{"id":305,"date":"2024-10-16T21:15:41","date_gmt":"2024-10-16T21:15:41","guid":{"rendered":"https:\/\/test7.samplewebsitelink.com\/parkinsonz\/?p=305"},"modified":"2025-04-02T17:12:29","modified_gmt":"2025-04-02T17:12:29","slug":"break-free-of-the-bubble-wrap-the-case-for-exercise-in-chronic-disease","status":"publish","type":"post","link":"https:\/\/test7.samplewebsitelink.com\/parkinsonz\/break-free-of-the-bubble-wrap-the-case-for-exercise-in-chronic-disease\/","title":{"rendered":"Break free of the bubble wrap: the case for exercise in chronic disease"},"content":{"rendered":"\n

It seems our society has the mantra that as we age we should \u201cbe super careful, don\u2019t do too much, take it easy, you might get hurt.\u201d It\u2019s like we treat the aging as if each year they should be wrapped in another layer of bubble wrap. We as humans are designed to be moving until the very end. We stay at our best by staying as active as possible for as long as possible.
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In fact, in every condition listed below, exercise has been shown to improve long term outcomes and quality of life. Exercise can also play an important role in preventing these conditions in those who don\u2019t have them.<\/p>\n\n\n\n

After my Parkinson\u2019s diagnosis, a physician advised that I not run anymore, because as a person with Parkinson\u2019s disease, I was at risk of falling. While I understand the concern, research shows that exercise can reduce fall risks and improve overall mobility, balance and improve cognitive function.<\/p>\n\n\n\n

Exercise will also make it more likely you will have a faster and easier recovery from setbacks. If you do fall, as you probably will whether or not you exercise, your bones and muscles will be stronger so you will be more likely to bounce back. In addition, the correct exercises can improve balance and posture reducing the likelihood and number of falls in the first place.<\/p>\n\n\n\n

Before starting an exercise program, it\u2019s crucial to consult with a physician to evaluate cardiac risk and discuss ways to exercise aggressively in a safe way<\/strong>. I have been on both sides of this discussion. I understand the physician\u2019s and other caregivers\u2019 desire to \u201cprotect\u201d the patient from injury, but I would argue many physicians are overly conservative. By limiting activity we often allow existing problems to become worse.<\/p>\n\n\n\n

Here are some common reasons a person may think they should not exercise, and some resources to help debunk these myths.

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1. History of Heart Disease:<\/strong><\/h2>\n\n\n\n

Exercise can strengthen the heart and improve cardiovascular health. A physician should assess your specific risks before starting and will recommend increasing intensity and duration gradually over time.<\/strong><\/p>\n\n\n\n

As you begin to exercise more, circulation will be improved to every muscle in your body including the heart. This takes time, which is why it\u2019s a good idea to start with a little bit every day and continue to increase gradually over time. Your physician can help you determine where to start and how quickly you can ramp it up.<\/strong>

Exercise and the Heart \u2013 Johns Hopkins Medicine<\/a>

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2. Brittle Bones (Osteopenia or Osteoporosis)<\/h2>\n\n\n\n

While the risk of injury from falls is higher with low bone density, strength training and balance exercises can improve bone health and reduce fall risks. Safer options like walking on a flat surface, using exercise machines such as a stairmaster or elliptical trainer are recommended. Experts recommend exercises where your bones and muscles carry your weight. Cycling and rowing are safe but you aren\u2019t carrying the weight on your bones and muscles which can help to strengthen them. If you do these combine with other exercises that are load bearing.<\/p>\n\n\n\n

Strength training has also been shown to be beneficial to improve long term health in people with low bone density.<\/p>\n\n\n\n

Exercising with Osteoporosis \u2013 Stay Active Safely<\/a>

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3. History of Diabetes:<\/strong><\/h2>\n\n\n\n

Exercise is critical for those with diabetes, as it enhances circulation and can help prevent complications like non-healing foot ulcers and the need for amputations. Exercise will also help control glucose levels, and reduce the risk of cardiovascular disease and stroke.<\/p>\n\n\n\n

I am an anesthesiologist and I have to take care of entirely too many people with diabetic feet that have gotten so bad they need to be amputated. It\u2019s not pretty.<\/p>\n\n\n\n

Fortunately, these patients usually don\u2019t have a lot of pain because by then the diabetic neuropathy that goes with it, is usually so severe by that point they can\u2019t feel anything in their feet. This in itself puts them as a major fall risk, which is why so many are wheelchair bound for this reason.<\/p>\n\n\n\n

Please do whatever it takes to ensure your glucose levels are well controlled. Tight glucose control means a Hemoglobin A1C level of less than 7%. HbA1c is an indication as how well your glucose has been controlled over the previous 3 months.<\/p>\n\n\n\n

Please, please take good care of your feet, whether you have diabetes or not. Without good feet, pretty much everything is more difficult and more dangerous.<\/p>\n\n\n\n

The Importance of Exercise for Diabetes \u2013 Harvard Health<\/a><\/p>\n\n\n\n

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4. Knee or hip replacements or arthritis:<\/strong><\/h2>\n\n\n\n

After joint replacement surgery, your surgeon and physical therapist will have you do exercises to help your range of motion and strength. After this rehab period it is important to continue to exercise increasing the amount gradually so that you build up the needed strength and circulation.<\/p>\n\n\n\n

You should avoid high impact activities such as jumping or running. There are plenty of good alternatives. These suggestions also apply to those with osteoarthritis in the knee or hip joints.<\/p>\n\n\n\n

How to Get Back to Exercising After Joint Replacement \u2013 Cleveland Clinic<\/a><\/p>\n\n\n\n

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5. Chronic pain:<\/strong><\/h2>\n\n\n\n

While it may seem counterintuitive, exercise and movement can alleviate chronic pain by improving strength, flexibility, and overall function. It will be difficult and uncomfortable at first, but movement is also a great medicine in the management of chronic pain.<\/p>\n\n\n\n

Chronic pain is frequently associated with depression, and in some cases mental health counseling and possibly an anti-depressant medication can help you get in the mindset where you are ready to get moving.<\/p>\n\n\n\n

These two resources are good. The first is geared towards patients, the Stanford resource has a lot of great information and is much more in depth.<\/p>\n\n\n\n