Boot Camp – Why Exercise is Essential
I have to confess, my passion for this topic is the reason I am writing up a three week boot camp plan. After an exacerbation, the first thing I know that I need to get back to is my exercise regimen…but it is frustrating (to put it mildly) to feel like I have to start all over every dang time. I know I’m not alone in this, so one of the goals of this Boot Camp is to provide a gradual re-introduction to exercise which is gentle and non-intimidating.
I am biased, and I am the first to admit it. It is my humble, yet fairly educated, opinion that a regular exercise program should be a part of any CF patient’s routine daily health maintenance. I place daily movement right up there with enzymes and pulmonary clearance. Why? Let me count the ways exercise rocks:
When you don’t use your lungs, and I mean really deeply breathe to the point where you might get some odd looks because of your cough, you won’t be as successful in getting the crud out of your airways. It just helps. Clearly then, exercising to the point where you breathe deeper and faster induces lung clearance. Not only that, but there have been some intriguing studies showing that fairly intense aerobic exercise inhibits a sodium channel, which has a hydrating effect on airway mucus. Go outside and run around the block a few times if you don’t believe me. But wait, that’s not all! There are other very important reasons to move…frequently. Would you like to slow the decline of your lung function? I would. Studies have not all shown improvements in lung function with exercise, but they have consistently shown that regular aerobic exercise (HR of 150 BPM for 20 minutes, 3 times/week) significantly slowed the rate of decline of lung function (Journal of Cystic Fibrosis 4 (2005) 7 – 26).
Like everyone else, when those of us with CF exercise, we increase our functional capacity. This means we can do more with less energy. This doesn’t sound like a big deal, but as lung function declines, efficiency becomes extremely important. Improving functional capacity improves efficiency.
Do you like the feeling of shortness of breath? It’s the worst, isn’t it? Again, for unknown reasons, a regular exercise program including aerobic exercise diminishes the sensation of air hunger. Many studies have shown this, both in CF and other types of COPD.
Hundreds of studies have shown that exercise improves quality of life in all people, including those with CF.
NOT EXERCISING IS A DEPRESSANT! Do you really need something else to bum you out?
Exercise, especially weight bearing exercises such as walking, jogging and weight lifting can prevent the loss of bone density. This is true for everyone. The reason we care more is that we have SO many risk factors for bone loss; I don’t even want to list them all (it’s depressing, and this is NOT a depressing Boot Camp). The good news is that we can help stem the tide of diminishing calcium stores. We do have some control over this one. We just have to do it.
Exercise improves bowel function. Enough said.
Exercise improves appetite. Therefore, you will eat more. Therefore, it will be easier to keep weight on.
Weight lifting (resistance) exercise builds muscle mass. This is true if you are a preadolescent. This is true if you are 95 years old. This is true even if your CFTR is messed up. I know this from my fitness training and from personal experience. This is ONE very visible aspect of your body that you have a say about! It’s nice to be normal that way. Try it!
Exercise (especially strengthening the back and stretching the front of the torso) will improve posture. Improved posture can increase the amount of lung volume available for breathing. This is significant. You can also reduce back pain by making simple improvements in posture.
Once you get past the initial distress (when you aren’t used to moving), exercising actually feels good! Don’t take my word for it, though. Give it a 21-day try, and see if I’m right.
Convinced? I hope so, and just to give you a little extra push, I am going to give you examples of easy do-at-home exercises to try during the Boot Camp. I have created a YouTube Channel, and have demonstrations of several exercises you can do with your body weight only, with your stability ball, with the resistance tubes, and with a combination of the above. I also have a short demo warm up which you should do before any work out.
The physical exercises I ask you to do during the boot camp include both aerobic and resistance exercises. They both are extremely beneficial, and whenever I talk to someone with CF about a good exercise program, I include both. Mobility and flexibility work are also important to include in a balanced program.
This is really a misnomer. Right now, you are doing an aerobic activity by reading this article. “Aerobic” just means you are using oxygen to create the energy to do what you are doing. What we really mean when we refer to aerobic exercise (‘we’ being fitness professionals) is continuous, rhythmic movement of large muscle groups for an extended period of time, requiring an increased demand for oxygen. This would include walking, jogging, swimming, jumping rope, biking, rowing, elliptical training, trampoline jumping, etc. The list is limited only by your imagination.
The idea is to work hard enough to use your lungs…deeply. Work hard enough that you have to take deep breaths. The goal is to expand the lungs so much, that some air gets beyond the small mucus plugs in your tiny airways, and when you cough…well, you know. Coughing is the goal. Dying of exhaustion and air hunger is NOT!
On a scale of 1 to 10, where 1 is how you feel while sitting down watching television, and 10 is how you feel while sprinting as fast as you can away from an escaped tiger at a zoo, you want to be around a 6 (moderately hard, but easy enough that you can do it for a sustained period of time). It doesn’t matter how fast you are going. What matters is that you FEEL an exertion level of about a 6 or so. For some people, this may occur at a walk. Others may have to break into a jog or a faster rate of whatever they are doing. At first, you may only be capable of doing this for a few minutes. That’s perfectly fine. It should not be unpleasant! As soon as it feels unpleasant, slow down. There is nothing that kills motivation like physical discomfort. The goal is to work up to 20 to 30 minutes of continuous activity, where your “perceived exertion” is at a 6-7 of 10.
Does this mean you don’t need to do CPT? No. What about the vest? Ask your doctor. I have heard different answers to this question. Personally, even though I exercise almost every day, I still continue to use the Vest. I just don’t have a good reason NOT to do it.
It is nearly impossible to describe using words alone the proper way to do an exercise. Given this, and given that this is the 21st century, I will use a bit of technology. I’ve created a few YouTube videos showing some simple resistance exercises using a stability ball and resistance tubing. The plan is to add more, of course, and since my new favorite toy is the “kettlebell,” I will likely demonstrate a few exercises with these as well. The beauty of kettlebell exercises is that they work strength, flexibility, and cardiovascular fitness at the same time. This takes efficiency to a new level. More to follow.
The next post will discuss preparation for the next few weeks of Boot Camp. Then, we’ll move on to DAY ONE.