Rebounding from Disease
Rebounding from Disease When we''re sick, we fall off the exercise wagon. If we don''t, our bodies tell us to. They moan, they gasp, they beg. They say, "Puhleeze. Don''t force me to do this!"
Your exercise routine can be a part of the healing process, or it can be a hindrance. Here, we''ll talk about how to recognize when to exercise and when to take it easy.
Mustering Strength
When your body is battling a bacterial infection, it needs every calorie of energy it can muster for infection-fighting and healing, says Charles Swencionis, Ph.D., head of the health psychology program at Yeshiva University in New York City.
During the acute period of the infection, lay off exercise completely, says David Nieman, Dr. P.H., professor of health and exercise science at Appalachian State University in Boone, North Carolina. You probably won''t feel like working out anyway, so don''t force yourself. Instead, conserve energy, he says. When your symptoms move to a point where you seem to be in the recovery phase—usually in a week to ten days or after any fever has passed—try resuming gentle exercise.
Viruses require a slightly different approach.
"If you just have a cold—runny nose, sore throat, the usual—then it''s okay to engage in moderate activity," says Dr. Nieman. In fact, sweating a bit may lift your spirits. "A leisurely stroll may help you psychologically; it may make you feel better," says world-class runner Bob Glover, who runs a New York City fitness consulting firm and is author of The Runners Handbook.
But don''t mess with the flu or other serious sickness. If you''re feverish and achy or if your throat is ticklish, skip exertion. It can make you a good deal sicker, says Dr. Nieman.
"There have been instances where people pushed themselves when they had an illness, and the infection ended up spreading to the heart muscle," says Dr. Nieman. "It could be dangerous, and possibly even fatal, to exercise strenuously if you''re seriously ill."
On the other hand, exercise is the prescription—or an important part of it—for rebounding from certain debilitating long-term diseases, such as arthritis, many heart problems, chronic pain, depression, chronic stress, chronic constipation and much more, says Dr. Swencionis. Just remember that an exercise program for getting the upper hand on any serious ailment—such as heart disease—should be designed only in consultation with a qualified doctor or therapist, he says.
Rebounding from Chronic Illness Chronic ailments and diseases put a damper on life in general, not to mention exercise. And yet, there are numerous symptoms of serious and chronic illnesses that exercise can minimize or eliminate. Below we''ve listed a few diseases in which exercise has been proven to make a difference. If you have these or any other serious illness, you should, of course, consult your doctor or specialist before exercising, says Thomas M. Petro, Ph.D., associate professor of microbiology and immunology in the Department of Oral Biology at the University of Nebraska Medical Center in Lincoln. He may be able to offer additional or modified exercises to help you work out with your specific condition. * AIDS. People who test positive for HIV or who have full-blown AIDS can benefit greatly from exercise, especially a muscle-building regimen. "It''s been shown that the more lean muscle mass you have, the longer you can resist the disease," says Dr. Petro. "And weight training can help you build and maintain lean muscle mass." On the other hand, sufferers should rest during those periods when their bodies are fighting off the opportunistic viruses that can attack during AIDS. "Rest during those times, so your body can marshal its forces to fight the disease. Then, when you feel well enough, you can resume exercising," states Dr. Petro. * Arthritis. Research shows that regular, vigorous exercise has a healing effect on stiff, painful joints and helps men and women beat common osteoarthritis symptoms. Exercise, says James Fries, M.D., associate professor of medicine at Stanford University, actually feeds cartilage with needed nutrients it wouldn''t get otherwise. Exercises that move painful joints through their full range of motion are best, according to Dr. Fries. For example, walking, rowing, cross-country skiing and cycling are best for arthritis in the knees and hips, he says. Swimming is an excellent exercise for arthritis of all types. There is no such thing as too much exercise for overcoming arthritis, he notes. The minimum, he says, is about 30 minutes a session, three or more days a week. * Cancer. Dr. Petro says the more physically fit you are, the better you can resist the ravages of certain types of cancer—and the better you can withstand the effects of cancer treatments like chemotherapy. In addition, exercise has been shown to limit your risk for other types of cancer, including colon and testicular cancer. * Diabetes. Roughly six million men suffer from diabetes, usually a variety known as adult-onset or Type II diabetes. As we get older or put on more weight, we become more prone to diabetes. But studies have shown that aerobic exercise—five or more times a week, 30 minutes per session—can reduce your risk of developing Type II diabetes by more than 40 percent. And if you already have Type II diabetes, you know controlling your blood sugar is key to controlling the disease. Studies show that exercise—especially walking—can be helpful as part of an overall plan to control blood sugar. * Depression. David Nieman, Dr. P.H., professor of health and exercise science at Appalachian State University in Boone, North Carolina, says that exercise has always been one of the best ways to cope with stress, a leading cause of depression among men. Studies have also shown that regular exercise doesn''t just improve mood, it creates a high-energy state that makes active people in general feel more optimistic and positive than sedentary people. * Heart disease. If you''ve had a heart attack, your doctor will probably recommend a specific program of regular, brisk exercise. This can reduce your chances of having another heart attack, says the American Heart Association. And if you''ve never had a heart attack, this sort of exercise is one of the best ways to ensure you never have one. Not only does exercise make you feel and look better but it also improves your chances of survival. If you''ve had recent heart disease, it''s important that your program be monitored and assessed by a doctor to make sure you aren''t causing further damage through overexertion. |
Restarting the Exercise Engine
As we begin to get well—or in the case of a long-term disease, as we begin to adjust to life with it—we''re faced with the daunting task of restarting our exercise program. Often, the first thing that needs to be kick-started is our exercise motivation.
Restarting can be tough. We can do it right, or we can do it wrong. If we do it wrong, we''re likely to become discouraged and lose interest in exercise. Or worse, we could make ourselves even sicker. Here are a few pointers from experts to help make sure that doesn''t happen.
Stick to the "neck rule." If you have a cold and you still want to work out, it''s probably okay to do that. "Just follow the neck rule: If your symptoms are from the neck up—sniffles, headache, runny nose—then a light to moderate workout won''t hurt," says Dr. Nieman. If your symptoms involve the chest or include body aches, or if you have a fever, do not work out. "Just rest—working out when you have more systemic, body-wide symptoms can actually be harmful," says Dr. Nieman.
Use the 30-second rule. For aerobic exercise or sustained activities, Dr. Swencionis swears by his 30-second formula. It''s simple: If you''ve been unable to exercise for a long time, subtract 30 seconds from your regular exercise routine for each day, beyond three, that you were laid up. Then restart at that lesser level and add 30 seconds per day until you''re back to the ideal. Remember, if your symptoms get worse, back off.
Be a lightweight. If you were working out three days a week before your cold, don''t expect to jump right back in at the same level of intensity. You''ll probably still feel a little weak, says Dr. Nieman. "Once your symptoms subside, it''s okay to start working out again, but keep your weight training to one day a week for a couple weeks, then resume your normal schedule," he says. For your first week back, do just one set for each exercise, and use a light to moderate weight.
Ease into stretching. Ligaments tend to overstretch when you''re running a fever. That''s part of why you feel so achy when you''re sick, says Dr. Swencionis. This capacity to overstretch makes ligaments particularly prone to injury if you work out when you have a fever. Don''t resume stretching until your body has kicked the bug and lost its achiness.
Carry a bottle. Illness makes us sweat. Exercise makes us sweat. Put the two together, and you''re looking at one dried-out body.
"It''s for a very good reason that doctors tell you to drink lots of fluids when you''re sick," says Thomas M. Petro, Ph.D., associate professor of microbiology and immunology in the Department of Oral Biology at the University of Nebraska Medical Center in Lincoln. It''s not just to flush a cold out of your system. When you''re sick and feverish, your body temperature is raised in an attempt to kill off whatever''s infecting you. Even if you''re on the mend, you''re probably still sweating a lot more than usual, so be sure to carry a water bottle with you and drink from it every couple of minutes while you exercise. "Dehydration not only inhibits your performance in exercise but it also makes you weaker and more prone to relapse," says Dr. Petro.
Soothe the savage throat. When you''re just getting over a cold, especially one that has affected your throat, suck on a cough drop or hard candy a few minutes before your workout, says Dr. Petro.
"Exercise is going to be hard on a throat that''s just recovering from sickness," says Dr. Petro. "Even if your throat isn''t sore, take the cough drop. It will pre-soothe your throat and prepare it for all the heavy breathing you''re about to do."
Cough it up. Aerobic activity can be part of the healing process, says Dr. Petro. "Once you''re past the point of fever and you''re starting to feel better, you''ll probably still be coughing and hacking a lot, especially when you exercise." And that''s okay—increased physical activity will help you bring up phlegm and mucus and clear out your passages. "Just keep a handkerchief or some tissues handy," he says.
If your cough becomes dry, your throat starts to feel scratchy or your coughing starts to sound more like a goose honking, stop exercising. "When this happens, you''re irritating your airways, which can expose you to infections like bronchitis and sinusitis," warns Dr. Petro. Take it easy for another day or two, then resume your workout.
Germs in the Gym You still have the sniffles, but you want to work out. Public-spirited soul that you are, you don''t want to get your germs all over the equipment and infect the next guy. Consider this the expert''s germ-free gym guide to post-cold etiquette. Wait three days. Even after your cold symptoms have subsided, you can still infect others with your cold germs. As a general rule, postpone your return to the gym until three days after your symptoms have subsided, suggests David Nieman, Dr. P.H., professor of health and exercise science at Appalachian State University in Boone, North Carolina. Meanwhile, exercise by yourself, either with weights at home or by running, walking or cycling. Wash up before the workout. We often transmit cold germs with our hands, so after you change into your workout togs, eradicate the germs on your paws by soaping up and washing with hot water. "It can greatly minimize the amount of germs you spread," says Dr. Nieman. Carry two towels. One towel is for you—to wipe off all the sweat and other fluids that are likely to be leaking out of you while you''re recovering from a cold, says Dr. Petro. Do not use this towel to wipe off the equipment. If you''re really considerate, use a second towel exclusively for wiping off the equipment before the next guy. "You could even go so far as to spray that towel with some kind of antiseptic," he says. "Just don''t forget which towel is which." |
Watch your meds. Cold medicines may keep your head clear, but their active ingredients—antihistamines and decongestants—can affect your balance and concentration. Keep that in mind before you go pounding away at the stair-climber or treadmill, both of which require a little balance to use safely, says Dr. Petro.
Check the side of your medicine bottle. That warning about operating heavy equipment applies to weights, too. Make sure you have a spotter with you during your first few days back at weight training, suggests Dr. Nieman. He''ll keep your attention focused on the weights and help you out if your concentration—or the weight—slips.
Although it''s generally safe to exercise while you''re taking most antibiotics and cold medications, check with your doctor if you''re on medication for a specific chronic disease, advises Dr. Nieman. Certain heart medications, for example, can affect your blood pressure, and exercising while you''re on them could lead to serious injury, or even death.
Monitor your vital signs. During your first few days back in the gym, pay close attention to your body, says Dr. Swencionis. If you sense your symptoms getting worse with exercise, if your heart works harder than normal, if you feel dizzy or find yourself short of breath, or if you develop serious discomfort, back off, he says. You probably returned too soon.
If it feels good, do it. If you''re coping with a long-term illness, it''s important to remember that you have the disease, says Dr. Petro; it doesn''t have you.
"With a chronic illness, it''s easy to slip into the mode of, ''I''m sick, I shouldn''t exercise.'' But often, exercise can be very good both mentally and physically when you''re dealing with an illness," says Dr. Petro.
Always consult your doctor first to make sure physical activity is okay, says Dr. Petro. Then, if you feel up to a little activity—even if it''s just getting out of bed and walking around the house, do it. "Don''t set yourself a strict fitness regimen; try to go with the flow. Some days you''ll feel too weak to do anything—so don''t, and don''t feel guilty about it. Know that on your better days, you can get up, get a little exercise, maybe get a change of scenery in the bargain. That will make you feel better," says Dr. Petro.
Rebounding from Arthritis Arthritis needn''t put a stop to your active lifestyle. Research shows that regular, vigorous exercise has a healing effect on stiff, painful joints and helps men (and women) beat common arthritis symptoms. Exercise, says James Fries, M.D., professor of medicine at Stanford University, feeds cartilage with nutrients it wouldn''t get otherwise. Cartilage has no blood supply, unlike most other tissues. How does exercise feed joints? When a runner bears weight on a knee joint, for example, it squeezes out all the water and waste products from the cartilage—"just like water squeezes out of a sponge when you press down on it," Dr. Fries says. "When you let up on the pressure, it fills up again with water and oxygen. That exchange nourishes the cartilage cells and keeps them alive." The Arthritis Foundation recommends the same three exercise types for overcoming the disabling effects of arthritis as we''ve been pushing throughout this book: range-of-motion flexibility exercises, strengthening exercises and endurance exercises. Data now suggest endurance exercise as particularly important. Much of this book covers strength and endurance training. But here are some specific range-of-motion movements suggested by the Arthritis Foundation for various body parts. Understand that these don''t add up to a workout program; rather, they are highly specific stretches that should be plugged in as needed to a broader routine. Finally, if you have arthritis, check with your doctor before beginning any exercise program. Start each of the following exercises lying on your back. Do these exercises once or twice per day, three to ten times each. Don''t bounce. Move slowly and remember to keep breathing. If you have severe pain, stop. * Knee and hip: Bend one knee, so your foot rests flat on the floor. Extend and lift the other leg. Then bend the knee of the lifted leg, and using your hands behind your knee, pull it toward your chest. Next push the leg into the air, straightening it. Finally, lower it slowly to the floor. Don''t kick it into the air if you feel pain in the knee. Repeat with the other leg. * Hip: Avoid this exercise if you have lower-back problems, a hip replacement or osteoporosis. With your feet about six inches apart, legs straight, point your toes upward. Slide one leg out to the side, keeping the toes pointing up. Don''t lift the leg, just slide it. Then slide it back and do the other leg. * Hip and knee: With your legs as straight as possible and your toes pointed upward, roll your hips and knees so your left toes point to the left and your right toes point to the right. Your heels should pivot but essentially remain in the same place. Return to the starting position and repeat. When you finish with that motion exercise, and with your legs still straight, push one knee down toward the floor by tightening the muscles on the front of the thigh for a slow count of five. Relax. Then repeat with the other leg. * Shoulder: Lie with your arms close to your sides, fingers pointing to your feet. Raise one arm in a smooth motion, keeping the elbow straight, moving it through a circular arc until your hand reaches the floor beyond your head. Then smoothly return it to the side of your leg, going through the same arc, elbow still straight. Repeat with the other arm. * Fingers: Stretch and spread the fingers of each hand. Next bend all the finger joints except the knuckles. With your bent fingertips, touch the top of your palm. Then reach your thumb over until it contacts the second joint of your little finger. Next stretch out the thumb. Finally, stretch all your fingers again. Repeat. Want more assistance? You can call the Arthritis Foundation at 1-800-283-7800 for a free copy of "Exercise and Your Arthritis." Or check into "The ROM Dance" (ROM stands for Range of Motion). This is a great, oft-prescribed form of stretching that generates relief from arthritis pain and enhances the mind-body connection. If your doctor or therapist suggests that you try ROM, you might check with adult schools, recreation programs and occupational or physical therapists in your area to see if "The ROM Dance" is available. For a list of ROM certified therapists, contact The ROM Dance Network, P.O. Box 3332, Madison, WI 53704-0332. |
 | |
