How to Progress
WHERE TO BEGIN AND HOW TO PROGRESS
For the purpose of this site I have chosen three accessible approaches to building fitness , depending on your starting point. You may need to stay within one level, or you might find that your stamina will improve enough for you to progress through the levels.
As a general rule of thumb, particularly if your health is challenged, it is recommended that you only increase one of your exercise sessions at a time, and by 20%. Only increase when you are sure that you have been comfortable at the current level for a few days. If you are planning to increase your waling distance, you can also change your route to include an incline, or some steps!
LEVEL ONE: - LITTLE, OFTEN, DAILY.... FOR THOSE WITH LOW FITNESS
When you are beginning to build up stamina, in the context of poor health, it is a good idea to begin to challenge your physical comfort zone a little, several times a day and every day.
This method can look like a sliding scale of exercise. Keeping the momentum going on days when you are not feeling as good,is important, dropping back as much as you think you need to on the repetitions of the activities you have chosen. It is also important not too push too fast on days when you feel optimistic and physically better, resisting the temptation to push into a Boom and Bust pattern. It can be helpful to keep a record of your progress and so I have included a simple recording sheet for you to use. If you have a difficult day, you can use the record sheet to decide a level to drop back to, rather than guessing, or stopping completely.
At this level you can try 3 or 4 small daily activities to stimulate your fitness.
You might choose to use the stretches in the download provided to help you start the day. The stretches are in three sections so you can decide what works best for you. It may be that you can only manage one section-or even just a couple of the movements. It really doesn't matter where you begin. It is better to start at a realistic level even if that seems like very little . Remind yourself that with exercise...
IT IS ALWAYS BETTER TO DO SOMETHING THAN TO DO NOTHING!
Later in the day your other activities may be accessible exercise like going up and down a few steps. It is important to have this step exercise as a separate part of your routine, your ‘rehab programme’, and not just incorporated into your other jobs. You are taking control of your physical health, and it is good to keep that as a separate, empowering and enjoyable part of your day. I have known people to start with as little as one step, four times a day, and progress from there to feel the benefit in the strength of their legs. I have known others who start by sitting up for a few minutes in every hour, if their CFS/ME symptoms are advanced.
You may decide to build up your walking distance, and may decide that you can only manage to walk one or two minutes from your front door [or even just a length of your hallway]. This could already be your third burst of ‘rehab’ for the day!
You can then repeat the stair exercise later on, building strength in your leg muscles and creating a little extra stimulus for your heart and lungs, or you might decide to begin to strengthen your upper body with a few simple ‘push-up’s against a wall.
Use your recording sheet to note down the activities and repetitions you are using. On a bad day drop to the level you feel you can manage, and build up through the stages as you recover. On a good day, and if you know the programme is not flaring up your symptoms, you can increase the repetitions of one activity by 2o%.
IT IS IMPORTANT NOT TO INCREASE BY TOO MUCH OR TOO QUICKLY. IF THIS CAUSES YOU TO FEEL WORSE YOU MAY GIVE UP, FUTHER FEEDING A SENSE OF THE HOPELESSNESS OF EVEN TRYING.
There is some excellent advice on how to build up stamina, in this handbook accompanying the PACE trial, a large multi-centre trial looking at the best interventions for CFS/ME.
Even though this was written for the benefit of those recovering from CFS/ME, there are many useful strategies for those with long term health issues, or significant loss of fitness.
LEVEL TWO: BEGINNING TO EXTEND YOUR EXERCISE SESSIONS
As time progresses and if you are beginning to feel a bit fitter, you may be able to cope well with lengthier sessions of exercise.
To get the best benefits , it is recommended that you have 3o minutes of exercise daily, on at least 5 days a week. You could begin with 3 bursts of 1o minutes or two of 15 minutes, aiming to reach the ability to sustain 3o full minutes . For most people , walking is the most accessible form of exercise.
As you get comfortable with the time increase you can begin to speed up , or take a route involving a hill or two ! In this way you are skilfully expanding your comfort zone, without popping your balloon! At this stage you are beginning to work you heart and lungs , and so you should feel a little hotter, and a little sweaty !
You are aiming to exercise at a ‘somewhat hard’ level of effort, as shown on an exercise scale known as the BORG scale. At this stage, as you exercise you can also manage to talk...but not to sing! This will help you build endurance.
At the ‘Somewhat hard’ level, your heart rate will be at 13o/min.
LEVEL THREE: BUILDING CARDIO-RESPIRATORY HEALTH
At this level, you are beginning to work at the optimal level of your heart and lungs. You won’t be talking or singing!
The recommendation is that for 3o minutes on five days a week you exercise at 7o% of your maximum heart rate.
You individual maximum heart rate is considered to be:-
220 MINUS YOUR AGE
DIVIDE BY 1OO AND MULTIPLY BY 7O
Exercising at this level begins to look more technical! It may be helpful to use a strap-on monitor to measure your heart rate, or you may just be aware that you are pushing into the ‘hard’ level on the Borg scale.
At this level you begin to build cardio-respiratory fitness, general strength and your body releases mental tension and produces ‘feel good’ chemicals which help to reduce your feeling of stress and boost your sense of vitality and well being.
SET-BACKS AND THE UNEXPECTED ......
IF YOU FEEL UNWELL - Check that you have not increased too quickly or by too much. Are you feeling the effects of using muscles that are out of practice? OR is there a ‘flare up ‘of your symptoms? You may need to rest for a day or two to let yourself recover, but try to maintain the momentum of your well intentioned plan, and if you can, drop back on time or repetitions maybe even by a lot, rather than stopping completely!
UNEXPECTED PRESSURES .... or even holidays! It is inevitable that your plan will be disrupted by things outside of your control. That’s life. Drop back a level or two; again try to maintain some momentum. If all else fails you can learn from your experience and get going again when you have space in your life to re-engage with looking after yourself better! It IS important!