I was forced to be sedentary for 5 years due to a very serious back injury. I'd ruptured a disc, which resulted in a compressed nerve root, partial paralysis for weeks, and the permanent loss of lower leg reflexes.
When I'd read about how important exercise was for overall heath and the control of diabetes, I'd just sigh and turn the page. When I tried to exercise I'd aggravate my injury and end up in severe pain for weeks. One year, a few days of following a gentle walking program resulted in severe leg pain that lasted weeks and my big toe went numb and stay that way for nine months. Visits to the physical therapist and doing the exercises they gave me only made the pain and numbness worse. I decided exercise was not for me.
Learning from Successful Dieters
But years ago, while I was losing weight by low carbing, I read an old book about the characteristics of weight loss (summarized here
One of the things that leaped out at me while reading that book was that many of the women followed in this study, who had lost at least 20% of their body weight and kept it off for five years or more, reported that they had not started to exercise until after
they'd achieved significant weight loss. The weight loss made exercise possible and was a large part of how they maintained their new weight.
Strolling on the Treadmill
That got me thinking. So when I had lost about 10% of my starting weight, I decided I'd see what I could do. I started out very slowly. Mindful of how I'd injured myself the previous year, I started out doing only doing 15 minutes on the treadmill at a leisurely 2 mph. The treadmill, it turns out, is much
easier on the body than walking on a street because the motion is less complex and doesn't strain the hip area. Even so, at this gentle rate my heart rate would
soar into the 160s after only a few minutes. When I told my doctor about that, he made me go to a cardiologist to make sure I wasn't going to drop dead pursuing my new fitness goal!
Fortunately the cardiologists stress test showed that I was in lousy shape but not suffering irregular heart rhythms. So I kept at it. I used the heart rate monitor to keep myself in a safe low intensity heart rate range until, at six weeks, my heart suddenly seemed to strengthen and I was able to push the intensity up a bit without having the rate accelerate too quickly.
By the end of nine weeks I was doing 1 hr a day on the treadmill at 3.2 mph, and working up to a healthy cardio heart rate!
Enter the Pedometer
Around that time I was browsing some diabetes news sites when I ran into an item about the "10,000 steps" program.http://www.diabetesincontrol.com/studies/step.shtml
The idea here is simple. Participants wear a pedometer and try to rack up 10,000 steps each day. The article claimed that over a 3 month period participants with diabetes improved their blood sugar, cholesterol and lost some weight without dieting simply by using the pedometer to help them meet their daily goal.
Well, years ago my daughter had given me a pedometer for my birthday. So I put it on my belt got going.
Because of how much I'd been doing on the treadmill I thought I was doing a lot of exercise. But when I started using the pedometer I discovered I was only getting up to about 5,000 or 6,000 steps even with the workout. That motivated me to add a lot of little walks through the day. As a result I hit the 10,000 step goal four times in the first 10 days. The other days I got up to around 8,000 steps.
What is really great about using the pedometer is that it is motivating me to "sneak in" steps here and there all day to make my 10,000 step goal. For example, I started to walk to the post office (.7 miles each way) instead of driving. I'm walking to my friend's house (.5 miles). I'd park at the far end of the supermarket parking lot. One night, I was upstairs reading and about to put on my nightie when I looked at my pedometer and saw I was up to 8,500 steps. Since I knew by now exactly how far everything in the neighborhood is, I got up, walked down the road just far enough to get my 750 steps in, got to see a spectacular sunset, and came home. Final tally 10,007 steps!
The Basic Strategy
Start ridiculously slowly! The key for me was monitoring my heart rate and not letting it go over 65% of the calculated maximum.
At first my heart rate would be extremely variable--climbing 20 or 30 points after I'd start to walk. Fortunately, I'd done some reading about exercise and knew this was not a good sign. People who are in as poor shape as I was can give themselves heart attacks if they strain their heart at the outset of an exercise program. So I kept a close watch on my heart rate. Every time it sped up past 75% of maximum, I'd slow way down.
Always Do a Five Minute Cool Down
If you get your heart pounding and stop cold, your heart rate may soar. That's because while your legs are pumping they help move the blood around your body. When you stand still, that pumping stops forcing the heart to work harder to supply the oxygen needs of your muscles. So if you stop cold after a half hour exercise session where your heart rate got up high to start with, when you stop your heart rate may reach dangerously high levels, which may be enough to cause a heart attack.
How to Set a Heart Rate Target
To calculate your own target heart rate, subtract your age from 220. This gives you the calculated maximum heart rate.
For example, if you are 55, your calculated maximum heart rate would be 220 - 55, which is 165.
Now to get an appropriate low intensity exercise heart rate, multiply this number by .65. This gives you the heart rate that is 65% percent of your maximum, which is the heart rate you should aim for when you first start out after being sedentary.
For the person in the example, 165 times .65 is 107. So 107 beats per minute should be your target heart rate.
To make sure you are reaching your heart rate, use machines at the gym that have a heart rate monitor built in or if you aren't exercising at a gym, invest in a heart rate monitor. They sell them in the sports section of many department stores. Just counting your pulse doesn't work very well when you are really out of shape since the rate can vary so much.
Start with Short Periods of Exercise and Add Time Gradually
When you exercise start out with a short period of exercise--15 minutes worked for me. Don't let your heart rate go above the 65% rate. Slow down to whatever speeds it takes to keep it there but don't stop without a cool down period.
Gradually add five minutes to your daily routine. Do 15 minutes the first week, 20 minutes the next, 25 the next and then 30 the fourth week.
Increase Your Heart Rate Target
About six weeks in you should see a great improvement in how steady your heart rate stays as you exercise. Now start increasing your target heart rate. At first I raised my target from 108 to 112. I kept it there for a couple days. Then I slowly increased it a couple beats every few days until after nine weeks I worked up to a steady 133 which is a cardio heart rate for someone of my age.
I started each session at a slow rate and gradually increase to my new high, giving my heart a chance to get used to the speed. As I exercised more it became harder and harder to push my heart rate up, a sure sign I was getting more fit!
Aim for 10,000 Steps
Once you can walk comfortably for half an hour, get yourself the pedometer and see if you can add another 1,000 steps to your daily total every couple days.
Pain Means "Slow Down!"
If things start to hurt (which they did for me, especially at first) take a day off! Don't try to push through pain. Respect your joints. If you haven't been exercising in years you need to wear them in gradually. This strategy goes against all the things you learned in High School, but it works and will let you exercise happily for years to come.
A Final Caution
If you have diabetes as I do, or even if you only have prediabetes, you may be more prone to developing tendon problems. The tendon problems associated with elevated blood sugars are discussed HERE
After a full year of exercise, I developed tendon problems in my feet which made me have to stop exercising so hard. Too energetic use of the treadmill may cause repetitive motion injuries in those of us with fragile tendons!
When I started a new walking program I walked only outside. I went with a partner, and chose different routes to keep things interesting, and was fortunate to live near a town that had steep hills with even steeper staircases that made it possible to get a good hills workout. I worked up to 45 minute walks, gradually, and backed down to 30 minutes at any hint of soreness. This worked out well.