# Exercise



## Stillnaked (Jan 19, 2003)

My doctor is telling me I need to exercise, and I try, but it HURTS! He tells me the pain will get less, I need to push harder. In my experiance if I push I hurt more for days. Will that go away if I keep it up? I don't see how, but if it works for anyone here I will try. I usually do one lap in the pool, and then I am shaking and foggy. He wants me to keep adding laps, says it will help.Laurie


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## M&M (Jan 20, 2002)

I think this is an extremely personal part of your treatment. Everything I've read said exercise is important to stop your body from losing all its muscle mass. But, as we all know, if we do too much it sends us into an even worse flare up. From all the reading I've done, everyone with experience says do as much as you can without wearing yourself out. Here is an example I read. A lady was bedridden for a long time, hence lost her muscle mass. She was advised that each time she got up to go to the bathroom (that was the only reason she could get out of bed) to walk to and from the bathroom 1 extra time, for exercise. After that became easy, she walked to and from the kitchen. This woman had been unable to leave her house in 3 years (if I remember right), and eventually she built up to walking to her mailbox. The point? We have to measure success differently. We even have to measure progress differently. I think you should exercise, but stop when you feel you could still do more. That way you exercise, but don't send yourself into a flare. My feeling is your doctor obviously doesn't know what it's like to live in your body. Hope this helps.


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## katjam (Jun 5, 2003)

I would just keep doing that one lap for now, until your not shaky and foggy. At least you're getting some exercise in! Then add half a lap, or maybe just tread water for a little while. It will probably take time, but eventually you'll be able to do more. Like MrsMason says, we have to work within our limits- we know our body better than anyone. I know I can do more now that I exercise on a semi-regular basis than I did when I didn't exercise at all. My goal is to exercise at least 5-6 times a week. I find it does help, if I don't over do.


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## Susan Purry (Nov 6, 2001)

Laurie, you and others might be interested in this, which was posted to the Co-Cure email list (www.co-cure.org):


> quote:*Physical exercise in fibromyalgia and related syndromes.*Best Pract Res Clin Rheumatol. 2003 Aug;17(4):629-47.Mannerkorpi K, Iversen MD.Department of Rheumatology and Inflammation Research, Goteborg University,and Department of Health Sciences, Division of Physical Therapy, LuleaUniversity of Technology, SwedenPMID: 12849716Fibromyalgia and related syndromes are characterized by chronic pain andfatigue. This chapter identifies the types of exercise that are effectivefor these patients and provides recommendations for exercise prescriptions.Based on a systematic review of randomized controlled studies of exercise,we suggest that low-intensity aerobic exercise, such as walking, canimprove function and symptoms. Aerobic exercise performed twice a week atmoderate intensity can improve aerobic capacity and reduce tenderness.Pool exercise can improve function, distress and symptoms. Strengthtraining at adequate load can improve strength without exacerbation ofsymptoms.Most patients tolerate low-intensity exercise. High-intensity exerciseshould be undertaken with caution. Due to the large variability offunctioning and symptom severity in patient populations, exerciseprescriptions should be individualized and should include a long-term planto maximize functioning and wellbeing.Studies with larger populations, allowing subgroup analyses regardingbenefits and adverse effects of programmes, are needed.


The others gave you great and v. sensible advice, which I'd echo: IMO, find a low level of exercise, and keep at it until you can do it most of the time without exacerbating your symptoms. Then move up a notch, and so likewise. This way we have improvements and plateaus, and (barring unforeseen circumstances beyond our control) no regressions. The fact that you're shaking is perhaps a sign you're doing just a little too much. Your muscles are bound to hurt after you exercise, that happens in healthy people too, but other symptoms may suggest over doing it. Have you tried walking?


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## M&M (Jan 20, 2002)

Here is an excerpt, and link, from an article about exercise in Fibro and/or ME patients. Hope it's helpful!


> quote: According to Derek Enlander, M.D., "I consider exercise from different points of view with FM and CFS. CFS patientsï¿½ prominent symptom is fatigue. This word is not truly descriptive of what these patients feel. When we use the word fatigue, the average person typically thinks tired from activities such as work, physical exertion, or lack of sleep. CFS patients feel a different type of ï¿½fatigue.ï¿½ At times, they feel they cannot lift an arm or leg without significant effort. Their energy base is depleted. Therefore, I suggest my CFS patients do only slow, very graded exercise. Exercise is a very slow and tedious but necessary aspect of recovering to a more productive level of functioning. If CFS patients overdo exercise or any physical activity, immediate repercussions typically occur. At times, CFS patients do have spurts of energy and typically overdo because suddenly they can do things. One of the hardest obstacles to learn with CFS is to find balance in all things. Patients walk a fine line regarding exercise and physical exertion. CFS patients have relapses that often last for several days before they recover. I tell patients to follow this rule: ï¿½only do 50% of what you think you can do.ï¿½ I prefer my CFS patients to begin with stretching exercises, then begin walking perhaps a block or to the end of their driveway and back if necessary. Walking can be done at their own pace, place and distance, so as to not overtax their bodies. Then, very slowly progress to 2 minutes twice a day with exercise that is not of a strenuous nature, but include something different."


Here is a link to the complete article: http://www.immunesupport.com/library/showarticle.cfm/ID/3855


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## Guest (Jul 20, 2003)

When I don't exercise, I hurt more, get tired more quickly and in general feel worse.I find that I do have to moderate the exercise, however, and that if I push myself too far, the hurt, fatigue and general malaise also get worse.I think the type of exercise in which we participate is significant. It needs to be low or non impact and not leave us gasping for air.......







Over the years I've utilized swimming, bicycling, walking, modern dance. I prefer the modern dance for its stretching benefits that seem to temper the pain better than anything else, and I perform the stretches outside of class often in conjunction with walking or bicycling. But my stamina is not great. My walks and bike rides are usually limited to half an hour. In dance, the initial workout is 45 minutes, beginning with mild stretching on the floor and progressing into aerobic stretching standing up, after which we take a break, then resume half an hour of across-the-floor movements during which time I often end up having to stop and rest.Regarding the stretching, I have found that being aware of and controlling my breathing so that it flows in and out with the stretching movements seems to work the best for me and allows me to stay in the game longer. Timing is everything.Example: If I am sitting on the floor, legs spread, toes pointing and doing a side stretch over one leg, I don't just assume the position and sit there....several times I retract and contract my muscles to perform the stretch, breathing in as I release and breathing out as I contract, with the momentum for the movement emanating from my pelvis/torso trickling into my extremities. This way of moving actually GIVES me more energy than if I were to do nothing at all. Besides that, it is very beautiful to watch.But overall, some form of exercise is essential to feeling better. Even lifting weights can be good exercise.Evie


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## M&M (Jan 20, 2002)

Here's a little more info on this same topic. (This is obviously a popular topic among doctors and patients alike!)


> quote:Claudia Craig Marek, an FM patient-expert, author of several books and a big proponent of exercise for FM patients, sets down the basic rules of stretching: "The basic rules of stretching are simple. Move slowly and gently, not vigorously or jerkily. When youï¿½ve stretched to the point where you feel gentle pressure you must hold that position for three seconds breathing deeply and regularly. What youï¿½ll do as you progress is hold your stretch longer: first five, then ten, then fifteen seconds, until you work up to thirty seconds each. Start by doing just a few of each stretch, and gradually add to the number that you do. -Longer skeletal muscles need stretching the most.-Start with three repetitions per stretch and work up to more.-When your muscles are sore be very gentle and never work through intense pain. If something hurts in a way that youï¿½re not used to, ease back immediately.-Yoga exercises, which combine deep breathing with gentle stretching, are often very helpful to fibromyalgics."


For more info go here: Immune Support Website Or to learn more about this book, go here: http://www.amazon.com/exec/obidos/ASIN/156...7796424-5131341


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## Mountain Gal (Aug 9, 2003)

Water aerobics is great for Fibromyalgia. I take an arthritis water class three times a week for an hour each time. It is somewhat slower than a regular water aerobics class. I take it at a health club and dont even have to have a membership there, just pay a small quarterly fee for the class only. I believe the YMCA has classes, too. You can find out about it at the Arthritis Foundation website. I have been doing the class for a little over a year and have much better flexibility in my body, less aches and pains. When I first started, I thought there would be no way I could go three times a week because I get so fatigued. But I love it and look forward to each class. I have much more energy and also enjoy all the friends I have made who come to the class each session. We have a great support group. We are all different shapes, sizes and age,but no one seems to care. We all are hurting and enjoy the exercise in the water.


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## Guest (Aug 10, 2003)

MrsMason & MountainGal... both of your suggestions are terrific for those of us with FMS!! Yes yes YES !!!We gotta be careful and temper what we do.... but when we do it.... the pain is relieved temporarily... and when done regularly... the pain relief is also more consistent.Evie


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