I've had
Fibromyalgia for 24 years and I'm a 60 y/o male when most sufferers of the condition are female. Way back then I ran and swam daily and when the condition kicked in I've been on this roller coaster ride that has impacted on my 'fitness' greatly. I'm about one third capacity of where I used to be in terms of doing stuff -- everyday stuff, exertion,etc.
The physiological features of FMS have always, understandably, interested me because there's a ready option in doing less so that you are less stressed by pain and stiffness. I was a RN and also --when my condition kicked in -- trained as a massage therapist when I couldn't work a full time job.
En route I've explored a few 'fitness' and exercise modalities as well movement regimes like Feldenkrais and Tai Chi. I even helped teach Tai Chi for a time -- and I've done walking and everyday pool exercises in line with the presumed wisdom about light exercising to maintain flexibility.
But the reality is -- and I have the intimate knowledge of my own body to prove this -- that light is a mistaken course as is just aerobic.None of these approaches arrest the condition. Inasmuch as they have an impact they slow its course but disuse and stiffness bears down upon the muscular skeletal system nonetheless. So, five years ago I was walking with a cane and thought I'd be in an electric mobile thing in a few years.
So here's what I did, because i think it's an interesting story.
#1 I switched from a walking cane to trekking poles -- either singly or in pairs and the shift pulled me upright as my shoulders rose to the higher grasp. I no longer walk with any aids.
#2 Since I had difficulty mounting a bicycle, I built myself a scooter -- a dog scooter -- and pushed that. I know use a (Norwegian style)
kickbike. to get around.
#3 Two years back I started at a boxing gym with a weekly trainer. It has taken me the best part of 20 months to register physical gains as I slowly built up my exercise capacity.The literature in regard to FMS is dead wrong in regard to pain management and the like -- weight training in the context of boxing exercise has been the best thing I've ever done to deal with my condition.
It is because I've really taken to kettlebells that I found my way to CrossFit -- as I did a search, "Fibromylagia" + "Kettlebells" and found this thread.. After watching the videos I'm gonna find my own way into CrossFittery.
The kettebells were very important for me because they broke through a sort of amour that had constrained my lower back and core. Granted a light workout with the bells meant that I spent a good part of the next 3 days in bed -- but as I kept at it, moving the weight up slowly and restraining the vigor of my workout -- I'm getting to a level of confidence with fewer side effects.
So what's the drill with
Fibromyalgia?
Lesson 1: Weights. Push the envelope slowly. Don't over do it or the client won't come back or won't be able to. I cannot as yet comment on gymnastics although I've taught myself to skip.
Lesson 2: The FMS client has to set the parameters. Not you. There's no room for a Boot Camp approach. Its' all about , I guess, movement awareness and confidence with the routines an you gain strength.. (And the knowledge -- like this -- that others have also done it). Group sessions are no good-- it has to be one on one.
Lesson 3: Pain in FMS is relieved and restrained by exercise that pushes the body rather than simply moving it. My first break through was to relieve upper body pain through the poles and then by weight lifting and boxing. Lower body pain only began to lessen by using the kettlebells. Sit ups were a waste of time.
Lesson 4: FMS is also a sleep disturbance complicated by the depth of restful sleep you get. An exercise regime that strains the body a bit (but not too much) is the very best hypnotic(?2-4 hours before bed). I'm trying to establish an evening routine of workouts so I can harvest it effect on my sleep pattern. The problem is I'm more tired, stiffer and cumbersome as the day wears on. But that's another consideration -- designing an at home routine that promotes good rest.I can come home from a gym session and sleep for up to three hours -- so there's no ready solution here.
I guess the main thing to note is that I'm having my best Summer in years -- and Summer here in sub tropical Brisbane, Australia -- is always my worse time.Its' the strength training routine I'm no exploring and, inasmuch as I understand the CrossFit philosophy I think there are a few aspects there that are very relevant to where I need to go
but without over doing it as bed is a bugger of a place to spend your life.
Furthermore, while I'll never be free of this stinking dog -- as weather changes set me off and I always will get relapses big time -- the heavy training I am now doing enables me to bounce back quicker so that I'm less incapacitated. when I do have relapses. Even "having relapses" is nice change as I was chronically ill all the time for years so there seemed hardly much variation!
In real time, my first achievement was to be able to move my session time up from 10 minutes to 30. Now I do 40 intense minutes at home most days. But some days I tun up and am just happy that I can make it though my half hour so I just gotta do it light. (I say "light" and try to distract my instructor by prattling on and sharing anecdotes. Some days I literally cannot walk home the one mile from the gym.)
But that's OK. In FMS: no pain/no gain!
Inflammation would be good in FMS if it could be located.
In comparison your everyday arthritic has it good cause they 've got identifiable symptoms. The reserve option is usually pain killers -- not that they are very effective -- and Tricyclics which impact on sleep patterns and reduce pain and stiffness.
I don't want to take up this thread with treatment options, but I point out that with Tricyclics -- the standard treatment -- there's usually an associated weight gain and that impacts on an exercise regime. Whether exercise can replace the use of Tricyclics is something I'm keen to investigate in real time exertion.
But for instance I can crawl to the gym (with stiffness and pain and mental fog)for my session and go though the most limited of workouts and come away with greatly reduced pain levels. So long as I tick the main "circuit" boxes -- even in light pencil, I'm ahead!
To give you and idea : I live near an urban train line and often use it to travel across town. I may have an appointment and leave my house for the 6 minute walk to the station. Only when I'm mobile does my underlying condition that day begin to register. (I think that's important as exercise tells you where you at in the way that no exercise will not)So when I get to the station I have to walk up this 30 degree ramp -- and every so often -- far too often -- I have to turn around and go back home because I cannot ascend the ramp. If I do I'm dragging on the hand rail to do so.
There's two factors here: One is whether I can walk up the incline -- and the other is once I get where I'm going,how do I manage to drag my body back home again?
But the very next day, or maybe even later that very day -- I can do a 30 minute workout or push my kickbike 5 kilometers.
So we aren't talking about constancy. This is a mercurial condition harnessed I think by playing around with the pain and exertion threshold. And, if I kick in some adrenalin -- the pain is overridden such that if I'm crossing a street in stiffness mode and a big semi trailer bears down on me I can run across to save my skin when I began the crossing shuffling. I may not be at my fastest, but I have leeway in that context to do more than I thought I could. Thats' always the case.
So I think you can always exercise regardless how you feel --so long as you pitch is ts demands on your physiology.
Exercise is a war with your body's seeming preference.
Another feature of exercise worth while noting is that it has proven a boon for concentration which goes into free fall with FMS. Memory and focus do suffer with FMS and --as the contribution here from a woman with FMS indicates re typoes(as my own surely) -- a sort of poor typing discipline, aphasia and dyslexia kick in. In that regard I've found the discipline of gym exercise -- the counting and the numbers/calls -- the noting of the clock -- very useful in retaining my mind to work with more focus.
For instance it took me a long time to master the number/punch scatter that occurs with focus mitts. It took me 12 months to be on the right punch for the call for a whole workout. Now I hardly lose it as I've retrained my head to lock into what I'm doing.
Well a diagnose can also offer its own burdens because that by default can be a sentence if you let it.
I just read Katrina's excellent paper and note the scattered nature of the conclusions from research into exercise programs.But what I wrote before is true: it has taken me close to 2 years to register observable,albeit subjective, changes in my FMS. That comes after many years of experimentation with different modalities and an extended period during which my condition was deteriorating.
There is a difference between
improvement in symptoms and
symptoms not getting worse and the literature doesn't recognise that divide as the latter is hardly a research topic registered in standard hypotheses. Exercise is a given -- an absolute imperative -- but what form of exercise is best suited to also encourage symptom moderation is the main question.
I guess my answer, for now, isn't so much low intensity at all (eg: Tai Chi, a water aerobics, etc)but reasonably high intensity workouts so long as it is of short duration (eg: approx 30 minutes ) -- with consideration that the intensity is varied according to symptoms presenting on the day.It is very important for me to attend my weekly session with my trainer, regardless of how I feel, as the routine has to rule. And outside that time I need to follow a regime that includes at least two other workouts in any one week (although I usually do more in any seven day period -- at least that's always the plan).
I've done daily water workouts(we have a pool here which I used even in winter when I'd wear a wetsuit), tai chi, walking, stretches, cycling, sauna and massage -- and my conclusion thus far is that I'm now on a bit of a winner. I haven't got my head around the ways and means of CrossFit so I cannot say what application that philosophy may have to FMS -- but my initial reaction is supportive of its utility.
I also have an interest in getting off Tricylics for pain or reducing my dosage so that I can be free of the side effects but these meds do reduce pain significantly (and, of course, they ameliorate symptoms of depression).
But I do think there is a case to be made for drafting a trainers charter for FMS clients as it's clear that many professionals are ignorant of the nature of the condition and have not one iota of a comprehension of how to relate to it. At my gym, with another trainer, I would have given up long ago because I would have been macho overworked. My complication is that I'm highly motivated and don't make a habit of saying I have Fibomyalgia, so I'm not about being passive or playing at victim hood either.
So what's my conclusion? At least anecdotally, from my POV.
FMS sufferers can do 30 minute workout sessions if the program is graduated and pitched not so much on a week to week rising scale of attainments but how the symptoms present on the day. Of course more challenging exercises has to be built into the overall graph of the program --if only for a sense of accomplishment -- but the impact of the program may not be felt for many months.
I don't think what exercises are performed is so important but consideration should be given to ameliorating pain in specific regions of the body.I am always a touch confused with FMS as to its record of impact and pain in weight bearing as against other muscle groups -- and I'm thinking more about that in regard to the use of kettlebells which are devices that seem to tick a lot of boxes. Boxing was excellent for ameliorating my upper body and upper arm pain and I had been using a leg press machine for my lower body. But kettlebells were more effective in dealing with lower back and thigh ouch points. This may have something to do with why chiropractors recommend them .
I should also point out that there is a safety issue with FMS in any gym as the nasty 'fibro fog' can greatly undermine concentration even, at times, independent of muscular pain and stiffness symptoms.So treat such clients like children in a gym situation if required.That means instructions may have to be repeated several times so that the procedure is adhered to in complete detail.
In summary I guess I have to revert to and recommend the standard gym mantra: no pain/no gain -- so long is due consideration is given to variability.For instance I worked out this morning by myself at the gym with skipping, leg presses, kettlebells and a bit of very light clean and jerk over 30 minutes. I felt fine and walked another 3 kilometres afterwards to grocery shop in 30C heat (86F) . .. But tonight I could hardly walk once the weather change kicked in and I had to drag myself across town and transit by hobbling.
(But you see I still hobbled foward. That's the point.)
Tomorrow, I expect to be OK for another (light) morning session because I know that the catalyst for the stiffness wasn't the workout....But that's the drill. What the exercise gives me is "bounce" -- I can recover much quicker from such relapses which other times used to last days or even weeks.
That's the core treasure that exercise like this offers me -- that and the amelioration of some pain symptoms more generally day to day.And yes, body/movement awareness -- that's crucial.
Anyway I'll leave that for my contribution and maybe check back in months with a similar homily....By then I should be more familiar with CrossFit ways and means.
Originally Posted by Stephen R. Lampl  Meg,
For right now, though, she continues to have issues with any "standard" weight/resistance exercise - - she is normally bed-ridden for two or three days afterwards. |
Yeah, well that's the case unfortunately but the main issue is that you aint gonna die. I think too much has been written about the dangers of physical exertion in FMS.
While stress is very real and potent and exercise is indeed very stressful, it is stress with a return. I spent too long playing up to those notions, too long being protective and careful that I may 'overdo it' while pandering to 'range of motion' regimes premised on aerobic notions.
I've just spent the last three days in and out of bed -- and most of today asleep -- primarily because of weather changes -- but I know that I will recover and I will bounce back much quicker because I've toned up the old bod with regular workouts.
Without it there's this down time envelope that may persist for awhile as though my body has lost its memory of how to navigate itself back to normal mode. Thats' the trick: with FMS in free fall you forget what 'well' is like and accept passively what the illness throws at you so you try to negotiate comfort by its terms: prostrate rather than upright.
Easy. But the very worse response.
I've spent two or three days stiff, sore and often asleep and bedridden after a workout too. Every time I up my exertion level is it may happen but the trick is to negotiate the curve nonetheless -- working a little bit longer or a little bit harder as the weeks go by: gambling with your body's response.
This may seem totally ridiculous as though it's only invested true grit -- but if you do your homework and chart your recovery time, you bounce out of relapses faster . You'll note a steady gain in controlling your symptoms: less pain, fewer analgesic medications, more vitality, etc. The real trick isn't the sense of exertion but the somatic awareness.
It's real hard work to get a sense of that.
Yesterday morning I worked out at the gym on kettlebells and skipped; did a little boxing, tried to do a few pull ups, and was a bit stiff in the afternoon and had to sleep as a weather change swept over the town.
All my chores and my routine were put on hold.(Eg: I write journalism and none got written so I missed my deadline)
This morning I walked to the railway station to attend a meeting but couldn't climb the ramp and had to come home. I went straight back to bed and then slept to early afternoon..
Nonetheless I walked the dogs for 40 minutes this afternoon had a meal and went back to bed. So I went out between naps.
I have a session with my trainer early tomorrow morning and I'm hoping to be able to make it and last the full 30 minutes.I almost postponed it and thought: let's risk it -- let's see how I pull up when I awake.
Obviously a big component of this is cognitive -- by working out I get to sit in the driver's seat and feel a bit like 'can do'.It puts me in a sort of co-control.
That's because, in my estimation, surviving FMS is an exercise in opportunism -- you do the best with what you've got at any one moment.
It's a series of levels I guess which you engineer. My base level is cooking an evening meal. If I do nothing else in the day at least I should be able to do that. Sometimes I can't manage that, maybe a few times each year. Another level is walking the dogs. A third is working out for 20-30 mins or pushing my kickbike..
Then there are other levels -- with the advantage of using a gym being a regular reason to get out of the house. (I try to get to the gym at least 3 times per week) I actually think I have pandered too much to 'working from home' . And having a session with my trainer is a major event for me every week -- it's like going to church. (But the day -- or for the 2 days after -- I never plan on achieving much as my sessions with the trainer are harder than the ones where I push myself)
So I have these levels and some accompanying aims. The levels give me a meter of where I'm at and the aims push me along.
So I had to increase my session times from 8 minutes to 30; skip rope from 20 skips to maybe a few hundred now; box work out on the bag longer than 30 seconds to a succession of 2 minute rounds,etc. There is nothing special about such gradations except that I'm occasionally physically and mentally gah gah. Nonetheless I can expect to increase my weight and resistance regime and as I wrote above -- I am saying I do now register qualitative results after 18 months to 2 years of this!
I've never found a direct result between 'x' amount of exercising and illness moderation immediate after or within a set period of time. I don't have that luxury so it is a mistake to expect there is a direct immediate relationship between the two. And the research I've seen about exercise & FMS tends to fall into that trap. The research period is of such short duration that there is likely to be a placebo effect in play as much as physiological gain being registered.
I cannot then say -- well go for it! CrossFit for the Fibomyalgics -- because I don't understand CrossFit much. I think the exertion level may be too intense from what I've seen on the videos. But the perspective, the exercises themselves, the postural correction and the challenges of the main routines should be within my own reach overtime time.
[For instance I'd like to be able to do one pull up sometime over the next year...]
I like the CF approach primarily because it starts with the squat and I've learnt that the squat, for me, is a powerful means for me to overcome pain -- just as weight training (and boxing)has impacted on pain and stiffness in my limbs.
But since I've had this beast for 24 years now....I have its measure a bit. And I guess the main thing is to do what someone suggested here and ignore it. Transcend the illness and instead deal with the range of symptoms as they occur. So when I come to my session with my trainer -- nothing is set in stone. If I have a few symptoms that day we work around them. And in a normal gym what you lose on the swings you can gain on the slides....
{That also suggests that any trainer working with someone with FMS should only address the symptoms not the illness as though its somehow pre-ordained rehab. I haven't bothered my trainer with a diagnosis I just say 'arthritic' and "it varies" and we trim the work out to suit the day. No sweat. }
I've also learnt that working out has to be niche driven -- that is by being opportunistic. If I was asleep for a good part of today I seized the window of walking the dogs just as if I cannot work out at 10am and may be able to do so at 7pm.
