During intense training or a new strength routine, you might experience some major soreness, but if you begin experiencing pain—especially above your normal threshold or typical postworkout soreness—this can signal something more serious.
If this intense pain come after a traumatic event or once you hit your 30s, but it’s not clear what’s causing it, it may be fibromyalgia. We spoke with experts to explain what the condition is, how to diagnose and treat it, and how it may impact your running. (And remember, anytime you’re in pain or having trouble recovering when you previously didn’t, it’s important to scale back on workouts and connect with your doctor.)
What is fibromyalgia?
Fibromyalgia is a chronic disorder characterized by musculoskeletal pain. It is usually accompanied by other symptoms such as fatigue and memory and mood issues. While researchers don’t have a great understanding of the disorder and the issues that come with it, it is believed that fibromyalgia affects the way a person’s brain and spinal cord process painful signals, according to the Mayo Clinic. This means that once a person is diagnosed with fibromyalgia, the pain can affect their running in many ways.
Fibromyalgia is a highly individualized disorder that often comes on in a person’s 30s. Sometimes, it can appear as a sudden uptick in body pain, and other times it can happen gradually.
How is fibromyalgia diagnosed and treated?
It can often be tricky to get a diagnosis and take a person a long time going through the medical system, according to Kaitlyn Baird, ACSM certified exercise physiologist at NYU Sports Performance Center.
According to the Mayo Clinic, fibromyalgia is typically diagnosed if you’ve experienced “widespread pain throughout your body for at least three months.” (“Widespread” means pain on both sides of your body, and also above and below your waist.) To make a diagnosis, your doctor will typically perform a physical exam of your muscles and joints, as well as a neurological exam, according to the Mayo Clinic. They may also want to run a few blood tests to rule out other conditions.
A lot of people will feel that physical activity is exacerbating their pain, so if you’re an avid runner, you might find your runs leave you in pain. So, you may have to reduce your physical activity, especially at onset and while seeking a diagnosis and care, Baird says.
“As people get through their diagnosis, we know that aerobic activity—especially light to moderate exercise—is important to people with fibromyalgia,” Baird tells Runner’s World.
One important thing to note is that a fibromyalgia diagnosis can feel like a real loss of sense of self, loss of confidence, or loss of sense of control. While it will be different for everyone, even some of the mental health obstacles that come with fibromyalgia, such as depression and brain fog, can affect your desire or motivation to run, Baird says. So just know if these things are affecting you, you’re not alone and it’s important to care for yourself both mentally and physically.
Treatment for fibromyalgia can include medications and a variety of therapies—such as physical therapy, occupational therapy, and counseling—according to the Mayo Clinic. Additionally, self-care strategies—such as getting regular exercise, sleeping enough, and eating a healthy diet—can help.
Can I run after a fibromyalgia diagnosis?
“Don’t let the label of ‘fibromyalgia’ be your identity and make you think there is no hope. Many runners have been diagnosed with fibromyalgia and have been able to return to running at their previous level,” Terry Gebhardt, P.T., D.P.T. and CEO of Colorado in Motion, tells Runner’s World.
Baird suggests keeping track of your pain level following different types of runs—such as recovery runs, track workouts, long runs, etc.—and note how often and how far you can run without causing extra pain.
“It will involve rethinking your routine and setting new guidelines for yourself,” Baird says. “The main thing to remember is even if you’ve been a runner, start low and progress slowly. Resist the urge to jump right in.”
Every runner or person who is starting a run program will have a different set of resources, such as access to doctors, coaches, or exercise physiologists who are familiar with the disorder.
Aerobic exercise could improve health-related quality of life and physical function while reducing stiffness and pain in people diagnosed with fibromyalgia, Sue Hitzman exercise physiologist and creator of the MELT Method, tells Runner’s World.
Another thing to consider is to go easy if you’re experiencing a flareup.
“You don’t want to fuel that negative cycle of the fear of ‘oh I ran, so now I hurt,’ which may cause you to shy away from running,” Baird says.
The secret of maintaining an active lifestyle with fibromyalgia is figuring out what time of day you normally have more pain, Hitzman says. Figuring out what activities flare your symptoms and your overall tolerance to pain is all part of the process in creating self-care plans for fibromyalgia.
While everyone is going to be different, Baird suggests starting training with a running/walking program, or even a minute of light jogging during a walk and building up mileage slowly. Consider factors that go into planning a running program, including volume, frequency, and intensity. Higher intensity activity will likely cause a flareup, so it’s suggested to start in a lower activity zone and work up from there.
Though many people may use heart rate to track intensity, Baird actually suggests using rate of perceived exertion (RPE), and keeping your RPE between a 2 and 4 out of 10.
The reason for this is that your heart rate may fluctuate, but RPE is dependent on your effort, which can help you gauge if the exercise is too intense.
Can a trainer help me with a running program?
It’s going to be different for each person, depending on their medical team, access to care, and what a person can afford or has insurance to cover.
A good place to start is trying to find a center or hospital that has a movement disorders department, Baird says. Then, you should work with your physician or an exercise physiologist—who would have more specialized knowledge than your average trainer—for a training plan.
“Half of the programming will probably involve motivational coaching and recovery,” Baird says. “It will likely be a very collaborative effort. It’s important to help each individual find confidence in their body and manage other stressors.”
Keep in mind, work and life stress can exacerbate fibromyalgia, and getting proper sleep can be difficult as well, which can affect both training and everyday life, so it’s important to work with a specialist who can help you look at a program holistically.
Should I alter my training in other ways after a fibromyalgia diagnosis?
“We need to treat the system, not just the symptoms of fibromyalgia,” says Gebhardt. This means addressing all factors that influence your pain and fatigue. Some of these include: sleep, nutrition, meditation, and gradual exercise progression (including strength training and mobility, in addition to running) to allow your body to adapt.
Though many runners love to run and don’t like to do other types of cross-training, training your body to be stronger and have better mobility and balance, along with a consistent meditation practice, are necessary if a runner with fibromyalgia wants to be able to run, Gebhardt says.
And, allowing extra recovery time and avoiding intensities which would exacerbate symptoms are possible alterations that will allow runners to be the most successful in their training, Stephanie Palunchowski, P.T., D.P.T., at Strive Physical Therapy and Sports Rehabilitation, tells Runner’s World.
Additionally, running technique may need to be addressed to minimize stress on the body, and a physical therapist can help work through adjustments to technique, Gebhardt says.
Can I race again after a fibromyalgia diagnosis?
It’s certainly possible.
“I know of people who are living with fibromyalgia who run marathons and ultras,” Baird says. “What becomes important, especially when training for something so intense, is learning how to determine running pain and soreness vs. other pain and symptoms.”
It can be hard enough to know when you should push through pain during training, then this added layer with fibromyalgia pain can be catastrophic to both your training and confidence, Baird says.
One great option is to have a backup plan if running isn’t going to be a good thing for you that day, such as rescheduling your run, adding a recovery day, or opting for something lower impact, such as swimming or a stretching routine. Studies have shown that incorporating a stretching routine can help to manage pain and stiffness that comes with fibromyalgia.
“I would say knowing your body is one of the biggest things that would give yourself the confidence you need to race again, even though this can often be a traumatic diagnosis,” Baird says.
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