Mind/Body/Spirit

How to start your personal exercise program

Exercise

Let me guess: One of your New Year’s resolutions was to increase your fitness level. Hustling up and  down the unit’s hallways and lifting patients may seem like a workout, but these activities alone won’t help you reach your fitness goals. Although Nike’s “Just do it” slogan makes it sound like a snap, starting a regular exercise program may prove to be a challenge. To develop a safe and effective program suited to your specific needs, you’ll have to do some research and get answers to such questions as:

• What’s the best type of exercise for me?
• How often and how long should I exercise?
• How can I be sure my exercise program will help me achieve the health benefits I want?

Some people never get further than asking these questions. But if you want to reach the “just do it” stage, you’ll have to take it to the next level.

For starters, your exercise program should be based on your personal fitness goals, strengths and weaknesses, likes and dislikes, and your best exercise options. For example, if your goal is to lose weight, your weakness is arthritis of the knees, you hate riding a bike, and your workplace has a gym, a good exercise program for you may include using an elliptical machine in the gym at least three days a week.

Go aerobic
Aerobic exercise maintains your heart rate within the target range for your age and health. Regular aerobic exercise has many health benefits. Types of aerobic exercises include walking, biking, and jogging.

Actually, a good exercise program has three components—aerobic activity, strength training, and flexibility exercises. Each component has different benefits, but aerobic exercise should be the centerpiece of a fitness program and should serve as the focus for starting your program. Regardless of other types of exercise you do, try to get 30 minutes of aerobic exercise at least three times a week.


Take sensible precautions
Before starting an exercise program, get evaluated by your primary healthcare provider. Discuss any exercise limitations if you have two or more cardiac risk factors—for instance, hypertension, hyperlipidemia, obesity, cigarette smoking, impaired fasting glucose, family history of coronary heart disease, or a chronic health condition (such as diabetes, or cardiac or pulmonary disease).

Exercise FAQs
It’s normal to have plenty of questions when starting an exercise program. Here are the answers to frequently asked questions about exercise.

How often should I exercise?
If you’re just starting your program and are healthy but haven’t exercised regularly in years, begin by exercising only for the suggested minimum frequency—three times a week.

How long should my exercise sessions last?
If you’re a beginner, start with 20-minute sessions, which should include a 5-minute warm-up and a 5-minute cool-down. Gradually work up to 45- or 60-minute sessions.

How hard should I work out?
You can use any of several methods to gauge your exercise intensity level. Common methods include heart rate monitoring, a subjective scale such as the Borg rating of perceived exertion (RPE), and the “talk test.”

Heart rate monitoring. To find your simplified target heart rate (THR), subtract your age from 220, and then multiply by 55% for your lower heart rate limit or by 90% for your upper limit. For example, if you’re 50 years old, your THR is 94 to 153 beats/minute. To see if you’ve reached your THR, check your pulse immediately after you stop exercising; count for 10 seconds and multiply by six.

Be aware, though, that the age-calculated simplified THR is a general guideline for exercise intensity level. It doesn’t take into account your health, your fitness level, or any medications that may affect your heart rate.

Subjective scale. To use the Borg RPE category ratio 10 (CR10) scale, assign a subjective feeling of your exertion level to the numbers 0 (nothing at all) to 10 (absolute maximum).

“Talk test.” This intensity gauge is based on your ability to talk while exercising. If you can say three or four words at a time without gasping for breath, your intensity level is appropriate. (On the other hand, if you can sing, you may not be working hard enough!)

For the first 8 to 10 weeks after starting your exercise program, keep the intensity level at the lower end of whichever gauge you’re using. Then increase the intensity gradually.

How can I safely and efficiently increase my exercise level?
If you can tolerate the activity, keep the intensity and frequency of your workout the same, but gradually increase its duration by 5 minutes every 2 weeks. Don’t increase the intensity until you can exercise for 30 to 45 minutes without getting overly tired.

How do I know if I’m overdoing it?
If you don’t feel normal within 10 minutes after your exercise session ends, reduce your intensity. If you are extremely short of breath, feel faint, or have prolonged weakness during or after exercising, this means you’re exercising too hard; cut back.

And erase the adage “no pain, no gain” from your memory bank. Exercise shouldn’t hurt. Although youcan expect some soreness when you start your program, don’t regard pain as an expected or desirable outcome. Signs that you’re overdoing it are delayed onset of muscle soreness (2 days later), feeling fatigued the next day, and difficulty sleeping.How can I be sure I’m exercising enough to get cardio­vascular benefits?

You don’t have to exercise at the highest intensity to benefit from aerobic exercise. Research shows you can achieve and maintain cardiovascular benefits by doing moderate- to high-intensity aerobic exercise at least 3 days a week at a heart rate between 55% and 90% of your maximum heart rate. Increase or decrease your intensity so you’re within the beneficial range. If you use the Borg CR10 scale to gauge intensity, your range should be 3 to 7 (moderate to very strong exertion).

Be diligent about warm-ups and cool-downs
To help prevent injury and prepare your muscles and joints for exercise, warm up for 5 minutes before your exercise session. Begin exercising slowly at a medium pace and gradually increase your pace by the end of the 5 minutes.

After warming up, stretch your major muscle groups. Hold each stretch for 10 seconds and repeat three times. Do stretches slowly with gentle, steady movements. Never bounce into a stretch or “lock” your joints.

Stretching should never cause pain. If it does, you’re stretching too far; reduce the stretch so it’s not painful. For more information on stretching, visit www.nia.nih.gov/HealthInformation/Publications/ExerciseGuide/chapter04c.htm.
After your exercise session, cool down to prevent arrhythmias and pooling of blood in your legs, which can cause fainting and dizziness. To cool down, slow your pace gradually until your heart rate is within 10 points of its pre-exercise rate. Repeat the warm-up stretches to relax your muscles.

Commit to getting fit
Starting and continuing an exercise plan requires commitment. To help you commit:

• schedule your exercise program into your week’s activities.
• get a friend to exercise with you, so you can offer each other encouragement. You’ll have more fun, too!
• frequently remind yourself of why you started your exercise program.

If you can commit to a regular aerobic exercise program for at least 12 weeks, you’ll start to notice the physical benefits. By that time, you’re sure to be loving the new, fitter you.

Selected references
Aerobic exercise: what 30 minutes a day can do for your body. Available at: www.mayoclinic.com/health/aerobic-exercise/EP00002. Accessed November 26, 2006.

American Heart Association Fitness Center. Available at: www.justmove.org/home.cfm.
Accessed November 27, 2006.

Crandell S. Living longer: exercise. AARP Magazine. September-October 2006. Available at: www.aarpmagazine.org/health/living_longer_exercise.html. Accessed December 29, 2006.

Dadoly AM, ed. Exercise—A Program You Can Live With. Boston, Mass: Harvard Health Publications; February 2002.

Gladwin L, ed. Fitness Theory & Practice: The Comprehensive Resource for Fitness Instruc­tion. 4th ed. Sherman Oaks, Calif: Aerobics and Fitness Association of America; 2002.

National Institute on Aging. Measuring progress. Available at: www.nia.nih.gov/HealthInformation/Publications/ExerciseGuide/chapter07.htm. Accessed November 25, 2006.

Karen Willis, BSN, RN, is Manager of the Cardiac Health and Fitness Center at CaroMont Health in Gastonia, N.C. and a certified group exercise instructor.

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