Exercise and fibromyalgia

If you or someone you care about has fibromyalgia, you know it can be one of the most frustrating illnesses around.  The symptoms of widespread pain and tenderness (sensitivity to touch) that tends to come and go and move about the body mean you never know what will hurt next.   The fatigue is compounded by sleep problems, which compounds other problems.  The wide range of symptoms effect every aspect of life and can leave you feeling like your body is the enemy.

Exercise is part of the standard recommended treatment, yet this can often lead to even more frustration when it only leads to more pain and fatigue.  Let’s look at why exercise with fibromyalgia so you know how to make exercise work for you.

Since the cause of fibromyalgia is unclear, we can only use exercise to treat the symptoms rather than the root cause of the illness.  Exercise has the most impact on preventing the secondary symptoms of fibromyalgia, the ones caused by living with pain and fatigue.  Let me explain.

The first secondary symptom is the loss of strength, stamina and mobility the comes when movement is limited by pain and fatigue.   This leads to the spiral of inactivity where you move less because of pain and fatigue, which causes you to lose function, which causes you to move less, and so on. This downward spiral continues so it looks like the disease is progressing when in reality it is the direct result of moving less.

So first and foremost, having regular routines for exercise that includes strength, cardio and stretching will help you recover from a flare up by reclaiming what is lost when you were resting.  Equally as important is having a ‘flare up’ routine you can switch to so you can keep moving but adjust the way you move to help with healing.   This duel approach to exercise gives you the ability to use exercise to help your body get what it needs in each stage; one is about rebuilding, one is about recharging.

That leads to the next important factor in fibromyalgia – mindfulness. Mindfulness, paying attention to what is happening in the present moment has been shown to be helpful with fibromyalgia pain.  When combined with exercise, mindfulness helps you stay out of the frustration of comparing your body to what you used to do or think you should do.  The focus on noticing when you are judging, and shifting to curiosity helps you move in the way your body needs to move now.  The most important ingredient of mindfulness is kindness.  Remembering that you are exercising to take care of your body, rather than trying to overcome it.  Mindfulness during exercise is the mindset that keeps you exercising in the way that helps fibromylagia.

Another side effect of fibromyalgia is depression.  Exercise, done in a way that helps your body feel better, will also help your brain function better.  Just ten minutes of exercise releases a natural balance of brain chemicals that raises mood and calms nerves.  Since stress is a trigger for fibro flare ups, using regular exercise to reduce stress in some way every day in your brain and body can help to lower the frustration of the changing symptoms of fibro.

For all of us to function well in daily life, we need strength, stamina and mobility.  There is no one type of exercise that gives you all three of these.  When you have fibromylagia, finding the balance between these three types of exercise is even more important. It helps you avoid doing too much of one kind and straining your body rather than helping it regain function.

• Stretching: Helps your connective tissue regain some elasticity, reducing pain and stiffness, and helps your lymph system reduce inflammation. Stretching is the foundation of exercise for fibromyalgia because it can help directly improve the symptoms both in a flare up and between flare ups.
• Strength training: Helps your muscles and bones and metabolism stay strong and counteract the effects of prolonged times of resting during a flare up.  Do strength training in a way that teaches your body to be strong for movements of daily life.  Stay clear of the athletic type strength training that tends to push your body to do more faster. Also stay clear of the  aesthetic fitness style strength training that is more about changing the look of your body (which is mostly myth and marketing based anyway) than the function of your body.
• Cardio:  Helps keep your stamina up so that you have more energy for every day activities.   Find a kind of cardio that feels good on your joints and allows you to modify the intensity depending on how you are feeling that day.  Doing shorter bouts, like 5-10 minutes, often feels better and still improves stamina.  Starting with one a day and then gradually adding more bouts during the day makes it easier on your body to adapt well without increasing pain.

Lastly, one sure way to put yourself in a flare up is doing too much too soon.  The fact is,  the body can adapt to a 10% increase in exercise a week.  That is not much.  When you have a medical concern like fibromyalgia, the rule is 5% increase per week. That means if you are doing a 10 minute walk, increase by 30 seconds! That is much less than your brain thinks you should, but is the amount your body can do. By working with your body in this way, you help avoid flare ups and can better use exercise to help you manage fibro well.

Bottom line: When you have fibromyalgia, it is extra important to be sure your brain and body are working together.  When you work with your body, listening to it as your best guide, giving it the right balance of rest and movement, exercise can be a great part of your fibro management toolbox.

Keep Moving, Be Well,

Janet

Sources:

1. Fibromyalgia:  https://www.rheumatology.org/I-Am-A/Patient-Caregiver/Diseases-Conditions/Fibromyalgia

2. Mindfulness and Fibromyalgia:  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5693231/pdf/nihms916892.pdf

3. Mindful Movement and pain management:  https://med.stanford