It’s an excellent form of light aerobic exercise, which provides a list of healing benefits: It brings oxygen and nutrition to your muscles to keep them healthy, helps rebuild stamina, boosts energy, and reduces stiffness and pain. In fact, a comprehensive research review found that low-impact aerobics is most effective for improving FMS symptoms. Biking is another good option: “The reciprocal, or back-and-forth, motion helps provide relaxation,” adds Iversen, who also chairs the Department of Physical Therapy at Northeastern University Bouve College of Health Sciences.
Other effective forms of aerobic exercise include swimming and water aerobics in a heated pool (warm water relaxes muscles, and the buoyancy of the water helps with movement, whereas cold water can make muscles tense up) and using an elliptical trainer (which is lower impact than a treadmill).
Fibro-friendly tip: Do short bursts, not long stretches. Research shows breaking a longer workout into shorter chunks provides the same health benefits—and for people with fibro, the latter strategy is best: “If your goal is to walk for 30 minutes, start with three 10-minute walks a day,” says Iversen. “Just don’t leave your last walk for too late; that’s when fatigue is the worst.” Experts generally recommend doing aerobic exercises three to four times per week on nonconsecutive days. To help motivate you to stay on track, join a walking or workout group, adds Iversen.
MORE: 14 Walking Workouts To Boost Energy
Do it at least once a day to help increase flexibility, loosen tight, stiff muscles, and improve range of motion—the combination of which will help ease everyday movements, like looking over your shoulder or reaching for a can on the top shelf of your pantry. Stretching during workouts may also help you to tolerate training better.
Fibro-friendly tip: Stretch to cool down, not warm up. The best time to stretch is after some form of light warm-up exercise, says Iversen; you could hurt yourself trying to stretch cold muscles. Start by positioning yourself until you feel a slight stretch in the muscle, then hold the stretch for a full minute for the most benefit.
3. Strength training
The trick is to use light weights (start with 1 to 3 pounds, says Iversen) and lift slowly and precisely to improve tone and make muscles stronger—stronger muscles use less effort than weaker muscles, which may leave them less fatigued. Plus, studies show strength training can help treat depression, even as well as some medications. Aim to work out each major area—legs, chest, shoulders, back, arms, and abs—two to three times per week, with at least a 1-day break in between. Start with a weight you can lift comfortably for eight reps, then gradually up it to 10 and 12 reps. When you can lift the weight 12 times, two sessions in a row, you’re ready to increase the weight slightly (and start back down at eight reps.)
Fibro-friendly tip: Shorten the range of motion. Take a bicep curl, for example: There are two parts to that move—when you bring your hand up to your shoulder (the concentric phase) and when you lower it back down to your thigh (eccentric phase). That second part can be the problem—going down too far can cause discomfort and make pain worse for people with fibromyalgia, says Iversen. Studies show shortening that phase can help decrease muscle soreness.
MORE: 5 Reasons Your Weight Lifting Routine Isn’t Working
Practicing the Hatha kind—a more gentle combination of postures, breathing, and meditation—reduces the physical and psychological symptoms of chronic pain in women with fibromyalgia, according to a recent study published in the Journal of Pain Research. Participants reported significantly less pain; they were also more accepting of their condition and felt less helpless and more mindful.
Yoga also helps build endurance and energy and improves sleep and concentration. Tai chi, where you slowly and gracefully perform a series of movements, has also been shown to help relieve fibro pain and other symptoms—maybe even better than stretching, according to a recent study from Tufts Medical Center.
Fibro-friendly tip: Modify moves to reduce stress. If a particular position hurts, you can tweak it to still get the benefits with less pain, says Iversen. “With the downward dog, for example, the pressure on the wrists can be painful for someone with fibromyalgia, so rest on your forearms instead.” And don’t worry about extending your knees fully, she adds—as long as you can get into the basic position, and are comfortable in that position, that’s what matters. For beginners especially, it’s important to find an instructor who understands your needs—ask your physical therapist or doctor for recommendations.
MORE: Yoga Poses That Reduce Pain
5. Everyday activities
That’s right—studies show that playing with your kids, mopping the floors, gardening, and other things you do in daily life count toward increasing fitness and reducing symptoms.
Fibro-friendly tip: Plan your day to better manage pain. “Spread out your list of chores throughout the day, doing the tougher ones in the morning,” suggests Iversen. And give yourself a break: If you want to play with your kids, but you’re in pain, get on the floor with them so you don’t have to lean over and run around. Don’t clean your floors on your hands and knees; get a lightweight mop instead. And when you need a rest, take it.