After much prodding throughout the years from various doctors, a few weeks ago I bought a stationary bike as I finally decided not to be a couch potato anymore, to improve my heart muscle, and to better control my pre-diabetes that I've had long before PMR.
On two separate days I've used the stationary bike for just 10 minutes at a time at a steady moderate pace. I wanted to start off slow and easy. Nothing strenuous, just a nice steady pace. While riding the bike I would briefly feel the "muscle burn" in my thighs but as briefly as it came on it would also quickly subside and I would just continue to peddle.
After 10 minutes I would stop but 5 minutes later every single muscle in my body hurt. Prior to exercising, I would feel pretty good with no aches or pains but 5 minutes after stopping my exercising, I'm in pain. This happened on two separate occasions. So now, I'm afraid to exercise for fear of being in whole body pain.
So I Google "exercise and inflammation" and there are lots of articles regarding exercise being pro-inflammatory, but digging further there are also articles stating that the more frequent you exercise it then becomes anti-inflammatory.
I have a few questions to ask:
Is it possible to exercise with PMR?
Do I keep at it?
If so, any suggestions?
But if not, is it the PMR that makes this impossible, or the steroids, or just the combination of both?
Lastly, if my muscles hurt after just 10 minutes of easy exercising does this mean my PMR is still relatively active in the background even though I'm on prednisone and my muscles didn't hurt prior to exercising?
TIA
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perceptual63
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After just over a year the underlying cause of your PMR is almost certainly still active - half of patients are said to be off pred in just under 6 years, the rest take longer. Only about a third of patients are off pred in 2 years and far fewer after just a year. YOu will know it is gone and no longer active in the background when you are able to taper the pred dose to zero and no symptoms return in maybe 6 to 8 months.
You haven't done much for over a year - even if you didn't have PMR you would struggle to get back into exercise having done nothing. There have been many discussion over the years and we consistently tell people to start with just a couple of minutes - whatever the form of exercise you choose. The next day you assess whether you tolerated that and have no leftover muscle pain. If you did, add a minute for the next day. Actually what we usually suggest is walking first - and walk out for a few minutes and back for the same. If you know you can walk for 10 mins OK, start with 5 out, 5 back. If that was OK, add a minute each way, so 6 mins out, 6 mins back. Assess on the next, rest, day. Keep doing that until you can feel it on the rest day - and then stay at that level for a few weeks training and then start to add minutes again. When you achieve the length of walk you want, you can start to increase intensity and speed. But again, not all at once.
With the bike - did you use a bike of any sort before? If notm again, start with just a couple of minutes at a time with a break between. But not more than maybe 5 or 6 mins in total at first. Then build it up in the same way.
It sounds silly, very slow. But you have a whole new normal and you have to start from scratch if you haven't exercised for so long. It is different if you were used to exercising and have continued all through PMR. I continued to ski in the winter after PMR arrived and then later after starting pred. But for the first few times I couldn't do much and started with just a few short runs - building up very slowly. You have to be careful about fatigue too - if you walk, choose a walk where you can bail out if it gets too much. Skiing I needed the rest on the lift between runs, I couldn't do the same distance as a longer run without the seat on the lift!
As with tapering, it isn't slow when it works! And if you don't overdo it at the start it won't put you off.
PMRpro, thanks for your suggestions. Much is appreciated.
Yes, absolutely a whole new normal and at times I get frustrated with it because I never know when I'm going to hurt even though I try my best not to trigger it. The last thing I was thinking was that PMR even effects exercising, particularly the whole body.
But yes, it's true I haven't exercised in ages but my sense was that (besides my heart) only my legs would be a effected being that I was just using a stationary bike, not my whole body that I experienced. Boy, was I wrong.
I chose to start exercising with a stationary bike because where I live it's sub-tropical with lots of heat and humidity that would make walking around a park a drenching mess. So I chose to exercise indoors where it's climate-controlled.
I will heed your suggestions with just trying a couple of minutes a day to see how that goes.
Now I need to spread out eating a mandarine orange, a banana, and about ⅔ cup of blueberries that I eat everyday, at the same time, all in one sitting. About a half hour of eating all that I've been noticing that my body aches, even still after I increased my prednisone to 15 mg. So I'm also going to try and spread each piece of fruit throughout the day and not eat in one sitting to see how that makes me feel.
There is such a steep learning curve with knowing PMR's triggers. It's absurd to say the least
A mandarin has about 10g net carbs, a banana over 20 and the blueberries probably 13 - some of the higher carb fruits. A total of 45g carbs taken all at once will cause a pretty impressive spike in blood sugar! Many people find that PMR doesn't react well to sugar rushes.
Using a bike doesn't just use the legs - you are holding position so that the abdominal muscles and spinal erectors are working pretty hard. But this article explains how pretty much ALL trunk muscles are involved - which will happen even on a stationary bike though it will be less:
I started having blood sugar issues starting in 2009 due to the side effects of a medication that I take and have been pre-diabetic ever since. But since prednisone I'm finding that controlling the highs and lows of my blood sugar seems to be a little more challenging. I try to keep my carb intake below 50 grams per meal but all the fruit I eat in one sitting was giving me problems of aches and fatigue.
I even recently started baking my own whole wheat bread because any store bought bread was just giving me blood sugar swings and intestinal aches. One of my doctors even said that there's just so much junk in food that it's no wonder that I was having food issues.
I have read and bookmarked the link to the cycling article you have kindly referenced. So now tomorrow I'm going to try cycling again but only for a couple of minutes to see how that goes.
Prior to my PMR diagnosis back in 2019 I'd always led a healthy, active lifestyle, attending the gym regularly and enjoying frequent walks every weekend with my husband.
Once I'd come to understand my condition and medication a bit better I very quickly realised that I now had new limitations and therefore would have to formulate different and more realistic expectations regarding physical activities and exercise regimes.
I quickly introduced some form of daily exercise into my new 'lifestyle' though, which began (as Pro suggested) with just a short walk, around the meadow that I'm fortunate enough to have right on my doorstep.
I began with two circuits of the meadow (a total of 10mins) and my safety net was knowing that should I feel it was too much for me (as it did on some days) I could literally cut straight across the field and I was never more than two minutes walk away from my front door.
I gradually built this up to 4 circuits, then 6 circuits until eventually I was able to complete a longer walk around the village. I still planned my route to include benches and seating areas that would offer me respite should I require it.
The past two years, I've been able to exercise back at the gym, doing gentle treadmill walking and some resistance work with light weights. I obviously 'tweak' the exercise to suit how I am on any one day and if I don't feel well enough, I won't go that day.
I have to be sensible and disciplined... in the sense that if I'm feeling tired, fatigued, achy or generally out of sorts, then I don't go to the gym.
I also engage in some gentle 'yoga for osteoporosis' and manage some short walks around the local countryside.
It's nothing like the more intense and demanding exercise regimes of previously, but it definitely has a positive effect on both my physical and mental well-being.
As others have already indicated though, introducing any kind of exercise regime whilst managing PMR/GCA has to begin very gently and be built up very slowly but it's definitely not an impossibility for many people.
I need to find my patience button with all things PMR because I'm finding that PMR digs into all aspects of ones life.
Walking for me would be preferable but it's just way to hot and humid outside where I live so I chose to cycle indoors instead where it's more comfortable. But as per you, PMRpro, and DorsetLady, I just need to start very slowly.
I am familiar with the aches and pains of starting an exercise program and is usually isolated to the muscles used but I was very unfamiliar with the PMR aches and pains when starting an exercise program. When exercising, PMR pain can be all over and not just in the isolated muscles that are used. It was never on my radar but now it is, so my hope is to be more mindful of it as well as being most patient. 🙂
Unfortunately, the 'learning curve' involved with PMR is a very abrupt one, particularly if you overstep your own limits......you very quickly suffer the consequences!
You're perfectly correct when you say, "...it digs into all aspects of one's life."
I personally have had to make many changes to my life too, including giving up my job... and although I'll never return to teaching, as I slowly improve and my PMR hopefully continues to diminish, I look forward to being able to resume some aspects of my life that are currently on hold.
This condition hasn't just closed doors though, it's opened others too, and I've found myself exploring and engaging in activities and past-times I'd never have considered previously.
So keep an open mind and try not to focus any more than you need to on any of the negative impacts. You just have to find your new 'normal', and embrace it.....for now at least.
When I started pmr the NHS physio told me to start exercising on the bike for just 3 minutes every other day. I gradually built up to 15 minutes over the months which was hard with terrible fatigue. So... slowly does it.
when I was diagnosed with PMR I was immediately put on prednisone. I did not have complete relief of my pain for quite a while. Eventually my dose was increased. It took a lot of up and down until I finally had relief. I wouid say to go very slowly with exercise. Your Doctor could advise you as to what kind of exercise.
I chose to ride a stationary bike as it's just too hot here to exercise outside. And if I did exercise outside then it would have to be before the sun comes up or when it sets and neither option is appealing to me.
The consensus from you and others is that I just need to ease into exercising very slowly, of which I will greatly heed.
Tomorrow I'm going to try to start out with just a 2 minute bike time to see what that does to my body as a mere 10 minute bike time that I did a couple of times seems to destroy it afterwards with me feeling whole body pain. It was intense.
Although I have a lot of apprehension about tomorrows exercise I just need to bite the bullet and do it. 😯
I have thee same experience with you with exercise, but found, to my surprise, that I can cope with swimming for halfan hour a couple of times a week. I do not know why this is magically easier, but I'm quite happy because the rheumatologist said swimming was the best form of exercise.
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