10 Tips For Healthy Exercise In Fibromyalgia

Published: October 7, 2015

In recent newsletters, I've discussed the basics of using the S.H.I.N.E.® Protocol:

  • Sleep
  • Hormones
  • Infections
  • Nutrition, and
  • Exercise as able

To recover from CFS and fibromyalgia, double-blind placebo-controlled research has shown that 91% of people improve with an average 90% increase in quality of life using S.H.I.N.E. Today, let's discuss the "E" in S.H.I.N.E., which is Exercise.

This whole area has become very controversial. Not because there is uncertainty about the importance of exercise in any chronic disease, but rather because there is still a small subset of fools who insist that fibromyalgia is not a "real" disease, and who attempt to twist the research that shows that conditioning helps as a way to invalidate it as an actual illness.

We have seen this before when multiple sclerosis used to be called "hysterical paralysis," and lupus and rheumatoid arthritis were considered diseases of neurotic women. Just as some people will persist in believing that the world is flat, some will persist in believing that these illnesses, and fibromyalgia, are somehow all in people's minds.

Research is clear that exercise helps cancer–induced fatigue. Yet no one would dream of saying that this suggests that cancer is not a real disease. In the same way, anyone who implies that the research showing that conditioning helps fibromyalgia somehow suggests that the illness is not real is simply being a fool.

For today, let's ignore the fools.

So What Is Happening?

Because of the energy crisis occurring in CFS/FMS/ME, people are unable to condition beyond a certain point. Instead, if they exercise beyond that point, they get postexertional fatigue, often being bedbound for a day or two. This, along with the pain, often leaves people afraid to exercise at all, which leads to severe deconditioning. In this illness, the deconditioning can be devastating. In fact, it can be more devastating than the exercise.

The Answer?

You want to begin a walking program so that you can condition as much as your body is able to.  For some this may be 50 steps a day, and for others this may be 2 miles. Simply start slow, and listen to your body. If you feel good tired right after you exercise and better the next day, then that was a good level of walking. Increase by 50 steps each day as you're able. A good $15 pedometer will help you to do this easily. If you get to the point where you feel wiped out the next day, simply cut back.

Fortunately, after you give the S.H.I.N.E. protocol 10 to 12 weeks to build energy production, you'll be able to start conditioning again, instead of simply crashing. When you feel your energy building on the protocol, continue to increase your walking by about 50 steps every day or two, as feels comfortable.

It can be as simple as this, and does not need to be complicated.

For many fibromyalgia patients, doable exercises include walking, yoga, and Tai Chi just to name a few.  Walking is an ideal exercise. 

10 Tips for Effective Exercise

Here are 10 tips to get you started safely, and to make the exercise program more effective:

1. Begin With Light Exercise

Try walking or even warm water walking (in a heated pool) if regular walking is too difficult.

2. Feel Good Tired

Walk to the degree that you feel "good tired" after and better the next day. If you feel worse the next day, stop a few days and then cut back your routine when you begin again.

3. Work Out Comfortably

Walk only as much as you know you comfortably can (or start with 5 minutes). Then increase by 1 minute every other day as is comfortable. When you get to a point that leaves you feeling worse the next day, cut back a bit to a comfortable level, and continue that amount of walking each day.

4. Expect Considerable Improvement by 10 Weeks

After 10 weeks on the S.H.I.N.E. Protocol, your energy production will usually improve considerably, and you'll be able to continue to increase your walking by 1 minute every other day.

5. When Able to Exercise 1 Hour a Day, Increase Intensity

When you get to 1 hour a day (or 5,000-10,000 steps throughout the day if using a pedometer), you can increase the intensity of the exercise.  Again, listen to your body, and only do what feels good to you.  You'll know the difference between how "good pain" feels versus "bad pain" or crashing.

6. Consider Using a Pedometer

It's more fun to be able to see your endurance go up (set it for total steps you walk a day).

7. Wear Woolen Long Underwear When It's Cold

A cold breeze can throw muscles into spasm. So can sweating during the walk if you're overdressed. Woolen long johns will soak up any sweat and wick it away from your skin. Meanwhile, don't forget a scarf and hat. More info on this, and overall pain relief, in an upcoming newsletter.

Unless it is cold, and the cold flares your pain, I recommend you get your exercise by walking outside, so you can get sunshine — your key source of vitamin D. Many people with CFS/fibromyalgia are vitamin D deficient. Vitamin D from sunshine (or supplements) will help improve immune function and will also decrease the risk of hypertension, diabetes, and cancer (low vitamin D is responsible for upwards of 85,000 deaths a year in the US).

8. Enjoy Your Exercise!

Otherwsie you won't stay with it. No pain, no gain.You've heard that slogan, of course. It reflects the belief that unless exercise hurts, it's not doing its job. I have another slogan I want you to say to yourself instead:

"Pain is insane!" Or, "No pain no gain is stupid!"

Pain is your body's way of telling you, "Don't do that." Exercise should be virtually pain-free.

9. Find an Exercise You Enjoy

Find an activity you love to do, look forward to, and that fits into your routine. This way you'll be more likely to stick with it. Whether you begin with a simple walk to the mailbox, or as you improve you find that you're doing a dance class, going for a walk in the park, doing yoga, or even shopping, doing something you love makes it more likely that you'll stick with it.

10. Have a Regular Scheduled Routine, and Workout With a Friend

The obligation of meeting somebody results in your being more likely to show up.


Some of you will have orthostatic intolerance (e.g. NMH or POTS), where your symptoms get worse if you are upright for an extended period. We will discuss how to effectively treat this in a future article.

We have begun with an overview of how to use S.H.I.N.E. to recover from fibromyalgia. To make this easier, I recommend doing the free "Energy Analysis Program." This will analyze yur answers to a series of  quizzes, and pertinent lab tests if they are available, to tailor a program to help optimize your energy production. I also recommend the free iPhone and Android app "Cures A-Z," which you'll find very helpful in addressing day-to-day problems, and my books The Fatigue and Fibromyalgia Solution and From Fatigued to Fantastic!

In my next newsletter, I'll discuss effective pain relief in fibromyalgia, and then a series of articles looking at individual components of S.H.I.N.E. in depth.

You can get your life back!

Jacob Teitelbaum, MD

is one of the world's leading integrative medical authorities on fibromyalgia and chronic fatigue. He is the lead author of eight research studies on their effective treatments, and has published numerous health & wellness books, including the bestseller on fibromyalgia From Fatigued to Fantastic! and The Fatigue and Fibromyalgia Solution. Dr. Teitelbaum is one of the most frequently quoted fibromyalgia experts in the world and appears often as a guest on news and talk shows nationwide including Good Morning America, The Dr. Oz Show, Oprah & Friends, CNN, and Fox News Health.

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