Incidental Exercise

Never underestimate the value of incidental exercise. For many years 10,000 steps a day has been considered a desirable minimal level of daily activity for health. I’ve shared the video below in other articles, about the dramatic drop in activity from our active past to our now relatively passive present. Here it is again as a reminder!

I love that video because it illustrates so well the change in how we live. Our bodies were designed for the active past lifestyle but too many of us live the passive present depicted.

Back in 2014 I participated in the Global Challenge. Looking at the website for the 2018 event, I see it has changed since 2014, but the objectives remain the same. This is an annual event to encourage office workers particularly to get out and about and moving. I am proud to say I won all the trophies available, despite some challenges such as ending up on crutches due to a very, very grumpy knee.

2014 was the year I found out I was sick. Looking back, what I find interesting was my actual steps per day in early 2014, compared to that recommended steps a day number of 10,000. We received our pedometers well before the event started and several of us started wearing them to see how much of an improvement was needed. I found I was walking approximately 2,500 steps a day. I was shocked, as I had a history of being active, but, as they say, “life happened” and I had found myself in a very inactive phase.

To paint the picture of my life at the time, I was a senior manager with a company car. In the morning, I would walk out my back door, jump in my car, drive to work, park in the basement, take the elevator up to my floor, sit in my office or meeting rooms all day, at the end of the day repeat the journey in reverse. At home I was helping children with homework, cooking dinner – there was little time for me to take care of myself. I should have made the time!

Now I deliberately use every opportunity to clock up a few extra steps: my kyBoot shoes definitely help. Without the heels I can decide, weather permitting, to walk an extra 1,000 steps down the road from my office before catching the tram.

The photo at the top of this page was taken on just such a day recently. It was a beautifully sunny end of the day, not too hot, the trees provided such a pretty filtered sunlight effect and the evening birdsong was a lovely musical accompaniment: I really enjoyed just de-stressing from the office by stretching my legs.

I am extremely lucky in that the tram line goes directly from my work location to my home location with many stops along the way. I can easily walk part way, tram part way. Not everyone has such a convenient transport situation.

If you drive to work, is it possible to park a little further away from work? That isn’t possible for me, on the days I do drive to work my only parking option is the staff car park. This is one of the reasons I prefer to take the tram as it gives me more options for incidental exercise.

Cycling to work is great exercise already: my knees don’t like cycling, so it is not an option for me. Luckily my body doesn’t object to walking in any way, which is one of the reasons incidental exercise is so important to my welfare and the management of my rheumatoid arthritis and damage in my lumbar spine.

How many of us travel to the gym or the pool, to diligently undertake exercise, in our car? My swimming pool is only 1.5 kms from my home. I have reached the point now where walking 1.5 kms is easy. One issue I have to be careful of is exposure to the sun, so I can only do that walk weather permitting. I also need to be careful not to overdo it. I am well aware that a three kilometre walk and a swim may send me into the #spoonie Boom/Bust cycle if I am not careful. Pacing is paramount. My gym is located at work: I do the same incidental steps as on a normal work day.

I walk to my general practitioner’s clinic rather than drive.

As I am a person with chronic health conditions, I don’t get to 10,000 steps on a daily basis due to the energy/lethargy issues that go with my conditions. Yet. I am slowly building up and each month I am more active that the previous month.

Look at your daily routine and determine what adjustments you might be able to make to increase your level of daily activity. I am a firm believer that frequent movement is better for our bodies and our health than being stationary all of most days then working out like mad in the gym for 45 minutes maybe three days a week. I was very happy to have my belief confirmed when I did the Pain Management Program! The reality was brough home to me more recently when I spent a day in the Emergency Department (why is a story for another day) – my body almost turned to concrete through not moving. I was very stiff after lying on a hospital bed all day.

Yes, I certainly do work out in the gym because resistance training is very important, especially as we mature, but moving as much as possible is perhaps even more important, yet so difficult for many of us to achieve.

I know from my own experience with my conditions, the days I am not working in the office and move a lot more I get to the end of the day with no stiffness or little niggles anywhere. Days when I am more stationary I will end the day in discomfort. Not pain, but discomfort. Move more. Movement is medicine has become my mantra.

This is an edited version of an article I first wrote for Kybun.

Chronic Illness Writings by Other Authors Plus a Book

While I strongly advocate exercise where at all possible, there are many other aspects to suffering from chronic conditions. Today I am sharing some of the non-exercise related writings I have been reading recently that I hope readers may find interesting and helpful. We are all on a road, treading a path – sharing our journeys can be very worthwhile. Also –  you deserve a break from my lengthy ramblings!

Sam Moss is a fellow Australian experiencing far greater disability than I am – we are at opposite ends of a very wide spectrum. Sam had a very successful, award-winning career until she was unexpectedly forced to medically retire.

Sam recently wrote a terrific article I highly recommend, Is Acceptance Just Resignation? Readers may remember the ‘A’ in the PACT pain management program I attended. The ‘A’ was for Acceptance. Sam draws a lovely distinction between acceptance and resignation. Sam builds on that article in a follow-up, Loves and Losses. I do like the 5 G Change Model.

The second piece of writing I am highlighting today is They’re called liars and malingerers because they face pain you can’t see by reporter Julie Power about a longtime Twitter co-follower. Andrew did not fall sick or inherit a condition like so many, he was the victim of a car accident. While many of us are able to at least produce blood tests, MRIs or other diagnostic test results to substantiate our situations, Andrew cannot and has suffered as the headline indicates. Some chronic condition patients suffer similarly, such as fibromyalgia patients. Chronic Fatigue Syndrome (Myalgic Encephalomyelitis) used to be similar – I have a very dear friend who had CFS/ME back in the days when many still thought it was “all in the head”. Now research is proving it is very definitely real. Andrew’s experience has been complicated by the legal issues surrounding seeking compensation for his injuries, but the negativity he faces is something many with chronic diseases face.

Harmoni Raie is another Australian chronic illness patient who really struggled with the mental health aspects of learning to live this new spoonie life. Harmonie recently wrote, Change Begins With Us – Be A World Changer! which is uplifting.

When Doctors Don't Listen

Lastly, there is a book I spotted in the work library one day, When Doctors Don’t Listen: How to Avoid Misdiagnoses and Unnecessary Tests. I am in the process of reading it and I am finding it extremely interesting. Although written in the context of the USA health system, there are lessons for Australian patients and Australia’s health system. It is written by doctors, expressing concern about the modern cookie-cutter, recipe approach to medicine. My doctors are all great, very good listeners. The fact I am reading this book must NOT be taken as a criticism of my own doctors, I am reading it out of interest!

Don’t give up on the exercise though! Call, text or email if you’d like to discuss how exercise may help you.

Competition: Free Training to LIMBER UP!

ENTRIES NOW CLOSED!

To welcome in this brand New Year and celebrate whipping my thyroid into submission with some radioactive iodine, I have an offer for readers! I am now ready and able to re-launch my Limberation activities: giving a lucky winner eight weeks free training seems a good way to start the year. As of this week, my thyroid function is rated as normal: I am definitely feeling the almost three month enforced hiatus was worth it!

Would you like to Limber Up to Live Life? To Move More? To start using Movement As Medicine? Reduce/manage pain? I’ve done it, so can you. 

There are rules! There are always rules! This might seem like a lot of rules for a competition, but we are talking about your health here, so precautions are appropriate!

Rules and entrant criteria

  • Have a medically diagnosed condition that will benefit from exercise (that is most of them – check with your doctor if in doubt). Please provide brief details of your condition/(s) with your entry.
  • Be taking any medications prescribed for your condition as scheduled (i.e. not skipping doses).
  • Have or be willing to obtain a medical clearance to exercise. This should include any restrictions recommended by your medical team (e.g. at one point I was not allowed to do shoulder presses).
  • Be committed to undertaking a personalised program for eight weeks. This will involve eight personal one hour consultation sessions over a two month period and completion of unsupervised exercises as prescribed on other days of the week (frequency to be determined at initial consultation).
  • Live within a 40 kilometre radius of postcode 3181 OR be prepared/able to meet within a 40 kilometre radius.
  • Be available Saturday through to Tuesday, one day per week for eight weeks.
  • Give permission to be interviewed for this website and have photos published.
  • Undergo standard fitness industry pre-exercise screening.
  • Complete initial consultation questionnaires and agreement to undertake exercise as applicable.
  • In 30 words or less tell me why you want to undertake exercise.
  • Entries close Saturday, February 10, 2018.
  • The winner will be announced February 24, 2018. The winner will be contacted personally and announced on this website. The prize is non-transferable.
  • Submit your entry via email to enquiries@limberation.com including your name, address and contact phone number. The subject line should be Limber Up.
  • The winner’s initial consultation will take place between February 24, 2018 and March 10, 2018 but can be subject to negotiation, within reason, if required.

If this page is your first visit to this website, please read my About page to understand why I offer a different training experience. I’m in the same boat as you: multiple chronic conditions, was losing quality of life, wanted to stay off pain medications.

Your contact details will not be used for any purposes other than your competition entry. All contact details of entrants other than the winner will be destroyed after the winner accepts the offer (unless the entrant indicates otherwise). If the winner is unable to accept the offer for any reason, the runner-up will be made the offer.

The winner will be chosen by me based on suitability for an exercise program and the authenticity of the 30 word outline specified above. I reserve the right to contact entrants if I determine clarification of entry details is required prior to determining the winner. This is for your protection.

Take that first step to a better quality of life today.

Pacing For Beginners

Pacing in the context of managing our pain relates to our rate of activity or our performance progress. In this article I am using walking (that’s why the feet!) as an illustration, but the same logic can be applied to sitting, standing, resistance (weight) training or whatever activity it is that we are having trouble doing to the level we want to.

As I have shared previously, when I was first started on this journey, I walked five minutes at a time, four times a day. Five minutes was how long I could manage before I experienced pain. Slowly, by pacing, we can build up.

Please be aware pacing is only one component of condition management, it is not THE solution. This is a general introduction only, each person requires specific planning tailored to their circumstances.

Warning: Maths Ahead

Let’s assume for the maths part of the exercise that like me, you can also walk five minutes before you experience pain.

  1. Take that five minutes as your Test 1 measurement.
  2. After a suitable rest, do a second Test. The Test 2 result might be four minutes.
  3. Add 5 + 4 = 9. To find the average of your two trials: 9/2 = 4.5 minutes.
  4. Now you need your baseline, your official starting point. This is 80% of your average. 4.5 * 0.8 = 3.6 minutes, or 3 minutes 36 seconds.
  5. Increase at a rate of 10% from your baseline. 3.6 * 1.1 = 3.96 minutes. Let’s just call it 4 minutes!

Each day you increase by 10%. JUST 10%.

Putting Pacing into Practice

How does this work in practice? I did some timings on a stroll the other day. It took me 217 steps and 1 minute 48 seconds to walk from one tram stop to the next.

What is a tram, you ask? I’m glad you asked! This is a Melbourne tram. Terrific mode of city transport.

If you don’t have trams in your area, do you have an alternative?

Why was I doing the timings? Because we can use local infrastructure to our advantage. After a while you will get very bored with your backyard or walking around the same block. Tram lines are fantastic because we can walk, hop on a tram for a rest, get off further down the line preferably within one or two metres of a nice cafe, finish our rest over a nice coffee and then repeat the exercise back.

As we build up, we can use the distance between trams stops as stepping stones. Looking at my 1 minute 48 second walk between stops cited above, that is way more than a 10% increase from a 4 minute baseline. That would be closer to 50%, WAY too much. But later on it will be possible. You are not stuck on 4 minutes for long! As you build up you can walk just past a tram stop then back and still catch a tram to reward yourself with coffee. Over time you will be reaching the next tram stop.

A little reconnaissance may be necessary. This is the tram stop I was passing. In the middle of a busy main road, there are lots of steps up from the pavement, an over-bridge and then more steps down. This may not be ideal for those pacing up slowly! This is one of the tram stops you might want to zoom straight past – as a passenger!

Of course there are many alternatives: drive to a favourite park or beach, then walk. I don’t suggest the shopping centre, as it could take 20 minutes to walk from the car park to your store of choice!

The Rules

Rule #1: stick to the times. DO NOT be tempted to do more than you should, despite how great you might feel right that minute. You risk undoing all your hard work to date if you do that.

Rule #2: do it every day. Even if you don’t feel the best today, do your allotted time. Every day.

Rule #3: Wear appropriate footwear. If it is sitting you are working on, ensure you have an appropriate chair.

Other Thoughts

I also apply pacing strategies to manage the fatigue, along the lines of how much I do on any given day. I’ve mentioned before I don’t do grocery shopping on days I do a strength workout. I don’t do strength workouts the days I work eight hours in the office. We work out rules for our individual circumstances.

Christine Miserandino (lupus and fibromyalgia) has written The Spoon Theory which is a great way to visualise the energy/fatigue situation. I found it very early on in my journey and it certainly helped me adjust to my new life. I do have many more spoons these days than I used to, but that didn’t happen overnight.

Our Pain, Our Brain and Our Nervous System

Most of us felt cynical, and disliked the physio and doctors enormously. We’d talk among ourselves, ‘Oh it’s all right for them to tell us so and so, they’re not in pain.’ “Like most in the group, I’d been protecting my painful body, using the old reasoning, if it hurts, rest it. I’d bundle my arms around me and pick things up with my toes. My life had become massively restricted.” Source: Barbara’s Story The University of Sydney

That is Barbara Walker speaking about her initial introduction to a new approach to managing her chronic pain (see definition below). While Barbara was skeptical, the approach worked so well she and her family were instrumental in establishing the centre in Melbourne.

The following short video covers a lot in five minutes, please do take the time to watch it.

I was very surprised to learn 1 in 5 people worldwide suffer chronic pain. This is not a small percentage of the population. Think of all the people in your family, your workplace and your circle of friends. 100 people? I like round numbers. So it is statistically probable 20 are suffering or will suffer chronic pain.

I am writing this as a patient, just like you or someone you know. My objective today is to highlight there are evidence based approaches to living with chronic pain which you may like to consider. Referral information and other details about the Barbara Walker Centre for Pain Management are found on this St Vincent’s web page for those in Melbourne.

Because I am not qualified to speak on the topics of neuroplasticity or the finer points of nerve receptors and neurotransmitters, I’m not going to. This is actually sad, because I’d LOVE to, it is interesting and exciting stuff! It is also very specialised and the multi-disciplinary team have many years of clinical experience. Providing patients with an in-depth understanding of how pain works is a vital component of this approach to improving our quality of life. The relationship between our nervous system and our brain is very much a part of the solution. No, the pain isn’t “all in our heads” – but our brain is involved.

Ask yourself what are all the things you have tried to date? Has your quality of life improved as a result, or has there been only brief periods of respite? How often have you felt you had to choose between taking pain meds OR going to work, because invariably doing both is not an option? Is it worth trying something different, as Barbara did in 1995? As I have done and continue to do.

I feel as if I’m writing an advertorial for others, when if I should be writing one for anyone, it should be for my services! The truth is, while exercise and movement are part of the equation, there are other variables, some of the practical ones I have addressed in previous introductory articles. I would be remiss if I didn’t draw attention to the work being done and the support available in this sphere. After all, I didn’t know of pain centres until I was referred by a general practitioner.

Chronic pain is defined as pain that continues after the initial cause of the pain (injury, surgery, inflammation etc) has healed. Those of us with chronic conditions/illnesses/diseases may have ongoing causes of pain – so perhaps a mix of chronic and acute pain but the approach should still help us.

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