Chapter 4 Endurance Exercises Strength Exercises Balance Exercises Stretching Exercises Chapter Summary Personal Testimony: Making It Work

A lot of different physical activities can improve your health and independence. Whether you choose to do the at-home exercises shown in this chapter or other activities that accomplish the same goals, gradually work your way up to include all four areas of fitness shown here: endurance, strength, balance, and stretching. Here are some points to keep in mind as you begin increasing your activity:

If you stop exercising for several weeks and then return, start out at about half the effort you were putting into it when you stopped, then gradually build back up. Some of the effects of endurance and muscle-building exercises deteriorate within 2 weeks if these activities are cut back substantially, and benefits may disappear altogether if they aren't done for 2 to 8 months.

When an exercise calls for you to bend forward, bend from the hips, not the waist. If you keep your entire back and shoulders straight as you bend forward, that will help ensure that you are bending the right way, from the hips. If you find your back or shoulders humping in any spot as you bend forward, that's a sign that you are bending incorrectly, from the waist. Bending from the waist may cause spine fractures in some people with osteoporosis.

It's possible to combine exercises. For example, regular stair-climbing sessions improve endurance and strengthen leg muscles at the same time.

Sample charts for recording your activities are at the end of this book.

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When you first start out, you might have trouble keeping up with even the minimum amount of exercise we suggest in the first chart below. Start out with a schedule that your body can tolerate and that you think you really can manage, and build up from there.

Note that the schedules are arranged so that you are never doing strength exercises of the same muscle groups on any two days in a row. If you want to do strength exercises every day, alternate muscle groups. For example, do strength exercises of your upper-body muscles on Monday, Wednesday, and Friday and of your lower-body muscles on Tuesday, Thursday, and Saturday. Or you can do strength exercises of all your muscle groups up to every other day.

Begin exercising gradually. Once you have worked your way up to a regular schedule...

...get at least this much exercise each week:

Sunday	Monday	Tuesday	Wednesday	Thursday	Friday	Saturday
Stretching	Endurance	Strength/Balance, all muscle groups	Endurance   Stretching	Strength/Balance, all muscle groups	Endurance	Stretching

...or

...you can exercise up to this often each week (more than this could cause injuries):

Sunday	Monday	Tuesday	Wednesday	Thursday	Friday	Saturday
Endurance Stretching Anytime, Anywhere balance	Endurance Strength/ balance, upper body Stretching Anytime, Anywhere balance	Endurance Strength/ balance, upper body Stretching Anytime, Anywhere balance	Endurance Strength/ balance, upper body Stretching Anytime, Anywhere balance	Endurance Strength/ balance, upper body Stretching Anytime, Anywhere balance	Endurance Strength/ balance, upper body Stretching Anytime, Anywhere balance	Endurance Strength/ balance, upper body Stretching Anytime, Anywhere balance

We can, however, provide some advice based on scientific research: Listen to your body. The level of effort you feel you are putting into an activity is likely to agree with what actual physical measurements would show, researchers have found. In other words, if your body tells you that the exercise you are doing is moderate, measurements of things like how hard your heart is working would probably show that it really is working at a moderate level. During moderate activity, for instance, you can sense that you are challenging yourself but that you aren't near your limit.

One way you can estimate how hard to work is by using something called the Borg scale, shown to the right. It was named after Gunnar Borg, the scientist who developed it. The numbers on the left of the scale don't indicate how many times or how many minutes you should do an activity; they are just a way of helping you describe how hard you feel you are working.

For endurance activities, you should gradually work your way up to level 13 - the feeling that you are working at a somewhat hard level. Some people might feel that way when they are walking on flat ground; others might feel that way when they are jogging up a hill. Both are right. Only you know how hard your exercise feels to you.

Strength exercises are higher on the Borg scale. Gradually work your way up to level 15 to 17 - hard to very hard - to build muscle effectively. You can tell how hard an effort you are making by comparing it to your maximum effort. How hard does your current effort feel compared to when you are lifting the heaviest weight you can lift? Once you start exerting more than a moderate amount of effort in your muscle-building exercises, your strength is likely to increase quickly.

As your body adapts and you become more fit, you can gradually keep making your activities more challenging. You might find, for example, that walking on a flat surface used to make you feel like you were working at level 13 on the Borg scale, but that now you have to walk up a mild hill to make you feel like you are working at level 13. Later, you might find that you need to walk up an even steeper slope to feel that you are working at level 13.

The Borg scale is simple to use. But if you feel that your level of effort doesn't match the numbers you see on the Borg scale - for example, if you feel you are doing the exercises correctly, but you aren't progressing or you feel exhausted by your effort - check with the kinds of exercise professionals described in Chapter 3 (under "Finding a Qualified Fitness Professional"). These experts are likely to understand the science that went into developing the Borg scale, and they can teach you how to match your level of effort with the right number on the scale.