Training With An Illness

Depression (major depressive disorder) is a common and serious mental disorder that negatively affects how you feel, think, act, and perceive the world.  Nearly three in ten adults (29%) have been diagnosed with depression at some point in their lives and about 18% are currently experiencing depression, according to a 2023 national survey.  "In people who are depressed, neuroscientists have noticed that the hippocampus in the brain—the region that helps regulate mood—is smaller. Exercise supports nerve cell growth in the hippocampus, improving nerve cell connections, which helps relieve depression," explains Dr. Miller of Harvard Medical School and Harvard Health Publishing.  When starting an exercise program, start out small with things like walking, jogging, yoga and some strength training.  First consult your doctor before starting any exercise program.

Regular exercise helps people with diabetes, especially with Type II.  For those recently diagnosed, glucose should be measured before, during and after exercise.  Keep a snack handy while exercising to avoid sudden hypoglycemia.  Avoid excessive plyometric (jumping) exercises and higher intensity training is not recommended.  Self-myofascial (rolling) techniques should have a doctor's approval first.

Hypertension is a condition in which the force of the blood against the artery walls is too high.

Usually hypertension is defined as blood pressure above 140/90, and is considered severe if the pressure is above 180/120. Exercise can help lower your blood pressure.  Low to moderate intensity cardio exercise has been shown to be just as effective as high intensity exercise in reducing blood pressure.   

Supine or prone positions (especially when the head is lower in elevation than the heart can often increase blood pressure, so focus on exercises where you are standing or seated.  Avoid heavy lifting or clinching weights too tight.  Also, the Valsalva Maneuver (a forceful attempt of exhalation against a closed airway, usually done by closing one's mouth and pinching one's nose shut while expelling air, as if blowing up a balloon.should be minimized) should be avoided.  Remember to consult your physician before starting any exercise training program.

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When exercising use the Peripheral Heart Action (PHA) method which is alternating between upper and lower body exercises.  By switching between upper and lower body work with minimal rest, this system helps maximize blood flow, increases calorie expenditure, and builds both muscular and cardiovascular endurance. 

The safe upper limit of exercise, preferably by heart rate, must be obtained.  The exercise should be low intensity to start.  Aerobic exercise should be 20-30 minutes at 40-85% of maximal capacity but below the safe upper limits prescribed by a physician.  Resistance training may be started after doing aerobic exercise comfortably for 3 months.  When starting a resistance training program, including static and active stretching and core exercises, it should be in a seated or standing position.  And, always consult your physician before starting any exercise training program.

Resistance training helps build bone density.  Include movement exercises such as multiplanar movements, lunges and plyometric. The eccentric (lowering) portion of the lift is just as important as the concentric portion.  The weight you lift is also more important than number of reps but you must start slowly with light weights and the proper form.  Exercise should be limited to 20-30 minutes per session with low intensity resistance training and balance exercises.  Focus on hips, thighs, back and arms.  Avoid excessive spinal loading on squat and leg press machines and avoid spinal flexion or twisting at the waist, such as Russian twists.  For those with severe osteoporosis, exercise should be shifted to walking, light resistance band and water exercises.

Focus on flexibility, pushing and pulling exercises.  Use low to moderate intensity for no more than 30 minutes, 3-5 days a week.  Treadmill walking, cycling, rowers and low impact aerobics are acceptable.  Use low to moderate loads when lifting, and avoid high reps, except with light weight may be acceptable.

People with lung disease experience fatigue at low levels of exercise and should proceed cautiously. Workloads of 40-60% of peak work capacity, 3-5 days a week for 20-30 minutes.  Circuit training in a PHA format is recommended (8-10 exercises, 1 set of each exercise for 8-15 reps, emphasizing breathing control and rest between sets as needed.  Treadmill walking, stationary cycling, steppers and elliptical trainers are okay.  Pushing and pulling are okay if tolerated, but upper body exercises cause increased dyspnea and must be monitored.  A good focus is lower body exercises such as walking, static and active stretching.  Always consult your physician before starting any exercise program.

There is no one exercise prescription that is right for every person with Parkinson’s. The type of exercise you do depends on your symptoms and challenges. For sedentary people, just getting up and moving is beneficial. More active people can build up to regular, vigorous activity.

Research suggests that people with PD do at least 2.5 hours of exercise every week for a better quality of life.

To help manage the symptoms of PD, be sure your exercise program includes a few key ingredients: aerobic activity, strengthening exercises and stretching. There are many types of exercises you can do to incorporate all three elements, including but not limited to the following:

• Running and walking

• Biking

• Tai chi, yoga, Pilates or dance

• Weight training

• Non-contact boxing

Some exercise programs focus on functional movements – things that are part of daily life, such as walking, standing up or lifting and reaching for objects. Researchers are also studying the impact of novelty: trying something new. When you begin a new activity, your brain – not just your muscles – learns the movements. So be creative, and vary your routine: exercise indoors and outside, by yourself, in a class setting, or one-on-one with a trainer or physical therapist. Just be sure to get guidance from your healthcare team.

If you’re just starting an exercise program, build up to the recommended 30 minutes of exercise five times a week. For example, walk for 10 minutes three times a day instead of one 30-minute walk (Parkinson's Foundation).

According to Steadiwear, a company specializing in revolutionary gloves for tremors, awareness, education and support states exercise can help with hand tremors by improving steadiness and reducing muscle tension.  Exercise can also improve cognitive impairment and neurological capacity.  Check with your doctor first before starting any exercises.  Some exercises that might help include:

• Resistance Training such as push-ups, planks, shoulder shrugs and bicep curls

• Yoga

• Wrist exercises

• Finger Tap (tapping the index finger to the thumb on both hands)

• Finger Bend (bending your fingers on a flat surface

• Tight Fist (clenching and unclenching your fists, or using a stress ball).  Hold tightly for five seconds, release and repeat 10 times.

• Resistance Bands such as holding a resistance band with both hands and pull it apart, stretching the band across your chest.

Proper nutrition can have a positive effect on tremors.  Vitamin B-12 supports nerve health. Found in meat and dairy.  Omega-3 Fatty Acids.  Support brain health and reduce inflammation.  Found in fatty fish, flaxseeds and walnuts.  Magnesium helps relax muscles.  Found in leafy greens, nuts and seeds.