By: Tim Gribbin, MEd, ATC*
Many people have reasons why they can’t just go to the gym
and work out freely. For instance, you might be working around an active
injury, dealing with persistent pain, or have a heart or other condition that
limits what you can do. No matter your limitations, experts agree that the
benefits of being active far outweigh the risks, as long as you play by your
specific rules. Exercise is generally safe for people with chronic conditions.
For example, for people with existing heart disease, we expect to see about one
cardiac event or complication for every 62,000 hours of exercise. For those who
don’t have heart disease, the risk falls substantially, with one event for
every 400–800,000 exercise hours.
Know your limitations!
Workout limitations are usually set by your medical provider. Speak with them and create a list of what you can and can’t do. For people with chronic conditions like heart issues or type 2 diabetes, there are generally few limitations. You just need to be aware of the signs and symptoms of an issue (dizziness or light-headedness, chest pain, irregular heartbeat, shortness of breath [more than what your exercise might be causing], or nausea). Your doctor might limit your intensity to a certain percentage of your max heart rate or the amount of time per week you need to exercise. For example, people with type 2 diabetes can start to see health benefits and improvements with as little as 90 minutes of exercise per week. That’s a good number to shoot for when you start your exercise program. As you become more active and get used to the higher activity level, you can start to work your way towards the 150-minute recommendation for moderate-intensity physical activity each week.
If you have a musculoskeletal condition, such as knee pain
or osteoarthritis, your limitations will be a little more specific and generally
guided by your pain. Some doctors might actually recommend running over walking
if you have mild arthritis because the cumulative impacts from running can
actually be lower than for walking. You take fewer steps when you run a mile
than you do when you walk a mile. However, some healthcare providers might
advise their patients to avoid walking or running for exercise because the
arthritis and pain will be too bad. That doesn’t mean no cardio! It just means
you need to find another way, like on an elliptical, bike, or through swimming.
Alternatives for
exercise
Exercise alternatives are based on what your limitations are. Here are some common limitations and how you can work around them.
Low-impact
People with osteoarthritis, knee pain, or who might be overweight
are often instructed to perform “low-impact” exercise. This type of exercise
limits the pounding forces that can make these conditions worse or hurt more.
Examples of low-impact cardio activities include using an elliptical machine,
swimming, or biking. Walking can also be lower impact than running because the
forces through your joints are lower, but as mentioned earlier, can create a
higher cumulative load. Listen to your body when it comes to walking vs.
running. The activity shouldn’t be painful, or at least a very low level of
pain, when you’re doing it. Pain afterwards (as opposed to soreness) is a sign
that you did too much. There’s no clear answer when it comes to walking vs.
running, so if you prefer those activities to other cardio options, choose the
one that leaves you feeling best afterwards.
Low-intensity
High-intensity workouts are all the rage these days. But for
some people, they might be too much. If you’re instructed to keep the intensity
down, find workouts that keep your heart rate at 64–76% of your maximum heart rate. Some options include fast walking,
swimming, slow biking, dancing, or yard work.
Limiting range of
motion
People with joint pain are often OK moving around in a
smaller range of motion. For example, those with knee meniscus injuries do OK until
they get into a deep knee bend, which can make things like gardening difficult.
If it hurts when you exercise, find alternatives that don’t go as far into the
motion that hurts. For example, try not going as deep on a squat or doing
lunges instead. If there are day-to-day tasks that hurt, there are also ways to
modify those. Going back to the gardening example: If kneeling hurts, try
sitting on a gardening stool or bucket so your knees don’t bend as much.
There are countless ways to modify your activity so you can
still stay active. Don’t let a few limitations stop you from reaching your
workout goals. If you have a question about how to modify activities around
your doctor’s prescribed limitations, submit your question using HPRC’s Ask the
Expert form, and we’ll help you find some work-arounds.
About the Author
Tim Gribbin, of the
Henry M. Jackson Foundation, is a Senior Scientist for the Consortium for
Health and Military Performance (CHAMP) at the Uniformed Services University of
the Health Sciences.
* The opinions and assertions expressed herein are those of the author and do not necessarily reflect the official policy or position of USU or DoD. The contents of this publication are the sole responsibility of the author and do not necessarily reflect the views, opinions, or policies of The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc. Mention of trade names, commercial products, or organizations does not imply endorsement by the U.S. Government. The author has no financial interests or relationships to disclose.
