ACSM'S Health & Fitness Journal:
Departments: Fitness Focus Copy-and-Share
Thompson, Dixie L. Ph.D., FACSM
Dixie L. Thompson, Ph.D., FACSM, is the director of the Center for Physical Activity and Health and a professor in the Department of Exercise, Sport, and Leisure Studies at the University of Tennessee, Knoxville.
Fibromyalgia (FM) is a condition characterized by muscle and joint pain, stiffness, and fatigue. The cause of FM is unknown, but it affects millions of Americans, with most cases diagnosed affecting women. One frustration for people with FM is the difficulty in diagnosing the condition. There is no single physiological test used for FM diagnosis; however, physicians now have specific criteria that can be used to identify the condition. There is no known cure for FM, so disease management is the standard approach to treatment. Those with FM often avoid exercise because of their perception that exercise could exacerbate symptoms; thus, many FM patients are quite deconditioned. In reality, many people find some relief of FM symptoms from regular moderate exercise.
Aerobic exercise can take many forms, so FM patients can search for the activity that best suits their lifestyle and is least likely to result in a flare-up of symptoms. Walking is the most commonly chosen aerobic activity because of its low impact nature and the ease with which people can fit it into daily life. Water-based activities also are popular for FM patients. The ease of movement in water and the warmth of the water make swimming and/or water aerobics the choice for many. Some fitness facilities offer water activity classes specifically for individuals with joint and/or muscle problems. Such classes not only provide an opportunity for activity but also give FM patients social support and encouragement.
Because joint stiffness is a common complaint of those with FM, stretching is a logical activity choice. Stretching, sometimes called range of motion (ROM) exercises, can be performed throughout the day and does not have to be tied to a specific workout time. Generally, ROM exercises can be performed on a daily basis. Stretches should be held for 10 to 30 seconds at a position that elicits gentle tension but not strain. Both upper and lower body exercises should be performed, with particular attention paid to problem areas. As is true for aerobic exercise, fitness facilities sometimes offer stretching and strengthening classes specifically designed for people with joint and muscle disease.
Developing good muscle strength is important for overall health and for performing activities of daily living, but those with FM have to be careful not to overstrain muscles. Many different approaches to strength training can be taken (weight machines, resistance bands, etc.). The key is to find what works best for a given individual. Sets of exercises should be performed on a regular basis (2 to 3 times per week) and should include upper and lower body muscles. However, repetitions of a given exercise should not be performed to 100% muscle fatigue.
Fibromyalgia presents itself differently among individuals, so no one specific exercise approach can be used for all people with FM. For those living with FM, two keys to starting an exercise program are beginning with activity that is well within one's ability and progressing slowly. Close monitoring of muscle pain using a daily pain diary can be useful in identifying exercises that lead to flare-ups. Fitness and/or medical professionals who have experience working with FM clients can provide expert advice about how to individualize an exercise program based on needs.
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