By now there is probably a group of you out there that are saying, “Cara, I am motivated to get out and exercise but I’m just not sure if I’m doing it right.” This is great! You came to the right place. As a physical therapist, I enjoy helping patients get on track with their exercise routine safely and efficiently. But before we start we need to get some house keeping information out of the way.
#1- I would just like to remind everyone that this is a health and wellness blog. The information provided is for the purpose of preventing injury, avoiding non-communicable diseases and feeling good. This is NOT information to improve performance. So, for all you athletes out there, this is not meant to improve your athletic performance. That’s a topic for another day.
#2- I am a physical therapist by profession but I am not YOUR physical therapist. Please consult your physician and physical therapist to ensure you are able to exercise safely. I do not want anyone to get hurt nor am I responsible if you do.
#3- Finally, exercise and physical activity are great ways to help prevent disease in addition to an infinite amount of systemic benefits. However, we can not change genetic factors that predispose you to disease. We can lower the risk of disease but can’t ELIMINATE risk of disease. The purpose of exercise and physical activity is to reduce this risk as much as possible for you. Therefore, I am not responsible for your medical diagnoses.
Phew… Now, let’s get to the good stuff. As previously mentioned, we can’t change your genetic make-up that can be putting you at risk of disease but exercise and physical activity works with many systems of your body to help reduce the risk of these disease as much as possible. For this reason, it is certainly something you want to make a priority in your life to have your body feeling its absolute best. After receiving clearance from your doctor, here are some basic exercise guidelines you can follow.
Cardio is a shortened version of the term cardiovascular exercise, pertaining to the heart. So no, this term is not defined specifically as “the elliptical.” This type of exercise is dependent on the heart’s activity which is altered by repetitive, rhythmic activities such as but not limited to cycling, walking, running, swimming, circuit training and yes, the elliptical. The way you train this system effectively is by performing moderate cardio ≥5 days per week, vigorous cardio ≥3 days per week or a combination of the two. Each bout of moderate exercise should be 30-60 minutes and each bout of vigorous exercise should be 20-60 minutes. And remember, the American College Sports Medicine, ACSM, recommends 150 minutes of moderate physical activity per week or 75 minutes of vigorous physical activity per week.
Moderate and vigorous activity are related to how hard your heart is working, typically reflected as a percentage of your maximum heart rate. Max heart rate is calculated by 220-your age. Example, I am 27 years old. My calculated maximum heart rate is 220 – 27 = 193 beats per minute. Moderate activity is 60-75% of your maximum heart rate and vigorous activity is 75-95% of your maximum heart rate. To continue our example, if I wanted to exercise at a moderate intensity I would keep my heart rate within 60-75% of my calculated maximum heart (193 bpm). I calculate this by 193 bpm x .60 =116 bpm and 193 x .75 =145 bpm. After all these calculations, I would perform activity that keeps my heart rate between 116 – 145 bpm in order to exercise at a moderate intensity. You perform the same calculations if you are performing vigorous activity by adjust the percentages to 75%-95%.
As you can see, this can be kind of daunting and annoying to track. It has been made easier by wearable tech but something that can be used as an alternative is the Rating of Perceived Exertion Scale. This is a 6-20 point scale used to rate how hard you feel you’re working. It has been closely correlated to heart rate and can be used during exercise and physical activity to gage moderate-vigorous activity. Below is a chart of this scale for your reference. This should make monitoring cardiovascular intensity easier.
Moving on, we have resistance training next. This is what typically is referred to as strength training. Resistance training is the way people increase strength of muscles by increasing the load the muscle is pulling. Each major muscle group (ie. legs, arms, chest, shoulders, core, back) should be trained 2-3 times per week. This too should be performed at a moderate to vigorous intensity. The way this is measured is typically by testing the greatest amount of resistance moved by that muscle group for 1 repetition. I do not recommend performing this test without a trained professional (athletic trainer, strength coach or physical therapist). As an alternative, I remind patients in clinic that if you are doing a set of 10 repetitions, the last 2-3 reps should be the absolute last you could do with good form and without a rest break. If you are doing this you are using a good resistance for YOU. I care more about form than how much weight you can pull. And yes, 3 sets x 10 repetitions is perfectly alright to use for strength training dosage. Don’t try to reinvent the wheel. Keep things simple and stay with the ACSM guidelines. They worked hard to do the research on these topics so you don’t have to.
Now last but certainly not least is what I have found to be the most underrated of the fitness categories, flexibility. Good flexibility is a great way to prevent injury. If your joints and muscles aren’t moving to the best of their ability a different joint or muscle group has to pick up the slack when it is not designed to do so, resulting in injury. This theory is also true of resistance training and these fitness tools need to be balanced, as do most things in our lives 🚲. We’ll circle back to this idea next week.
So how do we train flexibility? Each muscle group should be stretched 2-3 times per week according to the ACSM. Each stretch should be held for 10-30 seconds. The trick here is NOT to torture yourself. Believe it or not. You should hold a stretch at the point where you feel slight discomfort NOT when it is painful and you can’t wait for it to be over. Like I always say, listen to your body here. Each stretch should be repeated 2-4 times for maximum benefit. Flexibility training is something that should be done while muscle are warm (after at least a warm up) and become much easier to do the more consistently you do them (this is true of most things).
I know that was a lot of information at once and can be overwhelming. I also feel strongly about giving you guys a whole picture and not just the easy stuff. I have found that the more my patients’ know the more inclined they are to stick with their plan of care. Knowledge is power. It is all good information to know but take things one step at a time. You don’t need to know or perform all this at once. And always remember, I’ve got you. We will work through this together. This is just some information to get you started on the right track. The keys of this lesson are, consult your doctor to establish it is safe to exercise, performing any of these exercise types will have you feeling good and any step forward is better than staying on the couch. I am going to recommend starting with any one of these for a week. Cardio, resistance or flexibility and see what works and doesn’t work for you. Then add in another type and finally the third type. Keep track of any questions you have and please reach out so we can work through them together. Finally, keep checking back here because were going to keep this conversation going by talking about the importance of rest, how to progress from here and how to keep them all balanced. So don’t miss a beat. Good luck and as always…