If you or someone you care about has fibromyalgia, you know it can be one of the most frustrating illnesses around. The symptoms of widespread pain and tenderness that tend to come and go and move about the body mean you never know what will hurt next. The fatigue is compounded by sleep problems, which compounds other problems. The wide range of symptoms affect every aspect of life and can leave you feeling like your body is the enemy. The advice to exercise regularly often leads to even more frustration if exercise leaves you with even more pain and fatigue. Even if you know it is important, knowing what to do, how much is enough, and staying motivated to do it regularly is no easy task. This article provides information about how to exercise when you have to manage fibromyalgia* in a way that makes exercise is friendlier to your body and staying motivated easier.
The power of mindset for exercising with fibromyalgia
To exercise regularly, the place to start is how you think about exercise. Take a moment to notice what comes to mind when you think about exercising with fibromyalgia. You may be up against a long history of struggle with symptoms that get in the way, or even exercise triggering a fibro flare-up. This history and the fear of making symptoms worse can develop into a mindset that you can’t exercise or that you don’t have enough energy for exercise. There is a way to develop and strengthen the kind of mindset about exercising with fibromyalgia that has been shown to lead to lasting motivation.
How exercise helps with fibromyalgia
Since the cause of fibromyalgia is unclear, exercise is mostly used to treat the symptoms rather than the root cause of the illness. Exercise has the most impact on preventing the secondary symptoms of fibromyalgia, the ones caused by living with pain and fatigue.
The loss of strength, stamina, and mobility that happens when movement is limited by pain and fatigue is called the spiral of inactivity. You move less because of pain and fatigue, which causes you to lose function, which causes you to move less, and so on. This downward spiral continues so it looks like the disease is progressing when in reality it is the direct result of moving less.
One of the most important qualities of exercise designed for fibromyalgia is having regular routines for exercise that include a balance of strength, stamina, and mobility that help you recover from a flare-up by reclaiming what is lost when you were resting. Equally as important is having a ‘flare-up’ routine you can switch to so you can keep moving but adjust the way you move to help with healing. This dual approach to exercise gives you the ability to use exercise to help your body get what it needs in each stage; one is about rebuilding, one is about recharging.
Stress, fibromyalgia, and exercise
As you know, stress can cause a fibro flare-up. Because the stress response prepares your body for movement, exercise is the way to reduce stress. However, when stress causes a fibro flare-up, the last thing you want to do is move.
It is essential to move well and that means knowing how to exercise the way your body is designed. Exercise based on marketing or designed for athletic performance rather than function for daily life is likely going to leave you feeling worse. When you know how to move smart with a balance of the three different types of exercise we discuss below, you can use exercise to lower, rather than increase, stress.
An updated view of pain and exercise
The ‘no pain, no gain’ mantra was invented to remind athletes that pain is a side effect of pushing your body to the limit. Pain is part of exercising to gain a competitive edge, but not part of exercising for health and well-being. Exercising for health and well-being is not about competition—it’s about functioning and feeling better. When you move smart, based on the science of how your body is designed, you are less likely to end up in pain.
If you think exercise needs to be painful to work, it’s important to change your mindset about pain. When you know the new understandings about pain, you learn how to use it as a guide, rather than something to overcome. Pain scientists know that acute pain is there as a helpful signal. Over time, however, our thoughts about pain change the intensity of that signal. Pushing through pain, thinking you need to overcome your body when you exercise, is likely to make pain signals higher. Learning to listen to your body, use movement to help it, and responding to pain with kindness is the way to lower pain signals. When you learn how to exercise with your mind and body working together, you are much more likely to lower pain as you improve function. This is not easy, especially when your body seems to be fighting against you. Pain scientists find having a growth mindset and using mindfulness are very helpful in lowering pain signals.
How mindfulness helps when exercising with fibromyalgia
Since stress is strongly connected with fibromyalgia , combining mindfulness with exercise elevates your chances of using exercise to improve function and feel better without ending up with more pain and fatigue. Mindfulness allows you to tap into the subtle cues your body sends when it needs more rest or more movement. It also helps you stay aware when competitiveness or other attitudes are making exercise more stress-producing than stress-reducing. Using mindfulness with exercise allows you to pay attention, to listen to and trust your body, which improves your ability to exercise at the just-right level to strengthen your body without straining it.
How to exercise regularly when you have fibromyalgia
Exercise is really three medications in one. Each type of exercise has unique ways of helping you feel and function your best when you have fibromyalgia. When you have fibromyalgia, finding the balance between these three types of exercise is important. It helps you avoid doing too much of one kind, which strains rather than strengthens your body. Knowing how to use each of them, and using the skill of mindfulness, will give you a greater sense of control over fibromyalgia symptoms and confidence you exercise regularly. Let’s look at how each type can be used to help with fibro symptoms.
Mobility: Stretching helps your connective tissue regain some elasticity, reducing pain and stiffness, and helps your lymph system reduce inflammation. Stretching is the foundation of exercise for fibromyalgia because it can directly help improve the symptoms both in a flare-up and between flare-ups. Stretching is also a great way to help your mind and body calm before bed, so you can sleep more soundly. Balance exercises, or what I call Trust Training, are a way to keep your brain and body working together so moving is not stress-producing because of the fear of falling.
Strength: Often strength training is thought of as a way to build muscles and feeling sore is part of the process, but this is not true. Strength exercises help your brain and muscles work together so you can move well in daily life. When not used, the nerve pathways fade, leading to feeling weaker. This leads to a loss of balance and function and muscle stiffness. Strength exercises are important for fibromyalgia because they keep these nerve pathways strong, and help you regain them when they fade during a flare-up. When strength training is designed to teach your body to be strong for the movements of daily life, you avoid the downward spiral of function that often comes with having fibromyalgia.
Stamina: Exercises that build stamina, known as cardio, are about building a greater energy reserve. When stamina is low, everyday activities take more energy. When stamina is high, everyday activities take less energy, and you have more left over to do more of what you enjoy. It is important to have types of cardio you can do that feel good on your joints, and know how to adapt the intensity for what your body needs each day. Doing shorter bouts, like five to ten minutes several times a day rather than all at once, often feels better and still improves stamina.
How much is enough exercise to manage fibromyalgia?
With any type of exercise, one sure way to put yourself in a flare-up is doing too much too soon. The fact is, the body can adapt to a 10% increase in exercise a week. When you have a medical concern like fibromyalgia, the recommendation is to increase by 5% increase per week. That means if you are doing a 10-minute walk, increase by 30 seconds! That is much less than your brain thinks you should do, but is the amount your body can do. By working with your body in this way, you help avoid flare-ups and can better use exercise to help you manage fibro well.
When you have fibromyalgia, it is extra important to be sure your brain and body are working together. When you work with your body, know how to move smart, listen to it as your best guide, and give it the right balance of rest and movement, exercise can be a great part of your fibro management toolbox. Remembering that you are exercising to take care of your body, rather than trying to overcome it, keeps you exercising in the way that helps manage fibromyalgia.
*Important Note: This article provides general information about exercising well with fibromyalgia. The specifics about how much is enough and how to modify exercise when you have fibromyalgia are very individual. Exercising WELL is the way to have a clinical exercise physiologist as part of your care team. Along with your health care providers, I can help you decide the way to use exercise to help manage symptoms of fibromyalgia. Click the button below to learn more about the Exercising WELL online program and coaching. If you have specific questions, please feel free to contact me.
- Booth FW, Roberts CK, Thyfault JP, Ruegsegger GN, Toedebusch RG. Role of Inactivity in Chronic Diseases: Evolutionary Insight and Pathophysiological Mechanisms. Physiol Rev. 2017 Oct 1;97(4):1351-1402. doi: 10.1152/physrev.00019.2016. PMID: 28814614; PMCID: PMC6347102.
- Fibromyalgia. July 26, 2020 https://www.rheumatology.org/I-Am-A/Patient-Caregiver/Diseases-Conditions/Fibromyalgia
- Adler-Neal AL, Zeidan F. Mindfulness Meditation for Fibromyalgia: Mechanistic and Clinical Considerations. Curr Rheumatol Rep. 2017;19(9):59.