Movement is Medicine

Let’s discuss working out-

Earlier this week, while browsing around the Instagram, I came across a post from Health Central (their handle is healthcentraldotcom). Health Central had invited a well know rheumatoid arthritis advocate and fitness instructor (their Instagram handle is anotherdaywithra) to provide some tips and tricks on getting back into working out after being diagnosed with a chronic illness. Her post is great and much needed! Now I have the upmost respect and admiration for this advocate and want to make it perfectly clear, I do not disagree with anything she said in her post. In fact, I would highly encourage everyone follow her because she is definitely smarter than I am in this area. However, my experience with getting back into working out has been different than what she recommends so I thought I would share my experience with you all. After all, we all know that with rheumatoid arthritis having multiple options is a huge win when trying to raise our own quality of life. One size definitely doesn’t fit all with chronic illness when trying to live by the mantra “movement is medicine”.

Ego - the good and the bad-

To begin with lets tackle the guilt of getting back into working out will cause once you start again. Regardless if you were a 5-times a week gym rat or a 100 time a year ski bum (that was me at one point), your mind will play “remember when” with your mental and physical health the first couple of weeks after returning. This will sting extra bad when you have to get off the indoor bike, for example, after only 12 minutes due to pain or can’t ski at all during the winter even though the mountains are getting dumped on. The good news is once your mind quits playing “remember when”, the positives from working out will be that much more rewarding.

It is incredibly important, I have found, to immediately realize your mind playing “remember when” is your “I” wanting attention, to put it another way its our ego. Our ego is the reason we are able accomplish five gym workouts in a week or skiing 100 times a year. It is what makes us want to lift that next 10 pound weight or ski in the tree’s after an epic powder dump. However, that also means its our ego that hurts after realizing that today 12 minutes on that indoor bike is all we can do. Our ego’s are a great source of pain too, its easy to forget that.

Here is the antidote. If 12 minutes on that indoor bike is all you can do today, that’s a win. If 2 minutes is all you can do that day, that’s a win. When you are getting back into working out with a chronic illness a win is making it to the gym, walking around a block once, hell walking to your neighbors house and back can be considered a win against “it”. I don’t know how many times I’ve gone to the gym, tried my first set, and was back at my car wondering if I can make it home (the engine block was still warm from the drive to the gym). A win has nothing to do with time, calories burned, weights lifted, or any other metric your watch or phone might be telling you. Its the act of moving that is the win, movement is medicine or motion is lotion. Time, calories burned, endurance will come with time, honestly that’s both the easy and fun part.

For patients, what does working out mean?-

Before we go any further, lets define what working out means. For chronic patients like myself, its any movement that is outside of their normal routine. It doesn’t have to mean going to the gym 3 times a week or 10,000 steps like popular culture likes to define it. In my case, working out has meant parking at the end of a row at the grocery store in order to get some steps in too going for a 6 mile hike in the mountains. Sometimes working out has been walking to my neighbors house or mailbox and back, sometimes it has meant going to the gym 3 or 4 times a week. With a chronic illness, especially when returning, ones schedule of working out needs to remain fluid and flexible. Instead of scheduling 3 days at the gym for the week, tell yourself you would like to hit the gym 3 times that week. Yes, there is satisfaction with putting a check mark by a to do item on a list. However, that means there is a sense of failure if you can’t check off working out that day (chronic illnesses are bastards and don’t care about your schedule). This is why I look at my schedule in week blocks, if I have to take 2 days off from working out that doesn’t prevent me from accomplishing my goal. Schedule based on your personal timeline and requirement, not a traditional calendar or timeline. Once again, the goal is movement is medicine.

Equipment - The one with the most toys wins right?

Lets discuss equipment. To begin with, braces and KT Tape. These are useful devices if a joint feels weak or unstable. Personal experience suggests these items won’t directly help with pain management, their purpose is to provide stability so we can use the joint correctly which should reduce pain. If you do need one of these items, it is probably wise to put more emphasis on working out correctly instead of working out intensively. As odd as it might sound, we can do more damage by walking incorrectly than we can by lifting too heavy or working out too hard but with correct form. Remember, the goal is returning to movement is consistently, once working out has become routine again then you can try to impress your gym crush.

The collecting of health metrics. Lets be honest, our Apply Watches and iPhones are amazing pieces of tech that can collect a mountain of health metrics for us. Not only can we collect distance, heart rates, calories burned, time moving, we can now perform EKG’s on ourselves. I’m sorry but this is so cool! However, the only real metric I care about is time moving. This is regardless if I’m in the gym or on a hiking trail.

Shoes. Shoes are incredibly important, especially if you are spending any time outside in the mountains or on trails. This kind of sucks for us patients due to the price of shoes I will admit. My recommendation, if you normally buy your shoes at Fred Meyer, for example, I would suggest going to a Dick’s Sporting Goods or REI for gym shoes. Both of these stores have people on staff that can help you find a shoe that will support both you working out and your chronic illness. This is why I’m putting so much emphasis on shoes, we are not “normal” customers because of our health needs.

Mountain or trail shoes. I currently have a ridiculously expensive pair of hiking boots. When I say ridiculously expensive, I’m talking in the $300 price range (I got them at an REI sale for much less). The reason I made this purchase is because of the support they provide versus a $150 pair of hiking boats from Adidas (which I also own for easy trails). My $300 boots have prevented so many injuries due to the traction they provide me, I’ve been able to tackle some seriously difficult single-track and rocks because of them. In the case of shoes, we get what we  pay for which is why I would highly recommend looking at high end hiking shoes if you are going to spend any time outside. Its better to hurt the wallet before you get on the trails than it is to wait until you need a doctor after the trails.

Quick qualifier-

I am no where close to being a multimillionaire but I can still work full-time. I know this allows me a certain level of privilege when shopping for workout gear, especially being a chronic patient. As I mentioned at the start of this post, this is my workout story. You will have to adjust based on your current life circumstances.

Although I’m not considered any expert is this field, I do have an incredible amount of experience and knowledge. Please please please feel free to reach out to me if you have any questions or would like some help getting back into working out or hiking in the mountains. I’m happy to help however I can!

Food-

MMMMMMMMMM food. For the record, I am a horrible cook. I once set off the fire alarm while trying to boil water.

Chances are good that by returning to working out this will burn a bunch of calories for you. This means a change in diet might be in order. However, since you do have a chronic illness, you might experience an increase in pain the first couple of weeks (this happens to me often after returning to the gym) after you start working out again. Cooking becomes harder because of this.

In order to combat the pain from starting to work out again, I like going to a local CO-OP and getting a bunch of sandwich type food (especially if its organic). A quick chicken wrap with some fruit and chips makes for a quick and easy dinner. And by quick and easy, of course I mean food to eat on the couch while I break out the ice packs :) Another trick is to pick up a fully cooked chicken from the deli. This is enough chicken to last a couple of nights. Also, don’t be afraid to pick up a few of their freshly baked cookies for desert. Just because you are working out doesn’t mean you have to forgo all cookies. After all, a life without cookies is just not worth living in my opinion.

Lets say my rheumatoid arthritis or degenerative disk disease flares up while working out, I will door dash dinner from places like Panera Bread. To often I have found that an increase in pain means either ordering dinner or not eating a healthy dinner at all (dinner becomes some chips or cookies so there is some food in my belly so I can take my nightly meds). By not eating a formal dinner I can put in jeopardy my next couple of workouts simply because I don’t have the calories available to heal from the current flare up.

As many chronic illness patients will attest too, eating healthy is hard enough even though food is medicine. It can be even harder if you are trying to reintroduce ones body to working out again. In this case, establishing a new workout routine comes first then I can adjust my diet to get me to the next level of fitness.

Food is incredibly important, but it is also easily neglected I’ve found if in pain. That is why I try to prepare for pain so I do continue to eat which increases my chances of making my next work out. Once I have a workout routine, then I move to preparing my diet to go with the increase in movement.

Medications-

About 20 to 30 minutes before a hike, regardless if it is rated easy or hard, I will take one of my Oxycodone’s. I also bring my opiates on a hike just in case. Regardless of what the news says, opiates are our medication and should be used as such. If by taking my med I can hike for an extra hour, that’s a huge win in my book. If by taking my med I can limp back to my car, instead of calling for help, that is a huge win in my book. Using my meds in order to raise my quality of life is why we take them.

Since dehydration can be a side effect of medications, I do bring extra water, Powerade, and food with me. Often, I probably carry to much with me but I figure its better to have extra than not enough. This is especially true since Boise Idaho is in the middle of the desert. If you live at 6,000 feet in the mountains, you can probably get away with carry less since it doesn’t get as hot.

To go to the gym I usually don’t take an Oxycodone. That’s mainly because it is easier to get back to my car while at the gym versus hiking in the mountains. However, if it comes down to a choice between taking an Oxy so I can go to the gym or no Oxy no gym, I’m going to take the med. Once again, I feel like all I’m doing is using my meds in order to raise the quality of my life. Regardless if I take the Oxy or not, I try to bring a Powerade to the gym for the ride home. Dehydration is the enemy, it can cause significant increases in my pain levels so I spend a considerable amount of time trying to prevent it.

Final thoughts for you-

Starting a new workout program should be fun and a little exciting. Its a new adventure. Not only will it help you feel better (both physically and mentally), its a great way to meet new people. Don’t worry, not everyone at the gym or on a hiking trail will look like a Greek fitness god. There are plenty of newbie’s starting their new workout program that it is relatively easy to find a new friend that has a similar ability as you.

That said, please remember the beast or “it” will win some days. Much like life, there will be days where you can’t workout due to pain or some other chronic illness reason. As I mentioned, I’ve had to quit working out after only a few minutes due to “it” noting wanting to play nice that day. This is what tomorrow is for, to try again. The only way “it” wins if you don’t try again the next day. Failure is a natural part of life, quitting is usually a choice when it comes to working out.

Ego. Chances are there will come a time were someone twice your age will beat you up the hill or some punk high school kid will be able to lift more than you can. All I can tell you is so be it. Believe me I know how embarrassing and deflating this can be, that’s just the power of our ego’s. As long as you continue to try, that is working out at its finest.

Finally, and I can’t stress this enough, working out is different for every individual. If you are breaking a little sweat, having fun, raising your heart rate a little, and feel a little bit better than you did yesterday, you are working out. Do not let anyone tell you different!!!!

Now, go get some cool new shoes and head to the gym unless the snow has left then head to the mountains!

Movement is medicine!!!