Exercise

@csimmonds
Is it PMR pain or exercise pain, or cortisol withdrawal.
I’m 79yo female, and found it was usually exercise pain, trying to get back on the horse too quick.
Options I use…..
Aqua pt…..exercises in pool
Functional movement specialist……a trainer with more depth of body functions
Good luck

@tweetypie13 Good question whether on what type of pain. I don't know about cortisol withdrawal--how would I know? I think I might be over doing it in the pool. I do pool exercises and some breast stroke. I use a pool noodle for resistance. During the summer I do this at least a half hour a day. We have a pool. During the winter I go to the YMCA but not daily and I stay longer. I think that is the difference and it is exercise pain and stiffness the next day. I will try to go more often and do fewer sets. This week I plan to just do weight machines daily and see how that goes. The town I live in is not large. We have good options for physical therapy for not sure how specialized. I will check into that.

Hello Tucker! I've been feeling a bit sad and depressed this past week after recently being possibly diagnosed with PMR. I've been spending a lot of time researching the condition as well as discovering forums like this one to help me better cope and accept. After reading your response, I found a lot of encouragement because we have traveled similar journeys. At an early age, I had two lower back discs ruptured two years in a row. I decided to take an aggressive action plan and dedicate myself to a life of fitness and health. For the last thirty to thirty-five years, I have become a fitness enthusiast ... weekly bootcamp classes, HIIT classes, heavy gym workouts, rowing marathons, running, sprinting, jumping rope -- you name it, and I probably tried it and / or still do it. A month ago I was at a really good peak of conditioning as I was training for an indoor rowing marathon. A week after the marathon, my body completely shut down and became immobile. It truly scared me. How could I be at the height of my conditioning and then become frail and weak? I visited many doctors and all of them simply felt I had overexerted myself and sent me home with new pain killers (none of them worked). Everything was a physical struggle for me ... walking, getting in and out of my car, getting dressed, picking things off the floor, writing on the whiteboard (I'm a teacher), raising my arms, sitting, standing, putting on shoes ... I went from being able to easily perform 15 to 20 pull-ups and 50 push-ups to not even being able to hold my body weight in plank position or hang on the pull up bar. Last week a doctor suggested that my symptoms might be related to PMR, so like many other people on this site, he prescribed Prednisone. I did regain a lot of mobility quickly, but after reading all the information about Prednisone, I returned to that place of fear and worry again. Perhaps what worries me the most is that fitness and exercise have been my safe place to escape my workaholic lifestyle. I've tried to be very cautious about returning to exercise (especially since I am now 61 years old). Your story honestly gave me a source of hope that I too will be able to once again rejoin the fitness community and the exercise regime that I once enjoyed a few weeks ago. I'm even a certified NASM personal trainer, so all of this is very humbling to me and all the goals I have tried to achieve by aging with a healthy lifestyle. Thank you for sharing your story online, and thank you for being an example of hope for me as I learn to battle and deal with this possible diagnosis. I could really use a friend right now, so I hope my words reach your heart as well. In sincere appreciation!!

I started lifting weight when I was 19. I never lifted competively but I always made time for my workouts. I became a jogger for awhile as well. It is addictive if you try to take care of yourself your whole life then get PMR. I had read it was not a muscle wasting disease but lack of activity could be. So I went from heavy weights(for my age) to barely lifting the bar. I could barely get out of bed but I felt better if I went to the gym. I set up an exercise rotation where I briefly worked every muscle. Everything hurt. I have about 15 exercises I do where I do one set of ten and then start over and do the second and then the 3rd. Then 3 times a week I do the treadmill for 15 min. I do the Bruce protocol on the treadmill. PMR and Covid made gym workouts difficult but I did my best. Once I started steroids I was almost pain free. Like you I had to be careful. I was not feeling any pain. There were days that I just did what I could but I very seldom miss. I go every day for about an hour and fifteen minutes. I have kept the same workout since PMR. The only difference is my 3 sets are the first set is an easy set of 10 for warmup. Second set I add some weight and the third set is where I can barely do a set of 10 or 8. I am 72 now. That has also added a level of humility. I attribute the fact that I burned out PMR in 6 months and was off steroids to my dedication to exercise and knowledge of steroids. Steroid dependency was a lot more serious condition than the PMR. I no longer believe I can build muscle due to age but I can still maintain and strengthen what I have. I also after PMR had all my hormones checked. I have been able to stop most medications that I started from 6 months on steroids. I dont know if this helps. I can give you specific exercises I do. Its just a full range of movement from legs , shoulder, back , abs, arms. They say to let muscles rest a day or two between workouts but I needed to keep blood flowing to everything. I very seldom do single rep heavy weights. Occasionally some young pup fires me up into competing then I pay for it.

@tuckerp I was dx’d PMR in Nov. ‘25. I’m 68. I have to ask, how you are doing now. Almost the same story as yours. Other than the two weeks of barely being able to get out of bed, I haven’t slowed or changed my workout routine. Two days into Prednisone I felt great again, so I didn’t reduce or change my workouts 1-1/2 to 2 hours a day (mornings.) half of that is treadmill occasionally running, followed by serious stretching. I’m on the same Mediterranean-like diet that I’ve been on for 4 years.
I’m at ten weeks taking Prednisone from 40mg/day to now 15mg/day.
How are you doing now?

@stonewheel glad your keeping moving. I still go to the gym every morning. Same workout. Trying to hold my strength and form the best I can. I will be 74 in June. I started testosterone about 2 years ago and that has helped my overall physical health. My wife passed 1 year ago after 51yrs of marriage. That has been huge. Exercise has kept my sanity. In my PMR journey I found that 10mg was my comfort spot. I tried about once a month to move lower and could not. At 5 months I started to taper and had no issues. I tapered off over the next month rather quickly. It took about 6 months to feel better. Fatigue was my worse thing. Thats when I started the testosterone. At about 9-10 months I had what I thought was the start of PMR again. I took a 5 day pack of prednisone and it was gone. I had another about 3 months later and did the same. That was in 2022. I have not had a flare again. I take a daily BP pill now and I have genetic cholesterol issues. I take a twice monthly injection of repatha. Just found out I need a hip replacement. Dr credits the fact that its not crippling pain to the fact I keep it moving every day. A lot has happened since I turned 68. I hope to slow the train down. Keep up the good work.

@tuckerp Hi. Thanks for your reply. I’m touched to hear your loss. I hope you had family help.
“ At 5 months I started to taper and had no issues. I tapered off over the next month rather quickly. It took about 6 months to feel better. Fatigue was my worse thing.”
Do I understand correctly that after 5 months at 10mg, you went from 10mg prednisone to 0mg in one month? If so, your adrenals responded quickly. If so, perhaps it was the exercise? My personal thoughts are that exercise circulates rejuvenated blood faster to our tissues, that increases and speeds up available resources for cells to repair and systems to get back to normal. Perhaps maintaining exercise, more good blood circulating faster, the adrenals normalized sooner? I know we’re all different, I’m just trying to share my reasoning for exercise and at the same time be aware of what to expect. I appreciate the feedback. I hope you don’t have any more flares. Testosterone added is something that I had not thought of.

So sorry to hear about your wife, tuckerp. You were together, not only for such a huge part of your lives, but also began your journey as kids. I can only imagine the impact of this gut punch and life-altering loss. I'm moved by what's between the lines. Sounds like yours was a good marriage. My sympathies.
About exercise, I echo your sentiments. I can't tell you many times I've said the same thing to others:
"Working out has saved my life."

Interesting PMR journey. Nothing vaguely interesting about PMR unless you don't have it. I did not take steroids with my bout (began early '24) but it did abate in about 10 months. Unfortunately, the Baker's cysts come and go still and are very painful. Right now, I'm also experiencing a bit of a PMR flare but if it gets no worse than this, I consider myself lucky. It's great that the predpak helped you! Hope you're done with PMR but seems like for some of us, it sits there, like a tiger, waiting to pounce.

I'm also interested in the repatha! Also have genetic high chol and have been taking first Lipitor, than generic, for decades. Have you had any side effects with repatha?

Sounds like you're doing a great job of taking care of yourself. I had the same run.........basically excellent health till a hit in my early 60's which didn't keep me down. Went right back to work and working out at high level.
Then osteoporosis diag in mid-late 60's. From there, one thing or another driving me nuts. PMR was a biggie, but I'll take it over about a zillion other issues.

It was a thought-provoking to find out that PMR is not a muscular disorder, but rather one of the tendons. My rheum, who was great except for the constant harangue about osteo meds, was thoughtful and professional enough to do an ultra sound on me before even suggesting steroids and she explained afterwards that PMR was more like severe tendonitis than perhaps arthritis or other rheumatoid disorders. Anyway, she decided to leave her job as a physician for a desk job at the FDA. I was crushed. The "person" who took her place was worse than I expected and the practice would not let me switch docs. It's huge, and a commanding presence in my geography, so haven't found anyone to go to.

Anyway, wanted to also say you are 100% right. Less pain with your hip is a result of your excellent body conditioning over the years. Exercise is truly the only miracle prevention, cure and medication that really works....if done consistently and appropriately for your body.

Again, my deepest sympathies for your loss and all the very best to you in the future.