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How to Go From Couch to 5k with Fibromyalgia

Updated: Oct 27, 2021

Couch to 5k running progression for fibromyalgia. The shoes of someone running it.

Do you have fibromyalgia and struggle to exercise? Does the idea of going from your couch to 5k with fibromyalgia seem completely out of the possibility?

This article is for anyone glued to the couch from chronic pain with dreams of getting back to an active lifestyle again - maybe even running again.

In this blog post, we'll outline why exercise can be helpful if you suffer from chronic pain and the framework necessary to begin improving your physical capacity. We suggest you talk to your doctor or physical therapist to make sure you're safe to exercise and for any other personalized medical advice. All in all, this article will give you the bird's eye education to go from your couch to 5k with fibromyalgia.


Table of Contents


Why Aim To Run a 5k?

Someone confused why they'd run a 5k with fibromyalgia

When you hear the title of this article, you may be thinking... "My body is too broken to ever run a 5k." For some, the thought of running again can be both daunting and painful.

What does running a 5k accomplish anyway? Well, in all honesty, there's nothing all that special about moving your feet quickly for 3.1 miles. But the journey to exercise again? This is where the true benefit resides.

The process of gaining enough strength, mobility, endurance, and resilience to run a 5k (or any distance outside your current capacity) can lead to enormous benefits to your pain, health, and overall wellbeing.

What if you simply cannot run? What if you can only walk? Or wheel? Again, the distance and method is inconsequential.

The most important benefits of exercise come from your body adapting to a slightly larger physical stress than it's used to.

Can Exercise Help with Fibromyalgia?

Someone with low back pain from fibromyalgia

Exercise and chronic pain are a true catch-22. For example, if you hurt, it's hard to exercise. But, at the same time, if you can't exercise consistently, it can lead to more hurting!

Let's suspend your disbelief of exercising again for 2 seconds to see what benefits exercise may hold for fibromyalgia.

According to a massive 2017 review of the literature on fibromyalgia and exercise, favorable effects on pain and physical function were seen for individuals with fibromyalgia that engaged in regular exercise (Geneen et al., 2017).

In another study, a group of women with fibromyalgia performed low-intensity physical exercise for 8 weeks. At the end of the program, the women with fibromyalgia who engaged in exercise had improved pain pressure threshold, anxiety, depression, self-perceived functional capacity, and physical endurance. The women in the control group without exercise? They received no such benefits (Izquierdo-Alventosa et al., 2020)

Finally, a Cochrane Review on aerobic exercise and fibromyalgia found that aerobic exercise may have the capacity to improve pain intensity, physical function, fatigue, and stiffness (Bidonde et al., 2017).

6 Tips to Exercise with Fibromyalgia

6 tips to exercise with fibromyalgia

So if exercise has a positive effect on fibromyalgia, but you hurt too much to run a 5k right now, where can you start? Here are 6 tips to get you started.

1. Find a Physical Therapist to Work With

A physical therapist working with a fibromyalgia patient

First and foremost, you should have a medical team in place if you want to exercise with pain! Why is this? Well, for one, it's important to know when and what is safe to perform. Understanding what is "hurt" vs. what may be "harm" is crucial to getting started.

Because pain is a sensation that arises in response to a "potential threat" to the tissues of your body, it's crucial to exercise in a manner that isn't threatening to you! When you are more assured that an activity will not produce lasting harm, it helps lower the body's sensitivity.

Sore - But safe.

2. Start Easy

This is a challenging one for many of us. Me especially.

Sometimes our eyes go wide at the possibility of getting back to activities we enjoy. But, here's the thing, when you're in chronic pain, your body is working overtime to try and protect you from potential harm. Because of this, it may not let you get away with too much past your baseline.

When we say start easy, we mean REAL easy. Sometimes just a short walk of a few minutes or a few basic muscle contractions such as a "quad set" or "glute squeeze" may have to be the starting point.

3. Work With Your Pain

What's the right mentality to have while exercising with pain? Is it "no pain - no gain"? Or is it "no pain at all"?

Of course, first, check with your medical team to make sure it is okay to have some pain with activity; however, what seems to be the sweet spot is somewhere in between.

With "no pain - no gain," you push your body until you can't possibly go anymore. But with this exertion often comes a rebound pain and fatigue that can keep you glued to the couch for days or weeks on end. We call this the "Boom-bust cycle." This isn't very productive towards long-term progress.

On the other hand, avoiding pain at all costs may lead you to never leave the couch in the first place! This is because when you have fibromyalgia or any chronic pain condition, typically, your pain system is overactive and extra-protective. Meaning, it produces more pain than it should to keep your body "safe."

The idea of working "with your pain" means that you exercise in a way that you feel safe and believe that you won't pay for the activity afterward. Pain is certainly not a requirement to achieve a good level of exercise; however, having minor soreness may not always be harmful. This is where checking with your medical team is super helpful!

4. Pace Yourself

A tortoise going at slow pace representing pacing for fibromyalgia and exercise

When it comes to physical activity, pacing is a wonderful strategy for both pain and fatigue. The idea of pacing is to break up your activity into chunks of time. These periods are predetermined in length and not set to your fatigue or pain limit.

For example, setting a work/rest cycle of 10 minutes working and 5 minutes resting would represent pacing if you were to do some yardwork. This doesn't mean that you have to stop all your activity after one cycle. You can do as many cycles as you feel your body can do without paying for it. Though similar to tip number 3, it may be good to start with just a few cycles to begin with.

When it comes to running, a "walk-jog" progression is a great example of pacing. We'll get to that below.

5. Small. Gradual. Overload

How does a runner become a marathoner? How does a gym-goer become a bodybuilder? How does a gymnast become super flexible?

It turns out that when you repeatedly subject your body to a small physical stressor just outside its usual range of comfort, your body responds. Basically, your body looks to improve itself to meet the increased demand for the next time it may be subjected to a similar situation. This concept is known as "adaptation."

To achieve physical adaptation and change your body for the long term, it's important to slowly, gradually progress the physical challenge you present yourself. In addition, you'll need to be consistent for an extended time.

This is why pacing and starting easy is so important. If you can't stick with a program, likely you'll have a hard time making progress, regardless of how good that program is.

Any consistent and progressive program is better than none when it comes to fibromyalgia and exercise.

6. Focus on Recovery

Rest and recovery for fibromyalgia running and exercise

Your training and exertion are only as good as your recovery. This is more important than ever with fibromyalgia. What helps with recovery? Focusing on sleep, nutrition, and stress management is key. These domains are also key to chronic pain treatment in general. With NewFrame, we guide you through actionable habits to improve in these areas.

Stretches and Strengthening Exercises for Fibromyalgia

stretches for fibromyalgia

If you want to prepare your body to start running, it's important to give some love to the muscles and joints involved with running. Improving the strength of your glutes, quads, and calves will serve you well. In addition, stretching to improve your ankles and hips' range of motion can be pretty helpful. So what are the best stretches for fibromyalgia? A fibromyalgia exercise program could incorporate these exercises below.

Strengthening Exercises

  1. Hip Bridge (Glute/hamstring strength)

  2. Single leg balance (Glute stabilization/endurance)

  3. Wall sit (Quad strength)

  4. Heel raises (Calf strength)

Stretching Exercises

  1. Kneeling ankle dorsiflexion

  2. Calf stretch

  3. Hip flexor stretch

4 Ways to Start Running

Starting a couch to 5k running program

You've got a great physical therapist at your side, your doctor says go for it, and you're ready to begin your couch to 5k journey. Now what? Just run? It turns out there are many creative strategies to ease yourself into running than just running.

1. Start By Not Running

One of the best ways to start running is by... well... not running. Building up your body through strengthening and stretching before running will help ease your body into the demand of running. See the 4 key strengthening exercises and 3 key stretching exercises above.

2. Walk-Jog

As it is with most things in life, an all-or-nothing mentality can work against you. Why force yourself to start running 1 mile out the gate? One effective strategy many runners employ is the walk-jog technique. With this method, runners will walk for a pre-planned period and then jog for a period. This cycle is repeated several times. This all goes back to pacing!

3. Water Jogging

Is the impact of the ground a bit jarring to you? Starting your running journey by jogging in the water is a fantastic way to begin. You utilize many of the same muscles employed during running, get the running neural machinery going, and break a sweat at the same time. All while feeling better!

4. Elliptical or Machines

What if it's raining outside? What if you live in a place that's unbearably hot or cold? For some runners, utilizing machines such as ellipticals can offer a solid alternative to running. In addition, many of these machines make running even easier to boot.


An active lifestyle doesn't have to stop if you have chronic pain. In fact, exercise has been shown to demonstrate benefits in pain and function levels in people with fibromyalgia.

Getting started and finding a routine that works well for you is often the number one challenge. Talking to your doctor and finding a physical therapist is a great starting point to getting back to running.

There are a variety of tips, strategies, and exercises that can make running easier with pain and fibromyalgia. NewFrame provides all of the latest information on how exercise can help chronic pain and the habits you need to do it effectively.

What race will you be signing up for?


Relevant Articles on NewFrame


  1. Geneen LJ, Moore RA, Clarke C, Martin D, Colvin LA, Smith BH. Physical activity and exercise for chronic pain in adults: an overview of Cochrane Reviews. Cochrane Database Syst Rev. 2017;4(4):CD011279. Published 2017 Apr 24. doi:10.1002/14651858.CD011279.pub3

  2. Izquierdo-Alventosa, R., Inglés, M., Cortés-Amador, S., Gimeno-Mallench, L., Chirivella-Garrido, J., Kropotov, J., & Serra-Añó, P. (2020). Low-Intensity Physical Exercise Improves Pain Catastrophizing and Other Psychological and Physical Aspects in Women with Fibromyalgia: A Randomized Controlled Trial. International journal of environmental research and public health, 17(10), 3634.

  3. Bidonde J, Busch AJ, Schachter CL, et al. Aerobic exercise training for adults with fibromyalgia. Cochrane Database Syst Rev. 2017;6(6):CD012700. Published 2017 Jun 21. doi:10.1002/14651858.CD012700

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