Should You Exercise If You Have Fibromyalgia Or Chronic Fatigue Syndrome?

Do weight training and other forms of exercise make fibromyalgia worse? Or, could it actually improve both pain and fatigue levels?

Research shows people suffering from fibromyalgia/chronic fatigue syndrome who follow a supervised exercise program actually experience improvements in many areas of their health.

The information from a number of studies looking at the effects of exercise on patients suffering from fibromyalgia and chronic fatigue were put together in 2013. Two types of exercise were examined:

• Resistance training
• Aquatic training

The effects of resistance training exercise on fibromyalgia and chronic fatigue syndrome

Resistance training is lifting weights or using machines, elastic bands or even the body’s own weight to provide resistance to movement. It makes the muscles work harder to move, which over time makes them stronger. However, the harder and more regularly the muscles work, it is more likely that they will be tired and sore – something people with fibromyalgia already suffer from and tend to avoid.

For those with chronic fatigue syndrome (CFS) even the thought of exercise or exertion can be exhausting. But much like fibromyalgia, there is a paradoxical effect at play. Proper exercise can actually help to increase your energy levels.

Resistance training is an excellent form of exercise to increase overall muscle strength. Stronger muscles help make everyday activities, like lifting groceries and vacuuming, much easier. (1)

The people who took part in the studies examining the effects of resistance training on fibromyalgia/CFS were supervised by a certified personal trainer. (2) All of the people in the study were women who exercised using resistance training 2-3 times per week for at least four months. Their results were compared with a control group of women who did not exercise using resistance training.

At the end of the study, both groups were asked to rate their progress on a scale of 0 to 100 for well being and physical function and a scale of 0 to 10 for pain.

The group who exercised using resistance training showed noticeable improvements. They rated their:

• Overall well being 17 points higher than the control group;
• Physical function six points higher;
• Pain levels 2.5 points lower.

This group also grew significantly stronger. The women who exercised using resistance training could lift an average of 27kg (almost 60lbs) more than those who did not do resistance training!

This study proves that women with fibromyalgia or chronic fatigue syndrome who exercise by following a resistance training program show noticeable improvements in:

• Their ability to do normal activities;
• Pain levels;
• Tenderness;
• Muscle strength;
• Energy levels;
• Overall well being.

So, while it may not seem to make sense for people with fibromyalgia/CFS to engage in a training program that promotes muscle fatigue and soreness, the research shows that following a resistance training exercise program over several months can actually improve common symptoms associated with fibromyalgia and CFS.

The effects of aquatic exercise on fibromyalgia and chronic fatigue syndrome

Weight training improves the symptoms of those with fibro and/or CFS. But does the same hold true for other forms of exercise? 

A number of studies were done on the effects of aquatic training (exercising in the water) on people suffering from fibromyalgia/CFS, and the results were very similar to the weight training group.

Aquatic training is exercising while standing at least waist deep in a pool. Aquatic exercise is a low impact activity that provides natural resistance while taking pressure off the body’s bones, joints and muscles.

Just like the resistance training studies, the participants with fibromyalgia and chronic fatigue being studied were mainly women. They all took part in a supervised group aquatic training program led by an instructor. (3) Their results were compared with a similar group of patients who did not exercise.

At the end of the study, all participants were asked to rate their progress on a scale of 0 to 100 for well being and physical function and a scale of 0 to 10 for pain.

Those who exercised in the water reported:

• A lowering of pain levels;
• Lower levels of muscle stiffness;
• An almost 40% increase in muscle strength;
• An increase in energy;
• An ability to walk 37m (more than 120 feet) further than those that did not exercise.

Perhaps just as important, there were no serious negative side effects reported in the group that exercised.

What is the best way to exercise if you have fibromyalgia or chronic fatigue syndrome?

A few studies have been done on whether aquatic exercise or exercise done on land, like resistance training, shows better results. While those who exercise on land showed a slight edge in increased muscle strength, results in areas such as overall well being, stiffness, and pain were fairly similar.

The results of these studies show us that rather than avoiding exercise and the muscle pain that may go with it, patients with fibromyalgia/CFS should instead embrace it. Whether it is resistance training, aquatic training or other moderate forms of working out, when it comes to fibromyalgia and chronic fatigue, any exercise is better than none.

Remember that there is a law of diminishing returns. Those with fibromyalgia and/or CFS should have a highly structured and supervised exercise routine. Too much exercise can create an exacerbation in both fatigue and pain levels.

What about muscle soreness and fatigue?

However, exercising doesn’t mean the soreness and fatigue that are the key symptoms of fibromyalgia/CFS go away. Improving your fitness will reduce pain levels and muscle stiffness, but they will still exist.

Fortunately, people who have fibromyalgia receive the same benefits from massage as those who do not. Providing you find a massage therapist trained in caring for patients with fibromyalgia, muscle soreness can be treated with massage therapy.

But what about energy levels?

How to avoid fatigue when starting an exercise routine

Many people suffering from fibromyalgia also have chronic fatigue syndrome. Chronic fatigue syndrome or CFS is a debilitating illness characterized by low energy levels. For those suffering from both fibromyalgia and chronic fatigue syndrome, exercise is still a good idea as long as it’s done carefully and properly.

If you have chronic fatigue syndrome and fibromyalgia, you must approach new exercise routines cautiously. Too much exercise can cause an increase in fatigue levels which then makes it less likely that you will stick to the new exercise routine. Remember, to get results from any exercise program consistency is key.

To best avoid increasing fatigue levels, I recommend paying close attention to two variables:

1. The intensity of exercise – how difficult the exercise is
2. Recovery time – how long it takes your body to recover after exercise

Exercise intensity for chronic fatigue and fibromyalgia

For those with chronic fatigue and fibromyalgia, I recommend moderate intensity exercise like:

• Resistance training;
• Aquatic training;
• Walking quickly (but not racing);
• Gardening.

Avoid vigorous exercises such as:

• Running, jogging, or sprinting;
• CrossFit;
• Skipping;
• High-intensity interval training (HIIT).

A simple way to figure out whether the exercise is too intense is called the ‘talk test’. While doing an exercise of moderate intensity, you should be able to comfortably talk. However, the exercise should not be so easy that you’re able to sing while doing it. If you struggle to maintain a conversation during the exercise, it is too intense.

Another way you can determine the intensity of your exercise program is your heart rate. If you are aiming for an exercise of moderate intensity, your heart rate should fall somewhere between 50-70% of your maximum heart rate.

Your maximum heart rate is calculated as follows:

220 – (your age) = your maximum heart rate

For example, if you are 45 years old, your maximum heart rate is 175. You want your heart rate to fall somewhere within 50% and 70% of 175. That means your maximum heart rate should fall between 88 bpm (beats per minutes) and 123 bpm while doing an exercise of moderate intensity.

Exercise recovery time for chronic fatigue and fibromyalgia

When starting a new exercise program, be mindful of the amount of time it takes you to recover after each session. If you notice that you still feel tired three hours after your workout, your exercise was too intense and you need to scale it back.

Ideally, you should feel energized after your workout. If you feel:

• An increase in pain levels,
• A decrease in energy levels,
• An increased frequency of colds/flus, or
• A decreased appetite,

Try turning down the intensity level. For example, if you are currently exercising five times each week but you are so exhausted by Friday that you can barely function, scale your routine back and try working out only three or four times instead.

You could also try decreasing the intensity of your exercise. Try wearing a heart rate monitor like a Garmin or Fitbit and decreasing your heart rate by 10%. Notice if you start to see an improvement in your symptoms.

If you are new to an exercise program, slowly build up to exercising three days a week. For the first month, I recommend starting with one day a week. Then, build to two days a week for the next month. By your third month, you should comfortably be able to exercise three times a week. This gradual loading of frequency will allow your body time to adapt.

Ok, now you know the best type and amount of exercise for those with fibromyalgia and/or chronic fatigue syndrome.

Now, I want to hear from you.

If you have fibromyalgia or chronic fatigue syndrome have you tried to exercise?

What type of exercise best helped improve your pain and energy levels?

How often do you exercise each week?

You can read more about fibromyalgia in these blog posts.