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Exercise with Fibromyalgia

People with fibromyalgia live with pain symptoms that fluctuate day to day and even within the same day. Pain is detrimental to motivation to exercise and can be a barrier to becoming physically active. Because of this, many people with fibromyalgia do not receive sufficient exercise to maintain their strength, stamina, balance, mobility and thus gradually reduce functional fitness and/or their ability to sustain an active and/or independent lifestyle.

A careful and progressive designed exercise program can help to decrease chronic pain over time and allow more ease in performing normal daily activities. Begin excerise when pain levels are stable.  By strengthening muscles around sore joints there is less stress on the joint. Stronger muscles are less prone to micro trauma, meaning less daily pain. Cardiovascular endurance or aerobic exercises such as walking, swimming and recumbent cycling will help in weight loss and this also reduces stress on joints especially the weight bearing joints such as the knees and hip, cardiovascular exercise also benefits the heart, the vascular system and lungs.

Exercise Smart:

Start low and progress slow. You may just begin with more postural awareness, breathing techniques and progressive muscle relaxation before beginning with flexibility and resistance training. Older adults with Fibromyalgia should also include balance and mobility exercises targeting their specific impairment as part of their overall exercise program.

Shorter training sessions are appropriate, exercise should be somewhat challenging and do what you can tolerate. It is appropriate to start with shorter training sessions or include shorter virtual training combined with in person training. Establish good core strength before progressing. Certain exercises especially in the beginning such as balance and mobility, resistance training and flexibility may need to be performed under close supervision for safety and correct execution..

The first days or weeks of a new activity program your Fibromyalgia symptoms (pain, tiredness, stiffness) may increase until your body gets used to exercise. Be determined and go slow! Over time you can increase your active time and then increase your pace.

Progressing one step at a time with careful recording of exercise selection, resistance used, number of repetitions, alternating or not alternating left and right side, pain level before and after and the day after the exercise sessions determine how to progress. Keep track of symptoms that are getting in the way of exercise.

A Fibromyalgia exercise training program should be performed on a regular basis (minimum twice a week, optimally three times per week) with one or maybe two days of rest in between). An exercise program that is not performed on a consistent and regular ongoing basis provides limited results because it is like starting over each time when too much time has passed for physiological changes in the body to happen and you may continue to experience too much pain.

Exercise under guidance of a certified and qualified exercise professional such as ACSM Exercise Physiologist, ACE Medical Exercise Specialist, personl trainer with experience working with people with Fibromyalgia.. A Physical Therapist can also get you started in the right direction.

Exercise avoidance leads to deconditioning, less movement, muscle weakness, increasing pain, frailty (even when obese), falls, increasing body-fat and weight gain, increasing loss of function and decreased quality of life.

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

  • The 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

  • Safe and effective exercise

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

Fibromyalgia exercise recommendations

The American College of Sport Medicine (ACSM) and Exercise is Medicine recommends the following for people with Fibromyalgia:

Aerobic exercise: aerobic or cardiovascular exercise such and as light cycling, walking, water exercise

Frequency: 2-3 days/week

Intensity: Begin very light.,.Build to fairly light to somewhat hard.

Time: Start with 5-10 minutes. Gradually build up to 30-60 total minutes over the day.

Resistance training- muscle strengthening exercise utilizing hand weights,

resistance bands, weight machines, calisthenics or your own body

Frequency: 2-3 days/week *Rest day in between

Intensity: Start fairly light to somewhat hard. Build up to somewhat hard to hard. Muscle endurance: Very light to fairly light.

Time: Start with 4-5 repetitions. Build up to 8-12 repetitions (for each major muscle group). Gradually build up to 2-4 sets. Muscle endurance: 15-20 repetitions. Build up to 2 sets.

Flexibility: Stretch a muscle to the point of feeling tightness for 10-30 seconds. In addition, move your joints through a pain free range as much as you can.

Balance exercise: when you are beginning to experience balance problems, experience a change in your balance or have a fall history(with or withourt in jury) then balance exercises are recommended as part of your overall exercise program.


(Jones KD, Clark SR, Bennett RM. Prescribing exercise for people with fibromyalgia. AACN Clinical Issues; May 2002.

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