How do I start an aerobic exercise program?

How do I choose an aerobic exercise program?

If you have heart disease, are at high risk for heart disease, or have not been exercising, it is important to start slowly and build up your exercise program gradually. Gentle stretches and short walks are a good way to begin. As you begin to feel stronger, you can lengthen your walks and incorporate some uphill segments. If you decide to take the stairs instead of the elevator, take them slowly at first, resting whenever you need to catch your breath.

In choosing a form of exercise, keep in mind that in order to be aerobic it must be regular and rhythmic, require an accelerated breathing rate over the duration of the exercise, and use the large muscles of the arms and/or legs. It is an advantage to practice more than one kind of regular exercise, since different muscle groups are toned and stretched by different exercises.

There are hundreds of exercise options, and the key to picking the “best” one for you is to pick one or several that you really enjoy doing. This may require some experimentation, particularly if you did not exercise regularly before your heart disease diagnosis. You have a far better chance of succeeding with your exercise program if you’re enjoying yourself.

How often should I exercise? 

Your goal should be to exercise three to five times a week, for twenty to thirty minutes at a stretch. However, if time allows, exercising daily is even better. But don’t be concerned if you do not make the full thirty minutes at first you will, with practice and time. Don’t make exercise an all or nothing situation. Even five minutes a few times a day is better than no exercise at all. It has been shown that short periods of exercise, even five minutes, are still beneficial, especially when they add up to at least twenty minutes per day. After a few weeks you will likely notice that moving around is easier. Then you will need to work a little harder to elevate your heart rate. This is a good sign, for it means that your heart is becoming stronger.

How hard should I exercise? 

You need to get your heart beating fast enough to be of benefit but not so fast as to be potentially harmful. Your most beneficial heartbeat rate is called your target heart rate. It is a straightforward matter for you to determine your target heart rate and to monitor your actual heart rate during exercise. This is an essential element of your exercise program, because exceeding your target heart rate can be dangerous, and failing to achieve it can limit the benefit of the exercise.

How do I determine my target heart rate? 

To calculate your target heart rate, subtract your age from 220, which gives you the number of beats per minute you would achieve during maximal all out effort while exercising. This is referred to as your maximum heart rate. The optimal heart rate for maximum benefit is between 70 percent and 80 percent of your maximum heart rate. This means that a sixty five year old woman or man with a maximum heart rate of 155 (220 - 65 = 155) has a target heart rate of between 109 and 124 beats per minute (70 to 80 percent of 155). You can use the table below to quickly find your approximate target heart rate, but the most accurate way is to use the formula given above. To find out if you are in your target range, take your pulse immediately after you stop moving. Don’t delay, as your pulse rate typically drops rapidly. Learn how to find your own pulse: place two fingers don’t use your thumb, because it has a pulse of its own on the inside ofyour wrist. Count the beats for 10 seconds (practice taking your pulse until it becomes easy) . Then multiply by 6 to get heartbeats per minute. If the sixty-five-year-old person in the example above had a 10-second pulse of 20 beats (20 times 6 equals 120 beats per minute), it would fall within the target heart rate range of 109- 124. (Inexpensive watchlike devices that you wear on your wrist are available to electronically measure your heart rate if you find that helpful.)

Another way to do this is to divide your target heart rate by 6, which gives you a 10-second value. In the above example the target heart rate would be between 18 and 21 (109-124 beats per minute divided by 6 yields a range of 18-21 beats per 10 seconds). Then when you take your pulse, it will be immediately obvious whether your pulse falls into the target heart rate range. If it is lower than your target rate, you will know that next time you need to either increase the amount of effort used or the length of time spent exercising. If your pulse is higher than your target rate, then next time slow down until it falls into the proper range. In the beginning especially, take your pulse often to get a sense of how your body is responding. As you get into better shape and continue exercising, however, you may find that you can estimate your heart rate based on the way your body feels.

What if something goes wrong? How will I know if I need medical help? 

You should always be free of pain and able to move and talk comfortably and to breathe regularly and rhythmically. If you can carry on a normal conversation, then it’s likely that your heart rate is not too high.

The maxim “No pain, no gain” is a myth; and it can be a dangerous myth for someone with heart disease. If you sense any pain, you know you’re exercising improperly or something is going wrong. Whatever physical activity you do should take some effort, but real pain is a sign that your muscles and your heart are working too hard or in the wrong way. Stop immediately whenever you feel pain, and don’t resume that activity until you can do so without pain.

Why do I need to cool down after exercising? 

At the end of any physical workout that raises your heart rate, you should slow down gradually rather than coming to a sudden stop. This gives your heart a chance to decrease its rate gradually and helps prevent a sharp drop in blood pressure, which can happen ifyou stop abruptly. It also helps to reduce muscle stiffness.

How do I cool down? 

In modem gyms, many treadmills or other aerobic exercise machines are programmed to slow down for at least one or two minutes before stopping. You should also slow from jogging or fast walking to a normal pace for at least five minutes. Follow your workout with a few minutes of gentle stretching using the exercises we’ve designed. If you plan an easy walk, a slow swim, or other nonstrenuous physical activity, warming up and cooling down are not as important.

Can you give me some ideas for putting extra activity into my day? 

There is much more you can do to increase your physical activity beyond formal exercise routines. You are surrounded by gadgets from elevators to power lawn mowers to TV remote controls designed to reduce physical labor. Here are ideas to help you add more physical activity to your days. Not only will you help your heart but you will control your weight as well.

• Slightly exaggerate your movements, by slowly stretching, when you garden or clean house.

• Go back to using hand powered household tools and appliances a whisk, a manual rotary beater, a carpet sweeper instead of electrical ones, unless you have arthritis.

• Use a push mower instead of a power or ride on mower to cut your lawn.

• Hide the television remote control so that you must get up to change channels.

• Use stairs, rather than elevators and escalators, whenever possible.

• Park at the far end of the parking lot.

• Walk your dog.

• Take short, periodic walk breaks at work, even if it is just around the building or the floor you are on.

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