For people who are really out of shape, the best way to start exercising is walking. For elderly, frail people any walking is good. The important thing is to just get moving. For the frail, elderly, walking does improve muscle strength in the lower extremity, the hips and legs. It helps with muscle co-ordination and balance and as long as you are careful, will help decrease fall risk.
These are all important goals for older adults. Studies have shown that about 25% of people over 65 fall every year. Falling once doubles your risk of falling again. One out of every five falls results in a serious injury such as a broken bone or a head injury. Each year 3 million older Americans are treated in an emergency room for fall injuries. Over 800,000 patients a year are hospitalized because of a fall injury with over 300,000 hospitalized for hip fractures. Falls are the most common cause of traumatic brain injury. In 2015 the total medical costs of falls totaled more than 50 billion dollars with Medicare and Medicaid carrying 75% of these costs. These statistics were all pulled from the CDC website. I will talk more about falls and fall prevention in later episodes so stay tuned.
For those of you who would not be considered frail there are some requirements to walking. First of all when I say walking, I am not talking about casual window shopping walking. Yes that is better than sitting on your sofa watching television, but it will not help your fitness much. I am really, really sorry to tell you this, but despite what you may hear or see in ads, to get fit and lose weight, you need to sweat and get short of breath. If you can walk and carry on a nonstop conversation, you need to pick up the pace. There are two ways to make sure your pace and effort are sufficient. One is to check your heart rate. Now we need to do a little math. Ah, you didn’t know math was involved. Sorry. Take the number 220 and subtract your age. This is your maximum heart rate. (MHR). Now take 75-85% of that number. That is your target heart range. For example, a 60 year old person. 220-60=160. 75% is 120. 85% is 136, so that person would want a heart rate of 120-136 when exercising to help their heart get stronger.
The second way is called the perceived level of exertion method. You should be able to carry on a conversation, but should feel fairly short of breath. If you can talk nonstop speed up. If you can’t complete a sentence without pausing to catch your breath, slow down. As you get in better shape you will find you can eventually do more and maintain the same heart rate or perceived level of exertion. The is the training effect.
Secondly, it is important to remember that for the most part, unless you walk for long periods, like over an hour, walking will not do much to build muscle. Yes it will help some for hip and leg muscles, more so if you walk hills or stairs, or you walks trails where you are going up and down hills and climbing on rocks. But please, don’t start out walking trails. It can be dangerous if your legs are not used to it or if you have balance issues. Work your way up to trails.
Once you have established a walking program, you can increase the amount of calories you burn in one of three ways. You can increase the speed and distance you walk. You can invest in a weighted vest or carry a back pack with a weight not greater than 15% of your body weight. This will greatly increase the number of calories you burn while walking. The third way is to invest in a set of walking poles. Walking poles mimic the action of cross country skiing and can help work chest, arms and abdominal muscles and increase calorie burn without increasing injury risk.
One thing I would not recommend is using hand weights. Studies show that they can increase energy expended but at a risk of injury to arms and shoulders.
Wear shoes with good support when walking. I would NOT recommend flip flops or loafers and definitely not heels. Invest in a good pair of walking shoes from an athletic store to prevent foot injury.
That’s about all I have to say regarding walking. Use common sense please. If you develop chest pain or severe shortness of breath, if you get dizzy or light headed, sit down and rest. If you are diabetic check your blood sugar before exercising and take something with you in case your blood sugar drops.
In future episodes I will be talking about many other topics to help you on your road to wellness including how to warm up before exercising, stretching after, body weight exercises, weight training, training with exercise bands, training your core, TaiChi and fall prevention, and many others.
Just remember, anything beats nothing, so get up and so something.
Mike Fedak. The exercise doc