How tough is it to get moving?

You may be asking yourself “How tough is it really, to get moving?” This may be moving again or starting from scratch. I’ll be honest, it may be tough-ish. How tough (or easy) will depend on many aspects: your specific condition, were you diagnosed early and therefore received appropriate medical care early, your pre-diagnosis level of activity, the medications you are on, the symptoms you specifically experience, do you have a chronic condition or are you in recovery from treatments such as chemotherapy.

The aim  of moving is to prevent de-conditioning, which I spoke about in Launching Limberation. Specifically here I am referring to pain management, but the benefits extend beyond this.

My Journey

I’ll share some of my own journey but as you read please be aware your situation may be entirely different. I do use time, distance and weight in this article to provide a sense of progress. Different people, different situations, different numbers, different timelines. What applies to me may not apply to anyone else at all.

Thankfully, I wasn’t completely starting from scratch – while I’d had an activity hiatus for roughly four years, I did have a gym junkie background to leverage. Or so I thought. In the beginning it certainly didn’t feel like I was leveraging anything!

Because I was diagnosed with two different autoimmune conditions at once, my medical team advised we stabilise one condition (hyperthyroid) before attempting to treat the other (autoimmune arthritis). Fatigue was a major problem for me in the beginning. Coping with getting to and from work, work itself and home life was draining what energy I did have. There was basically nothing left in the tank in the early days.

At the Starting Line

When I did start, I started very slowly. I did five minute walks four times a day. It didn’t take me long to realise I felt better when I moved. Pain and stiffness receded very quickly once I was actually MOVING. I increased to ten minute walks, three times a day. Finally I got to twenty minute walks, twice a day. I also moved as much as I could during the working day: sitting was hell. Even now, writing this in my home office where I do not have a sit-stand desk, I will not sit for long. No amount of activity is too small to start.

I didn’t do any strength (resistance) work at all in the beginning. I added some swimming: gone were my 2.5 km sessions: my physio was advising I swim 250 metres. I mumbled and grumbled that 10 laps wasn’t worth getting in the pool for, but I did stick to her advice the first time. The inflammation was also in my shoulders, meaning I had to strengthen my shoulders: be able to do 20 prone shoulder rotations (each side) daily with a 2 kg weight before I was allowed back in the pool.

Resistance Work

I wasn’t until late 2015/early 2016 I got back on the weights. I’d always liked the leg press, but had no idea what I should try to start with. Prior to the autoimmune arthritis and the hyperthyroid diagnosis, I’d been diagnosed (by MRI) with meniscus tears in my left knee, not a lot of cartilage to speak of and I’d had a Synvisc shot. I was understandably cautious, but knew I was continuing to lose muscle strength which wasn’t going to help me long term at all. I needed strength to support my joints, especially the damaged ones.

I loaded 10 kg weights on either side of the leg press and felt SO frail. I was in my school gym – most (not all) fellow fitness students were athletic and I felt like I didn’t deserve to be there. 20 kg was perhaps overly cautious. I upped the weight to a total of 60 kg quite quickly. From 60 kg to 100 kg took quite a bit longer. If I recall correctly, I got stuck around the 80/90 kg mark for quite some time. One of the issues was not actually physical by then – it was not knowing what was safe for me to aim for and no-one I asked was quite sure either. Will I ever get back to 200 kg? Right now, I doubt it – and you what? I’m OK with that. I know I have achieved what I set out to do – stay off pain medication. I’ll let the healthy people worry about 200 kg leg presses.

Climbing back up

Ultimately I asked my rheumatologist, who is very supportive of what I am doing, “How far is it safe for me to go? I don’t want to damage anything”. He is well aware I am using my own body as a research subject. He smiled and said “You’ll be fine. You’re sensible. Back off if it hurts.” After that I was more confident to push myself. I am careful. I don’t subscribe to the “no pain, no gain” philosophy – after all, pain is what I am working to manage, I don’t need to have more of it. Pace, incremental gains, no lifting to failure. My definition of “push myself” is not the general fitness industry definition – for very good reason.

I have just, this month, August 2017, managed to do a dumbbell bench press with 12.5 kg dumbbells (25 kg). I started back at 5 kg (10 kg total): it has taken me over 12 months to get to this far.

Other Considerations

Sometimes progress stalls. I find I lose gains very quickly if I miss a strength workout. Whether this is due to medications, the conditions themselves, my age (yes, I do have to consider that these days) or a combination of all three, I’m not sure. I’ve searched for research around such questions but have yet to find anything specific.

In late July 2016 I had a change of medication. I found this helped dramatically with the fatigue and therefore it has helped all the other aspects of my re-conditioning.

I don’t run. My knees are pain free and I want to keep them that way so I just don’t risk putting them through jogging or running. I walk a lot. I walk to my Pilates classes, I walk to or home from the gym, I walk to the next tram stop. While I’d love to get back to 10,000 steps a day, I’ll settle for 8,000 plus my other activities. I do indoor rowing, great whole body exercise.

In 2014 I could swim a 2.5 km session. In 2016 I was finally allowed by the physiotherapist to swim 250 metres. Now I’m back to 1.2 km sessions. Sometimes I only swim 800 – it depends on how I feel and how my shoulders feel. The message here is listen to your body at all times. Don’t use that as excuse to not do anything – but listen to your body. On Saturday I did my usual strength workout: I had every intention of increasing that leg press again, hopefully by 10 kg – I was aiming for 140 kg. As soon as I did my warm-up set I knew for whatever reason today was not the day. My strength was just not there. I suspect it was lack of dietary protein the day before – I’m currently monitoring how I feel against my dietary protein levels as mentioned on the Science Stuff page. So I simply did not try any increase. Next week will do, there is no rush, I’m not competing with anyone. I didn’t go backwards and that is my focus.

I’ve added Pilates to the mix at the suggestion of my physiotherapist. While this may look easy (looks like I’m doing absolutely nothing, doesn’t it?), trust me, after ten of these retracting the scapulae and opening the chest, I don’t want to do any more until the next day!

Objective Achieved!

As you can see, it isn’t achieved overnight. I’ve worked at it. Slowly, but surely, I’ve achieved my original goal: to stay off pain medications. Now on to the next goal, which is to help others in similar situations.

Will you give movement a try? Contact me for a preliminary chat. Limber Up to Live Life.

Disclaimer: This article is based in part on personal experience and is of a general nature, not tailored for any individual circumstances. Where appropriate, readers should seek medical clearance before embarking on an exercise program. 

Launching Limberation!

Welcome! Limberation is now live!

Stay tuned for weekly articles of interest to people trying to manage the competing demands of a job, family, pets, medical conditions and their own physical maintenance.

Managing the demands of life is difficult enough for most people. Then one day you come out of a doctor’s consultant with a diagnosis and referrals to specialists. Your life just got a bit more complicated – or a whole lot more complicated.  Now you have to fit in taking care of yourself.

You know how sometimes you used to skip breakfast because the mornings were just so hectic and you have to catch THAT particular train or you’ll be late for work? Not so fast. NOW you have to find time for breakfast because you have to take medication and that medication must be taken with food. No scoffing down those pills on an empty stomach – that’s just asking for more trouble.

You’ve been busy the last few years and your exercise regime has fallen by the wayside. Suddenly finding time for exercise is mandatory. But you feel tired all the time now, hitting the gym or even just walking around the block is more challenging that you thought it would be.

I’ve experienced days where just getting off the bed was so painful I didn’t know how I’d actually get on my feet. I also knew once I did get on my feet, once I got moving, my pain improved dramatically. This will NOT be the case for every person immediately: those suffering chronic pain, for example, may need to work slowly to desenitise their nervous system. Just because something works for one person does not mean it work for another. We are all different.

Years ago I spent a lot of time working out – then I got too busy and I let it go. After all, I rationalised, I can get back to it when things settle down. This can be a psychological challenge post-diagnosis: for a competitive person, finding I could only leg press about 30% of what I used to be able to do was demoralising and demotivating. I had to fight that feeling of uselessness. I felt completely incompetent in a gym setting, yet I knew strength training was important for me.

The challenges those of us with chronic conditions face are not just medical. There are social, family, financial and psychological challenges. We have to examine our values and goals and reset some if not all of them.

Learning to pace ourselves can be the biggest challenge. Maybe working full-time is no longer the best thing for us, despite the financial ramifications. Maybe our current career is not helpful to us physically. In my case, sitting for long periods, being stationary, is not pleasant (and that is putting it mildly). A sit-stand desk helps greatly: changing careers to one with greater movement helps much more.

We need to prevent the de-conditioning of our bodies.

Deconditioning

None of this is likely to help us manage our conditions long term.

If your doctor hasn’t already told you to “get exercise” (as mine did), ask if exercise will be beneficial for you.

Then let’s Limber Up to Live Life.