Dr. MJ Bazos MD, Patient Handout
Exercise: How To Get Started
Why should I exercise?
Increased physical activity can lead to a longer life and improved health. Exercise helps prevent heart disease and many other problems. Exercise builds strength, gives you more energy and can help you reduce stress. It is also a good way to curb your appetite and burn calories.
Who should exercise?
Increased physical activity can benefit almost everyone. Most people can begin gradual, moderate exercise on their own. If you think there is a reason you may not be able to exercise safely, talk with your doctor before beginning a new exercise program. In particular, your doctor needs to know if you have heart trouble, high blood pressure or arthritis, or if you often feel dizzy or have chest pains.
What kind of exercise should I do?
Exercises that increase your heart rate and move large muscles (such as the muscles in your legs and arms) are best. Choose an activity that you enjoy and that you can start slowly and increase gradually as you become used to it. Walking is very popular and does not require special equipment. Other good exercises include swimming, biking, jogging and dancing. Taking the stairs instead of the elevator or walking instead of driving may also be a good way to start being more active.
How long should I exercise?
Start off exercising 3 or more times a week for 20 minutes or more, and work up to at least 30 minutes, 4 to 6 times a week. This can include several short bouts of activity in a day. Exercising during a lunch break or on your way to do errands may help you add physical activity to a busy schedule. Exercising with a friend or a family member can help make it fun, and having a partner to encourage you can help you stick to it.
Is there anything I should do before and after I exercise?
You should start an exercise session with a gradual warm-up period. During this time (about 5 to 10 minutes), you should slowly stretch your muscles first, and then gradually increase your level of activity. For example, begin walking slowly and then pick up the pace.
After you are finished exercising, cool down for about 5 to 10 minutes. Again, stretch your muscles and let your heart rate slow down gradually. You can use the same stretches as in the warm-up period.
A number of warm-up and cool-down stretching exercises for your legs are shown at the end of this handout. If you are going to exercise your upper body, be sure to use stretching exercises for your arms, shoulders, chest and back.
How hard do I have to exercise?
Even small amounts of exercise are better than none at all. Start with an activity you can do comfortably. As you become more used to exercising, try to keep your heart rate at about 60 to 85% of your "maximum heart rate." To figure out your target heart rate, subtract your age in years from 220 (which gives your maximum heart rate), and then multiply that number by 0.60 or 0.85. For example, if you are 40 years old, you would subtract 40 from 220, which would give you 180 (220 - 40=180). Then you would multiply this number by either 0.60 or 0.85, which would give you 108 or 153 (180 x 0.60=108 and 180 x 0.85=153).
When you first start your exercise program, you may want to use the lower number (0.60) to calculate your target heart rate. Then, as your conditioning gradually increases, you may want to use the higher number (0.85) to calculate your target heart rate. Check your pulse by gently resting 2 fingers on the side of your neck and counting the beats for 1 minute. Use a watch with a second hand to time the minute.
How do I avoid injuring myself?
The safest way to keep from injuring yourself during exercise is to avoid trying to do too much too soon. Start with an activity that is fairly easy for you, such as walking. Do it for a few minutes a day or several times a day. Then slowly increase the time and level of activity. For example, increase how fast you walk over several weeks. If you feel tired or sore, ease up somewhat on the level of exercise, or take a day off to rest. Try not to give up entirely even if you don't feel great right away! Talk with your doctor if you have questions or think you have injured yourself seriously.
What about strength training?
Most kinds of exercise will help both your heart and your other muscles. Resistance training is exercise that develops the strength and endurance of large muscle groups. Weight lifting is an example of this type of exercise. Exercise machines can also provide resistance training. Your doctor or a trainer at a gym can give you more information about exercising safely with weights or machines.
Warm-up and cool-down stretches
Calf Stretch
Face a wall, standing about 2 feet away from it. Keeping your heels flat and your back straight, lean forward slowly and press your hands and forehead to the wall. You should feel stretching in the area above your heels (this area is shaded in the picture). Hold the stretch for 20 seconds and then relax. Repeat.

Quad Stretch
Face a wall, standing about 1 foot away from it. Support yourself by placing your right hand against the wall. Raise your right leg behind you and grab your foot with your left hand. Gently pull your heel up toward your buttock, stretching the muscles in the front of your right leg for 20 seconds. Repeat the stretch with your left leg.

Groin Stretch
Squat down and put both hands on the floor in front of you. Stretch your left leg straight out behind you. Keep your right foot flat on the floor and lean forward with your chest into your right knee, then gradually shift weight back to your left leg, keeping it as straight as possible. Hold the stretch for 20 seconds. Repeat the stretch with your right leg behind you.

Hamstring Stretch
Lie down with your back flat on the floor and both knees bent. Your feet should be flat on the floor, about 6 inches apart. Bend your right knee up to your chest and grab your right thigh with both hands behind your knee. Gradually straighten your right leg, feeling gentle stretching in the back of your leg. Hold the stretch for 20 seconds. Repeat the stretch with your left leg.