Exercise Programs For Ex-Junkies?

January 26, 2011 3:29 PM

How should an ex-junkie start exercising and being active again after pretty much ruining his body's constitution with drugs?

I'm a recovering narcotic user (heroin & oxycodone mostly) just about six months clean. The good news is that my doc has given me a clean bill of health: no diseases or damage to my liver, veins or heart, my blood chem is normal, and I even have good cholesterol counts. I still, however, am in terrible physical shape. I've gone from being scrawny to having a spare tire, I get winded walking up a single flight of stares, drench myself in sweat if I have to jog half a block to catch a bus, and generally have little energy and feel like crap most of the time.

I know that what I need is to get into better shape, but I've honestly never had to start from such a sorry state of physical atrophy before. In the past, I'd join a pick-up soccer league when I needed some exercise, but I would literally only last 30 seconds in my current condition. I also now experience intense muscle and joint pain the day after attempting any sort of physical activity, particularly in my knees, all of which is new to me. I feel as frail as my 90 year old grandmother at this point.

What would be the most effective way for me to get some stamina back and safely build up enough of a baseline of strength and flexibility that I can start participating in recreational sports again without hurting myself?

posted by anonymous to health & fitness (28 answers total)

It's a cliche recommendation here, but the Couch to 5K program sounds pretty good for you in terms of slowly building up stamina. If even it is too much for you, I think you can repeat weeks if you don't feel ready to move on.
posted by brainmouse at 3:31 PM on January 26, 2011 [4 favorites]

Actual 90 year old grandmothers often user aquatic resistance exercises to stay in shape. Easy on the joints (which may be the issue in your knees) and not immediately strenuous (while still being a good work-out over time.)

They typically do it in groups, which you definitely want to consider if you ever feel like passing out (buddy system.)
posted by oblio_one at 3:32 PM on January 26, 2011 [4 favorites]

Swimming is a good low impact exercise that you could use to get back some strength and stamina. Also make sure that you're eating right, because you've probably lost a lot of muscle and you'll need good nutrition to build it back up.
posted by geegollygosh at 3:36 PM on January 26, 2011

I have stamina issues due to a different medical condition, and my doctor recommended walking. Take lots and lots of walks. It's not that strenuous, and it is at least some physical activity. Then you can build up to something more rigorous. (Myself, I'm starting to walk a mile a day as part of my commute).
posted by spinifex23 at 3:38 PM on January 26, 2011 [1 favorite]

Change up the diet to include mostly real vegetables and meats you've prepared yourself and, on top of that, start walking as much as you can and perhaps swimming. Other than that, I second the Couch to 5K recommendation.
posted by Hylas at 3:40 PM on January 26, 2011 [1 favorite]

Yup- water aerobics for a while, then Couch to 5k.

And if your MD has any suggestions on nutritional supplements, etc, that might be worthwhile, too. I don't know where you're located, but if you can find an ASAM MD, they'll likely have a better idea of what you need. (ASAM = American Society of Addictive Medicine.)

From what I hear, opiates are relatively benign from a physical damage point of view, so count yourself lucky to have gotten hooked on those, and not speed or alcohol.
posted by small_ruminant at 3:42 PM on January 26, 2011

Before embarking upon physical exercise to restore yourself, first ensure you have been eating a healthy diet for a good few months. Nobody goes anywhere in a car that has a five litres of fuel and oil that hasn't been changed in three years.
posted by dougrayrankin at 3:47 PM on January 26, 2011 [1 favorite]

I'd start by walking. Seriously. Get a good pair of walking shoes and go. Walking is a lot easier on your joints than running or stair-climbing, and you can vary the intensity by walking briskly or slowly.

If you can walk a couple miles reasonably quickly (20 minutes/mile, or 3 mph), then you could take a look at some of the fitness programs in Getting Back in Shape, by Bob Anderson, Bill Pearl, Ed Burke, and Jeff Galloway. It has a range of simple programs, from basic (and even "pre-basic") to intermediate, that combine stretching, lifting (strength training), and moving (aerobic exercise).
posted by brianogilvie at 3:49 PM on January 26, 2011 [4 favorites]

Like water aerobics, cycling is an extremely low-impact activity. As well, you get to select from an infinite number of levels of intensity, from easier-than-walking to climbing-the-Alpe-d'Huez. If you can get your hands on a good, safe bike, try it. I don't know what your joint issues are, so you might have to consult a doctor, but cycling is a great way to begin strengthen some of the large muscles that stabilize your joints.

Bonus: it's a good way to get around.
posted by klanawa at 3:51 PM on January 26, 2011

Great attitude. I would recommend to you what I would recommend to any other couch potato wanting to improve his or her aerobic fitness: try jogging (NOT sprinting!) for 5-8 minutes, walking one minute, and repeating for two miles. If it's too strenuous, jog slower. Once you start getting the hang of it, gradually jog faster or jog longer. Don't do this every day, but perhaps 3 times a week at most if you are just starting off.

For strength training, I don't have many tips there but you consider hiring a personal trainer to guide you and keep you motivated.

Finally, I want to point you to the story of Todd Crandell, an addict turned Ironman. Here's one story, you can find more by searching his name: http://sportsillustrated.cnn.com/2006/writers/the_bonus/07/13/tri.athlete/index.html
posted by fenster_blick at 3:52 PM on January 26, 2011

Cardio-wise, walking and easing into running is a great idea.

Don't neglect weight-bearing exercises, though. As you build muscle, your body becomes stronger and more efficient. I find that my aerobic conditioning is much improved when I also lift weights.

Body weight exercises to begin with and then light weights, moving into heavier weights is a good way to start. Starting from square one, you'll find you build muscle much faster than you expect.
posted by xingcat at 4:17 PM on January 26, 2011 [1 favorite]

Congratulations and keep it up!

I'd agree with walking and some resistance exercise. I'd recommend yoga. You can take it at your own speed and it can be pretty gentle (don't jump in with anything with the word Ashtanga in it!).
posted by Pax at 4:27 PM on January 26, 2011

Yoga. It will help you get reaquainted with your body in a soothing way. After that, there's really nothing like biking for fun, low key exercise, and saving bus fare.
posted by yarly at 4:30 PM on January 26, 2011 [6 favorites]

The guiding principle should always be "Can I do more?" and if the answer is yes, wait until tomorrow, then do more.
posted by dougrayrankin at 4:36 PM on January 26, 2011

Seconding brianogilvie, just walk 30 min per day...it's good for you, it's a good start, will eliminate spare tire (if you can continue to do it, eat healthy and try to raise it to 1hr, 1.5 on weekends) as well as giving you a new perspective on your neighborhood (and maybe life!). Walking is good, I'm a big fan. (or a smallish fan...due to the walking!:).
posted by bquarters at 6:03 PM on January 26, 2011

Start with walking. It isn't glamorous, but it is a fantastic, low-impact activity that you can do at any time and will gradually build up stamina without over-fatiguing you.

Yoga is a good idea, but if you can start with a beginner's class that would be best as intermediate or advanced classes would involve holding a number of poses for a while and may fatigue you too quickly.
posted by schroedinger at 6:36 PM on January 26, 2011 [2 favorites]

Agreeing with those advocating walking and cycling. If your community has one of those outdoor gym areas where you can do pull-ups and other body-weight exercises, that can be a great inexpensive way to build muscle, too. Walk there for a double-whammy.

If you can afford a gym, my Y has great facilities, classes, trainers, yoga - basically everything you'd need for the basics up to inter-mural "team" sports. Best of luck!
posted by ldthomps at 6:44 PM on January 26, 2011

Walking, yoga, and good food. Also take the stairs instead of the other options whenever feasible.
posted by mareli at 7:40 PM on January 26, 2011 [1 favorite]

Start where you are and walk a little more today than yesterday. Go up and down a few steps today and a couple more every day or two until you can do whole flights like there's nothing to it. Rise up on your toes 10 times and do 10 middling knee bends while you're waiting for the water to boil. Do other simple exercises and gradually increase the reps. Get a cruiser bike with a basket or saddlebags and go to the farmer's market or do errands or ride in the park. Make friends with your body and listen to it as it learns how to operate again.

Don't just aim for doing things the way you used to do them--do things better and do better things. Don't worry about getting back to where you were before; that didn't turn out so well. Go forward to where you have never yet been able to be. Combine your physical exercise with attending to the inner person--finding and preparing healthy food, enjoying nature, doing yoga. Make all of yourself fit and strong. More than most people, we who have known addiction have to find ways to bring and keep mind, body and spirit into harmony.
posted by Anitanola at 8:28 PM on January 26, 2011

I recommend a stationary bike. It's low impact because most of your weight is on your butt. Put it between where you spend your time such as your bedroom or your computer or your couch and the places you gotta go to deal with personal needs such as the bathroom and kitchen.

Set it to the lowest resistance.

Every time you get up and walk out to the bathroom to pee or the kitchen to get a drink of water get on the bike and peddle nice and slowly until you feel ugh, you really want to stop. Then stop. Go pee or get your drink of water. On your way back get back on the bike and do it again.

Aim to get on the bike as often as possible but don't push yourself to meet any mile or time goals. Just peddle until your body says forget it. This part is to get your body used to moving.

Once this is a habit and you are getting on the bike and peddling like that 20 times a day or more do the same thing, but from now on talk steadily while you are on the bike. Reading out loud works well to keep you from running out of things to say and going silent. This part is to build up your aerobic capacity.

If you are not using the bike umpteen times a day figure out other forcing functions or structure to get you on it such as putting your phone on the other side of it or getting on the bike every time you run out of building material inventory in Minecraft or something that makes you get on the bike over and over.

Make sure you take care of your knees. If you have been abusing painkillers it is not impossible that your body has gotten bad at producing natural painkillers so they may not be getting inflamed as much as the pain indicates, so much as you now being more aware of it.

It's your choice if you work on peddling just a little longer, or upping the resistance on the bike. I would suggest going for stamina first so switch from peddling until your body says "Urk, stop" to peddling to the first number ending in a zero after it says stop.

Do this for a month or two and then look into a "real exercise program". For someone my age and gender I am at optimal exercise to be fit if I peddle eight miles a day. I am in my late forties and female. If you are male and younger I would go with aiming to get to ten or twelve miles a day. For best results peddle throughout the day in single mile increments. Anything more strenuous than that takes you into "athletic" territory from "Physically fit" and actually will only pay limited health benefits.

Meantime put on some nice mood altering music that makes you feel cheerful but not manic and do some very light moving to music. Don't even do stretches. Get used to raising your arms above your head before you get used to pulling the muscles and tendons taut. Get used to leaning over sideways before you lean over so far you have to tense up to balance. You can move up to real stretches gradually so that by the time you start the real exercise program you are doing stretches. But remember to keep the stretches comfortable and not bounce or lunge.

When you start with resistance (weights) go very slowly until you know if the problem with your knees is going to show up anywhere else.

Take a comprehensive list of nutritional supplements and eat a lot of highly nutritious food.

Make sure that you are getting enough water so dehydration isn't a factor. It could be if you are sweating more than you used to with exercise.
posted by Jane the Brown at 10:37 PM on January 26, 2011

First thing, congratulations for getting to the point where you're enthusiastic about getting your life back in order. Seriously, that is one hell of a thing.

Second, it sounds like you're at the "just get moving" stage, which is fine, but I suspect that with a little work you'll move past that soon enough. What then? My experience has been that it is hard to stay motivated to exercise regularly when goals, like "get more fit" are vague. What works for me is something specific to aim for so that I'm not just exercising, I'm TRAINING for an event. A goal like that is surely going to be highly personal, but it could be something like "Run a 5k event this year" or "Ride a 60 mile charity cycling event." I'm sure you get the idea. With a goal like that you've got a reason to train and you've got something you can track your progress towards. Look up "SMART goals" and you'll get the idea.

Best wishes, really, and I hope you have a great time on this new road you're heading down.
posted by LastOfHisKind at 11:21 PM on January 26, 2011

Nthing walking. Find a flat route for a while (or even downhill), then switch to a more uphill route. Going uphill--jogging or walking--is very, very good exercise.

Then try advancing to the Couch to 5k system mentioned above. In case you aren't fond of reading, here it is in a nutshell: when you start jogging, that first day jogging, walk first for 10 minutes to warm up. Then jog really slow. Slower than you think you should. Jog roughly as slow as a walk. You might even feel ridiculous, but go slow anyway. And only jog for about 5 minutes, then walk again for 10 minutes. Repeat a few more times, total of about 30 minutes, then stop. Do this for the first week, every other day.

The next week, increase your jogging to 6 minutes, walking to 14 minutes. Repeat for 30 minutes. Week after that, increase jogging to 7 minutes, walking for 14 minutes....get the picture? The idea is to gradually challenge yourself.

The cool thing about getting into shape is just how fast it can happen. You may feel like crap now when you try to exercise, but if you really keep with it regularly, and keep gradually making it more challenging, you'll be surprised how strong you become. At some point you realize you've passed a threshold and think Godammn! I can keep going! And I feel great. Really, it should only take a few weeks of dedicated exercise to reach this point.

Warning: jogging can be intensely boring. Use an mp3 player and listen to something. It helps a lot.
posted by zardoz at 11:24 PM on January 26, 2011

I have a friend in her twenties who was diagnosed with rheumatoid arthritis, and her doctor suggested water aerobics specifically for its easy-on-the-joints properties. I accompanied her, and I can say that I had a great, rigorous workout and the rest of the participants absolutely went at a pace that was comfortable for them. If you can join a gym with a pool, you can start out as slow as you need to and work your way back into shape.

And congrats!
posted by SeedStitch at 6:04 AM on January 27, 2011

The spirit of your endeavor is summed up well in The Sick Jock Guide: 10 Steps to Late-Life Fitness by the writer Marion Winik. Go read it.

Winik, whose past includes heroin addiction, bulimia, and a total lack of ability (or interest) in physical exertion, says:

"Don't improve -- at least not consciously. Rather than setting goals for time and speed and reps, rather than going on six-week ramp-up plans from fitness magazines, just forget about getting better at it, and just work on getting more comfortable with it. To me, the point of aerobic exercise is to hit the zone where you don't even know you're moving: where your head lifts out of it and you are as free as you thought you were when you did your first line."
posted by virago at 11:31 AM on January 27, 2011

Hey, good for you!

I would start by going for walks in the morning or the evening. Keep this up for four weeks, increasing your distance as you go along (e.g. add a 1/4 mile every 4th day). Sounds casual but will get your body ready for other things. Including the jog for three minutes, walk for 2 and keep building up. If you end up liking it, get some good shoes.

Then, while you keep walking, go try some things and find out what you like. Several suggestions above and getting in shape is a variable goal - but you have to like it. You mind find several things and change them around during times of the year. Yoga in winter and swimming throughout - who knows. Try some things and figure out what you want to do. If you get excited about it, some goals may fall in place (5k for running and on to a 10k; lots of swim races out there and there are no shortage of bike clubs, same with Yoga.)

Lastly, depending on your exercise of choice and goals. A heart rate monitor will go along way to ensuring you are exercising towards your goal.
posted by fluffycreature at 1:51 PM on January 27, 2011

First, start with walking. It's good exercise, and I think (based on my own experience with severe depression) it's really good for the mind and spirit to be moving through your environment with your head up under your own power.

Next, Convict Conditioning. Each of the six exercises is broken down into 10 stages, of which Level 1 is "so you just got out of the hospital or have spent the last 25 years at a desk and are so badly deconditioned you have trouble walking up a flight of stairs". Seriously, wall pushups — stand at arm's length from the wall, bend your arms until your forehead brushes it, then straighten your arms again. Vertical pulls, where you stand sideways in a doorframe with your toes touching the edge of the frame while holding onto the frame with both hands, lean back until your arms are straight, then pull yourself vertical again.

I've always been the skinny, unmuscular type, and CC is the first strength program that's ever clicked for me. I'm really happy with the results I'm seeing in how I'm muscling up and how much stronger I feel. Yeah, the goals are ambitious ones — the Level 10 exercises are things like one-armed pushup, one-armed pullup, one-legged squat, and one-armed handstand pushup — but there's no need to set a time goal, and I really believe that if I keep working at this I'll get there. I'd bet it would do well by you too.
posted by Lexica at 8:03 PM on January 27, 2011

I would actually negate what lots of other people suggested upthread EXCEPT short walking trips at the very beginning. By short, I mean pacing while you're on the phone for a good 10-15 minutes, or going up and down every aisle at the largest grocery store you have with the cart (including the ones where you won't buy anything), mall-walking, that sort of thing. If you're truly getting winded going up and down a flight of stairs or jogging for the bus, you need to build up some muscle tone first before taking on an aerobic exercise regimen.

Start by doing rounds of squats, push-ups, and maybe small free weights (5-10 lbs. tops, no more) around the house. 5 reps, then 10, then 15, built up to 20. Sit-ups and pull-ups are good, too, just go SLOW. (You can always go SLOWER; going FASTER = injury.)

Once you've got some muscle mass, you can move on to longer walks, swimming (need to get used to increasing your breathing capacity first before lapping it at the Y), yoga, and especially Lexica's Convict Conditioning suggestion. Sounds like you're busy and maybe might not have money for yoga classes, exercise equipment or access to a pool, so do basic calisthenics around the house until you can increase your number of reps to fill up 30 minutes or more. Then alternate on/off: calisthenics one day, with cardio for 30 minutes the next.

Running, jogging, long bike rides, jumping rope, recreational pick-up games of soccer - all of these things will be impossible without building up some muscle mass first. LOTS of people try the Couch-to-5k program and fail because they repeatedly hurt their knees, ankles and hips precisely because they don't bother to build up any muscle mass after a long period of being sedentary - maybe even a lifetime of it. As explained here, you need to build strength in your joints, ligaments and tendons at the same rate you build muscle mass to avoid injury; too many people try to start doing too much, too soon, hurt themselves and give up. By building overall strength and flexibility beforehand, you greatly decrease your chances of repeated set-backs, injuries and frustration and increase your ability to gain overall health benefits before you start tackling those long walks, running, or soccer games again.
posted by Unicorn on the cob at 10:26 AM on January 28, 2011 [1 favorite]

>you need to build strength in your joints, ligaments and tendons at the same rate you build muscle mass to avoid injury; too many people try to start doing too much, too soon, hurt themselves and give up.

This is very good advice (says the woman who gave herself a running injury by adding too much mileage too fast).

In the book Running for Mortals by John "The Penguin" Bingham, he writes

…while your aerobic system can achieve one cycle of measurable improvement in 3 to 6 weeks, your muscular system achieves one cycle of measurable improvement in 6 to 12 weeks.… your aerobic system is changing every 3 to 4 weeks, and your muscles are changing every 6 to 12 weeks, but your joints and tendons won't — and can't — change except every 6 to 12 months.…

That is why people so often begin to experience joint pain after just a few months of running.… Their hearts and lungs are feeling better than ever and their muscles are starting to feel great, so they push themselves to go farther and faster before their joints and tendons are ready. [Running for Mortals, pp. 58-59]

posted by Lexica at 11:25 AM on January 28, 2011