Matching Exercise Components to Goals

For someone who is just starting and whose goal is basic fitness, I suggest placing the greatest emphasis on cardiovascular exercise (as that has the greatest health benefit) while also building some strength and flexibility work into the program (see table 2.1). Note that the warm-up is relatively short on the days when the activity is walking and longer on the days when it is strength training. As you will see in the next chapter, people can even begin with several short sessions, such as a 5-minute walk in the morning, at lunch, and in the evening, if they are unable to tolerate longer walks at the beginning.

SAMPLE OF INITIAL EXERCISE INFORMATION

Date: February 10, 2001     Weight: 145 lbs.

Current activity level: Walking 3 times per week for 15 minutes at a time

Goals:

1. Increase the amount of time I can walk without fatigue.
2. Decrease stiffness in my hands and shoulders so I can get objects out of the upper cupboards.
3. Decrease pain in my knees.
4. Lose 5 pounds.

Baseline assessment:

Walking test: 16:42 time, estimated VO ₂max of 32 (average fitness category) Abdominal strength: 15 sit-ups (poor category) Trunk and shoulder strength: 4 push-ups (very poor category) Sit-and-reach test: 18.5 inches (fair category) Shoulder flexibility: fair category

Objectives from baseline tests:

1. Decrease time for walking test, improving to good fitness category.
2. Improve in both strength categories to fair.
3. Improve flexibility to good category.

Next, look at a program for a golfer whose goals are to walk nine holes of golf without fatigue and to increase his flexibility for playing golf. Because he is already somewhat active (plays some golf), he can start with a slightly more intense level of aerobic activity. In order to follow the principle of specificity, the program sticks to walking. To address the person's flexibility goal, the program increases the flexibility component; it uses some activities specific to golf as well as some general stretches, but emphasizes stretching the shoulders and trunk. See table 2.2.

What if you are already doing regular aerobic activity, but are having problems with pain, stiffness, and loss of motion in your legs? I would suggest these program goals: (1) maintain cardiovascular conditioning,(2) decrease resting pain to 3 on a 10-point scale, and (3) increase hip and knee range of motion (flexion and extension). Remember that strengthening muscles around a joint decreases pain. Therefore, you would design a flexibility program to improve your range of motion, and a strengthening program to build up muscular support around the lower-extremity joints, as exemplified in table 2.3.

When you put together your program, you need to make sure that it fits your needs. We have all seen suggested training programs (usually more elaborate than the previous examples) in magazines or articles. Such programs, however, may not match your goals, abilities, or restrictions. If you have a very busy schedule, you may not have the time or desire for a complex program. That is why it is helpful to understand some of the basic principles and guidelines of exercise; you can design or modify a program to fit your own needs and achieve your personal goals.

I saw a patient many years ago who had started a flexibility program that she found in an article on low back pain, which she was experiencing. She did not know how to personalize the program to her needs, unfortunately, and was seeking help because the program as outlined took more than an hour to complete. With a large, busy family, she was not able to stick with the program, and her back pain had increased. She did not need many of the recommended stretches—the program had stretches for every area of the body—and besides, the recommendations were not in line with underlying research. The program instructed her to hold each stretch for 1 minute, with 10 repetitions of each stretch. As you will see in the chapter on flexibility, this procedure does not follow basic guidelines for stretching. After altering her home program to a few stretches and adding some simple strengthening exercises, she was able to complete her daily program in 15 minutes; this program met her need for a short, simple workout and relieved her low back pain.

I have introduced the basic components and principles of exercise in this chapter and have discussed the need for you to individualize your program. You need to know more specifics about each one, however, in order to tailor your exercise plan effectively. The next chapter focuses on cardiovascular fitness—what it is, what activities stimulate it, and how to design the cardiovascular component of your program.