Have you been spending the past 1 year sitting down without any physical activity coupled with an unhealthy diet, and is contemplating on starting a physical routine? I urge you to read this first!

THE NOT SO HEALTHY YOU

If you’re over the age of 30 and have been living a sedentary lifestyle for more than half of your life, you are likely developing or have developed one or more health conditions such as hypertension, dyslipidemia (high cholesterol), diabetes or cardiovascular disease. You’re also likely to have some form of orthopedic problem such as osteoarthritis or past/present injury at your knees, hip, back or shoulders too. As you get older, you begin to feel more lethargic, fall ill easily and realise that you can’t fit into most of your clothes any longer. Part of your diet may also include pills and medication to manage your symptoms developed over time. And like the majority of us, you feel frustrated and worried about your health.

The good news is that most of the conditions mentioned, which you may perceive as “part of the aging process” are preventable and REVERSIBLE. Medicine only manages or suppresses symptoms with side effects. They DO NOT address the root of your problem. This is why many health care providers advise you to exercise and eat healthier. In other words, exercise is medicine. I would like to congratulate you if already recognize the importance of exercise. It’s a first step towards better health. But I am also sure that a majority of you who are currently reading this are unsure on what and how to begin.

There are many considerations to look into before designing an exercise strategy or program. As a medical exercise professional, it is my responsibility to ensure that you get the correct dose of exercise that is safe and effective according to your condition and goal. However, it is your responsibility to follow through the program and commit to a recommended lifestyle change for your own health.

WHAT SHOULD YOU DO BEFORE YOU BEGIN AN EXERCISE PROGRAM?

Most of you will jump straight into running, swimming, gym or join a boot camp class. While this is commendable, it is also potentially risky. If you have any health and/or musculoskeletal issue, seek professional help first. A certified exercise professional are required to do the following when they sign up with a new client:

1. Are you even ready in the first place?
We need to get a rough idea if you are ready to commit to the program by doing a behavioral interview. Most changes only happen if you are at the ‘preparation’ stage onwards. And when you’re ready to commit, we need to discuss and agree to a realistic and suitable goal.

2. Have you been diagnosed by a doctor?
Have you been told by a doctor that you have a health condition? This is very important because it will determine the type of exercise program that is best suited to you. For instance, people who are diagnosed with diabetes may need to consider avoiding high impact exercises that may affect their feet.

3. Are you aware of any symptoms or conditions in the past 6-12 months?
The last time you’ve visited a doctor could be months or years ago. Since the last visit, you may have developed a health condition that you may not even be aware of. A simple questionnaire can help identify any potential symptoms that may indicate a visit to a doctor or at least to perform a health screen before you start exercising.

4. Does your parents/siblings/grandparents have a health history?
Some diseases are passed down through genetics. For example, your risk of developing heart disease increases if your father or brother experienced a heart attack by the age of 55.

5. Are you currently on any medication?
Medication has contraindications and can affect you physiologically. For example, if you’re taking blood thinners for cholesterol, it is advisable to avoid high contact sports to minimize bleeding. Taking beta-blockers for hypertension can alter your heart rate, and so on. By understanding basic medication can ensure that your exercise is safe.

6. Assessing your risk
Before we begin our first session, we need to perform risk stratification for every client we engage. If you are categorized as high risk, you may require a doctor’s clearance before beginning any exercise program.

Assuming that everything has cleared out and due diligence is done, the next step would be to screen and assess your movements. Most of us has some form of dysfunctional movement, muscle imbalances or an injury from the past or present. It is important to address and correct them before we advance into the exercise program. As an example, if you do not display sufficient range of motion (ROM) at your hip joints, you need to improve on that first. Else you will only risk injuring yourself in the process, limiting your full potential.

Apart from an orthopedic perspective, we must also ensure that basic health screening is done prior to workout. For example, if you’re diagnosed with hypertension, blood pressure should be measured before and after exercise. If you’re diabetic, glucose level should be checked before and after exercise if necessary. If you’re asthmatic, make sure that you have your inhaler with you in case you suffer from an attack. The environment you work out in also plays a major role. A room temperature that is either too hot or cold may aggravate your condition.

Progression in exercise is also important so that you don’t start out too hard and too soon. An over vigorous exercise can cause negative perception and relationship with exercise. It can be debilitating and may also affect your daily activities. It is important to first establish your ‘cardio base’ to gauge how intense your exercise program should be. Going too easy may not provide sufficient physiological response that we want. Going too hard may only injure you or risk a heart attack! And throughout the process, you need to re-assess your commitment and modify the program to make it sustainable in the long haul.

Other than being physically active, you also need to look into your diet, habits and nutritional needs. What you eat plays a huge role too. Giving nutrition guidelines that are scientifically proven, that suits your lifestyle and behaviour while avoiding eating disorder can be very tricky. Fad diets will only backfire in the long run.

Lastly, an exercise professional should learn how to recognize symptoms and know when to refer out to other allied health care providers for further help. They could be your physician, nutritionist or therapist. The common impression of a ‘personal trainer’ is not someone who is constantly screaming at you “ONE MORE REP!” or a cheerful cheerleader. Nor is he/her someone who knows 101 different exercises to get your ultimate 6 packs, or furnish you with motivational quotes to push harder. Instead, he or she should carry the same confidence and professionalism like any other reputable and highly respected health provider. The exercise professional is someone whom you can trust to provide the correct dose of exercise that is safe and effective according to your body. It is definitely a career that I am proud of!

By reading this, you should already understand the complexities involved before you start exercising! But this does not mean that you shouldn’t start at all. However, if you’re unsure, it is best to seek professional help that are credentialed, certified and experienced. You’ve got nothing to lose after all.

ABOUT THE AUTHOR:
Ke Wynn is an award winning corrective exercise specialist and a certified personal trainer specializing in the field of corrective exercise and medical exercise.

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