Fibromyalgia
The Bio mechanics, of day to day moves
The problems and some solutions
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Pain is the most prominent symptom of FM, but there are many others, especially when CMP on site link, gets in the picture. CMP trigger points cause muscle tightness. This is a major under statement. They can and often do clench to the point of nearly total oxygen and blood starvation to the muscle in question.

Imagine yourself standing there and clenching your fist. Now, hold it tight ... after a moment or two you will start to feel the loss of blood to your fingers. If you keep doing it, you will shortly lose the ability to open your hand. Even if you force that hand open with your other hand, you will find the hand in pain and nearly useless, as it lays there in your lap. This is what often happens where the muscles join to the bones, in CMP states. In Fibromyalgia, this effect can happen almost body wide.

One thing we all must do and tend to have the most trouble doing, is just walking across the room without running into anything. We have become a total klutz, in point of fact, for the simple reason that latent trigger points, meaning ones we are not aware of until we make demands on them, give way when we take action. This creates the "drunken" walk we are all too familiar with, as we bash into; doorways and walls, hit the furniture, trip over dust bunnies :) etc.

Now, understand, you are telling the legs, move this way. Your nerve impulses ARE telling the body where your feet are supposed to be going, but in the case of muscles with trigger points ... they lie, big time. The signal they are giving off does not match what your eyes are saying to your brain. You say, go this way and they go that way and wham, yet another bruise or broken toe.

You tend to look down at your legs and ask "will you get with the program here please ! " Which makes everybody think you have lost your marbles, as you are talking to your body parts... But anyway, cut the body some slack here, it is trying. But due to scrambled signals it cannot do the job very well. So, what to do to try and avoid broken toes, being black and blue or stressing your body into pain or a flare ?

( Please note: That while I was trained in bio mechanics, specifically for use for persons with disabilities and I have developed others on my own, understand, I make no claims that they will suit you, or even be possible for you. Use any of the tactics I outline here, at your own risk ! ) That said, onward:


Heads up ! For almost everything I am going to say here, the first rule is to bring your head up, you will see why in a second.

Walking 101:

First off, slow down a bit, we tend to go too fast and the impaired nerve transmitters can't keep up. Walk like a snake would, if a snake had feet. Let the body sway slightly, as you move your feet. A belly dance move I learned years ago has been a saving grace, called the camel walk, where you glide as you move.

Dance your way down that hallway and you may find yourself in a bit more control over the movements. The normal heel toe walking can make you trip over your own feet, as I am sure most of you have experienced. Keep your head up and eyes forward, this keeps your back in line and gives you better balance.

If, despite all this you do trip up and go to fall, my personal advice, as well as the advice of many body workers ? Mind you, you follow this suggestion, at your own risk, and this one takes practice. Which is, to roll with the flow and just go ahead and go down in a controlled fall taking the impact on your side. You are better off to let yourself go down, than trying to catch yourself. The sudden stop and jerk, yanks your entire body. That sudden stop can do some seriously painful damage to your neck, hands, elbow and shoulder joints, back etc.

The only exception to this is if you are on the stairs, or if there is hard furniture that you are going to land on if you let yourself go down. In which case, the yanked abused muscles and joints when you grab something to stop that fall, might be preferable to possible impact with things that will do you even more damage. But if it happens in open space ? Then relax and fold to the ground. If you are going down and you know it don't tense up and resist it, as you will just hurt more. Practice this, and I mean that quite literally.

Drop on the bed or other soft surface until you can fold and drop in a controlled fashion. This move is taught in all martial arts classes and we knew how to do it as small children perfectly. Kids can fall, get up, dust themselves off and keep going. Heck, they do it on purpose in their games. Why don't they get hurt very often? It's not just because they are young. It is because they don't tense up, as they are not yet afraid of falling.  We need to remember this.

Such a move, despite how it sounds, can prevent the dreaded dead drop. You know, the point where your walking along and wammo, your down, eating floor, with your head ringing and feeling like you just had a fight with the floor and the floor won. Feel yourself going down ? Take control over that move and minimize the potential for damage.

A note here: If this happens very often, there is bound to be some wise guy who says you are faking the fall, since it's under control when you go down. Never mind them, it's your bones, muscles and your own pain, you are saving.


Getting into or out of a large chair:

Now, if you are like most FMers any chair that you favor has arms on it. If it doesn't, it should. Getting your legs under you to rise can be a challenge, so here are a few tips on ways to minimize the strain. Make like a Queen on her throne here.

Go slowly, don't rush yourself. The chair should be the right size which means if you cannot put both feet on the floor, it's too high for you and you should not be using it. The same goes for the infamous "vampire" chairs and sofas, that swallow you. If you have any like that, get rid of them or don't sit in them.

To get up, first off, look up. That action tightens the muscles in your back and helps you to lift yourself up. Use your arms to start the process of rising. As you come up, lean the back of your legs against the chair and push off with them ( this tactic does not work with light or armless chairs, or ones on wheels, more on those in a second ) at this point, both feet should be on the floor, your legs pressed against the chair for leverage. Your arms are just for balance at that point.

To sit down is the reverse. Keep your head up, as this keeps the back straight. Back up to the chair and put your legs against it, this gives you a cue that you really are close enough to sit down. As if you don't do this what can end up happening is that you think you are close enough ( recall,  the nerves are lying to you here) and you end up flopping down in the seat. Not good, as you can jar everything that way. Use your arms for balance as you go down.

Now, if the chair can move like your desk chair or a light armless kitchen chair, use either the desk or the table... to push yourself away slightly. Then use the desk or table as your support to rise, as you shove the chair back with your legs. To sit down, pull the chair in as close as possible, stand in front of it and use the desk/table as your support as your going down. Again put your legs up against the chair, so you are certain where it is. 

To get in close, grab the table or desk and pull yourself forward. Do not reach down and grab the chair bottom and try and hitch it forward with your body weight in the chair. Put small gilding furniture movers under the legs if need be, say for the kitchen chairs, but make it mobile. For chairs with wheels, be sure that there is a full space behind you to shove the chair back as you rise. If the wheeled chair has arms, use them.


Sofas:

By and large, you will want to avoid them. Because as I am sure you have found out already that getting into or out of them, can be a pain. However, if you find it's comfortable to use one. Here are some ways to make it easier.

Getting down: 
Pick one end that has an arm, head up, then back up to it and lean into it with your legs. Use the side arm to balance as you go down. To get out, this is trickier, given how deep a sofa is compared to an average chair. Use your legs, hook  the front of the sofa, grab the arm on the side and pull with the one arm and then push with your legs against the sofa at the same time. You are basically throwing yourself into a standing position. Better however, is to have someone help you to rise.

The proper way to have someone help you:

One, do not have them grab your hands. This will just hurt you and you can easily lose such a grip. Reach beyond the hands and grab each others forearms. Have them stand directly in front of you and lock themselves into position, with them ready to lean back slightly. Do not let them pull you up, you pull yourself up, using their body as a stable leverage point. Their job is just to stand there, leaning back slightly against the pull and let you control the movement.

This can take practice and the helping party has to be able to withstand your weight, otherwise they are gonna wind up on the sofa with you, on top of you generally speaking. While this might be fun if it's your mate, them falling on you is gonna spoil any mood you might get going here, so make sure they can handle the weight before you attempt this.

No one in the house can help, or there's no one home ? Plan B and C.

Plan B, is to put a simple short chair near the sofa and use the back of the chair as your second chair arm in order to rise. It's much the same as getting out of a normal chair that way.

Plan C, worst case, is to roll off the sofa and on to the floor and then use the sofa itself to rise. Again, head up, back straight, lean both arms and hands on the sofa seat and use it to lever your body up off the floor, pushing off with your legs.


Going up or down stairs:

This one can be a major challenge for any of us. First thing, if the stairs do not have hand rails, get some ! Keep your head up. I know, we tend to look down at the stairs, but this just puts you more off balance. Lumber like a bear as you go up, meaning, holding on to the rail, sway a bit and bring up one foot, then sway the other way and bring up the other foot. 

Remember how you took stairs as a child ? By bringing up both feet to the step before moving to the next riser ? This can be very helpful. But even if you can do one foot per stair motion, keep a hold of the hand rail for balance. The muscle signal problem is very likely to cause you to lose your balance, as you are not only on just one foot, you are at an angle as well. Which is almost more information than the over stressed muscles can handle.

Going downstairs can be even more challenging as you often feel like your about to fall down. Again, head up, back straight, the same moves you used to go up.. is how you go down. Keep your eyes forward, not looking down. When you look down you tend to pitch the body weight forward, which will put you off balance. Lean back a bit if need be. A side step move, like a crab walks, is also a good alternative.


Carrying things:

Keep the head up and your back straight. Holding whatever it is, close to your body, using both hands, even if it's small, or both arms if it's larger. You do not want things dangling at the end of your arms if you can avoid it. Hug the item to you, even if it has handles, like a laundry basket ( the worst, as they are heavy ). Your arms can handle the weight, a lot more than your hands can. Futhermore, by doing it this way, you are not hunched over the item, pulling your shoulders out of their sockets by the weight at the end of your arms.

Bringing in groceries:

Don't rush and don't over load yourself. Hook the bags onto your forearm, not your hands and carry them close to your body. Even better, is to use a stick or cane to thread bags on to both ends and grab the middle of the stick, just like the over the shoulder carry sticks used for water buckets. Use both hands, not one. One handed puts you way off balance as all the weight is on one side. Use both hands and carry it in front of you. Hooking it over your elbows, rather than your hands can be useful, as it keeps the weight closer to your body. Besides which, your elbows are stronger than your hands.

If the house has just a few stairs to get in put the bags down at the bottom, hold on to the hand rail,  lean out over the stairs and place the bags on the landing. Anything non breakable, like paper towels and such, just toss it up there. This avoids having to go up the stairs with the weight. This tactic works very well, if there are two of you, one to get the stuff out of the car and the other to take them off the landing and bring them inside. This way, neither of you, has to carry them up or down stairs.

If you have a chair with wheels on it, drag it over to the door and load the bags into it and then wheel them into the kitchen. You can use both tactics, even if it is just yourself doing it. Try and avoid carrying the bags, and yourself up the stairs at the same time, if at all possible.

If this is not practical, hug your arm with the bags close to your body and use the hand rail to rise on the stairs. Use the hand that does not have the bags on it, to balance yourself. Rest as often as needed, during such movements.


Getting onto or off of, the porcelain chair:

Now, they don't build them with arms, ( more is the pity ) but you can either A: buy one of the toilet surrounds that does have arms and get up and down, just as you would a normal chair or B: if there is a counter top within reach, attach a towel bar or other handle on it to lever yourself up and down. If neither of these is possible, use your hands on your own knees, with your legs slightly splayed outward as a means to balance your weight as you go down or rise. As with all else, keep your head up, and your back straight.

Getting in and out of the tub:

Rails, rails and more rails, make the tub area look like a railway switching station if you must, but put in a rail for any move you plan to make. First is to get in, have a rail either on the wall or attached to the tub, or both, so that you are balanced getting in. And yes, again head up, back straight. ( You are getting tired of me saying that by now, aren't you ? :)

Place one at the rear of the tub so you can lever yourself up and get your feet under you to rise from the tub floor. It also creates a place to put your feet to wash them, or bring your leg up for shaving. Likewise on the side of the tub wall. It is yet another place to grab and steady yourself.

If you have one of those tub enclosures, where it is impossible to attach any rails. As some are made in a cast thin fiberglass shell, with no way to attach anything that would hold weight, not even the suction cup variety. Then the clamp on rails that go on the edge of the tub, becomes paramount.

A bath chair might also be wise for those days when you are just wiped and you don't have the energy to even stand there. This commands the need for a hand held sprayer as well, as you sit down to bathe. Many bath chairs have short hand rails, use the rails to rise up just as you would from any other chair.


In and out of the Car:

Depending on how far your vehicle is from the ground, getting out of the car is much like getting in and out of the tub or out of a chair, it's a bit of both really. The typical stance of one leg out and shove off as you drag the other leg out and stand, is asking too much of the muscles. Too many things are going on at once and the body will get confused.

Option one, getting in: 


Open the door all the way, turn and face away from the door opening and grab hold of the door. Then sit, as you bend your head under. This takes some practice to do well, as otherwise you might hit your head since you cannot see. 

Once your buttocks on are on the seat, let go of the door and grab the wheel, use that leverage to swing both legs around at the same time. Still holding the wheel, reach out and grab the door to close it. Use your grip on the wheel to draw the door to you, so you whole body is part of the process, not just your left arm.

Note: If you drive a truck, ( as I currently do ) this will mean doing the step up and then, the above moves as you stand on the side rail instead of the ground.

Option two: 

The most common. Door all the way open, hold on to the top of the door and the right or left hand side door opening, meaning the car body, reach one leg in and let the body ease down into the seat, using your grip on the top opening of the doorway to control the move. It also saves you from hitting your head, as remember what your eyes see and what the body will tend to do, is not always predictable. Once the derriere has landed, again grip the wheel or the dashboard and gently pull your other leg in. Lift it up and in, if need be. To close the door: Still holding the wheel or dashboard, reach out to grab and close the door.

Reaching back for the belt: 


It's habit to try and look at it, but don't. You know where it is, you do not need to see it. That extreme crank of your head to look at such an angle, is likely to be painful. Reach with your right or left hand over your body, grab the belt and pull it over. Now, you can look down to hook it up if you have to, but again, by preference do it blind. You don't want to pull your head that far out of neutral.

Getting out of the car: 


Option one: Fully open the door, grab the wheel or dash and get the body turned to face the door, swinging your legs out. Then grab the door and the car body, and push off with your legs to stand. Watch your head as you rise. If you have doors that do not lock into position strongly enough, another option, ( the one I use most myself ) is to put out both arms, once you get your feet out and grab the door jam itself on both sides and pull against the car frame to stand. This also puts your hands in equal positions.

Option, two: 


Fully open the door, get one leg out, grab the wheel or dash and use it to slide your body sideways, towards the door. Do not try and use the leg that is now outside the car to drag you over. Then reach up and grab both the door and the car body, or both edges of the door frame, and use your arms to lever the body upwards until you can get your other leg out to stand on.


Computer work:

This is one where most of us tend to mess up, as we get rather absorbed in what we are doing. However: Ways to ease the strain.

First off, where your monitor is, is of paramount importance. If you have to dip your head up or down to see it, it's not in the right place. Put as many books or what have you under the monitor as needed, but get it to where most of what you do, is at eye level. As otherwise, what you tend to do is hunch over, be it your body or your head, or both. Or, you are hyper extended and your neck and back are leaned out like a giraffe's head trying to get to the tree tops.

Keyboard: 

Optimal placement, is to where you can pull your arms in to your sides and just extend your hands out to type, preferably with somewhere to rest your wrists. Most people find that an under drawer set up that you can pull out from under the desk, works best for this rather than have the keyboard on the desk itself.

Mouse use: 

This one can be hard to get right. First off, get a large mouse pad. Don't even bother with those things the size of a postage stamp, get one that covers the entire front of the desk space. ( They sell these at most office supply places ) and get the mouse set to where you can use it from any position. 

Use a wireless mouse, you want free range of motion here. Re-set the mouse movement to fit you. How you do that is go to your control panel, find the mouse set up and fiddle with the adjustments, until you find a movement, speed, and tension that fits your needs.

Avoid short repetitive movements with the mouse. Set the adjustments to where you need to move it more to get action, than what are its default settings. This makes you have to move it further, to get the cursor to move. This might seem like extra work, but it forces you to use a wider move, instead of short tiny ones. 

Most of us have carpal tunnel and using the mouse with tiny moves from just the wrist, is a promise of numb hands. ( This is also true for those without FM, as the tiny movements court carpal tunnel, so make the mouse run its little feet off to spare your hands )


Watch the body postures:

A great many of us, due to pain, will contort ourselves, without even realizing that we are doing it. That is we don't until the muscles we have put under strain, scream at us. Pay attention to your entire body interface here. Listen to the messages and make whatever adjustments you can, to avoid stressing them out.

Take breaks: 

Get up, walk, stretch, drop your hands into your lap when your not using the mouse, instead of sitting there with your hand on it. Come on, we all do it and we know it :) but for the sake of your hands, get out of the habit.

Center everything: 

What tends to happen, is we are off center, especially with the mouse off to one side, which is why the large mouse pad and getting the keyboard off the desk. Place whatever you commonly use, in easy reach. Build pigeon holes over the top of the monitor if need be to have what you use all the time, handy. If you are having to lean over the side of the chair to get something, it's not in the right place. 

Moreover, absolutely do not lean over the side of the office chair, especially if it has arms, can you say owww ~ In the case of drawers, stop, move the chair over to it, then pull it open or turn the chair to face it, again keeping the body level and not twisted sideways in the chair.

Use the scroll bar: 

Get the part of the page you are reading or looking at  level with your eyes as much as possible. Do not fall into the habit of reading the entire screen down to the bottom, before you pull it up. Your head should not dip down, until and unless you are forced to as there is no more page to pull up.

Using a laptop: 

This is a bit more of a challenge, as ordering where everything is, is next to impossible. Due to their size, we can and do tend to use them almost anywhere. Set up the lap top to where your arms are supported, while your hands are on the keys. Fully open it, even to it being hyper extended, so you don't have to dip down your head to see it.

Use larger fonts were possible:

If the font size is too small, what you will tend to do is lean forward, bringing your eyes closer to the screen. Bad move, as it pulls on your back, neck, and rubs your tail bone raw from how often you move in and out, to read.

Windows is, by default, set to a medium font in your browser, however, you can change this. On your browser itself ( in IE and Fire fox, Google ) look up to the top row, the stuff above everything in the window and find the word view. Click that and you should see something that says, text size.

In IE, this means setting it to large or largest, ( default is med size) and on sites where they have not frozen the font at a given size, everything will get bigger and therefore, easier to read. In Fire fox the settings just says increase or decrease, just hit that until things are a size you can read, without leaning into the screen.

Most of us who have FM, are at least middle aged and it's common to reach a point where your arms just are not long enough to read, as you are near sighted, so bump it up. Another means to do this on most modern systems, is to hit and hold the control button and then move the wheel on your mouse. This will bring the font up or down, depending on what direction you wheel the mouse.

Learn to touch type: 

By that I mean, learn how to type. Know where the keys are so you are not sitting there with your head cranked down at a steep angle, looking at the keys. There are many programs available, to teach you how to do this.

Lighting: 

Place lighting to where it only lights up the area you need to see, like on the keys and in front of the monitor where the mouse is. You do not want an over head light, or window light, glaring on the screen. As again, this will force you to lean in, and squint  to see clearly past the glare. So lose the over head lights and block out the light from whatever window is behind you. ( This is also true for TV's ) 

A small but important hint, clean the screens. While it might not seem like it just looking at the screen, they get dirty rather quickly and if the screen is dusty, greasy, has streaks and such like, it is going to be harder to see things. The same goes for any glasses you wear.


In the Kitchen:

Now, most kitchens are horrid places to work in or around, for the simple reason, you are forced to either bend down and or, reach high, for just about everything you want. This includes the refrigerator. Which, unless you happen to be lucky enough to have a bottom freezer model, means that just to get anything out of, or put into your average fridge, is an extreme bend and crank your head and body. See details below.

The cabinets:

First off, move the most commonly used items to the most accessible shelf. For anything high, use a small step ladder, the kind with a high carry handle. The reason for this is simple, if you use what is typical, a small four legged stool, for one, they are often too small and we are off balance as our feet are too close together and for two, there is nothing at all to grab ( just as a note, they do make these very same tiny stools with large stand up handles, but I wouldn't trust them even then, as there is still not enough room for our feet )

Now, if you must go down to the lower cabinets, lower the entire body, in effect doing a squat. To bring your head down to see, using the wall and or cabinet to stabilize yourself. To rise, grab the cabinet door, the counter top, or open the cabinetry above it and grab a shelf to help you to rise.

Alternatively, if the knees will not stand for such an extreme move, make like a sumo wrestler and spread the feet out and bring the body down. The knees are under much less stress. 

We have all seen this move and while it looks funny, it is a much more stable position to move from and rise from. Hands on knees both going up and down, is one way for stability. Consider the fact that sumo wrestlers are much larger than most of us could even think of being, but they are perfectly able to move in any direction from such a position. Again, use the wall or cabinet door for stability during the move up or down, if you find that is easier.

If an item you need to lift out of a cupboard is heavy, like a large pot, put it on the floor beside you, rise up, then with your foot, move the pot near the stove, then using the stove top, do the same move to get down and pick up the pot and rise, using the stove to balance yourself. Do Not use the oven door to rise, as it will open up on you, making you fall, with the pot htting you too boot, use the stove top.

Getting into the refrigerator: 

Your typical freezer on top refrigerator, can be murder to get things into or take out of,  as it forces you into some very awkward and often painful positions to do it.

Several things:

One, move the most commonly used items to the front of the top shelf. Two, reach in blind, by that I mean, you know where the milk is, why are you bending down to look at it with your eyes ? Just open the door, bend the knees slightly and without ducking your head, keeping your back upright, reach in and get whatever it is, the same goes for putting it back. If your face is close to the freezer door as you reach in, your doing the move correctly. Now, for things on the lower shelves, and buried in the back, use the same sumo wrestler move, to get down, holding on to the top of the door or the body of the refrigerator, for stability if needed. 


Getting Into and out of Bed:

Believe it or not, there is a right way and wrong way to do this, for anyone, much less for us. If you have leg use, that way goes like this:

Getting out: 

Roll your body until you are facing the edge of the bed. Drop one leg to the edge of the bed, and hook it. Pull with that leg, while at the same time, push upward with your arms to bring up the rest of the body. Once the second leg is within reach, you can use it to pull as well. You want the body to remain in line, at all times, no twisting, no turning and yes head forward and back as straight as possible. 

At no time do you want to stress out your lower back, hips etc, by trying to force your entire upper body, bolt upright in bed, using just your back or tummy muscles to rise up.

Getting up from the bed is the same as for any armless chair, with no table handy, or rising off the commode. Legs spread, hands on knees and lean forward at the hip, letting your own body weight, pull you forward, then tighten the thigh muscles as you straighten your legs, to stand.

If you do not have leg use, to rise, a possible way is a cotton rope, ( no nylon, it will burn your hands ) of a large diameter so it does not cut into your palms, with knots in it, to give you pull points, about one foot apart, tied to the foot of the bed rail. Position the tie down to the bed rail, about centerline of where your body normally is in the morning, then hook it somewhere behind you so it will be in position, in the morning ( a hook on the wall near the edge of the bed works fine ). This rope will give you a way to raise up the body, even if the legs cannot be directly used. 

Preferred however, is the roll over bringing your legs with you, face the edge of the bed and use the arms and the same on your side move as outlined above. Once upright, lift your legs down to transfer to your chair or other conveyance.

Getting into the bed is much the reverse. Check your distance with your legs, to be sure you are close enough. Sit down, then fold the body down on your side, using your arms as support, until your head hits the pillow, drawing your legs up, as you go. 

Otherwise, what you can wind up doing is the more typical, get in, get your legs in and covered. Then sitting bolt upright, do a controlled fall into the pillow, using your back and stomach muscles to control the move... well, I think you can see the problem with that idea, for us anyway, for yourself ... especially if your muscles or back gives out, which at the end of a long weary day is much more likely.

Not to mention that what we think we see, is not always how things are with FM. How close you think you are to the wall and how close you really are, might be two different things entirely... which means if you do this drop onto the pillow routine, you are going to misjudge that distance at some point, likely on the same night that the back and stomach muscles give out on you and BAM..

The contact of your head with the wall might solve your sleeping problem for the night, but I think it would make for a very lousy morning. :(


More coping tactics on Day to Day living