Do I need equipment or a gym to exercise with medical conditions? – Hamilton Spectator

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A well designed fitness plan is more important than the equipment that you choose to use.
Q: I have arthritis, back pain and atrial fibrillation, been in a couple of car accidents and could stand to lose a few pounds. I’m not sure where to start and if I should join a gym or exercise at home. Do I need special equipment? What should be my first step to get myself going?
A: There are real differences between medical care, physiotherapy, medical exercise and fitness training. Each has its place and order of when it should be used.
When working with clients like you, I use exercise as a way to help restore function, enhance strength and increase endurance. In other words, I help people to safely work “around” their injuries and medical conditions to help them manage their unique situation while they receive treatment (or after they have been discharged from care.) The timing is important; some people are simply not ready for exercise while others are clearly beyond the need for physiotherapy or medical care and just need to get to the gym and get back in shape.
One of the first things that I would consider is whether you have full range of motion throughout your joints. To be able to build strength and endurance, you have to be able to flex the muscles that surround a joint. If you can “flex” or contract the muscles, then you can make the stronger. When they get stronger, your pain will likely decrease and you’ll be able to get more ambitious with what you can do. If you can’t work through even a tiny range of motion, then you are a better candidate for physiotherapy where a therapist will use modalities other than exercise to increase your range and decrease your pain.
Assuming that you are able to move through a decent range, but, are simply weak, de-conditioned and/or new to exercise, you don’t “need” any special equipment. A good set of resistance bands and/or dumbbells will be all that you need to start building your body back. The most important consideration would be the program and routine that you come up with. It needs to be balanced and should be progressive. This means that you should be more concerned with working all of your muscles equally (pushing versus pulling) and that you continue to challenge yourself over time to avoid hitting plateaus where it feels like you are stuck and not making any more gains. One option, at this point, would be to join a gym where you have many more training options. You could also continue to change your routine at home with the gear that you have, making sure that you have enough resistance (weight) to truly challenge your muscles. I recommend changing up your routine every two to four weeks.
In regards to training to manage back pain, the only real equipment that you’ll need other than bands or set of dumbbells is an exercise mat. Your doctor, physiotherapist or chiropractor can help you to understand what the source of your back pain is and how to address it with exercise. The two most common reasons that someone has back pain are arthritis and disc disease (including disc herniation.) Both conditions are best managed with exercise. The challenge is in understanding whether you should be extending or flexing your spine (leaning back or hunching forward.) You don’t need special equipment for that; you need input from a trainer or therapist who understands how to best manage your condition.
Finally, it is important to be able to monitor how you feel when you are exercising with atrial fibrillation. This heart condition results in irregular heart beats making it difficult to judge exertion levels by checking the pulse or using a heart rate monitor. Once you have been cleared to exercise by your doctor, start walking or your favourite piece of cardio equipment and base your intensity level on how you feel. Aiming for up to 150 minutes per week of aerobic exercise (broken into manageable chunks) at a level that would feel like a “5 to 8 out of 10” can be considered safe and healthy. As your fitness level improves, speak to your Doctor about safely increasing the intensity of your training.
I believe that the program or plan that you come up with is much more important than the equipment or facility at your disposal. Think of the gym as another tool that you can access (if desired) to continue the progression that you started at home; not essential, but, still valuable.
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