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Symptoms of fibromyalgia syndrome (FMS), a condition characterized by chronic and often debilitating pain of muscles and fibrous tissues, may be eased by regular participation in aquatic exercise. 

FMS affects approximately 12 million people in the United States. While those who suffer from FMS experience symptoms differently, the most common complex of symptoms include burning or stabbing pain in muscles; tenderness in the neck, shoulders, back, pelvis, hands and feet; fatigue and anxiety; and depression and poor sleep. 

Physicians have long recommended exercise as a non-medical treatment; but for most FMS sufferers, land-based exercise  is too strenuous or painful.  Recent studies and significant anecdotal data suggest that aquatic exercise is a better option.  

Free from the stress of gravity, FMS patients feel relief from pressure-point symptoms in the water, and the buoyancy cushions and supports the body.  Water exercise provides the same endorphin-releasing benefits of land-based exercise to improve depression, anxiety, fatigue and poor sleep. An added benefit is that it is actually feasible for many FMS patients to perform movements in the water. Consequently, physical and emotional symptoms may be relieved.

An FMS water workout may include aerobic, core and limb strength and flexibility training. The key is to keep all movement nonimpact and low-weight-bearing.

Aerobic movements should be performed as deep-water exercise, with the participant suspended via flotation devices such as a water running belt, if necessary.  Depending on the participant’s conditioning level and other considerations such as relative joint health, appropriate deep-water exercise may include running, walking or aerobics. 

Strength training movements should be performed in water deep enough to cover the moving muscles and joints; the deeper the water, the greater the buoyancy effect and the less stress on the rest of the body. However, participants should be shallow enough that they can maintain control of the movement and props.

For example, if doing bicep curls, the elbow should be under water, the rest of the body as deep as possible for comfort, but not so deep the participant cannot control the aqua dumbbell.  Core-strengthening movements may be of particular benefit to those suffering from neck and back pain. 

Flexibility training is especially important for those who maintain largely sedentary lifestyles. Stretching reduces risk of injury and pain from poor body mechanics. To stretch safely in water, the area being stretched should be completely submerged and the water must be warm.

Water temperature may be the biggest barrier to successful FMS water exercise programs. FMS patients often report constantly feeling cold, and may have trouble regulating body temperature. 

In addition, warm water

relieves muscle soreness; cold may make muscles tense up or “snap back” after being stretched, thus making the water exercise counterproductive. 

Water temperature above 88 degrees Fahrenheit with relatively similar ambient temperatures (for indoor pools) is best. Otherwise, participants could be encouraged to wear wet suits or skins to maintain a sufficient body temperature.