We are often asked by patients who are winding down with formal physical therapy treatment, what makes a good fitness program or “what should I do to stay fit?” When we ask those patients what they currently do for fitness, we usually hear, “I walk,” “I do cardio,” “I go to aerobic classes,” or “I like to lift weights.”
What we do not usually hear is, “I do cardio, stretching, and strength training, and work on my balance and do power and speed exercises.” A good and comprehensive fitness program will incorporate all of these components, and not just one of them alone.
Cardiovascular health can deteriorate quickly if we do not stay active. This is a pretty obvious statement. The ACSM (American College of Sports Medicine) recommendation for cardiovascular exercise includes 30–40 minutes per day. Newer research suggests that high-intensity interval training is another very effective way to improve cardiac output at any age.
This includes doing four one-minute intervals of high-intensity (100 percent max heart rate) exercise three times per week. Cardiovascular exercise by itself will not affect your ability to stand on one foot, touch your toes, or lift that 50-pound bag of dog food. Therefore, to be fit you must balance your exercise time to include strength training, stretching, balance activities, and power work.
The use of balance boards at the gym, as well as progressing single-leg standing activities in your living room, are ways to improve your body’s sense of where it is in space. These activities can also be effective in maintaining and possibly improving your ability to balance during various activities as you age.
You can hit the gym with weight machines, free weights, resistance bands, physio-balls, medicine balls, and/or kettle bells. Movements that use a number of upper and lower body muscles together are usually more functional and time-efficient. If done while weight-bearing, these movements can also help increase bone density.
It is best to incorporate functional-based movements when possible, including squats, lunges, and diagonal patterns of movement where you push and/or pull at different angles across your body. These diagonal patterns of movement help engage the core trunk muscles, which stabilize your middle so that you can be truly strong in your extremities. Engaging your pelvic floor and lower abdominals together (creating the “pelvic brace”) while performing strength training exercises enhances the control and coordination of the inner core unit. Strength and coordination of the inner unit is important in maintaining a healthy pelvic floor.
Power training is strength training with a speed component, which usually incorporates jumping and hopping activities. There is potential for injury when doing power exercises, so an adequate amount of base strength is important. Again, these weight-bearing activities can be excellent ways to improve bone density. Power exercises should especially be incorporated if you plan to participate in explosive, cutting, or jumping sports. Jumping rope, box jumps, and lateral bounding are examples of power exercises.
Stretching done by itself can both prepare a body for movement (dynamic) and improve the static length of muscle (static). Dynamic stretching is best prior to dynamic activity. It uses 2–3 second holds (about the length of a good exhale) and then moves out of the stretch in about the same time (or the length of a deep inhale).
Stretching done by itself can both prepare a body for movement and improve the static length of muscle.
Doing 5–10 repetitions of traditional stretches where you are moving in and out of the stretch would be a good way to warm up the target tissue while allowing your body to monitor the changes in muscle length. Static stretching can be done at home or in the gym and is accomplished by holding a stretch 20–60 seconds, which can be an effective way to improve overall muscle length due to asymmetry from an injury.
The practice of yoga integrates components of strength, flexibility, and balance. Even if you are never able touch your toes, gaining flexibility, balance, and whole-body strength will improve your performance in daily, recreational, and/or competitive endeavors.
Many find themselves happy with their aerobic program and are comfortable in the weight room, but when considering yoga they may think, “what’s the point?” Yoga can enhance aerobic capacity and endurance in addition to strength, flexibility, and balance gains. It is not uncommon to hear patients and friends comment that they hesitate to begin a regular practice of yoga because they feel inflexible. That is like avoiding the dentist because your teeth are not perfect. Yoga can be a time-efficient form of exercise that encompasses multiple aspects of “fitness.”
If you are considering starting a new fitness program, just remember doing any form of the above types of exercise is better than doing nothing, unless you are experiencing pain. Consulting with your physical therapist is a good place to start on your road to better health and fitness.