My doctor told me to exercise! Basics to start working out.

Did you know that moving around is the best thing you can do for your health? The health benefits of exercise and regular physical activity are widely documented.

Maybe you are not used to exercising. Maybe you have not done it in a while. You might have many questions! Let’s get to our lesson. We will discuss the What, Why, Where and How’s of Exercise.

What?

General recommendations for exercise.

The Physical Activity Guidelines for Americans1 recommend that to obtain significant health benefits, adults should exercise at least:

  • 150 minutes a week for moderate exercise OR
  • at least 75 minutes a week for vigorous aerobic exercise (cardio) OR
  •  a combination of both.
  • Also, muscle strengthening exercises for the major muscle groups are recommended to be done at least twice a week. The major muscle groups are the: legs, hips, back, abdomen, chest, shoulders and arms.
Exercise Guidelines

What is moderate exercise? You can talk, but not sing during exercise. For example: brisk walking or dancing

What is vigorous exercise? You can’t say more than a few words during exercise. For example: running and swimming (please don’t try to talk during swimming!).

Here, we will be focusing on recommendations for relatively healthy adults.

Older adults should work with their balance as part of their exercise program. Patients with chronic medical conditions should be under their doctor’s supervision and work as tolerated, but should avoid being inactive.

But what do all of those recommendations mean?

Let’s do an example with walking used as moderate exercise. An exercise plan would look like this:

  • Walking three days a week, 50 minutes each time. (That would be a total of 150 minutes a week).

OR

  • Walking five days a week, 30 minutes each time. (Also a total of 150 minutes a week).

For vigorous exercise an exercise plan would look like this:

  • Running three days a week, 25 minutes each time. (Total of 75 minutes a week.)

Besides that, a program for muscle strengthening exercises should be done twice a week. These could be done the same day the cardio is done.  Or, it could be done on alternate days.

So, for a person who does walking three times a week and then, intercalates the weight training twice a week; this person will be exercising 5 days a week.

Exercise does not have to be only walking or running.

Some other examples of exercise include: jogging, hiking, water aerobics, aerobic exercise classes, bicycle riding (stationary or outdoors), jumping rope, kayaking, sports like tennis, soccer, basketball. For some people, even doing some yard work, may count as exercise.

Why?

Why exercise? Because it has many benefits.

Those benefits include:

Feeling better! Exercise may help your mood and may help you feel more energetic. Exercise is known to reduce anxiety and risk of depression. You might even notice that you are looking better.

It will be easier to do your daily activities (for example, climbing stairs or doing the yard).

Better overall health. Health benefits from exercise include:

Sleeping better.

Exercise lowers blood pressure.

Exercise lowers the risk of heart problems, diabetes, some cancers and stroke.

It helps improve bone health.

Exercise may help with mental processing and memory. It helps reduce the risk of dementia (including Alzheimers).

Exercise boosts the immune system (the one that helps you fight infections) and helps decrease inflammation2.

Weight loss.

Working out and weight loss

Even if you don’t lose weight, you can have health benefits from increased physical activity. The more active you are, the greater will be the overall benefits.

Since losing weight is one of those known benefits of exercise that motivates many people to go and work out; let’s consider this subject in a little more detail.

If losing weight is the goal of exercise, many people will need more than the recommended 150 minutes of moderate activity a week just to maintain their weight. That means, people who want to lose a significant amount of weight or keep that weight off, may need more than 300 minutes of moderate exercise a week to reach those goals.

That means: the recommendations given at the beginning of this article are given to achieve general health benefits. If you want to lose weight, walk the extra mile. Also remember to work on your diet. Do not get discouraged by weight fluctuations. Be happy that you are being more active, because that means you are working in your well-being and closer to your goal.

Working out and Pain

If you are having any back pain, knee pain or any type of pain that might be interfering with your mobility and function, you might need a physiatrist evaluation.

You could be recommended physical therapy, which should help you perform your range of motion adequately and with less pain. Once the medical aspects are addressed, and your joints and muscles are prepared, you could follow a home exercise program and then do regular exercise in your community.

Where?

Here is a list of places to consider for your workout sessions:

Your home. You can choose an open and ventilated space in your home to work out. You can do video lessons or run a stationary bicycle for example.

Around your neighborhood. Encourage your neighbors to start a walking group!

Parks, hiking trails and other outdoors.

Pools

The beach. Here is a tip: walking in the sand helps with balance.

Community recreation centers. They could offer exercise classes. Invite your friends or make new ones!

Fitness Centers. Some health insurances may offer gym membership discounts or fitness programs.

Wellness center facility in a hospital. This is a good option for people with medical conditions.

Make sure you are safe. Go to places where there are other people. Use walking trails that are away from cars. Use helmets if biking. Don’t swim alone. Use sunscreen if you are going outdoors.

How?

Start slow and go slow”. Just please START doing some physical activity, even 5 minutes to start is good, then you can add one minute every day you exercise and so on. Also, please sit less and walk more. You can park your car farther away when going to the store; this will add more steps and physical activity to your day.

You might be telling yourself: “I don’t have equipment at home or money to pay for a gym membership”. You don’t need fancy equipment, as long as it is safe and comfortable. For example, some affordable elastic bands or an exercise ball might be useful. Use what you already have at home.

Keep track of your fitness sessions.

You can write an exercise log, or you can use an app in your smart phone. Having a log will help you remember what you did on your last session. Then, you won’t need to wonder if you walked 30 or 35 minutes in your last session or if you lifted 3lbs or 5 lbs dumbbells for biceps strengthening. It can also help you plan ahead of time what your routine will look like.

Once you have been doing exercise for a few weeks or months, to get some motivation, you can go back and look in your exercise journal or planner to see how far you have come. You might also want to include your diet in your planner, or do a separate nutrition journal.

How to plan your workout sessions:

Start simple and do what you can tolerate. Once you can tolerate your initial exercise activities you can progress the exercise. If you were walking 5 minutes, and now you feel it is easier to do so, then you might progress to 10 minutes of brisk walk. Or let’s say, you can bike for 20 minutes 3 times a week and you have been doing it for a couple of weeks. Now you feel the ride is easier, this means you can progress your routine by biking for 20 minutes 4 to 5 times a week. Progress your exercise, until you can reach or exceed the guidelines.

You may do a warm up session prior to your cardio and cool down session at the end of exercise. You may also do stretching, which helps improves flexibility. Do not count the time you take to do the stretches, towards the total time of exercise.

But, what about muscle strengthening exercises?

Before doing the resistance exercises you may do stretching of the major muscles to be worked. Do two to four repetitions, holding each stretch for about 30 seconds.

For flexibility exercises, the American College of Sports Medicine states that “a series of exercises targeting the major muscle–tendon units of the shoulder girdle, chest, neck, trunk, lower back, hips, posterior and anterior legs, and ankles are recommended. For most individuals, this routine can be completed within 10 min”3.

Strength training can be done using dumbbells, elastic bands or even your own body weight (like push-ups, planks and squats).

The recommendation for resistance training is to perform:

  • two to four sets per muscle group
  • 8 to 12 repetitions for each set,
  • with rest for 2 to 3 minutes between each set.

Resistance exercise can be progressed by increasing resistance (the amount of weight lifted), number of repetitions or by training more often. Two days of rest should be allowed between sessions.

While doing muscle strengthening exercises it is important to use a correct technique, doing controlled movements and also breathing adequately (exhaling during muscle contraction, inhaling while you release). Some people do whole body sessions, while other people split the routines between upper and lower body routines.

Exercise does not need to be boring, there is a variety of routines and techniques that could be done. Working in balance, agility and coordination would be a helpful addition to the fitness regimen.

Other considerations:

Goals.

The first step to start working out is to make the decision. The second step would be to establish some goals. Your goals should be realistic, specific and reasonable.

Let’s say your doctor asked you to exercise. Then, there should be some specific things to consider. Why did your doctor recommend the exercise? What is the main concern? For example, if your doctor is concerned about obesity, set a goal to work on weight loss.

The goal to get started would look like this: Walking 30 minutes 3 times a week for one month. Note that a deadline to reach that goal was established, and the goal is clearly defined. This goal in particular will help you establish a routine and make some lifestyle and behavior changes.

Then, you can outline a plan to progress your workout routines and diet towards your main goal of losing weight. You can break the main goal into a few smaller goals to be met in specific timeframes.

Reassess.

Use measurable ways to track your progress. As an example, if your doctor’s concern was high blood pressure, set your goals towards lowering the blood pressure. You can measure progress by having a blood pressure monitor at home and by keeping track of your blood pressure readings during your medical appointments.

Motivation.

Try to make the experience pleasurable, choose the activities you enjoy the most.

Some people find that they get home too tired from work, so they are not motivated to exercise. There are some solutions to that problem:

Waking up a few minutes earlier to work out in the morning.

Going for a walk after lunch or during breaks at work. Going up the stairs instead of taking the elevator at work.

Planning ahead of time. Having a bag prepared with snacks and the gym clothes, then you can go straight from work to the gym.

Including exercise in your daily schedule to establish the days of the week and the time to exercise.

Working out with a friend for support and accountability. Hiring a personal trainer, may serve this purpose as well.  

Risks and medical problems.

Some people fear about the risks involved with doing exercise. The higher the level of physical activity, the higher the risk of musculoskeletal injuries. The risk of injuries will depend on how fit you are and how much physical activity you do. (But at the same time, the more you do, the more fit you get). If you are worried about risks, you can do activities that can be safe, such as walking, riding a stationary bicycle or swimming.

Diet.

An appropriate nutrition is an essential part of this new lifestyle. It is an essential component of a wellness regimen and it also involves goal planning and behavior change. The exercise performance and recovery depend a lot on the way nutrition is done. The body will have different demands depending on your health history, physical activity and goals. That means that the dietary recommendations may vary from individual to individual. In general, please keep a healthy and balanced diet. You may consult your nutritionist or physician.

Clothing.

Chose comfortable clothing, one that allows for movement and avoids overheating. Reflective clothing is a good choice if working out at night.

Hydrate.

Drink plenty of fluids to avoid dehydration.

Sleep.

Last but not least, rest and recovery are an essential part of fitness. Make sure you get enough sleep!

References:

  1. U.S. Department of Health and Human Services. Physical Activity Guidelines for Americans, 2nd edition. Washington, DC: U.S. Department of Health and Human Services; 2018.
  2. Scheffer DDL, Latini A. Exercise-induced immune system response: Anti-inflammatory status on peripheral and central organs. Biochim Biophys Acta Mol Basis Dis. 2020 Oct 1;1866(10):165823. doi: 10.1016/j.bbadis.2020.165823. Epub 2020 Apr 29. PMID: 32360589; PMCID: PMC7188661.
  3. Garber CE, Blissmer B, Deschenes MR, Franklin BA, Lamonte MJ, Lee IM, Nieman DC, Swain DP; American College of Sports Medicine. American College of Sports Medicine position stand. Quantity and quality of exercise for developing and maintaining cardiorespiratory, musculoskeletal, and neuromotor fitness in apparently healthy adults: guidance for prescribing exercise. Med Sci Sports Exerc. 2011 Jul;43(7):1334-59. doi: 10.1249/MSS.0b013e318213fefb. PMID: 21694556.

The expressions published in this website do not represent professional medical advice. It does not establish a doctor patient relationship between us. This content, does not substitute in any way the evaluation, diagnosis, treatment or the recommendations of your physician. This content is for general educational and entertainment purposes only. Every person has a different medical history and characteristics, and general recommendations may not apply to everyone. Consequently, you and your physician are responsible for your health and consequences.

The names and situations presented in this website are fictitious. They are used in an explicative and entertaining way. Remember that patients who have similar conditions, may present questions and situations that are similar. This website does not present cases of real patients. Read the full disclaimers here.

My doctor told me to exercise! Basics to start working out.