How Hard to Push

It is not uncommon that I am asked about exercise.  Am I working out hard enough? How much is too much?  We have all heard of people who have gone out to exercise and had a heart attack and died. What is one to do?  How should one start and with how much intensity?

First of all, make sure that you meet with your doctor prior to starting an exercise program.  For the vast majority of people it will be quite safe to start exercising without any further testing. There are some patients who will need to make sure that there are no blockages in the heart arteries prior to beginning.  Your doctor will make that judgement.

The best way to start exercising is slowly and gradually.  It is more important to build a habit in the beginning than it is to build muscles and endurance.  The worst thing that can happen is to jump into a program aggressively and get injured.  That will just lead to discouragement, making it even harder to get back into a regular regimen. I would start just three days a week.  It may be for only 5 or 10 minutes.  Every day build it up little by little.  Ultimately, you want to be doing some sort of exercise for 45 minutes at a time, four days a week.  That is the goal.  More is even better.

The intensity with which you work out will vary depending on the activity.  In the beginning, I do not suggest that you track your heart rate.  Again, it is more important to just make the habit of exercising.  Certainly if you feel short or breath or dizzy, stop exercising and check your heart rate.  To calculate your heart rate, count the number of beats in fifteen seconds and multiply that by four.  If you feel your pulse and there are 20 beats in fifteen seconds, your heart rate is 80 beats per minute.  The maximal predicted heart rate for steady cardiovascular exercise can be calculated by subtracting your age from 220 and taking 80% of that.  If someone is 56 years old, 220-56 is 164.  My way of figuring out 80% is to take 10%, double it and subtract it again.  In this case 10% is 16, doubling it is 32; 164-32=132.  This is not a number that if surpassed will lead to immediate death.  It is just a recommendation to keep you at a steady level.  If short burst of exercise raise your heart rate above this level and do not cause dizziness, excessive shortness of breath or chest discomfort, that is acceptable.

If during exercise you start to feel any of the above mentioned symptoms, it is not time to panic.  It is time to stop and let your heart recover.  Lay down so that blood will get to your head.  Get some fluid in you.  Make sure you stay well hydrated during your work out. If you exercise for more than 30 minutes, you need to have a water bottle with you.  If you go for more than 45 minutes, you should add carbohydrates and electrolytes such as a sport drink or energy bar.  If resting for five minutes does not result in feeling better, you should get assistance.  Remember, keep moving but let's make sure to use common sense.