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Beginning an Exercise Routine


Featured Speaker

Brett Gervais, DPT

Brett Gervais, DPT

Brett Gervais, DPT, Areas of Special Clinical Interest include Manual Therapy, Orthopedics, Sports Medicine, Parkinson's Disease, Geriatrics.


About this Podcast

Physical Therapist Brett Gervais gives tips on beginning an exercise routine.

Transcription

Alyne (host):  Welcome to Aspirus Health Talk. I'm Alyne Ellis. Today, we're discussing how to begin an exercise routine. Joining us is Brett Gervais, a physical therapist at Aspirus Keweenaw Outpatient Therapy. So Brett, how do we get started particularly if exercises isn't something one does often or at all?

Brett Gervais (guest): So the first thing is you're going to want to find something that you enjoy doing. So oftentimes when individuals think of exercise, they think of the dreaded, you know, "Oh, it's going to be painful. It's going to be something that I don't enjoy doing." Find an activity that you're going to want to do at least a few times a week. And that could be something as easy as working in the garden. It could be walking. And it might be being in a gym, you know, working with actual equipment. And it all depends on what type of thing you want to really do.

Alyne: And a lot of people like to do it alone, some people don't. What's your advice on finding an exercise partner?

Brett Gervais: Yeah. So oftentimes, at least when I'm starting an exercise program, I'll talk to some of my friends and I'll see if it's something that they're interested in doing as well. Not only does that improve your ability to motivate yourself because you'll have someone alongside of you kind of working toward the same goals. But it makes it a little bit more fun. You know, it makes it so that you're going to adhere to your program, whatever you come up with that you want to do on a weekly basis. It's somebody to hold you accountable,

Alyne: And possibly to talk to, although I'm assuming that with aerobic exercise, if you're doing it correctly, it's a little hard to carry on a conversation

Brett Gervais: Right. And sometimes, with moderate intensity activity, which is typically recommended by entities such as the American Heart Association, you should be able to have a conversation with your exercise. Um. and I know sometimes it depends on your age. You know, if you're over the age of 50 or 60 years old and you want to stick to something a little bit lower intensity, it's okay if you're able to have a conversation. You don't need to be exercising so hard that you're out of breath.

Alyne: Go over a little bit of how technology can help us to stay motivated and what you might recommend that we use to keep track of how we're exercising.

Brett Gervais: Sure. Well, especially nowadays we have-- you know, smartwatches have become a bigger ticket item with exercise, because they have the ability to track your heart rate, track even an electrocardiogram. You know, you can print an EKG off of your watch nowadays, which is pretty amazing just to monitor your cardiac function. You can also monitor, your trips. So if you take a jog down a trail, you can map that jog. You can see how many calories you've burned.

And then you can also use things like you see nowadays like the Mirror, so things where you can exercise with somebody right in front of you, or even using your television with, you know, a YouTube video pulled up or an old exercise video. You have things like that. Even with biking, now they have the Peloton where you're biking live stream with other individuals at the same time.

So it's pretty amazing where technology has come. And, um, I think there's down sides to it, but there's also a lot of benefit, especially in a time with COVID going on where you might not have the local gym open. You might not be able to go exercise with a partner, you know, somewhere at the local gym, so using something like that can be a lot more safe.

Alyne: So it's important to be realistic, I think, particularly when you're starting so you really don't hurt yourself. And how do you set a smart goal so that you don't overdo it, but yet you're pushing yourself to advance?

Brett Gervais: In physical therapy, we often set smart goals for our patients and you should do the same for yourself when you're exercising, just so that you have a place to go from, you know, what you want to try to do. You know, for me, I like to lift weights. So I want to be able to lift a certain amount of weight with a specific lift.

So a smart goal really broken down is it's specific, it's measurable, it's achievable, it's relevant, and it's time-based. So being it's specific, it's talking about a specific thing that you want to do as in "I want to be able to walk a certain distance." So walking is my specificity. It's measurable, "I want to be able to walk one mile." It's achievable. I'm making it one mile because if I make it 10 miles, I'm going to hurt myself or I'm going to get lost along the way. It's relevant, meaning it's something that is going to apply to your daily life and make you more healthy because of it. And it's time-based, so I want to walk one mile to be able to more comfortably walk around the grocery store in one month. So by one month, I want to achieve that goal. So that's a better way to apply yourself to your workout so that you can see some benefit objectively.

Alyne: And when you say time-based, that could also mean that I want to walk that mile in a certain period of time.

Brett Gervais: Sure. Yeah. It can definitely apply to that aspect of the goal as well. So meaning I want to walk one mile in, you know, 15 minutes or whatever is relevant to you.

Alyne: What about sets and reps for your goals in terms of measuring how you're doing?

Brett Gervais: So oftentimes we look at an exercise program as the stereotypical three sets of 10. And that's an okay place to start, but really if you're looking at your smart goal and you're saying, "I want to be able to improve my endurance," or "I want to be able to lift a greater amount of weight," whatever it might be, when you're setting your sets and reps, it should apply to that.

So usually how I'll look at it as if I want to improve my overall strength, so my gross ability to lift a certain amount of weight, I want to try to be working on a lower rep range with more resistance. So for me that's about three to eight reps somewhere within there I'm lifting that weight or I'm pushing that load for three to eight times and distributing that along a couple of sets.

If I want to work on an intermediate zone, so I kind of find a happy medium, which is where that 10 reps usually comes from, anywhere from eight to 14 reps somewhere within there is where you're working on that. And then if you're working on pure endurance, so aerobic activity, you're working on something more than 14. Fourteen to 20 is usually where I'll cap it off, but it can be more than that. I mean if you take an activity like just a simple recumbent bike or an exercise bike, if you're biking for 10 minutes, that's thousands of reps that you're doing with your legs.

So understanding your sets and reps don't need to be, you know, exactly what you see is printed out in front of you. You can change that up and you can have a little bit of fun doing it, and understanding how that makes it individualized for yourself.

Alyne: Let's talk a little bit about understanding equipment. And with COVID right now, not all that many people are going to the gym if the gym is open, so not everybody has expensive exercise equipment at home. But let's talk a little bit about basic equipment and understanding that, and anything else you'd like to add about things that are more fancy.

Brett Gervais: It's become more important than ever to have an understanding of what you're going to try to use, because you don't have the benefit of being in a gym. You know, if you're sitting next to somebody in the gym that is doing an exercise, you can kind of copy them, right?

So when you're at home, what I would recommend is just starting with lighter dumbbells. You can do enough with light dumbbells than you would really imagine. And really what I've done throughout COVID is I've set up a little area in my basement. You know, I have some lighter dumbbells. I'm obviously not going to have the most extensive equipment because eventually the gym will open up for me.

But if that's something you want to pursue, then that's doable. You obviously want to have enough space. You want to have a safe environment to exercise in, and then you want to try to find a workout that's appropriate for that light dumbbell exercise. So if you want to do something like that, it becomes important to look on the internet for something or finding a YouTube video that you can follow along with, or going back to having an exercise partner, having somebody to be with you, maybe it's your significant other that might go through that program with you as well, so that they can have different ideas of different exercises.

So really dumbbells are the big one. Obviously, resistance bands, those are something that you can acquire. Even from a local sporting goods store, you can find things like that. And then from there, you can build on your program. You can start from ground zero, and then you can acquire more and more as you want to delve into more exercises.

Alyne: So how many days a week should I be exercising? And should I be changing things up if I do it every day? Give me sort of a grounding beginner rule.

Brett Gervais: Sure. It ultimately depends primarily on your age. If you were an adult, you're older than, you know, 17 years old, what is recommended by the American Heart Association is about 150 minutes per week of moderate intensity aerobic exercise. So what that means is you're going to do three days a week of about an hour of moderate intensity activity, and remember how I said that those are things where you're not out of breath, but you're working a little bit. That could be as easy as just working in the garden. Other examples of that could be taking a brisk walk outside. If you're not in Winter Wonderland, it could be playing tennis, playing tennis with a partner at the local tennis center or even biking nice and slowly through town.

It's also recommended that you get about 75 minutes a week of vigorous aerobic activity. So this is a little bit more intense, which could be like running, jogging. It could be cycling a little bit fast around town, jumping rope. and then on top of that, it would be moderate to high resistance training a couple of times a week.

So you're really breaking activities down into the amount of intensity that you're applying yourself with them. And you're trying to do that over three to five days a week, and you're splitting that up to make it fun for yourself and not complete torture so that you're not looking forward to it next time.

Now, if you're a little bit younger, if you're a kid anywhere from-- with the American heart association, we'll say it's six to 17 years old, the recommendation is a little bit higher than that. You have that energy to expend. So it's about 60 minutes a day, your moderate to high aerobic activity, and then vigorous intensity activity three days a week.

So you're really doing a lot more moving around if you're a younger population. And so that's where I would start with trying to figure out how many days a week. It should be at minimum two days a week that you're focusing on your ability to improve overall cardiovascular health.

Alyne: Now I know as an infrequent exerciser myself  that when I really get going on this, a few days in I usually start feeling way better. It's really hard before that to stay motivated. I'm wondering if you could talk a little bit about that and also how long I should stick with a routine when I finally find something that works for me.

Brett Gervais: So a lot of what I talk to my patients about is, you know, doing an exercise program for even a couple of days. You're likely not going to feel the benefits of that other than maybe feeling muscle soreness, that delayed onset muscle soreness. I usually say it's going to be about two to three months before you reap the benefits of what you've done. And oftentimes that gives people a little bit more hope that what they're doing will work eventually.

So for instance, for myself, if I change my routine up to a different lifting regimen, I'm not expecting to feel the benefits of that for about three months into the future. And then I start to switch that program up again. It's important not to stay with the same program so long that you almost get bored of it, or you're not letting your body adapt. You usually want to make it challenging for your body because that's how we as humans get stronger, right? We adapt to a certain load or stimulus to our muscles or joints or bones. I know it becomes stronger because of that. So typically I would stick to something at least a month before you want to switch that routine up and try to have a little bit more fun with, you know, changing your activities.

Alyne: So given all that, when is it important to call a doctor or see a coach or a trainer, or start off with physical therapy? What are your recommendations on all of that?

Brett Gervais: So that boils down to your past medical history. So if you have, um, any history of cardiovascular, um, pathology in your body, it's important to have an understanding of when exercising might be dangerous. And if you have any hesitation, you probably should contact your health professional.

And in regards to which professional to the contact, I would say your primary care physician would be the first to let them know, "Hey, I'm thinking about trying this new exercise routine, and this is why I want to do it. What do you recommend?" You can also contact a physical therapist such as myself and have the consultation on ‘What is the appropriate intensity that I should be exercising at? How do I track how safe I am? And then individuals such as a dietician or a strength coach or an occupational therapist even, to be able to track am I doing this in the most safe way?

Alyne: And part of that safety is to understand your vital signs, so you don't, for example, get your heart rate up too fast.

Brett Gervais: One of the easiest ways to try to understand how hard your heart is working when you're exercising is finding your heart rate maximum. So if you take 220, then you subtract your age, that's going to give you your heart rate max. So that's how many times your heart is beating in a given minute.

And so let's say you're 50 years old, two hundred twenty minus 50 will give you 170. So 170 beats per minute, that would be the heart rate max, meaning if I'm running on the treadmill and my heart is beating 170 times in a minute, that's how I know I'm working maximally. That's about as hard as I should push myself and I should probably hop off the treadmill and start to cool down a little bit.

Now what the American Heart Association will recommend is exercising at a range, so 50 to 85% of that heart rate max. So for instance, if we take that 50-year-old individual, their heart rate max is 170, 50 to 85% of that would be about 85 to 145 beats per minute. So how you're going to be able to tell this, it could be as easy as just putting your fingers on your wrist. Usually, the thumb side of your wrist, you're able to feel a little bit of a pulse there. Otherwise, gently on the side of your neck, you can feel a pulse. Or if you don't know, you can always acquire a watch or a heart rate monitor, something of that sort to be able to tell electronically.

So if you're going to do it manually, what you'll do is you'll put your hand on the side of your wrist. So the palm side of your wrist on the thumb side, if you can feel your pulse there, otherwise on the side of your neck and a simple way to do it is just count how many times your heartbeats in 15 seconds. If it beats 10 times in 15 seconds, you take that you multiply by four. So that would be 40 beats per minute at rest.

So the resting heart rate is a good indicator of your cardiovascular function. So individuals that have a lower resting heart rate, it's a better indicator that they have good heart function, and they're going to do better with exercise. The normal range is 60 to a hundred. So it's okay if you have a little bit of a higher resting heart rate. um, but it's just important to understand where that lies in your heart rate max once you do 220 minus your age. So that's the easy way to be able to track your heart rate and kind of understand when you're exercising, if you want to see how hard you're working or how hard your heart is working to track that.

Alyne: Are there any other vital signs we should be aware of?

Brett Gervais: Yeah. other vital signs would be, you know, your respiratory rate. So how hard are you breathing? So let's say you're on the treadmill. you feel like you're really working hard, but your heart rate really isn't up, your heart rate is still saying-- you know, say it's at 80 at rest and it's only at 85 when you're on the treadmill. If you're breathing very hard, that's a good indicator that you're working hard and maybe you should slow down. Another indicator would be your blood pressure. Typically your blood pressure, you can take a blood pressure cuff and get that. You obviously know if you check up with your doctor regularly, they'll give you an indication if you're hypertensive or not where that lies.

If you do track blood pressure while you're exercising, let's say you might have a history of a stent placement in your heart or any type of cardiac surgery, if you're monitoring that it's normal for the top number, so your systolic blood pressure to go up to a certain extent. If it's going up above 220, you're likely pushing your heart a little bit too hard. And then the bottom number, it really shouldn't change all that much. So we often think of our normal blood pressure as 120/80 or less than that being a normal range. If your blood pressure is increasing over 220/95 or 100, that bottom number is changing, that's likely an indication that your heart is not functioning appropriately and you should maybe talk to your doctor about why that's changing. And then your systolic blood pressure, the top number, is also increasing a little bit too much, so maybe you're pushing yourself a little bit too hard.

Alyne: So finally, Brett, let's talk for a minute about how one would plan to progress and also the importance of recovery.

Brett Gervais: Sure. The progression, um, as I said, usually about a month in time you'll figure out that you're either getting bored of an exercise or you're growing and you're feeling that you can actually do a little bit more resistance or you can change an exercise or add an exercise. So I like to progress my workouts slowly. They evolve over time. So I'm doing, exercises A, B and C. Well, after about a month, I'll maybe add five pounds of weight onto exercise A and then I'll leave B and C the same. And then after that, I'll add on a little bit of weight on exercise B. And then maybe after that, I'll add on exercise D. Now I have A through D. And then after that, I'll get rid of A altogether and I'll put another exercise in there. So I slowly evolve into-- in three months time, it looks like a completely different workout.

And then other ways to progress, you never want to put too much resistance on the bar or whatever you're using for resistance, even if it's a resistance band. You don't want to perform one exercise at a certain resistance and then progress that by more than 15, 20 pounds at a time. Five pounds, 10 pounds, maybe at a time and see how your body responds to that. You want to ensure that you're doing exercises appropriately with the perfect form before you add more weight and more resistance, because doing that-- well, in the short-term, it might seem like it's going to benefit you more, it's really just going to make your form a lot worse and then make you more injury-prone later on when you've progressed that exercise regimen.

And then the importance of recovery, as I said before, when you're exercising, you're causing damage in your body, so you're causing your muscles to have to work. And then once they're done working, that's where you feel that soreness. You feel like you've done damage to the muscles. They feel a little bit puffy. um, you feel tired, you feel like you have less energy. That's when recovery is essential.

The three pillars of health, our nutrition, our exercise habits and our sleep. So the nutrition and the sleep really comes into play after you're done with that exercise, making sure you're eating the adequate amount of protein to rebuild that muscle, keeping your carbohydrate intake appropriate so that you have energy for the next workout. And then having an adequate amount of sleep so that you're recovering fully so that you're not getting into the next exercise regimen already feeling tired, already feeling lackluster and, um, having a more injury-prone muscle tissue.

Alyne: And I'm sure that you also would recommend that we keep notes in some fashion of what we've done so we can look back and go, "Wow, I did it all week this week."

Brett Gervais: Sure. And it's become easy now with smartphones to be able to track what you're doing. Even if you wanted to track to the very single calorie of what you've eaten, you could do that with your smartphone now, you just type in the food that you ate.

But especially with activity, it holds you accountable. So having a written record or a typed up record of what you're going to do, it helps you progress appropriately. So you say, "Okay, I walked a half a mile last Monday, but I only walked a quarter of a mile on Wednesday." So you don't have to go back and think about it. You can just see what's written down and then you can appropriately keep track of where you're going to go and how close you are to achieving your goals.

Alyne: Thank you very much. uh, Brett. It's very inspirational. I really appreciate it.

Brett Gervais: Yeah, thanks a lot for having me.

Alyne: Brett Gervais is a physical therapist at Aspirus Keweenaw Outpatient Therapies and Fitness. Find more information and podcast episodes at Aspirus.org. And if you enjoyed this episode, please subscribe and share it.

This has been Aspirus Health Talk. I'm Alyne Ellis. Stay well.

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