Walking can very easily become a routine part of one’s life, and well it should be. You’re likely to get to a point when you’ll be disappointed if anything should get in the way of your “daily constitutional” as the day’s walk used to be called.
When so many goals take so much effort to achieve, it’s nice to think that something as simple and easy as taking a daily walk can have so many benefits. This is something that’s available to most of us.
During my media tout in London to talk about my books, I checked into a hotel that had a health club just across the street. I planned to get a short-term membership so I could keep up with my exercise program. But then I found that walking is absolutely a way of life in England. One good reason is that traffic is often so congested that one can walk to a destination faster than a taxi could get there. Before I knew it, I was walking all over the place, aided by a map and by the friendly people, who were always happy to provide directions to a foreigner. I never did go into that health club, and I never felt better.
Whether you’re in a formal, structured cardiac rehabilitation program or following your doctor’s exercise prescription on your own at home, walking will be a part of your recovery. A while back we used to believe that walking was the place to start a conditioning program; today we know that it very well may be all you need, now and in the future.
I happen to be lucky enough to live where the weather allows me to go out for a walk just about every day of the year. Those living in cold climates may not fare as well when the mercury drops below zero and the wind chill factor comes into play. On those days many cold-clime residents take to the shopping malls. Today’s huge enclosed malls, typically on two or three levels, offer a wonderful opportunity to walk regardless of the weather. In fact, in many cities there are mall-walking clubs, and malls often open before the shops open their doors so that walking will be unimpeded. Another alternative is the treadmill. We’ll get into the pros and cons of that and other equipment in the coming pages.
A terrific way to stay on a routine walking program is to do it with a friend or two. Many couples become fellow walkers after a cardiac event. It offers a nice way to talk about the day’s events when the walk is planned as the first thing to do after coming home from work. Certainly a healthier way to start the evening than with a cocktail!
What’s the best time of the day to exercise? Some folks can get their exercise by simply taking advantage of opportunities throughout the day: taking a few flights of stairs instead of using the elevator; walking to put a few letters in the mail box; parking the car several blocks from the final destination.
Others find it best to have a specified time of day to get in their walk. I happen to like to get in a workout first thing in the morning. My wife prefers doing so after work. I feel that getting some exercise sets the tone for the day, providing a charge of my batteries that carries me through and helps to offset the day’s stresses. Dawn absolutely hates it then, but finds it relaxing after a day in the classroom.
Investigators at the William Beaumont Hospital in Royal Oak, Michigan, compared morning and evening cardiac exercisers. They checked a total of nearly 30,000 patient sessions of rehab over a 23-month span of time. It turns out that evening exercisers missed more sessions than did their morning counterparts, even though everyone was free to choose the time of day he or she preferred. The difference wasn’t that great, however, with the morning crowd attending 68 per cent of the sessions and the later group coming 60 per cent of the time!
I must say that on those days when I decide to exercise later in the day, I tend to come up with excuses, postponing it hour by hour until the day’s over and I’ve not gotten my workout. For me it’s best to set my workout as my day’s first assignment.
That need for structure is also why I belong to a health club. I find it helpful to have to get into the car to go to the club where the phone can’t disturb me and I’m not tempted to do anything other than what I’m there for. I also like working on a variety of workout apparatus, including the treadmill, stair climber, exercycle and rowing machine. Others, on the other hand, might find it ridiculous to drive a car to a place just to do some walking.
If you need further motivation and encouragement to get out for that daily walk, there’s no better way than to get a dog. We’ve already seen how owning a pet is a very effective stress-reduction technique that has been shown to lower blood pressure levels. You may not want to go out for a brisk walk when it’s drizzling outside, but your dog won’t care at all. Come rain or shine, your pet will give you your signal that it’s time to get the leash and go!
If, after a while, your neighbourhood starts getting a bit too familiar, you might want to expand your territory. Make a list of the places you’d like to walk. Then when you have a little extra time, get into the car and drive to a new location. Maybe there’s a nice park a few kilometres away, or a forest preserve, or a nature path.
Or how about listening to some music? A number of manufacturers make a self-contained radio/earphone set which allows you to listen to your favourite station while walking along. Do you prefer your own music? One of the Walkman-type portable stereos might be just the thing. You’ll need some tapes to set the mood for your brisk walk.
One man had a hard time doing that. He went to music stores and found that most of the tapes didn’t suit his generational tastes. The “easy listening” tapes didn’t keep the pace up enough. So he proceeded to create his own series of four walking tapes, each orchestrated to accompany a brisk walk of three to four kilometres per hour. Each tape is an hour long, with invigorating and motivating music.
If you do decide to try a treadmill, you might want to set it up in front of a TV set so you can watch the news or a videotape while walking off the kilometres. That’s another advantage of the club I joined; they have a line of treadmills facing the TV with plugs to hook up one’s headphones.
Since we’re really talking about making walking a way of life, don’t forget to pack your walking shoes when you head off for a business trip or holiday. Consider it a terrific way to become acquainted with a new area. Just ask someone at the hotel where you can get a nice two- to three-kilometre walk where you can see some of the local sights.
At the beginning, you might find that a brisk walk to get your heart rate up into the target range will be just about five kilometres pet hour. As you progress, your walking speed will increase gradually. Don’t push it. You’ve got the test of your life.
You might want to get in the car one day and measure out a one-kilometre stretch near your home. Then see how long it takes to cover that kilometre. Let’s say you do it in 20 minutes. You’re walking a 3 kmph pace. If you finish in 15 minutes, you’re up to 4 kmph.
Once you know how fast you’re walking, you can use your watch to log the kilometres. Start walking and note the time. If you’re walking a 4 kmph pace, even if you’re in a different neighbourhood, you can note the time, start walking, and after 15 minutes, just turn around and come back. You’ll have covered two kilometres.
While some authorities, including Dr Blair, discount the heart rate, most believe that patients should keep track of how fast their hearts are beating. A 60 to 75 per cent target zone will give you a good cardiovascular workout. Gardening for Fitness. Many men and women love to work in the garden and on their lawns. If you’re one of those gardeners, you probably never thought of it as being work, especially work that’s good for your heart. But it can be just that.
As with any other activity during your recovery, the key is to not overdo it. During the first week you might want to spend about 15 minutes in the garden, then gradually increase both your time and your activities. At the start, avoid lifting heavy sacks and stooping, especially if you’ve just had open-heart surgery and your chest incision isn’t entirely healed.
There’s no rule saying you have to finish a given task at one time. Maybe today you can mow the lawn in the front, and tomorrow you can mow the back. Or perhaps you’d like to do a little work in the morning, and then return later in the day to do a few more chores. Raking, shovelling, hoeing—all can be very aerobic activities, as well as being terrific stress-busters.
Just don’t ignore the basics. Quit before you get tired. Stop immediately at the first sign of distress. If you suffer from angina, sit and rest before going on. If you go back into the house and you’re feeling exhausted, you’ve done too much. Don’t do it again. Learn your limits, realising that your limitations will lessen as time goes on.
Pedalling for Good Health. Almost everyone knows how to ride a bicycle. Cycling can offer an enjoyable alternative to walking. Apply the same rules. Go easy at first. Take another look at the energy expenditures in Table 3 for different speeds of cycling on smooth, flat surfaces. Start off with a warm-up period of easy pedalling, then speed it up to get to your target training range. Then finish off with a five-minute cool-down.
One advantage of cycling is that you can easily increase your heart rate by increasing the speed a kilometre or two per hour faster or by riding over hillier terrain that gives extra challenge. But don’t get yourself into trouble by biting off more than you can chew.
Another thing I like about cycling is that you can go a lot farther from home than you can while walking. This means that you can expand your territory quite easily without having to get into the car. Put some saddle-bags or a basket on the bike and you can kill two birds with one stone by using your bicycle to run errands around the neighbourhood. After all, the bicycle is considered a major form of transportation in many parts of the world. And parking places for that bike are a lot easier to find.
Whether walking or cycling, try to avoid hot days or, if you live in an urban area with air pollution problems, days when the air quality poses a problem. On such days, a stationary bike comes in handy.
I’ll admit that just pedalling and going nowhere can be mighty boring.
That’s the time to put the bike in front of the TV or tune in some music on your headphones.
As time goes on, you just might find that you’ve become a true cycling fan. A number of clubs have been formed in recent years, and you might want to look into joining one. Some hospitals even have formed cycling clubs for former cardiac patients. I met one man whose heart attack didn’t keep him from becoming a cycling fanatic. Now he looks forward to each weekend when he takes off on his mountain bike, riding through some of California’s roughest terrain. He takes a great deal of pride in his abilities. For him, cycling is the perfect outlet for his stressful life, in addition to providing exercise.
Staying in the Swim of Things. For those who have a pool conveniently available, swimming can be a wonderful way to get exercise. It has a number of advantages over other activities. Swimming is much less likely to lead to orthopaedic injuries than jogging or running. You use both arms and legs, providing an overall workout. And there’s something particularly soothing about gracefully swimming laps back and forth. Many swimmers report that they do their best thinking when in the water.
Whether swimming can serve as an adequate workout, however, will depend on your own skills. Simply paddling about, doing more standing than swimming, won’t achieve cardiovascular fitness, though it can still be fun. If you’ve got a good stroke, on the other hand, you can put out a lot of energy.
For those who aren’t as good as they’d like to be, the problem most often is a lack of skill in breathing properly. But you can still use swimming as an exercise alternative. Just get a mask and snorkle, keep your face down in the water, and paddle away. Most people find that with this technique they can do continuous laps until they achieve a target heart rate.
You might also want to look into the possibilities of “aqua aerobics” classes in your area. Standing in a shallow lap pool, you use the resistance of the water to bring your efforts up to an aerobic level. A good instructor can make this a lot of fun, and you’ll be pleasantly surprised at how good a workout you’ll get.
Another way to watery fitness is to use a kick board. Be careful with this one, though, since it can bring the heart rate up faster than you might imagine.
As you start off doing laps in freestyle swimming or by using a kick board, do a lap or two and then check your pulse. At the beginning you might be able to do only one or two laps, with resting sessions in between. As you improve your fitness, you’ll find yourself doing more and more. It’s a great way to see progress quickly.
Running in the Water. Let’s say you’ve got a pool, but it’s too small to do serious lap swimming for exercise. And you find running hurts your knees. The answer is to combine the two by running in the water.
Skipping Back to Health. What’s an easy way to exercise that’s so much fun that children all over the world love to do it? How long has it been since you picked up a jump rope and tried skipping? Here’s a very inexpensive and portable approach to aerobic fitness. You can even put it into your suitcase and take it along on business trips. And don’t pooh-pooh this as child’s play; remember that rope skipping is a favourite training technique for prizefighters. Just 10 minutes of vigorous skipping equals the cardiovascular benefit from 30 minutes of jogging!
To get started, make sure that your rope is the right length. It should reach up to the armpits when held beneath the feet. Stand on the middle of the rope and bring the two ends up to your armpits. If too long, cut some off or wind it around the handles. Don’t use a rope that’s too short; you won’t be able to skip well, and you may get tripped up. You can find a good-quality jump rope at any sporting goods store. Today’s design makes jumping easier, especially for beginners.
If you’ve never tried rope skipping, start without the rope. Stand on a mat or carpet with your arms down and bent at a 45-degree angle. Then bounce from one foot to another, jumping just 2.5 cm off the floor in order to get the rhythm. (If your cardiac event was recent, this alone may be enough to get your heart into the target zone and you might want to stick with this alone for a while.) Keep your body as limber as possible, with knees and hips relaxed and slightly bent.
After you’ve mastered the rhythm, try it with the rope. Place the rope behind your ankles, with your arms bent and your hands just ahead of your hips. Then swing the rope, jumping just high enough to let the rope clear, about 2.5 cm.
You might also try jumping with both feet at the same time. Some people find that easier, though I don’t.
Don’t feel like a klutz if you don’t get it right away. Do one jump at a time. Then two. Pretty soon you will put together a reasonable series of jumps. While you’re working at it, take your pulse now and then to make sure you don’t exceed your rate.
Once you’ve got the rhythm down pat, you can skip without even thinking about it. That means that you can pick up the rope and do some jumping now and then throughout the day. If you have high ceilings, try it while watching the news.
Just one word of caution about rope skipping. You may be tempted to show off your new skills to your children or grandchildren. Don’t. First, they won’t be impressed, since their skills will no doubt be much greater than yours. And you may be tempted to overdo it, as you won’t want to take your pulse in front of the kids.
While both men and women can derive great benefit from skipping, most women are better at it. This provides women with a very convenient way to get exercise, especially for those who might be embarrassed to exercise in front of others. I’m convinced that, if done regularly, rope skipping could easily be the total exercise program for those who just don’t enjoy other activities.
“Put a Little Fun in Your Life! Try Dancing!” If you remember Kathryn Murray saying that as she twirled across the floor with her husband Arthur, you’re at least as old as I am! And if you are, then you no doubt enjoy dancing. In fact, the older an individual is, the more dancing has always been part of his or her social life. I’m happy to tell you that it’s another wonderful way to get physically active.
Even if you just came home from the hospital, you can put a record album on and dance with your spouse for at least one foxtrot. In addition to the exercise, this is a wonderful way to bring you together. An extra hug and kiss at the end is perfectly appropriate and very therapeutic!
Tomorrow you might do two dances in a row. Tired? Take a few minutes to test and chat, then do another dance. As your energy returns, add a cha-cha to your repertory. Don’t rush the agenda, but soon you’ll be doing the polka, the tango, and all your ballroom favourites. Check your heart rate to see how you do for any given dance and gauge yourself from then on. See Table 3 for a look at the energy expenditures of dancing.
One cautionary note. Avoid dancing situations where the air is thick with smoke. Unfortunately, that means most discos. Breathing in that smoke while exercising isn’t a good idea.
Include Golf and Bowling in Your Program, You may have heard that golf and bowling aren’t aerobic activities, and that they don’t “count” for those of us trying to improve our cardiovascular fitness. Certainly that may be true for those who drive through a golf course on an electric cart. But if you use a pull-cart, or especially if you carry your clubs, golf can, indeed, provide aerobic benefits. Bowling can also get the heart rate up, especially in the early months of your recovery.
Moreover, the reason you started golfing and bowling was to have fun. And having fun is a very important part of the recovery process. Be nice to yourself, now and in the future, by frequently doing something that’s fun. All work and stress and no play make Jack (and Jill) unhappy cardiac patients instead of former patients.
Enjoy Tennis and Other Games as Well. My game of tennis is so bad that it does very little to my heart rate. I just chase the ball most of the time. But even for those of us who aren’t very good, tennis can be both fun and another way to get some exercise.
If you’re a very good player, you might want to limit your play to doubles until you’ve fully recovered. A singles game might be just too much for a while. The same applies to racquetball and handball, both of which can elevate the heart rate enormously.
A number of years ago, cardiologists told their patients to give their racquets away, since those games were forbidden for life. Aren’t you glad you’re living in these more enlightened times, when you can look forward to becoming a former cardiac patient?
The fact of the matter is that you should become a better player than you were before your cardiac event, since you’ll be paying more attention to the healthy lifestyle that all athletes are following these days. Just look at Martina Navratilova. She credits her ability to keep up with the youngsters on the tour to a strict program including a low-fat diet and exercise.
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Cardio & Blood/ Cholesterol
