Fibromyalgia: Improving through Fitness
Deborah A. Barrett
http://www.paintracking.com/fms01.html
A doctor who has fibromyalgia once told me: "You can have weak muscles
that hurt, or strong muscles that hurt." This statement made a big
impression on me. Although exercise will not cure the pain and
exhaustion of fibromyalgia, muscle endurance increases our
capabilities. The message in the medical literature is clear: people
with fibromyalgia who are physically fit suffer less symptoms. The key
question is how we get there. How can we get in shape when it hurts
just to get out of bed? The answer, like most aspects of dealing with
this condition, is not simple. It requires discipline, faith, and lots
of patience. But sticking to a personalized exercise program can really
pay off.
When I first read about the helpfulness of exercise, I literally tried
to exercise the fibromyalgia right out of me. While bouncing on the
StairMaster, I felt no pain. Endorphins made me feel terrific and
invincible. Hours afterward, however, the pain was excruciating. My
life became divided between intense workouts and sheer agony. No
surprise -- I soon stopped exercising altogether.
I now understand the im****tance of working with the body I have, not
one I wish I had or have had in the past. The adage, "listen to your
body," cannot be overstated with fibromyalgia. We need to proceed like
a tortoise: slow and steady. And, like the tortoise, we too will reach
the fini****ng line. Slowly and steadily, I built up to a one-hour
cardiovascular workout, and a strengthening routine on Nautilus
machines. I am stronger, both physically and psychologically, and have
much greater stamina in daily activities. Over the years, my routine
has been interrupted by the flu, a car accident, or other unplanned
event. Each time, I found the level where I could exercise comfortably
when I was again ready and built back up slowly. At times I have had to
adjust the type of exercise as well. When a lower-back injury kept me
from walking for months, I adopted a water program. However carefully
we live our lives, such setbacks occur. The resiliency of our bodies,
however slow, inspires confidence.
Your exercise routine should be devised under the supervision of a
doctor and a physical therapist who are knowledgeable about
fibromyalgia. Because you are the one familiar with your daily
symptoms, you need to take the most active role in adjusting your
program. Here's what I found (the hard way) to be the central points of
a successful exercise regime.
A Daily Re****t Sheet
As I emphasize over and over, a worksheet is critical to figure out how
to proceed. Create a personalized worksheet to monitor your exercise
and your reactions to it. It is helpful to include other factors that
may affect how you feel, such as the amount and quality of your sleep;
any changes in medication; weather conditions; activities; and stress
levels. Careful daily records make it possible to gauge progress. When
pain is bad, it is very hard not to become discouraged. But recorded
evidence of long-term improvement is quite inspiring. Review your
re****t sheets frequently to understand your body's response to your
program. The golden rule is to moderate your activity so you can
exercise again two days later. If you hurt too much, cut back! Those
who have not been active for some time should start very slowly. Try
something minimal, like walking on a treadmill for less than one
minute. In 1995, I started with just 30 seconds because walking
irritated my hips and shoulders. As my tolerance grew, I was able to
increase, first by 30-second intervals, then by several minutes. By
1997, I was walking easily more than four miles up a ten-degree
incline! It also helps if you have a friend with whom you can share
your improvements, someone to call and say, "Guess what? I walked one
and a half miles today and feel OK!" If you have a buddy who can join
you for workouts, even better!
Pain-Relieving Modalities
Exercise can cause muscle soreness; and for us this is an
understatement! Therefore, you need to have a full array of methods to
make yourself feel better and keep going. I always end my workout by
relaxing in a sauna. Massage helps some people tremendously. Strong
muscle relaxants and analgesics, a TENS units, and heat packs can also
make a big difference. A leisurely hot bath with candles, earplugs, and
baby oil may bring any sort of day to a pleasant close. Always keep in
mind that although our muscles may hurt like hell, using them will not
injure them. Post-exercise soreness will decrease over time, especially
if you respond to your body's signals and pace yourself. No doubt it
will be hardest in the beginning, so stockpile your most effective
modalities to keep your levels of pain and fatigue tolerable.
Physical Fitness Program
Whether you decide to join a gym, participate in a class, or develop a
home routine, there are three components of a thorough exercise
program: cardiovascular fitness, strengthening, and stretching.
Cardiovascular exercise. Choose an aerobic exercise you enjoy, perhaps
something you are already doing. Some like using an Aqua Jogger in a
warm pool, yoga, or dancing to music at home. I like the treadmill
because it is easy to track the intensity of my workout and because I
wanted to increase my ability to walk distances. What's im****tant is
that you choose something easy to do on a regular basis. Make it
something you look forward to, not dread. Listen to books on tape or
your favorite music, or use the time for reflection. For exercise to be
aerobic, you needn't be out of breath. According to the American
College of S****ts Medicine, the training effect of aerobic exercise
takes place between 60% and 90% of your maximum heart rate (calculated
as 220 minus your age). So if you are 30 years old, for example,
aerobic exercise begins when your pulse reaches 114 beats per minute.
(At 40, it begins at 108; at 50, 102; and so on).
Strength-building exercise. Guidance from a physical therapist who
understands your needs is particularly helpful in devising a
strengthening routine. Strengthening exercises can include pushups,
lifting cans of corn, or stretching those colorful, rubbery
physical-therapy bands. If you decide to join a gym, make sure whoever
assists you knows about your condition and the im****tance of light
weights and gradual increases. If you begin with something extremely
minimal you can do it daily. As you increase, give your body a day or
two of rest in between. Try to ignore the bodybuilders around you. The
only comparison that matters is how you are doing over time. My first
day, I tried several Nautilus machines with no extra weight (I removed
the pin) and lifted the weight one time. As I discovered the effect of
each machine on my various muscle groups, I increased accordingly. I
now do several repetitions on ten machines, lifting as much as forty
pounds on some. With others I have kept the lowest setting and
increased the number of repetitions. Keep track of and celebrate your
progress!
There are also endless exercises you can at home do to build up
im****tant muscles. For example, the staircase offers a great way to
build up to doing pushups. "Push ups!" you protest. Yes, push ups. But
not lying prone and grunting out many sets. Begin with just one. Stand
at the base of your stairs and arrange yourself to do one push up on
the step around chest level. Remember, just one. If your arms,
shoulders, and back do not feel any worse for wear the following day,
try another. If you do not have a staircase at home, you can use other
sturdy objects such as a table or bed at comfortable gradients. Over
time slowly increase the number of pushups. When you feel you have
mastered that level, add one push up with your arms one step lower.
Build up again. Eventually you may be doing floor pushups and feeling
very proud of yourself.
Stretching. Exercise causes muscles to contract. Through stretching,
you want your muscles to achieve a nice, elongated state. Never stretch
cold muscles. Good places to stretch are first thing in the morning
while under a warm comforter. Or better yet, in a hot shower, a sauna
or hot tub, or after a hot bath. Exercise also warms up your muscles.
To get the most out of a stretch, you must relax. Breathe slowly and
deeply through your diaphragm. (Fill your belly, not your chest.) Do
not push yourself, as you can 'pull' or injure a muscle. As you exhale
let your muscle gently stretch to a comfortable point. Breathe slowly
and relax into the stretch. Hold the muscle in place as long as it
feels good, up to a minute. As you exhale, try to stretch a little
harder. Relax and hold it there. Never stretch or hold a muscle past a
level of comfort. Stretching after exercise decreases the likelihood of
soreness.
A Final Note
Each of us is different. Our abilities depend on our age, our past
level of fitness, and the severity of our symptoms. But whatever your
condition, a moderated exercise program can make you feel better. In
the worst case, you will be stronger, in better shape, and look better
.... and still hurt. Most likely, however, physical fitness will
decrease your pain and increase your abilities. It has for me.
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