We with FM are told, repeatedly and without fail, that we need to exercise. Nor would any reasonable person disagree that moderate fitness requires a certain amount of exercise, for over all health. However … what is most often not said is the proper way to go about that. As the wrong kind of exercise is not only not helpful, it can be downright damaging.
The work hardening and strength training programs that are commonly recommended, can literally cripple a person with FM. Allow me to explain why …
Most of us have, CMP (on site link), which creates Trigger points or Trps, on the muscles themselves. Not only are they in pain, they are also compromised and weak. You literally cannot strengthen a muscle with Trps. Any attempt to do so, in the incorrect fashion, can permanently damage the muscles themselves, unless the CMP itself is treated correctly. If this is not done what you have is..
“… muscle is already contracted and tight. Strengthening exercises and repetition exercises will worsen the TrP, and may cause the development of satellite and secondary TrPs. Some of the latter patients did not have full-blown CMP when they started the inappropriate therapies, but were disabled by the time they finished or dropped out of the training. “The Facts, on site. So treatment, if you can find a doctor who knows how, of any TrP’s is a must.
Even if lacking in treatment, just being aware that they are there and acting accordingly with regard to exercise types, can be helpful.
So, we have on one hand, doctors recommending exercise, yet on the other hand, a largely unrecognized issue of exactly how this should be accomplished
OK, why do doctors recommend it ?
Fairly simple, in persons with a normal functional system, exercise … even of the cardiovascular type, is directly beneficial.
What occurs in a normal person due to exercise of the cardiovascular type:
Increase in temperature
Increase in cortisol production
Increase in growth hormone production
Increase in catecholamines (norepinephrine and epinephrine)
Increase in cerebral blood flow
Lessened perception of pain
What happens in a person with FM doing the same cardiovascular type:
Decrease in temperature
Decrease in cortisol production
Decrease in growth hormone production
Decrease in catecholamines (norepinephrine and epinephrine)
Decrease in cerebral blood flow
Decline of mood
Heightened perception of pain
Disruption of sleep
In short, you get the exact opposite of what one would expect to find and furthermore, even those who are able to improve basic over all aerobic fitness,doing the typically recommenced exercises, find no improvement in their FM.
“No association was noted between improvement in aerobic fitness, as measured by VT, and the improvement of pain, function, or scores … aerobic exercise is beneficial to patients with FM overall, but the possible cardiorespiratory fitness gain is not related to any notable improvement of FM symptoms.”
It is common to suggest stretching and flexibility exercises, but here again some factors need to be take into account. Over 81% of persons with FM, have what is called, Joint Hypermobility ( Joint and tendon issues, on site ) For example, during stretching exercise, it is common for those of us with FM to over extend and therefore injure the joint. This is possibly due to hyper flexibility. The overlap of these two conditions is so high, they are treated almost identically.
So, what should we be doing ?
Any movement, is exercise. Understand, that if you have been sedentary, even just walking across the room, is exercise. Rotating your arms, shoulders, feet etc., while seated, is exercise. In short, any move you do on purpose, can be exercise.
It is not about special clothes, or weight sets, or going to the gym. It’s about moving the body in a controlled fashion. The more you can soothe the tension in the muscles and joints, by and large, the less they will hurt. Simply because they are not tensed up and clenched. Soothing them out also allows them to have greater blood flow and fluids, so they can heal themselves better of the damage that is done to them, by being constantly clenched in pain.
And no I don’t just mean in a hot tub or heated pool ( but if there is one handy, all the better ) I mean in the bathtub in your house, slow moves in the shower. Working out just hands or feet, in a bucket of warm water, if that is as close as you can get.
( The recommended temperature is at least 91 degrees or higher. It is not recommended you try such a work out in cold water, as the cold makes the muscles and joints, tense up, which is counter productive to what you intend. Swimming is good exercise, but it is not the kind of pain reducing exercise we need, unless it’s in a heated pool )
Ok, now, why in water ? Simple, the water is warm, which loosens the tension in the muscles and joints for one and for two, buoyancy. The normal human body floats in water, so a lot of the weight is supported all the way around. And more, even simple, easy movements, with water as resistance, is more exercise than in the air.
Just to get in the pool and walk, just walk, will work out muscles all over your body. When I had access to a hot tub by the pool at my apartment complex, I was in much much better shape, as I was in it almost daily.
But even small movements, while in an ordinary tub is of good benefit, with a lot less of the strain and pain we often experience. The water helps prevent the hyper extension, due to the waters resistance, so it’s very difficult, unless you are really pushing it hard to over extend the joints and do them injury.
Keep your water work outs short. You are using a lot more energy than you realize in the water and can wear yourself out in short order. So pay attention to your fatigue levels.
This form of exercise is the ultimate in low impact, for the simple reason it is all about sifting your own body weight and slow full range of movement. Done properly, Tai chi causes no impact strain. As well as, it can be done in a minimum of space and can be done, by just about anybody. There are lots and lots of videos and books out there on it and I highly recommend you find a few and read them.
This form can keep you flexible and reduce muscle and joint tension. The low, slow compression, is also a perfect means to feed the joints and cartilage between the bones and joints.
Cartilage feeds by compression. If the joint is not moved, there is no compression, so it does not get fresh fluid flow and like any joint, no lubricate means, it’s stiff. Neglect this for long enough and the cartilage can literally dry out and die. The slow moves of Tai chi, do the compression gently, with lots of time for the fluid to flow in and out of the joint.
If you are not up to doing it standing up, then do so sitting down, moving just your arms, shoulders, rib cage, neck etc. and work your way up to where you can get the rest of the body, into the game. If you can only do so, for a few moments, fine. Do that few minutes, for as long as needed, until you can work your way up to longer time frames Your body did not get into the shape it’s in, in a day and it will take time to work its way back out of its current state. Make haste, slowly, or you will undo all the good you might obtain.
Problems with most exercise routines:
The problem, with most “exercise” routines is: One, they are often the wrong kind, which cause more pain, for no gain. Two: They tend to be too much, and too often. We are not your average person, our bodies are not average, so there is no reason to expect YOUR exercise routine to be the same as your average non FMer.
Realize, this is the goal most often set by doctors and even most therapists. They are used to working with people who have otherwise healthy muscles, who have had an injury they are trying to recover from. Most simply cannot accept, that by and large WE do not respond the same way to most exercise, as other people.
Most of them are not geared to dealing with anyone who has the kind of limitations we have, so honestly, your best bet, is to go it alone, at your own pace and your own time frame. Rest when you need to. Remember the idea of push crash ( on site ) the object is to improve your flexibility and reduce pain, not increase it by working yourself into a flare. Give yourself extra rest time after your work outs, you have expended energy and you need to recoup that.
Will this cure FM ?
Lots of argument on that but over all, the answer is … NO. Will it help ? Yes, for the simple reason of “use it or lose it”, if you do not use a muscle or joint, it atrophies and if that goes on long enough, you can damage it to the point where it cannot recover.
Is it a challenge ? You bet .. Will it hurt ? Very likely it will increase pain … for a while. But done right, slowly, without strain and stress, you can improve the over all functionality of the body and reduce an already high body stress level.
Do not expect your FM will go away for doing this. Anyone who tells you that is .. lets be nice .. mis-informed ! I will forgo what I would rather say 🙂 But, can you reduce some of the body stress and therefore the pain with the right kind of exercise ? Yes, it’s been proven you can, but ONLY if it’s the right kind and done the right way. Anything else … and you can do damage you might not be able to undo… so go slowly, listen to your body … pay attention to the signals it’s giving you. YOU and only you can listen to the things your body is saying and know what works for you.