a strong outside strengthens the...

This product was developed by the St. John's Regional Medical Center CSI-Diabetes program, as part of the Better Self

Management of Diabetes Program, funded by the Missouri Foundation for Health.

A strong outside

strengthens the inside

Exercise



Table of Contents

Activity pyramid …………………………………………………………………………2

Benefits …………………………………………………………………………………..3

Safety …………………………………………………………………………………….4

Common barriers ………………………………………………………………………...6

What to do if your have complications ………………………………………………….10

Target heart rate …………………………………………………………………………11

Beginning Exercise ……………………………………………………………………...13

Understanding your muscles …………………………………………………………….14

Stretching exercises……………………………………………………………………...15

Strength training exercises……………………………………………………………….19

Aerobic exercises…...……………………………………………………………………23

Walking guidelines...…………………………………………………………………….26

Sources ..………………………………………………………………………………...27



Why should I be physically active?

Being physically active is important in the prevention and treatment of diabetes… that’s

right, TREATMENT. Regular physical activity can actually prevent and delay the onset

of diabetic complications.

Do you know the benefits of exercise? They include the following:

Keep and improve your strength

Increase your energy levels

Improve balance which will help prevent falls

Prevent or delay diseases such as heart disease and cancer

Perk up your mood which will reduce depression

Improve diabetes as well as heart disease, high blood pressure, stroke, and colon

cancer

Reduce body fat

Help you lose weight

Improve your body’s ability to use insulin

Lower bad cholesterol and increase good cholesterol

Now that we know the benefits of exercise, let’s stop and go over a few definitions.

Physical activity- anything that gets your body moving

Exercise- planned, structured and repetitive bodily movements done to improve or

maintain one or more components of physical activity

Aerobic activity- also called “cardio” gets you breathing harder and your heart beating

faster

Intensity- how hard your body is working during aerobic activity

Moderate intensity- means you are working hard enough to break a sweat and increase

your heart rate. If you are working this hard you will be able to talk, but not sing the

words to a song

Vigorous intensity- means you are breathing hard and fast and your heart rate is up. If

you are working this hard, you will not be able to say more than a few words with out

pausing for a breath

Cardiovascular- includes the heart and blood vessels, which carry nutrients and oxygen to

the tissues of the body

Cardiovascular disease- includes diseases such as coronary artery disease, heart attack,

heart failure, high blood pressure and stroke

Range of motion- the normal amount your joints can be moved in certain directions

Weight bearing activities- includes doing aerobic exercise on your feet with your bones

supporting your weight

Repetitions- or reps, is the number of times you repeat an exercise



Safety

When to check with your doctor:

If you have any complications of diabetes (numbness or tingling of limbs, kidney

problems or eye problems)

If you are a man over 40, or a over woman over 50, and have never tried exercise

or have a chronic health problem (you do not have to check with your doctor for

walking)

Any new symptom that has come up and you have not discussed with your doctor

Dizziness or shortness of breath

Chest pain or irregular heart beats

Blood clots

An infection or fever with muscle aches

Unplanned weight loss

Sores that will not heal on the feet or legs

Joint swelling

A hernia

Recent hip surgery

Safety Tips

Start slowly

Increase your activity level each time you exercise

Don’t hold your breath during exercise, this will increase blood pressure

Proper foot wear should be worn

If you are not on any fluid restriction, be sure to drink plenty of fluids even if you

don’t feel thirsty

Always bend forward from the hips not at the waist, to make sure you are bending

right see if your back is straight when you bend forward, if it humps your are

bending wrong

Always stretch to prevent injuries

Wear some form of diabetes and personal identification

Avoid vigorous activity in extremely hot, humid, smoggy, or cold environments

Exercise should not make you feel really tired or keep you in pain. If these symptoms

occur, discontinue exercise and talk with your doctor.



Shoes

When exercising, it is important to wear proper shoes. People with diabetes sometimes

lose feeling in their feet and legs. Wrong fitting shoes can pinch or rub your feet causing

sores.

What to look for in shoes

Breathable

No interior seams or covered inseams

Plenty of room in the front of the shoe so the toes can move

Elastic or an adjustable fit to prevent the shoe from sliding around

It is a good investment to have custom insoles made or go to a shoe store that specializes

in diabetic shoes. There are also diabetic socks.

Taking care of your blood sugar

It is a good idea to check your blood sugar before and after exercise. Do not

exercise if your blood sugar is less than 70 or more than 300.

Carry a snack (carbohydrate) in case your blood sugar gets low during exercise

Examples of snacks include:

1/2 peanut butter sandwich

Juice box and string cheese

Peanut butter and small apple

Banana and peanut butter

Crackers and cheese



Common barriers to exercise

What is a barrier?

The dictionary defines a barrier as, “a structure such as a fence that is

intended to prevent access or keep one place separate from another.”

We all experience personal barriers to things. A personal barrier to

exercise is something that personally prevents you from exercising. So how are you going

to jump that imaginary fence in your way?

Barrier: Between work, family, and other demands; I am too busy to exercise!

Solution: Make it a priority the same way you make other things a priority. Carve time

out in your day or certain days of the week. Write it on a calendar and write the time to

keep yourself accountable. Wake up 30 minutes earlier to go on a walk. Take an evening

exercise class to keep you accountable. Try to schedule a walk during your lunch hour.

Additionally, you can try to build physical activity into your routine chores. Rake the

yard, shovel snow, wash your car, or vacuum at a fast pace.

Barrier: By the end of a long day, I am too tired to work out!

Solution: Spread your work out through out the day. Break it into three 10-minute

increments. Walk in the working, mid-day, and evening. Figure out what works best for

you. Trick yourself into exercise; take the stairs, park at the back of the parking lot, or

walk in place while watching TV.

Barrier: Getting on a treadmill or stationary bike is boring!

Solution: Meet a friend for workouts; this will keep you motivated and accountable.

Watch TV while on a bike or treadmill, or read a book or magazine. Listen to a book on

tape, or music that inspires you. You can check out books, books on tape, or music from

the library. Change your scenery and go outside and ride your bike, or go on a walk.

Barrier: I am afraid I will hurt myself!

Solution: Start slow and increase the length of time you exercise by one or two minutes

every time. Start with moderate intensity workouts first and then progress to harder

exercises. Take an exercise class, the instructor will show you the safest ways to perform

exercise and watch you do the exercises to ensure you are properly performing them.

Water workouts are the best if you are worried about your joints or muscle aches.

Swimming laps or doing water aerobics is a fun way to do water workouts.



Barrier: I do not want to spend a lot of money to join a gym or buy workout gear!

Solution: Choose free activities. Dance, garden, take your children or grandchildren to

the park, go on walks, walk around a local mall or store, such as Wal-Mart. Find out if

your job offers any discounts at fitness clubs, some companies will pay for half of the

membership. Some fitness clubs offer discounts or scholarships based on income. Use

canned food, or fill milk jugs filled with water or sand and use them as weights.

Barrier: I don’t have anyone to watch my kids while I exercise!

Solution: Do something physically active with your kids. Remember your children need

exercise too, so involve them. Dance to music, walk while they ride their bike, run

around at the park with your kids, or play games such as soccer, basketball, or tennis.

Take turns with your spouse while one of you exercises. Hire a babysitter. Try to find

fitness clubs that offer childcare.

Barrier: I would be embarrassed if my neighbors or friends saw me exercising!

Solution: This can be a common fear that people face, but does it really matter? You are

doing something positive for your health and you should be really proud of it. If someone

sees you exercising you may inspire him or her to start exercising, and they may even

want to join you. Ask someone to exercise with you. Having someone to exercise with

will make you feel less self-conscious, be accountable, and make it fun. If you do not

want to exercise in your neighborhood go to a local park, nature trail, or fitness or

community center to be active.

Barrier: The winter is too cold and the summer is too hot to be active!

Solution: Walk around the mall or a store such as Wal-Mart. Join a fitness or community

center that allows you to pay for the months and classes you want instead of a whole

year. Work out at home; check out exercise videos from the library every week or share

videos with friends to switch up your work out.



Now that you have heard common barriers, what are the barriers that stop you from

exercising?????

Take a few minutes and write down 2-3 barriers you have.

My barrier: ________________________________________

My barrier: ________________________________________

My barrier: ________________________________________

Now from the discussion above what can you do as a solution to these barriers?

Solution: __________________________________________

Solution: __________________________________________

Solution: __________________________________________

Now that you have critically thought through barriers and solutions, take the next step.

Know your goals: Short-term goals like walking 10 minutes 3 times a week are good to

start out with. Write on a calendar the days and times you want to try to exercise. Then,

track your exercise on the spreadsheet that is provided.

My goals: ______________________________________________________

______________________________________________________

______________________________________________________

Have support: Think of people that can encourage you to exercise. Think of your

patients, spouse, siblings, relatives, and friends for encouragement. These people can help

keep you stay on track by providing encouraging words that motivate you, watch your

children or get them to exercise with you. Don’t forget your biggest cheerleader, your

dietitian or healthcare provider. We really want to see you succeed, because we know

how much you will improve your overall health.

Lastly, write a memorable message for yourself to motivate you to exercise.

A memorable message is a 6-10 word message for you to look at and remind yourself

why you are exercising.

My memorable message for you is, “A strong outside strengthens the inside.”

Your memorable message is ___________________________________________



Put this message in a place that you will see everyday such as your mirror, refrigerator, or

bulletin board.

What to do if you have complications of diabetes

Cardiovascular disease

You may need to be monitored in a cardiovascular rehabilitation program.

Avoid activities that can increase your blood pressure greater than 260/125,

activities that increase blood pressure are the ones that primarily use the upper

body and arms.

Avoid activities that require heavy lifting or straining.

Avoid trying to move a heavy object while holding your breath.

Try activities that use the lower extremities such as walking, light jogging, and

cycling activities.

When doing resistance exercises, try low resistance with high repetitions.

Peripheral vascular disease- narrowing of your vessels that carry blood to your legs,

arms, stomach, or kidneys

During physical activity you may experience pain, because oxygen is not

getting to your muscles

A walking program with periods of rest may help improve circulation and

decrease pain

Everyone is different, so you will have to start slow and work up slowly,

because higher intensity requires more oxygen which will cause pain

Use conversation, music, and other elements to distract attention from the

discomfort and pain

Stop exercising when you cannot distract the pain, and the pain becomes intense

Weight bearing activities are ok (fast walking, jogging, running, jumping,

jumping jacks, step aerobics, dancing, weight lifting, hiking, stair climbing, and

push-ups)

If you have pain when you are resting or in the night, do not start a walking

program

Retinopathy- eye problems causing blurred vision

This is a very serious disease, talk with your doctor or eye doctor before starting

any exercise

Visual impairment

Swim in lanes that use lane guides

Stationary cycling

Treadmill walking

Dancing with a person that doesn’t have any vision problems

End-Stage renal disease



Activity levels will depend on the level of kidney function, speak with your

doctor

Start at a very low level and slowly progress

Brisk walking, swimming, and cycling should be ok

Peripheral Neuropathy- numbness or tingling in arms, fingers, legs, or feet

Stretching is ok, but overstretching can occur so only hold for 10 seconds

Avoid lifting weights due to an increased chance of tissue and joint injury

Do low impact activities such as cycling and swimming. Brisk walking is ok if

balance is not impaired

Avoid jogging because it puts extreme pressure on the feet

Chair exercises are ok

Autonomic Neuropathy- affects involuntary body functions such as heart rate, blood

pressure, perspiration, and digestion

Your body may not be able to cool down or increase body temperature during

exercise, so avoid extremely hot or cold environments

Avoid high intensity physical activities

Possible low blood pressure or high blood pressure can occur after high intensity

exercises

Frequent blood sugar monitoring may be needed

Review the following 6 questions. If you answer yes to any of the following questions, do

not start exercising and speak with your doctor.

1. Are you a man over 40 or a over woman over 50 and have never tried exercise or

have a chronic health problem?

2. Do you have any new symptom come up and that you have not discussed with

your doctor?

3. Do you experience dizziness, shortness of breath, chest pain or irregular

heartbeats?

4. Do you have blood clots, a hernia, unplanned weight loss, joint swelling or an

infection or fever with muscle aches?

5. Do you have a sore that will not heal on the foot or leg area?

6. Have you had recent hip surgery?



Target heart rate

Everyone should determine his or her target heart rate. When doing aerobic exercise,

your target heart rate will give you an estimate of how hard you are working.

How to determine your target heart rate

Taking your pulse is the first step to determining your target heart rate

Press the tips of your index and middle fingers on the inside of the opposite wrist just

below the base of the thumb. Count the number of beats over a minute (60 seconds).

Do it when you have been sitting for a few minutes.

When taking your pulse after exercise, count the number of beats over a 10 second

period and multiply this by 6. Don’t count your pulse for an entire minute. During the

minute your heart rate will slow down and you won’t get an accurate reading.

You want your exercise intensity to be in the rage of 50-80% of oxygen uptake reserve

(VO2R) or heart rate reserve (HHR). So what does that mean?

Let’s do an example of a 50-year-old male.

First we estimate the heart rate maximum.

Estimated HR max = 220-age

Now we estimate the target heart rate range with 50% as the lower estimated range and

80% as the higher estimated range.

Lower range = [(220 – Age) x .50%]

Lower range = [(220-50) x .50]

= [170 x .50]

= 85 beats per minute

Higher range = [(220- Age) x .80%]

Higher range = [(220-50) x .80]

= [170 x .80]

= 136 beats per minute

This person would want to keep their heart rate between 85 to 136 beats per minute

during exercise.

This is just an estimation of heart rate, don’t use this method to determine your maximum

heart rate if:

You are on medication that will change your heart rate such as beta-blockers.

Beta-blockers alter your heart rate response to physical activity and mask

hypoglycemia. Some examples of beta-blockers include: Propranolol, Sotalol,



Atenolol, Metoprolol, Lopressor, and Coreg. Ask your dietitian or your healthcare

provider if you are on any beta-blockers.

You have a pacemaker or have an irregular heart rhythm called “atrial fibrillation”

You have other conditions that affect your pulse rate



Beginning exercise Your exercise routine should consist of a warm up and cool down .

Warm up

5-10 minutes of low intensity aerobic exercise

Why do you need to warm up?

It prepares muscles, heart and lungs for the activity

It helps reduce muscle injury

It helps you safely transition from resting to exercise by increasing blood flow,

elevating body temperature, increasing oxygen availability, and increasing

metabolic rate

Stretching should be part of your warm up

An easy warm up is to walk in place for 5 minutes, then stretch for 5 minutes

Cool Down

5-10 minutes of low intensity activity

It is a good idea to include stretching in your cool down

Why do you need to cool down?

It helps the body to safely transition to the resting state

It prevents blood pooling in the arms and legs

It removes metabolic by products

It may reduce risks for cardiovascular complications immediately after exercise

Extra tips for exercise

Make sure when you exercise to breathe continually and avoid breath holding, exhale

during the exertion or lifting phase, and inhale while returning to starting position

Lift weights with slow controlled movements

Try to use complete range of motion

Try to keep your body straight while performing exercises

STOP exercising if you feel dizzy, light headed, unusual shortness

of breath, or chest pain



Understanding your muscles

As you read through this book, you will see the names of the muscles used. Refer back to

this picture to understand the muscles you are exercising. You want to make sure you do

the recommended repetitions, so you don’t overwork your muscles.



Stretching Hold each stretch for 15 to 30 seconds.

Complete 2 to 4 repetitions.

Try to stretch at least 2 to 3 days per week.

Breath in and out normally when stretching

Neck stretch

With your hands behind your head, push your head back into your

hands focusing on the force coming from your neck. Do not push too

hard otherwise you may strain your neck. Hold stretch for 10-15

seconds and repeat once.

Neck stretch

Gently grasp side of head while reaching behind back with other

hand. Tilt head away until a gentle stretch is felt. Repeat to

other side. Hold stretch for 30 - 60 seconds. You can repeat 2 to

3 times as desired.

Shoulder stretch

Bring your arm across your body and hold it with your other arm, either

above or below your elbow. Hold the stretch for 30-60 seconds and switch

to your other arm.



Triceps extension

Extend your arm up, and bend at the elbow, so that you are reaching

down the center of your back. Hold that arm down at the elbow with

your other hand.

Hold each side for 30-60 seconds.

Arm circles

Extend your arms out to the side forming a “t” with your body. Make small circular

motions for 10 seconds; slowly enlarge your circles for another 20 seconds.

Wrist Stretches

Extend your arm straight in front of you, flex your palm up, and point your fingers down.

Use your other hand to gently pull your hand back. Hold this stretch for 20 seconds. This

exercise can also be done

with your fingers pointed

up.



Runners Stretch

Excessive tightness of the calf muscles can contribute to many foot

problems and some knee problems. This exercise is very important

for diabetics to prevent leg and feet problems

Lean forward against the wall with the legs in a position as if you

were walking, straighten your back leg and keep the front leg bent.

Lean into the wall until the stretch is felt in the calf, try to hold the

stretch for 20 seconds and then switch legs. Repeat this for a total

of 3 times on each leg. This totals 1 minute per leg. It is best to do

6 minutes total a day, which is 3 minutes per leg. This exercise

distributes your weight evenly.

Hip stretch

Sit in a chair, cross your leg so your ankle is on the

opposite leg, push down on the leg that is crossed, and lean

forward until the stretch is felt in the hip. Hold for 20

seconds and repeat on the opposite leg.

Hamstring Stretch

Sit upright and tuck foot near groin with the opposite leg

straight. Reach forward from the hips and grab your ankle

until the stretch is felt in the back of the thigh. Hold for 20

seconds and repeat with the opposite leg.

Hamstring Stretch

Slowly bend forward from the waist with your knees slightly bent and

reach for the floor keeping your head up. Only go as far as you can, the

stretch will be felt in your lower back and hamstrings. Hold for 20

seconds.



Quadriceps Stretch

Find something to hold on to in order to keep your balance.

Stand in an upright position and slowly bring one leg behind

your back and grab your foot. Hold for 20 seconds and

switch legs.

Seated straddle

Sit in an upright position with your legs as far apart as possible, bend forward at the hips

keeping your head up and reaching toward your feet. Hold for 20 seconds in the middle,

hold for 20 seconds when trying to reach to one side, and then switch to other side.



Strength Training

What is strength training?

Strength training includes weight lifting, weight machines, and resistance bands.

It is best to exercise large muscle groups before you exercise small muscle

groups. This means doing back and chest exercises before arm exercises.

Frequency: 2 to 3 times per week with 48 hours of rest between sessions.

Start with one set of 10 to 15 repetitions for each area, and then increase to 2 sets

of 10 to 15 repetitions.

When you feel comfortable with those repetitions, increase to 3 sets of 8 to 10

repetitions.

Rest is very important, a minimum of 15 seconds to 1 minute; with higher

intensity training 2 minutes rest may be needed.

If this is too much for you, try 1 set for each area starting with 10 t o15 repetitions and

progressing to 15 to 20 repetitions.



Bench Press

Grab a pair of hand weights and lay flat on your back. A weight

bench is ideal, but if you don’t have one just lie on the floor.

Position your hands wider than shoulder width apart with your

elbows pointing away from you. Weights should be in line with

your arms. Lift your arms up over your chest and bring them down

until they nearly touch your chest, and repeat. Do this 10-12 times

and take a break, then do another 10-12, and another 10-12. This

will work your chest muscles.

To change this exercise tuck your elbows into your side and keep your elbows tucked as

you lift. You can use a prop for your feet, or if you are on the floor curl your legs up.

Squat

If you are a beginner, start with this squat. Start with your feet

shoulder width apart, push your butt back, bend your knees, and keep

your arms straight out in front of you. Once you are in this position,

push your butt towards the floor as if you were to sit in a chair. Keep

your torso straight, and don’t strain your back. Slowly rise and return

to your starting position. Do 3 to 5 reps as desired.

The blue

shows the

modification



Dumbbell squat

Grab a pair of hand weights (8-10 pound hand weights will show the best

results). Stand with your feet hip width apart and arms to your sides. Squat so

your thighs are parallel to the floor and return to standing. Do this 10-12

times; take a break, repeat 10-12 times, rest, and repeat. This works your

quads.

To change this exercise, position the dumbbells in front of your

thighs with your palms facing your body. Let the dumbbells drop

straight toward the floor as you squat. This works your glutes and

hamstrings.

Pushup

Get in a plank position with your feet together and hands wider than

shoulder width apart. Bend your arms, lower your chest toward the floor,

and press back up. Do this 6-12 times, rest, and repeat 2 more times.

To change this exercise, place your feet on a six to eight inch high

step. This works your shoulders.

The blue

shows the

modification



Lateral Bend and reach

Grab a pair of 5 to 10 pound dumbbells and stand

with your feet about four feet apart. Turn your left

foot out 90 degrees. Raise your right arm straight

up above your shoulder, palm facing in (A). Brace

your abs, and bend to the left, lowering the left

dumbbell to your left ankle (B). Rise up keeping

your right arm overhead. Do 12 to 15 reps and

repeat on the other side. Do three sets, resting for

up to 30 seconds between each set.

This is an example of a strenght training workout.

Lunge twist

Stand with your feet hip width apart knees slightly bent, elbows bent 90 degrees by hips.

Lunge forward with right leg and rotate torso and arms to the right. Rotate back to center

as you quickly push off right foot to return return to start. Do 16 reps aleternating sides.

This will target your abs, obliques,gluteus, and quads.

Step hop Stand with feet hip width, knees slightly bent, hands on hips. Step forward with right

foot, then lift left knee to hip level as you hop straight up on right leg. Land with feet

together. Do 16 reps alternating sides. This will target your abs,

gluteus and legs.

Shot put

Stand with right elbo bent with hand by ear, left arm out at shoulder level. Lunge to right

with right leg: rotate torso to right. Push off right foot to stand, pivoting to left. Extend

right diagonally (as if throwing a shot). Do 16 reps alternating sides.



Aerobic

Aerobic activity can also be called “cardio”. This exercise really gets you moving, your

heart beating, and your blood flowing. Aerobic activity can be broken down into two

categories, moderate intensity and vigorous intensity. Benefits of aerobic exercise include

blood glucose control and improved cardiovascular status.

Guidelines: 20 to 60 minutes (can be divided into three 10-minute sessions 3 to 5

days of the week preferably every other day

Moderate intensity workouts include increasing your heart rate and breaking a sweat.

Walking fast

Riding a bike on a flat surface or with a few hills

Playing doubles’ tennis

Pushing a lawn mower

Shoveling light snow

Bowling

Water aerobics

Vigorous intensity workouts include breathing hard and fast while increasing your heart

rate

Jogging or running

Swimming laps in a pool

Riding a bike on hills or at a fast pace

Playing singles’ tennis

Playing basketball

Step aerobics

Jumping rope for extended periods of time

Shoveling heavy snow

Boxing or kick boxing



Water aerobics can be considered moderate or vigorous intensity depending on what you

do.

Water aerobics can include running, jogging, or walking in a pool. It is best to

start in the shallow end, move in thigh deep, and then move in chest deep.

A typical aerobic routine lasts 30-45 minutes and involves warm-up, cool down,

and stretching exercises.

Each exercise should be held for 20-60 seconds.

Remember even in water you can hurt your feet, so it is best to wear a good pair

of water shoes.

Here is an example of a water aerobics workout:

Warm up: Run or walk easy for 10-15 minutes, slowly increasing your speed and

intensity. Do a few stretches to loosen up your muscles and finish the warm up with a few

short fast sprints.

Main set: Alternate between running and cross-country skiing. First two minutes easy,

next 2 minutes moderate intensity, next 2 minutes hard, next 2 minutes moderate

intensity, last 2 minutes easy. Repeat if you like, 2-4 times as the maximum.

Cool down: Run at an easy pace for 10 minutes gradually decreasing intensity. Finish

with a good stretch.

Other things you can do in water:

Water squats - stand in the water with your feet apart, bend your knees, and push

your hips back like you were to sit in a chair. Do this about 5 times. This will

work the front of your thighs and buttocks (hamstrings and gluteus).

Do laps walking forward and backward.

Kick - use a kick board or the side of the pool. This will work your thighs and

buttocks (hamstrings and gluteus).

Pull ups - grab the side of the pool and pull your self up as far as you can keeping

your knees bent, exhale as you pull yourself up. This will work your back,

shoulders and arms.

Arm motions- stand in water up to your neck and reach your hands out to each

side, elbows straight, palms forward, slowly bring them forward and clap your

hands, return to starting position. This will work your chest muscles.

Arm motions- stand in water a little above your waistline with your palms down

on the surface of the water. Keep your elbows locked at your side as if they were

glued to you rib cage, exhale and push your hands down until you are at your

hips, turn your hands and bring them to starting position. This will work you arm

muscles (triceps).

Arm motions- stand in water a little above your waistline with your arms at your

hips, palms forward, exhale as you bend at the elbow to bring your hands toward

your shoulders. This will work your arm muscles (biceps).



Pool crunches- stand with your back to the wall holding into the rim of the pool

with your elbows, keep your knees bent, bring both legs into a sitting position and

hold it for 10 seconds. Bend at the knee to bring the legs down. Remember to

keep your back straight and breathe slowly through out this exercise. This will

work your stomach muscles (abdominals).

Jumping rope

Start out doing the recommended amount of repetitions and increase the amount and

speed the more you become familiar and comfortable with these exercises. You can

combine the different jump rope exercises to fit your preferences.

Basic jump - grabbing the handles on the rope with the middle of the rope behind

your calves and swinging it forward. Start out by doing this 10 times and rest.

Reverse basic jump - is the same as the basic jump except you start with the rope

in front of you by your ankles and swing it over your head in a backwards motion.

Start out by doing this 10 times and rest.

The twister - when doing the basic jump keep your feet together and twist your

lower body, to the left on one jump and then to the right on the next jump,

alternate sides for 10 jumps and rest.

Jogging step - when doing the basic jump, walk or jog over the rope 10 times at

the speed you are comfortable with and increase at your own rate.

Double under - when doing the basic jump keep your feet together and jump up

once but swing the rope under you twice. Do this up to 5 times and rest. To add a

challenge to the double under swing the rope under you 3 times, 4 times, or 5

times in one jump. Increase the number of jumps at your own pace.

Criss Cross - start in the basic jump position when the rope is at the top of your

head cross your arms by putting your left arm on your right side and your right

arm on your left side. Open your arms when you have jumped over the rope. Do

this 10 times and rest.

This is just an example of how to turn jumping rope into a 30-minute exercise routine.

Basic jump - 3 minutes

Rest - 2 minutes


Rest - 2 minutes

Reverse basic jump - 3 minutes

Rest - 2 minutes

Jogging step - 2 minutes


Rest - 1 minute



Criss Cross - 2 minutes


Rest - 1 minute

Twister - 2 minutes


Rest - 1 minute

If you like walking but find it to be boring or feel like it is not working your muscles

enough try this routine below.

MINUTES WHAT TO DO RPE*

0:00–3:00 Warm up slowly 2–3

3:00–5:00 Increase to a moderate pace 4–5

5:00–8:00 Speed up and lengthen your stride;

your breathing should be faster 5–6

8:00–10:00 Do walking lunges 7–8

10:00–12:00 Walk at a moderate pace 4–5

12:00–17:00 Alternate 30 seconds fast; with 30

seconds moderate 6–8;

4–5

17:00–18:00 Repeat walking lunges 7–8

18:00–20:00 Recover 4–5

20:00–26:00 Alternate 1 minute fast; with 1

minute moderate 6–8; 4–

5

26:00–30:00 Slow pace to cool down 2–3

*Rate of Perceived Exertion (RPE) is based on a



scale from 0 to 10, 10 being the most challenging.

How many steps do you walk a day?

The new guideline for steps taken per day is 10,000 steps. An easy way to count steps is

to wear a pedometer. Most pedometers are made to be worn on your waste line. People

with bigger waste lines may have trouble keeping the pedometer on; in this case there are

pedometers made to wear around your neck or very slim pedometers that fit in your

pocket. Some pedometers include a radio and will talk telling you how far you have gone

and how far you need to go. Some watches now have pedometers on them. You can also

buy pedometers that measure heart rate. Pedometers are a simple way to track how far

you have walked through out the day to see if you are meeting the steps taken guideline.

Sources and picture sources



U.S. Department of Health and Human Services, National Institute of Health. (2007). Exercise: A

Guide from the National Institute on Aging. NIH Publication No. 01-4258.

Mensing. C. (2006). The Art and Science of Diabetes Self-Management Education: A Desk

reference for healthcare professionals. Chicago, IL: American Association of Diabetes

Educators.

http://win.niddk.nih.gov/publications/tips.htm

http://www.cdc.gov/physicalactivity/everyone/guidelines/adults.html

http://members.aol.com/clfsong1/MyAcousticNeuromaStory2.html

http://www.hmsa.com/go/letsgo/stretching.asp

http://www.mayoclinic.com/health/stretching/SM00043/RETURNTOLINK=1&RETUR

NTOOBJID=2F776F30-10D2-49FC-BA32D2D61AD736E1&slide=8

http://www.bodyteen.com/fex/exflex/tricep.gif

http://www.uwhealth.org/images/ewebeditpro/uploadimages/clip_image005(4).png

http://www.chap.com/30.html

http://www.starlightladieswalk.co.uk/8.html

http://www.sporttalk.com.au/quadriceps-strain-and-injury-torn-quad/

http://www.usd.edu/msc/pt/strech.html

http://www.healthsystem.virginia.edu/internet/diabetes/pyramid.cfm

http://www.fitnessmagazine.com/workout/cardio/no-treadmill/staircase-climbing-

workout/

http://west.ballyfitness.com/rapid_results/expert_advice/product_tip_sheet/Exercises/jum

prexerc.asp

http://www.thewalkingsite.com/10000steps.html

http://www.sciencedaily.com/releases/2007/11/071120195723.htm

http://win.niddk.nih.gov/publications/tips.htm

http://www.cdc.gov/physicalactivity/everyone/guidelines/adults.html

http://members.aol.com/clfsong1/MyAcousticNeuromaStory2.html

http://www.hmsa.com/go/letsgo/stretching.asp

http://www.mayoclinic.com/health/stretching/SM00043/RETURNTOLINK=1&RETURNTOOBJID=2F776F30-10D2-49FC-BA32D2D61AD736E1&slide=8

http://www.mayoclinic.com/health/stretching/SM00043/RETURNTOLINK=1&RETURNTOOBJID=2F776F30-10D2-49FC-BA32D2D61AD736E1&slide=8

http://www.bodyteen.com/fex/exflex/tricep.gif

http://www.uwhealth.org/images/ewebeditpro/uploadimages/clip_image005(4).png

http://www.chap.com/30.html

http://www.starlightladieswalk.co.uk/8.html

http://www.sporttalk.com.au/quadriceps-strain-and-injury-torn-quad/

http://www.usd.edu/msc/pt/strech.html

http://www.healthsystem.virginia.edu/internet/diabetes/pyramid.cfm

http://www.fitnessmagazine.com/workout/cardio/no-treadmill/staircase-climbing-workout/

http://www.fitnessmagazine.com/workout/cardio/no-treadmill/staircase-climbing-workout/

http://west.ballyfitness.com/rapid_results/expert_advice/product_tip_sheet/Exercises/jumprexerc.asp

http://west.ballyfitness.com/rapid_results/expert_advice/product_tip_sheet/Exercises/jumprexerc.asp

http://www.thewalkingsite.com/10000steps.html

http://www.sciencedaily.com/releases/2007/11/071120195723.htm

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