Fibromyalgia Exercise: Learn how they can reduce pain

Pain. Its vice grip can wear on even the most resilient, especially those living with the chronic pain from fibromyalgia. Fibromyalgia affects the muscles and soft tissues in the body. The disorder is characterized by persistent musculoskeletal pain, fatigue, and issues with sleep and mood regulation. Fibromyalgia exercise can reduce pain and fatigue for over 3 million people diagnosed with the dreadful condition. Here’s why.

Fibromyalgia Exercise and the Brain

Patients with fibromyalgia often feel tired, sluggish, and experience pain in various trigger points throughout the body. Exerting additional energy for exercise might seem undesirable, yet physical activity is proven to be beneficial for cases of fibromyalgia.

When experiencing chronic, widespread pain, the nervous system becomes trapped in fight-or-flight mode. Studies by leading pain experts associate fibromyalgia to hyperactivity of the sympathetic branch of the autonomic nervous system (Martinez-Lavin, 2012). Pain causes distress, sending distress signals to protect the body from danger, but with the malfunction of the sympathetic system, it only converts stress to additional pain.

Exercise reconditions these responses to distress in the brain. Exercise also releases endorphins—opioid-like chemicals that combat pain by interacting with opioid receptors—and neurotransmitters, which are the brain’s chemical messengers. It is in this process that the overactive fight-or-flight response is decreased.

Benefits of Exercising When You Have Fibromyalgia

Fibromyalgia exercise improves the following:

• Sleep quality
• Range of motion
• Flexibility
• Reliving pain
• Building and strengthening muscles
• Bone health
• Cardiovascular circulation
• Weight management
• Mood
• Concentration
• Memory / “Brain Fog”

How to Begin Fibromyalgia Exercise

First a foremost, finding the motivation to exercise is a great place to begin. Securing a positive mindset is half the battle. Exercising with fibromyalgia is a learning curve, as one has to pay close attention to their body’s warnings while recovering from exercise. Deconditioning is common with illness. Nobody can go from sedentary to Olympic athlete in a day. To start fibromyalgia exercise, apply these tips:

• Start Slow: 30 minutes of low to moderate-intensity exercise 3 times per week is the overall goal for fibromyalgia exercise, but if that is too strenuous, start with 5 to 10 minutes and gradually add a minute each week. Something is better than nothing.
• Pace Yourself: Those with fibromyalgia struggle with fatigue. When exercising, do not jump into high impact activities or expend all energy at one time. Take it easy, stretch, and breathe to accomplish the entire workout.
• Recovery: A recovery day or two between workouts is imperative to allow the muscles to heal. Without recovering properly, the after effects of exercise may exacerbate pain.
• Document Progress: Journal exercises, times, and symptoms correlated with activity. Documenting these details is important to discern symptom patterns. For example, aerobic exercise for 20 minutes daily increases pain levels above a 6 yet walking for 20 minutes does not. This will show what exercise regimen is best for you.
• Choose Activities that Interest You: Exercising will feel like a chore if you choose boring activities. You are more likely to be consistent if you look forward to a particular activity and equally as likely to bail on an exercise you dread.
• Workout with a Buddy: Completing exercise with a friend is fun and holds you accountable. You are less inclined to skip sessions when you know someone else is depending on you to show up.
• Be Patient: It can take up to 6 weeks to notice an improvement in symptoms after beginning an exercise regimen.

Physical Therapy for Fibromyalgia

A physical therapist is a healthcare professional who seeks to improve the quality of life of patients with injury or illness through prescribed exercise and coaching of daily tasks. The goal of physical therapy is to promote independence in conditions where movement is limited. The particular exercise regimen differs patient to patient depending on individual needs. Teaching occurs in a controlled setting for the patient to eventual implement at home. While fibromyalgia is a chronic condition, physical therapy helps symptoms become more manageable.

Completing the exercise regimen under the guidance of a physical therapist is essential to learn which exercises will not cause further injury. Additionally, physical therapy offers special techniques to relieve muscle pain such as massage, biofeedback, and even cognitive-behavioral therapy.

Exercising in A Flare

The symptoms of fibromyalgia are chronic—meaning they occur regularly. However, periods of worsened symptoms are called flares. Any deviation in routine can result in a flare. That is why it is important to be consistent with exercise. Remain as active as possible to prevent long-term symptom exacerbation.

When flaring, go even slower than usual to prevent overexertion. Overdoing it can stress the body out causing symptom exacerbation 3 to 5 days afterward. The key to fibromyalgia exercise is to find that delicate balance between doing enough physical activity to prove beneficial, yet not exceeding your limits.

Other tips for exercising in a flare:

• Added Stretches: Incorporate additional stretches prior to exercise. Stretching prepares the body for movement by increasing range of motion.
• Don’t Test Your Limits: Stop exercise before reaching your max. While testing your limits is necessary, doing so during a flare is not advisable.
• Stay Hydrated: Exercise is more productive when the body has access to sufficient fluids and nutrition. Be sure to consume plenty of fluids to prevent dehydration.
• Longer Recovery: If already under stress, you may require a longer recovery period between workout sessions.

Exercise Fibromyalgia Exercise: Stretches

To avoid injury, warm-up before exercising. Stretching is integral to the warmup process because it loosens stiff muscles, tendons, joints, and ligaments. Recent studies relate low oxygen circulation to fibromyalgia (Lund, 2009). As stretching enhances circulation, the circulatory system more easily pumps nourishing oxygen to all areas of the body to decrease pain.

Include routine stretches into your exercise regimen that focus on large muscle groups: calves, thighs, lower back, hips, and shoulders. Remember, stretching should feel good! Hold each stretch for at least 30 seconds, but stop at the first signs of pain.

Seated Calf Stretch

Obtain a seated position on the floor with your legs in front of your body. Lean forward. Grabbing the arches of your feet, pull your toes towards you. Once you feel a stretching sensation in your calf muscles, hold for 30 seconds.

Cobra Lumbar Stretch

Lie on your stomach. Placing your palms flat on the floor, hold yourself up on your elbows. Straighten your elbows until you feel a gentle stretch in your lower back. Slowly release the stretch so that your elbows have returned to the floor. Repeat.

Knee-to-Chest

With both legs extended, lie on your back. Pull one knee into your chest while the opposite leg remains straight with your lower back pressed to the floor. Hold for 30 seconds and repeat with the other knee. This stretches the hips, knees, and lower back.  

Cross Body Shoulder Stretch

Sitting or standing in a comfortable position, keep your elbow at shoulder height. Grab one arm slightly above the elbow. Pull your arm toward your chest until it is across your body. You should feel a stretch in your shoulder. Hold for 30 seconds and repeat on the opposite side.

Seated Side Stretch

From a chair, sit with your legs square to your shoulders. Intertwine your hands with your palms facing up towards the ceiling. Lean to the right without bending your arms. The stretch should be felt on the opposite side. Repeat with your left side.   

Fibromyalgia Exercise: Aerobic Exercise

Aerobic exercise is the fancy term for low to moderate intensity cardiovascular exercise. Aerobic activities condition the metabolism of the heart and lungs. It also increases the mitochondria, which is a component of the cell that fuels the body’s muscles with energy.

As with anyone, aerobic exercise increases the efficiency in which the heart pumps blood and the lungs to take in oxygen. Fibromyalgia patients reap the advantages of these functions. Aerobic exercise “helped individuals with fibromyalgia improve functional capacity and raise quality of life” (Bidonde, 2017).

Aerobic exercises are any activities that get the heart rate up. For fibromyalgia, avoid aerobic exercises that place high impact on the body such as jumping.

• Fast walking (Outside or treadmill)
• Swimming
• Cycling
• Elliptical
• Sports (tennis, skating, etc.)
• Rowing

Fibromyalgia Exercise: Walking

Walking is a basic, low impact exercise with many benefits. Without being too strenuous, walking elevates the heart rate enough for a workout, but it does not require special equipment and is easily altered to fit various levels of fitness. If just beginning, walk for 5 to 10 minutes. As stamina improves, lengthen sessions and bring dumbbell weights along!

Fibromyalgia Exercise: Pool Exercises

Water exercise, also called hydrotherapy, is therapeutic for fibromyalgia patients. Pools for hydrotherapy are heated—reaching temperatures of nearly 90 degrees Fahrenheit. Heat reduces inflammation, which is conducive to chronic pain.

Pain and stiffness do not impede exercise like on land, as the water of the pool environment enhance flexibility and range of motion. The buoyancy of the water makes movement easier because it supports a portion of your body weight while providing resistance to your exercises. This decreases the chances of injury or ‘overdoing it.’ You can complete a variety of exercises in the pool.

Standing Knee Lift

Plant both feet on the pool floor. Stand against the pool wall for extra support. Act as if you are marching and lift one knee. When the raised knee is level with your hip, straighten and bend your knee 10 times. Do 3 sets of 10 repetitions per leg.  

Sidestepping

With your toes pointed towards the pool wall, take 10 to 20 sideway steps in one direction. Next, return to your original position. Repeat twice for the left and right legs.

Pool Plank

Locate a water noodle. Standing in the water, hold the noodle vertically. Using both hands, straighten your elbows to press the noodle into the water until completely submerged. Maintain this position for 1 to 2 minutes.

Arm Presses

Arm presses utilize the water’s natural resistance. While standing in the pool, extend both arms with palms open and fingers spread apart. Move your arms backward and forwards, and then up and down. Increase speed or add light dumbbells for a higher intensity workout.

Flutter Kick

Grasping the edge of the pool with your arms extended, kick both legs and feet. This can also be done with a kickboard to propel yourself around the pool.

Fibromyalgia Exercise: Yoga and Tai Chi

Originating in ancient India, yoga is a set of practices for the mind and body. It combines deep breathing, meditation, and physical postures to connect the mind, body, and spirit in harmony. In modern times, yoga is a popular form of exercise with less emphasis on its founding philosophy than in previous years.

Tai chi is another mind-body practice incorporating movement, meditation, and breathing. The practice originates from ancient China. Tai chi differs from yoga in that the movements are free-flowing and dance-like, whereas yoga postures are sustained.

The Pain Journal published a study of 53 women with fibromyalgia, confirming the improvements fatigue, mood, and pain after an 8-week Yoga of Awareness program. Tai chi yielded similar results. The relaxation component of either practice is vital for coping with chronic pain.

Get a mat and try a few yoga poses!

Child’s Pose (Balasana)

Sit on your hands and knees with your knees spread apart. Your buttocks will rest on your heels, and your toes should be touching. If you suffer from extreme stiffness, begin this pose with your knees together. As you exhale, bend forward, touch your chest to your thighs, and extend your hands palms-down in front of your body. When you bow forward, your forehead should touch the floor.

Forward Bend (Uttanasana)

Stand hip-width apart. Bend forward at the hips relaxing your head and neck. Your arms should remain straight with your palms to the floor (or grasping your lower calves). Hold for 30 to 60 seconds. Roll your body to a standing position.  

Corpse Pose (Shavasana)

Corpse pose or Shavasana is pose intended for complete relaxation. Lie on your back with your legs straight and your arms at your side. Close your eyes. Redirect wandering thoughts to the conscious awareness of relaxing each part of your body, particularly areas of tension and pain.

Fibromyalgia Exercise: Strength Training

Strength training entails strengthening muscles. Typically, exercises with resistance are categorized as strength training. Resistance training for fibromyalgia patients is a topic of much research. If you do not have access to weights, a resistance band, or an exercise ball, body weight serves as a comparable workout. Circuits with exercises like squats, lunges, planks, and push-ups are prime examples of strength training with or without weights. Modify according to ability.

Strength training is a little more rigorous than the exercises previously mentioned, but that does not mean it is not an asset to your fibromyalgia exercise regimen 2 to 3 times per week.

Resources

Bidonde J, Busch AJ, Schachter CL, Overend TJ, Kim SY, Góes SM., Boden C, Foulds HJA. Aerobic exercise training for adults with fibromyalgia. Cochrane Database of Systematic Reviews 2017, Issue 6. Art. No.: CD012700. DOI: 10.1002/14651858.CD012700

Martinez-Lavin M. (2012). Fibromyalgia: When Distress Becomes (Un)sympathetic Pain. Pain research and treatment, 2012, 981565. doi:10.1155/2012/981565.

Lund, N., Bengtsson, A., & Thorborg, P.  (1986). Muscle Tissue Oxygen Pressure in Primary Fibromyalgia, Scandinavian Journal of Rheumatology, 15:2, 165-173, DOI: 10.3109/03009748609102084

Cheyanne Perry

Cheyanne is currently studying psychology at North Greenville University. As an avid patient advocate living with Ehlers Danlos Syndrome, she is interested in the biological processes that connect physical illness and mental health. In her spare time, she enjoys immersing herself in a good book, creating for her Etsy shop, or writing for her own blog.