seeking advice on gentle strength training

anniekim

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Yesterday, I read with great interest on the Phonex Rising website the article Treating Chronic Fatigue Syndrome(M.E/CFS): 'Exercise'.

However, I didn't fully understand the bullet point on strengthening activities and I was wondering if anyone could clarify things for me futher, it would be much appreciated and thank you in advance.

The section on strengthening activties writes as follows:

...'Strength training should initially be limited to 30-60 seconds with at least 1 minute of rest in between and a maximum of 3-5 intervals per session. Start with 2-4 repetitions and build up to a maximum of eight. The total amount of activity in a single session should not exceed 20 minutes'.

My confusion is what exactly does 'a maximum of 3-5 intervals per session' mean? Should I read the word 'interval' as another word for 'rest', so it is saying you shouldn't ever go beyond 3-5 repeats of maximum 8 reps? Also does this advice apply for just the bit of your body you are working on, so for example a maximum of 3-5 repeat reps applies to just say working the biceps, or should i read it as a maximum of 3-5 intervals for strength training on your whole body?

I should note that I have had M.E for 12 years and severe M.e for the last seven, so I would be starting any attempt at strength training at the lowest possible level and at the moment still think stretching is the only thing within my limits, but am hoping if I improve a bit i can start at some point to do some gentle strengthening exercises. When I have attempted this in the past, I have always had a huge flare up of symptoms, so know i am doing too much.

Thanks in advance.
 

Athene

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Hi,
Your interpretation is right. You should do 2-4 reps, rest 1 minute, 2-4 reps, rest 1 minute, 2-4 reps, rest 1 minute, stop.
You can do this sequence for each muscle set, so if you do bicep curls, then you can do the same thing for another muscle or set.

I have been lucky enough to have a personal trainer for 2 weeks helping me with this.
You should use tiny weights so that you do not feel any burning at all. If you do feel burning, stop immediately.
You must drink lots of water the whole time - drink in every break.
Pay attention to twisting your body sideways to complete a movement - if you wiggle in any way the weight is too much for you.
Open the window and do deep breathing to make sure you have the most oxygen rich air possible while exercising.

Of you find you have overdone it, your body will contain lactic acid (achinig burning feeling). People with CFS are slow at eliminating this, and the overal acidity in the body being increased (a chronic problem for us) will also impair all your enzyme functions throughout the body. To counteract the acidity you can drink a glass of water with a level teaspoon of bicarbonate of soda in it. (Don't do this if you have high blod pressure though). To eliminate the Lactic acid, drink as much water as you possibly can. For me this makes a huge difference in reducing PEM.
 

anniekim

Senior Member
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Athene, thanks for your reply, it was very helpful and clarified a lot for me.

I do have one more question though that you may be able to throw some light on. My understanding, and I may be wrong, is that to build muscle one has to do enough reps to reach the burn sensation. However, obviously for those with M.E this can be too much and cause a crash. Would be doing only 2-4 reps (i read somewhere the maximum advised for someone with m.e is 8) still build muscle? Or is the idea that with time a person with M.e might be able to gently increase the number of reps and so eventually would build muscle?

I should note I watched a Nancy Klimas video on exercise on the CFSinformation center. She advised doing enough reps until one feels the burn and then two more. To me, this sounded too much, but stupidly I did try it about a week ago with one arm and have been worse generally since.

Many thanks in advance.
 

Athene

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Dear Anniekim,

As far as building muscle goes, I don't know if you have to reach that burn sensation, but I do know that it is very bad for someone with CFS do reach that stage, so definitely don't do it. I would suggest your best aim for the time being should be to regain tone/firmness in the muscle mass that you currently have and to prevent further loss of muscle. Any amount of activity you do will help with this, however little.

The Nancy Klimas advice should be ignored in my view. This is not what my trainer told me to do and in my own experience it is very harmful.

The one other thing I forgot to mention, that my trainer drummed in again and again, is that you must NOT think that becusde you did, eg. 4 reps yesterday, you must be able to do 4 today. Some days your energy level is low and you can do far less, it is not a step-by-step building experience. However, if you work within your limitations as they fluctuate from day to day, the long term trend should be upwards. You just have to be really patient.
 

Wonko

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it's a difficlut area for pwME

doing lots of reps can cause maximium muscle growth (but it aint necessarily so) but will NOT give maximium strength gains - if your aim is to get stronger not bigger then you should be doing less reps (5 or less) with a higher weight - if your aim is to get bigger then it's more reps (upto 20 but more normally 8-10) with less weight

to put it another way

intensity (weight lifted) builds strength - so 1 rep with the absolute max you can move without damaging yourself will give the biggest strength gain
volume (total weight lifted over time) builds endurance and forces the muscle tissue to store more energy locally (ie in the muscle tissue itself which is where most of the size increase comes from - however this local energy store is mainly in the form of sugars and water - not more ATP)

there is also another factor in untrained people - lifting weights (any weight), in fact any movement, will cause an improvement in CNS efficiiency for that movement (basically if you do something your body gets better at doing it regardless of any real gain in muscle tissue etc.) - this effect on it's own can practically triple your effective strength if your starting from a low base and tbh it's probably the most useful method for pwME

on that basis unless your healthy enough to be able to function (survive) pretty independantly eg you can manage to do routine household stuff on your own without being PEM'd all the time for it then I'd stick to short, low volume stuff - eg static and dynamic stretches (done very carefully with long rests inbetween) once or twice a week until you find a balance that works without significant PEM - the aim being to improve CNS function and improve strength that way - the trick is to get the balance right as for us there is a tradeoff between promoting efficiency and the damage (metabolic costs - repair of tissue, removing toxins, simple energy burned that has to be replaced etc) done by movement - in order for this to work you must keep the metabolic damage lower that the gains in CNS efficiency - or your just diggign a hole for yourself

if you get to the point where you are happy with that then you can then consider building up muscle tissue with wieghts

without a damn good reason I, personally, wouldnt consider any program which deliberately caused lactate burn - and tbh I'm likely to ignore the opinions of anyone without ME trying to convince me otherwise, no matter how well intentioned
 

Sallysblooms

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I try to exer. for CFS, but mostly for my POTS. I am CAREFUL. I just do a few and stop before I even think any good is being done. I get no after effects that way. Later, I do a few more.
 

anniekim

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Athene, Wonko and Sallysblooms many thanks for your answers, all incredibly helpful.

Wonko, I wish i'd taken your stance of 'without a damn good reason I, personally, wouldnt consider any program which deliberately caused lactate burn - and tbh I'm likely to ignore the opinions of anyone without ME trying to convince me otherwise, no matter how well intentioned'.

I still don't know why Klimas says do some reps until lthere is a little burn and then two more reps. I spoke to the person who runs the website the video was on and he said Klimas doesn't think you should go until the muscle burns, so goodness knows why she says that in the video. I have told the person who runs the website that it concerns me what Klimas says about going for a little burn is on the website, as it's potentially dangerous advice and too ambitious for most people with m.E.

Wonko, I can't manage basic household tasks with bringing on PEM, spend most of day in bed, although not completely bedridden(was for 16 months four years ago), so I going to take your advice and stick to the very few stretches I can do until my health improves and only then do some very light weights and NOT go for the burn.

Again, Klimas in a video suggests people who are bedridden can do some light weights, I think this is way too ambitious for someone at that level.
 

Sallysblooms

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Unless a person is really dealing with an illness, I think it is hard for a doctor to tell you really. Don't you think? They don't quite understand.
 

anniekim

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Unless a person is really dealing with an illness, I think it is hard for a doctor to tell you really. Don't you think? They don't quite understand.

True, but as I thought Dr Klimas is recognised as an expert on M.e, I thought her advice would be more in line with what patients tell her?
 

Athene

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I agree Anniekim, it is weird that Nancy Klimas is giving advice like that. Has she done any controlled studies to see if this technique actually produces improvements for a significant proportion of patients? I would be amazed if it actually helped anyone.
 
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Hi anniekim. Not sure what fitness level you are at.... but sounds like you want something kind of gentle.

They have something called "restorative yoga" here at the local gym. It's an hour class (you could leave early if you like) involves mostly sitting down and doing stretches. I'm sure videos are available for purchase if you would like to try yoga in the comfort of your living room. There are various levels and positions of yoga though and it is important to modify your effort and style to get the most benefit for your situation.

The thing about yoga is it is a form of meditation, stretching, strengthing, all in one. The meditation part, is the best part for me. Just turning off all the brain static.

good luck!
 

anniekim

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Thanks Mark, but I can only sit up in a bed for twenty mins or so without having to lie down, can only walk a few steps and haven't been able to leave the house for nearly a year, an hour's yoga class, however gentle and even leaving early would be too much. Am sticking to two or three stretches spead over the entire day for the moment.
 
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I hired a personal yoga instructor who came to my house and at first had to drag me out of bed where I'd appear red eyed and out of it. We went through gentle yoga, and she didn't push me too hard at first. Gradually I got better at yoga and my CFS got better, I was able to do the one hour sessions almost like a normal person. Finally I gained so much strength my CFS almost disappeared, I think this was because I was so much stronger it took much less effort to do other things.

I did relapse after these sessions but thought it was a small price to pay for the potential gain. She came 3 days a week. She told me I should never do a yoga exercise class.

This all ended when I had to have 4 years of surgeries for my hips and knees. My physical therapist said she thought it was because I was hypermobile and never learned to "stack my body" correctly. She also forbade me from doing yoga anymore because I'm hypermobile.

Now I've been doing a little weight training DVD with free weights, trying to get back to the point I was with yoga. I go for the highest weight I can lift while keeping form. I usually do relapse, maybe spend a day in bed after working out but still feel that is the pain of progress and know there is a wonderful rainbow of feeling really strong eventually. I plan to join a gym next week where I will do mostly strength training, cardio wipes me out.

Hollie
 

Athene

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Good to hear you're making progress, Hollie. I'm doing gentle exercises and also making progress that I'm really excited about. I can manage 30 minutes of gentle exercies a day now!
Anniekim, how are you getting on with your stretches? I hope it's helping you feel a bit better.
 

Wonko

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hollie9

if your relapsing after training then you need to figure out why as it's not inevitable - at least not until your lifting enough weight so that M.E. compromises your recovery ability (I'm still working on solving that issue but atm am not sure there is a solution) - training 3 times a week if your lifting enough to be close to compromising form (ie near your limits) isnt likely to be sustainable for long, and even if it doesnt cause 'issues' directly will use enough energy to compromise other activities - or thats my experience.

which isnt to say dont do it - just spend the time and figure out why it's causing problems, and adjust to try and fix them - as it's fairly easy to muck uop seriously with weight training and M.E. if you dont - it may not be a fun process but it's better than being wiped out the day after every time and risking a serious crash
 
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I am just too type A to mess around with gentle exercising and trying not to relapse. As I posted before, I've experienced great increases in strength and health with yoga, and I want those benefits again. I go for the normal people training and just take the relapses as they come. I know I'll eventually get strong enough to not relapse.

Yeah, I sometimes have to give up on "other activities" when building up with training, but that's my priority.

Yesterday I did my free weight program and didn't relapse. I think I'm getting stronger. I do 24 reps with 7-10 pounds in each hand for upper body, and use 15-20 pound single weight for squats. I don't take any longer breaks than the normal people on the DVD do, I do drink lots of water.

I have been doing this workout for awhile so have already progressed from lower weight, and I have been doing Pilates with an instructor for the last 6 months, so I'm not totally out of shape. I also ride my bike in nice weather for cardio and walk the dog.

I've always assumed the reason I relapse is because I overdid. But I've found that if I keep at it, eventually I don't relapse anymore while doing the same thing.

Since I posted this in "seeking advice on gentle strength training" perhaps my posts should be viewed as alternative or cautionary stories. Also, I've been working at exercise for years now...when I started I couldn't do anything. As I mentioned in an earlier post, I've had 4 major surgeries on hips and knees, for each surgery I had to go to physical therapy and exercise a lot. So I've been at this for awhile.

Hollie
 

Wonko

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this is just advice based on my experience

you'll never "get strong enough not to relapse" - thats not how it works - I can squat with well over my body weight on the bar but I still have ME and still get PEM'd - as far as benefits go they start tapering off and being out weighed (lol) by the time you reach about .5BW (on the squat) - above that whilst you will get stronger the energy cost is IMO too high for most pwME - the stronger you get, the more you need to use energy for recovery as your damaging more muscle tissue through lifting more weight - there comes a point where this is above both any increase in functional ability to utilise energy (ie anaerobic fitness) and above your bodies ability to recover - this happens to everyone it's just that for pwME this point is much lower

if you do a search on rep ranges you'll find that the rep ranges you are talking about arent designed to increase strength anyway - they're designed to increase the "pump" and increase muscle size and aerobic conditioning - but strength - not so much - I'd be surprised to hear if you werent getting significant lactate issues in those rep ranges - and at least IMO lactate is bad if you have ME.

but as i said initially I'm no expert and whilst the sort of routine your doing has caused me problems in the past a lot of people (myself included in a lot of cases) think my way of doing things is also seriously inadvisable for pwME
 
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When I had a personal yoga instructor I started out unable to do anything. By 6 months of 3 days a week sessions I felt great CFS wise, almost cured. And I gained a lot of strength. So, for me, I did get strong enough not to relapse. My instructor said it was due to the healing power of yoga...don't know if that is true or not.

I sure do feel a lot better after my weight training. My whole body feels like it walks more strongly, gracefully. So for me it's worth it.

I don't know the science of exercise, like you do Wonk. On the DVD the instructor keeps saying to shake out your arms, etc. to disperse the build up of lactic acid.

I'm not getting worse CFS from the weight training and am relapsing less, so will continue, it feels good.

Pilates seems to be a good gentle way to exercise, good for those with OI since so much of it is done laying down. I recently used up all my sessions...and my instructor has CFS!

Hollie
 
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Yes, I have ME/CFIDS/CFS, but since I don't live in the UK, don't know if I can claim ME.

So, you're wanting me to use all those initials instead of just one set?

Yesterday I skipped exercise, felt great and went to many stores, had labs taken, talked on the phone with attorneys, friends....today I am totally relapsed and did no exercise to cause it. My husband died 6 months ago and I'm not pacing as well as I used to, my routines are gone. Also wondering what role grief plays in ME/CFIDS/CFS.

Hollie
 
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