Exercise: How Caregivers Can Get Moving

(Note: This is fifth in a series of health-related posts that frame each topic in terms of the particular struggles busy, stressed-out, exhausted caregivers experience. Information is pulled from current research that might be most beneficial)

Current scientific research is unequivocal: exercise has multiple, far-ranging benefits across one’s lifespan. In fact, if there is any one pill or “cure” for stress, aging, and mental health struggles, exercise is the closest we can come. For caregivers, this is tremendously important. For decades we are asked to perform, not only under intense pressure and in intensely stressful situations, but also to contort our bodies into strange positions and to lift other human beings multiple times per day. Over time, this can take a tremendous toll. Yet, we have people depending on us and can’t afford for our minds or bodies to give out.

Most of us know we should be exercising and that it could help us be stronger, sharper, better versions of ourselves. But exercise is more than an endorphin boost or a set of powerful muscles. As for most people, exercise is a caregiver’s insurance for the future. Muscles trained in the right range of motion can act as our armor, protecting us against falls, injury, and exhaustion. Regular exercise can also help prevent strokes, heart attacks, diabetes, and neurodegenerative diseases.

But how do we exercise in the face of little time and even less mental bandwidth? It’s not an easy feat but it is possible. As busy and stressed as I am, I am also an avid exerciser who works out vigorously for an hour six days a week. I alternate between strength training, running, rowing, kickboxing, Pilates, ballet, and yoga. This is a decades-long habit that has served me well both before and after Rett Syndrome entered my life. But since becoming caregiver to my daughter, JJ, exercise has become a lifeline, mood enhancer, and reason to get out of bed in the morning. In short, I don’t know how I would function without an exercise routine and a strong body to lift and carry my girl.

What does the research tell us about making regular exercise happen? First of all, as with any habit, it is important to engineer your environment. Remove what habit researchers call “friction,” or impediments to achieving your goal. When I get up in the morning, I dress in my workout clothes and running shoes and keep my gym bag by the front door or in the car. When I make appointments, I try to map out when I will work out that day and how to make the appointment timeframe work. Every day I ask myself not if I can exercise, but when. I never have a set time; I just wait for the best moment to squeeze it in.

I also collect audiobooks, podcasts, and music that I like and keep them cued up on my phone. Habit research tells us it’s easier to add things and focus on the positive than restrict and take away. So, I view the gym as time for myself, an opportunity to listen to the books I love, and a way to be around people who do not need me to crush up their medications or solve their insurance issues. Also, don’t underestimate the benefit of “gamifying” your workout with fitness apps. By turning effort into reward, our brains release dopamine, which helps with attention, memory, and solidifying behavioral changes.

I do realize it’s a luxury to go to the gym or to work out for an hour at home. Fortunately, new research points to the effectiveness of short bursts of “vigorous exercise” (i.e. exercise that feels difficult but not painful, that causes elevated heart rate and makes us sweat). For example, from a cardiovascular standpoint, one minute of vigorous exercise equals 50-150 minutes of gentle walking. So, if you can just run, jump rope, or dance vigorously for the length of your favorite five-minute song, it is equal to five hours of walking—at least from your heart’s standpoint. The ratio is slightly different for other metrics, such as cancer risk and early death, but vigorous exercise still delivers a very big bang for your buck.

You also don’t have to do it all at once. Researchers find it is just as effective to spread small amounts of exercise throughout your day. They also point to the fact that it doesn’t have to be “exercise.” Any kind of physical activity (i.e., purposeful movement) will do. So, chasing your dog or running up stairs also count. And if you are truly not able to exercise, heat—in the form of saunas and hot baths—can mimic some of the effects of physical activity and provide some of the same benefits. Though it doesn’t build muscle or bone density, heat stresses your cardiovascular system and increases blood flow, reduces inflammation, and helps improve how your body manages blood sugar.

Though the conventional wisdom is to “find the exercise you enjoy doing,” I find this is not enough. For many people, it is helpful to have a rotation of exercises you pull from, depending on your mood and goals that day. In general, aerobic exercise is good for boosting endorphins and reducing anxiety, strength training increases energy, and yoga and walking in nature relax the nervous system and decrease stress. When I have stressed-out days that have me screaming in frustration, I get the most benefit from my runs. When I am tired and sleep deprived, I do a gentle Pilates video. When I am bored of the caregiving grind, I get cognitive stimulation from listening to neuroscience podcasts while strength training. In fact, using your moods and mental health as a metric can work better than forcing yourself to perform a set activity you simply don’t have the energy or motivation to do on that particular day.

When it comes to strength training, there are a few things to keep in mind for caregivers. First of all, leg strength and core strength are of upmost importance. We need a strong core and legs for lifting and to prevent injuries if we fall while carrying our loved ones. (Few people know that leg strength also acts as a marker for longevity and cognitive ability later in life). So, if you’re strapped for time, be sure to focus on your legs—particularly on hip hinges, squats, and lunges. When caring for your child, the muscle memory built up by these exercises will kick in and help you lift more safely, even under unexpected circumstances. Many caregivers also suffer from rotator cuff injuries, so if you work on your arms, be sure to focus on this area too.

These strength training tips came from my friend and fellow medical mom, Kayla Lyman. Kayla owns her own company, Helix Fitness for Caregivers and not only talked me through the best exercises for someone who regularly lifts her loved one, but also came to my home and taught me the safest lifting and transferring techniques for JJ. If you are able to do so, hiring Kayla or a trainer like her—a person who specializes in fitness for caregivers—is a wonderful bonus.

Lastly, there are many aerobic activities that can be beneficial to caregivers. And while you should choose the ones you like best, I can’t resist adding a special plug for running. Unfortunately, many people new to exercise shudder at the idea of huffing and puffing away on a treadmill. However, if, like me, you build up slowly over time—I started running for the five-minute duration of my favorite song—the brain and mood benefits are substantial. Running’s rhythmic motion, its left-right pattern (footfall, arm swing, eye movement), and the fact that it engages both hemispheres of the brain all act as a soothing balm to the nervous system. (Interesting side note: bilateral movement is also the basis of EMDR trauma therapy, discussed in a previous post). On a bad day, nothing beats running rhythmically to the beat of my favorite music. The moment the endorphins kick in, the worst of my stress melts away and I finally feel like myself again.

In the end, however, the most important thing is simply to find the right combination of strength training and cardio to meet your particular physical and emotional needs as an overwhelmed, stressed-out caregiver. And you might also consider doing what I do: taking a minute or two during each workout to send a thank you out into the universe for a body that is even able to exercise in the first place. This is a luxury I never take for granted, thanks to my experiences with JJ. The gratitude you feel for your brain and body just might give you the extra boost you need to get through your workout and the rest of your very busy day.

This concludes our blog’s series of wellness and neuroscience-focused posts centered on stress, nutrition, sleep, and exercise. I hope you found the information helpful and not too overwhelming or prescriptive. Please remember that caregivers have very limited cognitive resources and must choose wisely where they allocate their mental energy. If you do not have the bandwidth to implement all, or even any, of the tips found in these posts, give yourself grace. Perhaps you will one day. I have made improvements in my own health, but only because I have done so over long periods of time and in small increments. As in all domains of life, slow and steady will always win the race.