On an intellectual level, most people understand that exercising is good for us. On an emotional level, it is a little more complicated. Many of us are afraid to begin a program of exercise because we may think that it is too late, that we will get injured, that it will be too difficult, that it will not make a difference, etc. This becomes even more challenging for older individuals and/or those with long-term health conditions (LTCs).
I was diagnosed with Crohn’s Disease when I was 12 years old. This auto-immune digestive disease has all kinds of “embarassing” symptoms, but one of the main problems for me was that it was difficult to maintain a healthy weight (I was underweight), and my energy levels were lower than normal. As a result, in high school, I was excused from Physical Education classes; this did not set me on a path of healthy habits and fitness. It took over 25 years for me to realize the importance of taking care of my whole body and actually do something about it. Thank goodness, I have been in remission for a long time and am in great physical condition.
A recent statement in the British Journal of Sports Medicine, addresses this issue. The Physical Activity Risk Consensus group at University of Edinburgh in Scotland advises that while the benefits of physical activity for those with LTCs outweigh the risks, work needs to be done to properly prepare these individuals for what they will face when they begin exercising. It is all about setting proper expectations and readying them for how their bodies may react. The statement addresses 8 specific concerns: 1. neuromuscular pain, 2. fatigue, 3. shortness of breath, 4. cardiac chest pain, 5. palpitations, 6. elevated blood sugar levels, 7. cognitive impairment, and 8. falls and frailty. This all sounds kind of scary, right? The researchers say that those with LTCs can be helped to overcome their fears and reticence by having informed conversations with healthcare providers about the risks; this is why we always say, “Talk with a healthcare professional before beginning any exercise program.” Each case is different, so concerns will vary, conditions will not be the same, and point of entry will be unique. Looking at some of the 8 concerns above, it can be explained that some muscle pain is normal and that it will lessen as the body acclimates to the new routine. Fatigue and shortness of breath are normal when exercising. This should be accompanied with a clear description of the benefits of physical activity and how it can lead to reducing the occurrences of these 8 concerns.
Working with older adults, I am constantly reminding my clients of why we are doing what we are doing. I will say things like: “this exercise is strengthening the muscles that will help you walk better,” or “the more you practice doing this activity, the better your balance will be and the less likely you will be to experience a fall.” Fear is real. It stopped me when I was younger–when more physical activity was actually what I needed; I wish that there would have been a doctor who would have prepared me to leave my comfort zone. Thankfully, I eventually did…but it took a quarter of a century.
Manage expectations–both in terms of results and challenges–and most individuals, including those with LTCs, will have a greater chance of better health outcomes. The research backs it up.
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