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Women and Fitness

Our guest expert in March 2010 was Heather Robinson from the Sport CARE program at Women’s College Hospital in Toronto.

Heather Robinson is a certified athletic therapist who has worked in the Sport CARE program at Women’s College Hospital for over 13 years, where her daily responsibilities include patient education, exercise prescription, orthopedic bracing and fitness testing. Her varied role at Sport CARE has also included researching, developing and participating in the Athletes@Risk program, the Arthritis Education Program, and the North America-wide Pregnancy and Exercise Helpline. She is also a part-time instructor at Sheridan College Institute of Technology and Advanced Learning.

The following Women’s College Hospital professionals also provided expert input in answering this month’s Ask the Expert questions.

  • Debbie Childerhose, BPE, BHSc (PT), physiotherapist and program co-ordinator, Women’s Cardiovascular Health Initiative
  • Sonia Bibershtein, BSc PT, physical therapist, Multidisciplinary Osteoporosis Program
  • Chandra Farrer, BSc PT, advanced practice physiotherapist, Sport CARE
  • Kate Matchett, RD, registered dietitian, Sport CARE

Here are their answers on Women and Fitness.

Q: I am 36 years old and have rheumatoid arthritis. It has never been under control. I walk 30 minutes a day and work full time. When I lost weight recently, I lost most of it in my arms and legs. I would love to lose more in my stomach and thighs, but not in the rest of my body. I can’t do weights, sit-ups or yoga because I can't put any pressure on my wrists or knees, and I don't like to swim. My doctors don't want me to use a bike. What do you recommend?

A: I suggest you ask your doctor for a referral to a rheumatologist to try to get better control over your rheumatoid arthritis. If you are already seeing a specialist, ask about other possible treatments. You can also contact the Arthritis Society for suggestions for managing your symptoms prior to starting any exercise. A physiotherapist familiar with rheumatoid arthritis is an excellent resource for you and could prescribe appropriate, safe and non-aggravating exercise. I also suggest that you speak to your doctor about the weight loss in your arms and legs.

 


Q: I am in my early 40s with a family history of lower back problems. I just had my first lower back spasm a few weeks ago. My father (in his 70s) insists that jogging will do further damage to my back. I enjoy jogging and even training for half-marathons. Are my jogging days over now that I am getting older and in my 40s?

A: Jogging can be an excellent exercise but it is high impact. The impact may be what your father is concerned about. When we jog, the impact is transferred from our feet, up our legs through the hips to the spine and this may aggravate any arthritis in the spine (or other areas) as well as cause some compression of the disks in the back.  Many people run throughout their lives without incident, but if you find that running is aggravating your back either during or after activity, it would be wise to change to something gentler or lower impact. You may want to try cross training, a walk/run program, or running on grass or a treadmill to lessen the impact. If you have not had any incidents of back pain related to running, then continuing seems reasonable, but you may want to add in a core stability program geared toward strengthening the deep abdominal muscles to stabilize the back as you run.

 



Q: I'm in my 50s and have a medium frame. I have always exercised, but in the past two years I have noticed that I have more and more fat around my middle. My pants are too tight and I'm not buying bigger ones! Even though my metabolism seems slower, I am not any less hungry. How can I kick-start my metabolism and burn five pounds of fat? I already spin two hours a week, weight train with a trainer two hours a week and do Pilates one hour a week. I feel like I need to do something really different to reverse this trend. Do I need to do some kind of extreme fitness to shock my body into change?

A: No, I would not recommend an extreme fitness program to change your body. You may be exercising too intensely and therefore burning sugar rather than fat as your fuel. Ultimately, the fuel source you use doesn’t really matter, but people who exercise very intensely tend to be hungry after working out and may be eating more than they realize. If you exercise at a lower intensity for longer periods of time, the fuel source ends up being fat and the exercise actually acts as a hunger suppressant. Ask a registered dietitian to review your eating habits and provide suggestions for more filling foods (so you aren’t as hungry) that are lower in calories. Keep in mind that we lose weight by creating a calorie deficit, either by eating less or exercising more. What works the best is combining the two. Unfortunately, you cannot spot-reduce fat. However, it sounds like you are doing all the right things and your program just requires a bit of ‘tweaking’ to get you going in the direction you want to go.

 


Q: How important is cardio? Is yoga a suitable form of exercise, or is it cardiovascular activity that will see me through to old age?

Q:  Is it more beneficial to exercise in short, intense spurts (15 minutes) every day or for longer periods (30 minutes plus) every other day?

Q:  I am 63 years old and retired. I have been going to the gym for the past year and have lost 20 pounds (my BMI is 22.5). Is it better for me to walk daily or do weight training/aerobics for overall benefits? Also, despite my life changes, my blood pressure is around 130/80. Should I be concerned? My doctor isn't.

A: Health Canada recommends some form of endurance activity 4-7 days of the week with timelines provided based on the intensity at which the activity is being performed (20-30 minutes for vigorous, 30-60 minutes for moderate, and 60 minutes at light intensity). Flexibility is also recommended 4-7 days per week and strength or resistance activities are recommended 2-4 days per week (see the Public Health Agency of Canada Physical Activity Guides).

Yoga falls into the flexibility and strength categories so it would be a good idea to add in some form of aerobic exercise like walking, swimming or biking most days of the week. This will complete your fitness program and help you have a long and healthy life. 

Normal blood pressure is at or below 120/80. High blood pressure is defined as blood pressure that is consistently higher than 140/90. The first number is the pressure on your blood vessels when the heart is contracting and the second number is the pressure on your blood vessels when the heart is relaxed. If your doctor is not concerned, then likely your numbers are fine. 

If you want to learn more, visit the Heart and Stroke Foundation website where you will find many great tips on how to manage your blood pressure.

 


Q: I am 38 years old and trying to get rid of 50 pounds from having a child 15 months ago. My mom was diagnosed with congenital heart disease during my pregnancy. I am scared of having a heart attack or stroke. I eat lots of fruit and vegetables, less red meat than I used to, and I hardly snack. I stopped using fatty ingredients and stopped smoking two years ago. What can I do to protect myself from heart disease and associated conditions? I will do whatever it takes. Are there any tests that I should discuss with my doctor? Where can I find more information? I can't afford a gym membership.

A: Speak to your doctor about any necessary tests for your heart.  You should also check out the Heart and Stroke Foundation website for many excellent ideas about diet and exercise. Once you have been cleared to exercise by your doctor, you may want to go to your public library and see if they have a free program where you can borrow a pedometer and are provided with maps of walking paths around the city. This would be a gentle, free way to get great exercise.

 



Q: What are some healthy snacks that women can eat to satisfy cravings during the day? I work out four times a week and know that I must keep eating constantly to keep my metabolism up. But I need some ideas for healthy snacks. For now, I buy the 'blue label' stuff or 100-calorie snacks. Are they considered healthy?

A: Healthy snacks include fruit, vegetables, yogurt, nuts, crackers and low-fat cheeses. The list goes on and on. The ‘blue label’ products are healthier versions of some not-so-healthy choices (including cookies, crackers and chips) as well as some healthy options that include whole grains and lower-fat ingredients. The key to these, and all products, is to look at the label and check the portion size. You cannot assume that the whole package is okay to eat just because it is small or because it is ‘blue label.’  For example, if you read the label it may say that the portion size is ‘six chips.’ 

The 100-calorie snacks are helpful because they offer portion control as long as you eat just one package. They tend not to be healthy food choices, but do offer a little something sweet or salty which can be enjoyed in moderation to meet cravings.

 


Q: I'm obese and have been for many years. I have recently started trying to lose weight using a healthy diet, behaviour modification and exercise. I am trying to find a way to add exercise to my current regimen. I'm pretty self-conscious and fear setting foot into a gym (I'm worried about what people will think when they look at me, or worse, what they will say). I have read about this online and there are lots of articles that suggest working out at home. I agree with this solution; however I don't have the motivation to do it on my own. I don't push myself when I exercise at home and I'm scared to do something wrong and hurt myself. The only thing I currently do is walk. Do you have any suggestions?

A: I have a few suggestions for you:

  1. Hire a personal trainer that comes to your home and works you out in a private environment. The trainer will create a program, teach you how to do the exercise and correct you when you go wrong. Personal trainers also offer motivation. The down side is the cost. The visits will be anywhere from $60-$100 per session.
  2. Join a women’s only gym. There are many female-friendly or female-only gyms that offer supervised circuits. Being in the presence of women may be less intimidating than attending a mixed gym. The cost ranges from $25-$60 per month.
  3. Join a walking group in your community. Many communities have free outdoor and mall walking programs. Contact your local mall or parks and recreation departments. Many local running shoe stores have ‘learn to walk’ programs.
  4. Try some videos. Check out your local library or the Internet to see what is available to borrow or buy. They range in type from dancing, to boxing to ‘sweating to the oldies’ and are available in a wide range of skill and fitness levels. Cost is free if your library stocks them, or DVDs range from $10-$40.
  5. Try an exercise program that has web-based support groups. Several of the popular exercise videos have websites with chat rooms which may provide the social support you may be craving without the anxiety of going into a gym.

 


Q: Some mornings I wake up and within 10 minutes of waking up I use my treadmill or do aerobics for 30 minutes. What should I eat before I exercise? How soon after my workout should I eat my breakfast? Is there a ‘best’ time of day to exercise?

A: If you are exercising in excess of 60-90 minutes, you should definitely eat breakfast prior to doing so. If it is only 30 minutes, you should be fine with eating afterwards. If you feel you need a little something, try yogurt, a banana, or a piece of bread with jam or peanut butter. Avoid any high-fat or high-protein foods as they take longer to digest. What you eat will also depend on what your stomach may tolerate. Some foods may cause stomach upset, so go for plain foods in small portions and see what works.

 


Q: Do you think belly dance and other dance forms are good as a part of a woman’s fitness program if they are done with correct technique?

A: Any form of dance is an excellent part of a fitness program. 
The wonderful thing about dance is that it doesn’t feel so much like exercise. Most people enjoy it and it can be done at any skill level and with wide ranges of intensity. Dancing will help to maintain good balance, co-ordination and strength in the lower body while gaining aerobic fitness. There are many classes offered at dance schools, in community and seniors’ centres, or you can just turn on the radio and dance around your living room. Trying new forms of dance is a great way to stay interested or motivated to exercise so grab your dance shoes and try some salsa, or go barefoot and do some hula.

 


Q: I have a fitness trainer and have a one-hour session three times a week. Will this have a positive impact on the symptoms of menopause (including night sweats) that I am experiencing?

A: It is difficult to say if exercise will have any effect on the night sweats you are having as they are related to hormone levels in your body. There is some evidence that lower-intensity exercise or yoga-type activities may have a beneficial effect, but the focus of exercise during menopause is more on the positive effects it has on mood, health-related quality of life, and sleep. We do know that exercise is excellent for weight control, maintenance of bone density, improving muscle strength, posture and balance and it prevents heart disease. For all of these reasons, we definitely recommend continuing your current exercise regime and perhaps adding in a little bit extra!

 


Q: Hello. I have been menopausal for six and a half years after having a total hysterectomy when I was 40. I had a bone densitometry test and learned that I have advanced osteopenia with risk of fracture. What are the best exercises to strengthen my bones and to avoid the possibility of osteoporosis?

A: Generally speaking, weight-bearing exercise with some impact as well as strength-training exercise can help to increase bone density in women who are premenopausal, but will serve only to maintain bone density in those menopausal and beyond. The purpose of exercise in the post-menopausal woman is to maintain or improve posture and decrease fall risk and also fracture risk. Exercise should be seen as an important part of treatment of osteopenia and osteoporosis, but you must also speak to a dietitian to ensure you have adequate vitamin D and calcium. Also speak to your doctor regarding appropriate medical care and medication in managing this challenging condition. An excellent website on this topic is Osteoporosis Canada.

 

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