7 Tips for Creating Workouts for Clients with Fibromyalgia

Around 20.4% of U.S. adults have chronic pain according to the Centers for Disease Control and Prevention (1). What does this mean to you as a personal trainer? Roughly one in five people who hire you is likely dealing with some type of pain long-term. For 8%, their pain may even restrict their physical function. 

Knowing how to create an exercise program for these clients is key. This will help keep them safe and injury-free. It also enables them to continue to improve their physical fitness. 

Here we provide several tips for creating a workout for clients with the chronic pain condition fibromyalgia. But first, let’s talk about what fibromyalgia is. We’ll also briefly share how people with this condition can benefit from regular physical activity. 

What Is Fibromyalgia?

Fibromyalgia is a chronic illness that causes body-wide pain and stiffness. (It is also sometimes called fibromyalgia syndrome. Although, typically, it’s just fibromyalgia.) In fact, the most notable symptom of fibromyalgia is chronic muscle pain. 

At first, the pain may start in a certain area of the body, like in the neck area. As fibromyalgia progresses, it generally evolves into more widespread pain. For some people with this disease, the pain is mild. Others with fibromyalgia experience pain that is severe.

Another common symptom is fatigue. Research has found that it’s common for a person with fibromyalgia to also have chronic fatigue syndrome (2). This can leave them feeling tired most of the time. It may even present more issues for the person than the actual pain. 

More fibromyalgia symptoms include:

• Poor sleep

• Trouble thinking

• Memory issues

• Anxiety

• Depression

• Headaches

• Gastrointestinal issues

Benefits of Exercise for Fibromyalgia

Regular exercise offers many health benefits, in general. But it also provides quite a few specifically for fibromyalgia sufferers. 

According to a review of 13 studies, aerobic exercise can help improve health-related quality of life for people with fibromyalgia (3). There’s also slight evidence that it may:

• reduce pain intensity

• improve the ability of the person to function physically

• decrease fatigue and muscle stiffness 

Together, this would make it easier to perform daily activity tasks. This includes actions such as taking care of your kids or looking after the house or yard. It would make sticking to an exercise routine easier as well.

Another piece of research indicates that physical activity is the most strongly recommended non-drug fibromyalgia treatment (4). It notes that several studies have connected aerobic exercise with pain relief. Additionally, resistance training is often prescribed to improve function through improving muscle strength. And flexibility exercise helps by easing muscle tension. This, in turn, can increase range of motion.

A 2019 article reports that engaging in water exercise is good for fibromyalgia pain management (5). It adds that this type of exercise is one of the most known and recommended interventions by doctors. 

According to the Arthritis Foundation, fibromyalgia patients are 20% more likely to have mental health issues such as depression and anxiety (6). Exercise helps with these too, also aiding in better sleep. Some studies have even linked working out with improved memory (7). So, engaging in regular exercise can have a positive effect on numerous fibromyalgia symptoms.

7 Tips for Creating Workouts for Those with Fibromyalgia

Since fibromyalgia involves chronic pain and fatigue, this can make exercise a challenge. When creating workouts for those with fibromyalgia, these seven tips can help:

1. Start slow. 

Like with anyone starting a regular exercise routine, it’s important to begin slowly. This is especially true for clients with fibromyalgia. Taking the time to start slow allows your client to avoid injury and flare-ups. (It’s also helpful for clients to not start a new exercise plan during a flare-up. This will help reduce the risk of making the pain worse.)

2. Don’t skip the warm-up. 

Always start each workout with a warm-up. This warm-up should be designed to mobilize tight muscles and activate weak muscles. It should also slowly increase body temperature. This helps clients be better prepared for their workout.

3. Allow more time to progress with strength training. 

Start at a lower resistance level when strength training. Also, use proper progressions to increase intensity over time. Fibromyalgia clients may not progress as quickly as other clients. So, it’s important to allow time to increase weight, reps, and sets. A good starting point is one exercise per muscle group and one set of each exercise with a light weight.

4. Stick with low-impact aerobic exercise. 

Ease into any cardio training and stick to low-impact activities. These include walking and bicycling. Water exercise is another option that is low in impact. 

5. Give more rest time during the exercise session. 

Fatigue is one of the most common fibromyalgia symptoms. As a result, clients may need longer rest periods between exercises and sets. Structure these into the workout plan.

6. Give more recovery time between workouts. 

Clients with fibromyalgia also need longer recovery between exercise sessions. When devising their physical activity plan, start with 2-3 workouts per week. Have them take at least one to two days off in between. This allows ample time for recovery. And it is especially important on days where exercise may be more intense.

7. Consider shortening the exercise session. 

Depending on the client’s fibromyalgia symptoms, workout duration may need to be shortened. If their pain is severe, for instance, create shorter sessions. You may want to start with as little as five to ten minutes per workout.

Different people have different pain tolerance levels. People with fibromyalgia can also have varying levels of pain. (The pain can range from mild to severe.) Check in with your clients regularly to make sure the exercise isn’t making them feel worse. 

For instance, the pain with fibromyalgia can sometimes get worse with exercise according to the Arthritis Foundation (8). For many people, this occurs when first starting out. Let clients know this up front. Prepare them by setting realistic expectations. They may not notice the benefits related to pain for around six weeks. 

If the Fibromyalgia Pain Becomes Too Much

Some people still believe the old saying of “no pain, no gain.” So, they may want to push through exercise, even if it increases their pain. Yes, some increase in pain may occur at the beginning. But it’s important for clients to feel comfortable coming to you if it becomes too much. 

Sometimes a simple tweak to the exercise plan will reduce the pain or discomfort. You may have to schedule fewer sessions per week, for instance. Or you might shorten the duration of the sessions. If this doesn’t provide relief, ask them to reach out to their healthcare provider. Some other issue may exist. 

At a minimum, the provider may make other suggestions that can help. For instance, the National Institute of Arthritis and Musculoskeletal and Skin Diseases shares that people living with fibromyalgia may want to (9):

• Learn as much as possible about the condition

• Join a support group for people with fibromyalgia

• Talk to a mental health professional if experiencing emotional issues

• Engage in cognitive behavioral therapy to learn how to control the pain

• Develop a healthy sleep routine

• Reduce their energy expenditure during the day

A Final Word on Chronic Pain

Many health conditions can cause chronic pain. This means that you’re likely to have several clients who are battling pain. One way to help these clients is by becoming a health coach. 

ISSA offers Health Coach Certification. This course teaches you how to help clients with pain-based and other challenges. You also gain the skills needed to motivate these clients to make long-term lifestyle changes. 

References

1. Dahlhamer, J., Lucas, J., Zelaya,, C., Nahin, R., Mackey, S., & DeBar, L. et al. (2018). Prevalence of Chronic Pain and High-Impact Chronic Pain Among Adults — United States, 2016. MMWR. Morbidity And Mortality Weekly Report, 67(36), 1001-1006. https://doi.org/10.15585/mmwr.mm6736a2

2. Abbi, B., & Natelson, B. (2012). Is chronic fatigue syndrome the same illness as fibromyalgia: evaluating the 'single syndrome' hypothesis. QJM, 106(1), 3-9. https://doi.org/10.1093/qjmed/hcs156

3. Bidonde, J., Busch, A., Schachter, C., Overend, T., Kim, S., & Góes, S. et al. (2017). Aerobic exercise training for adults with fibromyalgia. Cochrane Database Of Systematic Reviews, 2017(6). https://doi.org/10.1002/14651858.cd012700

4. Araújo, F., & DeSantana, J. (2019). Physical therapy modalities for treating fibromyalgia. F1000research, 8, 2030. https://doi.org/10.12688/f1000research.17176.1

5. Zamunér, A., Andrade, C., Arca, E., & Avila, M. (2019). <p>Impact of water therapy on pain management in patients with fibromyalgia: current perspectives</p>. Journal Of Pain Research, Volume 12, 1971-2007. https://doi.org/10.2147/jpr.s161494

6. Fibromyalgia. Arthritis.org. Retrieved 31 August 2022, from https://www.arthritis.org/diseases/fibromyalgia.

7. Roig, M., Thomas, R., Mang, C., Snow, N., Ostadan, F., Boyd, L., & Lundbye-Jensen, J. (2016). Time-Dependent Effects of Cardiovascular Exercise on Memory. Exercise And Sport Sciences Reviews, 44(2), 81-88. https://doi.org/10.1249/jes.0000000000000078

8. Can I Exercise With Fibromyalgia and Osteoarthritis?. Arthritis.org. Retrieved 31 August 2022, from https://www.arthritis.org/health-wellness/healthy-living/physical-activity/getting-started/exercise-fibromyalgia-osteoarthritis.

9. Fibromyalgia. National Institute of Arthritis and Musculoskeletal and Skin Diseases. (2021). Retrieved 31 August 2022, from https://www.niams.nih.gov/health-topics/fibromyalgia/diagnosis-treatment-and-steps-to-take.