Exercise Adherence in Women With Chronic Disease

This post was co-authored with Dr. Gabriela Ghisi.

One of the cornerstones to managing chronic disease is exercise, due to its myriad benefits. The general recommendations are to accrue 150 minutes a week of at least moderate-intensity exercise per week. You know you are at the right intensity if you feel slightly short of breath. If you exercise more vigorously, fewer minutes are required. Two days a week of muscle-strengthening exercises are recommended as well. But any exercise is better than none.

Try to find a chronic disease management program that offers supervised exercise such as cardiac rehabilitation to help get you started safely. If your health care provider can’t suggest one that is accessible and affordable for you, you could engage a physiotherapist or kinesiologist with expertise in your chronic disease. They can help you determine the right exercise intensity for you and teach you how to monitor your intensity, such as by using an app on your smartphone.

Some women have not had much previous experience with exercise, but no experience is required. Once they do get started, studies have shown that women can be less likely to stick to exercise rehabilitation than men. This post will raise some considerations to support women in sustaining an exercise routine for a chronic disease such as diabetes or heart disease.

Common Barriers and How to Mitigate Them

The main barriers women report are related to time conflicts. Women are juggling a lot of roles and responsibilities. If time is a barrier for you, there are many videos you can find online to get your exercise in your home. This saves travel time. You can also try to fit in even a 5-minute walk in your neighborhood when you have a few spare minutes.

You might be like many women patients who care for others. Keep up with prioritizing your exercise, because then you will feel at your best to help. Also, exercise extends your life, so you can help them longer!

Overall, women have many competing obligations and are doing their best to improve their health, so focus on what is doable. Pick one small change or new activity to try for the week so that exercise does not become overwhelming. And don’t worry about how you look or what workout clothes you are wearing. What is important is you are moving and, with that, building back your health.

How You Feel During Exercise

At cardiac rehabilitation, patients commonly exercise on treadmills and cycle ergometers, but women have different preferred forms of exercise. Think about the kinds of exercises you have been doing, and whether they are working for you. Be sure to find an exercise modality that you enjoy. The more you enjoy it, the more likely you are to continue with it long term. Try to find classes or preferred equipment in your community. For example, some patients prefer Aquafit classes or Zumba.

Many women enjoy yoga or pilates as well, for example. Patients are encouraged to engage in these activities, especially if they are something they enjoy. But, please remember, for the most impact in terms of managing your chronic disease long term, you do need some aerobic exercise—where you get your heart rate up a bit and keep it there. Make sure you have enough activity where you are slightly out of breath each week, too.

Exercise can be tiring, but not too much so. If you find you are feeling too much fatigue to keep going, rather than stopping altogether, please talk to your health care provider. If there is no underlying cause, work with an exercise professional to adjust your exercise prescription and discuss other ways to overcome your fatigue. Plus, if you do exercise—even a small amount but regularly—you will actually have more energy very soon.

Exercise should not be painful. Speak to your health care provider about adjusting your prescription if anything becomes uncomfortable. They may also suggest taking a pain reliever an hour before your exercise or suggest a different type of exercise that is easier on your joints.

When You Have Several Chronic Conditions or Other Symptoms to Contend With

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Living Your Best Life With a Chronic Illness

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We also need to consider some other conditions many women have, which you may worry about in relation to your exercise. As mentioned above, many women have musculoskeletal pain or arthritis. Exercise professionals can work with you to reduce or mitigate your pain through a combination of strategies such as the timing of pain medication and mode of exercise. If you have urinary incontinence, there are also strategies to manage this. Perhaps you have brittle bones or osteoporosis and have a fear of falling with your exercise. If you work with an exercise professional, they can assess your fall risk and implement a plan with you to keep you safe. Finally, many women with chronic disease also suffer from depression. This can make it very difficult to motivate yourself. See your primary care provider as there are treatments that work for depression. And it is proven that exercise can also ameliorate all of these other conditions.

In closing, it is hard to stick with an exercise routine given the realities of life for women. Try to make exercise an enjoyable part of your everyday life. Start slow and reward yourself for taking the time to exercise. Take pride in the fact that you are taking good care of your health, so you can do the things in life that give you meaning for years to come.

Dr. Gabriela Ghisi is an affiliate scientist at the KITE Research Institute, University Health Network. Her research focuses on patient education for chronic disease management.