Meet Jacqui. She’s a 64-year-old client of mine who started working with me to get help with her fibromyalgia. Which symptoms was she experiencing?

• The obvious – muscle pain
• Weakness
• Lethargy, and low energy levels
• Insomnia

…and others.

Fast forward 11 weeks that we’ve been working together, and her success has been nothing short of monumental. Nowadays, she:

• Has so much energy some days she doesn’t know what to do with herself
• Gets so much more done in her day, from the simple household things, like laundry, to shopping, playing with her cats, and more
• Likes how her legs and waist look.

Not really something she could have imagined just 11 short weeks ago. If you’d like to see Jacqui tell her own story, check out the video here.

In this article, we’ll cover:

• How the fibromyalgia was affecting Jacqui
• What she’s tried in the past to help her with the fibromyalgia
• The physical exercises we used with her, and special adjustments we made for fibromyalgia
• The mental/cognitive exercises we used with her
• Strategies we used to improve her sleep
• The bottom-line results she’s achieved
• How her life is different now

If you have fibromyalgia yourself, we have a special program called “Fibro Fit”, which is specific for people with fibromyalgia. If you’d like to see whether you qualify for this program, just email me with the subject line “Fibro Fit.”

HOW THE FIBROMYALGIA WAS AFFECTING JACQUI

Jacqui originally noticed that she wasn’t herself, when she was working a very stressful job in the mid-90s.

She ended up going to her doctor, who diagnosed her with both fibromyalgia, and to go along with that, insomnia.

She was actually somewhat lucky to get diagnosed with fibromyalgia in the mid-90s, because at that time, a lot of doctors didn’t even believe that diagnosis, and dismissed it either as a person having depression, or just wanting attention. Now, we know better. And with a bad diagnosis, people with fibromyalgia either got a bad treatment, or no treatment whatsoever.

Pretty soon, the fibromyalgia started taking over Jacqui’s life:

• Some days, she had no energy, and was feeling lethargic almost all the time
• She stayed at home, and didn’t feel like going out and being social
• Simple household chores, like laundry and cooking became difficult
• Forget about exercise – she didn’t have the energy to do simple household chores, never mind expending energy at the gym
• Sometimes after a day when she did a bit extra, she “paid the price” the next 1-3 days, by pretty much just staying in bed, because it really knocked her out.

As if that wasn’t bad enough, fibromyalgia frequently comes along with insomnia, and sleep disturbances, which is a double whammy (it sometimes comes with psychiatric issues like anxiety and depression, but fortunately, that wasn’t the case for Jacqui). You’re tired and exhausted from the fibromyalgia, but you can’t sleep well. And you can’t sleep well, so you have even less energy.

What a vicious cycle. That’s been going on since the mid-90s.

WHAT JACQUI TRIED IN THE PAST TO HELP HER WITH THE FIBROMYALGIA

You can imagine that nobody wants to live this kind of life, so she’s tried a bunch of different things to help her with fibromyalgia, pain, and sleep:

• In her words, she’s gone to every clinic you can imagine. Eventually, around 2007, she found a pain clinic, that she’s been going to since, for monthly pain injections. Which helped, but only very slightly.
• Medications galore – from antidepressants, to insomnia medications (some real heavy artillery medications), and others.
• Supplements: the typical ones that are used for sleep – magnesium, melatonin, Valerian root, and others.
• Dietary changes

…and nothing really had a significant effect. The effects were somewhere between “maybe I feel something, but it’s not very pronounced” to “this doesn’t work at all.”

After over 25 years of this, she decided to try something she’s never really tried before in any serious way: exercise and personal training.

Of course, as a fibromyalgia sufferer, she had a lot of doubts and hesitations about exercise:

• What if I can’t do any exercise?
• What if I’m so sore, it’ll put me in bed for days?
• I just don’t know what to do once I’m in the gym. The only thing I’ve ever done is cardio.

She figured she’d be better off if she just started the right way to begin with. So she hired a personal trainer. Me 😊

After reading my newsletters for a few months, she decided to give it a shot. She liked that personal training was well… personal. We don’t have a set “program” that every single client goes through, regardless of who they are. Each program is personalized to the client. The program is meant to fit the client. Not the other way around. The client isn’t meant to fit the program. We are “client-centric”, not “program-centric.”

JACQUI’S EXERCISE PROGRAM

After our initial assessment, where we gather information about Jacqui’s goals, injuries, medical conditions, medications, and more, I put together her exercise program.

The goals of exercise for folks with fibromyalgia are:

• Improve strength, so that the activities of daily living become easier
• Improve endurance, so that they can get more done in their day, without feeling tired the next day
• Decrease muscle pain and tender points
• Change the way they perceive physical exertion

…so we got to work.

An exercise program for someone with fibromyalgia is aimed at making their life outside the gym easier… as opposed to getting “gym strong” – you look strong in the gym, but when you step into the “real world”, the strength you built in the gym doesn’t carry over outside of that.

So we used exercises like:

• One-legged deadlifts, which make it easier to pick up objects off the ground (groceries, pets, furniture, etc.)
• Squats, which make it easier to get off chairs, couches, and well… the toilet 😉
• Overhead presses, which make it easier to put objects in cupboards that are high up
• Seated rows, which make it easier to pull things (like opening doors, etc.)
• Incline pushups, which make it easier to push things (like when shoveling snow, mowing the lawn, etc.)
• Lat pulldowns, which strengthen the back muscles, as well as the arms
• Planks, side planks, and back extensions, which stabilize the spine and core, and make the back much less prone to “going out.”

 

But if you just read about the exercises, you’d miss the “secret sauce” of the exercise program – the progression model, and the workout-by-workout adjustments that we made based on her progress from the previous workout, energy/fatigue levels, injuries, and more. After all, no exercise program should be a static program, where you’re doing the same exercises for the same weights, sets and reps every single time. An exercise program should be dynamic, intelligently, purposefully, and systematically changing the exercise variables workout-by-workout to move the client forward… as opposed to haphazardly changing the program whenever you feel like it, without rhyme or reason… like a lot of personal trainers do.

At the end of every strength training session, we also do 11 minutes of cardio. How did we do it? We’d warm up for 2 minutes (a short warmup was needed, because she was already warm from strength training), followed by a 1-minute interval, at a speed that would elicit a pulse of 135-145 beats per minute (bpm) by the end of the minute.

Notice that I said the pulse, and not the actual speed in miles per hour. Why did I do that? Because speed is meaningless without knowing the physiological effect of that speed on Jacqui’s body. Furthermore, the speed that used to elicit that pulse after 6 weeks of cardio is not the same speed that used to elicit that pulse at the beginning of her program. As she got in better shape, we raised the speed, because her heart and lungs could handle it. And we used biometrics (her pulse) to figure out when is the appropriate time to raise the speed. We didn’t do it randomly.

After the 1-minute interval, we’d walk at a slower speed for 2 minutes, and then do 2 more intervals, followed by a 2-minute cooldown.

What was the purpose of doing cardio for Jacqui? To boost her capacity to do her activities of daily living (ADLs). If, hypothetically speaking, her maximum capacity is 10 “points”, and her ADLs took 8 points from her, they came pretty close to her maximal capacity. But if we could increase her maximum capacity from 10 to 15, and her ADLs still only take 8 points, that’s now only about half of her capacity. Which explains why she’s able to get so much more done in her day. From just 11 minutes of cardio, twice a week. But it was purposeful, targeted cardio. Not random cardio that pays no attention to the pulse and changes in pulse.

MENTAL/COGNITIVE EXERCISES WE DID WITH JACQUI

In addition to Jacqui’s physical training, I also have her doing mental/cognitive training.

There are many theories about the causes of fibromyalgia, like:

• The serotonin hypothesis: maybe there’s not enough serotonin in the brain
• The emotional trauma hypothesis: maybe emotional pain translates to physical pain
• The muscular glucose hypothesis: maybe there’s not enough sugar reaching the muscles
• The adrenal hypothesis: maybe there’s some sort of dysregulation with what’s called the HPA axis (for the geeks, that’s the hypothalamo-pituitary-adrenal axis)

You’ll notice a lot of “maybes”, and that’s partially because for one thing, there’s no certainty about any of these theories. That’s why they’re called theories. For another thing, it may be multi-factorial, so there may be more than 1 right answer.

But one thing that’s true for most people with fibromyalgia is that part of it is neurological (not to be confused with psychological).

There are certain neurological phenomena that happen in people with chronic pain that perpetuate the chronic pain cycle. One of those phenomena is called “central sensitization.” That’s an oversensitivity to stimuli that are not ordinarily painful. For instance, the feeling of silk on the skin isn’t painful to most people, but it could be painful to those with chronic pain.

There are multiple strategies for dealing with central sensitization. Doctors will often use medications (SSRIs), but since I can’t prescribe medications as a personal trainer, there are other effective strategies.

Here are some of the cognitive strategies that I used to help Jacqui with her pain:

 

STRATEGY 1: SENSORY/VERBAL TRAINING

Jacqui is hypervigilant of any sensations going on in her body. Even insignificant sensations. But each sensation worries her, and she had one word to describe all those sensations: pain. Though it really wasn’t pain that she was feeling. She just had no other words to represent or label those sensations that she was feeling. So part of her improvement came from improving her vocabulary.

When you lift weights, and your muscles start to burn, that’s the discomfort of exertion, as opposed to the pain of injury. Jacqui used the word “pain” for both of them. I gave her a couple of different words to use for the sensation she was feeling while lifting weights: burning (as in “my muscles are burning”) or pump (“I’m feeling the pump”).

Another time, she described the sensation of muscles contracting as stretching. I explained to her that what she’s feeling is not stretching. It’s actually the opposite. Contracting means shortening. It’s literally impossible for her to feel stretching while her muscles are contracting, and in a shortened position.

So I actually had her deliberately stretch the muscle that she thought was being stretched, and notice the difference in sensations between contracting and stretching.

We had to use the right label for the right sensation.

And every time she used the word “pain” or “hurt”, I ask her “is it really pain, or would another word be a more accurate representation of what you’re feeling?” Close to 100% of the time, she thinks about it for a few seconds, and re-labels her sensation. On a rare occasion, after thinking about it, it’s actually pain, in which case, we modify things. But the vast majority of the time, it’s not real pain. It’s a mislabeled sensation.

By changing her words, she changed how she felt pain.

STRATEGY 2: EXPLAINING THE NEUROLOGY OF CHRONIC PAIN

 …if you want to read the rest of this article, visit HOW JACQUI IMPROVED HER STRENGTH BY 40% DESPITE FIBROMYALGIA

 

About the Author

Igor Klibanov is the author of 7 books on exercise and nutrition, and the CEO and founder of Fitness Solutions Plus. He is a sought-after wellness speaker, having delivered over 400 presentations to some of Canada's largest corporations. Get a free PDF version of his book, STOP EXERCISING! The Way You Are Doing it Now - http://www.fitnesssolutionsplus.ca/stopexercising