Saturday, 12 January 2019

New year, new me: Lose weight, exercise and have more 'me time'

As we have now left another year behind and trying to ease ourselves into 2019, we are all motivated to think what we want from this brand new year and plan achievable goals. What with magazines, tv programmes and social media channels covering new year resolutions such as losing weight, joining to gym and getting your finances sorted, and advertising industry bombarding us with offers on discounted gym memberships, weight loss clubs and even elective-surgery to make us look 10 years younger, what choice do we have but reconsidering the cancellation of the direct debit to the gym membership we have not used since January 2018?

Well, for one, I thought to myself that this year I will not give into the social pressures and will not renew my gym membership -which I had for the past five years and used it about five times-. Don't get me wrong, I would love to be one of those people (e.g. my husband) who enjoys going to exercise classes and workout indoors, and can commit to doing so at least twice a week to make the membership count. But I am not. I am not going to make excuses such as 'I would love to but I don't have time' as I know that the gym is literally five minutes walk from my house and if I really wanted to I could easily make time for it. The truth is, I rather be indoors, curled-up on the sofa with a good book or walking outdoors with my dogs / touring the countryside with my bike, admiring houses I can't afford to buy. As someone living with arthritis, my default choice will always incline towards the sofa option. But I also know -and should know as a clinician and health researcher- that I need to increase my physical activity levels to cope better with pain and fatigue, as well as keeping fit and managing my weight. The recommended guidelines for physical activity suggests, to stay healthy or improve health, adults need to do 2 types of physical activity each week: aerobic and strength exercises.

Physical activity guidelines for adults 

How to remain/ become more active with arthritis?

So, how do we go about having more realistic goals towards increasing our physical activity levels if we are living with arthritis and not inclined towards wearing lycra in front of mirrors in public? The answer is simple, do something you enjoy, do it regularly and do it in manageable chunks, being kind to your body. The trick is, not do get too excited and over do it. You probably have done that before. You know, perhaps you were having a good day and over did it and then ended up hurting so much the following day, it put you off doing it again? I know, I have been there. In fact, this is how we develop exercise intolerance or a 'can't do' attitude. I see it all the time in my clinical practice, people say that they used to love doing gardening, but can't do it anymore.. or that they used to hike, but don't do it anymore as they don't have the stamina. The fact is, they actually CAN but just CAN NOT do it the way they used to do it. Or, some people are simply too worried about doing more damage to their joints. First of all, let me assure you that you can do more damage to yourself by doing nothing. Sedentary life styles leads to muscle loss, weight gain and decreased fitness. Sitting for long periods is thought to slow the metabolism, which affects the body's ability to regulate blood sugar, blood pressure and break down body fat. This includes watching TV, using a computer, reading, doing homework, travelling by car, bus or train but does not include sleeping. So it is really important that we at least maintain our physical activity levels, and ideally increase it, if we want to see real benefits.

Coming back to gardening, yes, you may not be able to trim down all your hedges at once and lay your flower bed in an afternoon. But can do it over a longer period of time with some sensible planning and careful adjustment as to how you go about doing it without compromising your joint integrity or energy levels. I understand that garden tools can be hard on aching hands and going down on your knees may not even be an option anymore if you are struggling with knee/ hip pain and problems. But, if there is a will, there is a way. None of us have to give up on things we love and enjoy, especially if they have additional health benefits. Rheumatology occupational therapists can help you to participate in activities you once treasured, by making tailored recommendations towards how to change the way you do things to keep active and achieve a healthy balance between daily activities, work and leisure. You can also access to written self-help information freely available on leading arthritis charity websites, such as the Versus Arthritis and NRAS on how to remain active, stay at work and manage common symptoms of arthritis. There is a wealth of self-help information out there to help with other important things too, such as sex and arthritis as pain and fatigue may reduce your enjoyment of sex and other activities and interests that you share with your partner.

So, my new year resolution for increasing my physical activity levels are to take my dogs out for longer daily walks, do daily stretching and strengthening exercises at home to manage pain, and perhaps most importantly to have regular 'me time' to look after my psychological wellbeing by doing more mindfulness and relaxation. Mindfulness practice involves giving the mind and body the space to relax, acknowledge and release feelings about pain or other challenges, let go of tension, and tap into a positive outlook. Research evidence supports that focusing on negativity exacerbates our pain and fatigue. Mindfulness practice can allow you to step back from the cycle of negative thinking and provide an opportunity to be more present in the here and now.

There are countless free resources available on the internet to help you understand how and where to start to practice mindfulness and take a mindful approach when interacting with other people and the environment that may challenge our inner peace. Here is a brief how to guide for people with arthritis.

So, don't sit there. Get up and potter around the house, go up and down the stairs, do some stretches. The less you sit still, better your pain and fatigue will get, and you will notice significant changes in your joint stiffness too. If you are still unsure whether to exchange your comfy sofa for a walk, I suggest you spend five minutes to read about the 'sitting is the new smoking campaign' here. Did you know that you burn on average of 50 calories more per hour by standing? Standing up for 3 hours/ day, five days/ a week adds up to 750 calories burned. In a year that adds up to 30,000 calories, which is equivalent of 9 pounds in weight! So, what are you waiting for?

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