MORE OF YOUR EXERCISE QUESTIONS ANSWERED

Welcome to part two of our Q&A with specialist physiotherapist Carol Keen, who has helped hundreds of people get fitter and stronger with PH. We invited you to submit your queries, and in the last issue of Emphasis, Carol advised on safety, breathlessness, and exercises to embrace and avoid.

Read on for more of her wisdom…

How sore or tired should I feel after exercise?

CAROL: You might feel like your muscles are achy or even feel a bit sore, the next day. It’s the body’s normal response to exercise.

It’s a good idea to warm up before you exercise, particularly if you are doing quite a lot. Spend up to five minutes very gradually moving yourself about, stretching, gradually building up your heart rate, and getting your blood flowing around your body before you start. Cool down in the same way afterwards and make sure you stretch too. This will help you feel less sore.

It’s perfectly normal after you’ve been exercising to feel a little bit tired afterwards, but we do know many patients with pulmonary hypertension experience symptoms of fatigue.

If you’re finding that your exercise is leaving you feeling very wiped out or fatigued afterwards then it may be that you need to think about doing something less intense, or breaking your exercise up into smaller chunks and doing more little and often. Complete the chunks over a number of days so that your exercise doesn’t impact on your fatigue in a negative way.

Exercise and being more active over time can help to improve symptoms of fatigue, but it is important to get it in the right levels and the right way.

Why is walking recommended as exercise for people with PH?

CAROL: One of the best forms of exercise that anybody can undertake is walking. It is free, it can get you outside in the world, it is good for your mental health and psychological wellbeing, and it can get you in touch with nature. You can vary your pace when you walk; you can walk more briskly if you want to exercise, or you can walk more slowly if you are out of breath and just want to be more active. Being upright and moving about can also help with joint stiffness and joint mobility. It can help with specific problems like ankle swelling, which can be a problem for lots of people with PH. And it can help sometimes with abdominal or intestinal problems like bloating too, which again, can be quite common.

I would really recommend, as much as possible, that people try to build some walking into their exercise if they are able to.

If you don’t do much walking at the moment, start small. Start with a tiny walk and come back, take your coat off, make yourself a cup of tea, and tell yourself you are amazing. The next day, go a little further, and gradually build up the amount of walking that you do.

Can exercise improve your lungs?

CAROL: We know that exercise is beneficial in patients with pulmonary hypertension. We know that it can improve what you are able to do functionally, and we know that it improves quality of life. What it doesn’t do, is improve the underlying condition. It doesn’t change your pulmonary hypertension. It doesn’t improve damaged lungs and it doesn’t increase lung capacity where that is reduced. But it does improve the circulation of the body; the way the body is able to transport oxygen around. It improves the strength in the muscles and therefore allows you to do more. If you have reasonably low oxygen saturations, doing exercise might not change that, but it will allow you to do more within the limitations that you have – and that is why it is important.

How can I find the right balance, so that I’m not doing too much?

Carol spent five years working within the Sheffield Pulmonary Vascular Unit, with part of her role funded by the PHA UK.

You can watch Carol answer your exercise questions in our new video at bit.ly/YourExerciseQuestionsAnswered

Always speak to your PH specialist before significantly increasing your physical activity.

CAROL: Exercise can make you feel more energetic, it can make you feel better, and it can make you feel healthier. But it is easy to overdo it, as if it makes you feel good, you might want to do more and push yourself harder. Sometimes you might try to keep up with other people or it just might be general over-enthusiasm. It is important to pace yourself and manage your energy levels. To do this, you might want to plan your week of exercise around other activities so that you’re not exercising on a very busy day –which might tire you out completely. If you have planned to do some exercise one day but you’re having a bad time with your symptoms, that’s fine. Be kind to yourself, take care of yourself on that day, and wait until a better day comes along. Exercise is really important, but you must manage it alongside your symptoms. Doing too much and pushing yourself too hard can take some of the enjoyment out of it.

For more on exercising with PH, turn to page 21