Yoga for fibromyalgia and ME/CFS

A regular stretching and conditioning practice is great for flexibility, balance and strength for anyone living with fibromyalgia or ME/CFS.  I am not talking #instagramyogapretzel type contortions, but basic stretches, often altered to accommodate our unique health challenges. As with so many aspects of spoonie living, it’s unglamorous and pared down to essentials. (However, crazy leggings do help)

If your symptoms are currently quite severe, then the aim is more maintaining or minimising loss in these areas, rather than getting super flexible.It helps to correct/ balance out any postural issues or asymmetries. These are often accentuated by the chronic myofascial tension and can make your pain much more severe.

The reasons I hear fellow spoonies say why they don’t try yoga, are indeed often the reasons they SHOULD. Many are understandably nervous of pushing it too far and crashing (the old paradigm of forced exercise therapy “treatment” of ME/CFS and related illnesses has a lot to answer for in this regard).

It takes a while to regain a sense of trust in your body after a big long-term crash. A physical practice is ideal for this. It gets people present and in their bodies, instead of the disconnected sense of being a consciousness fighting with a body that’s falling to pieces on them. Release the western exercise model of pushing yourself to gain progress, and think of it as finding and then gently testing your boundaries. Learn to trust your body – when it craves a good stretch and when you need to back off.

People are often also worried about making problems worse. I have fibromyalgia, ME, POTS, scoliosis, and an asymmetrical pelvis. If I don’t keep things in check with stretching (and basic abdominal conditioning) the scoliosis gets a lot worse, I get a lot of back pain, tension headaches and sciatic pain. In all but the worst days, even a few stretches really pay off. Nowadays, even chiropractors only pick the scoliosis on x-ray.

After a bedbound relapse, I was starting over, I could barely bend from the hips to touch my shins, there was that much tension in my body. I looked every bit as old and decrepit as I felt! It was very hard not to get frustrated and compare with how flexible and strong I used to be.

yoga-level-catsTaking baby steps, patience and compromise are the key. Do it in small spurts of a few minutes, and use walls, chairs, straps and blocks for assistance.  There are also sitting and lying variations of many stretches.

Warm up first: If you aren’t up to walking, after a bath or sauna is an ideal time. Getting increased blood flow and a slight increase in body temperature helps the body to open. This is particularly helpful if you are one of those fibromyalgia folks who flare in the cold or have a decreased basal temperature.

Hold the stretches, repeat if you have time/ energy. Most find it’s better to do a few stretches held for longer than an exhaustive array.

Small doses: I found doing 4-5 stretches every day worked far better than pushing through a 40 min session and crashing. One day you might concentrate on lower body, the next might be spine, and upper body

Low blood pressure and the POTS-prone: be very careful of postural changes, especially repeated vinyasa sequences. Even if you aren’t one of the dizziness-prone, the up-and-down of sun salutes does demand quite a bit from the autonomic nervous system to maintain even blood pressure. It’s surprisingly draining. I found classes that did long warm ups of flowing vinyasa sequences too much for years, even when I was up to doing 1/2 hour of yoga at home.

For standing forward bends, come out of them by bending at the knees and crouching down, waiting for a few seconds as required, then slowly standing up (that way, if you’re dizzy, you only fall a couple inches onto your butt). The other option with forward folds is using the sitting variations. If you do get the dizzies, come to the ground the ground in full child’s pose. Child’s pose is very soothing for the nervous system and is a good rest and reset.

Don’t overdo it. If you are really straining or head-spinning during the stretches, or more painful or exhausted afterwards, then you need to pull back. Sometimes it honestly looks like you’re standing/ lying there and barely stretching compared to everyone else, that’s OK.
Start conservatively and be careful of flaring problem areas. A common one is downward dog. A lot of yoga styles spend quite a bit of time in downward dog, but I would recommend working up to this. Holding the posture for too long can put excessive strain on the trapezius muscles of the shoulder area and set off tension headaches.

Expect hiccups and setbacks. On tense and tired days days the focus is just to loosen problem areas. Use lying or sitting variations rather than standing. Sometimes I would just lie on the bed and roll or twist and intuitively find what my system needed.

Try lying in savasana (corpse pose), running awareness through each body part, letting go of as much tension as possible. (Even this can be agony in a bad flare – I have a separate article on modified savasana and other lying poses for the very painful body). The may be days where you are too sick to even contemplate it. No problem, just take a break and get back on the horse when you can.

After a while you will become attuned to changes in tension/ flexibility levels as another indicator of the general level of inflammation in the body. (eg. between 24-72 hours after gluten or a chemical hit I notice I am asymmetrical, achey and tense)

Increased body awareness may feel like getting worse After getting your head round what the poses are and how to do them properly, then begins the real work of inward awareness – always correcting, aligning, relaxing, allowing. All the sore spots, tensions and asymmetries you have been carrying around, become uncomfortably obvious. As one muscle group relaxes and loosens, it allows you an extra few centimetres of movement, so the next muscle group becomes the focus. This is not a sign that you are getting worse, in fact this centredness and presence is one of the main aims of the yogic path.

Where to start?

If you are not familiar with stretching, a session with a yoga teacher or physio to establish a tailored routine is a great idea. I also found having basic notes to refer to helped – sometimes the energy was there for a short stretch, but the brain fog came up blank as to what to do!

If you want to try a class, shop around and don’t be afraid ask questions – different studios have very different cultures. Avoid people who subscribe to the you need to push yourself to see progress school of thought – that’s the worst thing for a spoonie.

Dedicated beginner yoga classes or yin yoga (a gentle format that uses the ground a lot) are a good start. A good yoga school will encourage students to only do the variations of each posture appropriate to their body on that given day. When half the room is doing slightly different things, people tend to feel less self conscious, and not get caught up into trying to keep up. You want a teacher who is open to you pausing, modifying poses or using blocks, towels etc as part of your practice.

Although not everyone’s cup of tea traditional yoga practices also include breathing focus and meditative techniques. The mind stilling effect is very helpful for a frazzled spoonie brain.

Let it be something you gradually add to your life. Mentally creating a timetable puts pressure and makes it a chore/ obligation (which many of us subconsciously resist!). As you improve, more challenging poses involving core strength and balance can be added to the routine.

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