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Exercise is a crucial
component for managing fibromyalgia. There are many benefits to
exercise. With exercise you can improve flexibility, endurance, strength,
and the ratio of fat to muscle in your body. In order to maximize your
chances at success for becoming physically better able to meet the demands
of daily living you need to be as fit as possible. Becoming fit does not
necessarily mean getting to the gym but rather may require incorporating
increased activity into everyday life. If prior attempts have been
disappointing, this is probably, in large part, due to the
unpredictability of the symptoms of FM and the increased pain that can
occur from overuse of your muscles.
As
we begin to better understand the reasons that FM patients experience pain
in situations that would not necessarily be interpreted as painful by
others, we can use this information for fibromyalgia treatment. The goal
is "gain without increased pain."
Many
of you have noticed that your muscles have become weaker since you have
had FM. The major reason for this is under-use often due to pain. When
usually non-painful signals from the muscles to the brain are interpreted
as coming from the pain pathways, the brain sends an inhibitory signal
back to the muscles which will result in under-use of the muscles. In
other words, the signals are misinterpreted and then action to protect you
from danger is put into place. Because this pain is not doing harm to the
muscles themselves well meaning but under-informed, health care providers
may have advised you to push through this pain and just keep exercising.
The unfortunate result of this advice is that you have experienced a flare
in your FM. Now not only do you have the signals from the brain being
interpreted as pain, but you have added the element of fear of another
flare. No wonder many are reluctant to proceed with increasing activity.
How
To Get Started And Know You Are Doing It Right.
If you have someone
available who understands fibromyalgia and can assist you designing an
exercise program, use them. A knowledgeable person can help you learn to
use different muscle groups that will lighten the burden on the more
painful muscles
Minimize The Amount Of
Eccentric Work.
How you use your muscles is important. You need to minimize the amount of
work you do with your muscles contracted and lengthening at the same time:
"eccentric work". Examples in everyday activities are: drying hair with
arms overhead, pushing a vacuum cleaner, putting clothes into a
clothes-dryer.
One way to picture how
to decrease eccentric work is by thinking of the hoop skirts that were
worn years ago. The waist was the smallest part of the hoop and thenthe hoop became larger until the bottom.
Now picture that you
have the waist of the hoop at chin level. Any activity with your
arms needs to be done inside the hoop. When you are doing an
activity, keep reminding yourself to stay inside the hoop. To minimize
the eccentric work of your lower body you will need to take smaller steps
when walking downhill and downstairs.
It is also important that you not continue to hold a muscle in a
contraction. There are two pointers for this:
¨
1: Take
a break from any activity every twenty minutes. This may be as much as
doing a different activity or as little as a 2 minute stretch break.
¨
2:
Pause between repetitions of the same activity. For example, if you are
putting several things into a cupboard instead of a steady
1--2--3--activity do a 1 slight pause, 2 slight pause, 3 slight pause
etc. Both of these will give the working muscles a break.
How you hold your body
while doing activities will be a factor in determining how quickly the
muscles fatigue and how much pain is experienced with activity.
Using the middle of
our trunk for support will decrease neck and back pain as the upper and
lower back do not have to work so hard to compensate for posture
*
Stand
with your feet about shoulder width apart, both heels flat on the floor.
*
Gently
rock forward, as you come forward you will get a sensation of becoming
"heavier" and a bit off balance
*
Rock
back, feel the point where you seem lighter and in balance. As you
continue backward, you will notice that you become heavier and
unbalanced. Now rock forward to the point where you feel balanced. This
is your center.
Try keeping your
posture such that you stay in the centered position. Be certain that you
are centered. Now get those shoulders down
¨
Drop
shoulders down
and pretend you have a weight on the backside of your a rmpit.
¨
Gently squeeze
your shoulders blades together; this will keep the shoulders down and
back.
¨
Once you
have the shoulders down and back, release the tension of squeezing
them together while maintaining the posture.
¨
Keep
your head over your trunk.
Goals with exercise
Set your own personal goals and share them with someone else. Decide if
you want to do exercise alone or with someone else.
Your goal with exercise will be to make progress, not perfection. You
will have slips and slides and it is important that they not lead to a
crash.
Record keeping will help to be certain how you are progressing in your
program.
Becoming more flexible through a regular stretching program may well
result in a decrease in your pain. Improving muscle strength and
increasing activity probably will not result in decreasing your pain, the
aim is to improve your level of fitness without increasing
your pain.
Always start your journey to fitness with a regular stretching program.
The goal is to release some the muscle tightness which in turn will
decrease the signals going to the brain. The next phase is to get the
muscles stronger. After you are more flexible and stronger, you will be
ready to begin aerobic or endurance activities.
Toning exercises using the proper technique, pausing between each
repetition and doing fewer repetitions than you are able. Pausing between
each repetition will allow the muscle to relax, a response that appears to
be delayed in persons with FM. If the muscles are not relaxed before
starting the next repetition, you are increasing the probability of
experiencing increased post exercise soreness.
Improving fitness not only includes increased flexibility, improving
muscle tone but also means improving "aerobic" i.e. endurance capacity.
In order to be able to increase your "aerobic" daily activities muscle
that need to be strong are the quadriceps (thigh) muscles and the gluteus
maximus.
A
good exercise for this muscle is to stand facing a table or chair. Place
your hands gently on the table, as you are using them only for balance and
not doing a "death grip". Keeping the leg straight, contract the gluteal
muscle and raise your foot about one inch off the floor, lower the foot
back to floor, count to four as you rest and then repeat with the other
leg. Do 2-3 per leg and build up over the next 2 weeks to doing 8 each
leg. Do this twice a week. This will allow you to start to increase
other activities such as walking.
Another area that is very important in order to hold the body in proper
position is the abdominal region. The muscles in this area easily become
lax. When they do the upper and lower back is put under increased strain
leading to more neck, shoulder and low back pain. Potbellies become more
prominent.
Sitting,
without moving from “sit bones”, scoop the abdominal so makes a C curve.
Standing,
back against wall, gluteal inserts against wall; without moving from the
wall, press your navel to your spine.
Lying,
keep “sit bones” on mat and move the lower abdomen by scooping, pressing
navel to spine.
We are all familiar with the sit-ups for doing abdominal strength
training, unfortunately these result in increased neck strain;
a "forbidden" activity for FM patients. The now popular machines for
abdominal work can help alleviate this if used properly. If not used
properly, you get an arm workout but nothing or little for the
abdominals. You can safely work
your abdominals
without straining the neck with the exercises listed below. Always curve
the abdominal muscles so that the belly button goes toward the spine and
not the other
way around; this will take pressure off the lower back. Remember to
breathe; inhale before you start the exercise, then blow the air
out as you contract the abdominal muscles. By doing this, you will also
know how long to do the exercise. At the end of the blowing out, relax
the muscle. Count to 10 before repeating. Repeat each one 2-3 times and
build up to 5-6 times.
Note:
When you are lying on your back, both of your shoulders should be in
contact with the floor. If they are not, then you are too tight in the
pectoralis muscles and need to do the stretching for that area.
Back strengthening
The muscles on the back need their work too in order to provide you with
good support.
Lie on your back, knees bent and put the soles of your feet on the floor.
Put the back of your arms on floor palms up and then bend at the elbows so
only the area from your elbow to your shoulder is in contact with the
floor. Now push down on your triceps ( muscles in back of arm) and lift
your breasts. The movement is coming from the back muscles alongside the
spine. Do not hold but release immediately, count to 10 and repeat 2-3
times. Remember to breathe; inhale before you start the
exercise, then blow the air out as you contract the muscles.
Lie on your back, legs extended in front, arms stretched overhead with
palms up and resting on the floor. Press your spine into the floor so
that you can feel each vertebrae in touch with the floor. If this is too
difficult with your legs straight, then bend your knees slightly.
Caution: do not arch your back. Remember to breathe;
inhale before you start the exercise, then blow the air out as you
contract the muscles.
Now
is the time to get started.
See
our Exercise DVDs
Remember to be kind to yourself
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