Exercise Guidelines

Regular exercise has many benefits. Exercise, especially aerobic exercise, can:

• Improve your circulation and help your body better use oxygen
• Build energy levels so you can do more activities without becoming tired or short of breath
• Strengthen your heart and cardiovascular system
• Increase endurance
• Lower blood pressure
• Improve muscle tone and strength; improve balance and joint flexibility
• Strengthen bones
• Help reduce body fat and help you reach a healthy weight
• Help reduce stress, tension, anxiety, and depression
• Boost self-image and self-esteem; make you look fit and feel healthy
• Improve sleep
• Make you feel more relaxed and rested

Talk to your healthcare provider first

Always check with your healthcare provider before starting an exercise program. Your healthcare provider can help you find a program that matches your level of fitness and physical condition.

Exercise can be divided into 3 basic types:

• Stretching: This involves slow lengthening of the muscles. Stretching your arms and legs before and after exercising helps prepare the muscles for activity, and helps prevent injury and muscle strain. Regular stretching also increases your range of motion and flexibility.
• Cardiovascular or aerobic: This is steady physical activity using large muscle groups. This type of exercise strengthens the heart and lungs and improves the body's ability to use oxygen. Over time, aerobic exercise can help decrease your heart rate and blood pressure, and improve your breathing (since your heart won't have to work as hard during exercise). Aerobic exercises include walking, jogging, jumping rope, bicycling (stationary or outdoor), cross-country skiing, skating, rowing, and low-impact aerobics or water aerobics.
• Strengthening: This is repeated muscle contractions (tightening) until the muscle becomes tired.

The frequency of an exercise program is how often you exercise. In general, to achieve maximum benefits, you should gradually work up to an exercise session lasting 20 to 30 minutes, at least 3 to 4 times a week. Exercising every other day will help you keep a regular exercise schedule.

Every exercise session should include a warm-up, conditioning phase, and a cool down.

The warm-up helps your body adjust slowly from rest to exercise. A warm-up reduces the stress on your heart and muscles and slowly increases your breathing, circulation (heart rate), and body temperature. It also helps improve flexibility and reduce muscle soreness. The best warm-up includes stretching, range of motion activities, and beginning the activity at a low-intensity level.

The conditioning phase follows the warmup. During this phase, the benefits of exercise are gained and calories are burned. During the conditioning phase, you should monitor the intensity of the activity.

The intensity is how hard you are exercising, which can be measured by checking your heart rate. Your healthcare provider can give you more information on monitoring your heart rate.

Over time, you can work on increasing the duration of the activity. The duration is how long you exercise during one session.

The cool-down phase is the last phase of your exercise session. It allows your body to gradually recover from the conditioning phase. Your heart rate and blood pressure will return to near resting values. Cool-down does not mean to sit down. In fact, do not sit, stand still, or lie down right after exercise. This might cause you to feel dizzy, lightheaded, or have heart palpitations (fluttering in your chest).

The best cool-down is to slowly decrease the intensity of your activity. You may also do some of the same stretching activities you did in the warm-up phase.

General exercise guidelines

• Gradually increase your activity level, especially if you have not been exercising regularly.
• Remember to have fun. Choose an activity you enjoy. Exercising should be fun and not a chore. You'll be more likely to stick with an exercise program if you enjoy the activity. Here are some questions you can think about before choosing a routine:
  1. What physical activities do I enjoy?
  2. Do I prefer group or individual activities?
  3. What programs best fit my schedule?
  4. Do I have physical conditions that limit my choice of exercise?
  5. What goals do I have in mind (losing weight, strengthening muscles or improving flexibility, for example)?
• Wait at least 1½ hours after eating a meal before exercising.
• When drinking liquids during exercise, remember to follow your fluid restriction guidelines, if applicable.
• Dress for the weather conditions and wear protective footwear.
• Take time to include a 5-minute warm-up, including stretching exercises, before any aerobic activity, and include a 5 to 10 minutes cool down after the activity. Stretching can be done while standing or sitting.
• Schedule exercise into your daily routine. Plan to exercise at the same time every day (such as in the mornings when you have more energy). Add a variety of exercises so you do not get bored.
• Exercise at a steady pace. Keep a pace that allows you to still talk during the activity.
• Exercise does not have to put a strain on your wallet. Avoid buying expensive equipment or health club memberships unless you are certain you will use them regularly.
• Stick with it. If you exercise regularly, it will soon become part of your lifestyle. Make exercise a lifetime commitment. Finding an exercise buddy will also help you stay motivated.
• Keep an exercise record.

Exercise precautions

• If your medicines have been changed, ask your doctor if you can continue your regular exercise program. New medicines can affect your response to activity.
• If you are too tired and are not sure if it is related to over-doing it, ask yourself, What did I do yesterday? Try to change your activities by starting out at a lower level today (but do not exercise at all if you are feeling very over-tired).
• Avoidheavy lifting, pushing heavy objects, and chores such as raking, shoveling, mowing, and scrubbing. When lifting any object, exhale while lifting.
• Avoid even short periods of bed rest after exercise since it reduces exercise tolerance. If you become overly fatigued or short of breath with exercise, take a rest period in a comfortable chair.
• Avoid exercising outdoors when it is too cold, hot, or humid. High humidity might cause you to become fatigued more quickly, and extreme temperatures can interfere with your circulation, make breathing difficult, and can cause chest pain. Instead, try indoor activities such as mall walking.
• Avoid extremely hot and cold showers after exercise.
• Reduce your activity level if your exercise program has been interrupted for a few days (for example, due to illness, vacation, or bad weather). Then, gradually increase to your regular activity level as tolerated.
• Do not exercise if you are not feeling well or have a fever. Wait a few days after all symptoms disappear before starting your exercise program unless your health care provider gives you other directions.
• If you are short of breath during any activity or have increased fatigue, slow down your activity level or rest. Keep your feet raised, or elevated when resting. If you continue to have shortness of breath, call your doctor. Your doctor might make changes in your medicines, diet, or fluid restrictions.
• If you develop a rapid or irregular heartbeat or have heart palpitations, rest and try to calm yourself. Check your pulse after you rest for 15 minutes. If your pulse is still above 120-150 beats per minute, call your doctor for further instructions.
• Do not ignore pain. If you have chest pain or pain anywhere else in your body, do not continue the activity. If you perform an activity while you are in pain, you might cause stress or damage to your joints. Ask your doctor or physical therapist for specific guidelines. Learn to read your body and know when you need to stop an activity.

Stop exercising and rest if you:

1. Have chest pain
2. Feel weak, are dizzy or lightheaded
3. Have unexplained weight gain or swelling (Call your doctor right away)
4. Have pressure or pain in your chest, neck, arm, jaw, or shoulder
5. Any other symptoms that cause concern