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How to Exercise

The exercise is divided into three general categories:

• Aerobic (also called endurance
• Isometric (also called strength or resistance)
• Flexibility

A balanced program should include all three. (Speed training is also a major category, but is generally practiced only by competitive athletes.)

Rules for Any Exercise Method

A few simple rules are helpful as you develop your own routine.

• Don't eat two hours before vigorous exercise
• Drink plenty of fluids before, during, and after a workout
• Adjust activity according to the weather and reduce it when fatigued or ill
• When exercising, listen to the body's warning symptoms, and consult a physician if exercise induces chest pain, irregular heartbeat, undue fatigue, nausea, unexpected breathlessness, or light-headedness

• Warm-up exercises should be practiced for 5 to 10 minutes at the beginning of an exercise session. Older people need a longer period to warm up their muscles
• Low-level aerobic exercise is the best approach, such as walking briskly, swinging the arms, or jogging in place.

• Stretching is appropriate for the cooling down period, but not for warming up because it can injure cold muscles
• Particular exercises may require stretching specific muscles. For example, a jogger or biker might emphasize stretching the hamstrings, calves, groin, and quadriceps, while swimmers would focus on the groin, shoulders, and back

Aerobic (Endurance) Training Benefits of Aerobic Exercise

Regular aerobic exercise provides the following benefits:

• Builds endurance
• Keeps the heart pumping at a steady and elevated rate for an extended period, boosts HDL (the "good") cholesterol levels, and helps control blood pressure
• Strengthens the bones in the spine
• Helps maintain normal weight
• mprove one's sense of well being

Types of Aerobic Exercise

Aerobic exercise is usually categorized as high or low impact. Examples of each include the following: Low to moderate impact exercises: walking, swimming, stair climbing, step classes, rowing, cross-country skiing.

Nearly anyone in reasonable health can engage in some low to moderate impact exercise. Some research indicates that simply walking briskly for three or more hours a week reduces the risk for coronary heart disease by 65%. Brisk walking also burns as many calories as jogging for the same distance and poses less risk for injury to muscle and bone. High impact exercises: running, dance exercise, tennis, racquetball, squash. High-impact exercises should be performed no more than every other day and less for those who are over weight, elderly, out of condition, or have an injury or other medical problem that would preclude high-impact.

Aerobic Regimens

• As little as one hour a week of aerobic exercises is helpful, but three to four hours per week are optimal. In general, the following guidelines are useful for most individuals: For most healthy young adults, the best approach is a mix of low and higher impact exercise
• Two weekly workouts will maintain fitness, but three to five sessions a week is better. People who are out of shape or elderly should start aerobic training gradually with five to ten minutes of low-impact aerobic activity every other day and build toward a goal of 30 minutes per day, three to four times a week. (For heart protection, frequency of exercises may be more important than duration.) Swimming is an ideal exercise for many people with certain physical limitations, including pregnant women, individuals with musculoskeletal problems, and those who suffer from exercise-induced asthma
• People who seek to lose weight should aim for five to six low impact workouts a week. One way of gauging the optimal intensity of exercise is to aim for a "talking pace," which is enough to work up a sweat and still be able to converse with a friend without gasping for breath. As fitness increases, the "talking pace" will become faster and faster.

Shoes and Clothing

All that's really necessary for a workout is a good pair of shoes, well-made, well-fitting, and broken in but not worn down, they should support the ankle and provide cushioning for impact sports such as running or aerobic dancing. Airing out the shoes and feet after exercising reduces chances for skin conditions such as athlete's foot. Comfort and safety are the key words for workout clothing, for outdoor nighttime exercise, a reflective vest and light-colored clothing must be worn. Bikers, roller bladers, and equestrians should always wear safety devices such as helmets, wrist guards, and knee and elbow pads, goggles are mandatory for indoor racquet sports. For vigorous athletic activities, such as football, ankle braces may be more effective in preventing ankle injuries than tape.

Shoes for Sports

Aerobic dancing

• Sufficient cushioning to absorb shock and pressure that is many times greater than ordinary walking
• Arches that maintain side-to-side stability, thick upper leather support. Toe-box. Orthotics may be required for people with ankles that over-turn inward or outward, soles should allow for twisting and turning.

• Rigid support across the arch to prevent collapse during pedaling. Heel lift. Cross-training or combo hiking/cycling shoes may be sufficient for casual bikers
• Toe clips or specially designed shoe cleats for serious cyclers. In some cases, orthotics may be needed to control arch and heel and balance forefoot

• Sufficient cushioning to absorb shock and pressure. Fully bendable at the ball of the foot. Sufficient traction on sole to prevent slipping. Consider insole or orthotic with arch support for problem feet

• Allows side-to-side sliding. Low-traction sole. Snug fitting heel with cushioning. Padded toe box with adequate depth. Soft-support arch

• Breathable upper material (leather or mesh). Wide enough to accommodate ball of the foot. Firm padded heel counter that does not bite into heel or touch ankle bone. Low heel close to ground for stability. Good arch support. Front provides support and flexibility

• Home aerobic exercise machines can be adapted to any fitness level and can be used day or night. Before investing in and bringing home any exercise machine, however, it is wise to test it out first at a gym. In addition, initial supervised training when using these machines can reduce the risk of injury that might occur with self-instruction. Very inexpensive exercise machines tend to be flimsy and hard to adjust, but many sturdy machines are available at moderate prices. The higher-end models may utilize computers to record calories burned, speed, and mileage. While their readouts may provide motivation and gauge the intensity of a workout, however, they are not always accurate

• A simple jump rope (skipping) improves aerobic endurance for people who are able to perform high impact exercise. Skipping should be done on surfaces that have some give to avoid joint injury. (A good floor mat is important to provide cushioning for all home exercises)
• For burning calories, the treadmill has been ranked best, followed by stair climbers, the rowing machine, cross-country ski machine, and stationary bicycle
• Elliptical trainers may be even better than treadmills for elevating heart rate and increasing calorie expenditure and oxygen consumption
• Stationary bikes and stair climbers condition leg muscles. Stationary bikes are fairly economical and easy to use safely. The pedals should turn smoothly, the seat height should adjust easily, and the bike's computer should be able to adjust intensity. Stair machines offer very intense, low-impact workouts and may be as effective as running with less chance of injury
• Rowing and cross-country ski machines exercise both the upper and lower body. Isometric (Strength or Resistance)

Training Benefits of Isometric Exercise

While aerobic exercise increases endurance and helps the heart, it does not build upper body strength or tone muscles. Isometric, or strength-training, exercises provide the following benefits:

• Builds muscle strength while burning fat
• Helps maintain bone density
• Improves digestion
• It appears to lower LDL (the so-called "bad") cholesterol levels

Isometric exercise is beneficial for everyone, even people in their 90s. In fact, strength training assumes even more importance as one ages because after age 30 everyone undergoes a slow process of muscular erosion, which can be reduced or even reversed by adding resistance training to an exercise program. (Please note, people at risk for cardiovascular disease should not perform isometric exercises without checking with a physician.)

Strength-Training Regimens

Strength training involves intense and short-duration activities, simply adding 10 to 20 minutes of modest strength training two to three times a week is important for a balanced exercise program. The following are some guidelines for starting an isometric regimen:

• Strength training involves repetitions; ie, moving specific muscles in the same pattern against a resisting force (such as a weight) for a preset number of times. In the beginning, most people can start with one set of 12 to 15 repetitions per muscle group
• They should choose a weight that is about half of what would require a maximum effort in one repetition. (In other words, if it would take maximum effort to do a single repetition with a 10-pound dumbbell, than the person would start with a five-pound dumbbell)
• Breathe slowly and rhythmically: Exhale as the movement begins; inhale when returning to the starting point
• The first half of each repetition typically lasts two to three seconds and the return to the original position last four seconds

An alternative technique called "super slow" training stretches out one repetition to a 14 second count. This method places far more stress on the muscle group, so fewer repetitions are needed. A full week of recovery is required before repeating this workout The goal is to initiate changes in the muscles so that the body continues to burn calories after the exercise. Some people report dramatic results from this approach, but scientific verification of these anecdotes is not available. Joints should be moved rhythmically through their full range of motion during a repetition and not locked up, for maximum benefit, one should allow 48 hours between workouts for full muscle recovery.

Strength-Training Equipment

Unlike aerobic exercise, strength training almost always requires some equipment. Strength-training equipment does not, however, have to cost anything. Any heavy object that can be held in the hand, such as a plastic bottle filled with sand or water, can serve as a weight. Many wearable weights are available to help strengthen and tone the upper body. Dumbbells (ranging in weight from 1 to 10 pounds) and resistance bands, for example, are inexpensive, portable, and effective. Ankle weights strengthen and tone muscles in the lower body. (Such wearable weights should not be worn during high-impact aerobics or jumping.) Handgrips strengthen arms and are good for relieving tension. A pull-up bar can be mounted in a doorway for chin-ups and pull-ups. More elaborate and expensive home equipment for working body muscles is also available, costing from £100 to over £1000. No one should purchase or use strength-training equipment without instruction from a professional.

Benefits of Flexibility Training

Flexibility training uses stretching exercises for the following benefits:

• Preventing cramps, stiffness, and injuries
• Allowing a wider range of motion (ie, the amount of movement a joint and muscle has)
• Certain flexibility practices, such as Yoga and Tai Chi, also involve meditation and breathing techniques that appear to have many health and mental benefits and may be very suitable and highly beneficial for many older people and patients with certain chronic diseases
• Certain stretching exercises are particularly beneficial for the back. Flexibility Training Regiments. Authorities now recommend performing stretching exercises for 10 to 12 minutes at least three times a week

• When stretching, exhale and extend the muscles to the point of tension, not pain, and hold for 20 to 60 seconds (beginners may need to start with a 5 to 10 second stretch)
• Breath evenly and constantly while holding the stretch
• Inhale when returning to a relaxed position. (Holding one's breath defeats the purpose; it causes muscle contraction and raises blood pressure.)

It is important when doing stretches that involve the back to relax the spine, to keep the lower back flush with the mat, and to work only the muscles required for changing position, usually the abdomen.

Specific Tips for Older People and Exercise

Studies continue to show that it is never too late to start exercising, at any age, even small improvements in physical fitness and activity (such as regular walking) can prolong life and independent living. The following tips for exercising may be helpful:

• Any older person should have a complete physical before starting an exercise program
• Any older person should have professional instruction in any exercise program.
• In starting out, remember the adage "Start low and go slow."

For sedentary, older people one or more of the following programs may be helpful and safe: low impact aerobics, gait training, balance exercises, tai chi, self-paced walking, and lower extremity resistance training using elastic tubing or ankle weights. (Even in the nursing home, programs aimed at improving strength, balance, gait, and flexibility have significant benefits.)Resistance training is the only form of exercise that can slow and even reverse the decline in muscle mass, bone density, and strength that occurs with aging.

One 2000 study found that men between the ages of 60 and 75 have the same potential to gain strength as men in their 20s. The study further noted improvements in cardiovascular health, cholesterol levels, and general well being. As little as one day a week of resistance training improves overall strength and agility. Eventually adding workouts that involve fast movements may be particularly beneficial for older people. Flexibility exercises promote healthy muscle growth and help reduce the stiffness and loss of balance that accompanies aging, easing these activities.