Building stamina and bone strength with health issues
February 3, 2017 9:29 AM   Subscribe

I want to build my stamina and increase my bone strength. When I Google "building stamina," I seem to find only stuff for fit people getting fitter. I need something for a non-fit person (with cancer!) trying to get fit. I take long walks, but I can't run. Couch to 5K is out of the question. Snowflakes inside.

I want to increase my stamina, but I can't run. I have multiple myeloma (bone marrow cancer), though my oncologist told me this week that I'm in complete remission (yay!). Because this cancer can weaken my bones, I need to be super careful to avoid breaks. When I was diagnosed in September, x-rays showed a stress fracture in my spine. A year ago, before I was diagnosed, I tried increasing my walking speed and ended up tripping on the sidewalk and breaking my arm. So I'm very worried about falling. When the weather's nice, I take walks in the woods (can't risk it now because of the ice). This is fun (which encourages me to do it) and involves hills, which gets me breathing a little harder, but in the winter, I use an indoor track. I belong to a gym, so I also have access to treadmills, ellipticals, and other exercise equipment. I do fifteen minutes of yoga every morning - I've had back problems, and that seems to keep it in check.

I just had a stress test, and it showed no cardiac problems. (I had chest pain, which my PCP thinks is costochondritis, but he ordered the stress test just in case.) My oncologist has said I can do weight lifting if I start with small amounts and build up gradually. I just ordered a weighted vest to wear when walking, which my oncologist has also OK'd as long as I start with a small amount of weight.

When I walk on the track, I just don't go very fast. For me, trying to walk fast on a track takes the pleasure out of it, and I think I'll be less likely to keep it up. With walking on a treadmill, I know I can use an incline to increase my workout, but I'd kind of like to come up with some sort of organized system to overcome my own basic laziness. But I'm not sure how to do this, and frankly, I feel overwhelmed about the whole thing. I'd like to come up with something like Couch to 5K for someone in my situation. If it's helpful to know, I'm a 58-year-old overweight female. I'm still doing chemo, but the side effects are very mild.

(I don't need or want diet advice for the bone strength - I've got that covered.)

Thanks MeFites.
posted by FencingGal to Health & Fitness (23 answers total) 3 users marked this as a favorite
Is there anywhere nearby with a swimming pool you can use?
posted by Thorzdad at 9:31 AM on February 3, 2017 [4 favorites]

My gym has an indoor pool.
posted by FencingGal at 9:37 AM on February 3, 2017

You should do this under the guidance of a physical therapist, but I think core strengthening would improve your general fitness level and therefore stamina (and I think it's generally considered good for bones to have a stronger muscular framework around them). Pilates is probably one way to do that with very little impact (swimming is definitely another) but in your situation, since you cannot afford an injury, you should work closely with a trainer or in a small class with some 1:1 attention to make sure your form is spot-on.

And it's enough of a challenge that it's engaging your brain while you do it, which to me is more fun/less dull than zone-out exercises like treadmill or elliptical.
posted by Lyn Never at 9:39 AM on February 3, 2017 [1 favorite]

Would a class help you with motivation and structure? My Y has classes specifically for recovery after injuries, and they've had them for people with cancer, as well.

Water aerobics could be just the thing. You can customize them -- how deep in the water you go, how hard you work -- and I've found the people in them to be as supportive as you can get. You wouldn't have to worry about falling.
posted by The corpse in the library at 9:40 AM on February 3, 2017 [3 favorites]

A weighted vest? That seems extreme, all things considered... Why not just gradually increase the incline on the treadmill and add time (for walking)? Walking is adequate for most people! Or there's the elliptical, too, you're still giving your bones some gentle, bone-building impact (unlike swimming). For bone strength, it'd be lifting with weights - along these lines [pdf]. (Also - it seems very worth investing in supportive and stable shoes with *really* good treads, as far as the falling goes.)

Congratulations on your remission, that is wonderful :) Best to you :)
posted by cotton dress sock at 9:44 AM on February 3, 2017

Ah sorry - would google interval incline treadmill walking workouts for something to give you a sense of structure, there are plenty online.
posted by cotton dress sock at 9:48 AM on February 3, 2017

Im nthing h2o aerobics. In addition to your walks. So very happy for you that you are in remission!
posted by WalkerWestridge at 9:52 AM on February 3, 2017 [1 favorite]

(The thing that gets me through less exciting cardio is music. Make a playlist with songs that rouse you (on Spotify if you have that - it's a good way to become acquainted with new music, too). You can select songs for beats per minute to set a pace for yourself.)
posted by cotton dress sock at 10:01 AM on February 3, 2017 [1 favorite]

I took a strength and flexibility course at university when I was an undergrad - basically very closely supervised weight training - which lead me to start powerlifting.

Powerlifting sounds very scary, but I actually found it to be an ideal introduction to strength training, as I was (a) under the supervision of a coach who (b) emphasised rest, form and a very gradual progression in (c) a very supportive environment.

In my experience, powerlifting gyms tend to be very inclusive places. My 63 year old mother recently started training at a powerlifting gym, and proudly sends me pictures of her deadlift.

So, the TL:DR, if geography and finances allow, maybe you could find a weightlifting focused gym and find an experienced coach or trainer to work with you on a very gradual, very gentle weight training programme?
posted by nerdfish at 10:09 AM on February 3, 2017 [2 favorites]

Yay remission! Congratulations!

The best way to build bone is to do "weight-bearing" exercise, meaning something against gravity, whether that's aerobics or weights. Swimming's great and fun but I'm not sure it's the highest yield if your goal is bone health.

I, too, hate the treadmill and can't wait for the weather to get good enough for walks in the woods. What I've been doing to keep my brain engaged, is listen to narrative podcasts -- I find story more interesting than music, because I want to know the ending! Selected Shorts, Radiolab, Season 1 of Serial, were all great for this. I also use the preset workouts on the treadmill to simulate hills -- not quite the same thing, but it's close. I find this easier than me periodically changing the incline in a not-at-all-organized fashion.

Check with your oncologist about whether calcium and vit D would be helpful at all. Bisphosphonates (prescription only) are also an option.
posted by basalganglia at 10:17 AM on February 3, 2017 [2 favorites]

You're already walking, which is exactly the right thing to do. Get a pedometer, so you can track your activity on a weekly basis. Make a note of how many hours you are walking a week now, and try to get it up to at least 8 hours. Walking will build bone density faster than swimming.

If you are walking on ground that is the least bit uneven, a single pole, available from REI, is startlingly helpful. It provides a third leg that allows you to transfer some load to your upper body for a little more exercise, and much more stability.

I don't like the pedometers you wear on your wrist, but they have the most features. I can personally recommend the Fitbit Zip or the Oregon Scientific PE326CA. The Oregon Scientific is the price:performance winner, and requires a little bit of easy adjustment before it counts accurately.
posted by the Real Dan at 10:29 AM on February 3, 2017 [1 favorite]

Congratulations on your remission!

My mother was in your position after chemo and radiation (non-fit person with cancer trying to get fit); she started with pilates and yoga classes and did those for a few years, then started weightlifting under the supervision of a personal trainer.

If you want strong bones, weightlifting is definitely a good way to go (says the lifter). Start with light weights, and definitely get a coach or trainer to watch you lift when you're learning, because of the stress fracture in your back. Starting Strength is the go-to weightlifting equivalent of Couch-to-5K, and it has apps. MeMail me if you'd like more specific weightlifting advice.

As far as walking and the treadmill/elliptical… when I used them, I brought my phone, rested it on the ledge, and watched Netflix while I walked. It helped distract me from the tedium. Maybe that'd work until you can get back outside again?
posted by culfinglin at 10:37 AM on February 3, 2017 [3 favorites]

Swimming is great exercise, but it is the opposite of weight-bearing and will not help significantly with building stronger, denser bones.

Weight bearing exercise, specifically lifting weights, is the best bet for what you're looking for. Normally I'd suggest trying to get into free weights, but given the already brittle condition of your bones you may want to start with machines first for safety and limit the free-weight stuff to bodyweight work for now. Machine-based programs are pretty varied and dependent on the type of machines you have. Would it be possible for you to talk to a trainer in your gym about putting you on a simple, full-body circuit?

When you do feel ready to move into free weight stuff, I strongly recommend Strong Curves. It provides very smart, comprehensive training advice and intelligent lifting programs, wrapped in the "make your butt look better" packaging to sell it. It includes a bodyweight-only program too, if you want to start with that. I have actually started recommending this to people over programs like Starting Strength, as the exercises are more accessible and learning to do a proper squat and clean can require an obsessive attention to detail and access to coaching assistance that most people who just want to get into shape don't have. The New Rules of Lifting for Women is also a great resource.
posted by schroedinger at 10:47 AM on February 3, 2017 [7 favorites]

I think a good phyiscal therapist with experience with patients like you would be tremendously helpful.
posted by radioamy at 11:52 AM on February 3, 2017 [1 favorite]

A good physical therapist would be a great place to start, if you can.

I was coming in to suggest rowing on an erg if that is available in your gym. Rowing is low impact, you're not going to fall down, and you can control how hard you're rowing (and SEE how hard you are working) very easily. For me, it's been a fantastic source of cardio and I've been able to improve my cardiovascular strength over time and at my own pace. It's a full body work out and anyone can do it, you don't have to be six-six and rowing like a beast at all times. Your profile doesn't have a location, but on the Concept2 site you can find instructors nearby and they have technique videos. If you are convenient to Atlanta, I can personally welcome you to the rowing gym I attend, just meMail.

For bone strength, as above, weight training is going to be the best. You don't want "just" a personal trainer in your situation - a physical therapist or a USA Powerlifting Certified Coach would be a good choice. I AM NOT SAYING A USAPL COACH AND A PHYSICAL THERAPIST ARE THE SAME THING. My personal experience with USAPL coaches is that they are very well-trained and very conservative and are very much about progress and not stupidity. You may also be interested in finding a woman-friendly gym with Girls Who Powerlift (that list is growing as that's a new feature in the community). I am a powerlifter and so that's where my knowledge and biases lie in terms of what I'm suggesting, obviously, but a good, smart coach will be helpful in any case, I'd think.
posted by Medieval Maven at 12:33 PM on February 3, 2017 [4 favorites]

In addition to swimming and walking (as mentioned above), I will suggest isometric exercise for strength. Isometrics (straining against an immovable object) have some advantages, less possibility of injury, you can do it anywhere with no equipment and the ability to put out 100% (the most strength building) without increasing weights. Make a game of it, push the door frame apart, pull the two sides of your table together, pull yourself up by your bootstraps (non-figuratively!, though I suppose that is technically calisthenics).
posted by 445supermag at 1:08 PM on February 3, 2017 [1 favorite]

Congratulations on your remission!

I think walking is great, but I understand your concerns on falls. Something I do in the winters for an hour a day is use a stationary bike.

With your hands free, you could use small weights to lift to build bone density. Another thing I do when walking or riding the bike is wear donut weights around my wrists. This way my hands are free for balance. I sewed mine with an old sock and BBs, but they also sell them. I don't necessarily worry about "lifting" them. Just wearing them helps my arms because they add weight to the swing of them when I walk.

I know riding a bike or using a treadmill gets boring, so what about listening to music, a podcast, or watching a TV show?

I went from being able to walk about a mile a day to 5 miles a day in the matter of three months by gradual increases. I think also putting in a variety of different things (bike one day, walk on treadmill the next, elliptical the next...) will help keep interest and also work different muscle groups.

Best of luck!
posted by LillyBird at 1:23 PM on February 3, 2017

Congratulations on your improved health.
I prefer walking at the biking / jogging track at the local lake, as well as in the neighborhood. I always bring a hat, scarf, sunscreen and bug spray, Walmart hiking pole, and at least one 16 oz. bottle of water. And pepper spray for aggressive dogs (my husband was attacked by a neighbor's dog across from our house, and the pepper spray was in the car).
I did some checking and there are refillable bottles that look like dumbbells or have handles. You can drink it, pour it out, or store it in a small backpack as you hike. Here is an exercise routine for a pair of bottles that might do.

I am not a fitness instructor, but as I understand it you can do many reps with small weights as well as a few reps to exhaustion with heavy weights (this builds bulky muscle). Wrist and ankle weights are also available, but I like the idea of drinking the evidence.
Good luck and healthy hiking!
posted by TrishaU at 2:05 PM on February 3, 2017

Also, I find indoor areas to walk in the winter: malls, universities, large general stores. I prefer going up stairs instead of down, so a multi-story place with an elevator is nice.
At last resort I put on the TV and walk on a stable cushioned surface. It kills the time during the evening news. Good jogging shoes and socks are a must, even indoors for a half hour.
I really miss Denise Austin in the morning on PBS.
posted by TrishaU at 2:12 PM on February 3, 2017

I'm a doctor

Swimming and cycling have a neutral to slightly negative effect on bone density. Eschew.

For resistance exercise, no machines and no free weights. Start with elastic bands. They're the best
bet for people with no experience with resistance trianing, and have several advantages over machines and free weights.

Specifically, they're inexpensive, portable, can be used at home, and provide steady resistance across an entire range of motion. They're safe, and they're easy to learn to use: one 45 minute session with a trainer is all you'll need to be able to work independently.
posted by BadgerDoctor at 7:11 PM on February 3, 2017 [6 favorites]

Another doctor here.

Nthing the (small, steady gains) weight training.

Don't forget about balance, however! Yoga is great for this. If you have an electric toothbrush, try balancing on one foot for each 30s or minute interval while you brush. Surprisingly difficult if you are out of practice, and surprisingly quick gains in balance if you do it every day!
posted by eglenner at 4:43 AM on February 4, 2017

I don't know if your budget precludes it, but this winter I've been going to a personal trainer and really enjoy/benefit from our sessions. Despite having a heart condition, trick knee, bad back, etc., I've made small but steady gains over the last three months in balance, flexibility and strength.

The trainer introduces a lot of variety, which I like, using elastic bands, isometrics, light free weights, etc. He also always has another way to exercise a muscle group if my knee or back precludes a particular position or movement.

I know that most people think a trainer is too expensive for what you get, but having a paid commitment is motivating. I know that without it, I'd be doing nothing. So for me it's well worth the cost.
posted by Short Attention Sp at 7:08 AM on February 4, 2017

I have CFS and have a rebounder (mini-trampoline). It's a good method of cardio that doesn't leave me out of breath, and is supposedly good for deconditioned people.
posted by decathexis at 1:18 PM on February 4, 2017

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