Start exercising during the confinement situation caused by the coronavirus. Recommendations for patients with fibromyalgia and chronic fatigue syndrome

Tips for starting a therapeutic exercise regime

Start with a minimal level of physical activity. Try to enjoy what you are doing, so you don’t get overwhelmed. Increase the intensity every day and create the habit of exercising, just like eating healthily or washing your hands.

Decide what activities or exercises you’d like to do or need to do. Walk around your house, go up and downstairs, do self-care activities like bathing, getting dressed, combing your hair, etc., dance, and get moving!

• Establish a baseline. This is the quantity of activity that you can do without triggering a reactivation of the pain or fatigue. For example, start with the exercises that the professionals have given you.
• Plan out your progress. Increase the intensity, the number of repetitions, and the exercises that you do each week. These increments should be small, gradual, and constant. On a calendar, mark your desired progress for the next 6 months. Then stick to the plan and don’t go over or under the activity level planned.
• If your alarm system is triggered, don’t worry if a reactivation occurs, and don’t get angry with yourself, despair, or stop exercising. These happen because your brain is trying to protect you from something that it mistakenly considers a danger. That will not cause you injuries.
• Don't let the pain determine how long your activity should be, and follow the plan you’ve established on your calendar. It’s essential for you to remain consistent and not skip out on your plan.
• It’s important that you feel good about your activities. You have to make a change in your lifestyle. If you can, find fun activities. Ideal activities are ones that make you feel positive emotions without feeling pain or excessive tiredness.
• Before starting the activity, begin by imagining yourself doing it. Imagining movements activates many areas of the brain, and this can help minimise the danger alarm, as you’re not doing the movement for real.
• If possible, change the space in which you do the activity, so that the brain gets used to variety and doesn’t try to interpret that a different setting means danger.
• Doing activities in different emotional states also helps tremendously. If you don't feel well, don't stop doing the activities. The more variety we give our brain, the more difficult it will be for it to feel like it’s in danger and to activate pain signals. The key is to do the activities you have planned on the calendar, regardless of how you feel when that moment comes.
• Listening to music, meditating, and doing the activity in front of a mirror is very beneficial. Distraction is a very powerful tool that can disarm the trigger for pain reactivation. If we add creative activities to this, we will increase its ability to do so.
• Routines that incorporate aerobic, strength-training, and flexibility exercises have been shown to produce the greatest benefits.
  • Aerobic exercise: walk every day around the house, on a regular basis. Look for the longest route and get started! 20-30 minutes of daily aerobic exercise are enough to improve sleep quality, pain, fatigue, and mood.
  • Strength training exercise: patients who do this kind of exercise report an improvement in fatigue level, mood, and sleep quality. We recommend between 5 and 8 repetitions per set and 1 to 3 sets per exercise. Then, you can go gradually increasing the number of repetitions, exercises, and number of sets.
  • Flexibility: Some of the benefits of flexibility exercises are improved posture and balance, increased blood flow to tissues, and improved muscle coordination. We recommend you do them before and after your workout session, for 5-10 minutes. Each stretch should be held for 10-30 seconds and you should try to stretch the joints as far as possible before you feel a slight amount of tension.

With these recommendations, now you’re ready to start your physical exercise regime and enjoy all of the benefits, helping you relieve pain and improve function and quality of life. Get that confidence in yourself and your body back! Step by step, it's not a race, it’s a journey.