My Physical Therapy

I just realized I didn't have a summary page for the third leg of my recovery program, physical therapy.

My fibromyalgia specialists have long encouraged me to get more exercise, but most conventional plans were so far above my ability that attempting them put me into a flare-up.  Even the Couch 2 5 K program was too intense for me, I was less fit than a couch potato.

The exercise program I found that worked for me falls into three categories:

  • Exploration of Movement
  • Balance
  • Very low intensity aerobics
Exploration of movement is not about developing any strength or flexibility, it is exploring your existing muscles and consciously activating more parts of your body.  When you lift your arm, which joints do you lift from?  Does this movement stop at your shoulder or go back into your neck?  Try it again and involve the spine.  Spend time with an infant on the floor, and copy his movements.  Roll around in bed and try to activate every muscle in your body one at a time.  These exercises are wonderful for short term relief of pain.  For more formal instruction, there are any number of resources full of exercises you can do:
  • Somatics - (Skip the useless narrative, go straight to the appendix.)
  • The Art of Slowing Down - (I do strongly recommend you get to the narrative, but the author suggests a faster path to the lessons and speaks assuming you have indeed skipped ahead.)
Any Feldenkrais book or therapist will be able to help you with this type of exercise.

Balance I mostly get from Tai Chi.  I can't really highly recommend a single source, but I suggest you try 2-3 different programs.  Try at least one that includes QiGong exercises.  Your problem areas will determine which style is best for you to work with.  For me the basic stances and the transitions between them was very important.  Some other forms of Tai Chi are more about exploration of movement and less about balance.  I am not able to do all the exercises in the DVD or hold out for the whole lesson, but I have found very helpful exercises within that I practice regularly.  I also occasionally enjoy some of the Wii Fit Yoga exercises.

Another source of balance exercises comes from the classic gym.  I work on the Asian squat and the pistol squat.  I can do a good Asian squat, my pistol squat is pretty sad and very high.  

The trick to aerobics for the unfit is to keep the exercise gentle and slow enough that we don't overdo it and hurt ourselves.  Our well-meaning friends may coach us to keep up, but that may not be the right thing for us.  I'd started using a heart rate monitor and experimentally found a range I could exercise in and feel good enough to repeat the next day, but you can shortcut my work and use Dr. Maffletone's formula to start out at the right zone.  When in doubt go for the lower heart rate zone.  Going to low may slow progress, but is not going to hurt you.  If you think your workout needs to be more challenging, add time rather than intensity.  You can always bump it up later if you feel good about that a few weeks into the program.  You can measure your progress with the MAF test, or just watch your time for a specified route at a specified heart beat decline over time.  I used walking and running for my MAF training, but you can use swimming, biking, or any other unencumbered steady movement instead.  

If you are severely disabled and can't get up and around, ask your doctor if you can do any exercises while sitting or laying down.  Some Feldenkris, Tai Chi and Yoga exercise can be done from bed, and on a really bad day that is what I do for exercise.  Make doing no harm to yourself your primary goal, and getting your body moving your secondary goal.  Never move further/harder than you are comfortable without the supervision of a medical professional, certified personal trainer, or other experienced coach.