Exercising With Physical Limitations

Photo: iStock

As Dom Lassonde felt the symptoms of rheumatoid arthritis creep into his body, the 40-year-old Vancouver Islander knew he needed a different way to stay fit. The autoimmune disease inflamed his synovial membranes-a connective tissue in joints that produces lubricating fluid for smooth movement-so much it felt like shards of glass were lining his joints. Ultimate Frisbee and hockey, two of his regular activities, were no longer feasible. 

After beginning a new medication regime about a year after his diagnosis, Lassonde could cycle and swim-activities that put less stress on his joints. He was right to keep moving: according to the American College of Rheumatology, regular aerobic exercise, especially when combined with strength training, can reduce joint pain.

Lassonde is one of many Canadians living with a physical limitation that makes exercise difficult. Two common issues, chronic pain and heart disease-which affect 3.9 million and 1.3 million Can­adians, respectively-make it challenging for individuals to achieve the 150 minutes of weekly moderate aer­obic exercise, or cardio, recommended by the Canadian Physical Activity Guidelines (CPAG). 

But the benefits of regular exercise are too important to pass up. Aerobics-any continuous activity that raises your heart rate and has you breathing rapidly-can lead to a longer life and prevention of Type 2 diabetes, osteoporosis and heart disease.

Physical limitations needn’t prevent you from working out regularly-it’s just a matter of knowing which exercises to do.

Pushing back against pain

Approach new exercise regimes cautiously. “People should never use mobility impairment as a reason not to participate, but they should def­initely seek guidance from a professional to make sure they’re doing it safely,” says Audrey Hicks, a professor of kinesiology at Hamilton’s McMaster University. She advises those experiencing chronic pain to seek out certified physiologists and personal trainers before beginning a new fitness routine.

Instead of jogging, Hicks recommends that people with joint pain or injuries try swimming or water aerobics, or use recumbent elliptical trainers-activities that reduce strain on joints. “You don’t want to do anything that’s going to make your pain worse,” she says. 

Exercising with caution

Those living with heart disease should be especially prudent in their efforts to meet the national CPAG recommendations.

The guidelines weren’t designed for people with chronic medical conditions, says Dr. Darren Warburton, a specialist in cardiology and exercise rehabilitation at University of British Columbia. Warburton was one of the creators of the guidelines. “We never prescribe 150 minutes of physical activity to someone who has just had a heart attack,” he says.

Warburton doesn’t restrict himself to a “magic number” or a certain type of exercise when prescribing fitness routines. “We advocate that individuals start early on at a very light to moderate intensity and progress toward higher levels of activity,” he says.

This might mean beginning with two weekly 20-minute sessions, doing activities like gardening or brisk walking. To be effective, your workout should reach a moderate level of intensity-that is, you should be able to feel your heart rate increase and have enough breath to talk, but not sing. This, of course, should only be done after consultation with a health professional.

Don’t deprive yourself of the benefits of the small efforts. McMaster University research has shown that short intervals of physician-monitored high-intensity workouts are just as effective as longer sessions of moderate-intensity workouts for the rehabilitation of patients with coronary artery disease.