vibration machine. It's a passsive but effective way to activate your muscles.
three. breath
Everyone knows that breathing is essential to life but did you know that not everyone does it correctly? There is a tendency among many people to take small, rapid breaths using the muscles of the chest instead of breathing slowly and deeply with the muscles of the abdomen.
This type of shallow chest breathing can cause a broad array of symptoms including mental fog, dizziness, irritability, chest, neck and shoulder pain, digestive problems, irritable bowel, and more.
Are Your Breathing Properly?
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Sit up in a chair with your back straight.
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Place one your hand on your chest and the other on your abdomen.
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Breathe normally.
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Which hand rises up and down the most as you breathe?
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If your abdomen rises and your chest stays relatively flat, you are breathing properly.
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If your abdomen barely moves and your chest rises, you are not breathing properly.
Go to the breathing page if you want to read more about breathing exercises.
four. stretch exercises
Bigelow noticed that people with fibromyalgia tend to have stiff bodies and rigid muscles so the next step is loosening up with stretch exercises.
Stretching, when done right, feels good. It’s calming, centering, and connecting. It doesn’t have to cost anything, has almost immediate benefits, and can be done anywhere.
Stretching should always be gentle. At no time should you feel pain or as though you’re going to break in half if you stretch one more inch. It’s also very important that you move into each position slowly and hold it for at least 20 seconds while you breathe deeply. When you’re ready to release, gently come out of the post before beginning the next.
five. aerobic exercise
Bigelow writes, “Aerobic exercise is the closest thing to a medical magic bullet that ever been found.”
When you exercise you create microscopic tears in your muscles which are repaired during sleep. After exercising, everyone will feel some degree of pain and discomfort, even the fittest and strongest athletes.
Someone with fibromyalgia will feel much stiffer and sorer than than most people. And when you’re stiff and sore, how likely are you to do more exercise?
So we need to take it much slower. Take as much time as you need to increase your activity level. Just don’t set yourself up for failure by trying to exercise too soon.
Key points to remember
Avoid impact. Impact is any motion that has you jumping and landing with a force harder than walking. Examples of high impact exercises are jogging, skipping, and jumping jacks.
Avoid movements that rely on the areas most affected by your fibromyalgia. If for example you have a sore neck don’t do exercises that strain your neck.
For most athletes high intensity, short duration is best, but we are going to choose low intensity, long duration exercises instead. This is less likely to cause a flareup and will give you the most pain relief.
Never start or stop exercising abruptly. Don’t go from being totally sedentary to jumping into a full exercise program without working up to it gradually.
six. weight training
According to Bigelow, “Muscle training is one of the best kept secrets in women’s health.” There are several reasons for this:
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it’s the fastest way to become fit and fit bodies have less pain
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strong muscle support painful joints
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strong muscles improve posture and muscle alignment thus reducing fatigue
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there is a bit of blood and oxygen flow
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strong muscles don’t cramp easily.
Bigelow suggests muscle training no more than twice a week. This gives your body time to rest and recover. She also suggests doing more reps with lighter weights to reduce the risk of strain and injury.
The overwhelming majority of health experts strongly recommend the people with fibromyalgia don’t lift weights ever. This is because they have repeatedly observed that after lifting weights, people of fibromyalgia experience an immediate and dramatic increase in pain.
There are three reasons for this: poor sleep quality, taking on too much too soon, and poor form.
One. Poor sleep quality
If you are not getting restorative sleep you should not be doing strength training. Every time you train you cause small injuries to your muscles which heal during sleep. If you are not sleeping well your muscles won’t heal after trying and you’ll experience rebound pain.
Two. Too much too soon
Hopefully by now you’ve worked your way up from activity, to stretching, to aerobics and are ready for resistance training. But be careful and start really slowly with light weights.
Three. Poor form
If you do muscle conditioning in the right way you will avoid the rebound pain.
The safest way to add muscle conditioning to your fibromyalgia care plan is to join a gym and then ask a personal trainer to work out a program that is right for you.
If you don’t have access to a gym or don’t feel you want have the extra funds for gym fees then the next best thing is doing exercises at home.
I feel that the best form of weight training for someone with fibromyalgia is bodyweight training and slow burn.
Body weight training also called calisthenics, is a form of strength training where you use your own weight to provide resistance against gravity. Bodyweight training uses simple abilities like pushing, pulling, squatting, bending, twisting and balancing.
The advantage of bodyweight exercises is that most of them don’t require any equipment.
Older people and people with fibromyalgia doing bodyweight exercises benefit through gains in muscle mass, in mobility, in bone density, as well as in reduced depression and improved sleep habits. It is also believed that bodyweight training may help diminish or even prevent cognitive decline as people age. Bodyweight exercises provide multi-directional movement that mimics daily activities, and as such can be preferable to using weight machines.
Slow burn is a form of weight lifting that uses very slow, smooth, and controlled lifting and lowering movements rather than the typical high force, explosive lifting seen in most gyms and training studios.
Think of it as the Tai Chi of the gym. There are no sudden, explosive or highly abrupt movements that can potentially cause injury. Every exercise is performed in a controlled and focused fashion.
Most professionals recommend exercising three to five times a week. However, using SlowBurn all you need is one or two thirty minute workouts a week.
The reason for this is that slow burn is a very efficient form of exercise. If the quality of an exercise program is high, one or two sessions a week is more than adequate for optimal results. Remember, exercise itself doesn't make you fit or healthy. It’s the combination of exercise and adequate rest and recovery. So not only do you not need to exercise on your days off, you shouldn't!
Getting started
To get the best out of your exercise and movement program it helps to join a gym and ask for the assistance of a personal trainer. If this is not your cup of tea give me a call and I'll be glad to help you out. Alernatively, click on the exercise books page and take on this exciting journey by yourself.
