Strength Training with Fibromyalgia

CharlieICURN

Hello folks
So I have fibromyalgia and Rheumatoid Arthritis and I find that staying active is definitely beneficial as far as managing my pain goes. I've been trying to lose weight (13 lbs so far in a month and a half) because I feel like the less weight on my joints and stuff the better I'll feel. I work on my feet a lot (a nurse) and generally try to avoid being sedentary. Anyway, to the point:
I've recently decided that strength training would probably be a good idea to help build muscle strength and tone and all the other good things that come along with strength training.
I'm finding this difficult. Not so much the actual exercises but the pain after.
I'm not going crazy lifting heavy weights or anything by any means. I've been using resistance bands mainly (I have a "light" one that's supposed to be like 20lbs and a "heavy" one up to 60 lbs but so far have only used the 20 lb one). I also have both 5 and 10lb dumbbells and have been only using the 5lbs thus far.
The problem is when I'm actually doing the exercises I don't feel like it's challenging enough- my muscles don't get fatigued really with the lighter weights- but then the next day I generally feel TERRIBLE. Every muscle group I worked has like deep pain to the point where it feels intolerable. And it'll last for days. It's like that post workout soreness pain but seriously amplified to the point where I'm almost in tears.
In my 20s before being diagnosed with these conditions and I would strength train at the gym I'd get sore but it was tolerable and would subside after 48 hours or so. Now I feel like it puts me out of commission for days and it takes so much longer to recover at all.
I'm concerned that I won't be effectively strengthening my muscles at the current state I'm in. I feel like I'm not lifting heavy enough for it to have any real effect and it's almost working against me and my whole pain control motive.
I asked my doctor about this and she said it's common with fibromyalgia and it more or less is what it is.
Does anyone have any experience or advice on how to manage this?

Cherimoose

For starters, follow a proven strength program. The workouts that come with bands are often imbalanced, and so are workout posters on Pinterest, etc. A good program is the book New Rules of Lifting for Life. Ignore that it's marketed to middle age folks - they simply have to take things slower. In the mean time there's a program in my profile you can follow. After working out, keeping the muscles moving throughout the day tends to reduce soreness and improve recovery. That could be hourly static stretching, or simply moving your joints through their full range of motion for a minute.

Azdak

You are going to have to find the level you can tolerate and work from there. And, as you have found, you cannot really evaluate the effects of workout until later or the next day. I know it's discouraging.

At first, I would recommend lower reps, fewer exercises, and shorter sessions. You are going to have to focus more on mobilization at first, and less on "progression". That might mean little to no resistance at all--just mild stretching. At the start, it might only mean 5-10 min of "exercise". For now, it's best not to think in terms of "strength training benefits" in the traditional sense.

I would not attempt to follow any structured weight training program. Any attempt at "progressive overload" is likely to cause even more debilitating flare ups. Your "soreness" has nothing to do with normal exercise soreness.

"Managing" means as much emotional management as anything else, because you can have good days and bad days seemingly at random. Social support can be important to helping stay positive.

However, with a cautious, measured approach to activity, I have seen clients progressively improve their tolerance over time. They have setbacks along the way, but they deal with them and continue to move on.

canadianlbs

^^^ basically, everything this guy said ^^^

i have rheumatoid arthritis. that doesn't make my experience a template for your experience because there's such a huge range and i'm pretty lucky with mine. plus, i don't have fibro at all. but with that said, and for what it's worth:

lifting with r.a. for me has been at least as much about colouring within the lines as it's been about trying to push the lines a little bit further apart each time. sometimes i lift with no other goal than 'i want to do this today, and then tomorrow i want to feel fine.' that's the entire 'challenge' and the whole goal. and yeah, for me there's been no short-cut around the fact that what it takes is experience. it's like any other aspect of learning-to-live-with that way.

so the first challenge when i started to lift was not to challenge my muscles at all. it was just to find out what the limits were. that took a while just in its own right, which i personally had a really hard time with emotionally, in spite of being used to having r.a. in all the other aspects of life. it still hit me hard, just for that 'other people don't have to fecking do this' effect. still, it was is-what-it-is, and that's what it was.

i'm also remembering that when i was first diagnosed - loooong before lifting occurred to me - they put me through this awful r.a.-person boot camp that was all about physio-oriented 'exercise' for joint stability. i didn't listen to a word of it at the time because i was still too angry about having the diagnosis in the first place and being told that this kind of *kitten* was going to be my new life and i should be just delighted with that. but if you have access to something like that, then maybe this would be a positive context for seeking it out.

Chieflrg

I don't deal with Fibro so this is more of a one sided advice.

I recommend a strength training program. It has proven to be beneficial for those with RA, particularly the hands/fingers.

Something along the lines of low volume that works slowly towards higher intensity such as Starting Strength has done wonders for those with RA.

The book also gives excellent form advice and a few of their coaches are more than willing helping people that deal with issues such as yours.

I concur on what @canadianlbs has said. Find your limits, don't be frustrated backing off when things are ridiculous.

Feel free to PM me with question of how to work around certain pains and flares from the RA.

CharlieICURN

Azdak wrote: »

You are going to have to find the level you can tolerate and work from there. And, as you have found, you cannot really evaluate the effects of workout until later or the next day. I know it's discouraging.

At first, I would recommend lower reps, fewer exercises, and shorter sessions. You are going to have to focus more on mobilization at first, and less on "progression". That might mean little to no resistance at all--just mild stretching. At the start, it might only mean 5-10 min of "exercise". For now, it's best not to think in terms of "strength training benefits" in the traditional sense.

I would not attempt to follow any structured weight training program. Any attempt at "progressive overload" is likely to cause even more debilitating flare ups. Your "soreness" has nothing to do with normal exercise soreness.

"Managing" means as much emotional management as anything else, because you can have good days and bad days seemingly at random. Social support can be important to helping stay positive.

However, with a cautious, measured approach to activity, I have seen clients progressively improve their tolerance over time. They have setbacks along the way, but they deal with them and continue to move on.

Thank you for these feedback. I've struggled a lot with an "it's not fair!" attitude and sometimes stubbornly insist on trying to do things as if I don't have limitations because I've got the mindset that I'm too young to feel this crappy all of the time. Then I definitely regret it.

I've also had so many people (doctors and trainers) tell me that fibromyalgia isn't even a real condition and it makes me feel even worse about things. One doctor told me that I was using it as an excuse to not work as hard as I should towards weight loss when I think I'm working pretty damn hard at it. My rheumatologist suggested things like yoga but I tried doing some basics/beginners things and was still met with being absolutely miserable for about 6 days after. Funny thing is, my actually JOINTS feel good with strength training- it definitely helps my RA. But the fibro is just obnoxious at this point. I'm currently taking cymbalta for it because gabapentin didn't really help and my insurance won't cover lyrica. The cymbalta helps a little bit but definitely not as much as I'd like, which is why I'm really trying to take things into my own hands and work on feeling better with getting healthier.
Blah it's frustrating for sure.

The frustration level is huge, especially because I can't really assess my tolerance while actually doing the excercises.

WendyLeigh1119

Have you tried things that are still very strength based, but less shocking and painful to the muscles like Pilates or PiYo? Are you including training that improves flexibility and mobility? Because more balance, stability, and especially flexibility should at least reduce the aftermath of your strength training. And things like Pilates already cover all of those bases while still being surprisingly challenging.

WendyLeigh1119

I see now the bit about Yoga. I'd still say give Pilates a shot and for awhile. It's very different from Yoga. I take Gabapentin as well for the nerve pain associated with my back injury. But it definitely isn't meant to help with muscle pain because it's an anti-seizure drug that "happens" to help the nerves, too.

Cymbalta never helped my pain at all, but it's worked for others...hopefully you'll be one of them. Give the Cymbalta a little time. I think it's often said to take up to 6 months to begin working.If you try it and your doctor submits evidence that it doesn't and cannot help you, you may be able to get pre-authorization for a drug normally not covered (like Lyrica). Unfortunately, that also means actually trying and exhausting all of the other drugs on their list first. Ugh...so frustrating.

I had to do this with insomnia medications. My doctor finally submitted paperwork saying I'd literally tried EVERY medication they cover and Belsomra is the only step he recommends. So they cover it now, but I have to go through the pre-auth process every 6 months to continue on it due to it's $385.00 per month price tag. Keep pushing, stay tough.

markswife1992

i have psoriatic arthritis and i experienced the same as you describe. the days after i lifted were excruciatingly painful for me. i take aspirin to help and also get into a steam sauna, that seems to really draw-out the pain, along with drinking a ton of water. i just started a cross fit that is kicking my butt, however it isn't causing me as much pain as weight lifting. i am still doing both, but i do very light weights with high reps two times a week and the cross fit every day. i used to be a heavy lifter, so doing 10 lbs on dumbells makes me feel like a weakling, BUT at least i am at the gym and i'm not dying the next day like i was when lifting heavier.

markswife1992

PS also try swimming if you have access to a pool. it is so much easier on your joints because it isn't weight-bearing. HOWEVER - weight bearing exercises are a must if you are over 40+ - you just might have to go more slowly on increasing how much you can lift.