I have fibromyalgia, but I need to start an exercise program. What can you recommend that will have the best impact, and the least amount of stress to my body.

As with any condition, you should first check with your doctor before beginning an exercise program. As you know, fibromyalgia is a condition whose primary symptoms include widespread musculoskeletal pain, severe fatigue and disturbed sleep. Treatment options for fibromyalgia may include medication and lifestyle changes such as a healthy diet, regular exercise and relaxation techniques. Regular exercise, in fact, can reduce the debilitating symptoms of fibromyalgia. However, the important thing to remember is too START SLOWLY and progress gradually. Activities that are good choices for you are: swimming, walking, biking, yoga and other non or low-impact aerobic activities. Here are some good exercise guidelines to follow:

Warm Up
Proper warm-up is critical to the person with fibromyalgia because it allows you to move slowly and gradually into an exercise. Moving your body slowly by walking five minutes allows the muscles to loosen up and prepares the heart and lungs for exercise.
Stretching
After a proper warm up of at least five minutes, stretching activities should be performed. Daily stretching is important to improve circulation, relieve pain symptoms and loosen tightened muscles. Stretches should be held for 20-60 seconds and repeated 2-3 times. Start with five minutes of stretching and gradually increase to 20-30 minutes every day.

Cardiovascular
As mentioned previously, non or low impact cardiovascular activities are important for people with fibromyalgia. The benefits of regular cardiovascular exercise include making your heart and lungs more efficient at delivering blood and oxygen to your muscles. This will decrease pain, improve your quality of sleep and increase your energy throughout the day.

Gradually increasing your activity is very important. Start with five minutes of walking or biking and add two minutes every week until at least 30 minutes of continuous activity can be performed at least three days per week. If your symptoms worsen after an activity, reduce your time, but continue to move your body slowly and continue stretching.

Strength Training
Strength training should only be performed if you have tolerated walking and light cardiovascular activity. If you are beginning a strength training activity, warm up by performing the exercises without any added weight. Simply moving your body through a range of motion allows the brain to send signals faster to the muscles and improving communication between your nerves and your muscles.

Gradually increase to using resistance bands, selectorized machines (the kind with a weight stack), or cable machines. Begin by performing a couple of exercises at a time, allowing 2-3 minutes between exercises to recover fully. Work toward competing a total body routine 2-3 times per week.

Consulting with a certified personal trainer that specializes in working with special populations is a great place to start when designing your exercise program. To find one in your area go to http://www.acsm.org or contact your local health club.

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