Health Society of South Africa

FITNESS AND HEART DISEASE
Improving your health with exercise

An Active Lifestyle for a Healthy Heart

Your doctor says that exercise can improve your heart health. Even though you have heart trouble, adopting an active lifestyle that includes regular exercise is important. In fact, it is one of your links to a healthy, enjoyable future. To begin, read this information. It explains how to get started and how to keep exercising for a lifetime.

Are You Thinking About Exercise?
If you're thinking about exercise, you're on the right track. Learning more about the rewards of being active may help you get started. And wanting a better life for yourself may help you make exercise part of your daily routine.

Overcoming Your Hurdles
Starting an exercise programme may seem like a big goal. But you can build up your goal slowly. If this is the first time you will be exercising routinely, know that it can be fun. The goal is to choose an activity you like. If your days are often hectic, you may need to juggle your schedule. But do make your health a top priority. If you don't plan to exercise soon, ask yourself why.

Exercise is Good for You

Exercising regularly offers many healthy rewards. It can help you:

Improve your cholesterol levels to help prevent further heart trouble
Lower your blood pressure to help prevent a stroke or heart attack
Control diabetes, or reduce your risk of getting this disease
Improve your heart and lung function
Reach and maintain a healthy weight
Make your muscles stronger and more limber so you can stay active
Prevent falls and fractures by slowing the loss of bone mass (osteoporosis)
Manage stress better

Exercise Feels Good Too
Exercise isn't just good for your body. It can also help you enjoy a better life. People who have started exercising and have kept it up say they feel:

Better about themselves
More upbeat about life
More energetic
More relaxed

For Family and Friends
Tell your loved one that you care about his or her health.
Talk about why exercise is healthy.
Join an exercise programme with your loved one. You, too, can reap the rewards of being active.

Before Getting Started

Before you start exercising, your health care provider may advise you to have an exercise stress test. This test shows how your body responds to exercise. Your exercise stress test may be done on a treadmill (a moving platform you walk on) or on an exercise bike. You may also have other special cardiac tests. Based on these results, you and your health care provider can plan an exercise programme that is safe and effective.

Questions You May Have About Exercise
Talk with your health care provider before starting your exercise programme. Be sure to mention all of your concerns and questions. Below are some questions people with heart disease often ask about exercise.

Is an exercise programme safe for my heart?
Exercise can help your heart in many ways. If you have safety concerns, ask whether you should have an exercise stress test.

How will I know my exercise programme is helping me?
You should be able to exercise longer with less effort. And your heart rate may be lower than it used to be at any level of effort.

What should I do if my heart beats too fast, too slow or irregularly during exercise? What if I feel pain or discomfort in my chest, neck, back or arms (angina)? Or, what if I have unusual shortness of breath?
Stop exercising right away and call your health care provider.

Ensuring Your Safety and Comfort

If you feel safe and comfortable while exercising, you are more likely to enjoy your workouts. You also have a better chance of maintaining your exercise programme. Following the guidelines below can help ensure your safety and comfort. If you have any questions, be sure to ask your health care provider.

Dressing Right for Exercise
When dressing for exercise, it's best to wear loose-fitting clothes. Put on layers, so you can take something off if you get hot. Always wear shoes that fit well and are designed for exercise. When it's cool outside, wear a hat to retain your body heat. Protect your eyes and skin from sun with a wide brimmed hat or visor and sunscreen.

Exercising Safely
Following a few guidelines can help you exercise safely. Exercise indoors on hot, cold, humid or windy days or when the air outdoors is polluted. You can do this at a shopping mall or community gym. Drink plenty of water before and after exercise. And take frequent breaks for water during exercise. If you take medication for angina, always carry it with you.

If You Have Diabetes
Talk with your health care provider before starting an exercise programme.
Eat 1 to 2 hours before exercise. Carry glucose tablets or a snack. If you have low blood sugar symptoms, take the tablets or eat your snack.
Carry a medical ID card or wear a medical alert bracelet that says you have diabetes.
Check your blood sugar before and after exercise. Don't exercise if your blood sugar is above 240.
Wear shoes that fit well and seamless cotton socks.
After exercise, check your feet for sores, blisters and spots that are red and tender.

Becoming Active Step by Step

To get fit, you don't need to become an athlete. But you do need a certain amount of exercise to improve your heart health. Aim to get at least 30 minutes of brisk exercise on most or, ideally, all days of the week. As you may be just starting out, you can build up to this goal slowly. If you stick with your goal, you're bound to succeed.

Take It One Step at a Time
You may have been active before your heart trouble. Or, perhaps this is the first time you've started an exercise programme. In either case, ease into your routine. Set small goals, then build on them. In time you will be doing enough exercise to improve your heart health.

Make Exercise a Daily Habit
You will reap the most rewards if you exercise at least 30 minutes a day. This takes about the same amount of time as watching a TV show or going to the market. You don't have to complete your whole exercise programme at once. You can also reach your goal by exercising for 10 minutes, 3 times a day.

Step Up Your Activity Level
Besides doing your exercise programme, try being more active throughout the day. This will help you reach your goals. Start by moving more during your daily routines. When doing errands, walk as much as you can. Take on more household tasks or yard work. For fun, chat with a friend while on a walk, rather than on the phone. Visit a local park or go out dancing instead of watching TV.

The Right Kind of Exercise

The right kind of exercise can improve how well your heart functions. You need to move at a brisk pace so your heart will beat faster. Moving this way will cause you to breath harder, you may break into a sweat. Exercise should fit your lifestyle, too. It should be safe, fun and comfortable for you. And it should fit your budget and schedule.

Picking Your Best Options
What kind of exercise you do is up to you. Swimming, walking and riding a bike can all improve how well your heart functions. So can many group fitness classes or exercise videos. But what also matters is that your activity should work for you. Do activities that you enjoy. For a change of pace, mix and match activities from day to day. Ask your health care provider what options may be best for you.

Why Walking Works
Walking works for most people. All it takes is a pair of sturdy, well-fitting walking shoes. Be sure to start with small goals, like walking 10 minutes a day. Then build up to a least 30 minutes a day. If you choose walking, ask your health care provider for advice.

What's in an exercise programme?

Whatever kind of exercise you choose, you will need to make it part of a regular routine. Exercise on most or, ideally, all days of the week. Your routine should include a warm-up, moderate intensity (brisk) exercise and a cool down session. You should also add muscle strengthening exercises to your routine 2 to 3 days a week.

Start With a Warm-up
Start with a 10 to 15 minute warm-up that includes both stretching and your chosen exercise. Warming up raises your heart rate slowly and loosens your muscles. Exercise at a very slow to slow pace for at least 5 minutes. And stretch for at least 5 minutes.

Get Your Heart Going
Moderate-intensity exercise does the most good for your heart. Exercise at a brisk pace. At first, 10 minutes may be all you can do. In time, you should be able to exercise at least 30 minutes a day. After this part of your routine, be sure to cool down.

Cool Down and Stretch
Cooling down lowers your heart rate and blood pressure slowly. This helps to keep you from getting light-headed. Cooling down also helps you recover from exercise. Do your chosen exercise at a very slow pace for 5 to 7 minutes. Then stretch your muscles for 5 to 7 minutes.

Strengthen your muscles
Besides making your muscles stronger, strength exercises can improve your heart health. Stronger muscles help keep your heart rate and blood pressure from rising too much when you do lifting tasks, such as carrying groceries. Your heart is then under less stress when you do these kinds of tasks. Do your strength exercises at the end of your routine, right before you stretch.

Learning to Pace Yourself

Moving briskly can improve your heart health, but don't overdo it. To strike the right balance, learn to judge how hard you are exercising. Pace yourself by using the talk test, checking your pulse (heart rate) or doing both. Ask your health care provider which method is best for you.

Using the Talk Test
The talk test can help you find out how hard you're exercising. Try talking during moderate intensity exercise. You should be able to carry on a conversation without slowing down your exercise. If you are too out of breath to talk comfortably, you're likely exercising to hard. Slow down, and find a pace that lets you talk with less effort.

Checking Your Pulse
Check your pulse before, during and after exercise. This is a good way to rate your effort. To check your pulse, gently press your index and middle fingers against the inside of your wrist. Count the number of beats you feel for 10 seconds. Then multiply that by 6. Ask your health care provider what your pulse should be during exercise.

Stop Exercising and Call Your Doctor if You:
Have chest pain
Feel burning, tightness, pressure or heaviness in your chest, back or arms
Have unusual shortness of breath
Have a pulse that is much faster or slower than expected
Feel dizzy or light-headed
Have increased joint pain
Have increased muscle pain
Don't exercise on days when you are ill or if you forget to take your medications.

Stretching Your Muscles

Stretching your muscles loosens them up. This may protect them from injury. During the warm up, stretching prepares your muscles for exercise. As you cool down, stretching lengthens and relaxes them. Try to do most or all of the stretches below each time you exercise. When you stretch one arm or leg, always repeat the stretch with the other arm or leg. If you've had recent heart surgery, talk with your health care provider first.

Head tilt
Sit or stand with your shoulders relaxed.
Slowly lower your chin until you feel a stretch in the back of your neck.

Shoulder rolls
Stand with your shoulders relaxed.
Put your hands on your hips.
Slowly roll your shoulders forward 4 to 6 times.
Roll you shoulders backward 4 to 6 times.

Chest stretch
Stand with your right arm and side next to a wall.
Place your right hand on the wall at chest level.
Slowly turn your upper body away from the wall. Feel the stretch in your chest and arm.

Triceps stretch
Sit or stand.
Using your left arm and hand, reach for your shoulder blades.
Use your right hand to press your left elbow downwards. Feel the stretch in the back of your left upper arm (triceps).

Calf stretch
Stand facing a wall. Put both hands on the wall.
Step back with your left foot. (Keep your toes pointed forward and your right knee slightly bent).
Lean into the wall, keeping your back heel on the floor. Feel the stretch in the back of your lower leg (calf).

Quadriceps stretch
Stand beside a sturdy chair. Hold the back of the chair for balance.
With your other hand, grasp the top of the foot or ankle that is furthest from the chair. Keep your knee pointed toward the floor. Feel the stretch in the front of your thigh (quadriceps).

Back stretch
Lie on your back on a mat with your legs extended.
Bring one knee toward your chest and grasp your leg behind the bent knee. (Keep the other knee slightly bent). Feel the stretch in your lower back, buttocks and the back of your thigh (hamstring).

Hamstring stretch
Lie on your back on a mat with your knees bent and your feet flat.
Using both hands, slowly bring one knee toward your chest.
Grasp your calf or your thigh. Slowly straighten your raised leg until you feel a stretch in the back of your thigh (hamstring).

Helpful hints for stretching
Stay relaxed and breathe normally when you stretch. Don't hold your breath.
When stretching, you should feel a gentle pull on the muscles being exercised. Avoid jerking movements. If you feel any pain, stop stretching.
Hold each stretch (except the shoulder rolls) for 10 to 20 seconds.

Building Up Strength

Strength exercises can make your muscles stronger. These exercises can also help control your weight. And they can help keep your bones strong. To get these results, do the exercises below 2 or 3 times a week, right before you stretch. Repeat each exercise 10 to 15 times. Talk with your health care provider before trying these exercises. Be sure to ask what hand weights are right for you.

Chest press
Lie on a bench or mat with your knees bent and your feet flat. With your arms bent, hold a weight in each hand.
Exhale and slowly press the weights toward the ceiling until your arms are almost straight.
Inhale and slowly lower the weights to the starting position.

Shoulder press
Stand while holding a weight in each hand at shoulder level. Your palms should face forward.
Exhale and slowly press the weights toward the ceiling until your arms are almost straight.
Inhale and slowly lower the weights to shoulder level.

Abdominal curl
Lie on your back on a mat with your knees bent and your feet flat. Gaze up at the ceiling. Cross your arms and rest them on your chest.
Squeeze in your stomach (abdominal) muscles. Exhale and slowly lift your head and shoulders off the mat.
Inhale. Slowly return to the starting position.

Biceps curl
Stand with a weight in each hand. Keep your arms straight, palms facing forward.
Exhale and slowly bend your arms, lifting the weights to shoulder level.
Inhale and slowly lower the weights to the starting position.

Tracking Your Progress

Once you've started exercising, track your progress. You can do this by keeping an exercise log. Seeing what progress you've made in your programme can help to keep you going. It can also help you change your programme to better fit your lifestyle.

Using Your Exercise Log
Use your exercise log daily. Even noting that you didn't exercise - and why you didn't - can help you track your progress. Complete each part of the log to learn what feels right to you, or what doesn't.
For instance, exercising too hard one day may leave you feeling tired the next day.
Finally, be sure to read through your exercise log to see how far you've come.

Rewarding Yourself

You'll soon start reaping the rewards of exercise. You may be able to do your exercise routine more easily. In a check up, you may learn that your blood pressure has improved. Or, you may simply feel better.
Reward yourself each time you reach a goal. This will help you stay with your programme. And rewarding yourself will add fun to your life.

Choosing Healthy Rewards
Reward yourself for exercising daily or for reaching new goals. You can start by patting yourself on the back. Then try some of these rewards:

Visit an art museum with friends.
Go bowling or fishing.
Take an active vacation.
Shop for new books or music.

Now think of some rewards to give to yourself. Try choose healthy rewards. List your ideas and don't forget to use them. You deserve rewards.

For family and friends
Think of ways to reward your loved one for his/her progress.
Choose healthy rewards.
Plan activities with your loved one that you'll both enjoy.
Always offer your support. It is one of the best rewards you can give.

Staying Fit for Life

Exercise is one the best things you can do for yourself each day. But it is not always easy to do, as obstacles can get in the way. Keep in mind that exercise is your link to a healthy future. This may help you overcome your obstacles. Follow the tips below to keep to your programme and stay fit for life.

Keeping on Track
Once in a while you may miss your workout. This doesn't mean you've failed. If you return to your exercise programme in a few days you won't lose any of it's healthy rewards. These tips may help:
To make exercise a habit, do your routine the same time each day.
When you are busy, plan ahead for your exercise. That way you're less likely to miss a workout.
If you are often sore or tired, you may be exercising too hard. Try doing lighter exercise for a few days.
Be active whenever you can. For instance, when you travel, try walking to see the sights.
Make exercise fun. Do you routine with a friend or listen to music while you exercise.

For family and friends
Know that you can help your loved one stay on track with exercise.
Think active and be active together.
Help your loved one keep up the exercise spirit during stressful or busy times.
Make time for exercise, even if this means changing your schedule.

Helpful Resources

By reading this information, you've started on the road to better health. For fitness classes or a place to exercise, call a local hospital about any cardiac rehabilitation programmes in your area. Or try a recreation or community centre.