Could anyone direct me towards good information on program design for a middle aged woman with polymyalgia?
Polymyalgia rheumatic (PMR) is an inflammatory disorder that causes widespread muscle aches and stiffness. The problem areas of this disorder are primarily in the neck, shoulders, upper arms, thighs and hips. PMR is very similar to fibromyalgia; both affect the same areas and cause similar pain and discomfort. But PMR is considered an arthritis-related condition while fibromyalgia is not. Like arthritis, PMR can cause significant pain and fatigue, and it can interfere with a person’s ability to carry on daily activities. In addition to pain and fatigue, PMR patients can experience headache, morning stiffness, restless legs syndrome (RLS) and numbness or tingling of the extremities. The causes of PMR are unknown, but there are probably a number of factors involved. Although some patients develop symptoms gradually, PMR can literally appear overnight.
Since PMR is an inflammatory problem like arthritis, this means it needs to be treated along the same guidelines. Although pain and fatigue may make exercise and daily activities difficult, it’s crucial to be as physically active as possible. Fitness programs and occupational therapy (i.e., massages) are two very effective ways to reduce the pain and stiffness in PMR clients. When developing a fitness program for a PMR client, you must keep in mind that a PMR client has more stiffness and pain than a normal client, so the progression and intensity will be reduced.
When training a PMR client, there are a few guidelines you need to follow.
- Warm Up - It is very important that your client is very warm before any workout. The more the muscles are warm and relaxed, the more efficient they will be. Also it will decrease the likeliness of an injury and/or pain.
- Low Impact Cardio - Starting off, you want to keep everything low impact, so no running! Swimming is the best low impact cardio exercise. Others to try include cross training skiing, biking and the elliptical machine.
- Increase Flexibility - The greater your client’s flexibility, the better her muscles will work, and there will be a decrease in pain and stiffness. Some good stretches are listed below.
- Controlled Movements - These are basic movements that are easy to coach.
- High Repetitions/Low-Moderate Weight
- Seated Chest Press (1RM 200lbs)
- 100-125lbs; 15-20 reps or timed for 30-60 seconds
This program will help your client, but you must stay on top of your client’s improvement. The pain and stiffness of PMR can be reduced, but a key factor in this outcome is the progression of your client. When she has improved, you have to progress her. Never let her plateau!
With any client, there are always hurdles you must jump over, but the important thing is to always ask questions and err on the side of caution. Seek an expert’s opinion if you are ever in doubt.