Dr Lily Tomas and Greg de Jong © 2015| Privacy Policy


Personalising Your Exercise Prescription


                         What Different Types of Exercise should you consider? 


A cornerstone of any heath programme, whether it is injury prevention or disease management, is a personalised exercise programme. Exercise programmes need to be tailored to your individual needs, no different to diet or medical prescription. Here are a few questions you may have over the iportance of an individualised exercise programme to your health. First of all, for the couch potatoes, we begin with the question...


Do I Really Need to Exercise? 


Let us put modern man in perspective to answer this question. Mankind is built on a framework that, in order to survive, consumed upwards of 3500 calories per day as either a hunter/gatherer or, in the least, early mankind actively participating in agriculture. Today the energy output of a sedentary person is almost half that with a large proportion of people spending 8 hours at the work table that otherwise would have been active in the fields. This is an enormous energy difference, much of which goes to explain the obesity crisis in the general community. So the truth is, to make up this difference we need to exercise frequently, not only to maintain a healthy weight, but adequate strength and cardiovascular health as well.


Or Just Get More Active?


This is the other possibility. In fact, there are some people who do not need exercise dur to the high activity levels of their jobs. Interestingly it is estimated that there is anything up to a 2000 calorie difference between people who are simply active in their jobs (such as the traditional walking postman) as compared to sedentary occupations (a full time receptionist). If you think you are active enough without exercise, here is a simple test. Using a pedometer, a cheap and effective tool to measure how many steps you take in a day, see if your reach 10,000 steps. If you do reach 10, 000 steps in a day, congratulations, you do not need to do any additional exercise. Yet if you do not, join the vast majority of us and begin an exercise or activity programme.


What if I have a Medical Condition?


All the more reason to exercise, in most instances. There are very few medical conditions that do not improve if you exercise. Of course, if you do have a medical condition, you MUST be cleared by your medical doctor for exercise and your programme may need to be modified by an Exercise or Physical Therapist. Yet all the same, exercise is critical for most health conditions.


Are there any Conditions I should not Exercise with?


As noted, there are a few medical circumstances when you should not exercise. These include:


•Unstable Angina

•Excessively High Blood Pressure; discuss this if your blood pressure rises above 160 Diastolic or 90 Systolic

•Severe Chronic Heart Failure

•Acute psychological instability

•Modified exercise is required during late stages of pregnancy.


What should I be careful of while Exercising?


You should start slowly and under guidance if you have little experience with exercise. Drinking adequate water is important as is maintaining a correct posture. The programme needs to be balanced for your specific needs.


What if I am using Medication?


If you are using any medication, discuss the effects of these with your doctor as they may need to be adjusted with your exercise programme. In particular medications to discuss include:


•Antidepressants (increase risk of falls in the elderly)


•Diuretics (affect hydration requirements, canincrease risk of falls in the elderly )


•Calcium Channel blockers (lower the heart’s ability to respond to exercise)


•Beta blockers (lower the heart’s ability to respond to exercise)


•Diabetic drugs (doses may need to be adjusted during exercise, particularly if using Insulin for IDDM – a careful programme will need to be used for intense exercise)


How Much Exercise Will I Need?


A minimum level of exercise would appear to be 30 minutes per day, yet individuals with NIDDM or are obese are encouraged to aim for at least 60 minutes per day. You should aim to be slightly out of breath while exercising, yet still able to have a comfortable conversation.


The key, however, is to aim to do more than you are presently doing for any improvement in your exercise lifestyle will be to your advantage. If you have a medical condition that limits your exercise, trial short bouts of exercise that accumulate to 30 minutes in the day. A slow graduated programme if you have fatigue or severe neurological/ musculoskeletal compromise may start as easily as:


•6 separate 5 minute walks in the first week


•5 separate 6 minute walks in the second week


•4 separate 8 minute walks in the third week AND SO FORTH UNTIL YOU REACH 30 MINUTES


Your progress can be as slow as you like as long as you continue moving forward. For conditions such as chronic fatigue or flare ups of arthritic conditions you may have set backs, but be patient, as long as you are continuing exercise even the small gains count.


Will I Need to Change my Diet?


As long as it is a healthy diet, you should not need to change your meal patterns unless you are participating in endurance or competitive sport. One change you might make in the first 6 to 12 weeks is a moderate increase in protein consumption to allow for muscle adaption, yet in most instances this only needs to be a short term adjustment.


Will I Lose Weight?


If you are overweight, yes. Yet this does not always happen immediately, especially if you had low muscle bulk to begin with. A loss of fat may be accompanied by a gain in muscle bulk, which in itself will be important for your long term health and eventual weight loss. The best advice is not to judge the success of your exercise programme by the scales, but how you feel and the muscle tone and fitness you develop. Do you look good, feel great and finally, what are you health parameters telling you? If you need a cosmetic measure, assess yourself by how you feel in your clothes. And if you really need to take a look at the scales, only every week or more, as day to day fluctuations in weight of 1-2 kg can be misrepresentative of your progress.


What if I am Over 65?


All the more reason to exercise for it will lead to healthy aging, stronger bones and increased longevity. Surprisingly strengthening exercises are particularly effective here so a combination programme is encouraged.


Is Exercise All I Should Do?


No. You should try to be as active as possible even when not exercising. Take the stairs and not the elevator. Park further away from your destination and walk. Walk to the corner store instead of driving. Walk a note across the office, don’t e-mail. In fact incidental activity can be very effective in adding important heart rate variability to your day, a measure that is considered very important to heart health.