“How Can I Afford to Exercise?”

This question has been passed to me from a health care worker and is a very valid question. Many people with chronic conditions are on a limited budget. They may be working reduced hours, be on the Disability Support Pension (or worse, have been forced onto JobSeeker) or Age Pension. Disclosure: I am an age pensioner, so I have lived experience of the budgetary constraints! Like me, many will not have qualified for the NDIS. I’ve written before about the The Costs of Chronic Illness, many of which no-one, least of all governments, seem to think about! If we can’t afford to take care of ourselves, the costs of our healthcare rise.

There is definitely an argument for governments, via the health system, to make exercise more affordable for the chronically ill, but what can we do now?

Please note there are many links in this article to past articles. That keeps this article shorter than it might otherwise be. Click through to read the details!

Doctors, I find, are often (not always) good at telling patients to get exercise, but that is where the advice stops! How is left up to the patient!

Most of us can’t afford a private physiotherapist or exercise physiologist on a weekly basis. I have both myself, but unless I need specific support for a specific problem, I don’t see them as it bites the budget. I wish I could see my exercise physiologist on a weekly basis! This was one of the reasons I initially undertook my Fitness Coach education – to help people like me.

So WHAT can we do to keep costs controlled? Then I will look at WHEN we should do the exercise!

Find a gym that offers concessions: I am a member of my local council aquatic centre. This has a fully equipped gym, great hydrotherapy pool, 25 metre indoor pool, 50 metre outdoor pool, spas and a sauna. Everything I need in one place. Due to my PCC (Pensioner Concession Card) I receive a 40% discount on the membership fee. I pay fortnightly so I can suspend my membership for four weeks a year for free (e.g. hospitalisation, surgery, etc). No lock in contract either – watch out for those! Places like this are harder to find in regional areas, unfortunately.

Memberships are generally much cheaper than paying casual rates per visit. Finding a facility that offers all the services you need, as mine does, is a bonus. If you are working reduced hours, you may qualify for a concession card even if you are not technically unemployed or on a pension. Check your eligibility. The Seniors Card also attracts membership discounts.

Aside from weights, a gym gives you access to indoor rowing machines, stationary bikes and treadmills. All very useful equipment.

Have equipment at home: therabands or resistance bands come in various strengths and are available from physiotherapists and stronger ones are available at sporting goods stores. I also have a swiss ball and my daughter lent me an aerobic step when I had my knee surgery. Many of us have space considerations therefore having equipment at home has limitations. It isn’t just space: I own 2 kg and 5 kg dumbbells but realistically that doesn’t allow me to Pace UP my strength training. I need the gym for that as I have no space to house a full dumbbell set, nor can I afford one! Suggest to family members a good Christmas Present would be [whatever it is you need].

Floor exercises at home: many exercises can be done at home without weights, sufficient for our therapeutic needs. Squats, glute bridges, planks, push ups (against the wall is fine) as a few examples. However, getting down onto the floor and back up again is not possible for all of us. I did glute bridges on my dining room table when preparing for my total knee replacement. After my knee surgery I found a way to slide off a lounge chair onto the floor using my arms, then used my arms to lift myself back up after I’d done my rehab exercises. I strongly recommend paying for at least one formal training session to ensure you have correct technique – you do NOT want to damage anything through incorrect technique. See your GP about a Health Care Plan to have five physiotherapist or exercise physiologist visits covered by Medicare – bulk billing is rare though, so make sure you are on top of your Medicare Safety Net details.

Walking: never underestimate the benefits of walking as exercise. Best of all, walking is FREE! Well, free after you’ve allowed for the cost of decent walking shoes – important with most medical conditions! It helps if you can find a local park or walking track that makes walking a pleasant experience. The featured photo above is of Gardiners Creek, a lovely spot! Some parks are implementing exercise/fitness equipment in a corner of the park, so keep an eye out for such in your locality. However, please take note of my “when” cautions at the end of this article before rushing off to walk your way to a healthier you.

These public fitness equipment spots generally do not allow for a balanced workout. For example, there is a leg press in that photo but no leg curl for the hamstrings.

Get a step counter of some sort. I recently upgraded from a Vivofit generation 1 to a Garmin Forerunner 55 (bought on special). It also counts my swimming laps. You need to be able to monitor your progress properly. Christmas stocking request! Nothing more motivating than seeing your progress graphically AND wanting to maintain/improve it. Below is a comparison of the last eight weeks. Bear in mind I moved home and retired in August. I was pretty exhausted to be honest, plus there was a health “glitch”. Therefore August/September situation was messy on the steps front. Even with that excuse, I like the graph on the right MUCH better! It is good to actually see your progress.

Garmin Connect on your phone lets you see everything at a glance. The app is free (just as well, because the watches aren’t!). If you already have an Apple watch, check out what you may already have available.

Before any reader goes “Uh ha! We caught you! That’s more that 10%.” Yes, it is more than 10% comparing those two 4 week periods, but not overall! Plus I was still going to the gym and swimming, just the steps and walking took a tumble. I also changed my goal structure after I retired, but that is a whole other discussion for another day!

I will walk to the supermarket or pharmacy and record that as a walk. Just over 1 km. Same back. Walk to my favourite coffee shop. 1.30 km trip. Not possible for all, I know, but think about what activities you can turn into an exercise event in a similar way.

Swimming: see gym membership above. If you live near a beach, even better! Swim for free!

Hydrotherapy: wonderful if you can have access to a hydrotherapy pool with a gym membership as I do. Definitely not enough of these around, especially in regional areas. I also do squats and lunges in the pool. I have specific equipment to help me achieve my goals. Bought before I retired, but perhaps another Christmas stocking option!

Cycling/Running: both great options if you are able to. Good running shoes are expensive. Buying (and maintaining) a bike and related equipment is even more expensive. Gym membership gives you access to stationary bikes. Stationary bikes can be better when starting out as you don’t accidentally overdo it – you can stop when you feel that change in your body (see Pacing for Beginners) rather than find yourself too far from home and suffering later from over exertion. There is NOTHING to be gained from riding 35 kms today and being unable to do anything for the next three days. Consistency is key.

Motivation: I personally struggle to find motivation to do exercises at home. I’m much better going to the gym. I was fantastic at the daily rehab after knee surgery, but that had measurements and specific goals involved. We are all different, some find being diligent at home easy. I don’t. Unless I’m trying to fix something, like rehab a temporarily grumpy shoulder. Joining walking groups is a great idea, but in practice not suitable for all chronically ill people. For example, a group may walk at a much faster pace than we can safely manage with our condition/(s), walk further or walk at times that don’t suit our condition/(s) (e.g. morning stiffness/pain). I’d love to join the local swimming group, but I need to be able to swim 2 kms without stopping – I’m not there yet. Fitness classes can be demoralising if we can’t keep up. I recommend strength training is more beneficial anyway! We need to select exercise modes that suit us in order to maintain our motivation, especially if we are paying for a membership.

Covid-19 Considerations: no matter where we go at the moment, remember to be Covid safe. We already have underlying conditions, we don’t need Covid-19 on top. But then neither do we want to let our underlying conditions run riot because we are protecting ourselves from Covid-19. I wear a mask into the gym. Depending how many people are there I may well keep it on while training. I may warm-up outside rather than on the treadmill. I’ll wear my mask in the hydrotherapy pool and the spa. For lap swimming I take the mask off just before I put my cap and goggles on.

Medical Clearance: Let me repeat something I often say on this web site: ensure you have your doctor’s approval to undertake exercise and ask if there are any limitations. In most cases, musculoskeletal conditions will have no restrictions other than “listen to your body”. Other medical conditions may have certain cautions. Get a clearance. I do notice men can be more gung ho about it, so please see your GP!

I emphasise it does take time to learn to listen to your body.

Now to the WHEN!

I’ll use walking as an example. My daily target is 7,500 steps a day. I know that if I do very little incidental steps, I need to walk 4 kms to reach that 7,500 steps target. I do not walk 4 kms in one go. Now I am retired from the workforce I can walk whenever it suits me. When I was working I would aim for 1.33 kms before work, lunchtime and after work. Now I generally do 2 kms in one walk and then two separate walks of 1 km each. Many of us can do (say) 4 kms per day easily with respite between the walks, but 4 kms in one burst would drain that internal battery.

Some people may think this takes too much time. Not really. I walk 1 km in about 11.5 minutes. Exercise physiologists tell me each activity over 10 minutes is good. All I have to do is find 11.5 minutes four times a day. That is manageable. In 2014 I started by walking around the block four times a day. Some people have walked around their clotheslines to get started. Where any of us start is not a competition. Maximising your health over time is the objective.

Obviously splitting workouts like that is not really sensible for strength training or swimming – I’m not going to go to the gym four times a day to split up my weight training! Of course, this is where pacing up comes in. Start small, build up slowly.

As mentioned above re cycling, it is critical to follow the pacing principles at all times, even with walking. Where you start with any movement/exercise activity will depend on your current state of health and mobility. We are all different. Cost is not the only consideration here. Depending on where you are starting from, it may be wise to build up on free exercise, then only consider a membership of a gym once you are in a position to utilise that membership effectively. Alternatively, paying a regular membership may actually be motivation to use the facilities: you decide what works for you!