Class 2-1: Planning for Fitness

Overview

Today's Class Overview

In today's class, you will learn about the benefits and fundamental principles of behavior change and adaptation to exercise.

Today's Class Objectives

By the end of this module you should be able to:

1. Summarize the health benefits of physical activity and exercise.
2. Apply the Transtheoretical Model of Change
3. Apply the S.M.A.R.T. principle for setting realistic goals.
4. Apply the F.I.T.T. principle for planning a physical activity program.
5. Apply the Seven Principles of Adaptation to exercise.
6. Identify the benefits of a proper warm-up and cool-down.
7. Strategize about barriers to physical activity.

Outline of Today's Class

• Materials
  1. Overview
  2. Review
  3. Health Benefits of Physical Activity and Exercise
  4. Transtheoretical Model of Behavior Change
  5. S.M.A.R.T. Goal Setting
  6. Principles of Adaptation
  7. Safe and Active
  8. Warm-up and Cool-down
  9. Overcoming Barriers to Physical Activity
  10. Summary

Review

As you prepare to move into this second portion of the course, take a moment to recall these major concepts and keep them in mind as you continue in the course.

• Hierarchy of Needs
• Seven Dimensions of Wellness
• Metacognition
• Cognitive Biases
• Emotional Intelligence
• Stress Management
• Mindfulness
• Healthy Relationships
• Sleep
• The Physical Built Environment
• Social Determinants of Health
• The "Health Gradient"
• Health Literacy
• Mental Health
• The Built Environment of Attention
• Psuedoinformation
• Media Literacy

Health Benefits of Physical Activity and Exercise

The following has been excerpted and adapted from Introduction to Health, Authored by: Kelly Falcone, EdD, Provided by: Palomar College(CC-BY-SA) under fair use:

Health Benefits of Physical Activity

Regular physical activity is one of the most important things you can do for your health. In many studies covering a wide range of issues, researchers have focused on exercise, as well as on the more broadly defined concept of physical activity. Exercise is a form of physical activity that is planned, structured, repetitive, and performed with the goal of improving health or fitness. So, although all exercise is physical activity, not all physical activity is exercise. Being more physically active and also doing more exercise can help to:

• Control your weight
• Reduce your risk of cardiovascular disease
• Reduce your risk for type 2 diabetes and metabolic syndrome
• Reduce your risk of some cancers
• Strengthen your bones and muscles
• Improve your mental health and mood
• Improve your ability to do daily activities and prevent falls
• Increase your chances of living longer

Begin Taking Steps to be More Physically Active Everyday

If you’re not sure about becoming active or boosting your level of physical activity because you’re afraid of getting hurt, the good news is that moderate-intensity aerobic activity, like brisk walking, is generally safe for most people.

Start slowly. Cardiac events, such as a heart attack, are rare during physical activity. But the risk does go up when you suddenly become much more active than usual. For example, you can put yourself at risk if you don’t usually get much physical activity and then all of a sudden do vigorous-intensity aerobic activity, like shoveling snow. That’s why it’s important to start slowly and gradually increase your level of activity.

If you have a chronic health condition such as arthritis, diabetes, or heart disease, talk with your doctor to find out if your condition limits, in any way, your ability to be active. Then, work with your doctor to come up with a physical activity plan that matches your abilities. If your condition stops you from meeting the minimum Guidelines, try to do as much as you can. What’s important is that you avoid being inactive. Even 60 minutes a week of moderate-intensity aerobic activity is good for you.

The bottom line is – the health benefits of physical activity far outweigh the risks of getting hurt. The following list explains how being more active can positively impact your health:

• Control Your Weight
  • Looking to get to or stay at a healthy weight? Both diet and physical activity play a critical role in controlling your weight. You gain weight when the calories you burn, including those burned during physical activity, are less than the calories you eat or drink. When it comes to weight management, people vary greatly in how much physical activity they need. You may need to be more active than others to achieve or maintain a healthy weight.
  • To maintain your weight: Work your way up to 150 minutes of moderate-intensity aerobic activity, 75 minutes of vigorous-intensity aerobic activity, or an equivalent mix of the two each week. Strong scientific evidence shows that physical activity can help you maintain your weight over time. However, the exact amount of physical activity needed to do this is not clear since it varies greatly from person to person. It’s possible that you may need to do more than the equivalent of 150 minutes of moderate-intensity activity a week to maintain your weight.
  • To lose weight and keep it off: You will need a high amount of physical activity unless you also adjust your diet and reduce the amount of calories you’re eating and drinking. Getting to and staying at a healthy weight requires both regular physical activity and a healthy eating plan. The CDC has some great tools and information about nutrition, physical activity and weight loss. For more information, visit Healthy Weight.
• Reduce Your Risk of Cardiovascular Disease
  • Heart disease and stroke are two of the leading causes of death in the United States. But following the Guidelines and getting at least 150 minutes a week (2 hours and 30 minutes) of moderate-intensity aerobic activity can put you at a lower risk for these diseases. You can reduce your risk even further with more physical activity. Regular physical activity can also lower your blood pressure and improve your cholesterol levels.
• Reduce Your Risk of Type 2 Diabetes and Metabolic Syndrome
  • Regular physical activity can reduce your risk of developing type 2 diabetes and metabolic syndrome. Metabolic syndrome is a condition in which you have some combination of too much fat around the waist, high blood pressure, low HDL cholesterol, high triglycerides, or high blood sugar. Research shows that lower rates of these conditions are seen with 120 to 150 minutes (2 hours to 2 hours and 30 minutes) a week of at least moderate-intensity aerobic activity. And the more physical activity you do, the lower your risk will be.
  • Already have type 2 diabetes? Regular physical activity can help control your blood glucose levels. To find out more, visit Managing Diabetes.
• Reduce Your Risk of Some Cancers
• Strengthen Your Bones and Muscles
  • As you age, it’s important to protect your bones, joints and muscles. Not only do they support your body and help you move, but keeping bones, joints and muscles healthy can help ensure that you’re able to do your daily activities and be physically active. Research shows that doing aerobic, muscle-strengthening and bone-strengthening physical activity of at least a moderately-intense level can slow the loss of bone density that comes with age.
  • Hip fracture is a serious health condition that can have life-changing negative effects, especially if you’re an older adult. But research shows that people who do 120 to 300 minutes of at least moderate-intensity aerobic activity each week have a lower risk of hip fracture.
  • Regular physical activity helps with arthritis and other conditions affecting the joints. If you have arthritis, research shows that doing 130 to 150 (2 hours and 10 minutes to 2 hours and 30 minutes) a week of moderate-intensity, low-impact aerobic activity can not only improve your ability to manage pain and do everyday tasks, but it can also make your quality of life better.
  • Build strong, healthy muscles. Muscle-strengthening activities can help you increase or maintain your muscle mass and strength. Slowly increasing the amount of weight and number of repetitions you do will give you even more benefits, no matter your age.
• Improve Your Mental Health and Mood
  • Regular physical activity can help keep your thinking, learning, and judgment skills sharp as you age. It can also reduce your risk of depression and may help you sleep better. Research has shown that doing aerobic or a mix of aerobic and muscle-strengthening activities 3 to 5 times a week for 30 to 60 minutes can give you these mental health benefits. Some scientific evidence has also shown that even lower levels of physical activity can be beneficial.
• Improve Your Ability to do Daily Activities and Prevent Falls
  • A functional limitation is a loss of the ability to do everyday activities such as climbing stairs, grocery shopping, or playing with your grandchildren.
  • How does this relate to physical activity? If you’re a physically active middle-aged or older adult, you have a lower risk of functional limitations than people who are inactive
  • Already have trouble doing some of your everyday activities? Aerobic and muscle-strengthening activities can help improve your ability to do these types of tasks.
• Increase Your Chances of Living Longer
  • Science shows that physical activity can reduce your risk of dying early from the leading causes of death, like heart disease and some cancers. This is remarkable in two ways:

Only a few lifestyle choices have as large an impact on your health as physical activity. People who are physically active for about 7 hours a week have a 40 percent lower risk of dying early than those who are active for less than 30 minutes a week.

You don’t have to do high amounts of activity or vigorous-intensity activity to reduce your risk of premature death. You can put yourself at lower risk of dying early by doing at least 150 minutes a week of moderate-intensity aerobic activity.

Everyone can gain the health benefits of physical activity – age, ethnicity, shape or size do not matter.

Transtheoretical Model of Behavior Change

The following has been excerpted and adapted from Concepts of Fitness and Wellness, 2nd Edition, Georgia Highlands College (CC BY 4.0) :

Behaviors That Promote Wellness

Bad habits are hard to break, but choosing to eat healthier and exercise more provides benefits that go far beyond a more ideal body weight and shape.

Being physically fit nurtures the mind, body, and spirit and is the cornerstone of wellness. The links below provide information about behaviors within your control that contribute to an improved quality of life and increased wellness.

Behavior Modification

Making permanent lifestyle changes is one of the greatest challenges a person can face.

This section will explore how changes to behavior occur, the psychological barriers that hamper efforts to change, and tips for making lasting change.

How Changes in Behavior Occur

The Transtheoretical Model, also called the Stages of Change Model, was developed by James Prochaska and Carlo DiClemente in the late 1970s. Considered the dominant model for describing how behavior changes occur, it evolved through studies examining the experiences of smokers who quit on their own and comparing them with the experiences of those requiring further treatment. The goal of those studies was to understand why some people were capable of quitting on their own. It was determined that people quit smoking if they were ready to do so. Thus, the Transtheoretical Model (TTM) focuses on the decision-making of the individual and is a model of intentional change.

The TTM operates on the assumption that people do not change behaviors quickly and decisively. Rather, change in behavior, especially habitual behavior, occurs continuously through a cyclical process. The TTM is not a theory but a model; different behavioral theories and constructs can be applied to various stages of the model where they may be most effective.

The TTM posits that individuals move through six stages of change: precontemplation, contemplation, preparation, action, maintenance, and termination. Termination was not part of the original model and is less often used in application of stages of change for health-related behaviors. For each stage of change, different intervention strategies are most effective at moving the person to the next stage of change and subsequently through the model to maintenance, the ideal stage of behavior.

Six Stages of Change:

• Stage 1: Precontemplation
  • In this stage, people do not intend to take action in the foreseeable future (defined as within the next 6 months). People are often unaware that their behavior is problematic or produces negative consequences. People in this stage often underestimate the pros of changing behavior and place too much emphasis on the cons of changing behavior.
• Stage 2: Contemplation
  • In this stage, people are intending to start the healthy behavior in the foreseeable future (defined as within the next 6 months). People recognize that their behavior may be problematic, and a more thoughtful and practical consideration of the pros and cons of changing the behavior takes place, with equal emphasis placed on both. Even with this recognition, people may still feel ambivalent toward changing their behavior.
• Stage 3: Preparation (Determination)
  • In this stage, people are ready to take action within the next 30 days. People start to take small steps toward the behavior change, and they believe changing their behavior can lead to a healthier life.
• Stage 4: Action
  • In this stage, people have recently changed their behavior (defined as within the last 6 months) and intend to keep moving forward with that behavior change. People may exhibit this by modifying their problem behavior or acquiring new healthy behaviors.
• Stage 5: Maintenance
  • In this stage, people have sustained their behavior change for a while (defined as more than 6 months) and intend to maintain the behavior change going forward. People in this stage work to prevent relapse to earlier stages.
• Stage 6: Termination
  • In this stage, people have no desire to return to their unhealthy behaviors and are sure they will not relapse. Since this is rarely reached, and people tend to stay in the maintenance stage, this stage is often not considered in health promotion programs.

Ten Processes of Change:

1. Consciousness Raising - Increasing awareness about the healthy behavior.
2. Dramatic Relief - Emotional arousal about the health behavior, whether positive or negative arousal.
3. Self-Reevaluation - Self-reappraisal to realize the healthy behavior is part of who they want to be.
4. Environmental Reevaluation - Social reappraisal to realize how their unhealthy behavior affects others.
5. Social Liberation - Environmental opportunities that exist to show society is supportive of the healthy behavior.
6. Self-Liberation - Commitment to change behavior based on the belief that achievement of the healthy behavior is possible.
7. Helping Relationships - Finding supportive relationships that encourage the desired change.
8. Counter-Conditioning - Substituting healthy behaviors and thoughts for unhealthy behaviors and thoughts.
9. Reinforcement Management - Rewarding the positive behavior and reducing the rewards that come from negative behavior.
10. Stimulus Control - Re-engineering the environment to have reminders and cues that support and encourage the healthy behavior and remove those that encourage the unhealthy behavior.

Limitations of the Transtheoretical Model

Limitations of the model include the following:

The theory ignores the social context in which change occurs, such as socioeconomic status and income.

The lines between the stages can be arbitrary with no set criteria of how to determine a person's stage of change. The questionnaires that have been developed to assign a person to a stage of change are not always standardized or validated.

No clear sense exists for how much time is needed for each stage, or how long a person can remain in a stage.

The model assumes that individuals make coherent and logical plans in their decision-making process when this is not always true.

To progress through the stages of change, people apply cognitive, affective, and evaluative processes. Ten processes of change have been identified, with some processes being more relevant to a specific stage of change than other processes. These processes result in strategies that help people make and maintain change.

S.M.A.R.T. Goal Setting

The following has been excerpted and adapted from Introduction to Health, Authored by: Kelly Falcone, EdD, Provided by: Palomar College(CC-BY-SA):

SMART Goal Setting

Have you ever said to yourself that you need to “eat healthier” or “exercise more” to improve your overall health? How well did that work for you? In most cases, probably not very well. That’s because these statements are too vague and do not give us any direction for what truly needs to be done to achieve such goals. To have a better chance at being successful, try using the SMART acronym for setting your goals (S= Specific, M= Measurable, A=Attainable, R= Realistic, T= Time-oriented):

Specific – Create a goal that has a focused and clear path for what you actually need to do. Examples:

• I will drink 8 ounces of water 3 times per day
• I will walk briskly for 30 minutes, 5 times per week
• I will reduce my soda intake to no more than 2 cans of soda per week

Do you see how that is more helpful than just saying you will eat healthier or exercise more? It gives you direction.

Measurable – This enables you to track your progress, and ties in with the “specific” component. The above examples all have actual numbers associated with the behavior change that let you know whether or not it has been met.

Attainable – Make sure that your goal is within your capabilities and not too far out of reach. For example, if you have not been physically active for a number of years, it would be highly unlikely that you would be able to achieve a goal of running a marathon within the next month.

Realistic – Try to ensure that your goal is something you will be able to continue doing and incorporate as part of your regular routine/lifestyle. For example, if you made a goal to kayak 2 times each week, but don’t have the financial resources to purchase or rent the equipment, no way to transport it, or are not close enough to a body of water in which to partake in kayaking, then this is not going to be feasible.

Time-oriented – Give yourself a target date or deadline in which the goal needs to be met. This will keep you on track and motivated to reach the goal, while also evaluating your progress.

Principles of Adaptation

The following has been excerpted and adapted from Introduction to Health, Authored by: Kelly Falcone, EdD, Provided by: Palomar College(CC-BY-SA):

Principles of Adaptation

There are seven major principles that inform how we go about developing strength, endurance, cardiovascular (heart and lung) health, as well as flexibility, balance, speed, and other skill-based components of fitness. 

1. Individuality - People will have unique responses to the same training stimulus, due to individual characteristics such as biological age, training age, gender, body size and shape, past injuries etc. Thus, training should be adjusted to the individual’s characteristics and needs.
2. Specificity - Physiological adaptations to training are specific to the muscle groups trained, the intensity of the exercise, the metabolic demands of the exercise, and specific movements and activities.
3. Overload - Certain adaptations require training with greater stimulus than that which the body is accustomed to.This could be done by increasing the intensity, duration, or frequency of training.
4. Progression - Overloading should occur at an optimal level and time frame to maximise performane. Overloading too quickly may lead to poor technique or injury, while very slow overloading may result in little or no improvements.
5. Diminishing Returns - An individual’s level of training determines how much improvements in performance they achieve due to training. A novice will see huge and relatively quick gains in performance when they begin training, however, the gains get smaller and come more slowly as they get more experienced.
6. Reversibility - The effects of training will be lost if training stimulus is removed for an extended period of time.
7. Rest and Recovery - Rest and recovery from the stress of exercise must take place in proportionate amounts to avoid too much stress and allow time to adapt.

F.I.T.T.

In exercise, the amount of stress placed on the body can be controlled by four variables: Frequency, Intensity, Time (duration), and Type, better known as FITT.

The FITT principle, as outlined by the American College of Sports Medicine (ACSM) falls under the larger principle of overload. 

FREQUENCY  

Frequency relates to how often exercises are performed over a period of time.

In most cases, the number of walking or jogging sessions would be determined over the course of a week.

A beginner may determine that 2–3 exercise sessions a week are sufficient enough to stimulate improvements.

On the other hand, a seasoned veteran may find that 2–3 days is not enough to adequately stress the system.

According to the overload principle, as fitness improves, so must the stress to ensure continued gains and to avoid plateauing.

INTENSITY

Intensity, the degree of difficulty at which the exercise is carried out, is the most important variable of FITT.

More than any of the other components, intensity drives adaptation.

Because of its importance, it is imperative for those beginning a fitness program to quantify intensity, as opposed to estimating it as hard, easy, or somewhere in between. Not only will this numeric value provide a better understanding of the effort level during the exercise session, but it will also help in designing sessions that accommodate individual goals.

How then can intensity be measured? Heart rate is one of the best ways to measure a person’s effort level for cardiorespiratory fitness.  Using a percentage of maximum lifting capacity would be the measure used for resistance training. 

TIME

The duration of exercise, or time, also contributes to the amount of stress experienced during a workout. Certainly, a 30-minute brisk walk is less stressful on the body than a 4-hour marathon.

TYPE OF EXERCISE 

Simply put, the type of exercise performed should reflect a person’s goals. In cardiorespiratory fitness, the objective of the exercise is to stimulate the cardiorespiratory system. Other activities that accomplish the same objective include swimming, biking, dancing, cross country skiing, aerobic classes, and much more. As such, these activities can be used to build lung capacity and improve cellular and heart function.

However, the more specific the exercise, the better. While vigorous ballroom dancing will certainly help develop the cardiorespiratory system, it will unlikely improve a person’s 10k time. To improve performance in a 10k, athletes spend the majority of their time training by running, as they will have to do in the actual 10k. Cyclists training for the Tour de France, spend up to six hours a day in the saddle, peddling feverishly. These athletes know the importance of training the way they want their body to adapt. This concept, called the principle of specificity, should be taken into consideration when creating a training plan. 

In this discussion of type and the principle of specificity, a few additional items should be considered. Stress, as it relates to exercise, is very specific. There are multiple types of stress. The three main stressors are metabolic stress, force stress, and environmental stress. Keep in mind, the body will adapt based on the type of stress being placed on it.

Metabolic stress results from exercise sessions when the energy systems of the body are taxed. For example, sprinting short distances requires near maximum intensity and requires energy (ATP) to be produced primarily through anaerobic pathways, that is, pathways not requiring oxygen to produce ATP. Anaerobic energy production can only be supported for a very limited time (10 seconds to 2 minutes). However, distance running at steady paces requires aerobic energy production, which can last for hours. As a result, the training strategy for the distance runner must be different than the training plan of a sprinter, so the energy systems will adequately adapt.

Likewise, force stress accounts for the amount of force required during an activity. In weightlifting, significant force production is required to lift heavy loads. The type of muscles being developed, fast-twitch muscle fibers, must be recruited to support the activity. In walking and jogging, the forces being absorbed come from the body weight combined with forward momentum. Slow twitch fibers, which are unable to generate as much force as the fast twitch fibers, are the type of muscle fibers primarily recruited in this activity. Because the force requirements differ, the training strategies must also vary to develop the right kind of musculature.

Environmental stress, such as exercising in the heat, places a tremendous amount of stress on the thermoregulatory systems. As an adaptation to the heat, the amount of sweating increases as does plasma volume, making it much easier to keep the body at a normal temperature during exercise. The only way to adapt is through heat exposure, which can take days to weeks to properly adapt.

In summary, to improve performance, being specific in your training, or training the way you want to adapt, is paramount.

Developing a Personal Exercise Program

To help you follow the guidelines for physical activity use the FITT chart to design your weekly exercise routine.  FITT stands for Frequency, Intensity, Time, and Type.

Safe and Active

The following has been excerpted and adapted from Lifetime Fitness and Wellness (Lumen) under fair use via Libretexts:

• Although physical activity has many health benefits, injuries and other adverse events do sometimes happen. The most common injuries affect the musculoskeletal system (the bones, joints, muscles, ligaments, and tendons). Other adverse events can also occur during activity, such as overheating and dehydration. On rare occasions, people have heart attacks during activity. The good news is that scientific evidence strongly shows that physical activity is safe for almost everyone. Moreover, the health benefits of physical activity far outweigh the risks. Still, people may hesitate to become physically active because of concern they’ll get hurt. For these people, there is even more good news: They can take steps that are proven to reduce their risk of injury and adverse events. The Guidelines in this chapter provide advice to help people do physical activity safely. Most advice applies to people of all ages. Specific guidance for particular age groups and people with certain conditions is also provided.

Explaining the Guidelines

Physical Activity Is Safe for Almost Everyone

Most people are not likely to be injured when doing moderate-intensity activities in amounts that meet the Physical Activity Guidelines. However, injuries and other adverse events do sometimes happen. The most common problems are musculoskeletal injuries. Even so, studies show that only one such injury occurs for every 1,000 hours of walking for exercise, and fewer than four injuries occur for every 1,000 hours of running.

Both physical fitness and total amount of physical activity affect risk of musculoskeletal injuries. People who are physically fit have a lower risk of injury than people who are not. People who do more activity generally have a higher risk of injury than people who do less activity. So what should people do if they want to be active and safe? The best strategies are to:

• Be regularly physically active to increase physical fitness; and
• Follow the other guidance in this chapter (especially increasing physical activity gradually over time) to minimize the injury risk from doing medium to high amounts of activity.

Following these strategies may reduce overall injury risk. Active people are more likely to have an activity-related injury than inactive people. But they appear less likely to have non-activity-related injuries, such as work-related injuries or injuries that occur around the home or from motor vehicle crashes.

Key Guidelines for Safe Physical Activity

To do physical activity safely and reduce risk of injuries and other adverse events, people should:

• Understand the risks and yet be confident that physical activity is safe for almost everyone.
• Choose to do types of physical activity that are appropriate for their current fitness level and health goals, because some activities are safer than others.
• Increase physical activity gradually over time whenever more activity is necessary to meet guidelines or health goals. Inactive people should “start low and go slow” by gradually increasing how often and how long activities are done.
• Protect themselves by using appropriate gear and sports equipment, looking for safe environments, following rules and policies, and making sensible choices about when, where, and how to be active.
• Be under the care of a health-care provider if they have chronic conditions or symptoms. People with chronic conditions and symptoms should consult their health-care provider about the types and amounts of activity appropriate for them.

Choose Appropriate Types and Amounts of Activity

People can reduce their risk of injury by choosing appropriate types of activity. The safest activities are moderate intensity and low impact, and don’t involve purposeful collision or contact.

Walking for exercise, gardening or yard work, bicycling or exercise cycling, dancing, swimming, and golf are activities with the lowest injury rates. In the amounts commonly done by adults, walking (a moderate-intensity and low-impact activity) has a third or less of the injury risk of running (a vigorous-intensity and higher impact activity). The risk of injury for a type of physical activity can also differ according to the purpose of the activity. For example, recreational bicycling or bicycling for transportation leads to fewer injuries than training for and competing in bicycle races.

People who have had a past injury are at risk of injuring that body part again. The risk of injury can be reduced by performing appropriate amounts of activity and setting appropriate personal goals. Performing a variety of different physical activities may also reduce the risk of overuse injury.

Increase Physical Activity Gradually Over Time

The risk of injury to bones, muscles, and joints is directly related to the gap between a person’s usual level of activity and a new level of activity.

Scientific studies indicate that the risk of injury to bones, muscles, and joints is directly related to the gap between a person’s usual level of activity and a new level of activity. The size of this gap is called the amount of overload. Creating a small overload and waiting for the body to adapt and recover reduces the risk of injury. When amounts of physical activity need to be increased to meet the Guidelines or personal goals, physical activity should be increased gradually over time, no matter what the person’s current level of physical activity.

Scientists have not established a standard for how to gradually increase physical activity over time. The following recommendations give general guidance for inactive people and those with low levels of physical activity on how to increase physical activity:

• Use relative intensity (intensity of the activity relative to a person’s fitness) to guide the level of effort for aerobic activity.
• Generally start with relatively moderate-intensity aerobic activity. Avoid relatively vigorous-intensity activity, such as shoveling snow or running. Adults with a low level of fitness may need to start with light activity, or a mix of light- to moderate-intensity activity.
• First, increase the number of minutes per session (duration), and the number of days per week (frequency) of moderate-intensity activity. Later, if desired, increase the intensity.
• Pay attention to the relative size of the increase in physical activity each week, as this is related to injury risk. For example, a 20-minute increase each week is safer for a person who does 200 minutes a week of walking (a 10 percent increase), than for a person who does 40 minutes a week (a 50 percent increase).

The available scientific evidence suggests that adding a small and comfortable amount of light- to moderate-intensity activity, such as 5 to15 minutes of walking per session, 2 to 3 times a week, to one’s usual activities has a low risk of musculoskeletal injury and no known risk of severe cardiac events. Because this range is rather wide, people should consider three factors in individualizing their rate of increase: age, level of fitness, and prior experience.

Age

The amount of time required to adapt to a new level of activity probably depends on age. Youth and young adults probably can safely increase activity by small amounts every week or 2. Older adults appear to require more time to adapt to a new level of activity, in the range of 2 to 4 weeks.

Level of Fitness

Less fit adults are at higher risk of injury when doing a given amount of activity, compared to fitter adults. Slower rates of increase over time may reduce injury risk. This guidance applies to overweight and obese adults, as they are commonly less physically fit.

Prior Experience

People can use their experience to learn to increase physical activity over time in ways that minimize the risk of overuse injury. Generally, if an overuse injury occurred in the past with a certain rate of progression, a person should increase activity more slowly the next time.

Take Appropriate Precautions

Taking appropriate precautions means using the right gear and equipment, choosing safe environments in which to be active, following rules and policies, and making sensible choices about how, when, and where to be active.

Use Protective Gear and Appropriate Equipment

Using personal protective gear can reduce the frequency of injury. Personal protective gear is something worn by a person to protect a specific body part. Examples include helmets, eyewear and goggles, shin guards, elbow and knee pads, and mouth guards.

Using appropriate sports equipment can also reduce risk of injury. Sports equipment refers to sport or activity-specific tools, such as balls, bats, sticks, and shoes.

For the most benefit, protective equipment and gear should be:

• The right equipment for the activity;
• Appropriately fitted;
• Appropriately maintained; and
• Used consistently and correctly.

Be Active in Safe Environments

People can reduce their injury risks by paying attention to the places they choose to be active. To help themselves stay safe, people can look for:

• Physical separation from motor vehicles, such as sidewalks, walking paths, or bike lanes;
• Neighborhoods with traffic-calming measures that slow down traffic;
• Places to be active that are well-lighted, where other people are present, and that are well-maintained (no litter, broken windows);
• Shock-absorbing surfaces on playgrounds;
• Well-maintained playing fields and courts without holes or obstacles;
• Breakaway bases at baseball and softball fields; and
• Padded and anchored goals and goal posts at soccer and football fields.

Follow Rules and Policies That Promote Safety

Rules, policies, legislation, and laws are potentially the most effective and wide-reaching way to reduce activity-related injuries. To get the benefit, individuals should look for and follow these rules, policies, and laws. For example, policies that promote the use of bicycle helmets reduce the risk of head injury among cyclists. Rules against diving into shallow water at swimming pools prevent head and neck injuries.

Make Sensible Choices About How, When, and Where To Be Active

A person’s choices can obviously influence the risk of adverse events. By making sensible choices, injuries and adverse events can be prevented. Consider weather conditions, such as extremes of heat and cold. For example, during very hot and humid weather, people lessen the chances of dehydration and heat stress by:

• Exercising in the cool of early morning as opposed to mid-day heat;
• Switching to indoor activities (playing basketball in the gym rather than on the playground);
• Changing the type of activity (swimming rather than playing soccer);
• Lowering the intensity of activity (walking rather than running); and
• Paying close attention to rest, shade, drinking enough fluids, and other ways to minimize effects of heat.

Exposure to air pollution is associated with several adverse health outcomes, including asthma attacks and abnormal heart rhythms. People who can modify the location or time of exercise may wish to reduce these risks by exercising away from heavy traffic and industrial sites, especially during rush hour or times when pollution is known to be high. However, current evidence indicates that the benefits of being active, even in polluted air, outweigh the risk of being inactive.

Inactive people who gradually progress over time to relatively moderate-intensity activity have no known risk of sudden cardiac events, and very low risk of bone, muscle, or joint injuries.

Advice From Health-Care Providers

The protective value of a medical consultation for persons with or without chronic diseases who are interested in increasing their physical activity level is not established. People without diagnosed chronic conditions (such as diabetes, heart disease, or osteoarthritis) and who do not have symptoms (such as chest pain or pressure, dizziness, or joint pain) do not need to consult a health-care provider about physical activity.

Inactive people who gradually progress over time to relatively moderate-intensity activity have no known risk of sudden cardiac events, and very low risk of bone, muscle, or joint injuries. A person who is habitually active with moderate-intensity activity can gradually increase to vigorous intensity without needing to consult a health-care provider. People who develop new symptoms when increasing their levels of activity should consult a health-care provider.

Health-care providers can provide useful personalized advice on how to reduce risk of injuries. For people who wish to seek the advice of a health-care provider, it is particularly appropriate to do so when contemplating vigorous-intensity activity, because the risks of this activity are higher than the risks of moderate-intensity activity.

The choice of appropriate types and amounts of physical activity can be affected by chronic conditions. People with symptoms or known chronic conditions should be under the regular care of a health-care provider. In consultation with their provider, they can develop a physical activity plan that is appropriate for them. People with chronic conditions typically find that moderate-intensity activity is safe and beneficial. However, they may need to take special precautions. For example, people with diabetes need to pay special attention to blood sugar control and proper footwear during activity.

Women who are pregnant and those who’ve recently had a baby should be under the regular care of a health-care provider. Moderate-intensity physical activity is generally safe for women with uncomplicated pregnancies, but women should talk with their provider about how to adjust the amounts and types of activity while they are pregnant and right after the baby’s birth.

During pregnancy, women should avoid:

• Doing activities that involve lying on their back after the first trimester of pregnancy
• Doing activities with high risk of falling or abdominal trauma, including contact or collision sports, such as horseback riding, soccer, basketball, and downhill skiing

Gradually Increasing Physical Activity Over Time: Real-Life Examples

Here are two examples that show how people at different ages, levels of fitness, and levels of experience can safely become more active over time.

Bill: A Man Who Has Been Inactive for Many Years

Bill wants to work his way up to the equivalent of 180 to 210 minutes (3 hours to 3 hours and 30 minutes) of walking a week. On weekdays he has time for up to 45 minutes of walking, and he plans to do something physically active each weekend. He decides to start with walking because it is moderate intensity and has a low risk of injury.

• The first week, Bill starts at a low level. He walks 10 minutes a day 3 days a week. Sometimes he divides the 10 minutes a day into two sessions. He prefers to alternate rest days and active days. (Total = 30 minutes a week.)
• Between weeks 3 and 8, Bill increases duration by adding 5 minutes a day and continues walking on 3 non-consecutive days each week. The weekly increase is 15 minutes. (Week 3 total = 45 minutes. Week 8 total = 120 minutes or 2 hours.)
• In week 9, Bill adds another day of moderate-intensity activity on the weekend, and starts doing a variety of activities, including biking, hiking, and an aerobics class. Gradually increasing the minutes of activity, by week 12 he is doing 60 minutes or more of moderate-intensity activity on the weekend.

Reaching his goal: Over 3 months, Bill has increased to a total of 180 moderate-intensity minutes a week.

Kim: An Active Woman

Kim currently does 150 minutes (2 hours and 30 minutes) a week of moderate-intensity activity. She wants to work up to at least the equivalent of 300 minutes (5 hours) of moderate-intensity activity a week. She also wants to shift some of that moderate-intensity activity to vigorous-intensity activity. Her current 150 minutes a week includes:

• Thirty minutes of mowing the grass 1 day a week;
• Thirty minutes of brisk walking 4 days a week; and
• Fifteen minutes of muscle-strengthening exercises 2 days a week.

Increasing frequency and duration: Over a month, Kim adds walking on another weekday, and she gradually adds 15 minutes of moderate-intensity activity on each of the 5 walking days each week. This provides an additional 105 minutes (1 hour and 45 minutes) of moderate-intensity activity.

Increasing intensity: Over the next month, Kim decides to replace some walking with jogging. Instead of walking 45 minutes, she walks for 30 minutes and jogs for 15 minutes on each weekday, providing the equivalent of 300 minutes a week of moderate-intensity physical activity from her walking and jogging.

Reaching her goal: After these increases, Kim is doing a total of 180 minutes of moderate-intensity activity each week (walking and mowing) and also doing 75 minutes (1 hour and 15 minutes) of vigorous-intensity jogging. One minute of vigorous-intensity activity is about the same as 2 minutes of moderate-intensity activity, so she is now doing the equivalent of 330 moderate-intensity minutes (5 hours and 30 minutes) a week. She has more than met her goal.

Warm-up and Cool-down

The following has been excerpted and adapted from the Penn State Extension article Warm-up and Cool-down under fair use:

Warm-up

The purpose of a warm-up is to warm your body and prepare it for the exercises to come. Usually a warm-up will consist of activities at a slower pace and reduced intensity. The goal of a warm-up is to increase your body temperature, therefore warming up your muscles. Blood flow and flexibility will increase during a warm-up. The warm-up may cause mild sweating, but it shouldn't leave you tired or fatigued.

During a warm-up, your heart rate and breathing will increase. A warm-up also promotes blood flow to your muscles to provide them with more oxygen and nutrients so they don't get fatigued. Your muscles also warm up, which increases muscle flexibility and makes exercises easier to complete. By preparing your muscles for exercise, your reaction time is increased and nerve pathways are ready for exercise.

In addition to all the physical benefits of a warm-up, it also prepares you mentally for the upcoming exercises. Warm-ups can consist of a variety of exercises and stretches. Contradictory to many beliefs, solely stretching as a warm-up will not warm you up properly. Instead, a dynamic warm-up (also called dynamic stretching) is more effective. Instead of holding still while stretching (also called static stretching), during a dynamic warm-up you move multiple muscles and joints.

A warm-up should last approximately 5 to 10 minutes. Choose a warm-up that mimics the exercises you will be doing. For example, if you are about to participate in weight lifting exercises, do the same movements without the weights. Some other examples of warm-up exercises are leg bends, leg swings, shoulder/ arm circles, jumping jacks, jumping rope, lunges, squats, walking or a slow jog, yoga, torso twists, standing side bends, lateral shuffle, butt kickers, knee bends, and ankle circles.

Advantages of Warming Up

• Decreases your chance of pulling a muscle
• Decreases joint pain
• Decreases your chance of injury
• Can reduce muscle soreness after exercises are complete

Cool-down

Similar to the warm-up, the cool-down, also known as the recovery period, usually consists of exercises at a slower pace and reduced intensity. This allows for your heart rate, breathing, and blood pressure to return to normal at a slower pace. The cool-down aids in your body's recovery after exercise and allows blood to return to your heart from your muscles. This will reduce the chance of your muscles being sore after exercise.

Completing a cool-down is not only beneficial immediately after the completion of exercises but also helps prepare your body for future workouts. By stretching out those muscles and properly cooling down, you will be more prepared to exercise sooner rather than later. If your body does not cool down properly, it will take longer for you to feel up to exercising again. All of the examples of warm-up exercises can also be used as cool-down exercises.

There are several benefits of a cool-down. It reduces the potential for DOMS (delayed onset muscle soreness). It can take 24 to 48 hours for your body to feel sore after exercising. Just because your muscles and joints may not be sore immediately after you've completed your exercises doesn't mean you won't feel sore later that day or the next day. A cool-down helps your body remove lactic acid, a by-product of vigorous exercise. If you do not cool down, the lactic acid may pool in your muscles, causing increased soreness.

Benefits of Cooling Down

• Helps lower your heart rate and breathing gradually
• Helps you avoid fainting or dizziness
• Helps prepare your muscles for the next time you exercise

Overcoming Barriers to Physical Activity

The following has been excerpted and adapted from Lifetime Fitness and Wellness (Lumen) under fair use:

Overcoming Barriers to Physical Activity

Given the health benefits of regular physical activity, we might have to ask why two out of three (60%) Americans are not active at recommended levels.

Many technological advances and conveniences that have made our lives easier and less active, as well as many personal variables, including physiological, behavioral, and psychological factors, may affect our plans to become more physically active. In fact, the 10 most common reasons adults cite for not adopting more physically active lifestyles are (Sallis and Hovell, 1990; Sallis et al., 1992):

• Do not have enough time to exercise
• Find it inconvenient to exercise
• Lack self-motivation
• Do not find exercise enjoyable
• Find exercise boring
• Lack confidence in their ability to be physically active (low self-efficacy)
• Fear being injured or have been injured recently
• Lack self-management skills, such as the ability to set personal goals, monitor progress, or reward progress toward such goals
• Lack encouragement, support, or companionship from family and friends, and
• Do not have parks, sidewalks, bicycle trails, or safe and pleasant walking paths convenient to their homes or offices.

Understanding common barriers to physical activity and creating strategies to overcome them may help you make physical activity part of your daily life.

Suggestions for Overcoming Physical Activity Barriers

Content in the “Personal Barriers” section was taken from Promoting Physical Activity: A Guide for Community Action (USDHHS, 1999).

Summary

Major Points

During today's class, you have learned:

• Health Benefits of Physical Activity
  • Regular physical activity is one of the most important things you can do for your health.
  • Exercise is a form of physical activity that is planned, structured, repetitive, and performed with the goal of improving health or fitness.
  • Both have direct benefits:
    • Control your weight
    • Reduce your risk of cardiovascular disease
    • Reduce your risk for type 2 diabetes and metabolic syndrome
    • Reduce your risk of some cancers
    • Strengthen your bones and muscles
    • Improve your mental health and mood
    • Improve your ability to do daily activities and prevent falls
    • Increase your chances of living longer
• Transtheoretical Model
  • Describes how people go about changing a behavior.
    • Precontemplation
    • Contemplation
    • Determination
    • Action
    • Relapse
    • Maintenance
• S.M.A.R.T. Acronym for successful goal setting
  • Specific
  • Measurable
  • Attainable
  • Realistic
  • Timely
• Seven Principles of Adaptation for Exercise Planning
  • Individuality
  • Specificity
  • Overload
  • Progression
  • Diminishing Returns
  • Reversibility
  • Rest and Recovery
• F.I.T.T.
  • Frequency, Intensity, Type, Time
• Guidelines for Safe Activity
  • Understand the relative risk of activity compared to inactivity
  • Choose activities and intensities appropriate to your current level
  • Start slow and increase activity gradually over time
  • Discuss with your medical professionals based on your unique needs
• Warm-Up
  
  • Decreased chance of injury
• Cool Down
  • Helps safety and recovery
• Overcoming Barriers
  • Understanding common barriers to physical activity and creating strategies to overcome them may help you make physical activity part of your daily life.