RETIREMENT & LIFESTYLE PLANNING      Baby boomers need to plan their transition into retirement for  Financial Security     Active Health Management  Emotional Wellbeing  Maximum Self Esteem ISSUE - 19 - WINTER 2004

Future fit

JANE BANTING

You're taking time for yourself now - and wanting to get fit. But for the first time in your life you really have to work at it. How do you get started? Physiotherapist Jane Banting offers a six-point program to get you going.

You're finally getting some more "you" time, as your children become less dependent, even beginning to drive themselves around. You may have noticed increased tiredness, low energy levels, increased stress, feelings of depression, sleep difficulties, weight gain, changes in body shape, and shortness of breath after sudden exertion.

Ask yourself if this is how you have to feel as you approach middle age. The answer is firmly, no. You can improve your general wellbeing by improving your fitness.

So why do you want to get fit? Is it to improve your sense of well being, your energy level, your general health? Do you wish to lose weight, tone your muscles, improve posture and flexibility, and stay active with your kids and grand-kids? Perhaps it is a broader ambition - to reduce the effect of the normal ageing process and look as young as you feel?

No matter what your reasons are, it's important to keep in mind some of the effects of ageing:

• loss of muscle mass and increased risk of weakness in muscles
• bone loss and increased risk of weakness in bone structure
• increased risk of heart disease, high blood pressure and high cholesterol
• increased risk of diabetes
• increased risk of wear and tear in joints

So which type of fitness program will best suit you?

Are you after a muscle toning and stretching program, a strengthening program using hand and leg weights, a cardio program to improve heart fitness, or a fat burning/weight reduction program? Other, more general, health concerns for your age group may be your motivation. Refer to the box on page 61 for some of these concerns and health risks.

Having assessed some of the negative health issues for mature males and females, let's look at some of the benefits of a fitness program. They can include improved heart fitness, energy levels, body shape, flexibility and agility, balance and co-ordination, sense of wellbeing, confidence and self-esteem, as well as increased muscle strength, reduced bone loss, reduced risk of osteoporosis, reduced insulin levels (related to adult diabetes), and better weight control.

YOUR PROGRAM

So you are motivated to get fit, but don't know how to start. The following six-point program will help you not only to plan a new fitness regime, but also increase the likelihood of making it an ongoing and satisfying aspect of your life. The six points are:

1. Complete the PAR-Q questionnaire below.

2. If necessary, see your doctor for a check-up.

3. Assess your current fitness level.

4. Fill in the personal musculo-skeletal checklist.

5. Choose an exercise program.

6. Get started.

1 The PAR-Q questionnaire

The Physical Activity Readiness Questionnaire (PAR-Q)* was developed by health professionals in Canada. It will clarify whether you need to see your doctor before starting an exercise program. Answer as honestly as possible, and make your response a Yes or No.

1. Has your doctor ever said that you have a heart condition and that you should only do physical activity recommended by a doctor? Yes/No
2. Do you feel pain in your chest when you do physical activity?
   Yes/No
3. In the past month, have you had chest pain when you were not doing physical activity? Yes/No
4. Do you lose your balance because of dizziness or do you ever lose consciousness?
   Yes/No
5. Do you have a bone or joint problem that could be made worse by a change in your physical activity? Yes/No
6. Is your doctor currently prescribing drugs (e.g. water pills) for your blood pressure or heart condition? Yes/No
7. Do you know of any other reason why you should not do physical activity? Yes/No

If you answered YES to one or more questions

Talk to your doctor by phone or in person BEFORE you start becoming much more physically active or BEFORE you have a fitness appraisal. Tell your doctor about the PAR-Q and discuss any issues it may have brought up.

You may be able to do any activity you want - as long as you start slowly and build up gradually. Or you may need to restrict your activities to those that are safe for you. Talk to your doctor about the kinds of physical activities you wish to undertake and follow their advice.

If you answered NO to all questions

You can be reasonably assured it is safe to become more active. Begin slowly and build up gradually. This is the safest and easiest way to go. You can also get a fitness appraisal to determine your basic fitness and to make a plan that helps you to monitor your progress.

If your health changes so that you would then answer yes to any of the PAR-Q questions, tell your fitness or health professional. Ask whether you should change your physical activity plan.

2 See your doctor for a check-up

Explain that you wish to start a fitness program and why. Discuss the type of exercise you are keen to do and ask if it would be suitable. The check-up should include records of blood pressure, pulse, weight, family history of heart disease or stroke,

See your health professional if you have any injury risks. Health professional is a general term used to indicate professionals who work in the health/fitness field who have a health science university qualification. Your health professional may be a: musculo-skeletal physiotherapist with a special interest in joint/ muscle problems sports physiotherapist osteopath with a special interest in joint and sports problems chiropractor with a special interest in joint problems exercise physiologist with a special interest in exercise programs personal trainer with a special interest in exercise programs. The choice is yours to make, and if you have not developed a relationship with a medical practitioner or health professional, now is a good time to start.

health risks (smoking and drinking habits), cholesterol levels, blood sugar, lipids, iron deficiency, thyroid function, as well as menopausal symptoms for women and stress levels for men. The doctor will also take into account family history of heart disease or stroke.

If health risks exist, your doctor may recommend having a stress test under supervised conditions, particularly if your goal is to achieve a high level of fitness.

3 Assess your current fitness

How would you rate your fitness - poor, fair, good, very good or excellent? Compare this with your previous fitness levels. Perhaps you've never been fit, and have always been put off by competitive sport. Or maybe you were fit 10 years ago, but have undertaken little regular exercise since. If you have an active lifestyle, you might need a formal fitness program or perhaps you are a former elite athlete, now retired from competitive sport?

4 Personal musculo-skeletal checklist

Do you have suffer from, or have a history of, headaches, neck, arm, back or leg pain, tingling or numbness, or general muscle soreness or tightness? Consider also the demands of your job and lifestyle - are they high, medium, or low? Do you spend long hours at the computer or sit for prolonged periods? On a scale from poor to very good, how would you rate your stress levels? Are your sleep patterns consistent?

5 Choose a program

Assuming your checklist shows no problems, you are ready to start. Next, you need to decide your primary aim and set your goals.

Do you want to:

• improve heart fitness
• improve muscle tone and flexibility
• improve muscle strength
• reduce weight

Where and how do you want to do it?

• The gym (individual circuit program, group circuit program, classes)
• At home
• Outdoors (walking, exercise class, running)
• In a pool (swimming, hydrotherapy, aquarobics)
• With a friend or alone

All styles of exercise (strengthening, toning, cardio) can be done at a gym, home, outdoors or in a pool. The choice is yours.

6 Get started

The gym

If you want to be involved in a gym program:

• have a fitness assessment at your local gym
• disclose your general health (including results from your medical check-up)
• supply the name of your health professional if there are any concerns and encourage the fitness advisor to consult where necessary
• be clear about your goals (cardio, toning, strengthening, or weight reduction)
• be clear about your needs (gym program or group class.

You should be given a gym program that is recorded on a chart and checked regularly. If you have any problems with the program, speak to the fitness advisor who set it up. You may also choose to be supervised by a personal trainer.

For all exercise regimes, wear loose fitting cotton clothing that allows good ventilation, thick socks to protect legs from ankle weights, and good, supportive walking/running shoes.

At home

Choose your goal (cardio, toning, strengthening, weight reduction). Record your starting weight and use a tape measure to measure your waist. Next, record your resting heart rate. Take your pulse at your wrist, on the thumb side - using your index finger, not your thumb - to measure the heart rate at rest (see box).

To reduce the risk of injury, and improve the recovery rate after exercise, divide your program into:

• warm-up and stretching
• cardio-vascular and strengthening and toning exercises
• cool-down and stretching.

Warm-up and stretching

Low intensity exercise is good for the warm-up as it allows for a gradual increase in heart rate and oxygen supply, preparing the heart, lungs and muscles of the body for the more vigorous exercise to follow.

At home, this would involve a walk, starting at a gentle pace. Stretching exercises prepare the muscles and reduce the risk of damaging them. For a walking program, it is essential to stretch calf muscles, hamstrings, quadriceps, and hips. As a guide, 10-15 second stretches maintaining a reasonable level
of comfort, not pain.

Cardio-vascular exercise

Activities that improve your aerobic fitness have a good effect on your heart. They include walking, running, cycling, swimming, rowing. Choose exercises you enjoy and that are within your physical capacity.

Measuring your heart rate If you time your heart rate for 15 seconds x 4, you will have your average resting heart rate per minute. This is usually 60-80 beats per minute, but it can vary. Now calculate your target heart rate. Maximum heart rate is roughly measured at 220 minus your age. For example, if you are 50 years old, your maximum heart rate is 220 minus 50 = 170 beats a minute. Target heart rate is 70-85 per cent of maximum heart rate - in this case, 110-144 beats per minute. You should aim to reach and maintain your target heart rate for 20-60 minutes for 3-5 sessions per week, exercising with a rate of exertion between somewhat hard and hard.

Aim to reach a target heart rate for 20-60 minutes, exercising with a rate of exertion between somewhat hard and hard.

Strengthening and toning exercises

There are many different styles of resistance exercise to improve your strength and tone. You will need hand weights (dumbbells), and strap-on ankle weights (with weighted inserts). Try out different weights, starting with a weight that allows you to do eight repetitions of exercise in a safe manner before needing to rest. Better to start with a lower weight, and build up gradually. A simple program of exercises is illustrated in a book called Strong Women Stay Young by Miriam E. Nelson PhD. These exercises are suitable for both women and men.

How many sets and repetitions are enough? And how often?

Start with one set of eight repetitions, and increase to two sets of eight repetitions when you feel one set requires only a moderate effort. These exercises need to be performed twice a week, with at least a one-day rest between sessions.

Flexibility and stability exercises

Simple programs of exercises for men and women are outlined in two books: Fit for 50+ men, by Greg Chappell, Fit for 50+ women, by Shane Gould. They show a program of exercises to improve flexibility and strength in the spine that you can perform twice daily.

Cool-down and stretching period

The cool-down period allows the extra blood that has moved into the exercising muscles to be pumped back to the heart. In addition, it reduces the likelihood of lactic acid build-up, therefore reducing the post-exercise sore-ness that is common, particularly in the early stages of exercise. You can use the same stretching exercises as the warm up.

NOTE

If your personal checklist shows an injury or a risk of injury, contact your health professional before starting your fitness program. You may need treatment before starting, advice regarding the type of exercise best for you or how to modify an exercise.

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