10 Exercise-Related Guidelines for People with Fibromyalgia

By James Peterson PhD, FACSM
From American College of Sports Medicine’s Health and Fitness Journal
July/Aug 2001

1. Exercise regularly. Fibromyalgia is a complex, painful condition that requires a multidisciplinary approach to treatment. To enhance the functional capacity of people who have fibromyalgia, regular exercise should be a critical part of their treatment program.

2. Stick with it. People with fibromyalgia should not give in to their symptoms and should avoid prolonged periods of inactivity. They should adjust the intensity and/or duration of their exercise regimen according to their symptoms and keep in mind that physical activity is essential for preserving function.

3. Start slowly. People with fibromyalgia who have been inactive should start with 5 to 10 minutes of activity three or more times per day. As their conditioning improves, they can gradually increase the duration of their activity and reduce the frequency. They should aim to exercise for 30 minutes three to four times per week.

4. Don’t overdo it. People with fibromyalgia should exercise at low-to moderate intensity levels- 40-70 percent of maximum heart rate of fairly light to somewhat hard on the Borg Rating of Perceived Exertion (RPE) Scale. Perceived exertion may be the best tool for monitoring exercise intensity. Using RPE allows for day to day variations in symptoms that may not be reflected by the individual’s heart rate.

5. Progress at a sensible rate. People with fibromyalgia should gradually increase the intensity level of their exercise program. They do not need to train hard to achieve the benefits of exercise.

6. Vary the mode of exercise. People with fibromyalgia should participate in a variety of activities, to avoid repetitively stressing the same muscles and joints. How soundly and how regularly you exercise is much more important than what modality you use.

7. Remember that muscles do matter. People with fibromyalgia should use very light weights, elastic bands or cords, and/or gravity for resistance training. Emphasis should be on proper exercise technique, keeping resistance loads at a minimal level and avoid explosive or jerking movements.

8. Be sensitive to how you feel. During periods of increased pain or fatigue, people with fibromyalgia should reduce the intensity and/or duration of their exercise regimen. Occasionally reducing exercise intensity and/or duration is acceptable provided the long-range pattern of exercising regularly is consistent.

9. Make mild, static stretching a part of your daily routine. Given their propensity for muscle-related problems, people with fibromyalgia need to understand that muscle, when not used, shortens and stiffens, and progressively loses function. They should engage in a static stretching program to enhance and/or help maintain their flexibility and joint mobility.

10. Keep the focus where it belongs. Exercise programs for people with fibromyalgia should be designed to promote health and wellness, not athleticism. Exercise regimens should be geared to safely meet an individual’s current health and functional status, focusing on “active relaxation” not sports conditioning.