I met my first client with fibromyalgia a couple of years ago. With persistence and continuity, this client is in a far better place now and puts her improvement down to her Pilates sessions.
Doctors once thought that exercise might worsen the condition or accelerate fibromyalgia, so encouraged patients to seek rest, not any form of activity. However recent scientific studies have shown that, for most patients, range of motion, strengthening, and body conditioning exercises are safe and necessary.
As many of you may know, Fibromyalgia Syndrome (FMS) is an increasingly recognised chronic pain illness characterised by widespread musculoskeletal aches, pain and stiffness, soft tissue tenderness, general fatigue and restless sleep. The cause is unknown however it affects millions of people.
MFS is difficult to diagnose but some common symptoms include:
- Sleep disturbances
- Morning stiffness
- Headaches
- Irritable bowel syndrome
- Painful menstrual periods for women
- Numbness or tingling of the extremities
- Restless legs syndrome
- Temperature sensitivity
- Cognitive and memory problems (sometimes referred to as ‘fibro fog’)
We must remember and remind our clients, that exercise is important to maintain and improve function and assist in managing pain. Of course considerations must be taken when working with this type of population include compliance of the client, any special conditions and/or medications the client is taking.
Some individuals suffering from Fibromyalgia tend to think that exercises will make their pain worse however low impact exercise performed correctly can be done without increasing pain. This population may gain strength and flexibility of time but not necessarily experience a change in their symptoms. They may experience improvement in their overall sense of well-being as well as improvements in posture, which will improve their ability to manage aspects of this syndrome.
We know that Pilates can be a very effective form of body conditioning for a client with Fibromyalgia. Pilates focuses not only on core strength and stability, but the use of breathing and breath work.
A strong tendency for those suffering from Fibromyalgia is to “disconnect” from their body. Pilates’ emphasis on the connection of the mind to the body, can be a huge benefit. Hypermobility has been reported to be an additional factor affecting clients with Fibromyalgia. There is a greater tendency for the muscles to rotate, causing imbalances and trigger points.
CONSIDERATIONS:
Key areas of focus for this type of program design are primarily endurance, posture and managing fatigue. One strategy for optimising the exercise program is for the client is timing their sessions earlier in the day. By starting the day with a breathing-focused routine, the onset of fatigue can in some cases be delayed.
Another very important consideration is to keep repetitions to a minimum. The issue of muscle endurance is paramount for success. The muscles must be comfortable during all phases of any exercise, during contraction and relaxation. It is important not to strain the body by having the client move too slowly. It is recommended that only an experienced and well trained Pilates instructor work with clients with Fibromyalgia as this disorder is multifaceted.
Clients with FMS will improve best with personalised programs. The focus should be on gentle stretching exercises, deep core and scapular stabilization and of course breathing. Generally, mat work may be too challenging to begin with for clients with Fibromyalgia. It may result in excessive stress to the muscles and joints resulting in a poor movement. Appropriate modifications of mat exercises can be incorporated into a home program that the client can perform safely in the comfort of their own home.
The most important thing the Instructor and the client need to take into account is any improvement will be slow. It’s important that both remain focused and have patience. Improvement takes time and a big commitment from both instructor and client. The important message to get across to clients, should they express frustration, is to reinforce to them that even if their pain level is staying somewhat the same, they are getting stronger.
If they are getting stronger then that’s progress.
Olga Tamara
PAA Vice President / Special Projects Officer
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