Topic Overview

When you are living with health problems, regular exercise and activity are important. They keep you healthier, give you energy, make you stronger, and help your mood.

Exercise and activity can help many health problems. An active body is less likely to give in to diabetes, heart disease, lung disease, arthritis, depression, or weight gain. And being active can help protect you from new health problems.

What is being active?

What does "exercise" or "being active" mean? It all depends on what you can do. When you think of exercise, you may think of running or going to a gym. This may be overwhelming to you. But exercise can be about making small changes in physical activity level. For example, parking your car in the farthest parking space from a store, can be a first small step.

It can be hard to be active when you have many health problems. Exercising enough to control diabetes can be a challenge when arthritis makes walking painful or when heart failure slows you down. But there are choices, like doing exercises in the water or as part of a cardiac rehab program.

With your doctor's help, you can decide what works for you. Figure out what is safe, what to avoid, and what kinds of choices you have. Don't be too active or get too much exercise at first. Do a little at first, and then gradually do more.

What are the benefits?

Regular exercise:

• Helps control stress, depression, and anxiety.
• Gives you more energy.
• Strengthens your heart and helps control your blood pressure.
• Makes your lungs stronger.
• Lowers your cholesterol.
• Keeps your weight down.
• Keeps your blood sugar at a healthy level.
• Can build bone strength.

How do you stay safe?

You want to live life to its fullest, but you don't want to hurt yourself.

1. Know your strengths and your barriers. When you have more than one chronic disease, there may be some physical limits on what you can do. If you push your limits, you could hurt yourself. It's also normal to have feelings that can get in the way, like fear, depression, or being self-conscious. These emotions and physical limits are called barriers.

2. Get expert advice. Talk to your doctor about all of your symptoms, medicines, and barriers to being active. Talk about your strengths and what you enjoy doing. If you've been feeling depressed, be sure to talk about that too. Depression can make even the simplest things seem hard.

Use this planning form to gather your thoughts. What do you most like to do? What kinds of things get in your way? What questions do you have for your doctor?

Go over your planning form with your doctor. Write down what you can do for exercise and what you need to be careful about. Set a long-term goal you can reach, and write the small steps you will take toward it. Working on these small steps will make it more likely that you will achieve your long-term goal. When you reach your goal, find a way to celebrate it. Then set another goal.

Your doctor may work with you on an exercise prescription. This clearly sets out what is safe for you, such as your target heart rate range and any need for medical supervision while you exercise. If you need medical staff with you when you exercise, your doctor will suggest that you sign up for an exercise rehab program.

3. Know when to stop and when to call your doctor. When you exercise, it's normal to have some minor muscle and joint soreness. But other signs may point to something more serious. Stop exercising if:

• You have pain in your chest or upper belly that may spread to your neck, jaw, upper back, shoulder, and arms. Call 911 right away if this happens. Chest pain can be a signal of a heart attack.
• You are panting or are very short of breath.
• You feel sick to your stomach.
• You have pain, joint discomfort, or muscle cramps that won't go away.

Your doctor may add other symptoms to look out for, based on your health.

Call your doctor if your symptoms don't go away quickly or if they come back again.

What are some basic tips for exercising when you have health problems?

Be as active as you can as often as you can, but honour your body's limits.

• Set goals that you can reach. If you expect too much, it's easy to get discouraged and stop exercising.
• Keep your emergency phone numbers with you at all times.
• Don't be too active when you begin. This could mean starting out with just a few minutes of exercise. Each day or so, slightly increase how long and how hard you're active.
• Find a group, class, or buddy you can enjoy being active with.
• Stay within your doctor's guidelines. For example, if you have angina, walk just a little slower than the pace that gives you chest pain. If you have arthritis of the knee or hip, walk on level ground and avoid hills. Even better, exercise in the water. If you are unsure of your safe range, work with a physical therapist to find it.
• Do not exercise if your condition is worse than usual. For example, if you have heart failure, do not exercise during a flare-up.

Health experts suggest that older adults and people with long-term health problems try to:

• Stretch for at least 10 minutes a day, 2 days a week.
• Strengthen the major muscle groups with 8 to 10 exercises a day, at least 2 days a week.
• Try to do at least 2½ hours of moderate exercise a week. One way to do this is to be active 30 minutes a day, at least 5 days a week.

These are guidelines. A slow walk might feel hard, easy, or somewhere in between for you, depending on your health and fitness levels. You and your doctor can decide what's best for you.