Newsletter #3: On exercise
May 4, 2011
Yet another variation on “there are two kinds of people” is the folks who exercise and those who don’t. I certainly see this dichotomy in my patients who range from enthusiastic exercisers who are very fit to patients who know they should but have a very hard time making exercise an integral part of their lives. I hope this newsletter will provide some useful information for all of you, but I am specifically hoping that I can provide some encouragement and ideas for the non-exercise group.
There are very few exceptions medically for initiating some form of exercise; in fact it is critically important for most patients to exercise to tolerance to speed up and optimize their recovery. In any case, if you have a serious health disability, please confer with me or another medical professional before initiating an exercise program.
“Exercise” broadly defined includes flexion, strength and cardio or aerobic. For most people, the more one can integrate all forms of exercise into one routine the less time it takes. There are many ways to accomplish this; some forms of Yoga, routines like Zumba, sequential use of exercise machines ect. The problem is that very few people will go to a facility come rain or shine and keep it up. In fact, as all gyms are acutely aware, membership spikes with New Year’s resolutions and within two months precipitously drops off.
The core element of any exercise program is aerobic or cardio exercise. Without laboring the point, let’s start with reminding ourselves of a few of the abundantly proven advantages of aerobic exercise to our health and well being; significant reduction in risk for heart disease, decreased risk for several forms of cancer as well as significantly reduced risk for diabetes, obesity, dementia, depression and age related loss of functionality, plus, on average, you will live longer and have a higher quality of life.
Wow, sounds pretty good! So why doesn’t everyone embrace it? It certainly beats the alternative. There are a few common themes when I discuss this topic with patients that wrestle with maintaining a fitness program that I hope I can help with. The more common complaints are: “There’s no time, I’m busy.” “I never have exercised much and I don’t enjoy it.” “I’m confused about how much and what type of exercise is best.” “I don’t have space in my house for equipment.”
If you have never been able to sustain participation in gyms or exercise groups let’s focus on a routine that you can do at home on a daily basis if possible but minimally four times per week. The core element is sustaining an aerobic level of exertion for 30 minutes. Rather than giving you the standard formulae, let’s keep it simple. You needn’t “huff and puff” but you do need to have a comfortable increase in your respiratory rate. For example, if you are walking briskly with a friend you can still converse but you feel your body heating up and a need to take deeper and more frequent breaths. That’s it! As your conditioning improves, exert yourself more but it is not necessary to ever get to the “gasping for air stage.”
If you are lucky enough to live in an area where you can safely walk, one approach is to walk with hand weights.( Be aware that some exercise experts advise against this because of possibly falling with the hand weights). However, If the walking surface is flat and you start with 2 lb. weights for women and 4 lbs. for men, it is a safe, inexpensive and fun way to tone your body while you walk. If you search “heavy hands” on Amazon, you will find several options that will allow you to read about the science, the basic exercises and also how you can integrate stretching into the routines.
Walking with hand weights can not only achieve aerobic conditioning for virtually any level of fitness, it can also provide resistance weight bearing and muscle toning for all of the major muscles. You simply start at your most comfortable weight and exertion level and advance as your fitness dictates.
Okay, but what about those days when it’s too uncomfortable to be outdoors. What can we use at home, that is light, doesn’t take up much space, is inexpensive, convenient, combines all three forms of exercise and can be effectively used by the young and the elderly, the fit and the not so fit?
There are two inexpensive pieces of equipment that are small enough to fit in a small apartment and can be easily carried onto a deck or patio in good weather and put anywhere in your house. They are the ministepper and the mini trampoline or rebounder. The ministepper can be used with hand weights and it is much like heavy hands walking but you are stationary and can listen to music, audio books or watch the tube. The rebounder or minitrampoline uses complementary muscles to the ministepper and together they will tone all major muscle groups, improve your balance and coordination and can quite quickly start you on the road to fitness, The inexpensive versions are available everywhere; Target, Big Five, Wallmart, Kmart etc. If you find that you really like the ministepper you can eventually think about the “Exiser”. This is the Gym version and is much smoother and has a resistance adjustment that is also designed for high intensity interval training. I use mine every day. I have helped many of my exercise averse patients learn to exercise in this way and, as they begin to see and feel the results, it becomes self reinforcing. See for yourself, you will have more energy, improve your mood state, develop a healthy counter to stress and, if you combine this with a healthy diet as outlined in the first two newsletters, you will likely lose weight naturally and keep it off.
For those folks with very real time constraints, and I’m thinking first and foremost about working moms with children, do what you can when you can. Every little bit helps. But, if we are honest, almost all of us can find thirty to forty minutes that we can set aside.
Exercise is best in the morning because it changes the set point of our metabolism for the day and it will improve alertness and stamina. But don’t rule out exercising after work. If you are otherwise healthy, you will find that even though you are tired and perhaps stressed after work that that a brisk 30 minute workout invigorates mind and body.
The first few minutes when you begin to exercise don’t worry about becoming aerobic. Let your body acclimate and you will notice that quite naturally you want to expend more effort. Beginners will notice that once they have warmed up and gotten past the first ten minutes it becomes much easier.
For my older patients, those suffering from serious health problems and overweight patients who are not used to exercise, please start slowly without weights but try to make this program a daily habit and you will be surprised how quickly you are able to increase your time, start using light weights and more comfortably exert yourself.
Do not use hand weights if you have any problems with your arms, for example rotator cuff tears, elbow tendinitis or joint pain or restrictive movement. Once these problems are largely alleviated, these exercises can be therapeutic but they can aggravate preexisting inflammation or injury. Once you acclimate to this program, you should be much less vulnerable to sprains, tendinitis and muscle strain. If you are injured, do stop the portion of your program that affects the injured area. If you are not able to resume in two weeks it’s probably time to see me or another medical professional that can help you.
Make health a habit, you won’t be sorry.
Dennis R Tucker, Ph.D., L. Ac.
