Strength Training For Fibromyalgia with Rachel Smith, MS, CPT

 

When Your Body Says No: Transforming Your Relationship with Exercise and Chronic Pain

This article examines key insights from Rachel Smith, MS, CPT, a personal trainer specializing in chronic illness. Her evidence-based approach to fibromyalgia management offers valuable perspectives on exercise adaptation for chronic pain conditions. Smith's professional journey from middle school teacher to fibromyalgia patient to specialized fitness expert provides a framework for understanding the intersection of chronic pain and physical activity.

man in a wheelchair lifts a barbell in a gym

The Diagnosis That Changed Everything

"I was diagnosed with fibromyalgia in 2010," Rachel shared. "This was way before I was even a certified personal trainer. I was actually a middle school teacher at the time."

That diagnosis sparked what she describes as her "self-discovery journey," ultimately leading to a master's degree in exercise science. For her thesis, she researched how exercise could be used to manage fibromyalgia symptoms – transforming her personal struggle into expertise that would eventually help hundreds of others.

Rachel now hesitantly shares: "My fibromyalgia has been in remission since 2014." Not an overnight miracle, but the result of years of consistent experimentation with exercise, stress reduction, improved sleep, and pacing techniques. 

Beyond Labels: The Complex Reality of Chronic Conditions

Working with over 200 clients has given Rachel unique insights into how conditions overlap and intersect. She describes her own constellation of conditions with precision: fibromyalgia and hypermobility, but not EDS; allergies but not MCAS; fatigue but not at the level of ME/CFS. Recently diagnosed with ADHD and autism, she notes this neurodivergence is "extremely common among those with chronic illnesses."

This complexity resonates deeply with me.

I've been learning about neurological differences in autistic individuals – how autistic brains maintain more neural synapses rather than "pruning" them as neurotypical brains do. This heightened sensitivity might explain why our bodies remain on high alert, manifesting as pain, tenderness, and heightened reactions to stimuli. Personally, I wonder if bodies with chronic pain also see a reduction in neural synaptic pruning, keeping us on high alert to way too many stimuli.

The Perfectionist's Paradox

"People with fibromyalgia tend to be perfectionists. We tend to be all-or-nothing thinkers," Rachel explained. "We always want to just go, go, go, and do all of the things."

It’s ironic: the very personality traits that drive many with chronic illness – ambition, thoroughness, determination – collide catastrophically with physical limitations.

When suddenly your body says, ‘No, you can’t’... it can be incredibly frustrating.
— Rachel Smith, MS, CPT

We also talked about what some clinicians label "pathological demand avoidance" and the fact that PDA isn't some desire to be difficult; it's your body enforcing boundaries after being pushed beyond its limits for too long.

It's not avoidance by choice – it's your nervous system saying "enough."

A woman stands on a wooden box in an industrial-style gym

Rethinking Energy Management: Beyond Spoon Theory

While many in chronic illness communities rely on "spoon theory" – carefully rationing limited energy reserves – Rachel offers a nuanced perspective based on research.

"A lot of people will kind of hoard their spoons or hoard their energy because they will say, 'Oh, I've got this really big event tonight, so I'm not going to do anything all day,'" she noted. "But the research shows the opposite – too little activity can also cause symptom flare-ups."

woman practicing yoga on mat in front of laptop screen

Instead, Rachel advocates what she calls "pause and pivot" – regularly shifting between different types of activities rather than maintaining one posture or task for extended periods.

"Whether you are working at your computer, heads down, focused, or you're up on your feet running errands... an hour in, two hours in, set an alarm and remind yourself to change what you're doing."

For those with ADHD (like both of us), this approach presents challenges. "Easier said than done," Rachel acknowledged with a laugh. The neural pathways etched deeper by years of hyperfocus make transitions difficult, but with practice, these pivots become more natural and protective against symptom flares.

The Strength Revolution: Why Lifting Changes Everything

Rachel's most transformative discovery came through strength training. After trying trendy exercise programs like Tone It Up and the notorious BBG (Bikini Body Guide), which left her exhausted and flaring, she found Jamie Eason's weightlifting program on Bodybuilding.com.

"I started weightlifting and I noticed a difference... it didn't make any sense at the time. Why can I lift weights and be decently okay, but I can't walk to the grocery store without causing insane amounts of fatigue?"

The contradiction puzzled her, but the results were undeniable. She fell in love with the practice and its effects on her body and symptoms.

"I will die on this hill. Everybody should strength train," she insisted, emphasizing that the approach varies dramatically based on individual needs and abilities.

For those with chronic pain and fibromyalgia, Rachel recommends starting with programs designed for seniors.

"Anybody who's ever looked at a weightlifting program designed for someone over the age of 65, that's going to look closer to the type of weightlifting that you should try when you are first starting out with exercising with chronic pain."

For Rachel, at just five feet tall, lifting offered psychological benefits beyond physical improvements: "There was something about going into the gym and picking up a 30-pound dumbbell and being able to pick it up that just sparked something in me... I'm way stronger than I give myself credit for."

person adjusting barbel in gym

This sentiment perfectly captures what many chronic pain patients need most: concrete evidence of their own capability amid circumstances that often make them feel powerless.

Breaking the All-or-Nothing Cycle

Perhaps the most important aspect of Rachel's approach is her challenge to perfectionism around exercise. "You don't have to finish a workout for it to count," she told me.

This simple permission slip counteracts the deeply ingrained belief that partial efforts are failures. "If you go to the gym and it doesn't feel right... if you're like, 'Okay, I'm going to do this for 10 minutes, 5 minutes'... and reevaluate – if you're still like, 'Nah, this isn't it,' just stop."

This approach teaches your body to trust you – that you're not going to push through pain warning signals. This trust becomes the foundation for sustainable progress.

Rachel's clients typically fall into two categories: those who abandoned exercise after diagnosis and those who stubbornly maintain pre-diagnosis routines despite the consequences. Both extremes present challenges.

"I've had some folks who continue their marathon training and run their marathon, which is amazing. But there are also folks who do the whole boom and bust cycle where they push, push, push for three weeks and then all of a sudden can't do anything for multiple weeks."

The middle path requires careful attention to individual responses and readiness to adjust – not throwing techniques at the wall to see what sticks, but systematically exploring what works for your unique body.

The Truth About Diet and Fibromyalgia

"The most common myth that I am busting is that fibromyalgia is caused by diet," Rachel stated firmly. While she acknowledges she's not a registered dietitian, her research findings are clear: there is no universal fibromyalgia diet that works for everyone.

"So anybody saying that the carnivore diet is going to heal you or paleo is going to heal you... it's all questionable."

Instead, Rachel advocates for individualized approaches that recognize potential sensitivities without extreme elimination protocols. "The only way to know for sure is through trial and error,” but it’s important to remember that most of us don’t know how to properly trial elimination-style diets. For more information on that, check out the post Why It's Not Just About Eliminating Foods: The Truth About IBS and Nutrition.

Her research has found that gluten sensitivity is common among fibromyalgia patients. "Of the 200-something clients that I've had, only about five or six of them have not noticed a reaction to gluten."

Rather than overwhelming clients with massive dietary overhauls, she recommends testing one food at a time, starting with gluten and then potentially exploring dairy, artificial sweeteners, caffeine, or corn.

This measured approach prevents the post-restriction binges that often follow highly restrictive plans like Whole30. But again, I highly recommend you work on a diet with a Registered Dietitian, as they often understand the nuances that are important when it comes to determining which foods are actually necessary to cut out.

Her nutritional starting point is refreshingly simple: "Eat three meals a day." Each meal should include a fruit or vegetable and a protein source – a foundation that many with chronic illness struggle to maintain consistently.

The Power of Shared Experience

Central to Rachel's FibroFit Warriors program is the community element. Research demonstrates that "people with fibromyalgia do significantly better when they are in a group with other people who also have fibromyalgia," says Rachel.

This peer support creates a powerful environment where participants can witness others succeeding despite similar limitations.

"I see this a lot with... clients who join FibroFit Warriors and they're still petrified to work out. Having the few people who do jump right in and share in the community group like, 'Hey, I did this workout and it didn't flare me'... then I have the others go, 'Oh, okay, let me try it.' And then everybody's working out."

As a therapist, I appreciate how Rachel handles misinformation in her communities. She notes that because she's evidence-based, she tends to attract people who also value research. When questionable claims arise, she's ready with scientific studies to address them, which prevents people from falling down false hope and expensive rabbit holes.

group of people exercising together with barbels and mats

A Path Forward

Rachel's upcoming free webinar, Fibromyalgia 101: What You Wish Your Doctors Had Told You, aims to address common questions and misconceptions. She'll cover why many physicians lack comprehensive fibromyalgia knowledge, diagnostic criteria, theories about causes, how to exercise in a way that doesn’t cause flare-ups and prevalent misinformation.

"For me, I'm now able to say, okay, I have fibromyalgia. I'm also hypermobile. I have many allergies, but I do not have MCAS. And I had fatigue, but not to the point of having ME/CFS."

This clarity – born from both personal experience and professional expertise – embodies what so many chronic pain patients seek: understanding, validation, and actionable paths forward.

What makes Rachel's approach so valuable is its foundation in both evidence and lived experience. She bridges the gap between research and real life, offering hope without hype and structure without rigidity.

For those struggling with chronic pain, her message is simple but profound: your body isn't your enemy. With patience, compassion, and the right support, you can transform your relationship with exercise from one of fear and frustration to one of empowerment and possibility.

Even when your body says no, there are still ways to move forward – just differently than you may have imagined.

 

If you're interested in learning more about Rachel Smith's approach to fibromyalgia management through exercise, you can follow her on Instagram @coachrachelsmith or sign up for her free webinar on March 20th, Fibromyalgia 101: What You Wish Your Doctors Had Told You.

Looking for more info about exercise with fibromyalgia? Join Rachel and I in our workshop together on March 29th - register here!


 

Listen to Rachel’s interview with me, Destiny, on Episode 85: Strength Training For Fibromyalgia w/ Rachel Smith MS, CPT.


Rachel Smith, MS, CPT, diagnosed with fibromyalgia in 2010, refused to accept that her life would be defined by the condition. She made it her mission to discover how to manage it, dedicating years to research and experimentation—until she found the answer. Now, through Fibro Fit Warriors, she empowers others to take control of their health through movement, lifestyle changes, and evidence-based strategies. With a Master’s in Exercise Science and multiple certifications, Rachel is committed to helping others with fibromyalgia build strength and live a pain-free life!


Meet Destiny - The host of The Chronic Illness Therapist Podcast and a licensed mental health therapist in the states of Georgia and Florida. Destiny offers traditional 50-minute therapy sessions as well as therapy intensives and monthly online workshops for the chronic illness community.

Destiny Davis, LPC CRC, is solely responsible for the content of this document. The views expressed herein may or may not necessarily reflect the opinions of Rachel Smith, MS, CPT.

Destiny Davis (formerly Winters)

Destiny is a Licensed Professional Counselor and chronic illness educator.

Previous
Previous

Bigger than Pain: Insights on Improving Movement, Sleep, and Healing with David McGettigan

Next
Next

Why It's Not Just About Eliminating Foods: The Truth About IBS and Nutrition