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Hi folks, I have fibromyalgia, which comes with chronic fatigue and I've found that every time I try to start at bodyweight level 1 it ends up triggering a fatigue flare. 

 

I posted about this in a different area of the forums and they said that heavy, low rep stuff had worked for them: 

She suggested barbells but I only have dumbbells, so she suggested I ask here if you had any advice, specifically "to check if it's safe to  do heavy , low rep dumbbell work, and to ask what the best basic push, pull and legs movements" would be. 

 

Thank you all! 

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So, I gotta say, I think you'd be best off chatting with your doctor and/or a trainer with fibro specific experience. Without someone helping to you programme and observe exercises in person, no-one can really accurately say if 'low rep & heavy can be safe'. 

 

The thing is, those living with fibromyalgia and chronic fatigue don't respond to exercise stimuli in the same way as the standard research subject, so most of the literature available is only vaguely useful as 'grey area guidelines' for yourself. In addition to that there is SO MUCH variation in the responses between individuals to different types of activity, so realistically the only reliable recommendations will be ones that you yourself develop over time through tracking your responses. And what research IS out there for fibro-specific workouts typically isn't for resistance training, unfortunately.

 

Personally, the first thing I'd do is start a mood & energy journal, tracking every day to get a feel to see if there are obvious cycles/correlations that you can take into account. For example you may find that any exercise during menstruation puts you on your ass, regardless of intensity. Or that if you wake up with a headache you'll be able to power through a workout and actually feel better the next day - who knows? The only way to really gather that data is to...well, gather data. You could also take a look at heart rate variability tracking, if you're the personality type that enjoys empirical data in addition to the subjective energy tracking.

 

Are your recovery strategies dialled in? That may be a good area to focus on as well - I know that sleep and stress management can be challenging, but whatever can be done (eg. sleep hygiene, meditation, gratitude practice, etc.) will still help somewhat. Also, diet: you want to set yourself up for success in recovering from your workouts, and for most folks that's staying well hydrated, 0.7-1g of protein per lb of bodyweight every day, plus 5+ servings of fruit & veg, with a balanced fat/carb intake.

 

I understand why @Harriet recommended high weight/low rep work for you; for some folks (especially those whom used to do predominantly endurance training, eg 12+ reps for lifts), it can be a revelation. But again, so much of that comes down the individual and the cause of the fatigue - for example, low volume high intensity resistance training can be quite beneficial to balance thyroid hormones and improve insulin resistance, and can provide a welcome change if the individual was previously in an extended caloric deficit. It's definitely a good strategy - but not for everyone, all the time. As in all things, variety (ie. periodization) is the spice of life. ;) Progress can be made with endurance work too, it's just a different type of progress!

 

Also, while I appreciate her caution for safe usage of heavy dumbbells, personally I often prefer DB over BB lifts anyway. They typically offer better flexibility for movement patterns, allowing healthier joint alignment - but that's my own bias. It's kind of like machines vs free weights - neither is better or worse, you just need to choose what's best for your needs & goals.

 

On the topic of goals: what are you looking to get out of your workouts? Are you just generally trying to improve health? Add muscle? Lose fat? Increase aerobic endurance? Those goals will determine what you really want to focus on in your exercise programming. For example, you may find that getting outside for 30-60min of brisk walking every day is a good place to start, gently improving your health over time without massive nervous system or physical stressors.

 

From what I'm reading in your post though, you're experiencing additional fatigue from the bodyweight workout - which (depending on your bodyfat percentage and starting fitness levels) should be difficult but not balls-to-the-wall. So personally, I'm not convinced that adding weight to the movements are the best choice (I'm totally not an expert though, hence my recommendation to go chat with one! :P). For many folks, those bodyweight exercises need to be regressed back into comfortable movements, aiming for gradual progression over time as strength and endurance improve. It sounds to me like that workout may not be a good choice for you to start with.

 

Bearing in mind that I'm just a random stranger on the internet, and I'm not a doctor, health professional, trainer, or anything even vaguely related to expertise on the subject, this is what I might look at for yourself to start with:

 

1) Pole Bodyweight Squats, progressing up to 'freestyle' bodyweight squats and then maybe weighted goblet squats over time

2) Banded Pull Downs

3) Glute Bridges, Bird-Dogs, Clamshells, Fire Hydrants, etc. IE. glute specific work, which will help with posture and overall balance

4) Incline Dumbbell Presses with a rotating grip, which can act as a 'two for one' for upper body vertical and horizontal pressing when you're first getting started (less is more sometimes)

5) Some kind of plank work, be it RKC, side, on the knees, on elbow vs hands - whatever works best for YOU

6) Banded Face Pulls (targets back & shoulders, less likely to cause arms to compensate like what can happen with inverted rows or DB rows)

 

I'd choose weights/resistance/progressions that are comfortable but not TOO easy for 8 reps, and then do the whole thing as a circuit - working out for TIME though, not reps; just do as many as you can within the 30 seconds while still maintaining good form. 30 seconds of a movement followed by 1min of rest before going on to the next exercise. That way, you can do the whole thing in only about 10min.

 

And then I'd only do enough to feel better, but not so much as to feel fatigued - this is where that mood journal will come in handy. For example, if your energy levels are rated from 1-5, then a 4 day means you could do 2 or 3 circuits; or split it out for 1-2 in the morning and 1-2 in the evening. Whereas a 2 energy day you might only do 2 altogether, or 1 each morning & afternoon. The advantage of spreading things out throughout the day as well is that it gives your system more recovery time, and is less likely to cause as intense stressors as a 30min workout all at once.

 

I'm guessing that over time, you'll slowly be able to start tolerating more circuits, and/or more advanced progressions of the movement - I'd suggest here for a 'minimum effective dose' or rather to only workout enough that recovery is still easy, and give yourself permission to progress according to your energy levels rather than a trying to push progress before your body is ready. You may also want to avoid anything that causes too much muscular damage (eg. eccentric focused movements, lifting until failure, etc.); in your case, it may be more stress than you want to push your system through.

 

But I'm also positive that a third (+fourth, fifth, etc. :P) voice will chime in here with ANOTHER different idea of how you could do things - and honestly, none of us are wrong or right. It's just a matter of experimenting to see what works best for YOU. As always, go slow, be safe, and have fun!

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10 minutes ago, Defining said:

So, I gotta say, I think you'd be best off chatting with your doctor and/or a trainer with fibro specific experience. Without someone helping observe and help you program exercises in person, no-one can really accurately say if 'low rep & heavy can be safe'. 

 

The thing is, those living with fibromyalgia and chronic fatigue don't respond to exercise stimuli in the same way as the standard research subject, so most of the literature available is only vaguely useful as 'grey area guidelines' for yourself. In addition to that there is SO MUCH variation in the responses between individuals to different types of activity, so realistically the only reliable recommendations will be ones that you yourself develop over time through tracking your responses. And what research IS out there for fibro-specific workouts typically isn't for resistance training, unfortunately.

 

There's so much uncertainty about chronic fatigue, unfortunately. I don't know if I got the wrong doctors, but when I told them about the fatigue I had (for 20 years now, though it's getting better) I got "can't help", "don't know" and "some people just have less energy than others". The reason I recommended low reps is that it sounded like OP had the same problem I did - fatigue prevented me from pushing hard enough on lighter weight/higher rep exercises to see much progress. I'd feel sick quite quickly, even with bodyweight exercises, which meant that while my sets felt subjectively hard, they weren't hard enough for me to improve. Heavy-ass barbell lifts were the one thing that were hard without making me feel sick (no idea why, but I'd rather do barbell squats than bodyweight squats...) And over time, they've increased my general energy levels moderately. Obviously I don't know if nighteyes will respond the same way as I did... But like you said, the research isn't where it should be, and doctors don't necessarily know as much as they should. If heavy weights don't work for them they can always go back to a different type of exercise. I just feel it's worth trying heavy lifting because it has the potential to be qualitatively different from bodyweight, light or even medium weight lifting in my experience. Tracking and journaling is an excellent idea. 

 

So, assuming you still want to give heavy, low rep lifting a try, OP: @Grumble, @Blocky, is it okay to do a basic 5x5 lifting programme with dumbbell only movements? At what stage would heavy dumbbells get difficult or dangerous to handle? I am guessing OP is a woman and sometimes the dumbbells can be difficult to get into place with the lower wrist and forearm strength we tend to have. Is there a point at which you *have* to switch to barbells if you want to go heavy, or can you keep doing heavy dumbbells indefinitely with the right technique? 

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Regarding doing 5 x 5 with DBs, I don't see why not - the only real hassel with DBs is they are harder to load incrementally (BBs can be incrementally loaded with microplates).

 

However,

 

I think the crux of this problem is building up a tolerance to exercise. My approach would be to do a limited number of exercises but do them over and over to build tolerance - this is known as the repeated bout effect. This is the primary reason that programs like SS work so well... right up until they don't. You do the thing, you get good at the thing, you add weight to the thing... but eventually you adapt so well to the thing that it no longers imparts enough stress to drive adaptation. That is the point to change to something else - for the average person making average gains, a linear progression should only last 2-3 months - however you can stretch that out by making smaller weight jumps.

 

So pretty much do any of the 3x5 (this would be my pick - to limit overall fatgiue) or 5x5 programs - focus on 3-4 things and repeat for a while. Don't push to absolute failure (if you know what RPE is then keep it at 7 or 8).

 

I have worked with 1 or 2 peeps with CFS and used slow, incremental progress with good results - just use some common sense and back the intensity down during a flare.

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I should also add - I would start any squat progression with box squats (they tend to have less of an eccentric component and induce less fatigue).

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2 hours ago, Harriet said:

I just feel it's worth trying heavy lifting because it has the potential to be qualitatively different from bodyweight, light or even medium weight lifting in my experience. 

ALWAYS worth trying! :D My apologies, wasn't trying to somehow discount your advice, just to add another dimension. It will always come down to the individual, and what they enjoy & what works for them - and you can't know until you try!

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Thanks very much, everyone, I really appreciate you putting so much thought into this.

 

I'm planning to start with 3 different moves, with one set of 5 reps for each.

 

From advice given (and based on the fact the only kit I have are DBs and a yoga mat), it looks like 3 good moves to pick would be

  1. DB squats (potentially box squats)
  2. DB rows
  3. DB presses

Does anyone have any particular thoughts about a good weight to start with, per DB?

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