Managing fibromyalgia with exercise
One of the more difficult conditions that I have helped people to manage over the years has been fibromyalgia. Fibromyalgia is a common disorder, seen most often in women between the ages of 25 and 55, that is characterized by aching, fatigue and general malaise. People suffering with this condition may also have sleep disorders, memory problems and mood issues.
The challenge for someone looking for help is that fibromyalgia is not diagnosed with typical lab tests or scans. It is considered a “syndrome,” which is a group of symptoms that consistently occur together. This has led to some speculation that fibromyalgia doesn’t actually exist, adding to the frustration of those seeking answers.
There are, however, very specific criteria that must be met for a diagnosis of fibromyalgia syndrome (FMS) to be made: a history of whole body pain (unexplained by other diagnosis) lasting three months or more, and the presence of nine or more of a possible 18 tender points throughout the body. The diagnosis of FMS cannot be made without the presence of these tender points, which means that they will be part of the routine physical exam when the condition is suspected.
For people suffering from FMS, the symptoms can be unrelenting. Some would even classify the pain as “disabling.” Because of this, it is not uncommon for sufferers to lose their strength and endurance and to gain excess amounts of body fat leading to functional disability and/or chronic disease.
The good news is that there is evidence that appropriate exercise programs for FMS patients can increase physical fitness, restore functional capacity (the ability to complete activities of daily living) and even alleviate symptoms.
Here are five keys for using exercise to manage fibromyalgia syndrome:
1. When starting out, it is important to “under do” things. One of the hallmarks of FMS is a diminished recovery capacity. This means it takes longer to recover after an exercise session and it is easy to over-do it in the beginning, leading to setbacks.
2. Begin with low-impact aerobic exercises like cycling or water walking. Strength training should also be part of your fitness plan but that plan should emphasize exercises using minimal “eccentric” contractions. These are the contractions your muscles go through when they are lowering a weight against gravity and are very difficult for FMS patients to endure. The best strength choices to include would be aquatic resistance exercises in the pool, or movements using rubber resistance bands in the gym.
3. Allow for more rest between exercise sessions. I ask clients to take two days off between workouts until their conditioning level has increased and they are able to handle exercising every other day. It’s important to understand that strenuous workouts can leave FMS patients bedridden for several days in the worst-case scenario.
4. During symptom “flare-ups,” light exercises can help make symptoms better, particularly if they are performed in a pool where buoyancy will relieve stress on the joints.
5. Make fitness and working out an absolute priority. In the years that I’ve worked with clients with fibromyalgia, I have been told, consistently, by their referring physicians that exercise is the most important part of their plan to manage the condition. It should be a part of everyday life.
Finally, it’s important to understand that while aquatic training is often the best way for FMS patients to get moving and to build back their strength and stamina, we don’t live in the water! In designing long-term fitness plans, I consider the pool to be a great bridge between physical therapy and “regular” land-based fitness training. When managed and planned correctly, most people can get back to doing activities that carry over into their everyday lives, helping them to function better and with more ease.