06 March, 2010

Riley's Ist , 2nd , 3rd and 4th Laws of Fibromyalgia

This weather! Oh, this weather!

With a flood the size of Victoria out west, I think I have been every where my body can take me without actually going anywhere: sharp twitches of pain, stiffness, massive fatigue, gah gah mental fog. I've been so physiologically mercurial that I don't know what's beckoning from one hour to the  the next.

Ah Summer!

I have occasionally done studies -- is it the temperature, the humidity, the temperature and the humidity, the barometric reading, the rate the barometer changes...? After 25 years of being my own subject of investigation, I cannot make a ruling. But one thing is certain: the more physically active you (ie: I)  have been in regard to exercise, the faster you (ie: I) will recover from episodes of pain , stiffness and fatigue.

That's Riley's Ist Law of Fibromyalgia: a body will return to steady state as a quotient of its exercise parameters.

I'm not quite sure what that means but let's say that you can't have your cake without first baking it.

There is also a trick to this -- a trick that is well worth meditating upon. How do you 'exercise' if you are so often stiff, sore and fatigued? You'll have to imagine that this presents a major obstacle to generating an  exercise routine. I mean why build up a sweat doing something if it is so uncomfortable to do so?


Herein lies Riley's 2nd Law of Fibromyalgia: a body when physiologically stressed may release pain relieving endorphins. 
Endorphins resemble the opiates in their abilities to produce analgesia and a feeling of well-being. Endorphins work as "natural pain relievers."
That's a contradiction, of course: why generate more pain to get less? I agree that that does present a complication as it can be so very difficult indeed to convince your head that straining and paining may lead to a measure of relief. But being a betting man I can say that odds are  that after an intense work out session -- despite the physical difficulties you may have to negotiate  and the shallow level of your attainments during it -- you may feel better than you did before you started.

And besides, you won't feel any worse!

So the magic word is : exercise. No secret that. What kind of exercise, however,  is a moot point. I think weight bearing is very useful as it is more likely to focus on different muscle groups where stiffness and musculature stress may aggregate.

That said, and assuming you are hell bent on developing an exercise regime, how do you manage that if you are so much handicapped by illness?

This relates to  Riley's 3rd Law of Fibromyalgia: a body must exploit the physiological window of opportunity. 

Fibromyalgia is not a level playing field. The intensity of its  symptoms are very mercurial. Why that should be , I don't now , but any one episode is not a constant  and there are periods of amelioration. These may be undefineably slight in nature but  they happen.

These "physiological windows of opportunity" need to be harnessed for the common good and as soon as you are aware (and that in itself is a real skill) that there's a lessening of symptom intensity, rise up from your pallet and walk.

That means you go do some intense physical activity, the likes of which you should have to hand. This is why weight training can be so useful as it is all about picking up a  weighted exercise device and doing something with it. In my case I love lifting and swinging the kettlebells.

Since that can be a tad boring and at times seemingly too stressful, it pays to have a few options. And a few options I do have: lifting barbells, working on  a boxing heavy bag, and kicking the kickbike around a set neighborhood course.

Each day now I try to do -- when I can -- all of these things. 

I find that after I rise in the morning, the overnight stiffness may lessen within 30 minutes and I have an  exercise window of opportunity before there's a relapse.

That's when I bike it. No helmet. No fuss. I even go barefoot. It's all Carpe diem stuff.

I get on the bike and go. On the kickbike the stress only begins to kick in around the first kilometre mark.

In contrast a weight lifting segment may last no more than 5 or 7 minutes; boxing the bag,maybe 5-10 minutes; and kettlebell, 7-12 minutes.

I used to rely on a half hour walk with the dogs each day -- when I was up to it -- but really that shallow level of exercise is insufficient to impact on the symptoms of Fibromyalgia or avail you a significant level of symptom protection.

The regime has to be moderately stressful but not so stressful  as to lead to a ongoing strain effect. Recovery should be completed soon after  finishing the session.

Herein lies, Riley's 4th Law of Fibromyalgia: a body with Fibromyalgia must be worked more intensely than one without (but not so that it is over stressed).

That contradictory conclusion is a product of the first three of Riley's Laws of Fibromyalgia.

Discussion
I've had this condition for 25 years and in that time have utilized a few exercise regimes and at times did not exercise at all. The conundrum is that exercise won't cure you and may not even make you feel qualitatively better -- such that you are subjectively aware of its effects -- but it will at least  slow down your symptoms from worsening.

Stop exercising frequently and regularly and then note the difference!

However, the perception that exercise must be soft and almost passive, I think, is a mistake. Water exercises or Tai chi ( and I've done both for years on end)are only useful in sustaining range of motion and because they don't stress you physically there is much less rebound effect.

A similar complication is the notion that exercise must be routine -- same time, same day , same schedule. If you want to become dispirited with any exercise plan, make it a strict routine.

No, you have to forget about rules and learn to be opportunistic. This of course turns the challenge of motivation back onto you. In this regard I have one religion: every Friday morning I have a 30 minute session with a personal trainer at a local boxing gym. That sets my threshold, pushes my envelope and let's me know, since I can compare how I felt session to session, where my body is at.

It happens that I may miss a few of sessions each year as I am occasionally too stiff and sore to attend. But that's not the end of the world...that's just another day.

My challenge -- and my success -- is that I have been able to adopt what I do at the gym -- and what I learn there --  to what I do at home. This allows me to negotiate a gradient where what I do at the gym and what I do at home improves over time as my capacity to exercise and tolerate the physiological stress improves.

Will I 'get better'? No way. Will my symptoms ease? Perhaps -- but the real plus is that the worse symptoms -- the worse episodes -- are easier to recover from. Your capacity to 'bounce back' improves.