A new set of exercise guidelines was recently announced by the American College of Sports Medicine and the American Heart Association. Craig Stoltz, health journalist on HealthCentral’s MyDietExercise.com site, wrote a very good SharePost summarizing the guidelines.
Why am I telling you this? Because there’s a part of these guidelines that causes me concern for chronic pain patients. The first set of guidelines is clearly for healthy adults under 65. Those I have no problem with. It’s the second set that bothers me–– guidelines for adults over age 65 (or adults 50-64 with chronic conditions, such as arthritis). To my surprise, they recommend more exercise for this group than for the healthy young group.
What concerns me is that the term “chronic conditions” is not defined, except to use arthritis as an example. While I’m sure there are a number of chronic conditions that would allow the individual to exercise at the level recommended, others like fibromyalgia, chronic fatigue syndrome and many other chronic pain conditions would not. Since FM and CFS are my areas of expertise, I’ll address them specifically.
Fibromyalgia and Exercise
Most research on fibromyalgia and exercise clearly indicates that appropriate exercise is beneficial in helping to reduce pain and improve other symptoms. However, too much exercise too soon can be counterproductive. Many of you are probably wondering how I dare even suggest you exercise when every movement is painful. I know because I felt that way for several years.
The key is to start slowly––very slowly. If you haven’t been exercising at all, begin with doing gentle stretches for two minutes a day. That may not sound like much, but if you do too much too soon you’ll increase your pain, become discouraged and likely give up. Gradually add a minute each week. As you find your strength and endurance increasing, you can begin adding other types of exercise. The Oregon Fibromyalgia Foundation has several good articles about exercising with FM and offers three different FM exercise DVD’s.
Chronic Fatigue Syndrome and Exercise
Chronic fatigue syndrome is quite a different issue. While some CFS patients can handle a small amount of mild exercise, others cannot handle any. After all, a key symptom of CFS is post-exertional malaise, which is extreme, prolonged exhaustion and sickness following physical or mental activity. A recent study found that CFS patients suffer symptom exacerbation following physical exertion that is both real and incapacitating.
A great deal depends on the severity of the CFS in any given individual. Before attempting an exercise program, CFS patients should talk with a doctor who has a good understanding of the illness.
Chronic Pain and Exercise
I think it’s safe to say that pretty much every chronic pain patient has some kind of serious illness or injury. Therefore, it is essential that you consult with your doctor and possibly with a physical therapist before beginning any type of exercise program. There are most likely exercises you can and should be doing, however, they may require special adaptations based on your particular health problem.
As for the new exercise guidelines, I think they’re great for people who are basically healthy. I don’t, however, think they can be extrapolated to include everyone. While a certain amount of exercise is necessary and good for most of us (except perhaps some CFS patients), the level and intensity they recommend is beyond what many of us can and should do.
Published On: August 03, 2007