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Medical Pack

Exercise Management
Exercise has many known benefits such as improving fitness, aerobic capacity, mood, muscle strength, stamina, suppleness, sleep, weight, body shape and appetite.21,22 If your patients are unaccustomed to doing exercise, it is usual to experience unpleasant bodily or pain sensations when they start.


These sensations during or after exercise do not mean that they are causing any damage to their body, and they may need some gentle encouragement to continue with their exercise despite this.

In order to gradually increase their exercise and activity levels over time, a tolerance and baseline approach is most useful to encourage consistency and adherence irrespective of whether they are experiencing a "good" or "bad" day.

Start with exercises that are manageable and suggest that they focus on the quality of their movement and how they are performing an exercise, rather than the quantity of what they are doing.

Key principles of exercise management

  • Exercise is a means to increase daily activity levels.
  • Encourage the individual to choose a type of exercise that reflects their interests, their physical goals or specific activities they wish to return to or increase.
  • A tolerance and baseline approach is the best way to get someone starting to exercise gradually over time.
  • Encourage the individual to be patient and to persevere with a flexible routine they can easily incorporate into their daily lifestyle.
  • If they experience difficulty continuing to exercise on a bad day, remind them that they will need to modify their exercises in order to achieve their planned number for the day. For example, doing some stretches instead, exercising with a friend, breaking the exercises up over the day or starting with the easy ones first!

Example of a tolerance and baseline approach
EOD means to add one repetition every other day; ED means to add one repetition every day

Excercise Table

A physiotherapist, with an understanding of fibromyalgia, will be able to advise your patients how to select different types of exercises according to the training effect they choose to work on. This may be in relation to physical tasks that your patients are currently struggling to do or activities that they would like to do more. Encourage them to have a go, and then they can choose which approach suits them best.










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