Posted by MERM on 6/21/2008, 11:58 am
Becoming physically fit is essential to maximizing your successful management of fibromyalgia (FM). You probably already realize this but, like many, do not know how to achieve fitness.
Remember to start slow if you have let yourself seize up and become out of shape! Do not expect miracles and stay on a healthy diet and begin to increase your daily activity slowly but surely not letting up. This is the only way to approach it if you have allowed yourself to slide back and your muscles to become untoned and your body stiff and not supple. YOU CAN DO THIS
Chances are you have had well-meaning health care providers tell you to just go out and exercise.
Often this has left you feeling much worse. While exercise is critical for FM patients, it must be done correctly. For most of you, this means modification of your old exercise habits. Oregon Health Sciences University has found that those patients who exercise on a regular basis have been able to decrease their pain and increase their endurance.
A proper fitness program must include a comprehensive stretching program and an endurance (aerobic) program. Before starting with these, you need a few facts.
The first thing is to become aware of how you are using your muscles. When you use a muscle, it contracts. Contracting and shortening a muscle will usually be well tolerated, but contracting and lengthening a muscle at the same time, called eccentric contraction, will increase your chances of muscle soreness. This soreness does not occur right away but rather is soreness that you will feel one to five days after the activity. Consequently, you must become aware of eccentric work and learn to minimize it. Examples of eccentric work include:
Doing overhead motions such as drying your hair, putting things into cupboards;
Vacuuming, mopping, making beds;
Gardening with flower or vegetable beds far in front of you;
Putting dishes into a dishwasher; and
Walking down steps or down hill.
If these types of activities cause you to feel increased pain or have a flare of your FM, then eccentric work is a problem for you. While you cannot totally eliminate this type of work, you need to become aware of the activities you perform that are eccentric in nature and limit the number of minutes you continue them. The 20-minute rule should apply here: Change the type of activity, or at least stretch those working muscles, after 20 minutes of any activity.
I cannot overemphasize the importance of following a regular stretching program. This will help to improve your ability to move your muscles (such as looking over your shoulder) and will help to decrease your pain. Stretching must be done daily - or even more than once a day. It is important that you do not stretch too far as this will cause a reflex contraction and increase your pain. Your eventual goal will be able to hold a stretch for one full minute; however, do not start at one minute if stretching is new to you. It is better to start at 10 or 15 seconds. Keep working up to the full minute, as you will get more benefit.
After you are doing an exercise program, start to increase your daily activity. Your goal here is to build up to 30 minutes a day. This can be done in three 10-minute sessions, two 15-minute sessions, or one 30-minute session. Walking is a good way to do this, although there are several activities you can do. It is best to choose one or several that you really like. The important thing is to start low and build up gradually; this will help prevent a flare caused by activity that is too intense for your current level of fitness.
You will increase your chances of becoming physically fit if you start to keep a record of your activity. Once each week, write your exercise goals for the week. Each time you increase your activity (such as walking up one flight of stairs instead of taking the elevator), note it on your activity chart. Your activity should be a level that gives you a slight sense of exertion.
Also very important is to avoid the pitfall of trying to make up for lost time on days you feel good.
Tips for Staying Active
Set your sights on starting small and make incremental increases each week.
Note the time that you are most likely to feel your best and increase your activity during this time. If 2:00 p.m. is a good time for you, walk 10-15 minutes each day at 2:00 p.m.
Discuss your program with family and friends and enlist their support.
Keep track of each day that you exercise and note how many minutes you have increased your activity.
Exercise
Beginning a new exercise program may be difficult initially. New routines must be established and new priorities set. After a few days of regular exercise you will begin to notice some positive changes:
More confidence and independence
Sense of well being and vigor
May find it easier to maintain or reduce weight
Decreasing stiffness, soreness or discomfort
May note a decrease in your resting heart rate
Aerobic Conditioning
The type of exercise should be a low-impact aerobic program, such as walking, bicycling, water aerobics, or swimming. These minimize the risk for undue joint trauma.
Cross training can enhance participation by reducing the monotony of an exercise program. Therapeutic pools heated to 86 degrees Fahrenheit or higher are helpful in promoting relaxation and ease of movement.
These are four factors to be considered in an aerobics program:
Frequency: Generally recommended to be three to four times per week on non-consecutive days. When first beginning a program, you may need to exercise more frequently (5-7 days/week) at a lower intensity to build up strength and endurance. As the duration of each exercise session increases, the frequency can be decreased.
Duration: Twenty minutes at the training heart rate zone to receive maximum cardiovascular benefit. (Can range from 15-60 minutes; 20-30 minutes for most people).
Intensity: Determined best by monitoring heart rate during exercise. It is monitored by the "Target Heart Rate" (THR). Recommended to be between 60-75% of maximum Target Heart Rate.
Mode: Type of exercise. The ideal exercise for you is one that you will enjoy and that is convenient. The exercise should be low impact, continuous and rhythmical in nature.
To determine “Target Heart Rate”, use one of the following formulas. The first formula is better suited for those who are not regular exercisers and/or are over 35 years of age. It offers a more conservative THR zone. The second formula is best suited for those who are under age 35 and are regular exercisers. It takes into account the current level of fitness, which involves one’s heart rate.
Regular Method - Target Heart Rate:
220 - age = Maximum Heart Rate = ____________ ( = beats per minute )
Multiply by percentage required x .60 = ____________
x .70 = ____________
x .80 = ____________
Divide by 6 to obtain a 10 second count:
Target Heart Range:
60% = ____________/6 = ____________ in 10 seconds
70% = ____________/6 = ____________ in 10 seconds
80% = ____________/6 = ____________ in 10 seconds
Karvonen Method - Target Heart Rate:
220 - age = Maximum Heart Rate = ____________
Subtract resting heart rate - ____________
(After sitting quietly for 10 minutes) = ____________
Multiply by percentage required x .60 = ____________
x .70 = ____________
x .80 = ____________
Add resting heart rate 60% ____________ + ____________ = ____________
60% ____________ + ____________ = ____________
60% ____________ + ____________ = ____________
Divide by 6 to obtain a 10 second count
Target Heart Range: 60% = ____________/6 = ____________ in 10 seconds
60% = ____________/6 = ____________ in 10 seconds
60% = ____________/6 = ____________ in 10 seconds
How to Take Your Pulse
The best way to take your pulse is to find it on the radial artery at your wrist. Place your index and middle fingers side by side on your wrist, just below the base of the thumb and press very lightly. Another place is to press lightly on your neck, just to the right of your Adam's Apple. (Do not use your thumb to check your pulse. It has a strong pulse of its own and may confuse you).
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