An exercise program is the ONLY way to lead a long and HEALTHY life. Even if you have arthritis or low back pain, heart disease or lung disease, exercise is very important to your being able to get back to functioning at a level at least close to what you are used to. People who have arthritis often argue that their pain is too great to exercise. Let me help you dispel that myth. Exercise, once you get in a regular program, will help DECREASE joint pain! The joints are supposed to be used and will function better if they are used on a daily basis. People with back pain used to be told to keep to bed rest until the pain went away. Now we know that that is the worst thing that you can do if you have a bad back. It is important to get pain medicine and then to try to continue your normal life (with some modifications). The more you do nothing, the weaker the muscles of the back get, and eventually the only thing that is holding you up is the spine, not the muscles which are supposed to. For people with cardiac disease, exercise, along with medication and a proper diet, has been shown to reverse the hardening of the arteries that leads to another heart attack. For people with lung disease, exercise has been shown to decrease the sense of being out of breath and increase the ability to do daily chores such as going to the food store. Okay, okay, you've heard all this before. What does it mean to start an exercise program?

There have been many studies done to try to determine the most important aspects of an exercise program. If you are older than 50 years, or if you have heart disease or a high risk of heart disease, your doctor will likely suggest a stress test or another heart study before you start. Regardless of whether or not you have this, it is VERY important to start slowly. Do half of what you think you are able to. You will likely be surprised. The day or two after you start the program you may feel very sore in unusual muscles or you may find yourself unusually tired. This suggests that you likely did TOO much. Do less the next day that you exercise and then gradually increase from there.
The goal will be to spend 30 minutes (not necessarily all at once), at least 5 days a week, doing moderate exercise.
This is the exercise prescription. This does not mean, however, that you need to go out and ride a bike as hard as you can every day for 30 minutes. You can perform a different exercise every day of the week. Ideally, part of this exercise time would be spent doing resistance exercise, part of the time would be aerobic exercise and part would be stretching. All three of these are important.

If you are over 50 years old, doctors have recommended that you start with some resistance training before you start exercise other than walking. This is because it will decrease your risk of injuring yourself. Resistance exercise is another word for weight lifting. But weight lifting does not mean that you have to belong to a gym. Weight lifting can involve lifting your own weight, or using a can of food. For instance, chair squats (sitting in a chair and then getting up without using your hands) is a resistance exercise. Or you can weight lift that can of green beans in your cupboard, lifting it over your head slowly 5 times, until your muscles in your shoulder get a bit tired. Your doctor, or a fitness trainer at a gym, can give you a few specific exercises to start. As you build muscle doing these exercises, you will start burning more fat even while you are sitting still! This is because it takes more energy to keep muscle functioning than it does that fat sitting on your stomach!

Aerobic exercise is the part that is most important for your heart. Aerobic exercise is a type of exercise, which is done continuously for a set period. Walking is an aerobic activity. Going up a flight of stairs can be an aerobic activity (especially if you keep going up and down). Swimming, biking or aerobics classes are other examples of aerobic activities. The goal is to perform any of these types of exercises for at least 10 minutes at a time, to try to get a total of 30 minutes in during a day. When you perform an aerobic exercise you do not have to be gasping for breath the whole time. The definition that we use for moderate physical activity is that it is enough to cause you to become a bit out of breath, but you should still be able to carry on a conversation with the person next to you as you are exercising.

Stretching. Like resistance exercises, stretching is important because it decreases your risk of injuring yourself when performing your aerobic exercise. You can injure yourself by stretching improperly, however. Many of you remember toe touches as a classic stretching exercise - remember, you were supposed to raise your arms to the sky and then bend down and touch your toes and then immediately come back up again? We now know that this is the WRONG way to do this! Quickly bouncing up and down increases your risk of injuring a muscle. A toe touch should be a slow bend at the waist until your arms are close to your toes and then that position should be held for 15-30 seconds. All stretching exercises should be performed in this way, slowly and with a count to at least 15 before releasing.

Just because the goal is 30 minutes of exercise a week, you don't have to stop there! Once you realize how good exercise makes you feel, once you realize how much new energy you have every day, you may be inclined to do more. This is fine. Just increase your amounts slowly.

-Find a fun exercise. If you don't enjoy it, you won't continue very long.
-Find a partner. If someone else is depending on you, you are more likely to make time for exercise. Likewise, it is more fun to have someone to talk to.
-Ask for some help. Your doctor is a great resource. Sun Health also has fitness instructors whom come to many of the gyms in Sun City and Sun City West, and work out of Sun City Grand. They are happy to help you with exercises (they do charge a small fee, however)
-GO FOR IT! Energize your life today. There are NO excuses!

Jennifer Sosnowski, M.D.