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Take Action:Health - Wellness - Exercise - Reflections:Workout 911: How to Exercise with Chronic Pain
By Winnie Yu, August 31, 2011
Do you have an illness that makes you feel tired and achy? Whether you're living with heart problems, diabetes, arthritis or other disorders that leave you in chronic pain, exercise can help you feel better. And it's not as impossible as you think. Read on for easy, get-fit "remedies" for 4 chronic conditions...
Let's face it: Getting motivated to exercise isn't easy, even when you're feeling fine. And if you have a chronic illness or chronic pain, an exercise routine is often the last thing you want to start.
But here's the rub: Exercise even a little â' is essential to chronic pain relief and improving your health.
Just because you have a chronic disease doesn't mean you shouldn't exercise, says Sam Ho, M.D., chief medical officer for United Healthcare in Minnetonka, Minn. "But it has to be tailored to the patient."
Before leaping out of bed, consider these questions: How severe are your symptoms? How long have you had the condition?
Here are five diseases that make it harder to workout and how to kick-start an exercise routine. (Whatever your health condition, discuss your fitness plans with a doctor first, then start slowly and build gradually.)
1. Heart Disease
Workout woe: Worried you're going to overexert a fragile ticker? Your fear is understandable.
Too-rigorous exercise can trigger irregular heart rhythms, chest pain, dizziness and shortness of breath. Plus, many cardiac patients are out of shape, which can put them at further risk for injuries.
But, "if there's one thing you can do for your heart that's better than any medication, it would be exercise," says Teresa Caulin-Glaser, M.D., a cardiologist and executive director of the McConnell Heart Health Center in Columbus, Ohio.
Regular physical activity can lower LDL ("bad") cholesterol, increase HDL ("good") cholesterol and reduce inflammation and blood pressure, she says.
Solution: Before you start an exercise program, visit a cardiologist to assess your heart's health. Ask for a stress test, which measures how well your heart responds to exertion and whether it's getting enough blood flow during a workout.
You might also ask your cardiologist about joining a cardiac rehab program if you've had a heart attack.
During a workout, aim to get your pulse to 50%-75% of your target heart rate (Use our tool to calculate your heart rate). So if you're 50 years old, you'll want your heart to beat 85-128 beats per minute.Start your workout with a short, gentle warm-up and finish with a cool-down. Warming up which may be 5-10 minutes of gentle stretching or slow walking â' "provides a gradual increase in the heart rate and potentially decreases injuries related to exercise," Caulin-Glaser says.
A similar cool-down afterward allows your body to return more easily to a resting state while making sure that your heart gets the extra oxygen it needs.
Cool-downs also reduce high body heat, which can dilate blood vessels and lead to low blood pressure and dizziness. Plus, they prevent muscle cramping, Caulin-Glaser says.
Still afraid to get moving? Consider joining a support group for people with heart disease.
"Being with other [heart] patients will do more for them than anything I can say," Caulin-Glaser says.
Try this: The best exercise routine to achieve chronic pain relief for people with heart disease? Walking, she says.
Walk 5-10 minutes a day to start, then add 1-2 minutes every third time you exercise. Work up to 20-30 minutes per day, three times a week, by the end of the month.
No time? Break it into 10-minute increments throughout the day.
Also, wear a pedometer with a heart rate monitor to make sure you stay in your target range. Stop if you feel tired, have chest pain or shortness of breath and can't carry a conversation.
"You have to listen to your body," Caulin-Glaser says.
2. Diabetes
Workout woe: Diabetes sufferers often feel like they don't have energy to exercise. That's because they either lack or are resistant to insulin, the hormone that allows glucose which comes from carbohydrates we eat to enter cells and be converted into energy.
Many people with diabetes avoid exercise for the same reasons that healthy people do lack of time, motivation and fear of injury, says Sheri Colberg, Ph.D., an exercise physiologist and author of Diabetic Athlete's Handbook (Human Kinetics).
They may also be afraid of hypoglycemia (low blood sugar), which leads to ravenous hunger, shakiness and confusion, or that an exercise routine will worsen diabetes complications affecting the heart, nerves or kidneys."Exercise can be a hard sell to people with diabetes," says Gary Scheiner, M.S., a certified diabetes educator in Philadelphia, and author of Think Like a Pancreas (Da Capo Press). "But exercise is the best way to improve insulin resistance."
Solution: To prevent hypoglycemia, check blood sugar levels before and after workouts so you know how your body responds to the exercise routine. If blood glucose is low before exercising, eat a small carbohydrate-rich snack before you begin.
The time of day you exercise also can affect blood glucose. Some diabetics have more energy early in the morning before breakfast when glucose levels are generally higher. That's when you also have more cortisol, the wake-up hormone that increases insulin resistance.
After breakfast, your body will release insulin in response to the meal, making a drop in blood sugar levels more likely.
And talk to your doctor about adjusting dosages of diabetes drugs or insulin. Medications, such as sulfonylureas (Amaryl or Glucotrol), increase your risk for hypoglycemia because they spur the pancreas to release more insulin.
Complications from diabetes, such as neuropathy or retinopathy, are no excuse to avoid exercise either. You'll just need to be careful when developing and monitoring your diabetes workout.
For example, people with diabetic neuropathy should check their feet regularly for blisters because the condition, which damages nerves, can blunt the pain from foot injuries.
You may also want to consider doing non-weight bearing activities, such as swimming (check out these 8 pool exercises) or seated exercises, to relieve pressure on your feet.
One exception: If you have diabetic retinopathy, which damages the small blood vessels in the eye, and have an active hemorrhage, you may need to avoid exercise because more bleeding might block your sight even more."Learn how to adjust your regimen for physical activity and exercise safely with complications," Colberg says. "Almost everyone can participate in some form of physical activity without harm, and everyone will gain from doing so."
Try this: Start by increasing activities you do every day, Colberg says. Stand while gabbing on the phone with your friends. Park farther away from the mall entrance and walk. Go up and down the stairs more often.
You might just get more active without thinking about it, Colberg says. And the more you move, the better you'll feel and the more likely you are to achieve chronic pain relief.
3. Fibromyalgia
Workout woe: Living and exercising with fibromyalgia is no easy walk in the park: Most people with this chronic condition are already wracked with muscle pain, worn down by fatigue and weary from sleeplessness. Compounding the problem is its emotional toll: depression, stress and anxiety. The idea of exercising when your body aches may seem impossible. Many patients worry that any exertion will make pain and fatigue worse, and their fear isn't unfounded.
"Too much physical activity can make symptoms worse, but inactivity can too," says Matthew Goodemote, a physical therapist in Gloversville, N.Y., who often provides physical therapy to fibro sufferers.
Solution: The key is to tune into how you feel when you begin to move, Goodemote says. That "helps patients distinguish between what their mind tells them they should do and what their body tells them."
He recommends deep-breathing exercises or massages to relax. By paying attention to your breath as it moves in and out of the lungs, you'll realize where and how much you hurt.
"Pain doesn't equal injury," Goodemote says. "It's only a warning to make sure we're noticing our body."
Deep breathing also reduces tension and pain, making exercise seem less intimidating.
Try this: Fibro sufferers need low-impact workouts for soreness relief, so head to your nearest swimming pool.
"Water supports the body and relieves pressure on joints," Goodemote says. "Movement is easier in water and often patients are able to exercise for the first time without pain."
Prop your arms on a flotation "noodle" and bicycle around the pool. Step up and down on the pool stairs. Practice sitting in an imaginary chair in the water or hold on to the side of the pool and do gentle kicks, back and forth or sideways.
4. Osteoarthritis
Workout woe: About 27 million Americans suffer from osteoarthritis, the wear-and-tear condition caused by the gradual breakdown of joint cartilage. Spongy cartilage cushions bones where they meet. When it erodes, bones rub directly against one another.
Osteoarthritis pain and fear of more joint damage can stop the most active woman in her tracks. But that's exactly what you shouldn't do: Inactivity packs on weight, which puts more stress on joints and weakens muscles. And that worsens pain.
The bottom line? "You need to move," Goodemote says. "The joints get blood supply from movement and if you don't move, tissue will die."
Solution: Improve your joints' range of motion with gentle stretching exercise routines, which "help stretch ligaments and tendons and prevent joint capsules (the sac that surrounds them) from contracting," says Nathan Wei, M.D., a rheumatologist at the Arthritis and Osteoporosis Center of Maryland in Frederick.If your chronic pain is severe, start with 2-3 reps and repeat the set several times a day, Goodemote says. Stop if it hurts; you could cause inflammation, which will aggravate pain.
If you're feeling achy, take an over-the-counter anti-inflammatory, such as ibuprofen, before you start your exercise routine.
You can also apply moist heat (with a hot bath or steamed washcloth) to surrounding muscles and ligaments before exercising to help them relax, Wei says.
If you hurt after your workout, apply ice to the achy joint.
Done consistently, stretching exercises should improve your mobility in less than two weeks. At that point, you could add mild strength-training and low-impact cardio exercise routines.
Try this: Consider tai chi or qigong. Tai chi's 100 slow, gentle movements put your joints through their full range of motion and they can be done in a pool or land. Many senior centers and community colleges and centers offer tai chi classes. Or start at home with a DVD such as Step by Step Tai Chi with Tiffany Chen.
- Boycott advertisers of Glenn Beck's radio show and his guest spots on Fox News. Glenn Beck is anti-gay rights. Update: Boycott Successful: Update 4/7/2011: Beck has been fired by FOX NEWS! Radio stations dropping Beck as well in several locations. Now, tell FOX to stop having Beck as a Guest.
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- Boycott WALMART - The National Gay and Lesbian Task Force, force criticized Wal-Mart for denying employee benefits to same-s-x partners and for failing to prohibit discrimination based on gender identity. By comparison, the group said two other chain stores with a strong presence in New York, Costco and Walgreens, did much better.
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- "Tune Out Trump", Boycott all Trump Hotel, casinos, holdings, The Apprentice and NBC Network! At CPAC, Trump said he is considering a run for president as a Republican. In a interview with the Des Moines Register, Trump added that he opposes all forms of legal recognition for gay couples, not just marriage. "They should not be able to marry," he said. So why does NBC keep the Apprentice when Donald Trump has stated he may run for president? After making racist remarks about Obama and recv'g public backlash, Trump decided not to run for president after NBC renewed his awful TV Show. How can NBC re-new the clown's show after he pulled such hateful shenanigans? Boycott NBC! Boycott advertisers of The Apprentice and Trump's other business's. Don't shop at any bullding with Donald Trump's name to include Trump Hotels, Casinos, Condo's, Offices, Shops! The Donald has expressed extreme Hatred towards gays and blacks with his birther remarks and anti-gay rhetoric. Remember how poorly Trump treated Rosie O'Donnel? Now we know why he did that! It was hate against a lesbian as we now know he is biget. Unforgiveable! Again, Dump NBC because they air/re-newed Donald Trump's "The Apprentice"! Now the Donald Claims the Long Form Birth certificate is a fraud. And NBC keeps this guy?
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