How to Begin an Exercise Program When You Feel Too Bad To Start One

Kit S. Mays, M.D.

Exercise–most of us feel that we should do more of it. For the over 100 million Americans with chronic pain, starting an exercise program can mean the difference between continuing freedom and independence or restriction and limitation on our activities.

Nearly all physicians caring for individuals with chronic pain feel the cornerstone of a rehabilitation program is exercise. Indeed, in many patients, the purpose of using oral medications, nerve blocks, and physical therapy is to get an individual to a point where he can begin to exercise. People who adhere to an exercise program have significantly reduced disability, depression and repeat injuries.

How do you start? Almost anyone can begin an exercise program–witness the great advances in rehabilitation in individuals who have had serious accidents, or have suffered a stroke. Indeed, the most important muscle, the heart, is subject to rehabilitation which is a routine part of treatment after a heart attack or heart surgery.

If you have decided to begin an exercise program, of course, you can! Here are four keys:

  1. Start with an activity you do daily, and start with less than you can do.
  2. Do it everyday.
  3. Advance slowly but relentlessly.
  4. Keep an exercise diary.

Let’s talk about a simple walking program. First, start with less than you can do. Don’t worry about how far you can get. At your normal pace, determine how many minutes you can walk. You may have to do this by simply walking in front of your house. Get a countdown timer. Let’s say that you can walk eight minutes. Divide that in two. Take one minute from it. That would be three minutes. Always walk outside. If you are serious about your walking program, walk everyday. You should walk at least six days a week. Put your timer on three minutes. Leave your house and walk in any direction at any speed that is comfortable. When the timer goes off, turn around and retrace your steps. If you are walking less than ten minute total, you may do so twice a day. If it is cold or rainy out, put on an overcoat. If there is an ice storm or lightning or gunshots, do not go outside. But these are the only things that should keep you in.

Once you have begun your program, if you have an injury or aggravation of your pain that has kept you from walking, cut back a minute on your timer but continue to walk everyday. If you have been unable to walk for five days, it almost always turns out to be a matter of choice. You should drop minutes on your timer and start from there.

When you have mastered walking for the time you originally set, gradually add minutes. When you are comfortable with the increased time, add more. Try to go up by one minute on your timer. Do this on the same day of the week–any week you have walked six days you may increase your timer. Keep going. Don’t stop; don’t give up.

Use an exercise diary as a record of your progress. Every day write down how many minutes you walked and any other notes you may have. Here’s why: When you decide to keep a diary, you become more aware of the effort you are (or are not) putting into your program. Also, you have the pleasure of seeing on paper a progression of your abilities that will encourage you.

Dr. Suzuki, the famous educator whose method has taught very young children to play the violin, has been quoted as saying only to practice on days that you eat. I would gratefully borrow from Dr. Suzuki and tell you only to walk on days that you eat. It is simple. Do not eat until you have done your walking. If you are too busy or too sick to eat for 24 hours, you may take a day off. But if you are too busy to exercise but not too busy to eat; it’s simple. Skip a meal and exercise. It is probably more important to you. After three or four weeks, you will begin to see improvement in your stamina, your steadiness, your coordination, and in your overall energy. You will also lessen the likelihood of a fall.

Remember, you are fighting for your independence. We are talking about changes you must make for the rest of your life–a simple investment in the quality of your life; a simple thing that you can do to improve your health in general.

© Dr. Moacir Schnapp and Dr. Kit Mays