by Michelle Crouch, AARP, July 28, 2020
Experts share how to make a safe start.
You know exercise is vital for your health, but taking that first step can be overwhelming — especially if it's been a while since you've been physically active.
You may be concerned about a chronic health condition, hurting your joints or losing your balance. Or maybe you just don't know where to begin.
Fortunately, research proves that the benefits of exercise far outweigh any risks. Regular physical activity lowers your risk of falling and having a heart attack, and it also boosts your memory, lifts your mood and helps you live longer. Studies show you reap the health benefits even if you start late in life.
Here, experts offer their best advice on the concerns that may be holding you back — from worry about already achy knees to fear of taxing your heart. From there, you may have to dig deep to find the motivation to get started, but you'll feel so much better once you do.
It's been years since you exercised, and you don't know how to start.
One of the hardest things about starting to exercise is figuring out where to begin. Experts recommend choosing something you think you'll enjoy — whether it's doing yoga, ballroom dancing or walking with a friend — because you're more likely to stick with it.
If you are new to exercise, one of the safest activities to start with is walking, says Wendy Kohrt, an exercise physiologist and aging expert at the University of Colorado School of Medicine Center for Women's Health Research.
"Just about everybody can walk, and walking is great exercise,” she says. While any movement is better than none, you will reap more benefits if you do it at a pace that gets your heart rate up, so you start to sweat a little and your breathing quickens. Kohrt recommends aiming for at least a moderate intensity of about 65 to 70 percent of your maximum heart rate. (To calculate your maximum, subtract your age from 220.) You can find a moderate intensity without a monitor simply by paying attention to how it makes you feel.
"Judge for yourself whether it feels easy, somewhat hard or very hard,” Kohrt says. “You want to be in the more-moderate-to-somewhat-hard category, but you should still be able to carry on a conversation. You're not breathing so hard that you can't answer in a complete sentence.” Gradually add more time until you can go for 30 minutes at that intensity, Kohrt says, and then ramp up by quickening your pace.
You have no idea how to lift weights (and you're not sure you want to!).
Adding resistance training to your routine helps keep your muscles and bones strong, experts say, and it doesn't have to mean lifting heavy weights and barbells.
Researchers have found that lifting light weights many times is just as effective as lifting heavy weights for fewer reps. You can also avoid weights altogether and use a resistance band or your own body weight, says Tracy Bonoffski, an exercise physiologist and registered dietitian at the University of North Carolina at Charlotte.
Simply getting up and down from a chair is a great strength move, Bonoffski says. So are standing toe raises, pushups against the kitchen counter and planks.
If you've never strength-trained before, you might feel better getting help from an expert who can teach you the proper technique. Kohrt and Bonoffski typically recommend an introductory session with a certified personal trainer, a beginner class at a YMCA or senior center, or a session with a physical therapist. If one of those is not possible during the current epidemic, try a beginner-friendly fitness video from a certified fitness trainer.
You might fall.
It's true that your risk of falling increases as you get older, so a dose of caution is appropriate. But surveys show that many older adults are so paralyzed by fear that they avoid activities they are capable of, which ends up putting them at greater risk of a tumble.
In fact, research shows that simply staying active can reduce your risk of a fall by 10 to 20 percent, and exercising more than three hours a week is linked to a 39 percent reduction in falls. If you feel unsteady walking outside, walk inside the house or on a smooth track to build up your strength and confidence, says physical therapist Greg Hartley, president of the Academy of Geriatric Physical Therapy and assistant professor at the University of Miami. Use a cane or walker if it makes you more comfortable, or have a strong relative accompany you. If walking makes you nervous, you can get your heart rate up with activities that require less balance, such as riding a stationary or recumbent bike or rowing, says Hartley, who also recommends walking against the resistance of water in a swimming pool.
Make sure you also incorporate strength training and some simple balance exercises, like standing on one foot while holding on to the kitchen counter (and eventually letting go). Hartley notes that a big part of overcoming a fear of falling is psychological. “You have to go slow and keep telling yourself you can do this without falling,” he says. If you need help, consider a visit to a physical therapist. The therapist can work with you on specific strengthening, balance and coordination activities in a safe environment to help you regain strength and confidence.
You might trigger a heart attack.
If you have a heart condition or coronary artery disease, the idea of pushing your heart to beat faster through cardiovascular exercise may seem scary. But the research is indisputable: Engaging in regular physical activity actually lowers your risk of having a cardiac event over the long term. In fact, a 2018 Swedish study found heart attack survivors who identified as being the most active had a 71 percent lower risk of death than those who defined themselves as inactive. "Over the long term, exercise helps your heart work much more efficiently: Each heartbeat will pump more blood, and you will also extract more oxygen from the blood as it's pumping through,” says James Blankenship, an interventional cardiologist at the University of New Mexico in Albuquerque.
Blankenship acknowledges exercise can be a confusing issue for heart patients because abrupt, extreme exertion (like wind sprints at full speed after months of inactivity) can increase your immediate risk of sudden cardiac arrest. That said, he stresses that “the kind of exercise that most people do is not — I repeat, is not — going to cause a heart problem.” He tells his patients who have a heart condition to ramp up slowly, choose light rather than heavy weights and stick to moderate-intensity workouts. That generally means keeping your heart rate below 120 beats per minute.
"If you can't keep up what you're doing for 20 minutes, you are probably going too hard and too fast,” he says.
Heart patient or not, you should get checked out by a medical provider if you develop shortness of breath, dizziness or heart palpitations while exercising, Blankenship says — especially if your discomfort is getting worse each time you exercise, or if it's accompanied by another symptom such as tightness or discomfort in your chest, jaw or arm.
Your aching knees will just get achier.
If you have arthritis, just getting around the house can be painful, so going out for a brisk walk may seem out of the question. What you may not realize is that exercise is a powerful pain reliever.
In one study of nearly 10,000 people with knee and hip osteoarthritis, people who exercised twice a week for six weeks experienced a 25 percent drop in pain on average.
In fact, the Arthritis Foundation says exercise is considered “the most effective non-drug treatment for reducing pain and improving movement in patients with osteoarthritis.”
If walking hurts too much, start with getting up and down from a dining room chair. Do a set of 10 three times a day, Hartley advises: “It sounds simple, but over time, that will build strength around your knees and hips, and help you to get strong enough for a walking program.”
Your joints may hurt at first, so start slow and don't add too much too quickly, Bonoffski says. Low-impact cardio exercises like walking and stationary biking put less stress on your joints. Water exercises are especially good, Bonoffski says, because the water's buoyancy “helps take the pressure of your body's weight off your joint, but you're still moving.” Resistance training will strengthen the muscles around your joints so they can better support and protect your joints.
Working out will interfere with managing your blood sugar.
If you have diabetes, you've probably heard that physical activity is an important way to help keep your blood sugar under control.
But you may have also heard that you need to carefully monitor your blood sugar before, during and after exercise to prevent dangerous fluctuations — and that may make you nervous. It's important to talk to your doctor about your specific situation, but for most diabetics, exercising safely is easily manageable, says geriatrician and endocrinologist Medha Munshi, director of the Joslin Geriatric Diabetes Program at Beth Israel Deaconess Medical Center in Boston and an associate professor at Harvard Medical School.
"If you aren't used to exercise, your doctor may tell you to check your blood sugar before and after to understand how your body is reacting,” she says. “The prudent thing is to have a little snack half an hour before and to make sure you have your glucose tablets and some snacks with you.”
If you're prediabetic — meaning you have high blood sugar but haven't been diagnosed with type 2 diabetes — studies show that regular exercise can actually prevent diabetes from developing.
You think you're too weak, old or disabled.
If you think you are too weak, old or disabled to exercise, the experts have one word for you: Nonsense!
Several studies have found that nursing home residents (including some in their 90s) who follow a training program for eight to 12 weeks see significant improvements in strength, balance, muscle power and the ability to walk without assistance.
Munshi, who writes exercise programs for stroke survivors, says the key is finding the right exercises. If she's working with someone who's very frail, for example, she may start by challenging them to walk in the house for five minutes before each meal, using a cane or walker if necessary.
After a week, she might increase the duration to seven minutes. For resistance, they can make circles with their arms out to their sides, or lift their thighs up and down while sitting. "It doesn't matter if you are weak, frail or in a wheelchair, it's never too late to start exercising,” Hartley says.