Strength Training & Fibromyalgia: Why It’s Hard and Why You Have To Do It
We can all agree that fibromyalgia sucks. One day you’re able to do whatever you want, living life and taking it for granted--the next you’re dealing with pain, nonstop flares, and not able to be the person you want to be anymore.
Maybe your experience was different, but that was mine, and let me tell you--it sucked. I was diagnosed with fibro in 2020 and had a hell of a time the handful of years before that. I would be bedridden for months at a time, had no immune system, and would usually spend a cumulative 3-4 months each year so sick I could barely do anything. I used to be in so much pain in the morning that I would crawl for the first half hour of the day until I could stand up.
A doctor told me to "adjust to a new normal," which I decided was stupid and I wasn't going to do it. So I figured out how to manage my condition on my own after a lot of trial and many errors. Currently I can squat and deadlift far more than I weigh, do chin-ups, dance multiple times a week, and when I do flare (once in the last year) it doesn’t last long and I know how to manage it.
Top of the list to get there? Strength training.
But First, an Overview of Pain
Generally, with fibromyalgia (or other autoimmune diseases that increase your perception of pain), people will tell you that doing less is the answer. While rest and drastically altering your activity output is definitely the answer during a flare, that is a short term solution for a long term problem.
Pain becomes a vicious cycle. If you have pain and stop moving completely, that decreases your circulation, meaning that the fluid in your joints that needs to be moved around won’t be moving. This increases your sensation of pain and stiffness, making you reduce your movement even more--which increases your pain even more! And so the cycle repeats. You can’t do the things you love, and you feel disconnected from your body because it always hurts. Every day you struggle trying not to make it worse. You feel overwhelmed and ashamed of not being able to fix it on your own, and scared of what it means for your future. You want to live your life without pain or restrictions, but instead you’re feeling hopeless and afraid you’ll never get better.
This sucks, obviously. We don’t want to do this. What we DO want to do is scaled, progressive exercise that allows you to exercise without severe flares.
Exercising as a person with chronic pain means you have think about things differently than someone who doesn’t. You have different priorities--exercising without flaring, not making your pain worse--that the general population doesn’t need to consider. I know how it feels to be at the end of your rope, feeling desperate and frustrated and alone and like it'll never get better.
Reframing how you approach exercise is a good place to start. Focus on honoring where you are, instead of pushing yourself past your limits--"no pain no gain" doesn't get a seat at the table here.
Why Strength Training Helps:
Strength training increases your body’s ability to do things--meaning, the gym will be the hardest thing you do in your week. Being stronger means you aren’t running at 10/10ths all day just to get through laundry and dishes and making yourself breakfast. It leaves you more in the tank so you can use your energy on things you actually care about. That equals fewer flares, less pain, and better quality of life.
How to Strength Train With Chronic Pain
You’re probably familiar with this story: you finally have a good day after a long painful string of days, so you pour yourself into catching up on life. Then you flare again and can’t move for three days.
To avoid this, we’re going to move away from the all-or-nothing, boom-or-bust cycle that chronic pain sticks us in. Instead, here’s the blueprint:
1) Small, consistent actions over time.
Focus on sustainability more than intensity. If you can only do 5 minutes, great. Do 5 min. Add a few minutes more as you can, and scale back on bad days. You don’t need to be in the gym every day of the week to improve--in fact, less is more. 1-2x a week for 30 min is plenty for a beginner. Your priority in the beginning is to not flare and learn not only good form, but also which exercises can be done without flaring.
2) Prioritizing compound movements during workouts, and don’t do a lot of volume.
Compound movements are big, multijoint movements like squats, deadlifts, rows, push-ups, and glute bridges. This gives you more bang for your buck in less time, and builds more overall strength. Your goal is to be the smartest worker in the room, not the hardest. Very often my workouts are between 3-4 compound movements, and then I’m done.
3) Focus on the cumulative total of the week, not the day.
Most people overestimate what they can do in a day and underestimate what they can do in a week. For example, let’s say Monday sucks and you missed your workout. So what? If you’re exercising 1-2 times this week, move it to a different day. Focus on rest when you need rest. You’ll come back stronger each time.
4) Start learning the difference between hurt and harm.
Part of what makes fibro so difficult is that it makes us afraid of moving. We tense up. We steel ourselves for an attack. We’re so focused on self-protection that our nervous system (brain) is hyperaware of every single pain signal that’s coming our way.
The beginning stages of a comprehensive program will scale exercise so you start finding out what it feels like to move and not hurt. Once you get there, adding in slightly higher effort will help you learn how you can experience some positive discomfort while not having a harmful outcome. There’s a difference between bad pain and good pain, and a good exercise program will allow you to learn the difference and progress at your own pace.
5) End your session when you have something left in the tank.
When weightlifting with chronic pain, you aren’t aiming to push your edges--especially not at the beginning. Your goal is to get within a shouting distance of your edge and observe it carefully, but stay really far away from it. Eventually, as your exercise tolerance increases, you can push more. But don’t do this too quickly or you may set yourself back.
This is a lot to absorb, so if you’re overwhelmed right now it’s okay. It takes a lot of trial and error to find what works for you, and the exact methods used will be different from person to person. But the basics: treating your boundaries with respect, doing less when you have less to give, and adding load progressively over time, as it feels safe, stay true regardless of your starting level.
Some people don’t have the time or energy to learn, implement, and do the trial-and-error that this process involves. If you’re currently feeling really hopeless at the thought of having to do ANOTHER goddamn thing on top of everything else you need to do, it may be helpful to hire a coach who has the knowledge you need to help you get your life back. A good coach will find what helps you, start slow, and help you progress at a pace you’re comfortable with.
If this sounds helpful, I offer complete and customized programs designed to get people with chronic pain exercising safely. More information here.
