Choosing the correct exercise regimen for each fibromyalgia patient can help ensure the best possible outcome of the overall treatment plan. This article helps educate the clinician in how to identify the appropriate program for their fibromyalgia patients.
Rae Marie Gleason
Janice H. Hoffman, BA, CES
Advances in research within the last ten years have provided many new clues regarding ways to help those with Fibromyalgia (FM).
Where once patients with this condition were advised to limit their physical activity, we now understand that movement is essential for this population, to minimize loss of function and enhance quality of life. Consequently, physicians who once told their patients to rest now advise them to get some exercise.
This article provides guidelines, based on clinical research, which physicians can use when advising patients to increase physical activity. It will also provide sample exercise programs that will minimize post-exertion pain while still providing an increase in overall fitness and well-being.
The benefits of consistent exercise for anyone include maintaining muscle and bone mass, maintaining normal range-of-motion, and gaining overall endurance. The ultimate goal for FM patients is to create a conditioned body capable of moving through the activities of daily living without increased pain levels.
However, too often patients experience painful flares after attempting a standard fitness regime, and so they become reluctant to follow the advice of their primary care providers. This is understandable. Typical fitness workouts that might cause only a small amount of post-workout soreness in a healthy beginner can produce delayed onset muscle soreness (DOMS) in FM patients. It is thought this quick advance into muscle microtrauma derives from the loss of quality sleep and/or low levels of IGF-1, a growth hormone, often present in those with FM.1
Motivating Change in Activity Level
Two basic personality types stand out when discussing exercise willingness in FM patients. We could label them All-outs and Avoiders.
All-outs are patients who enjoyed an athletic lifestyle before their FM symptoms took hold. They try to make up for lost time whenever their pain symptoms start to improve. This leads to an ongoing cycle of exertion, flare, recovery, exertion, and flare that will frustrate their best efforts. These patients must learn to do less than they believe they can during any given exercise session. Success will occur when the focus is on long-term instead of short-term gains.
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