The Important Role Exercise Plays In Chronic Fatigue & Fibromyalgia

With an estimated 5 million people in the United States suffering from fibromyalgia, it’s indisputably one of the most common types of chronic pain conditions. Unfortunately, it often goes undiagnosed, as was exhibited by Lady Gaga’s struggle—the singer recently opened up about dealing with the aches and pains of fibromyalgia, only to be told time and time again that her illness was psychosomatic before finally receiving a diagnosis.

A disease that largely affects women, fibromyalgia is strikingly similar to chronic fatigue. But whereas chronic fatigue is characterized by exhaustion and brain fog (and yes, can include pain), with fibromyalgia exhaustion takes a backseat and aches and pains are front and center. In the quest to alleviate these symptoms, exercise is often a controversial piece of the puzzle: Not only do most people not have the energy to exercise, but working out too much can worsen symptoms. Here’s the best way to go about it.

When exercise causes fibromyalgia.

First things first: While chronic fatigue and fibromyalgia aren’t always caused by exercise, doctors first started understanding more about chronic fatigue when they studied the female athlete triad, a somewhat common condition among female athletes that’s characterized by an energy deficiency that causes bone loss and irregular menstruation. “In general, women with a low percentage of fat get their periods late, sometimes not at all,” explains Alice Domar, Ph.D. and executive director of The Domar Center for mind/body health. “Excessive exercise tends to halt ovulation. If you aren’t ovulating, you won’t get a period.”

Jacob Teitelbaum, M.D., an expert on chronic fatigue, says understanding the female athlete triad has been an extremely important step in understanding fibromyalgia better. “That was our first clue about 35 years ago,” he says. “That’s a little-known milestone along the way. If you overdo—and to be clear, it does take a lot—that’s where you’ll start to see it develop in women.”

How avoiding exercise makes chronic fatigue and fibromyalgia worse.

A condition characterized by aches and exhaustion, it makes sense that exercise isn’t exactly appealing for people suffering from fibromyalgia. But Dr. Teitelbaum insists that regular exercise is an important element in managing the condition. “It’s difficult, because they can’t make enough energy for their needs. And when you don’t have enough energy, your muscles get locked in a position. So after a hard workout your muscles are super tight—it’s not pleasant.”

The key, says Dr. Teitelbaum, is to find the happy medium. “The middle path is the best approach. With fibromyalgia, because the people who have it don’t make much energy, if they’re pushed past a certain point they crash. That leaves them afraid to do any exercise, so their symptoms end up worsening. You do need to move to improve symptoms!”

Why listening to your body is key.

Dr. Teitelbaum notes that the biggest mistake people with fibromyalgia can make is to assume there’s a one-size-fits-all exercise that will help them get better. “Everyone’s body is different,” he says. “No pain, no gain is stupid. There’s good pain, when you’re working your muscles and getting stronger, and deep down everyone knows the difference between good pain and bad pain. How does it feel to you? Learn to listen to your body and you’ll be fine.”

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