As the fitness centers and gyms fill up this time of year with folks eager to meet their New Year goals there lurks an ominous foe. Many people jump into exercise with gusto and never take into account existing medical issues, medication side effects, and ‘old injuries’.

Heart conditions, Respiratory issues, Diabetes will all complicate your body's ability to successfully negotiate an exercise routine. It goes without saying that clearance from your doctor is of the utmost importance. It seems obvious that your trainer or gym should be staffed to handle “special populations”, please check first. An unfortunate fact is that most facilities are not staffed or equipped to handle medical issues and especially medical emergencies. Signing a waiver does not constitute safety for you.

Most medical exercise professionals acknowledge that a gradual approach into fitness is key. A person with medical issues does not need to exercise with intensity; rather gradually increasing duration of cardiovascular exercise has been proven more effective and safer. The same holds true with resistance exercises, 1-2 sets is generally accepted as safer and more effective that multiple sets. The key is gradual progression into duration and intensity.

Keep in mind that the goal of ‘special population’ exercise is improving quality of life, decreasing injury risk, reducing onset and severity of osteoporosis, and limiting the severity of current medical conditions.

Here are a few tips for dealing with some of the more common medical issues.

Aerobic conditioning should be performed three to five days per week for at least 20 to 30 min at your target heart rate. Training at the proper intensity is the key to aerobic training. A leisurely walk does not qualify for aerobic training. During exercise we intentionally cause physical stress to our bodies. In response, our bodies make adaptations in order to better handle that stress in the future. Our muscles “learn” to work more efficiently through adaptations made by our central nervous system. Muscles adapt by getting bigger and stronger. Bone density increases and connective tissues become stronger. Adaptations made by the heart and lungs allow them to work more efficiently, increasing our capacity to utilize oxygen. During exercise we physically stress our body and it is our body’s adaptation to that stress that makes us healthier. If we don’t push ourselves during aerobic training our training stimulus will not illicit a physiological adaptation.

Recent research has shown that walking at a fast pace actually reduces back pain. This explains why walking at the mall (slow) increases the symptoms most of us feel.

Beware of the flashy exercise machines sold on TV by the pretty people. These devices are designed to make people wealthy not healthy.
It may be necessary to gradually work your way up to the recommended duration and target heart rate. If you’re new to aerobic training or haven’t exercised in a long time start out slowly. Monitor your heart rate during your aerobic exercise. Gradually increase the pace and duration of your aerobic workouts. Before you know it you will be working at the recommended intensity levels and reaping the full benefit of your aerobic training.

To determine your target heart rate you must first find your predicted Maximal Attainable Heart Rate (MAHR) or Heart Rate Max. (HRM).
To calculate the predicted (HRM) subtract your age from 220.
For example if you are 40 years of age, subtract 40 from 220.
220 - 40 = 180 Heart Rate Max. (HRM)
General guidelines for THR (target heart rate) using this method are 60 % HRM (heart rate max.) lower limit - 90 % HRM upper limit.
Multiply HRM and by .6 and .9

With regards to resistance training an opposing muscle group routine is the best. For every push do a pull. This means that if you performed a chest press the next exercise should be a pull down or row. Pay strict attention to the two R’s, Rest and Repetitions. Perform 12-15 reps per exercise, if the last 3 reps on each exercise are as easy the as the first 3 than go up a few pounds on the next set, if the last 3 are hard keep the weight the same. Take only 30 seconds between sets and only one minute between exercises. Never strain, never hold your breath and never lift more weight than you can control.

Listen to your body, push yourself within reason, less with better technique (quality over quantity) is better than more. When in doubt, consult with an exercise and or medical professional.

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