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Exercise for FM

FM patients cannot afford not to exercise as de-conditioned muscles are more prone to microtrauma and inactivity begets dysfunctional behavioral problems. However, musculoskeletal pain and severe fatigue are powerful conditioners for inactivity. All FM patients need to have a home program with muscle stretching and gentle strengthening, and aerobic conditioning.

There are several points that need to be stressed about exercise in FM patients:

(1) Exercise is health training, not sport's training;

(2) Exercise should be non-impact loading;

(3) Aerobic exercise should be done for 30 minutes each day. This may be broken down into three 10-minute periods or other combinations, such as two 15 minute periods, to give a cumulative total of 30 minutes. This should be the aim—it may take 6-12 months to achieve this level.

(4) Strength training should emphasize on concentric work and avoid eccentric muscle contractions.

(5) Regular exercise needs to become part of the usual lifestyle; it is not merely a 3-6 month program to restore you to health.

Suitable aerobic exercise includes: regular walking, the use of a stationery exercycle or Nordic track (initially not using the arm component). Patients who are very de-conditioned or incapacitated should be started with water therapy using a buoyancy belt (Aqua-jogger). [We highly recommend ongoing pool exercise programs for both FM and ME/CFS patients to reduce pain and to safely increase conditioning.—Ed]