Since I am currently altering my own exercise routine, I thought it might be a good time to talk a bit about exercising with fibromyalgia. I’m dedicating a post to exercise because it is very important that people with fibromyalgia move every day in some shape or fashion. If we don’t move, even for a day or two, our muscles will start to feel thick and gummy. Go three or more days without movement and our muscles will feel rigid to the point where we lose range of motion and strength, which leads to an increase in pain. Yes, it is a true ‘use it or lose it’ scenario.
Endurance and Current Fitness Levels
Before I talk about my own routine, I want to say that the level of exercise that I strive for is my choice. Before the fibromyalgia, I was an athlete. I did martial arts, I was a runner and a dedicated yogi. Therefore I believe that because I had a high level of fitness back then, I can maintain a higher level of exercise than others with fibromyalgia. It isn’t that someone who has fibro cannot get to the same level of fitness I have, I’m simply saying the ‘route’ to get here and their overall exercise regimen would be significantly different than mine.
Regardless of the level of fitness I have, I still have to be choosy about what types of exercise I’m doing, thanks to fibromyalgia’s limit on my endurance levels. Running is currently my choice for what I burn the most energy on. I love being able to run a 5K, and I’m not ready to give that up. So I’ve accepted the fact that I have chosen running as my main exercise, for now. I can’t do that and do other extended work in another sport. That means advanced yoga asanas like handstands, extended strength training sessions, or any type of martial arts practice are all out unless I stop running. I am trying to build additional endurance so I can do more, but so far, I’m not having much luck.
I am bringing the endurance issue up to remind non-sufferers that people who have fibromyalgia have a very specific level of energy and endurance they can use each day. It doesn’t matter what fitness level you are at; you still have to choose what you spend that energy on. I choose to use my energy by doing more exercise (as I have no kids and a desk job), another fibro sufferer may have to use their energy in a work position where they must be more active, drive a longer commute distance, or tend to young children. I am absolutely certain that every fibro sufferer wants to do more than they currently are, we just can’t because we are limited by the disease.
My Current Exercise Routine
My current schedule is a 5K run on the weekends, usually on Sundays as I don’t have much else going on during those days and can sit for most of the day afterward. I also try to walk at least 30 minutes 4 times a week. This isn’t a fast walk, just something that can keep my heart rate up for a general period of time. I do 30 minutes on an elliptical machine once a week, and a 15 minute routine with a strength training system called TRX once a week on a day I’m walking. All of that together means I’m exercising 6 days a week. If I don’t make 6 days of exercise, I don’t beat myself up. It is all dependent on how my body is feeling, and I’d rather err on the side of caution than cause a flareup of pain. It took me 3 months of work to get this current level of exercise into my regimen and not cause a flare. And it still isn’t without a tradeoff. About 6 or 7 in the evening on most days, I’m done. Other than crocheting, watching TV or reading, I can’t do any other activity. So the husband gets to cook, drive us someplace if we have something scheduled, or do any necessary cleaning. He’s OK with that (so far).
Currently, my own personal goals are to try to extend the 5K into a 4 mile run and include an extra 20 minute martial art practice into my regimen. That isn’t going too well. On weeks where I’m feeling awesome, I can get the martial art practice in, but not the extra running. But I’m still going to continue to try for another month or two. Regardless of what high impact work I’m doing, for those few moments, I feel like an athlete again, and that means a great deal to me.
My Exercise Recommendations for Fibro Sufferers – Bare Minimum
For the average person with fibromyalgia/CFS who doesn’t have any other underlying conditions, I highly recommend at the bare minimum some sort of stretching routine to keep the range of motion that you currently have. If you haven’t been doing anything, it’s going to be hard to get started, and I’m not going to lie, it will hurt worse for the first week or two, but the extra pain that you will receive from the exercise will be the type of pain can be dulled by icing, over the counter pain relievers or with muscle ointments. And even with the extra pain, to me it’s worth it. I’ve found that even 4 minutes of gentle stretching a day will allow you to start feeling more comfortable overall, and possibly reduce the amount of daily pain.
I do have some suggestions for starting out. I personally like Joe Yoon’s Better Stretching as a starter book as the exercises are very easy, yet effective. He also has a great Instagram presence and demonstrates many of the moves in the book there (or you can buy his application Better Stretching if you want a more structured regimen). Other options include Miranda Esmonde-White’s Essentrics program, which was created out of the “Classical Stretch” TV Program on PBS (which I believe is still available at some libraries). She also has written a book called Forever Painless, which is a good introduction to both Essentrics and the TV program, however, if you choose the online Essentrics program or TV show to try first, realize it moves faster than Joe’s videos do.
Of course, this being the beginning of the new year, many people are seeing advertisements for dynamic stretching programs like Pvolve, Kalisa Fit, GMB Fitness, ALO/Barre Strong and Functional Patterns. Pvolve, GMB, ALO and Functional Patterns require extra equipment, so those are a ‘no’ for me, as I’m not going to make an investment in equipment if I don’t know up front whether a program can be adapted for a fibromyalgia sufferer. Kalisa Fit is nice, but even I had a struggle just getting through her 10 minute warmup. I also didn’t see any way to modify some of the moves, so although the stretching exercises were very good, I could see someone getting discouraged very quickly (especially with some of the leg and hip stretches that could hyper extend the knees or cause significant weight on the joint).
Yoga is also another option, but it is very hard to find any yoga apps that show modifications of poses, which is a huge need in the fibromyalgia community. We just can’t make our poses look like the ones portrayed by teachers and social media personalities and we shouldn’t try. But there are some options out there that I think are good. If you are brand new, I suggest starting with the book Yoga for Pain Relief by Kelly McGonigal. Yes, the poses look very simple, but they are all very effective when done regularly. Or, find a yoga teacher who works with chronic pain sufferers and who will help modify the poses for you. I will say it again as it was a sticking point for me at first – yes, the poses with modifications may look over-simplified compared to what you would see a more experienced practitioner do. (In fact, my own mother refuses to do yoga because she doesn’t think simplified poses like cat/cow do anything.) But they are still very effective at providing the same type of benefit as the ‘professional’ looking pose, and this is a fact I really wish the yogic community would express more often.
My Exercise Recommendations – Moving Forward
A stretching routine will ensure you keep your range of motion and lower your pain regimen. However, I did notice an increase in my endurance and energy by adding a gentle, low impact exercise like walking to my exercise regime. This is why I also recommend starting some sort of small exercise habit if at all possible.
If you want to start a walking regimen, besides getting a good shoe, I would recommend starting slowly; maybe 15-20 minutes three times a day. You don’t have to power walk to get started. Even walking your dog (which is what I do three out of 4 times I’m walking a week) is beneficial. And the dog will love it.
If you are ready to add more time, the general rule of thumb I’ve heard is to add 10% more time or mileage to your walking regime each week. I personally feel for those of us with fibromyalgia, that’s too much. Instead, I recommend adding 5% more time or mileage every 2 to 3 weeks. Anything more than that will cause additional stress and pain which will force you to do too much in one day, and that leaves an opening for a huge flareup of pain. I learned this ratio by my own trial and error; I trained for a half marathon using the 10% method and ended up losing the entire last week of training as well as ended up being sick from a flare of pain for an additional week. So I changed to the 5% addition and have found that it works well for both my running and walking routines.
I recognize that this can be looked at as circular reasoning; here I am suggesting something that will cause extra pain for a fibromyalgia sufferer in order to reduce the pain. This is what doctors don’t realize when they recommend fibromyalgia sufferers exercise. There WILL be pain. It WILL hurt. And if I may be blunt, it fucking sucks that it hurts so much. I simply want to be able to move and do the things I love without the pain. But for fibro sufferers it’s a trade off. If you want to do more, you have to find that balance of how much pain you are willing to put up with in order to get to the chosen level of activity. If there is one thing about this disease that hurts the worst (and the one I’ve cried about the most), it’s this fact.
Regardless of my own personal goals and venting, my hope is that readers of this post realize that it only takes a little bit of exercise will go a long way to helping sufferers deal with the disease. And since there is no cost effective drug, medical device or therapy that can take out this disease, finding any little bit of comfort to me is worth trying.