Fibromyalgia

Brad Walker explains how to use gentle aerobics and stretching exercises to reduce fibromyalgia pain.

Fibromyalgia and Chronic Fatigue Syndrome (CFS) are thought by many to be separate manifestations of the same disorder, the main difference being the primary symptom associated with each of the disorders.

Fibromyalgia is a chronic disorder in which the sufferer complains of severe pain throughout their body. This pain can affect the muscles, joints, and soft tissues, i.e. tendons and ligaments, to the extent that any movement is a struggle. This disorder affects the female gender in 90% of cases and is commonly diagnosed between 25 and 40, although the symptoms can begin to show at any age. Other symptoms that are used to diagnose fibromyalgia include:

Tenderness in 11 of the 18 pre-determined sensitive spots of the body
Chronic fatigue
Sleep disorders
Headaches
Stiffness of the joints

Many individuals diagnosed with the condition suffer from all or the vast majority of these symptoms; however, because fibromyalgia is a relatively new disorder, many physicians mistake it for other, more common disorders. One such disorder is CFS.

CFS is another lifelong illness characterized by the above symptoms; however, in this case, the first diagnostic sign is fatigue, as opposed to widespread pain. The fatigue associated with the condition is often debilitating and is described by many as "having concrete arms and legs." Muscle and joint pain are also common in CFS, so, understandably, many experts get the two disorders confused.

The cause of fibromyalgia and CFS is still unknown, although many research papers commonly refer to four possible aetiologies:

Toxicity - due to long-term exposure to chemicals, pesticides, insecticides, etc.
Traumatic experiences and lifelong stress, possibly from a pre-existing medical condition or illness.
Genetic susceptibility.
Immunological breakdown - due to prior bacterial or viral infection.

Whatever the underlying causes of the two disorders, they are both as yet incurable, so treatment and management of the symptoms are seen as the key to relief. Surprisingly exercise is very beneficial for reducing the pain and fatigue associated with Fibromyalgia and CFS. So a regular exercise regimen needs to be tailored to each sufferer's needs.

Precautions, Limitations, and Dangers

As with any exercise plan, an exercise plan for people diagnosed with Fibromyalgia or CFS needs to cater to the individual's level of fitness, mobility, and experience. Extra precautions need to be taken to allow for the person's disability, so only certain exercise types should be included.

Because many of the joints, muscles, ligaments, and tendons will be affected by Fibromyalgia and CFS only low impact or non-impact exercise routines should be practiced. This reduces any additional stress that would usually be placed on already tender and painful spots.

Each case of fibromyalgia is different, i.e. one person may only have pain in their leg muscles and joints. In contrast, a second person may have all-over pain, which will inevitably affect the type and intensity of the exercises performed. All people with fibromyalgia or CFS should know their limitations and should thus try to stick to exercises that they know won't exacerbate their primary symptoms.

Over-exercising will often cause pain and soreness in even the healthiest of people. So in those already suffering from chronic pain, the intensity can effectively double, making any subsequent movements absolute torture. Sufferers of Fibromyalgia and CFS need to increase their levels of exercise very slowly and only push themselves as far as is comfortable. By overexerting themselves and causing their pain to become more intense, many sufferers of fibromyalgia will enter a period in which they refrain from all activity and effectively become inactive. This then causes de-conditioning and as a consequence, more pain.

Individuals diagnosed with either fibromyalgia or CFS need to break the above cycle by becoming active and keeping their bodies conditioned and healthy.

The Best Type of Exercise for Fibromyalgia and CFS

Non-impact and low impact aerobic exercise is very beneficial for sufferers of fibromyalgia and CFS. The cardiovascular training involved with aerobic exercise has been shown to significantly reduce the degree of pain and stiffness experienced by sufferers.

Light Aerobics

For those who can manage it, low impact aerobics sessions, including brisk walking, cycling, using a Stairmaster, etc., can be very good for reducing all levels of pain. Aerobic exercise should be performed for around 30 minutes per day, 3-4 times per week, to have a significant effect; however, it is crucial not to rush into things and stress the muscles and joints unnecessarily.

It is advised that people with fibromyalgia or CFS start with a simple 5-minute walk and build up gradually until they reach the 30-minute target. Pre-exercise stretching is also highly recommended as this helps to make the exercise session more comfortable and reduces the risk of injury. Regular stretching will also help with posture and flexibility while reducing the amount of muscle and joint stiffness experienced during and after the workout.

Aqua Aerobics

Water makes the body weightless, so any form of swimming or aerobic activity dramatically benefits people with painful muscles and joints. This non-impact form of exercise takes all of the strain off the joints meaning that for a time they don't have to bear the weight of the body. This is perfect for people with Fibromyalgia with very tender body areas who get excruciating waves of pain with every jolt. However, the swimming water must be warm because cold water can cause the muscles and joints to seize up and become infinitely more painful.

Stretching Exercises

Stretching, as it relates to physical health and fitness, is the process of placing particular parts of the body into a position that will lengthen the muscles and associated soft tissues. Stretching is a simple and effective activity that helps to enhance athletic performance, decrease the likelihood of injury and minimize muscle and joint soreness. Apart from the pre-exercise stretching that will be discussed in more detail as part of the following section, several exercises involve specific types of stretching.

As with most activities, there are rules and guidelines to ensure safety. Stretching is no exception. Stretching can be practiced in the privacy of the home or at the gym, where a qualified instructor can demonstrate the correct way to stretch so that the maximum benefit is achieved. Stretching can be extremely dangerous and harmful if done incorrectly. It is vitally important that the following guidelines be adhered to, both for safety and maximizing the potential benefits of stretching.

Stretching Guidelines

It is imperative to stretch correctly, as an incorrect stretch can do more harm than good, especially for fibromyalgia. There are five main things to remember when trying, which will help to keep the body in great shape and injury-free.

1. Warm up the muscles before stretching

Cold muscles can injure very quickly, so it is vital to warm up the body before strenuous stretching and an exercise session. Bringing the body's core temperature up by performing a warm-up will ultimately increase the temperature of the muscles, making them suppler and loose, i.e. in the condition needed to stretch safely.

A warm-up will also increase the heart rate and, therefore, the muscles' blood flow and nutrients. As the breathing rate also increases, the amount of essential oxygen reaching the muscles rises dramatically, creating the perfect internal environment for safe stretching.

A safe warm-up for fibromyalgia or a CFS sufferer might consist of a brisk walk or a short swim. The warm-up should not last more than 10 minutes, and it shouldn't be overly strenuous, especially if the individual's level of fitness is relatively low or severe pain is experienced.

2. Stretch slowly with gentle movements

Slow, gentle stretching helps relax the body muscles, which is often highly beneficial to a person with Fibromyalgia. Jerky movements or over-stretching can lead to increased pain, muscle strain, and even muscle tears, and so all stretches should be made as if in slow motion and as smoothly as possible.

3. Stretch only as far as is comfortable

Overstretching is one of the significant causes of muscle strains and tears, so individual muscles must only be stretched as far as is comfortable. The idea of stretching is to relax the muscles and make the body generally more flexible. In the case of Fibromyalgia and CFS, it can reduce the amount of pain felt in specific body areas. Overstretching a muscle can cause the tendons and ligaments attached to the muscle to contract spontaneously. This can cause significant problems if the stretch is forced beyond the comfort level. Stretching should never be painful, and if it is, then it is a sure bet that the muscle concerned is significantly overstretched.

4. Control of breathing while stretching

It is vital to concentrate on breathing while stretching as many individuals tend to hold their breath, and often they do not even realize they are doing it. Unfortunately, holding the breath can cause the muscles to tense up and trying to stretch tensed muscles will, more often than not, lead to injury, especially in people with Fibromyalgia. They already have tense and painful muscles. Holding the breath also limits the amount of oxygen and nutrients reaching the muscles. Suppose this anaerobic state continues for any significant length of time. In that case, the muscles will build up lactic acid and become highly painful, the opposite of what stretching is supposed to achieve.

5. Stretching correctly

Any form of stretching is better than no stretching at all, so even a few minutes is worth doing. Each stretch should be held for around 30 seconds for the maximum beneficial effect. Anything less than this will not provide sufficient time for the muscle to relax and lengthen. Also, each muscle group needs to be stretched two or three times in rotation, which is considered the bare minimum. People with Fibromyalgia may initially have trouble stretching to this extent and should only stretch until they feel uncomfortable.

People diagnosed with Fibromyalgia or CFS will benefit from stretching daily. Still, it is vitally important that they don't overexert themselves on a particular day as the following day may be more painful than the person can bear. In which case, the beneficial cycle will be broken, i.e. the pain causes inactivity, which continues for several days or even weeks, and this eventually causes even more pain.

Ultimate Guide to Stretching & Flexibility

While the recommendations on this page are a good starting point, you will get a lot more benefits when you include a wider variety of exercises. So to improve your athletic ability, reduce injuries and take advantage of all the stretching exercises on offer, grab a copy of the Ultimate Guide to Stretching & Flexibility (Handbook, DVD & CD-ROM).

Page Reference

If you quote information from this page in your work, then the reference for this page is:

WALKER, B. (2013) Fibromyalgia [WWW] Available from: https://www.brianmac.co.uk/articles/article150.htm [Accessed

About the Author

Brad Walker is a prominent Australian sports trainer with more than 15 years' experience in the health and fitness industry. Brad is a Health Science graduate of the University of New England and has postgraduate accreditations in athletics, swimming, and triathlon coaching. He also works with elite level and world champion athletes and lectures for Sports Medicine Australia on injury prevention.


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Fibromyalgia and Chronic Fatigue Syndrome (CFS) are thought by many to be separate manifestations of the same disorder, the main difference being the primary symptom associated with each of the disorders. Fibromyalgia is a chronic disorder in which the sufferer complains of severe pain throughout their body. This pain can affect the muscles, joints, and soft tissues, i.e. tendons and ligaments, to the extent that any movement is a struggle. This disorder affects the female gender in 90% of cases and is commonly diagnosed between 25 and 40, although the symptoms can begin to show at any age. Other symptoms that are used to diagnose fibromyalgia include: Tenderness in 11 of the 18 pre-determined sensitive spots of the body Chronic fatigue Sleep disorders Headaches Stiffness of the joints Many individuals diagnosed with the condition suffer from all or the vast majority of these symptoms; however, because fibromyalgia is a relatively new disorder, many physicians mistake it for other, more common disorders. One such disorder is CFS. CFS is another lifelong illness characterized by the above symptoms; however, in this case, the first diagnostic sign is fatigue, as opposed to widespread pain. The fatigue associated with the condition is often debilitating and is described by many as "having concrete arms and legs." Muscle and joint pain are also common in CFS, so, understandably, many experts get the two disorders confused. The cause of fibromyalgia and CFS is still unknown, although many research papers commonly refer to four possible aetiologies: Toxicity - due to long-term exposure to chemicals, pesticides, insecticides, etc. Traumatic experiences and lifelong stress, possibly from a pre-existing medical condition or illness. Genetic susceptibility. Immunological breakdown - due to prior bacterial or viral infection. Whatever the underlying causes of the two disorders, they are both as yet incurable, so treatment and management of the symptoms are seen as the key to relief. Surprisingly exercise is very beneficial for reducing the pain and fatigue associated with Fibromyalgia and CFS. So a regular exercise regimen needs to be tailored to each sufferer's needs. Precautions, Limitations, and Dangers As with any exercise plan, an exercise plan for people diagnosed with Fibromyalgia or CFS needs to cater to the individual's level of fitness, mobility, and experience. Extra precautions need to be taken to allow for the person's disability, so only certain exercise types should be included. Because many of the joints, muscles, ligaments, and tendons will be affected by Fibromyalgia and CFS only low impact or non-impact exercise routines should be practiced. This reduces any additional stress that would usually be placed on already tender and painful spots. Each case of fibromyalgia is different, i.e. one person may only have pain in their leg muscles and joints. In contrast, a second person may have all-over pain, which will inevitably affect the type and intensity of the exercises performed. All people with fibromyalgia or CFS should know their limitations and should thus try to stick to exercises that they know won't exacerbate their primary symptoms. Over-exercising will often cause pain and soreness in even the healthiest of people. So in those already suffering from chronic pain, the intensity can effectively double, making any subsequent movements absolute torture. Sufferers of Fibromyalgia and CFS need to increase their levels of exercise very slowly and only push themselves as far as is comfortable. By overexerting themselves and causing their pain to become more intense, many sufferers of fibromyalgia will enter a period in which they refrain from all activity and effectively become inactive. This then causes de-conditioning and as a consequence, more pain. Individuals diagnosed with either fibromyalgia or CFS need to break the above cycle by becoming active and keeping their bodies conditioned and healthy. The Best Type of Exercise for Fibromyalgia and CFS Non-impact and low impact aerobic exercise is very beneficial for sufferers of fibromyalgia and CFS. The cardiovascular training involved with aerobic exercise has been shown to significantly reduce the degree of pain and stiffness experienced by sufferers. Light Aerobics For those who can manage it, low impact aerobics sessions, including brisk walking, cycling, using a Stairmaster, etc., can be very good for reducing all levels of pain. Aerobic exercise should be performed for around 30 minutes per day, 3-4 times per week, to have a significant effect; however, it is crucial not to rush into things and stress the muscles and joints unnecessarily. It is advised that people with fibromyalgia or CFS start with a simple 5-minute walk and build up gradually until they reach the 30-minute target. Pre-exercise stretching is also highly recommended as this helps to make the exercise session more comfortable and reduces the risk of injury. Regular stretching will also help with posture and flexibility while reducing the amount of muscle and joint stiffness experienced during and after the workout. Aqua Aerobics Water makes the body weightless, so any form of swimming or aerobic activity dramatically benefits people with painful muscles and joints. This non-impact form of exercise takes all of the strain off the joints meaning that for a time they don't have to bear the weight of the body. This is perfect for people with Fibromyalgia with very tender body areas who get excruciating waves of pain with every jolt. However, the swimming water must be warm because cold water can cause the muscles and joints to seize up and become infinitely more painful. Stretching Exercises Stretching, as it relates to physical health and fitness, is the process of placing particular parts of the body into a position that will lengthen the muscles and associated soft tissues. Stretching is a simple and effective activity that helps to enhance athletic performance, decrease the likelihood of injury and minimize muscle and joint soreness. Apart from the pre-exercise stretching that will be discussed in more detail as part of the following section, several exercises involve specific types of stretching. As with most activities, there are rules and guidelines to ensure safety. Stretching is no exception. Stretching can be practiced in the privacy of the home or at the gym, where a qualified instructor can demonstrate the correct way to stretch so that the maximum benefit is achieved. Stretching can be extremely dangerous and harmful if done incorrectly. It is vitally important that the following guidelines be adhered to, both for safety and maximizing the potential benefits of stretching. Stretching Guidelines It is imperative to stretch correctly, as an incorrect stretch can do more harm than good, especially for fibromyalgia. There are five main things to remember when trying, which will help to keep the body in great shape and injury-free. 1. Warm up the muscles before stretching Cold muscles can injure very quickly, so it is vital to warm up the body before strenuous stretching and an exercise session. Bringing the body's core temperature up by performing a warm-up will ultimately increase the temperature of the muscles, making them suppler and loose, i.e. in the condition needed to stretch safely. A warm-up will also increase the heart rate and, therefore, the muscles' blood flow and nutrients. As the breathing rate also increases, the amount of essential oxygen reaching the muscles rises dramatically, creating the perfect internal environment for safe stretching. A safe warm-up for fibromyalgia or a CFS sufferer might consist of a brisk walk or a short swim. The warm-up should not last more than 10 minutes, and it shouldn't be overly strenuous, especially if the individual's level of fitness is relatively low or severe pain is experienced. 2. Stretch slowly with gentle movements Slow, gentle stretching helps relax the body muscles, which is often highly beneficial to a person with Fibromyalgia. Jerky movements or over-stretching can lead to increased pain, muscle strain, and even muscle tears, and so all stretches should be made as if in slow motion and as smoothly as possible. 3. Stretch only as far as is comfortable Overstretching is one of the significant causes of muscle strains and tears, so individual muscles must only be stretched as far as is comfortable. The idea of stretching is to relax the muscles and make the body generally more flexible. In the case of Fibromyalgia and CFS, it can reduce the amount of pain felt in specific body areas. Overstretching a muscle can cause the tendons and ligaments attached to the muscle to contract spontaneously. This can cause significant problems if the stretch is forced beyond the comfort level. Stretching should never be painful, and if it is, then it is a sure bet that the muscle concerned is significantly overstretched. 4. Control of breathing while stretching It is vital to concentrate on breathing while stretching as many individuals tend to hold their breath, and often they do not even realize they are doing it. Unfortunately, holding the breath can cause the muscles to tense up and trying to stretch tensed muscles will, more often than not, lead to injury, especially in people with Fibromyalgia. They already have tense and painful muscles. Holding the breath also limits the amount of oxygen and nutrients reaching the muscles. Suppose this anaerobic state continues for any significant length of time. In that case, the muscles will build up lactic acid and become highly painful, the opposite of what stretching is supposed to achieve. 5. Stretching correctly Any form of stretching is better than no stretching at all, so even a few minutes is worth doing. Each stretch should be held for around 30 seconds for the maximum beneficial effect. Anything less than this will not provide sufficient time for the muscle to relax and lengthen. Also, each muscle group needs to be stretched two or three times in rotation, which is considered the bare minimum. People with Fibromyalgia may initially have trouble stretching to this extent and should only stretch until they feel uncomfortable. People diagnosed with Fibromyalgia or CFS will benefit from stretching daily. Still, it is vitally important that they don't overexert themselves on a particular day as the following day may be more painful than the person can bear. In which case, the beneficial cycle will be broken, i.e. the pain causes inactivity, which continues for several days or even weeks, and this eventually causes even more pain. Ultimate Guide to Stretching & Flexibility While the recommendations on this page are a good starting point, you will get a lot more benefits when you include a wider variety of exercises. So to improve your athletic ability, reduce injuries and take advantage of all the stretching exercises on offer, grab a copy of the Ultimate Guide to Stretching & Flexibility (Handbook, DVD & CD-ROM). Page Reference If you quote information from this page in your work, then the reference for this page is: WALKER, B. (2013) Fibromyalgia [WWW] Available from: https://www.brianmac.co.uk/articles/article150.htm [Accessed About the Author Brad Walker is a prominent Australian sports trainer with more than 15 years' experience in the health and fitness industry. Brad is a Health Science graduate of the University of New England and has postgraduate accreditations in athletics, swimming, and triathlon coaching. He also works with elite level and world champion athletes and lectures for Sports Medicine Australia on injury prevention.