Exercise Guide

Fibromyalgia is a common form of arthritis that is characterized by generalized aches and pains, chronic fatigue, non-restorative sleep, and often other symptoms that suggest multi-system disease. Important research findings have shown FM patients to have higher levels of Substance P- a neurotransmitter responsible for pain processing- and lower levels of somatomedin C and growth hormone, substances required for normal musculoskeletal health. Abnormalities involving the levels of serotonin, dopamine, nor-epinephrine, and muscle- related chemicals, adenosine and phosphocreatine have also been demonstrated.

Deficiencies in brain blood flow patterns as well as new genetic research indicating a mutation in the regulatory region of the serotonin transporter gene are unraveling some of the mysteries surrounding FM. Despite these exciting discoveries, a number of myths still surround this condition:

Myth# 1: “Only women get FM.” Actually more than 5% of patients are men and that number appears to be increasing.

Myth#2: “Only adults get FM.” Actually, FM probably begins in childhood. “Growing pains” may actually be a form of fibromyalgia. Approximately, two and one half per cent of children seen in a pediatric rheumatology clinic setting have FM.

Myth# 3: “FM is only a form of arthritis.” FM, while often presenting as a musculoskeletal syndrome, is a disorder that has its roots in central nervous system neurotransmitter dysfunction. This dysfunction leads to multi-system complaints. That is why FM patients often have breathlessness, palpitations, bowel and bladder symptoms along with aches and pains..

Myth #4: “FM is a wastebasket term for when a doctor doesn’t know what to call it.” This is the most damaging of myths. Patients with FM have a real disorder. While the science is lagging behind as far as providing specific commonly used tests that may assist in diagnosis, there are multiple stereotypical signs and symptoms that demonstrate true objective abnormalities and can help trained physicians identify patients who have FM easily.

Myth#5: “There is no treatment for FM.” Nothing could be farther from the truth. While there is no one individual treatment that works well for everyone, there are multiple treatments that are usually effective. Most people respond to a combination of therapies that include cognitive behavioral therapy, non-impact aerobic exercise, and medications. Other therapies that often help include; acupuncture, hypnosis, massage, chiropractic, tai chi, water exercise, nutritional supplements, and biofeedback.

Myth# 6: “Patients with FM should avoid exercise.” False! If done too quickly or vigorously, exercise can be painful. However, if a graduated program that allows the patient to ease into exercise and allows them to progress at an acceptable pace is instituted, exercise is actually a cornerstone of proper FM treatment. The key is proper technique and pace.

FM is a common problem. Patients should have hope because FM can be managed successfully. People who suspect they might have FM should be evaluated by a trained physician.

Share This

My Aunt Helen once said to me “Sooner or later ole Uncle
Arthur-Itis will get you.” She lived to be 99 years old, so
apparently Aunt Helen was able to hold Uncle Arthur at
bay.

Osteoarthritis is one of the most common medical
conditions, affecting an estimated 15.8 million Americans.
Usually it is chronic and occurs when the cartilage erodes
that normally cushions the joint and protects it from impact.
As bone rubs against bone, a person will feel pain and have
difficulty moving the joint. Osteoarthritis can range from mild
to severe and age is a leading risk factor.

Symptoms of osteoarthritis include joint pain and swelling,
limited flexibility, grinding sensation with joint motion, and
numbness or tingling in an extremity.

In Aunt Helen’s day, doctors usually told the arthritis sufferer
to rest the joints. But if she were here today, her doctor
would likely suggest exercise and/or drugs or dietary
supplements instead.

There are prescription drugs available that help many
people and your doctor may recommend one of them.
Sometimes he may have to try several in order to find one
that helps you without undesirable side effects.

Another new treatment is a series of hyaluronate injections.
This provides lubrication and nutrition to the joint; however
some studies have found no benefit.

Also available are dietary supplements that help with
arthritis pain. Studies suggest that glucosamine sulfate, an
over-the-counter supplement, may provide benefit for those
with osteoarthritis in the knees. Other non-prescription
supplements include chondroitin and MSM which are often
combined with glucosamine into one capsule. Another
option is SAM-E, a product available in health food stores,
which some people find to be of benefit. SAM-E also helps
combat depression and should not be taken with
prescription drugs for depression.

Recently interest has developed in the role of exercise for
arthritis. Dr. Ronenn Roubenoff, MD, MHS, a rheumatologist
and associate professor in the Friedman School of Nutrition
at Tufts University in Boston, says, “Often what happens with
someone who has arthritis is that a doctor says to go out
and walk in order to reduce the pain. So the patient tries it.
But in people with arthritis, the knee is the joint most
commonly afflicted, followed by the hip, so walking hurts
and that leads to a negative cycle. The person stops
exercising and gains weight because they’re not engaged in
any physical activity. The extra weight then puts even more
pressure on the joints and the pain feels even worse.”
Indeed for every pound you weigh, each step you take puts
up to 3 pounds of pressure across your knees and hips.
Every step you take down, as when you are descending a
staircase or stepping off a bus, puts up to 6 pounds of
pressure on your lower limb joints per pound of body
weight. Gain just 10 extra pounds and you’re facing as many
as 60 extra pounds of pressure on your knees every time
you step off a curb.

Dr Roubenoff, along with Miriam Nelson, PhD and
Kristin Baer, PhD, of Tufts designed a study to test whether
certain kinds of exercises not generally recommended for
people with arthritis would help them move about more
freely and without pain.

After just 4 months, the two dozen exercisers in the Tufts
study experienced a 43 percent reduction in pain, compared
with just 12 percent in a control group that did not do any
strength training. And physical function in the exercise group
improved by 44 percent overall–almost twice as much as in
the control group.

Why is it that strength training can free up a person with
arthritis in a way that aerobics alone cannot? How can
strength exercise help a person with knee or hip arthritis to
walk and get around better, when walking without strength
training first might only cause more pain and
immobility?

Dr Roubenoff says: Think how a car functions on a bumpy
road. It’s the role of the shock absorbers to take each bump
as it comes so that a jarring shock isn’t sent up to the
passengers. If the shocks fail, the car’s spring and axle
assembly absorb the jolt, but the passengers really feel it.
In your body the muscles are the shock absorbers. The
joints are the springs and axles. Thus the better shape the
muscles are in, the better they can take each shock as the
body hits the ground, sparing arthritic joints and thereby
sparing the person further pain.

Strength training directly targets the muscles and when they
are stronger, you can walk and get around better because
the joints affected by arthritis are relieved of much of their
shock bearing burden.

I can testify that strengthening leg muscles help relieve
arthritis pain because I constantly hear participants in my
strength exercise classes tell me how getting stronger has
helped relieve their arthritis pain in knees, hips and
shoulders.

Now you’re probably asking, “What exercises should I do?”
Squats are the exercise most recommended for arthritic
knees–they help strengthen the quadriceps, the muscles in
the front of the thighs. For instructions on doing them
properly to avoid injury, visit my web site:
www.StrongOver40.com. My book “Over 40 & Gettin’
Stronger” contains an easy to learn weight training workout
for the entire body.

While squats help most people, I find that one person out of
everiy 100 cannot do squats without pain–they should not
do them and should check with their doctor.

Phyllis Rogers is not liable for any injury incurred while
doing the exercises recommended in this article.

Phyllis Rogers is a Certified Fitness Trainer and Specialist
in Fitness for Older Adults. She is author of “Over 40 &
Gettin’ Stronger” which contains an easy to learn strength
workout which uses only dumbbells and can be done at
home. She has taught more than 1200 strength classes for
older adults Her book is available at Amazon.com and on
her web site http://www.StrongOver40.com She can be reached
at fitness9@mindspring.com and is available for speeches
and workshops.

Share This

If you are interested in improving the efficiency of your strength training sessions, you may want to make stretching a bigger priority. A recent study by researcher and author, Wayne Wescott, Ph.D., shows that stretching after your workout not only increases flexibility but improves strength as well.

Participants in a 10-week strength training program either paused to stretch between each machine or stretched after their workouts. Surprisingly they showed a 20% increase in strength over non-stretchers.

Dr. Westcott says there’s no clear explanation yet for this finding; more research is needed to confirm it and understand the mechanism behind it.

As we age our range of motion often suffers due to lack of flexibility and stiffness and arthritis in the joints. Often we take the approach of avoiding movement-which is exactly the opposite of what we should do. The ideal approach is to incorporate a stretching routine into our exercise program.

Stretching has a host of benefits to the muscles, tendons and tissue surrounding the joints. A flexible joint may move farther in its range and requires less energy to do so.

Flexibility training (stretching) increases tissue temperature, which in turn increases circulation and nutrient transport. This allows greater elasticity of surrounding tissues. As a result there is an increased quantity and quality of synovial fluid, enabling more nutrients to get to the joint. The end result is more freedom of movement and a slowing in the process of arthritis.

Strong clinical evidence also indicates that lower back pain can be avoided or improved by stretching the hamstrings, hip flexors, and muscles attaching to the pelvis.

ABOUT THE AUTHOR

The cardiologist looked up from the treadmill report and grimly stated, “You are a walking time bomb. You need to go to the hospital immediately.” Two days later a heart surgeon sawed open Gene Millen’s chest and stitched in bypasses to six clogged arteries.

“A six way heart bypass isn’t a record” said Gene, “but it’s not bad for a skinny 59 year old with normal cholesterol and blood pressure. The villains and heroes in the heart attack melodrama may surprise you as they have me.”

Gene Millen reviews new research on heart attack risks that are more dangerous than high cholesterol… and how natural supplements and heart vitamins can send them packing! Check out The Heart Health website at http://www.heart-health-for-life.com

Need a free article for your newsletter or website? Go to…

Share This