Exercise and chronic disease: Get the facts

People with long-lasting disease, also known as chronic disease, need to exercise. Exercise can help people with long-lasting conditions cope with symptoms and improve their overall health. Long-lasting condition can include heart disease, diabetes, depression, or back or joint pain.

It's important to talk to a health care provider before starting to exercise. Find out from your care provider what exercises to do and how to do them safely.

How can exercise improve a chronic condition?

Besides helping prevent many long-lasting conditions, regular physical activity can help make life better for people who have them. A complete program includes exercise that raises the heart rate, builds muscle and helps keep joints moving well.

Exercise that raises the heart rate is known as aerobic exercise. It can help improve heart health, stamina and weight control.

Strength training, such as lifting weights, can improve muscle strength. Strength training can make it easier to do daily activities. It can slow disease-related losses of muscle strength. And it can help keep joints stable.

Flexibility exercises, such as stretching, can help joints keep moving, so they can work well. Balance exercises might help lower the risk of falls.

Another important part of exercise, especially for older adults and people who have trouble moving, is balance. Balance exercise might prevent falls and lessen injuries from falls. Tai chi, walking backward and practicing standing on one leg are examples of exercises that can improve balance.

Here are ways exercise can help some illnesses.

• Arthritis. Exercise can ease pain, build muscle strength around joints and lessen joint stiffness. It also can help people with arthritis move better and improve quality of life.
• Asthma. Often, exercise can help control how often asthma attacks happen and how bad they are.

• Back pain. Low-impact aerobic exercise is regular exercise that raises heart rate without putting stress on the body. It can build back strength and make muscles work better.

  Stomach and back muscle exercises, also known as core-strengthening exercises, can help ease symptoms by making the muscles around the spine stronger.

• Cancer. Exercise can improve the quality of life for people who've had cancer. It also can improve fitness. And it can lower the risk of dying of breast, colorectal and prostate cancers.
• Dementia. Exercise can improve thinking skills in people with dementia. People who move regularly are at less risk of dementia and problems with learning and thinking.
• Depression and anxiety. Regular exercise helps improve the symptoms of both these conditions.
• Diabetes. Regular exercise can help lower blood sugar levels. Exercise also can help control weight and boost energy. For people with type 2 diabetes, exercise can lower the risk of dying of heart disease.
• Heart disease. Regular exercise helps the heart. Exercise can lower the risk of dying of heart disease. And it can lower the risk of heart disease getting worse.
• Osteoporosis. This condition causes bones to thin and weaken. Some exercises, such as fast walking and lifting weights, help build strong bones and slow bone loss.

What exercises are safe?

A health care provider might suggest some exercises to ease pain or build strength. Depending on your condition, you might not be able to do some exercises at all or during flare-ups. Some people might need to talk to a physical or occupational therapist before starting to exercise.

People with low back pain, for example, might choose exercises that can raise heart rate without putting stress on the back. Walking and swimming are good choices.

Keeping an inhaler handy during exercise is important for people who have asthma that's brought on by exercise.

For people with arthritis, exercises depend on the type of arthritis and which joints are involved. A health care provider, such as a physical therapist, can help make an exercise plan that will help joints without hurting them.

How often, how much and at what intensity can I safely exercise?

Before starting to exercise, talk to a health care provider about how long and hard to exercise.

For most healthy adults, the Department of Health and Human Services recommends getting at least 150 minutes of moderate aerobic activity or 75 minutes of vigorous aerobic activity a week. Or combine moderate and vigorous activity. The guidelines suggest spreading this exercise over a week.

Even small amounts of physical activity can help. Being active for short periods during the day can add up to health benefits. For example, try walking briskly for about 30 minutes most days of the week. You can even break up physical activity into short chunks of time spread throughout the day. Any activity is better than none.

One way to work in exercise is to do high-intensity interval training. It's generally safe, works for most people and doesn't take much time.

High-intensity interval training involves switching between exercising hard and exercising less hard for short periods. Fast walking can be an example of exercising hard.

Do strength training exercises for all major muscle groups at least two times a week. Aim to do a single set of each exercise using enough weight or resistance to tire muscles after about 12 to 15 repetitions.

If you can't do this much activity, do what you can. Even an hour a week of physical activity can improve health. Start with moving more and sitting less and work your way up to moving more each day.

Do I need to do anything special before getting started?

Depending on your condition, a health care provider might suggest some safety actions before exercising.

People with diabetes, for example, need to know that exercise lowers blood sugar. Checking the blood sugar level before activity is important. People who take insulin or diabetes medicines that lower blood sugar might need a snack before exercise to help prevent low blood sugar.

People with arthritis might take a warm shower before exercise. Heat can relax joints and muscles and relieve pain. Also, shoes that absorb shock and keep joints stable during exercise are important.

How can I expect to feel?

Talk to a health care provider about how much soreness or tiredness to expect during or after exercise. Ask for ways to lessen both. Find out what's OK and what might be a sign of something more serious. Then listen to your body.

For people with heart disease, for example, dizziness, unusual shortness of breath, chest pain or an irregular heartbeat might mean it's time to stop exercising.

What else do I need to know?

Starting a regular exercise routine can be hard.

To help stick with the routine, exercise with a friend. Also, you might ask your care provider to suggest an exercise program for people who have the same condition as you. Some hospitals, clinics and health clubs offer them.

To keep wanting to exercise, choose activities that are fun. Set goals you can meet. And celebrate your progress.

Share concerns about exercising with your health care provider.