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Fibromyalgia and Exercise: up close and personal

Updated: Aug 5, 2020

Advances in research within the last 10 to 12 years have provided information about the specific ways fibromyalgia patients need to move and exercise to minimize loss of function and enhance quality of life.

Typical fitness workouts that provide only a small amount of post-exercise soreness in healthy beginners can in fact produce delayed onset of muscle soreness in fibromyalgia patients that is so severe and leads to an ongoing cycle of exertion, flare, recovery, exertion and flare. This will be frustrating people with FM in their best efforts and attempts to get stronger, more functional and fit. Modification of your previous or old exercise habits are a must to achieve success.

Exercise avoidance leads to deconditioning, less movement, a decrease in fitness and functional ability, muscle weakness, pain, falls, body- fat weight gain and more dis-function and affection quality of life.

Longterm gains

Breaking this cycle is possible when the focus of the exercise program is on the long-term gains. When fibromyalgia-specific-modifications are in place, gradual improvements in function and fitness is possible.

A carefully constructed fibromyalgia physical activity and exercise program can:

  • Release tight muscles and produce increased mobility, better posture, and less pain near joints

  • Reduce overall fatigue and improved sleep

  • In some individuals exercise may help control pain

  • Research shows that strengthening muscles, including muscles that hurt causes no structural damage

  • Secret to improvement is consistency over time.

  • Avoid inconsistent and over-intense training. Starting and stopping an exercise program because of too much pain is frustrating. Starting slow, with very gradual progression and being consistent in exercises frequency provides the benefits you are looking for.

  • Focus on 'health' training and not sports training.

  • Gentle stretching should become part of your daily routine

  • Using correct exercise technique and appropriate posture are important

  • Exercise program should include a variety of activities and exercise to reduce repetitive movement

  • Cold and heat can trigger a flare-up

  • Dress in layers

  • Stay hydrated, drink water through your day and during your workout

  • When you are new to exercise; at the end of your workout session you should feel you could have done more

A fibromyalgia specific physical activity and exercise program should include the following:

  • Breathing, posture, flexibility and relaxation

  • Balance and muscle strengthening exercise

  • Low impact cardiovascular endurance (walking, bicycling, water aerobics or swimming)

  • Pay attention to your inner feeling of exertion (not leg discomfort or labored breathing), use RPE- rating if perceived exercise to monitor your level of exercise intensity

Safe Effective and Beneficial

When you have additional medical conditions, your exercise program needs to be adapted to benefit these conditions as well. Your exercise program should be safe, effective and beneficial to all medical conditions such as joint replacements, balance problems and falls, diabetes, high blood pressure, heart disease, osteoporosis, being overweight and/or obese.


(1) Jones KD, Burckhardt CS, et al. Growth hormone response to acute exercise normalizes with long-term pyridostigmine but does not change IGF-1. Journal of Rheumatology. In Press 2007.

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(3) Jones KD, Burckhardt CS, Bennett R. Motivational interviewing may encourage exercise in persons with fibromyalgia by enhancing self-efficacy. Arthritis & Rheumatism. Oct 2004

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(10) Jones KD, Horak FB, Winters K, Bennett RM. Fibromyalgia Impairs Balance Compared to Age and Gender Matched Controls. Arthritis & Rheumatism. 2005.

(11) Pierrynowski MR, Tiidus PM, Galea V. Women with fibromyalgia walk with an altered muscle synergy. Gait & Posture. Nov 2005.

(12) Treatment Overview. Last visited 5/14/2007.

(13) Bennett RM. The contribution of muscle to the generation of fibromyalgia symptomatology. Journal of Musculoskeletal Pain. 1996.

(14) Clark SR, Jones KD, Burckhardt CS, Bennett R. Exercise for patients with fibromyalgia: risks versus benefits. Current Rheumatology Reports. Apr 2001.

15). www.myalgia .com


17) Fitness with Fibromyalgia, Monday, April 28, 2003, By: Sharon Clark

18) Give FM a Workout, Wednesday, February 15, 2006, By: Elisabeth Deffner

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