Jun 2, 2018

When Is Enough Exercise Enough? aka There is Good and Bad Hurt...Do You Know the Difference?

[This post is to all chronically-ill people, their caregivers (or personal assistants as I call them), their family, people who suspect a chronically disease eventually because it runs in the family, and that equals a lot of folks.]

I came across this statistic: By 2030, as many as 11 million people could be living with stroke as more people live longer. Yikes. Research time.  

The title from Flint RehabMore Is Better… Except When It’s Not, caught my eye. 
Flint Rehab says, "While repetition [of exercise] is important, too much exercise can start to hinder your progress. [Uh huh.] You need a good amount of rest and sleep in order to successfully recover."  

Something, but still nothing that answers my question specifically.  

And it got me thinking, because most times for me, it's never enough. Then when I hurt badly, aka when enough is more than enough, I turned to guilt because for several days, I rested my weary bones. One step forward, one step back, kind of thing. No progress at times. None at all.

When I achieved rest, and dreaded naps, it messed up my sleep, aka circadian rythyms. Then I couldn't go to bed before 3am. That's 3am on a good night. Now, I don't take any naps. And yes, I am tired, but it's a trade-off. I want to have good results with my exercise instead of giving in to my fatigue.

Now, I set the alarm on my cell for 15 minutes no later that 1pm. The power nap routine! That's just enough rest to re-fire my engine and sleep, aka nap, or not fall asleep. With my  eyes closed, it's still rest.

But I digress. This post is not about circadian rhythms, let alone mine. It's about exercise, specifically, "Am I doing enough exercise and how do I know when I reach that point of, it's enough?"

The Stroke Foundation across the other pond, aka Australia, says the repetition is the main focus on improvement. 

"Regular activity will help you to continue your recovery. Exercise improves your fitness, your general health, and reduces your risk of having another stroke." 

That means not when you feel like doing it but doing it every day. But nothing in that article addresses "when is enough exercise enough." I plowed on.

Then I came across this: Exercise is a valuable yet underused component for post-stroke care, according to an American Heart Association/American Stroke Association scientific statement. [Hmm. Now we're getting somewhere.]
"There is strong evidence that physical activity and exercise after stroke can improve cardiovascular fitness, walking ability, and upper arm strength," said Sandra A. Billinger, P.T., Ph.D., lead author and a physical therapist at the University of Kansas Medical Center in Kansas City, KS.
[Read more, I said.] 
"Yet, too few healthcare professionals prescribe exercise as a form of therapy for stroke. There is a big gap in America once stroke patients are discharged from rehabilitation and the transition to community exercise programs when they go home. Many are left on their own. [I was.] We don't have a system in place to help stroke patients feel comfortable with exercise.

And here it was:

"The general recommendation," says Billinger, "is that survivors exercise at least three days a week for 20 to 60 minutes, but that depends on their individual functional capacity. For many stroke survivors, multiple 10- to 15- minute bouts of moderate-intensity exercise may be better tolerated.

Aah. Hard data. At last. I was striving to do the exercise every day. It was too much, the good doctor implied. Every day. Core strengthening, 15 reps, 3 sets, the same with marching and leg stretches and Thera-band leg pulls and lifting my legs outward and behind me while holding on to the countertop, one leg at a time, and walking the halls for 500 feet, and weights, left hand only. 

Now I alternate with walking the halls and weights, and the other stuff aforementioned. I just started last week but no pain. I feel the good hurt. Life is good at the moment. I have the feeling that I found the key.

But Stroke is an ongoing mystery to find the other keys. Always a key. 

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