Why exercise is important to us
by Thom Twichell, MS

Editor's Note: Thom is an Exercise Physiologist. He was diagnosed with Sporadic Paraparesis in January of 2002 after two years of increasing difficulty walking and an initial diagnosis of PLS or SP. He uses a cane and a wheelchair while working full time in a regional medical health system. Thom is married to Margaret, with 2 golden retrievers in the woods of Michigan’s Upper Peninsula by the shores of Gitchee Gumee. He is happy to address individual questions.

Having Hereditary Spastic Paraplegia (HSP) or Primary Lateral Sclerosis (PLS) doesn’t automatically give you a “Get out of Exercise Free” card.  Just because you walk or wheel  differently than other folks doesn’t mean that you will avoid heart disease, diabetes, cancer, or any of the other Top 10 Diseases that may be fatal. So, enough excuses. I am going to tell you what you already know: Exercise IS good for you.

Exercise (see, it is NOT a four letter word) is one way to help get you through your day, easier. I am not talking about jogging, although that picture of us trying to run might bring on the laughter. I am talking about what each of us is capable of doing, because we are at different mileposts along this journey. If you can ride a bike without falling over when you stop, you have found a good cardiovascular exercise that falls into the American College of Sports Medicine (ACSM) guidelines for aerobic activity. ACSM encourages activity that involves large muscle groups, like the arms and legs, that is rhythmical in nature, which means it is a continuous activity, that can be performed for 20 to 30  minutes or longer during a single session 3 or more times per week, and can elevate your heart rate to a level appropriate for your exercise program.

I mentioned bicycling, either outside, or stationary, as one example of meeting the ACSM guidelines. Other activities might be swimming, water aerobics, chair aerobics, or wheelchairing (is that really a word?). Snowshoeing or cross country (x-c) skiing are a couple of winter activities here in the north country, that give a great cardiovascular workout, for those who are able. 

Can you think of other activities that also fit into this group? This is the aerobic type of exercise that is so good for controlling things like high blood pressure, high percent body fat, lowering “bad” LDL cholesterol and raising “good” HDL cholesterol, lowering our resting heart rate, extracting and utilizing oxygen in our blood more efficiently. Exercise can also help us to better control our caloric, intake, promote muscle strength and endurance, improve our self esteem, and may improve our overall quality of life.

Not all of us can perform moderate aerobic exercise for a number of legitimate reasons, and must work at lower levels to keep the joints loose, and to decrease pain due to tone and spasticity. For those who fit into this category, think about slow movement (I know, in our condition, everything is slow) exercises such as yoga, modified tai chi, basic stretching from head to toe, or chair exercises. 

The idea here isn’t to get into the Olympics, but to help us get through the day more comfortably. We need to keep our strength up, and can do that through exercises suggested above, or we can use weights which offer resistance, to increase muscular strength and endurance. Improved strength can help us somewhat with our balance issues. Increased muscle mass can also help protect us when we do lose our balance and fall, and even though it won’t correct our balance completely, any assistance is helpful.  You don’t need the 310 pound Olympic weight set you used when you played football, but some hand or ankle weights can be helpful. Think about using lighter weight, and performing the activity using more repetitions, which can give better definition to your muscles.  You don’t need to go to Gold’s Gym to purchase weights. You can use items from your kitchen to start with; soup cans, milk bottles that can be filled with sand, pebbles, or water to adjust the amount of weight you would lift, coffee cans filled with sand, pebbles, or water. Be resourceful and creative. This will exercise your brain a bit, also and we all benefit from that.

1. Start slowly. Don’t try to exercise for an hour if you haven’t been doing anything for a while, as it will only discourage you if you are sore from overdoing it.

2. Warm up and cool down by performing the activity at a lighter pace than the exercise itself.

3. Breathe comfortably. If you are huffing and puffing you are working harder than you need to, and may have to stop soon due to fatigue.

4. Work in a range that YOU would describe as Light, Moderate, or Somewhat Hard. This is a good range of intensity for most of us.

5. Exercise regularly. This means almost daily, but don’t flog yourself for missing a day. Get into the habit, and stay in the habit.

6. Exercise with a friend, if possible. This is always more fun, and safer, too.

7. Make it fun. If it isn’t fun, how long do you think you will continue to exercise?

8. Surf the net. Look up the activity you are interested in, and research the different sites. Many site are set up for the terms “disabled”, “handicapped”, “wheelchair” when used in conjunction with the terms “exercise” or “activity”. This is part of the mental exercise that keeps up fit above the neck.

9. If you feel dizzy, lightheaded, experience shortness of breath, pain, or headache, STOP the activity.  Report unusual symptoms to your physician

According to the American College of Sports Medicine, “the biggest risk to exercise is not starting”.

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