“Lack of activity destroys the good condition of every human being, while movement and methodical physical exercise save it and preserve it”, Plato
The search continues for the ultimate regime that strengthens and improves our overall health. From the ‘pump iron’ mantra… to the videos about Pilates… to the parks filled with the Tai Chi practitioners… to the joggers on our sidewalks…to the yoga clubs whose numbers continue to swell, we are left in a state of frustration and confusion, particularly if we can sometimes barely walk! What is to be done?
Keeping up with our mobility seems to be consistent advice given to those of us with chronic pain. Don’t give in to the desire to lie low, we are admonished. The less you move the less you will be able to do so on a daily basis, the experts tell us. We understand that, but if movement brings about more pain and fatigue, how do we work through it all? More importantly, how do we decide which activity to embark upon with so many offering what each considers to be the best program? From Nick’s website www.121wellness.ca, I have lifted information about choosing the right tool and I unashamedly pilfer some of his research and experience about various activities and exercise options after searching the internet myself for answers to these perplexing questions. But, ultimately the choice will be yours, I am not a physician and I cannot recommend any of the following for you; after consulting with a health professional which will you choose?
You will notice that I frequently leave you with a question. This is because there are more questions than answers to this array of choices and I too have tried to work through some of these dilemmas as I struggle with pain, both chronic and acute.
Yoga. For several years, at least a decade ago, I consistently went to Iyengar yoga classes. I chose this particular type of class because it was a supportive practice, that is, there were props that were very helpful with the challenges I faced, such as cushions, belts, pillows and bolsters to name a few. I was very lucky to have had access to a wonderful instructor, David who was very inventive with the various accessories he developed. Mostly what he encouraged me to do were poses intended to relax the nervous sytem, none that were harmful to my stiff muscles. I enjoyed the relaxation aspect that helped me during stressful days when I had a full time job. Furthermore, the gentle stretches helped with mobility.
Nick writes that yoga does not really build strength and that while it increases the probability of injury, it also increases flexibility. The down side of this then is that increasing flexibility without increasing muscle strength will result in injury and unstable joints. My yoga days are over and have been for quite some time. The pain became too intense and I was not progressing towards strengthening. However, I remember fondly the relaxed state I would be in at the end of the class, lying quietly on the mat and breathing slowly while relaxing. Yoga is somewhat helpful for the cardiovascualr system (CVS) as attention is paid to breathing, meditation, mobility and relaxation. However, yoga does not build muscle strength or mass. It is quite good for hypertension, the research has shown. There is a cost factor if done in a studio and it may also be inaccessible for many.
Tai Chi/Qi Gong
Neither of these activities improve muscle strength or muscle mass. However, both are helpful as ways to increase mobility . While I have not taken any Tai Chi I did attend a series of Qi Gong classes (CFQ) qualifying me at Level One and for awhile I played the tape, doing Qi Gong on a daily basis. I was not doing this for any of the quasi-healing/spiritual aspects of the practice (which, for me, has a somewhat uncomfortable ‘guru’ ring to it because of its association with ‘Master’ Yap) but for the actual movements that encouraged mobility. I am not an “energy systems” advocate as many are of the CFQ Qi Gong ilk. For me it was relaxing and meditative and although not intended for muscle strengthening or as a means of improving the CVS, I have decided to bring forth the old tape once more as I continue on the slow burn training journey. Together these kinds of approaches should be unbeatable as a movement therapy and a strengthening regime. It may even help cut down on pain medication! The mantra “motion is lotion” applies to Tai Chi and Qi Gong (and Feldenkrais). Buying a Tai Chi or Qi Gong video is not too expensive and can be done at home…this certainly is a plus. Moving slowly in the Qi Gong postures is an excellent way to help mobility and relax the nervous system. It is particularly helpful when done in a setting with others as there is usually a general feeling that relaxation is happening in the room and attention is being paid by instructors to the persons learning the moves. While much of this may be due to the ‘halo’ effect, that is, while being with an instructor we want to do well just because we are being observed and will also do it on our own at home because of the attention we are receiving, nonetheless any kind of gentle movement is beneficial anyway. It won’t ‘cure’ fibromyalgia but like most slow movements of any sort, Tai Chi, Feldenkrais or Qi Gong, the empahsis should be on increasing mobility and tranquilizing the nervous system. Something we all need!
This activity is considered by many to be the bright and shining star of the modern day era for physical fitness. Developed during World War l by Joseph Pilates for returning veterans, the intent was to use the mind to control the body. While none of us can negate the body/mind connection it seems as though there is conflicting information regarding whether or not Pilates actually does strengthen the deep torso muscles with the intense focus on the ‘core’, the new buzz word.
Pilates focuses on the postural muscles with exact precision and awareness of the breath and a specific breathing mechanism. It is intended that the mind would eventually control the muscles. There is however, severe criticism of many of the untrained instructors and in particular of some of its claims.
These are the cons from Nick’s blog: It is unscientific and makes untrue claims as a marketing ploy which suggests it can make a person ‘s muscles lengthen. It places too much emphasis on the abdominals and therefore can create unbalances. Furthermore, the recommended breathing exercises are harmful and can even elevate the blood pressure. Now, dear reader, please do not rebuke me for saying these things about Pilates if you are wedded to the practice. I have never done it, nor even watched it being done, nor seen a video about the system. I am merely citing the information taken from the internet and from the One to One site. There are, no doubt, many others who will swear to its value. I can only present the information which I have available. Dena, my chiropractor believes it is a wonderful program IF it is practiced with a fully trained instructor on a one to one basis. Videos may be harmful without the attention of highly trained teachers.
Those of us with fibromyalgia can usually not run; many of us are lucky to be able to walk without pain. In my younger days I did run but as time went on I began having so much pain that I could see that I was risking even more injury. I believe that running was very harmful to my muscular system even while I know it was helpful for my CVS and consequently blood pressure. About this form of activity Nick writes that it is not a flexible practice and tightness is more often the rule than the exception. He says that it can be a nightmare for the musculoskeletal system.
While in Tucson this past winter, the physical therapist, Terri, told me she even tells her older clients not to use a treadmill as this too is harmful to joints and muscles. She says that long walks, especially on hard surfaces, hiking, power walking and treadmills contribute to many of the problems she sees on a daily basis. Short walks on soft surfaces are preferable and in her words “walking and jogging are highly overrated”. Nick says of walking: “Sorry, this is not the panacea that many claim it is”. Oh great! What then?
A word here about all that. After running I took up walking relatively long distances until just within the last year when my hips became very painful. I can no longer do this. However, pool walking is quite wonderful, under ideal conditions: warm pool, quiet atmosphere, and pool sneakers. There is some degree of resistance but generally it is not a strengthening technique, but it is a plus for mobility! More expensive than walking outside in the fresh air (if the weather is fine!), but definitely less harmful for the joints and muscles. The problem of accessibility and the cost may be prohibitive. Walking and running are cheap! Furthermore, those of us with many physical challenges have to keep moving as mobility is central to calming of our nervous system and flexibiliy of muscles. What can a person do then if there is no pool available or the expense is too high? The challenges are numerous.
After many years of not swimming, I decided a year and a half ago that pool walking was boring so I would see what it felt like to swim again. Phew! After two weeks I could barely move. My arms, neck, back and legs were on fire. What was I thinking? The act of swimming resulted in muscle imbalance and repetitive strain. No more of that! Nick says:”It’s all about intensity. Swim hard or go home”. Well, I went home because as anyone with fibromyaliga knows, we cannot do anything with intensity, after all, it is all about pacing.
Well, I have to admit I am not quite sure what that is but the word core has become so popular of late that it sounds good. Right? Nope. Apparently it is another fad like Pilates. In fact, it actually is said to create stiffness through the trunk. Furthermore, no CVS benefit! Now come on, folks. There has to be something that isn’t a fad and is slow, gentle, strengthening and good all around for my poor aching, painful body.
Is this IT? My recumbent bike sits alone and lonely in my basement unused for many years. Surely, this would be helpful to me, I asked Terri then Nick. Nope, this isn’t it either! It may be good for the CVS but you still have repetition and strain. But, I have found it might be a good way to burn calories, so maybe a few spurts on the old bike is in order? Naw! I would have to peddle very fast to have any hope of doing much good. Still, it is said to be better than walking or jogging, easier on the joints, but hard on the back. Where is it? Where is the ultimate in exercising?
Well, now, have I found THE perfect tool for my aging, painful, tired body? According to many, this is IT! First off, I am told, progressive resistance training is the only way to build strength, slowly, over time. It is excellent for CVS, increases muscle mass and the only form of complete exercise. HOWEVER, it requires access to equipment and instruction and FURTHERMORE, it isn’t fun and it is hard work (see my blog on strengthening machines). Do I know this to be the best of all activities for certain? It seems like the recent research concurs. In the May 26,2008 edition of the Globe and Mail (p.L4) a university professor of 66 years listed her many activities such as modern dance class, stretch class, biking, Vinysasa yoga and walking. The list is impressive as she does this during her lunch hour every day (apparently). The critique made of her activities by an expert in Calgary is: the variety is great but “comes up short in resistance training”. In addition, classes in a group do not provide a person with individual attention which could result in injury. Moreover, as she seems to be doing this six or seven days a week she should make sure she is not overdoing it. One of the key elements of strength training is that the person must leave time in between for recovery. This of course is key for the person with fibromyalgia, that is, pacing, although I doubt any of us could undertake that kind of rigorous routine to begin with! She says that she loves the classes at the club.
Shouldn’t an activity be FUN? CHEAP? EASY? If so, strength training is none of the above. Is it worth it? Only time will tell. Does it alleviate the pain of fibromyalgia? No. Will I get stronger, then have less pain upon doing certain activities? Maybe. Is the jury still out? Yes. Aren’t people who ask questions of themselves and then answer themselves annoying? Yes:-)
I don’t know the answers. I just know I have to stay mobile and keep trying to find answers in spite of the pain and fatigue. I am so lucky to have been able to try several of these activities over many years. I DO however consider them to be ‘activities’ to increase mobility and relaxation and not a form of ‘healing’ in a mystical sense, as some in the Qi Gong movement consider that practice to be.
I still don’t have any definite solutions, but I keep seeking them. Because I have lived with fibromyalgia for so many years I sometimes think I should have been a pathfinder, yet I still don’t know the right path to follow, as there are so many. As to whether or not there is one activity that fits all of us, of that I am still uncertain.
For now, I will continue to pool walk a little and try this strength training technique. Also a bit of Qi Gong movement , and keep hoping for a better future with less pain. I have to keep hoping that I will find the right path for me.