Brunilda Nazario, MD
The hardest part of starting an exercise program is, well ... getting started. This can be an especially daunting task if you have osteoarthritis (OA), the wear-and-tear form of arthritis which causes joint pain and loss of function for 27 million Americans.
But "the more you move, the better you will feel," promises Laura Thorp, PhD, an OA researcher at Rush University Medical Center in Chicago.
"Walking is an easy way to get started and it can help you lose weight," she says. OA and obesity tend to travel together, and excess weight puts extra stress on your already creaky joints. Modest weight loss can help relieve your pain and restore function in your joints.
To make your challenge less daunting, WebMD devised this new, expert-approved, step-by-step, six-week walking program.
Step 1. Get medical clearance from your doctor. Do not pass go without it, says Thorp. "Never start an exercise program without talking to your doctor first, especially if you have been sedentary," she cautions.
Step 2. Seek guidance from a certified exercise trainer or a physical therapist, Thorpe says. If you are a couch potato by nature, a physical therapist can help design your walking program. He or she can also help you with your walking posture and teach you how to target the correct muscles when you warm up and cool down. If you are a more seasoned current or former exerciser, you can bypass this step.
Step 3. Start slowly. "If you are going to start an exercise or walking program and go full-force into it, you will get worn out," she says. "Set realistic expectations." Aim for walking three times a week for the first two weeks of this six-week program. "Start gradually and build up to 30 minutes on most days of the week." Keep a walking journal and record your progress. You can include information about how far, how long, and how often you walk.
Step 3a. Break it up. Walking does not have to be done consecutively for it to count. It can be done in brief spurts throughout your day.
Tip: Thirty minutes equals 3,300 steps a day. Consider buying a pedometer or step counter to help you keep tabs of your tracks.
Step 4. Grab a buddy. "Walking can be social," Thorpe says. "People walk in groups or go to the malls," she says. Now that you are a few weeks into the six-week program, you may need some extra motivation to stick with it. "Motivation and compliance are the biggest issue when it comes to engaging in regular exercise. "A walking group is motivating because there is accountability in a group," she says. For weeks three through six, shoot for 30 minutes on most days of the week with your buddy or walking group.
Step 5. Listen to your body. Now that you are walking more frequently and perhaps more vigorously, "there may be times when it's not a good idea to push it," says Michael Parks, MD, an assistant attending orthopaedic surgeon at the Hospital for Special Surgery in New York City. "Know your limits."
Step 6. Kick it up a notch. Once your daily walks have become a part of your routine, it's time to step things up. "Push it and go a little faster and a little longer," says Kevin D. Plancher, MD, an orthopaedic surgeon in New York City and Cos Cob, Conn., and associate clinical professor in orthopaedics at Albert Einstein College of Medicine in the Bronx, N.Y. This is good for your joints and your cardiovascular health. "The more you walk, and the faster you walk, the more you are building up the muscles around your damaged joints," he says. "We know if you can tone up certain muscles of the leg you can make a difference in the progression of your OA."
Tip: Increase the intensity by knowing and monitoring your heart rate. Here's how: Check your pulse periodically to make sure you are within your target heart rate, which is 50% to 75% of your maximum heart rate. This can be found by subtracting your age from 220. If you are 60, your maximum heart rate is 160, for example. When you start a walking program, aim for 50%. If you have been walking for some time, try to reach 75%.
SOURCES:Kevin D. Plancher, MD, orthopaedic surgeon, New York City and Cos Cob, Conn.Michael Parks, MD, assistant attending orthopaedic surgeon, Hospital for Special Surgery, New York City.Laura Thorp, PhD, assistant professor, anatomy and cell biology, Rush University Medical Center, Chicago.American Heart Association web site: "Target Heart Rates."
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