Importance of Warming Up
At rest, most of your blood circulates through the digestive tract, liver, spleen, brain and kidneys. A gradual warm-up helps re-direct this blood mainly to the active muscles, ensuring that the muscles you are exercising will have an adequate supply of oxygen.
​
Your heart is a muscle as well and requires a supply of oxygen in order for it to pump blood to your muscles. A gradual increase for oxygen to the heart during a warm up will gradually increase your heart rate and reduce the stress on your heart. Warming up will prevent spikes or rapid drops in blood pressure and helps maintain an optimal blood pressure during exercise. Warming up is an essential component to your exercise routine, therefore should not be shortened, overlooked or left out!
Importance of Cooling Down
A cool-down is also an integral part of your workout. While participating in cardiovascular exercise, most of your blood will be in your legs, delivering oxygen to these large muscles. Continuing to exercise while gradually decreasing your intensity facilitates the return of blood flow to the heart and brain, returning your body to rest. Cool-down for five to ten minutes, or until your heart rate is within 10 to 20 beats per minute of your resting heart rate.
If you do not cool-down and just stop suddenly after your workout, blood can pool in your legs, leaving you feeling light-headed, dizzy and potentially cause undue stress to the heart and brain. If you are doing a 10-minute cool down and the heart rate is not coming down, discuss this with your physician at the next scheduled visit.
​
Stretching is a great addition to your cool down. Because your muscles and joints are warm, your muscles are receptive to lengthening and your risk of injury is low. Stretching is a great way to help with joint pain (including knee and low back pain), relieve muscle cramps, improve posture and balance and maintain your range of motion. Flexibility is an important part of your exercise program, and after cool-down is a great time to work on it.
Additional Considerations for Cardiovascular Exercise



Due to the nature of cardiovascular exercise, it is always important to monitor for symptoms of exercise intolerance.
These would include, but are not limited to:
-
Sudden nausea
-
Headache
-
Dizzy or lightheaded
-
Any type of sudden chest discomfort that may include pain, pressure, heaviness or tightness in your chest, neck, jaw, shoulders down your arms or in your upper back.
If any of these symptoms present, stop exercise and discontinue further exercise until you can discuss this with your physician or other health care professional.
Resistance Training Exercise Guidelines

Stable body position:
It is important that you maintain good posture while completing your resistance training exercises. Poor posture can cause the force to be distributed incorrectly, leading to injury. Be sure to open up your chest and pull your shoulder blades back and down slightly. Engage your core by actively pulling your stomach in (like you are pulling your belly button toward your spine). Rather than sucking in your tummy, instead imagine bracing your stomach as if someone was about to punch you in the belly. By engaging your core in this way, you will be able to maintain good posture and complete your exercises safely and properly. Finally, if the exercise allows, ensure that your feet are shoulder width apart or have a staggered stance with one foot forward and one back. This will allow a secure base of support.
Proper Technique:
Following proper technique will not only assist in keeping you safe from injury but will also maximize the activation of the desired muscle and boosting the training effect. Ensure you lift straight and avoid twisting motions, so you can control your spine and avoid putting yourself at risk of injury. Follow the pictures and descriptions provided to ensure you are positioned properly. Using a mirror or an exercise buddy to watch your technique will help. If at any time you can’t remember the exercise, it is no longer feeling comfortable, or it is painful, contact one of the study team members.
Breathing:
Holding your breath while exerting force can cause your blood pressure to rise and cause undue stress on your heart. Continuing to breathe during exercise will ensure your muscles get sufficient oxygen and are able to function properly. A good rule of thumb is to exhale when you are doing the work (i.e., lifting the weight or pulling the band), and inhale while releasing. Breathing slowly and smoothly will ensure adequate oxygen supply to your working muscles, will help you perform the exercise in a controlled manner, and will reduce the stress on your heart.
Rest:
It is important to give your muscles sufficient rest to facilitate recovery. This means both within an exercise session (between sets) and between exercise sessions. Most exercise specialists recommend 24-48 hours between exercise sessions. After completing a resistance training session, you should take 48 hours rest before doing the routine again. Cardiovascular training requires 24 hours rest before the next cardio session. The research team has provided you with specific guidelines or schedules to follow. It is important to follow what they have advised. It is also important to rest between sets, so you ensure your muscles have recovered. Usually about a couple minutes between sets is sufficient. However, you should listen to your body. If you are feeling quite tired one day, resting longer between sets should help ease this fatigue. It is possible to do too much training (overtrain), which would be detrimental to your progress.
Exercising in a circuit that alternates upper and lower body or different areas of the body may have been recommended, allowing for proper rest. If you are ever unsure about what is appropriate, speak with a member of the research team. Allowing your muscles to recover will enable you to work them at an intensity sufficient to increase your strength.
Temperature:
Take caution to maintain your temperature when you are exercising. Ensure your exercise area is well ventilated (fans, open windows) and wear breathable clothing to avoid over-heating or discomfort. If you do feel you are overheating, stop exercising and cool off by drinking water and finding a cooler environment.
Hydration:
Hydration is very important during an exercise session. Dehydration will impair your ability to train and can lead to serious issues such as heat exhaustion, heat stroke, or exacerbate other health-related concerns. It is important to drink water before, during and after exercise to ensure proper hydration and recovery.
Considerations:​
-
Listen to your body in order to avoid exercise induced fatigue. Remember that completing your program in small, multiple chunks throughout the day is always a smart option.
-
Be aware of public exercise settings if you are immune-sensitive.
-
Stop exercising if you feel nauseous, light headed, short of breath, dizzy, or if you develop chest pain or any other sudden sharp pain in your muscles or joints.
-
If you suffer from neuropathy, ensure that your activity and exercise occur in a way that does not or only minimally increases your symptoms. Always ensure you are active in a cool environment or if outside make sure you are hydrated with cool liquid. If symptoms begin to increase listen to your body and rest until you return to your normal neuropathy levels.
Progression Guidelines:
Progression is an important part of any exercise program. Without progressing your exercise program, your program will become easy and you will not be achieving the benefits of your hard work. Once you start exercising, your muscles go through a cycle of shock, adaptation, and then staleness. The shock is what causes your muscles to feel sore initially. As you continue to exercise, your muscles adapt, and you become stronger and fitter. However, if you do not continue to adjust the resistance or the loading of your muscles as you get stronger, they will not continue to adapt. In turn, your workouts will become stale. Therefore, by including appropriate progression into your exercise program, your body adapts by becoming stronger and fitter.
If you have been working on your exercise program for a while and you find its beginning to get too easy, then it is time to progress. First, increase the number of repetitions (reps) you are doing; if your range is between 8-12 reps increase, gradually increase from 8 reps to 10. Eventually, progress your reps until you can complete 12 without too much difficulty.
Second, once you can complete 12 reps, try adding a set (increase the number of times you perform your reps). Usually, you will start with two sets and you can increase up to three sets. Unless there are specific training goals, it is not typical to do more than 3 sets of exercises. Third, increase the resistance you are using. This can mean using a thicker exercise band. It is important to note at this point that you may have to decrease your reps, as the increased resistance may be too hard to complete. You would then progress yourself in the same manner – first increase number of reps, then sets, and then resistance again.
Understanding Pain: Good Pain vs. Bad Pain
Discomfort in your muscles and joints can be a natural and normal response to exercise. However, it is important to be able to distinguish between the good pain that is caused by the muscle strengthening process, and the bad pain that is caused by or is a precursor to an injury. While exercising, natural minor damage occurs in the muscle tissue. Our body naturally repairs this damage thereby making our muscles even stronger. The byproducts of this repair and strengthening process cause muscle soreness.
You may start to feel sore as soon as a few hours post activity and it may persist for as long as a few days (up to 4) following your exercise bout. This muscle stiffness and soreness lasting up to 24-48 hours post exercise is called Delayed Onset Muscle Soreness (DOMS) and is a normal response to an exercise session. Muscle and joint stiffness/soreness will be more pronounced if you have been inactive for a long period of time or if you are performing an activity new to you.
On the other hand, pain that lasts more than a few days or pain that occurs during exercise is not a normal response and can even be serious. This could occur as a result of an uncontrolled or incorrect movement, or by performing an activity that is beyond your current capabilities. It may indicate an injury or an aggravation of a previous injury. This pain will feel different from muscle stiffness and soreness, as it may be sharp or shooting pain and may cause impairment of your day-to-day activities. You may also notice inflammation (heat, redness and swelling) in the area that is feeling painful. This is another indication that you may have injured yourself or are pushing your body beyond its current limitations. In summary, it is important to listen to your body and work within your current capabilities.
