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Exercise
Getting started:
People who do not normally get much exercise should begin physical activity with shorter durations of lower intensity exercise than people who are already more fit. As physical fitness improves, the duration, frequency, and intensity of exercise can be slowly increased toward a goal of getting at least 30 to 60 minutes of exercise four to six times per week.
Moderate exercise can be integrated into one's daily routine with activities such as brisk walking (at rate of three to four miles per hour), yard work, or dancing.
A simple way to start exercising is to walk. Start by walking a comfortable distance; establish your personal baseline by walking at a speed and for a length of time that you easily tolerate. Doing too much too fast may result in discomfort, disappointment, or disability from muscle pulls and strains. Try to increase the baseline distance by 10 percent each week. Measure out the distance in your neighborhood, a walking trail, or a shopping mall. Once walking for 45 to 60 minutes a day, try to walk a greater distance in the same time. This increases the intensity of exercise. The goal is to develop a habit of regular physical activity at a level that is right for you.
Exercise program:
An exercise program should include aerobic exercise, resistance training, and stretching.
- Aerobic exercise — Walking is an excellent aerobic activity. Cycling, rowing, stair machine climbing, and other endurance-type activities are also great. Swimming and water aerobics are excellent for people with arthritis because they are low impact activities. Running on a street is a higher impact activity. The exercises should be enjoyable and simple to carry out to encourage a long-term commitment. It may be best to vary the exercises you do each week (such as swim on three of the days and walk on three of the days) so as to decrease repetitive strain to your muscles and other tissues.
- It is not necessary to reach a specific heart rate goal to achieve health benefits. Persons who are breathless, fatigued, and sweating have achieved a high level of exertion. During moderate intensity exercise, you should be able to carry on a conversation.
- Resistance training — Resistance training can be done with weights, machines, or exercise bands. It should be performed at least twice a week with at least 48 hours of rest between sessions. Try to perform at least one set of exercises, including 8 to 15 repetitions for each of the major muscle groups.
- Begin with minimal resistance (light weights) to allow the muscles and other tissues to adapt. Use light weights, resistive bands, or even a can of food.
- It is important to use proper technique. Those who belong to a health club or gym might ask a trainer to observe technique. Be sure to maintain your normal breathing pattern while lifting weights—do not hold your breath; instead, exhale with exertion. Avoid resistance training during periods of pain or inflammation.
- Stretching — Stretching and flexibility exercises should include every major joint (hip, back, shoulder, knee, upper trunk, neck). Movement into a stretch should be slow, and the stretch itself should be held for approximately 10 to 30 seconds. Do not bounce getting into a stretch or while in a stretch.
- The degree of stretch should not cause pain, but only mild discomfort.
- It is best not to stretch "cold" muscles, so engage in a few minutes of low intensity aerobic exercise first.
Order of exercises:
- Warm up — Exercise sessions should begin with a five to ten minute period of warm up (i.e. some low level aerobic exercises like walking, stationary cycling, calisthenics) and then do stretches and flexibility movements.
- Workout — It is a good idea to mix up aerobic exercise, strength training, and stretching so as to keep the workout fun and interesting. Persons who will not be getting regular exercise during routine parts of the day (through daily activities like brisk walking and dancing) should ensure that the workout includes 30 minutes of aerobic exercise.
- Persons who are working out frequently can do resistance exercises using some muscles during one session and other muscles during the next (for instance upper body one day and lower body the next). That way, you can leave 48 hours between resistance exercises that use the same muscles.
- Perform stretches and flexibility exercises to maintain and improve range of motion. Stretch and yoga classes can help.
- Cool down — Cool-down exercises should be done for approximately five minutes at the end of an exercise session. Similar to the warm-up period, cool-down may include low-level aerobic exercise (such as slow walking, calisthenics, and stretching).
Exercise frequency:
The initial goal is 30 to 45 minutes of exercise. Exercise does not need to be continuous to produce health benefits; it can be broken up into three or four ten-minute sessions per day.
When progressing in an exercise program, it is better to first increase duration of exercise, rather than intensity. Persons who wish to further progress after reaching 45 to 60 minutes per day should increase the intensity of their exercise.
Moderate intensity exercise should be performed on most days of the week.
Evaluating an exercise program:
Exercise should fit into your daily schedule, should be enjoyable, and should feel safe. You should start to notice that you feel healthier after beginning an exercise program. It is common for an exercise program to be disrupted by health problems, changes in job type or hours, personal relationships, and vacations. Getting back on track can be tough, but is an important step in maintaining the benefits of exercise. If your exercise program does not fit your life, try to find ways to integrate exercise so that it can remain a part of your daily routine.
When to seek help:
In order to exercise safely, you need to know the warning symptoms that mean you may not be tolerating the activity. If any of these symptoms occur, you should stop your exercise and notify your physician's office. These symptoms include:
- Pain or pressure in your chest, arms, throat, jaw or back
- Nausea or vomiting during or after exercise
- Palpitations or heart flutters or a sudden burst of a very fast heart rate
- Inability to catch your breath
- Lightheadedness, dizziness or feeling faint during exercise
- Feeling very weak or very tired
- Pains in joints, shins, heels or calf muscles
Precautions:
- Remember to drink fluids during and after exercise. Your body will tell you it needs more fluid when you feel thirsty.
- Do not exercise outdoors if the temperature is too hot or too cold.
- In cooler weather, it is better to wear layers of clothes while exercising outdoors. You can always take off a layer of clothing if you get too warm.
- Wear supportive, well-fitting running or walking shoes.
Where to get more information:
Your health care provider is the best source for finding out important information related to your particular case. A number of other websites have information about exercise, find them at Health Resources.
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