Exercising

Exercising to keep the brain young: Latest research and expert opinions

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Exercise greatly benefits brain health, improving cognition, mood and reducing the risk of neurodegenerative diseases. Several new studies have demonstrated the profound impact of exercise on various biological systems, further explaining its ability to enhance health and fight disease. In this Special Feature, we explore the most recent research on how exercise can protect brain health as we age.

smiling older black man with long beard in swimming pool
Recent studies examine the ways in which exercise helps prolong the health span, and maintains brain health with age. Image credit: FG Trade/Getty Images.

Exercise is linked to increased muscle strength, improved heart health, lower blood sugar and numerous other health benefits.

Activities such as running on a treadmill, biking up a steep hill, lifting weights or taking a brisk lunchtime walk offer a wide range of advantages that go beyond enhancing physical appearance or stamina.

Evidence from studies suggests that regular physical activity could boost mood, alleviate stress, and sharpen cognitive function, underscoring the deep connection between body and mind.

However, different people can respond quite differently to various forms of exercise, such as aerobic workouts or strength training.

While it is well-known that regular exercise is crucial for a healthy lifestyle, some older research has suggested that intense exercise might have negative effects.

More recent research, however, showed that elite athletes experienced slightly extended life expectancies over the decades.

Exercise significantly enhances brain health by improving cognition, mood and by reducing the risk of neurodegenerative diseases through promoting neurogenesis and synaptic plasticityTrusted Source.

What does the latest evidence and expert opinion have to say about the ways in which regular physical activity helps maintain brain, as well as general, health as we age?

How exercise affects the body at the molecular level

In a new collaborative effort led by Stanford Medicine, researchers have explored the underlying mechanisms through which exercise promotes overall health, particularly brain health.

By understanding how exercise affects different organs at the molecular level, health care providers could tailor exercise recommendations more effectively.

This knowledge could also pave the way for developing drug therapies that mimic the benefits of exercise for those who are unable to engage in physical activity.

The study — whose findings appear in NatureTrusted Source — involved nearly 10,000 measurements across almost 20 types of tissues to examine the impact of 8 weeks of endurance exercise in lab rats trained to run on tiny treadmills.

Its conclusion reveals remarkable effects of exercise on the immune system, stress response, energy production and metabolism.

The researchers identified significant connections between exercise and molecules and genes that are already known to be involved in numerous human diseases and tissue recovery.

Other recent papers by Stanford Medicine researchers include a report in Nature CommunicationsTrusted Source that explores exercise-induced changes in genes and tissues associated with disease risk, and a paper published in Cell MetabolismTrusted Source, which examines the effects of exercise on mitochondria, the cellular energy producers, in various tissues, in rats.

How endurance training affects the body

The Nature study examined the effects of 8 weeks of endurance training on various biological systems, including gene expression (the transcriptome), proteins (the proteome), fats (the lipidome), metabolites (the metabolome), DNA chemical tags (the epigenome) and the immune system.

The researchers conducted analyses on different tissues in rats trained to run increasing distances and compared these with the tissues of sedentary rats.

They focused on mitochondria in the leg muscles, the heart, liver, kidney, white adipose tissue — which accumulates as body fat — as well as lungs, brain, and brown adipose tissue — a metabolically active fat that burns calories.

This comprehensive approach generated hundreds of thousands of results for non-epigenetic changes and over 2 million distinct epigenetic changes in the mitochondria, providing a rich database for future research.

Alongside the primary goal of creating a database, some notable findings emerged. For instance, the expression of mitochondrial genes changed with exercise across different tissues.

Researchers found that training upregulated genes in the mitochondria of skeletal muscle of rats that are downregulated in the mitochondria in the skeletal muscle of individuals with type 2 diabetes.

They also showed that training upregulated genes in the mitochondria in the livers of rats, that are down regulated in people with cirrhosis.

These two findings suggest that endurance training may help improve muscular function in diabetes, as well as boost liver health.

Does biological sex affect how we respond to exercise?

Finally, the researchers identified sex differences in how male and female rats’ tissues responded to exercise.

After 8 weeks, male rats lost about 5% of their body fat, while female rats did not lose a significant amount. However, the female rats maintained their initial fat percentage, whereas sedentary females gained an additional 4% body fat during the study.

The most dynamic difference was in mitochondrial gene expression after exercise in rats was in the adrenal glands.

The study authors propose that differences observed due to exercise are largely due to changes in mitochondrial genetic expression in organs and tissues responsible for maintaining energy balance.

Exercise’s rejuvenating effect on immune cells

Another study, this time completed by a research group from The University of Queensland in Australia, and published in Aging CellTrusted Source, demonstrated how exercise might deter or decelerate cognitive decline as individuals age.

Researchers examined gene expression in individual brain cells of mice, discovering that exercise profoundly influences gene expression in microglia, the immune cells supporting brain function in the central nervous system.

Specifically, exercise reverted the gene expression patterns of aged microglia to patterns akin to those seen in young microglia.

Experiments depleting microglia demonstrated their necessity for the beneficial effects of exercise on the creation of new neurons in the hippocampus, a brain region vital for memory, learning and emotion.

This study also revealed that providing mice access to a running wheel prevented or reduced the presence of T cells in the hippocampus as they aged.

These immune cells are typically absent in the youthful brain but increase with age.

Co-corresponding author Jana Vukovic, PhD, assistant professor and head of the neuroimmunology and cognition laboratory at The University of Queensland, explained the key findings to Medical News Today.

Vukovic explained that: “[T]he aging process affects all of the different cell types in the brain with the greatest impact on the resident immune cells: microglia. Importantly, exercise reverts the microglial gene profile back to their youthful state.”

Understanding how exercise supports brain health “is a key question for many scientists globally,” Vukovic noted, adding that she and her colleagues “propose that exercise alters the immune landscape in the ageing brain and therefore enables the immune cells to continue to support nerve cell function.”

“The role of microglia beyond being involved in clearance of cellular debris is not very well understood. We know that microglia support birth of new neurons in the hippocampus — a structure important for learning and memory. However, there could be many other mechanisms at play.”

– Jana Vukovic, PhD

Exercise strengthens brain cell connections

Ryan Glatt, CPT, NBC-HWC, senior brain health coach and director of the FitBrain Program at Pacific Neuroscience Institute in Santa Monica, not involved in these studies, told MNT they “underscore the multifaceted benefits of exercise on brain health, particularly through gene regulation, mitochondrial function, and immune response.”

“They offer valuable insights by merging molecular biology with practical health interventions for aging populations,” he added.

For example, “exercise enhances synaptic plasticity and blood flow while reducing inflammation and increasing the expression of neurotrophic factors like BDNFTrusted Source,” Glatt explained. “These effects can synergistically improve memory, learning, and overall brain health.”

“Exercise can influence gene expression related to brain plasticity, inflammation, and metabolism, while also enhancing mitochondrial function and modulating immune responses. Hormonal changes due to physical activity can also contribute to improved mood and reduced stress.”

– Ryan Glatt, CPT, NBC-HWC

The best forms of exercise for a healthy aging brain

Vukovic noted that “there are ongoing studies to optimise exercise programs for elderly; however, Pilates is a good starting point for those who are looking to engage their muscles.”

Glatt agreed, adding that “aerobic exercises like cardiovascular exercise, strength training, and balance exercises are particularly beneficial to brain health, in both shared and unique ways.”

“Activities combining physical and cognitive challenges, like dance or tai chi, can be especially effective for certain aspects of brain health,” Glatt said.

Nevertheless, he cautioned that: “While exercise benefits brain health, individual variability due to genetics and baseline health can affect outcomes. Further research is needed to determine the long-term sustainability and optimal exercise types and intensities for different populations.”

Exercising in Cold Weather

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Heart attacks and strokes are associated with high blood pressure and increased clotting, and systolic blood pressure increases up to 1.7 mm Hg in the winter months compared to the summer months (Am Heart Assoc Hypertension Scientific Sessions, Abstract 493. Sept 9, 2023).  Cold weather is associated with an increased incidence of heart attacks (Arch Intern Med, 2004;164(8):863-870). If you have heart or lung disease, you are far more likely to die in cold weather than in the heat (Lancet, May 10, 1997;349(9062):1341-6). 

How Cold Weather Can Cause Heart Attacks
• Cold temperatures cause your body to produce large amounts of adrenalin which constricts your arteries to raise your blood pressure and to make your heart beat faster. If you have damaged arteries or heart muscle, your heart can start to beat irregularly and you can die.
• Cold thickens your blood and makes it more likely to clot. A clot can shut off blood flow to the heart to cause a heart attack (BMJ, 1984; 289: 1405–1408).
• Cold causes the liver to make more fibrinogen that increases clotting (Lancet, 1994; 343: 435–439).
• Cold raises blood cholesterol levels (Am J Med, 1986; 81: 795–800).
• A drop in body temperature weakens your heart muscle, and people with weak or damaged hearts can go into heart failure and die. Winter also deprives many people of sunlight and vitamin D which weakens the heart muscle.

Cold Weather Can Damage Your Lungs
Almost 20 percent of North Americans have exercise-induced asthma, which usually is caused by breathing dry cold air, not by exercise. When these people breathe dry cold air, the muscles around the tubes that carry air in and out of the lungs can constrict to make them short of breath. Exercise-induced asthma can occur in people who do not have asthma otherwise. It affects almost 50 percent of elite cross-country skiers, ice skaters and hockey players. Exercise-induced asthma is far more common in winter athletes than in those who compete in the summer. Dry cold air also increases risk for common winter infections such as colds or influenza, which cause inflammation that can damage arteries to increase risk for heart attacks.

Tips for Outdoor Exercise in Cold Weather
• If you have heart disease, your doctor probably will recommend that you should not exercise outdoors in temperatures below 50 degrees Fahrenheit.
• Exercising in cold weather can cause chest pain in some people who have no problems when they exercise in warm weather. When cold wind blows on your face, your heart rate slows down. This decreases the blood flow to the heart and can cause pain in people with blocked coronary arteries. While freezing your face slows your heart, freezing your fingers makes your heart beat faster. Cold hands will not cause chest pain, but a cold face can.
• Air is an excellent insulator, and layering clothes traps air. Wear a silk or loosely-woven polyester inner layer that wicks sweat away from your body. Loosely woven wool or synthetic-fiber sweaters or vests are a good middle layer because they trap insulating air and wick moisture to the outside. The outer layer material should be tightly woven so it blocks the wind; a waterproof rain jacket can perform this function. Nylon and Gore-Tex are outstanding because they can be extraordinarily light and still block the wind. Winter jackets do not need to be heavy, they just need to provide insulation and a barrier from wind and rain.
• You feel cold most in your fingers, ears and toes, so be sure to cover these areas. During World War II, gunners on bombers complained bitterly about frozen hands, ears and toes. Special insulation was added to their gloves, hats and boots, and they stopped complaining, but they suffered frostbite on their necks and chests. They had unzipped their jackets because they didn’t feel cold.
• To help keep your hands warm on cold days, wear mittens that do not let wind or water in. The single compartment of mittens retains heat better than gloves that have separate compartments for each finger. If your hands still feel cold, swing your arms around rapidly from your shoulders with your elbows straight. This motion imitates a centrifuge that will drive blood toward your fingers and open up the blood vessels in your hands. You can buy single-use hand heating packets such as “HotHands,” online or in sporting goods stores, and rechargeable warmers are also available.

Frostbite
You should never develop frostbite because you get plenty of warning. Get out of the cold if your skin starts to burn or itch. Your normal skin temperature is a degree or two below the internal body temperature of 98.6 degrees F. When your internal body temperature starts to drop, your brain tries to preserve heat by sending a message to the nerves in your hands and feet to close the blood vessels there. With decreased blood flow, the skin temperature of your hands and feet drops rapidly. When your skin temperature reaches 59 degrees Fahrenheit, your brain sends signals to open up blood vessels in your hands, causing your fingers to turn red, burn and itch. This is called the “hunting response” and is normal. You should get out of the cold immediately when your hands or feet turn red and start to itch and burn. If you don’t get out of the cold, the blood vessels in your hands and feet will close down again and the temperature will continue to drop even more rapidly to below freezing. You will suffer frostbite and may lose your fingers and toes. More about Frostbite

Raynaud’s Phenomenon
People with Raynaud’s phenomenon have their hands turn white and hurt when they are exposed to temperatures below 60 degrees because their blood vessels do not constrict as norml blood vessels do. The blood vessels to their hands do not open as soon as their skin temperature in their hands drops to 59 degrees F and their hand temperature drops rapidly toward freezing. They often hurt also when they put their hands in cold running water. Researchers at the Army’s Research Institute of Environmental Medicine had Raynaud’s sufferers sit out in the cold with their hands immersed in warm water six times a day. This caused blood vessels in their hands to open while those elsewhere in the skin closed down. The people who were tested were able to be out in the cold without feeling pain in their hands after eight sessions done every other day.

The blood pressure drugs called calcium channel blockers, such as Nifidipine, can help to treat and prevent Raynaud’s phenomenon (Rheumatology, November 2005). Another option is nitroglycerin ointment that is used to treat angina. When applied to the forearm, it opens blood vessels leading to the hands. Check with your doctor to see if these prescription medications might be appropriate for you. More on Raynaud’s Phenomenon

Hypothermia
Hypothermia is a severe drop in body temperature. If you dress properly and exercise vigorously enough, it shouldn’t happen to you. Your body sends you signals as your temperature starts to drop. With a one degree drop in body temperature, your speech can become slurred. This, in itself, is not dangerous, but it serves as a warning that you are losing more heat than your body is producing. To protect yourself, you can produce more heat by exercising harder or you can conserve heat by adding more layers of clothes or seeking shelter.

With a drop of three degrees, you will find it difficult to coordinate your fingers. Seek shelter immediately. When your temperature drops five degrees, you won’t be able to walk and may fall and not be able to get up. Then you may not be able to get out of the cold and your body temperature will continue to drop rapidly and you can die. If your clothes are wet, your temperature will drop even faster. Take the warning signals seriously. If you have slurred speech or difficulty using your hands, take immediate action or you may not get another chance.

Recommendations
If you suffer from heart or lung disease, you should be very careful about exercising in cold weather. Breathing dry cold air constricts arteries and increases clotting to increase heart attack risk, and constricts bronchial tubes to reduce oxygen intake through the lungs. When the temperature drops, people with known heart disease or lung disease are safer exercising indoors where they can breathe warmer air.

The Truth About Exercising and Aging

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Can the Excuses: Just Get Moving!

Can the Excuses: Just Get Moving!

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You can come up with a million reasons for not being physically active. Some might even be valid. But know this: Stillness is bad. Roughly 3.2 million people die each year because of physical inactivity. Regular exercise, especially among older adults, is critical to good health.

I’m Just Too Old

I’m Just Too Old

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Exercise is good for just about everyone, including older adults. Even moderate amounts of physical activity can have a big impact. Talk with your doctor first, of course. If you’ve been inactive, take it easy as you get started, say, 5-10 minutes of moderate activity each day.

I Just Need to Take It Easy

I Just Need to Take It Easy

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It’s not your age that has you feeling the need to rest — it’s that you’re not moving. Even older adults with serious health problems — heart disease, diabetes, arthritis, and others — can live better lives by getting up and moving.

I Don’t Think My Heart Can Take It

I Don’t Think My Heart Can Take It

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The more you do to stay active as you age, the lower your chances are for things like heart attack and stroke. Your doctor can tell you what type of exercises are best, and for how long you should do them. You’ll probably shoot for 150 minutes of moderate aerobic activity a week, like a brisk walk or an easy bike ride. Mowing the lawn or a heavy cleaning session counts, too. And you don’t have to do them in 30-minute chunks.

I Don’t Move Like I Used To

I Don’t Move Like I Used To

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Exercises that promote flexibility are in a group of four cornerstone movements (along with those that improve endurance, strength, and balance) that you should probably work on. That stiffness can be alleviated with, for example, stretching exercises that target hips, legs, shoulders, your neck, your back … anywhere. Yoga can help, too. Take it easy, though, and don’t stretch so far that it hurts.

I’m Afraid of Hurting Myself

I’m Afraid of Hurting Myself

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To be safe, check with your doctor first, especially if you’ve been inactive or have health problems. Your doctor knows what you need and what you can do. Experts say those just starting out should begin slowly with low-intensity exercises. Drink plenty of water, listen to your body, warm up before your workout, and cool down after it.

I Am What I Am

I Am What I Am

7/13

A recent study suggests that certain exercises — like riding a stationary bicycle — actually slow cell decline that can happen as you age. In other words, it’s never too late to reap the benefits of exercise. No matter how old you are, how inactive, or how out of shape you have been for however long, exercise can be provide lots of help for lots of things.

I Don’t Like Exercise

I Don’t Like Exercise

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Being physically active doesn’t necessarily mean pushing around big weights at the gym or going for a 10-mile run. Do things that you enjoy and that will keep you at it. You could work in the yard, walk with friends, work in the garden (lifting and bending are great for flexibility and strength), or take a bike ride. Mix things up every so often, too, so you don’t get bored.

I Don’t Have an Exercise Buddy

I Don’t Have an Exercise Buddy

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Having a partner or getting into a group helps. Studies show that supervision and support can help you stay focused and feel good about what you’re doing. Buddies can really help if you’ve been inactive for a while and you’re cranking things back up. Some people do prefer to go solo. If you’re not one, find a group in your community. You can find one online, or your doctor can help you.

I Don’t Have the Time

I Don’t Have the Time

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A full schedule — because of babysitting the grandkids, other family obligations, housework, etc. — often is cited as a reason to skip exercise. When you think about all the benefits of regular physical activity, and the minimum time required (150 minutes a week of moderate aerobic activity), the answer is clear: If you want to stay healthy, you can find the time.

My Heart’s Fine

My Heart’s Fine

11/13

It’s not just about your heart. Regular exercise also helps your lungs, muscles, and your entire circulatory system. It’s about benefits that can include lower blood pressure, better bone and joint health, and less chance of things like colon cancer and diabetes.

I Don’t Want to Fall

I Don’t Want to Fall

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Falling can be a problem for older adults. But with regular physical activity, including exercises that promote proper balance — exercises that you can do almost anytime, anywhere — you can help prevent the falls that hurt so many older adults. Your doctor can point you in the right direction.

I Worry More About My Brain

I Worry More About My Brain

13/13

Exercise is great for your brain. Experts say not only can exercise help you stave off mental health issues like depression and anxiety, it can also help you stay on task and be better able to move from one to-do item to the next. Healthy body, healthy mind.

Exercising in the morning could reduce CVD risk

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The timing of physical activity could affect the risk for CVD, according to study findings published in the European Journal of Preventive Cardiology.

Using data collected from February 2013 to December 2015 in the UK Biobank, the researchers identified several “chrono-activity” (daily physical activity timing) subgroups of 86,657 participants (mean age, 62 years; 58% women).

Female running
The timing of physical activity could affect the risk for CVD.
Source: Adobe Stock

“Physical activity remains one of the most distinct cornerstones in CVD prevention. The present study adds to the previous evidence that timing of physical activity is an additional independent contributing factor to CVD risk, and therefore adds a novel dimension to CVD risk prevention,”Gali Albalak, PT,PhD candidate at the Leiden University Medical Center in the Netherlands, and colleagues wrote.

Participants wore an accelerometer for 7 days to measure objective physical activity.

At 6 years, compared with participants who had a midday pattern of physical activity, those who had an early morning pattern of physical activity had lower risk for incident CAD (HR = 0.84; 95% CI, 0.77-0.92) and stroke (HR = 0.83; 95% CI, 0.7-0.98), according to the researchers.

The effect was more pronounced in women than in men (P for interaction = .001), Albalak and colleagues wrote.

The results did not vary by total physical activity level or by sleep chronotype, according to the researchers.

“These present results might suggest that time-dependent physical activity interventions might be an added beneficial behavioral factor to reach maximum health benefits and to lower the risk of CVD,” Albalak and colleagues wrote.

To Lose Weight, Eating Less Is Far More Important Than Exercising More

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People working out on Manhattan’s Lower East Side last week. Exercise is beneficial for numerous reasons, but it’s not the best way to lose weight, many studies have shown. 

One of my family’s favorite shows is “The Biggest Loser.” Although some viewers don’t appreciate how it pushes people so hard to lose weight, the show probably inspires some overweight people to regain control of their lives.

But one of the most frustrating parts of the show, at least for me, is its overwhelming emphasis on exercise. Because when it comes to reaching a healthy weight, what you don’t eat is much, much more important.

Think about it this way: If an overweight man is consuming 1,000 more calories than he is burning and wants to be in energy balance, he can do it by exercising. But exercise consumes far fewer calories than many people think. Thirty minutes of jogging or swimming laps might burn off 350 calories. Many people, fat or fit, can’t keep up a strenuous 30-minute exercise regimen, day in and day out. They might exercise a few times a week, if that.

Or they could achieve the same calorie reduction by eliminating two 16-ounce sodas each day.

Proclamations that people need to be more active are ubiquitous in the media. The importance of exercise for proper weight management is reinforced when people bemoan the loss of gym class in schools as a cause of the obesity epidemic. Michelle Obama’s Let’s Move program places the focus on exercise as a critical component in combating excess weight and obesity.

Exercise has many benefits, but there are problems with relying on it to control weight. First, it’s just not true that Americans, in general, aren’t listening to calls for more activity. From 2001 to 2009, the percentage of people who were sufficiently physically active increased. But so did the percentage of Americans who were obese. The former did not prevent the latter.

Studies confirm this finding. A 2011 meta-analysis, a study of studies, looked at the relationship between physical activity and fat mass in children, and found that being active is probably not the key determinant in whether a child is at an unhealthy weight. In the adult population, interventional studies have difficulty showing that a physically active person is less likely to gain excess weight than a sedentary person. Further, studies of energy balance, and there are many of them, show that total energy expenditure and physical activity levels in developing and industrialized countries are similar, making activity and exercise unlikely to be the cause of differing obesity rates.

Moreover, exercise increases one’s appetite. After all, when you burn off calories being active, your body will often signal you to replace them. Research confirms this. A 2012 systematic review of studies that looked at how people complied with exercise programs showed that over time, people wound up burning less energy with exercise than predicted and also increasing their caloric intake.

Other metabolic changes can negate the expected weight loss benefits of exercise over the long term. When you lose weight, metabolism often slows. Many people believe that exercise can counter or even reverse that trend. Research, however, shows that the resting metabolic rate in all dieters slows significantly, regardless of whether they exercise. This is why weight loss, which might seem easy when you start, becomes harder over time.

This isn’t to say that exercise plays no role. There are many studies that show that adding exercise to diets can be beneficial. A 1999 review identified three key meta-analyses and other randomized controlled trials that found statistically significant, but overall small, increases in weight loss with exercise.

A meta-analysis published last year found that, in the long term, behavioral weight management programs that combine exercise with diet can lead to more sustained weight loss (three to four pounds) over a year than diet alone. Over a six-month period, though, adding exercise made no difference. Another systematic review from last fall found similar results, with diet plus exercise performing better than diet alone, but without much of an absolute difference.

All of these interventions included dietary changes, and the added weight-loss benefit from activity was small. Far too many people, though, can manage to find an hour or more in their day to drive to the gym, exercise and then clean up afterward — but complain that there’s just no time to cook or prepare a healthful, home-cooked meal. If they would spend just half the time they do exercising trying to make a difference in the kitchen, they’d most likely see much better results.

Many people think of dieting as a drastic and rigid change, with a high risk of putting the pounds back on. What is more likely to succeed is gradual change, made in a much more sustainable way. I also don’t mean to make it seem that weight loss with diet is easy and exercise is hard. They’re both hard. The challenge of a slowing metabolism, and the desire to eat more, occurs in both cases, although dietary change still works better than exercise.

But I can’t say this enough: Exercise has a big upside for health beyond potential weight loss. Many studies and reviews detail how physical activity can improve outcomes in musculoskeletal disorders, cardiovascular disease, diabetes, pulmonary diseases, neurological diseases and depression. The Academy of Medical Royal Colleges declared it a “miracle cure” recently, and while I’m usually loath to use that term for anything in medicine, a fairly large evidence base corroborates that exercise improves outcomes in many domains.

But that huge upside doesn’t seem to necessarily apply to weight loss. The data just don’t support it. Unfortunately, exercise seems to excite us much more than eating less does. After all, as a friend said to me recently, “The Biggest Loser” would be really boring if it were shot after shot of contestants just not overeating.

Aaron E. Carroll is a professor of pediatrics at Indiana University School of Medicine. He blogs on health research and policy at The Incidental Economist, and you can follow him on Twitter at @aaronecarroll.

Tips for Exercising During and After Cancer Treatment.

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During cancer treatment, patients may face side effects like fatigue, insomnia, anxiety andneuropathy. While some patients may seek additional medication to combat these symptoms, exercise is an excellent pill-free alternative.

Dana-Farber exercise physiologist Nancy Campbell, MS, recently answered questions during a live chat on exercising during and after cancer treatment. Campbell discussed ways to get started, how to stay motivated, as well as some tips for reducing neuropathy with exercise.

Nancy Campbell

Dana-Farber exercise physiologist Nancy Campbell, MS, leads one of her women’s exercise classes for patients and survivors.

Should cancer patients wait until they are done with treatment before starting an exercise routine?

If you feel well enough to start exercising, and if your oncologist and care team have approved a fitness routine, then patients can certainly work out during treatment. It’s important to start slow; try walking, yoga or stretching before working your way up to a more active routine.

 How do you recommend patients get started with fitness routines?

Patients should start slow and work their way up to more rigorous exercise. I recommend starting with a regular walking routine or some yoga and stretching. Flexibility exercises, likeyoga, can help you maintain mobility and get you ready for more vigorous exercises.

Once you feel comfortable, you can work your way up to aerobic exercises, like jogging, cycling (stationary bikes are fine), swimming, or brisk walks. These can help you burn calories, lose weight and build cardiovascular fitness.

Resistance training can also help maintain muscle and bone mass, which may be important during and after treatment.

It’s important to talk with your oncologist and care team before starting a fitness routine. Seeking help from a personal trainer or exercise physiologist can also help you get started.

Can exercise help with neuropathy? What exercises do you recommend?

Exercise is a great way to help deal with side effects of neuropathy. If you have neuropathy in your hands or fingers, I recommend exercises like:

  • Finger rolls – Extend your arms in front of you at shoulder height with palms facing away from you. Then, starting with your little finger, curl your hand into a fist one finger at a time. After that, rotate the fist to face you and open up your hand, one finger at a time, and rotate the palm back out to the front.
  • Finger taps – Extend your arms in front of you at shoulder height. Touch your little finger to your thumb and repeat with other fingers, then repeat the motion in reverse order (starting with index finger). You can also do finger taps sitting down; place your palms on your lap and lift each finger to tap twice on your lap.

If you have neuropathy in your feet, you can try:

  • Ankle circles
  • Calf raises/stretches
  • Standing heel to toe – Place right foot directly in front of left foot, eyes open, arms at side or across chest. Look straight ahead at a stationary object and hold for up to 30 seconds before repeating with left foot in front of right foot. If you need to, hold on to a chair for support.
  • Standing side leg – Stand next to a chair in an upright position with feet together. Then, raise your leg in an outward motion, as far as possible, making sure the foot is pointing forward. Hold this for two seconds before returning to the starting position. Keep your back straight and your abdominal muscles engaged. Then, repeat with the other leg.

 

How often do you recommend cancer patients and survivors should exercise?

The American College of Sports Medicine and American Cancer Society recommend 150 minutes per week of cardiovascular exercise and 2-3 days of strength training per week. However, it’s important to listen to your body and increase your exercise slowly, especially if you are still in treatment.

 

I have been exercising and doing yoga four times/week along with walking, but some days my tendons get so cramped I have to stop. It seems the more I exercise, the more my legs cramp and I have severe neuropathy in my feet. What do you suggest? I would like to get back to a normal activity level, if possible.

You may want to have a day of rest between your activities or decrease the intensity or duration until your leg cramps decrease. It might help to keep track of your activity in a journal or with an activity tracker like a pedometer or Fitbit.  At Dana-Farber we offer classes like Energize Your Feet to help with the symptoms of neuropathy and other foot issues. It’s also important to stay hydrated during activities and meeting with a nutritionist may help identify any dietary changes that could help with cramping.