Once you are found fit to undertake an exercise program, the next step is to choose the type of exercise you will undertake.

But before we even discuss the type of exercise, one very easy and simple step which you can take is to increase the activity level in your daily life. Here's how you increase you activity level

But if for some reason you are bound down to your chair for long periods, or you are kust plain lazy to get moving, here are some exercises for the “Couch Potato”.

Your exercise schedule will need to be followed over a prolonged period. Thus, the exercise chosen will need to be individualized for you. It will have to take into consideration your needs, work schedule, hobbies, interests, skills, ability and also, quite importantly, your financial abilities! In other words, the type of exercise that you choose should be one that you will be able to carry out easily, regularly and for a long period.

Isotonic exercises which involve the movement and use of large muscles are prefarble for most people. Isometric or muscle tensing exercises like weight lifting, Bullworker and pushups are not suitable for most of the patients and should be reserved for the very young patients and athletes with a special interest in developing certain muscles. These isometric exercises are specially meant to develop muscles and stamina, but they also cause a significant rise in the blood pressure and this can be very dangerous for many diabetics, especially those that have any problem with their eyes and kidneys. These exercises are not easy to carry out on a regular basis. Isotonic exercises are definitely more safer, easier and more than sufficient to meet the needs of most diabetics.

I don't exercise at all. If God meant us to touch our toes, he would have put them further up our body

It is also important that the exercise chosen should be of interest to you. You cannot become bored of the activity and stop exercising! One way out of this dilemma would be to choose different forms of exercise so that the type of exercise could be varied. But when someone is given too many choices, I find that he ends up doing none.

You may be wondering why I am laying so much stress on choosing the type of exercise. But from experience I know that quite a few patients have a tendency, in their initial enthusiasm, to choose some of the most exotic and fancy forms of exercise which they have no hope of carrying out for any period of time, thus defeating the very purpose of an exercise programme. Let us take an example from clinical experience. All of a sudden one finds that when we ask many of our patients, especially the younger ones, about the type of exercise that they would like to undertake, quite a few of them ones, about the type of exercise that they would like to undertake, quite a few of them choose to play tennis. This usually occurs in the month of July. A closer analysis would show that this is after the massive coverage given to the Wimbledon Championships on TV. I usually discourage all these sudden flights of fancy as these have a tendency to be quite shortlived, even if they ever take off in the first place.

Personally, I am in favour of walking as the type of exercise best suited for most patients. Walking needs no learning or special skill; after all, everyone knows ( or THINK they know) how to walk! Walking can be done easily, regularly, anywhere and anytime, needs no special equipment or place, is relatively the safest and costs nothing.

Do you really WALK correctly? find out here

EXERCISE……..HOW!

Once the exercises have been chosen, the next step is to learn at what intensity you will carry out the exercise. Remember, the aim of the exercise is to TRAIN the body and not to STRAIN it!

Therefore, the pace, initially, would need to be gentle and this could then be stepped up to optimal levels at a rate depending on the individual patient. It must be remembered that what one has not done for a lifetime, cannot be accomplished overnight! Inability to appreciate this simple but important point gives rise to a large number of patients who give up the exercise programme. The usual sequence is that patients in their initial enthusiasm exert at a strenuous pace and for a prolonged time. This causes in many cases, a severe bodyache and joint pains. In some cases, sprains and other more serious joint problems may also develop. The patient concludes that the exercise is causing too much hardship, has done him more harm than good. Whilst it may be excellent in principle, it is definitely not meant for him. That is the end of any exercise programme!

One cannot blame a patient for these excesses as these are quite human traits, and it is imperative that this initial exuberance be avoided. One only has to think back about one's childhood days when we went away for the holidays. On the first day, we would get our hands on a bicycle and pedal away furiously for hours on end. The next day, the body would be so stiff that it was difficult even to get up. All thought of doing any more cycling would be the furthermost from our minds. Therefore, the best maxim is slow and steady initially and this can then be gradually paced up.

From the figure above, you can see that the target heart rates are divided into zones.

Zone 1 : THE HEALTHY HEART ZONE: 50%-60% of your individual Max HR This exercise zone is at 50-60% of your maximum heart rate. Most people walking at a comfortable pace are in this zone. The body burns 85% fat, 10% carbohydrates and 5% protein when in this zone. This is the zone at which most of you will be walking in. Some of you will keep in this zone for almost all the time, others may use this as a stepping stone to a more vigorous exercise schedule in other Zones. This is also the zone in which the warming up and cooling off in your exercise schedule is done. This zone has been shown to help decrease body fat, blood pressure and cholesterol. It also decreases the risk of degenerative diseases and has a low risk of injury.

Zone 2 THE WEIGHT MANAGEMENT ZONE: 60% to 70% of your individual Max HR. It's easily reached by jogging slowly. While still a relatively low level of effort, this zone starts training your body to increase the rate of fat release from the cells to the muscles for fuel. Some people call this the "fat burning zone" because up to 85 % of the total calories burned in this zone are fat calories which is equally as important. Fit and unfit people burn fat differently. The more fit you are, the more effectively you use fat to maintain a healthy weight. On the other hand, perhaps you've been exercising vigorously, but not losing the weight you expected to. Could be you've been working too hard and need to drop back to this zone and exercise longer. To burn more total calories you'll need to exercise for more time in this zone.

Zone 3 THE AEROBIC ZONE: 70%-80% or your individual Max HR. In this zone -- reached by running easily as an example -- you improve your functional capacity. In this zone of exercise intensity, the body uses both stored fat and carbohydrates for energy. At 70-80% of your maximum heart rate, 50% of your calories burned in this zone are fats, 1% are proteins and 50% are carbohydrates. This intensity zone is excellent for increasing the number and size of blood vessels, increasing vital capacity and respiratory rate and achieving increases in pulmonary ventilation, as well as increases in arterial venous oxygen. The aerobic phase of your workout should be of 50 minutes or less to prevent build-up of lactic acid. Always warm up with 5-10 minutes of easy pace and after the aerobic phase, cool down with 5-10 minutes at an easy pace.

Most of you will be exercising in Zone 1, although later some of you may opt for Zone 2. In my opinion, most patients should not aim for a higher intensity, although many texts do advise that once the patient gets attuned to the exercise, he may opt for a more rigorous schedule. I feel that is only the younger group of people undergoing athletic training who should aim for the very high rates.

As a matter of interest, once the person becomes very fit, his heart rate may not rise to a significant extent and may even remain at very low levels. Bjorn Borg, even when he was playing the Wimble don Championships, would have a steady heart rate of about 45. This shows how fit Borg was.

Many people get quite confused with all this talk about MHR and the need to take their own pulse. How then is he to judge the intensity of his exercise? One simple, though not ideal, way out is for you to judge whether you would be able to talk normally (i.e. as if carrying on a routine conversation whilst sitting comfortably) during the exercise. If you can easily do so, you are obviously not exceeding your targeted intensity and can gradually increase the pace of exercise upto a limit where you feel that you would be able to just carry on a normal conversation, without huffing, panting and getting unduly out of breath.

I like long walks, especially when they are taken by people who annoy me.

Stretches and Mobility Exercises

Stretching will add flexibility and can make your exercise more comfortable.

b Warm up for 5 minutes at an easy walking pace before stretching, never stretch cold muscles or you risk tearing them. Incorporate mobility exercises designed to take a muscle and joint through its range of motion. You will start at the top of your body and work your way down.

Find an upright pole or fence or wall that will support you for leaning into on some stretches.

Head Circles: Make 1/4 circles with your head. Start with your ear near your shoulder on one site, rotate your head around to the front, ending with your ear near the shoulder on the other side. Roll your head back to the other side. Repeat 5-10 times.

Arm Circles: With one arm at a time, make backwards arm circle with your palm facing out, thumb pointed up. Repeat 10-15 with each arm. Then make forward arm circles with palm facing in, thumb pointed down, repeat 10-15 times.

Hip Stretch:Stand up, take a half-step back with the right foot. Bend your left knee and shift your weight back to your right hip. While keeping the right leg straight, bend forward more and reach further down your right leg. Hold for 15-30 seconds. Switch sides.

Quadiceps Stretch:

Stand erect, holding onto a wall for support. Bend your knee behind you so that you can grasp your foot, holding your heel against your butt. Stand up straight and push your knee gently back as far as you can, the hand just keeps the heel in place. (For some, it is more comfortable to use the hand from the opposite side). Hold for 15-30 seconds, then switch.

Calf Stretch: Stand an arm's-length from the wall/post. Lean into wall/post, bracing yourself with your arms. Place one leg forward with knee bent - this leg will have no weight put on it. Keep other leg back with knee straight and heel down. Keeping back straight, move hips toward wall until you feel a stretch. Hold 30 seconds. Relax. Repeat with other leg.

Achilles Stretch: From the calf stretch position, bend the back knee so that the angle is changed to stretch the Achilles tendon. Keep your heel down, hold 15-30 seconds. Then switch legs.

Leg Extensions: Facing the pole, hold on with both hands. Bending at the knee, bring one leg forward, then extend and swing that leg back and behind. Repeat 10-15 times, then switch legs. Be cautious of hyperextending your lower back.

Cross Over Leg Swings: Holding onto the pole or fence rail with both hands, face forward. Swing one leg in front of your body gradually swinging higher. Swing about 10-15 times with each leg.

After stretching and mobility exercises, now you are ready to walk the main portion of your walk at your desired speed.

I have flabby thighs, but fortunately my stomach covers them.

Warming Up and Cooling

Every time you exercise, you should have a five minute warming up period when the pace of the exercise is quite mild and it is only after this gradual warming up period that you should raise his intensity levels to the targeted heart rate. At the end of each exercise period, there should always be a five minute cooling off period, when the intensity of the exercise is gradually decreased and the heart rate brought back to the basal levels. In other words, the exercise should never be started or stopped abruptly.

Why is warming up so important? The main purpose of warming up is to increase your heart rate slightly. This has two benefits: 1) it raises your core body temperature; and 2) it increases the blood (oxygen) flow to your muscles to prepare your body for more vigorous physical activity. Your muscles and tendons (which attach your muscles to your bones) will be more flexible for stretching after mild movement has raised your internal body temperature. This flexibility helps you increase the range of motion of your joints and may help you avoid injuries such as muscle tears and pulls.

What muscles should you warm up? Focus on warming up large muscle groups (i.e. quadriceps, calves, chest, etc...). People who are using walking as their form of exercise should start off with a slow stroll and gradually increase the pace. Runners/joggers could begin their run with a fast walk for 3 to 5 minutes followed by a stretch prior to the actual run itself. In an aerobic class, participants can march in place, do knee lifts etc., for the legs. To warm up the chest and shoulder area, participants do shoulder rolls, arm circles etc.

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