Fibromyalgia Monthly Newsletter
May, 2005
With featured articles on Fibromyalgia treatment and Chronic Fatigue Syndrome, information on treating Fibromyalgia, reviews of recommended products, and interviews with practitioners.
Fibromyalgia and Exercise
by Tamara Peters
Published on: March 25, 2003
article reprinted from Suite101.com
To exercise, or not to exercise, that is the question. For the majority of the population the answer to this question would appear simple. In order to stay healthy and be physically fit you must be physically active. But, for those of us living with the chronic pain of fibromyalgia this poses a whole new question. How are we supposed to exercise when most days it seems to take super-human strength just to make it through the day? It is important to remember that we are not the majority of the population. There are valid reasons why we must be careful with the type and duration of exercises we choose.
FMers are known to have an exercise intolerance (hypersensitivity) and often feel worse after exercising. Compared to non-FMers we experience post-exertional (delayed) pain of increased intensity and duration. The resulting decrease in endurance leads to deconditioning and loss of function. It’s another one of those vicious cycles where the less we exercise, the more deconditioned we become, and the less we are able to exercise. I suspect that lack of exercise, deconditioning, and loss of function, is one of the reasons many of us tend to disagree with the fact that fibromyalgia is not progressive. It is not the fibromyalgia that is progressing, but rather our own physical health that is declining. The Alpha-Delta wave anomaly is a sleep disorder associated with fibromyalgia. This occurs when alpha-waves (waking brain waves) intrude upon delta-waves (sleeping brain waves) interrupting stage-4 sleep. Since this is the period of time when muscle tissue is repaired we must take care not to cause excess wear and tear to our muscles.
So what does this mean? While exercise might be difficult to begin with it is essential that we incorporate some kind of physical activity into our daily routines in order to prevent muscle atrophy and continuing decline. Initially, increased pain levels may cause you to become discouraged, and prone to give up, but with a little patience and persistence benefits can be realized.
In Steve’s article Pain Management - A Different Approach he shared the benefits gained through exercise as prescribed by a pain management program. My intention is to expand and explore some of the options to those more fixed modes of exercise.
Gentle Stretching
Stretching should be done before any form of exercise. Chronic pain causes our muscles to shorten and tighten therefore stretching helps to warm up and lengthen our muscles preparing them for activity and lessening the chance of injury. Dr. David L. Phillips gives some excellent pointers on stretching and flexibility. Dr. Mark Pellegrino’s brief guide to exercise and fibromyalgia offers helpful guidelines specific to FMers. As a form of exercise stretching can, and should, be done for several minutes every day.
Aerobic Exercise
Everyone’s favorite. ;-) Whether inside on a treadmill (unless you’re using it for a quilt rack as I am - lol ) - or outside on a flat surface - walking is something we all can do. Aerobic exercise gets the blood flowing, reduces fatigue, improves sleep and pain control, by regulating the body’s own pain-control system, improves stamina and conditioning, and may lessen anxiety and depression - to name just a few benefits. We must avoid high-impact activities such as running, jogging, high-energy sports, and activities involving sustained repetitive motions. This is especially true if you have an overlapping condition called Myofascial Pain Syndrome (MPS) which involves trigger points that can be aggravated by aggressive, repetitive motions. Prevention Magazine’s walking program.
Aerobics
Using a stationary bike is also an acceptable form of aerobic exercise. In addition to aerobic activity you may want to try an alternative discipline such as yoga, or tai chi (an execellent article on the benefits of this discipline).
Hydrotherapy - Warm Pool Exercises
Hydrotherapy is a form of aerobic exercise that takes place in a pool of temperate water (80 degrees is usually acceptable for most FMers) as cold water causes our muscles to tighten and spasm). This particular type of exercise allows your muscles to relax as the result of the gravity-free environment. Using a flotation device allows you to remain upright while walking or running in the pool.
Pool Exercise Combined with an Education program for Patients with Fibromyalgia Syndrome: A Prospective, Randomized Study, by Kaisa Mannerkorpi, Birgitta Nyberg, Monical Ahlmen, and Charlotte Ekdahl; The Journal of Rheumatology, October, 2000, as presented by the Colorado HealthSite, includes a description of the study program that you can print out and take to your doctor in the hope that a similar program may exist in your area.
Swimming For Strength.
Whichever form of exercise you choose - remember - the key words are low-impact, slow and easy. More is not always better, especially for FMers, and moderation and continuity should be our goal. If you experience a flare-up of symptoms try decreasing the duration and intensity of your exercise, but do try to keep moving as much as possible. Inactivity is as detrimental as over-doing it. The trick is to find a balance between the two. Strive for 30 minutes of exercise, 3 times a week, and allow a day in between for your body to recover and rest. Your level of fitness, pre-fibro, may not be an attainable or realistic goal - instead, determine to prevent further decline, and maintain a comfortable level of functioning.
I personally don’t believe the type of exercise you choose is as important as simply doing something rather than nothing at all. We’ve all heard the old adage ‘move it or lost it’, which seems to be especially true for those of us with FM. I also believe that replacing the word exercise with the words physical activity, if you hate the word exercise as much as I do, may be just the ticket for tricking our brain into perceiving it as something more enjoyable. If that doesn’t work for you then try taking a stroll in the park, walking your dog, playing with your children or grandchildren, gardening, or a dozen other ways I can think of to get yourself moving. That being said - as individuals we must choose what is right for us. Listen to your body, know your own needs, and do not be persuaded by those who would press you to exceed your physical capabilities. Focus on what you can do rather than what you cannot. And remember - always check with your physician before starting any kind of exercise program.
Tamara Peters works with Suite101.com in the following capacities:
Managing Editor: Medicine and Diseases
Contributing Editor: Fibromyalgia Friends
Associate Editor: Coping with Fibromyalgia-I&II CpE
Article originally printed at http://www.suite101.com/article.cfm/Fibro_Friends/99370