This article reviews some of the issues associated with various forms of exercise: walking, kickboxing, aerobic exercise, yoga, Tai Chi, weight lifting and using the equipment at a health club. The basic rules for all of these activities is to start slowly, warm up, cool down, set goals, get support and track progress while working up to a comfortable level of heart-healthy exercise.
Never begin an exercise program without a physician’s approval.
Walking
The Association for the Advancement of Retired Persons (AARP), an advocacy organization for people over the age of 50, endorses walking as an aerobic activity fit for all. People of any age and in virtually any physical condition can engage in some sort of walking program. Experts suggest beginning by walking three times a week at a comfortable distance and speed. For some people, this may be a mile, and for others it is around the block. The goal, of course, is to increase activity without causing muscle cramping or injury. The American Heart Association (AHA) recommends that people wear a pedometer and aim for 10,000 steps every day. Over time, people can gradually increase their walking speed, distance and number of walking sessions per week. Research has shown that increased intensity walking may provide increased health benefits.
People are urged to choose carefully when and where they are going to walk. The risk of injury is reduced when walking on flat, even ground with little to no traffic, such as in a mall. One should also wear comfortable, supportive and appropriate footwear. There is also less risk of being involved in a crime when walking in public, well-lit areas.
The following guidelines are offered for patients who choose to carry weights while walking:
Carry equal weights in each hand or around each wrist.
Never strap weights to the ankles or lower legs, due to increased risk of a knee injury.
Don’t swing the arms too far while walking; keep the swing natural to reduce the risk of a back injury.
Some people choose to walk with a dog, which tends to make the walk more enjoyable for both the pet and the owner. However, all pet owners need to take the dog’s comfort into consideration when heading out on particularly hot or especially cold day. Finally, neither humans nor animals should dash off on a fast walk right after eating a heavy meal.
Kickboxing
One of the popular current trends in exercise is kickboxing. For many, it is a high-energy and enjoyable activity. However, people have ended up in the emergency room after performing this type of exercise incorrectly. The following tips are offered:
Always work with a qualified instructor. Never attempt new moves without instructor supervision.
Do not do too much too soon. People who throw themselves completely into complicated kicks and punches in their very first kickboxing class, especially without one-to-one supervision, increases their risk of injury.
If not certain that the move about to be performed is correct, reconsider what is about to be done to the body and check out the move itself with an instructor.
Consider beginning with other forms of martial arts training (e.g., karate), which progressively build muscle groups before starting kickboxing moves.
Aerobic exercise
Simple exercises include pushups, a type of sit-up called a crunch, or leg or arm (lateral) lifts. Other simple aerobic exercises include water aerobics in a pool, or warming up on a treadmill or stationary bicycle. People are strongly encouraged to master these basic exercises before progressing to more complicated forms of exercise, such as an advanced aerobics class or a very fast stationary cycling class called spinning.
Yoga and Tai Chi
Yoga and Tai Chi are Eastern forms of movement that improve strength, flexibility, improve blood flow and keeps muscles from getting tight. Yoga may involve some stretches and positions that are inadvisable for some heart patients or patients with back problems. Therefore, patients are encouraged to speak to their physician before beginning. However, Tai Chi is a very gentle form of exercise that people in China often use well into old age. It may be a good place to start for people who have not been exercising up to this point.
Weight lifting
Light dumbbells can be used, with the weight progressively increased as an individual builds muscle strength. When beginning weight lifting, it may be tempting to lift all that a person possibly can when first starting out. However, the muscle cramping that often follows can stop an exercise routine before it has had the chance to really begin. It is critical for people to know the correct way to lift weights. For example, people are urged to avoid lifting with their backs instead of their legs, and to avoid jerking movements instead of smooth lifting. A spotter, who monitors posture and is there in case of emergency, can be particularly helpful. A personal trainer, health club staff member, physical therapist or other professional can also be a great teacher and motivator.
Joining a health club
Many health clubs are thriving businesses that might not take the time to ask each individual member about his or her heart or medical history. It is important for all heart patients to ask questions such as the following:
Will there be a staff member here at all times who is currently certified to perform cardiopulmonary resuscitation.
Is there a defibrillator present at this facility, in case of emergency?
Will there be a staff member here at all times who is trained to use the defibrillator?
Where is the closest hospital emergency room, and what transportation services are available for getting there?
Although the benefits of exercise far outweigh the risks, it is important to be in a facility that is prepared for any emergency that might arise.
Questions for your doctor on exercise choices
Preparing questions in advance can help patients to have more meaningful discussions regarding their conditions. Patients may wish to ask their doctor or physical trainer the following questions related to exercise choices:
What type of exercise do you recommend for me?
Do any of my health conditions prohibit me from using a particular type of exercise?
How frequently and for how long should I perform this exercise?
Does this type of exercise require any special purchases, or have any hidden costs?
What are the health benefits I can expect from this type of exercise?
Can you recommend a trainer, instructor, health club, or other form of assistance?
Am I performing this exercise safely and properly?
