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Pilates for Fibromyalgia

Before I tried Pilates for myself I had always thought of it as a fibro-unfriendly form of exercise since several of my patients had injured themselves in Pilates classes. But it turns out there are ways to make Pilates work really well for the fibromyalgia body, especially since it is a mind-body exercise that matches breathing and flowing movement to build strength and body awareness. I call it “enforced mindfulness” because when I am doing Pilates I can literally only focus on my body and breathing, there is no mental space for thinking or worrying or planning. And along with the mindfulness benefits, improving my core strength and flexibility resulted in less fibromyalgia pain.


So, what is Pilates?

The Pilates method is an exercise approach founded on the teachings of Joseph Pilates (1880–1967), which aims at improving general body flexibility, core strength, posture and coordination of breathing with movement. Pilates exercises emphasize proper breathing, correct spinal and pelvic alignment, with concentration on smooth, flowing movements and developing strength of the deep abdominal and spinal muscles. Some of the exercises are done on a mat, and others use specialized equipment. Props such as foam rollers, balls and straps are often used as well. Learn more about Pilates here.


Studies on Pilates for Fibromyalgia

A small study in 2009 compared 12 weeks of a Pilates exercise program done 3 times a week to a home relaxation and stretching program. The Pilates group reported pain reduction and improved function at the end of the 12 weeks, which was not found in the control group. A more recent study compared mat Pilates and aquatic aerobic exercise. The exercises were performed twice a week for 12 weeks. The mat Pilates group did nine exercises (seen in figure below) for the main muscle groups with progressions each month. The exercises were initially performed in 1 series of 8 repetitions in the first month. Then they were performed in 2 sets of 10 repetitions in the second month. Finally, they were performed in 3 sets of 8 repetitions in the last month.


Both the mat Pilates group and the aerobic exercise group had significant improvement in pain and function, along with reporting an improved quality of life. Research definitely supports pilates as a viable movement therapy for fibromyalgia, but if you aren’t careful it is possible to over-do and injure yourself, so read on to learn how to make Pilates helpful not hurtful.


Four keys to make Pilates fibro-friendly

1) Start with one-on-one sessions so your teacher can monitor your posture and let you know if you are tensing or using the wrong muscles. My upper neck and trapezius muscles always tense up and try to take over for my abdominals or upper arms.


2) Group classes are a less expensive option that can be great after you have done some individual sessions and know your problem areas. Once you have felt correct alignment it is easier to make those adjustments for yourself.


3) Finding the right instructor is essential- make sure they understand fibromyalgia and pain. I chose my teachers because they had experienced injuries and pain themselves.


4) Finally, just say no! There are a few exercises that no matter how I try adapt them they cause me low back pain for days afterward so now I just refuse to do them (looking at you, clamshells!)


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