Q: I love to be physically active and used to enjoy skiing, tennis and other sports. However, my fibromyalgia is frustrating all of this. What do I do?
A: Fibromyalgia syndrome causes fatigue, widespread pain in the skeletal muscles and connective tissue, numbness, impaired balance, depression, anxiety and sleep disorders. Combine this with chronic fatigue, muscle knots, arthritis and stenosis (a constriction in the spinal column), and it is not hard to understand why fibromyalgia seems to be the bane of physical activity. Those who suffer say that it is like having the flu all the time.
The widespread aches and pains do not inspire the desire to exercise. But Brad A. Roy, director of the Kalispell Regional Medical Center in Kalispell, Mont., says that those with FS cannot afford not to exercise.
“Appropriately applied exercise interrupts the downhill spiral of muscular and cardiovascular deconditioning and resulting loss of function that many individuals with FS experience,” Roy says. “Deconditioning makes the musculature more susceptible to micro-trauma from any given physical activity, which increases symptoms.”
Roy further explains that the postural imbalances, tight muscles and poor range of motion can lead to a loss of function. This can easily spiral into depression, which, when combined with inactivity, can lead to heart disease, among other maladies.
Most experts on the subject state emphatically that, when it comes to exercise, everything attempted must be done in very tiny doses and progressed slowly. The goal is twofold: Break the pain cycle, and enhance range of motion, strength and cardiovascular endurance but without pushing yourself to the absolute limit of exhaustion.
Research shows that staying in the low to moderate exertion ranges of both cardiovascular and strength exercise can be beneficial. While this may be frustrating, over the long term doing a little something every day boosts the mood and self-esteem levels and will help maintain, and eventually improve, muscle strength and general fitness.
Staying warm is of the utmost importance because getting cold makes the muscles tense, which can bring on a flare-up of symptoms. For this reason, one of the best ways to exercise is by swimming in a warm-water pool (defined as having water temperatures at 89.6 degrees). Warm-water exercise has been found to reduce pain, anxiety and depression. Exercise in water is non-impact — the buoyancy factor can be a gentle way to effortlessly enjoy physical movement again. Also, because the water provides resistance, it is possible to gradually improve muscular strength.
Water aerobics classes — especially if you are not a lap swimmer — can be soothing, as well as physically productive. To find a warm-water pool in your area log on to the Internet and go to . Other sources are Easter Seal and the Arthritis Foundation.
Other activities that enhance posture, involve a lot of stretching and other range of motion activities are yoga, tai chi and Pilates. Any of these can be helpful as long as they are done cautiously. Bicycling, either with a standard or a recumbent bike, and walking are also recommended.
Before exercising, take 15 minutes to warm up and stretch before attempting anything too vigorous, and stretch again afterward. Gwen Hyatt, author of many articles on the subject, suggests doing several shorter bouts of exercise throughout the day instead of one long session. She also suggests “shorter, less intense” sessions when you are having a “bad” day and cautions against overextending yourself on “good” days.
Great resources, in addition to your physician, include the Arthritis Foundation (800-475-6447; .) and the National Fibromyalgia Foundation (www.fmaware.org).
Linda J. Buch is a certified fitness trainer in Denver; linda@ljbalance.com.
