• Sarah Russell

Living in lockdown with a chronic health condition? Exercise could be your lifeline.

One aspect of my job that I love the most, is working with people who have long term health conditions and cancer. I teach and deliver 1:1 and group exercise/rehabilitation sessions to a wide range of people with a wide range of clinical conditions, both in person and via video.

There’s no doubt that being active is incredibly important for all of us, but for people with any kind of medical condition, it actually becomes an essential part of treatment and management of your condition.

And during lockdown, there’s a reason the government is encouraging our ‘daily exercise’ and haven’t yet restricted it. Because it’s just that. It is an essential activity that should be done daily and it’s so very, very important.

Even a very small amount of exercise or movement (10-15 minutes) helps to maintain basic physical conditioning. If you’re older, having chemotherapy/some other treatment or are dealing with any kind of long-term condition, it becomes non-negotiable.

Without it, you lose muscle, fitness and general condition, so even basic day to day activities become challenging. When things like getting out of the bath, opening a bottle, standing up from a chair or climbing the stairs start to become difficult, you need to take action. Fast.

Staying as active as you can improves quality of life, reduces risks of falls and in the case of many cancer patients, can extend life.

And right now, when we’re in lockdown it’s not only a million times more important, but it’s a million times harder to do.

Over the last few weeks, I’ve seen some clients start to decline rapidly in front of my eyes. These are the ones who are shielding at home, who are on chemotherapy and are in the ‘most vulnerable’ group.

The emotional and physical toll of self-isolating on these vulnerable people is enormous.

Many people aren’t leaving their homes (even for walks) and without their usual daily activities –weekly shopping trip, dog walk, coffee with friends or appointments at the dentist, hairdresser or exercise group; their fitness and physical function is declining rapidly.

Some patients I’ve been working with for many months who have previously been clinically stable (and in some cases getting fitter) have gone downhill since the lockdown. The combination of their medical condition, treatment, emotional stress and inactivity are having devastating effect. And it’s utterly heart-breaking.

They suddenly seem more frail, less stable on their feet and are finding day to day activities – even just walking, dressing, climbing up stairs and daily chores - much harder. This isn’t just the elderly either, these are younger people who before lockdown were struggling. But COVID19 has thrown them into a position where inactivity and lack of movement is creating a perfect storm for declining mental and physical wellbeing.

But it’s not all doom and gloom. One of my clients is bucking the trend. She’s in her 70’s and has stage 4 breast cancer. Although technically palliative, she is stable and relatively well, but she’s in the vulnerable group due to her treatment so she’s not leaving her home for any reason.

But it’s her attitude I admire the most. She lives completely alone and when lockdown was announced, she knew exactly what she needed to do. She invested in a treadmill and took to walking on it 15 minutes every day and increased her weekly fitness sessions with me to 3 times per week, which we now do on video. She knew what lockdown would do to her physically and she made it her priority to fight back. Not just against COVID19, but against her cancer, for which her exercise routine is essential.

She’s utterly determined to remain independent, fit and able. And when this is all over, to come out the other side, able to tolerate her treatment and still able to get out and about, travel and give herself the best chance of living for longer with her cancer. She’s not declining, but actually getting fitter and stronger. It’s become her priority and even on days when she doesn’t feel 100% she’s still there striding away and following me as I give her instructions from the other end of a video.

Each week I notice that she’s able to use heavier weights, do more repetitions and her balance is improving, not getting worse. She is an inspiration.

Of course, it’s not always easy for her, but what she’s proving is that anything is possible with the right mindset.

And whilst not everyone has access to a treadmill and a private exercise specialist, there are lots of resources online and there are things out there which are free, easy to access, suitable and appropriate.

But it’s not easy exercising at home, especially if you’re feeling unwell, tired, fatigued or scared. Exercising without supervision or support can be even harder. It can be hard to get started if you’re worried you might hurt yourself or do the wrong thing.

But here’s the thing. Something – ANYTHING – is better than nothing and it’s utterly vital to try and keep moving and do something every day. Even on the days when you don’t feel well or on the days when you’re tired or fatigued. We know from research that for the vast majority of health conditions, cancer, IBD, diabetes, arthritis etc – that getting moving, even just a little bit, will make you feel so much better, more energised and able to cope.

Right now, there are lots of fitness resources online and I find it pretty overwhelming. It’s hard to pick through the resources and find what’s best for you and your condition.

So here I’ll give you a few tips and ideas as well as signposts to recommended resources:

These tips are aimed at people either with cancer, more elderly, living with a long-term health condition or in the ‘very vulnerable’ group who are shielding and unable to leave their homes:

Tips on being active at home:

1. Firstly, acknowledge that doing some sort of exercise every day is absolutely 100% essential. It is more important now than it’s ever been. Even just 10-15 minutes is better than nothing. Every day.

2. A new mindset is needed. Forget the things you used to do. It’s time to think outside the box! Invest time researching resources and online classes and learn to be creative and inventive. What have you got in your house that can double as exercise equipment? Tin cans, bottles, logs of wood, the stairs, a heavy rucksack? Be creative.

3. If you have space and can afford it, rent or borrow home equipment – a bike, treadmill or rower. Many gyms are renting out equipment during lockdown or find a supplier online to purchase or rent something. It’s an investment in your health at this point.

4. If you’re able to walk outdoors, then continue to do so if it’s safe, even if that means laps of your garden. If you have outdoor steps you can step up and down for 5-10 minute while listening to some music. Just getting fresh air is vital especially for your vitamin D levels.

5. You may not feel like it much at all. I get it. Illness, depression, anxiety and stress can make you feel even less like doing some exercise. But guess what? It is probably the thing you need the MOST right now. Give something a go and see if you feel better afterwards?

6. A mixed exercise programme where you have a blend of various exercises – Pilates, yoga, strength exercises, cardiovascular, stretching etc - But it will depend on your individual needs and abilities. Mix it up over the week for variety as well.

7. Little and often is best, with ‘mini exercises’ scattered throughout the day. You can do absolutely anything you like. The key thing is to avoid sitting or being inactive for long periods of time. Get up and get moving every hour or so. Walk around your house, garden, up and down stairs. Whatever you have available.

8. Exercises ‘while the kettle boils’ are great – mini squats, calf raises and press ups against the wall are all quick and simple. The average kettle takes 2 minutes to boil. You make 5 cups of tea a day. Do your exercises as you wait… that’s 10 minutes of exercises right there. Check out the Cuppa Workout from Move it or Lose it.

9. There’s a mass of online classes available and something for everyone. Some resources may not be appropriate for you, especially high intensity or HIIT type training, so do choose with care. Do some research and try to think about what will work best for you. Getting your login, device to watch it on (TV, phone or laptop) and speakers set up is critical as this can make it much easier to access. Watch a video through first, before you start if you’re not sure if it’s for you.

10. If you’re older or feeling a little unsteady on your feet, focus on your legs to rebuild muscle and improve balance. Seated leg extensions, squats, calf raises, step ups etc are all great exercises to do to maintain leg muscle, and therefore balance and co-ordination. Little and often, 5 minutes of exercises x 2-3 times per day is ideal.

11. Ok so you may not enjoy it as much as your usual form of exercise. Maybe it’s not as fun as your usual fitness class, and it’s not the same as meeting up with a friend or going for a walk, but it’s all you’ve got. We have to make the most of what we do have and work with it. Accept that this is a means to an end and it will keep you fit, strong and agile during this tough time.

Here’s my top pick of online resources:

Cancer Rehab, Strength and Conditioning - FREE

This is a 20 Minute Workout from Macmillan Cancer Support. Aimed at people with cancer, but suitable for anyone. Seated and standing modifications offered throughout.

Balance Workout - 5 minutes standing - FREE

From Move it or lose it. A fantastic 5-minute standing balance workout.

The 2 minute cuppa routine - FREE

From Move it or lose it. I love this! a quick and simple 2-minute workout to do every time you make a cup of tea.

NHS Fitness Studio Videos - FREE

A range of 24 mini classes ranging from 10-45 minutes, created by fitness instructors including condition specific exercises (including arthritis and cancer), and seated classes for those less mobile.

Pilates Anytime – FREE for the first month, then £12.99 per month

I love this resource. Over 1500 Pilates style workouts. Free for the first month, then subscription of £12.99 per month thereafter. Search for classes for a specific condition (such as breast cancer) or any of the following are good starting points. Go for Level 1 without equipment to start with.

‘Beginners Centre’ – Starter Series - Breast Cancer - Active ageing - Pilates after trauma -

The Daily Dose – 21-day self-care programme - are all ideal if you're new to Pilates or have mobility concerns.

There are also loads of things on Youtube so take a look, do some searching, research and see what takes your fancy!

Stay safe and stay active.

Sarah x

Sarah Russell is a clinical exercise specialist passionate about working with people with long term health conditions, with injuries, after surgery and those with cancer. She has her own private practice from her studio in East Sussex, but works with people all over the world via video. She is also the author of ‘The Bowel Cancer Recovery Toolkit’ the first ever book about exercise and bowel cancer. She specialises in working with people after abdominal surgery and incorporates clinical Pilates and into her practice. She is currently offering sessions at £35 (for up to 45 minutes) or £50 for one hour as a special COVID19 rate until lockdown ends. www.sarah-russell.co.uk

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