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As a general matter, exercise is beneficial for every disease, every disease state, and every age. It can even beneficial while undergoing a treatment. There is generally no downside to exercising so long as it is done safely. 

Exercise has many advantages. For example:

  • Exercise is empowering.
  • Exercise helps your body function at its best to help fight a health condition and/or prevent a recurrence. 
  • Exercise improves mood, energy levels and quality of life.
  • Exercise helps with such conditions as depression, anxiety, fatigue, nausea, pain, difficulty sleeping, and diarrhea
  • Dr. C. Everett Koop, the former Surgeon General, has argued that a lifestyle without exercise is equivalent to smoking a full pack of cigarettes every day.

In general, it is recommended:

  • That to maximize our body's functioning and disease fighting ability, all of us should get 150 minutes (2.5 hours) per week of moderate- intensity exercise or 75 minutes per week of vigorous-intensity activity or an equivalent combination. While the time can be broken up, it is recommended that it not be less than 10 minute segments. Aerobic, muscle training and flexibility exercises should be included. NOTE: Research shows that exercise does not offset the negative effects from sitting continuously, it is advisable to take constant breaks and get up and walk around.
  • If you haven't been exercising, start low and progress slowly. Pay attention to how you feel. Keep in mind that dong something is better than doing nothing.
  • You do not exercise when you feel extreme fatigue, or extreme anemia. 
  • Before beginning a new exercise program: 
    • Check with your primary care doctor and your specialist to be sure the exercise you are considering is safe and appropriate for your condition, medications and situation. Consult both doctors because your primary care doctor may not be aware of particular needs relating to your health condition. Your specialist may not be aware of needs relating to the rest of your body and/or circumstances.
    • Check with your doctor about your physical condition and how much you can and cannot do. Perhaps he or she will also have advice about exercises to consider as well as exercises to avoid.

Now is the time to start - even if you are confined in bed. (Yes, there are even exercises to do in bed). Exercise can be adapted if your health changes.

What exercise to do and how to do it is as individual as each of us are.  Exercise does not have to be running a marathon or lifting heavy weights. Exercise can be as mild as waving your arms, climbing stairs, or walking.  Exercise does not have to be costly. Free exercise and free exercise programs are available. The keys to regular exercise are:

  • Find exercises that are comfortable for you and that you can fit into your schedule.
  • Take baby steps, one at a time.
  • Gradually increase your energy expenditure rather than worrying about maximizing it
  • Exercise consistently. 
  • Keep in mind that exercise does not have to be done at once. For example, if you are going to exercise 30 minutes, you can do it in short increments of a few minutes each, three times a day.

Think about how to incorporate more exercise into your everyday life. For instance:

  • Instead of the escalator or elevator, take the stairs. If you live on the 8th floor and you're not up to that much exercise, get off on the 5th or 6th floor and walk up from there.
  • Get off one stop early when taking public transportation and walk to your destination.
  • Socialize while you exercise. For example, consider doubles tennis or joining an exercise class or group.
  • Walk a dog.

Do not get thrown by lapses, either because of your health condition, or an injury, or because you have to skip your routine for any other reason. Get back to exercise as soon as you can.

To stay motivated, consider the following tips that have worked for other people:

  • Only engage in exercises that you like to do. If you don't like the activity, little excuses become a reason not to exercise.
  • Keep a journal of your progress.
  • Work out with a buddy, or with a personal trainer. (If you use a trainer, keep in mind that anyone can call him or herself a personal trainer. Choose one with care. Preferably look for a person who is certified by the American College of Sports Medicine: offsite link).
  • If you have children, be a role model for making healthy choices. Encourage your whole family to get outside and get active – go for a hike or organize a family game.
  • Make exercise a game. For instance, consider the following apps:
    • Habitica: when you complete goals, you move to higher levels and unlock new features. You lose points when you miss a goal
    • Pact pays you money when you exercise, eat fruits and vegetables or log meals. If you fail, you pay. 
    • Stickk: you donate to a cause you dislike if you do not meet a goal

You can heighten the impact of exercise with good nutrition, rest, and developing your own methods of coping with stress.

For more information, see:

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Nutrition Stress Wellness

Advantages Of Exercise

Exercise has many advantages.

  • Exercise makes you feel empowered and in control.
  • Exercise maximizes your body's ability to fight your health condition.
  • Exercise fights symptoms of a health condition, treatments and/or drugs such as fatigue, nausea and depression.
  • Exercise helps in the healing process. It is often said that exercise is one of the least risky and most beneficial treatment options doctors have to offer cancer survivors. 
  • Exercise improves overall health when exercise is done on a regular basis by doing each of the following:
    • Acts as a natural booster of the immune system which helps the body keep infections and disease at bay.
    • Helps to improve sleep patterns and even bowel function.
    • Helps to normalize weight.
    • Increases appetite.
    • Raises levels of HDL, the "good" cholesterol.
    • Lowers blood pressure.
    • Helps delay or stop large blood vessel and heart (cardiovascular) disease.
  • Exercise has a positive influence on mood and quality of life by reducing anxiety, stress, and depression.
    • Studies show aerobic routines and weight lifting improve mood and are effective at fighting depression. As the Wall Street Journal put it in 2005: "In addition to the famous "runner's high" or endorphin surge that provides a temporary mood lift following a workout, the studies show that there is a round-the clock relief that sets in several weeks after the establishment of a regular exercise routine." And in 2010: Exercise "can decrease depression as effectively as Prozac or behavioral thearpy."
  • Exercise reduces symptoms of fatigue, nausea, pain and diarrhea.
  • Exercise improves body image by providing a greater sense of acceptance of an altered body. (For information about other ways to improve body image, click here.)
  • Exercise helps to control or lose weight.
  • Exercise decreases the risk of getting a variety of diseases such as heart disease. The American Heart Association has found that heart-attack patients have a significantly lower death rate in people who exercised more.
  • Exercise improves the chances of living after a diagnosis of a variety of diseases.
  • Exercise helps withstand the effects of most treatments.

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Risks Related To Exercise

All of the following risks relatingn to exercise are containable if you proceed with caution.
  • You can get dehydrated (lose too much water) if you do not drink enough.
  • You can injure yourself by using the wrong "form" in exercises or by overdoing it.
  • Gyms can be breeding grounds for germs, including drug resistant bacteria.
  • Particular exercises could interfere with particular health conditions and/or treatments.
  • Too much exercise could hinder recovery.

How to Exercise Smart

In order to exercise smart, consider the following guidelines:
  • Talk with your doctor before starting any exercise program or restarting after a long period of rest - especially if you are in treatment or in a recovery period. 
    • In addition to asking whether you can exercise in general, find out what exercise you can and cannot do, how hard to push or not push yourself, and what problems you may run into. 
    • Do not be surprised if the doctor asks you to take some formal tests such as an electrocardiogram (EKG) or a cardiac stress test. 
  • Ask your medical providers if your cancer center employs an exercise physiologist or offers classes or if any local community organizations provide exercise programs for cancer survivors.
  • A physical therapy prescription may allow you to learn an exercise regimen which is individualized for you. Physical therapy is likely to be covered by health insurance.
  • Always keep in mind:
    • Focus first on safety; If something feels uncomfortable or hurts, don’t do it. 
    • The effects of any drugs you are taking. For instance:
      • Pain medications, including aspirin, can mask pain that would otherwise tell you to stop. 
      • Anti-depressants can also dull your perception of pain. 
      • Diuretics can lead to dehydration.
  • Plan to make exercise a habit. 
    • Regular exercise is needed to get the most benefit.
    • Put exercise time on your calendar - and keep to it. If you think of exercise as part of a medical regimen, you may think twice before skipping sessions.
    • When setting the amount of time to exercise, take into account your health condition as well as your physical condition. It's easy to overdo exercise - especially early on. It makes you sore and tired and may keep you from continuing.
  • Start slowly. 
    • For example, walk, jog or cycle for 30 minutes a day once a twice for the first week. Then increase your efforts by 5% to 10% each week. 
    • Look for easy ways to get more exercise. For example, take the stairs. Paint the house.
    • Aim to be exercising for four hours a week by the end of six months. 
    • To learn about walking, see: Walking Works at offsite link
  • Set small, simple, doable, goals for yourself so you can achieve them. 
    • Expecting too much too quickly may make it easier to give up.
    • When you achieve a goal, acknowledge it. For example, buy yourself a little gift such as a CD.
    • After achieving the goals that you set, re-evaluate and set new ones to keep you moving forward and to keep your program interesting.
  • If you are looking for an achievable goal, shoot for a heart rate that is right for your age. 
  • Learn about eating and exercise. The guide, Eating For Exercise, was written for people with HIV, but the information applies to everyone who exercises. See: offsite link
  • Keep hydrated. 
    • If you're dehydrated, your  heart must pump harder to get blood to your muscles. 
    • Heidi Skolnik, a sports nutrition consultant, recommends drinking one cup of water or a sports drink before your work out and another during your workout. A more vigorous workout may require more fluids.
  • Exercise with a buddy if possible. Buddies help keep each other motivated. It can be difficult to exercise alone, especially on days you don't feel like exercising.
  • Hiring a trainer can help keep you motivated as well as maximize your work out. 
    • A trainer can tailor exercises to your body and your goals.
    • Trainers are schooled in teaching the correct way to perform specific exercises. 
    • Trainers are schooled in treating injuries. They are not generally schooled in learning about illnesses.
    • If you cannot afford a batch of sessions with a trainer, perhaps you can find one that will help you create a training program in one or two sessions. (One to set the program and the second to check on your form and tweak it.)
  • Exercise while you do something else.  For example:
    • Ride a stationary bike while talking on the telephone or watching t.v.  
    • Turn housework into an exercise. Set a timer to ensure that you move for 30 minutes straight which is the recommended amount of moderate intensity daily exercise. (You may have a timer on your smart phone.) Upbeat music can help. Going up and down stairs helps. If you don't have stairs, consider doing a squat each time you bend to pick up something.
  • Continuity and regularity count. It's better to do less exercise consistently than to do more exercise once in a while.
  • Do not feel guilty if you miss a day, week or even a month.
    • Guilt leads to stress. Stress is not good for your body or your spirit.
    • Just plan a time when you can get back on track. Congratulate yourself when you resume.
  • When determining which exercise to do, consider the amount of energy each exercise burns. 
    • In general, studies show that the more vigorous the exercise, the greater the benefits. 
    • You can measure energy used in metabolic equivalent task (MET) hours. One MET hour is the equivalent of the energy expended by the body during one hour of rest. You can use several MET hours of exercise during one real time hour. For example, one hour of doubles tennis is equal to 5 MET hours. To see a list of activities and the MET hours each generates, see: offsite link
  • Keep track of how well you are doing. 
    • There are a variety of apps for your mobile phone  and smart devices you can wear on your wrist to help you keep track. 
    • If you want to keep track on your own, easy to-do measurements are:
      • Weigh yourself.
      • Track body mass index (BMI). You can do the math by going to the web site of the Centers for Disease Control and Prevention and plug in your height and weight. offsite link. You can find "normal" BMI at the website of the National Institutes of Health at offsite link
      • Check your heart rate. Inexpensive heart rate monitors are available at sporting goods stores. If you don't know your target heart rate, use the following formula:
        • Maximum heart rate (MHR) = 200 less your age
        • Target heart rate: Lower limit  = 0.6 x MHR
        • Target heart rate: Upper limit: = 0.8 x MHR
      • A pedometer which measures how many setps you take during an exercise session or other period of time.  You can purchase an inexpsneise pedometer at a sporting goods store or on line.
  • Avoid becoming overly fatigued.
    • Alternate periods of activity with a rest break.
    • Decrease the intensity, duration and/or frequency of a session.
  • Be intuitive about your body. If it doesn't feel right, don't do it. There are usually alternative means of accomplishing the same goal.


  • Readjust your exercise program if you begin to lose weight.
  • Call your doctor if you experience any discomfort.

How To Fit Exercise In To Your Daily Life

Alternatives to consider to fit exercise into your daily life are the following:

  • Walk when you can. For instance:
    • Get up a few minutes earlier and take a brisk walk.
    • Park at the far end of the parking lot, or around the corner. Better yet, walk or use a bicycle.
    • Get a dog that suits your lifestyle, borrow one from a neighbor or foster care for one from a local shelter.
      • Dogs require daily exercise. Walking them gives you exercise (and fresh air as well). It's also fun to chase them around the yard.
      • Dogs (like other pets) provide additional benefits such as relief from depression, loneliness and stress. They also help reduce blood pressure, and the effects of chronic pain.
      • To learn what you need to know about living with a pet, click here.
  • Use stairs whenever possible. For example:
    • Instead of an escalator or taking an elevator for a few years.  
    • Get off an elevator a few floors below where you want to go.
    • Use the stairs when going from one floor to another at the office.
  • At home
    • While watching television,instead of using the remote, get up to change channels.
    • Exercise while watching television or reading. 
      • For instance, on a stationary bike, walking up and down the room, doing push ups or leg lifts, lifting small weights.
      • If exercise disturbs your concentration, exercise during commercials.
    • In the kitchen, or when doing handy work, use hand powered utensils and tools instead of electric ones.
    • Exercise equipment does not have to be expensive.
      • Check sources such as CraigsList offsite link or your local Pennysave for inexpensive used exercise equipment.
      • Repurpose your bicycle. Put the rear wheel on a training stand. It creates a stationary bike.
    • Form a workout group with friends. 
      • You can work out to a DVD, or one of you can be the leader. 
      • If you can't get people together in person, do it on the phone, or see each other through Skype  offsite linkor video on smart phones.
    • Household chores 
      • Do household chores yourself to the extent you can instead of hiring someone.
      • Do chores faster than normally. 
      • Use human power whenever possible instead of modern conveniences. For example, a push lawn mower instead of electric or gas power.
      • Instead of carrying everthing at once, carry half what you would normally carry so you have to return to collect the other half.
    • While brushing your teeth, stand on one foot for 60 seconds. Then switch.  When it becomes easy, try balancing while lifting a leg to the side.
    • Dig in the garden. Rake leaves.
    • While on the telephone, pace -- or at least stand up.
  • On the way to work, school or elsewhere
    • Consider biking to work or walking - even if only for part of the way.
    • Alternatively, consider taking the bus. Walking to and from your bus stop  and getting off a stop or two early to walk the rest of the way will increase your daily activity
    • Park a few blocks from the office or get off the bus a few blocks earlier.
    • Do isometric exercises while waiting for the bus/subway/ride.
    • Use the stairs instead of the elevator.
  • At work:
    • Walk to see a colleague instead of using the phone.
    • Pace when talking on the phone instead of just sitting at a desk.
    • If your day includes a lot of chair time:
      • Stand at your desk instead of sitting.
      • Sit on a stability ball at your desk for 20-30 minutes a day.
      • Stand up and walk around frequently
    • Learn exercises to do when you take a short break, such as with elastic bands.
    • Keep an exercise machine or ball handy.
    • Take a fitness break. Consider exercising at lunch.
  • Travel
    • Before you travel, build exercise into the plans for the trip. For example, stay at a hotel with a gym or pool. Carry a jump rope or exercise band.  (See If You Travel, below.)
    • Walk while waiting in the airport. (Some airports have gyms. Check the airports you will be using before traveling).
    • Explore a new city on foot or by bicycle.
  • In the car:
    • Do isometric exercises  when stopped at a light. For example, :
    • Hold onto the steering wheel with both hands. Clench and unclench your hands.
    • Breathe in, then gently draw your navel towards your spine as you exhale. Repeat until the light changes. 
    • Park as far away from an entrance as you can - at the end of the parking lot, or a few blocks away.
    • When filling-up your car, contract and hold your abs until the tank is full.
    • When traveling, stop every 45 minutes and walk around
  • When socializing:
    • Instead of meeting friends for a meal, meet for a walk or a sport.
    • Visit an art exhibition or museum. The bigger, the more walking.
  • Do an activity you love, that also involves movement. For instance:
    • Dance - even at home by yourself.
    • Make walking as a family to a local park a weekend activity.
  • Do activities you enjoyed as a kid - such as jumping rope, throwing a Frisbee or using a Hula Hoop.
  • Wear a pedometer. At least one study shows that wearing the step-counting device can motivate people to take an extra 2,000 steps a day.

For additional tips that were created for people with cancer, but which apply to everyone, see: Getting Active, Staying Active from American Institute For Cancer Research. The guide is available online. You'll be asked for your e-mail address. See: offsite link

NOTE: Do not exercise right before you go to bed.

  • Exercise within an hour before sleep can contribute to poor sleep. 
  • Appropriate rest and sleep are essential to healthy living. 
  • For information about sleep, and how to get it, click here

What Exercises To Consider

Any regular physical activity is good, from brisk walking to weight lifting.

Just getting and staying active in your daily life is a good way to start. (For more, see: How To Fit Exercise In To Your Daily Life.)

Ideally, an exercise regimen should include all four types of exercise: Flexibility, Strengthening and Cardiovascular (Aerobic, Endurance) and Balance.

  • Flexibility (Stretching, Range-of-motion): Flexibility exercises stretch your muscles and can help your body stay limber. Gentle stretching exercises help reduce the risk of joint injury and warm you up for more strenuous exercise. Flexibility exercises include shoulder and upper arm stretch, calf stretch and Yoga.
  • Strengthening (Resistance): Helps strengthen muscles by using weights or resistance to make your muscles harder/stronger. These exercises include lifting weights, and using a resistance band.
  • Cardiovascular (Aerobic, Endurance): Physical activity that uses the large muscles of the body in rhythmic, continuous motions to make your heart and lungs work more efficiently.  Cardiovascular exercises include: brisk walking or jogging, yard work (mowing, raking, digging). dancing, swimming, biking, climbing stairs or hills, playing tennis or basketball.
  • Balance: Balance exercises help prevent falls which are particularly a problem in older adults. Many lower-body strength exercises also will improve your balance. Balance exercises include: standing on one foot, heel-to-toe walk, Tai Chi.

The best kind of exercise is one that you will actually do. Pick an activity that is fun for you. You are more likely to stick with it. Participating in a sport is one good way to keep in shape. So are soft exercises like light gardening, yard work, dancing, golfing or biking.

For help setting an exercise program that works for you, see:

  • Exercise: A Guide From The National Institute On Aging. An excellent free primer that includes exercises, information about safety, self-tests, benefits of exercise and nutrition. The guide is available at: offsite link  The same information is presented in a dfiferent format at: offsite link. Choose whichever works best for you.
  • Fitness Fundamentals: Guidelines for Personal Exercise Programs, available free from The President's Council On Physical Fitness And Sports. Available online at: offsite link,
  • Nolan Ryan Fitness Guide available free at: offsite link.
  • For illustrated exercises, see the American Council on Exercise's web site at offsite link.  Type "Exercise Library" in the search box.

For exercise programs: In addition to local gyms, DVDs and Videos, consider free resources such as:

  • AARP offers a free booklet on a 12 week program for beginners. American Association of Retired Persons (AARP), Health Advocacy Services, 601 E Street, NW, Washington, D.C. 800.424.3410 or 202. 434.2230.
  • offsite link offsite link(click on "Exercise Library").
  • offsite link offsite linkfor free online videos, slide shows other tools for stretching and other exercises.

NOTE: When deciding which exercises to do, think about the amount of energy you expend per hour. While it is difficult to set a preferred minimum amount of energy to expend each week to get maximum beneficial effects of exercise, a large study has shown that 8 to 27 MET-hours of exercise each week reduced the risk of recurrence and death for women with breast cancer when compared with sedentary survivors—those who exercised three MET-hours per week or less. Doing 18 MET-hours a week is not difficult. It is equivalent to walking at a modest pace for one hour, six days a week, or playing tennis or jogging for two-and-a-half hours each week. For a complete list of activities and the MET hours each produces, see: offsite link

Tips To Help You Keep To An Exercise Regimen

Consider the following tips to help keep you on an exercise regimen:
  • Find an exercise or a mixture of exercises that you enjoy. Exercise does not have to be in a gym. Dancing, gardening, and hiking are exercises too. Try different exercises to find the one or ones that work for you.
  • Keep in mind that exercise does not have to be in one continuous session. A few brief bouts of exercise can be as beneficial as a longer one.
  • Set a schedule for your routine that anticipates your energy highs and lows, when you take medicines and special instructions that relate to your medicines (such as taking a drug on an empty stomach). 
  • Try to keep to your schedule just as you would any other appointment relating to your health. People who exercise in the morning can often avoid the inevitable distractions that come up during the course of a day.
  • Consider exercising with a partner, friend, or someone with your condition. You can help each other stay motivated.
  • Exercise in a place or places that are convenient to the way you live your life.
  • Keep track of your activity.        
    • One way is to use a measuring device if appropriate. For example:
      • A pedometer keeps track of your steps each day. A good pedometer should have a stride adjustment in it which increases the accuracy. Many smartphones offer reliable pedometer apps that are free or available for a small fee.
      • Activity measuring devices such as FitBit, available through offsite link or Nike's FuelBand, offsite link
    • Another way is to keep a log of what you do. A simple notebook will do. Or you can keep track online through such free sites as offsite link or offsite link
  • Set realistic goals. 
    • Setting a target for waht you want to achieve with your excerise plan can be incredibly motivating. After you hit a goal, move it higher. Self confidence will grow each time you hit a goal.
    • Reward yourself for achieving goals: a gift, an extra trip to the movies, a massage. Don't use food as a reward - unless it's healthy.
  • Be patient. Changes occur slowly.
  • If you travel, think ahead. (see the next section below.)
  • Do not get thrown by injuries or time lapses. They happen. Start again. Consider backing off to a lesser amount of exercise when you restart, then gradually building back up.
  • Consider getting a dog. Walking a dog several times a day, every day, can be an exercise program in and of itself.
  • If taking care of yourself doesn't motivate you to exercise, do it for the people you love.
  • Consider using an app. For example:
    • HABITICA. offsite link Users et goals such as exercising daily.  When you complete a task, you move up to a higher level. You lose points when you miss a goal.
    • PACT offsite link Users pay you an amount of money when you exercise, eat fruits and vegetables or log meals. If you fail, you pay a preset amount.
    • STICKK offsite link  Users donate to a cause if you do not meet a goal

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How To Keep To An Exercise Schedule When You Travel

When planning a trip:

  • Think about where you can exercise. For instance, if you are going to stay in a hotel, look for one with physical facilities like the ones you use at home or that provide day passes to a nearby gym or club.
  • Include time for exercise in your plans.
  • Think about what exercises you can do in a hotel room, such as push ups, squats, leg lifts, stomach crunches, and lunges. Inexpensive elastic resistance bands take up almost no room in a suitcase. (You can learn how to use elastic bands through such books as Tamilee Webb's Original Rubberband Workout by Tamilee Webb et al. Inexpensive used copies are available online through such sites as Barnes and Noble offsite link).
  • To find gyms within 20 minutes of airports, see: offsite link

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Free and Low Cost Exercise

It doesn't have to cost a lot of money to exercise. While gyms have a lot of advantages, there are plenty of things you can do at home for free. For example, walking up and down the steps in an apartment or office building is a great aerobic exercise. Walking staircases also builds the lower part of your body.

Among other places, you can find free exercise programs at:

  • YouTube offsite link (type in exercise, exercise programs, exercise videos etc)
  • offsite link
  • The President's Council On Physical Fitness And Sports' brochure: Pep Up Your Life: A Fitness Book For Mid-Life and Older Persons (don't be put off by the title or the drawings), available at: offsite link
  • offsite link - free information about walking
  • On your mobile device. 
    • Free apps are available for yoga, walking, running, calisthenics and almost eery type of exercise. Plus you can easily take these workouts with you when traveling.
    • Consider joining a health or nutrition challenge. There are many free challenges available online or in communities to help people get fit. Many provide online badges or other awards for motivation. 

The odds are that there is a free or low cost public gym and/or pool in your area. In expensive New York City, a person age 50 and over can join a city gym for $10 a year. .


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How To Locate And Choose A Personal Trainer

Why Use A Personal Trainer?

Personal trainers can be useful if:

  • You are a beginner and need help establishing an exercise program, or
  • If you need motivation to exercise regularly, or
  • If you want someone to push you.

If you just want someone to count reps or to chat with while you exercise, you may be wasting money by hiring a personal trainer.

How To Locate A Personal Trainer

  • Ask your oncologist, a social worker or the hospital at which you are treated. Also consider asking members of a support group.
  • Search for an American College of Sports Medicine/American Cancer Society Certified Cancer Exercise trainer. See the ACSM website offsite link

How To Choose A Personal Trainer

When choosing a personal trainer, keep in mind that anyone can call him or her self a personal trainer. because no licensing is required. Consider the following:

  • The person's training and education. The spectrum ranges from people with a certification from passing an online exam to majoring in sports medicine at the college level.
  • The way the person works. A trainer should:
    • Conduct a fitness assessment.
    • Discuss your goals and lifestyle.
    • Design a program specifically for you.
    • Start each session by telling you what you will do, rather than asking what you feel like doing.
    • Discuss your eating habits and basic nutrition. However, unless the person is a trained nutritionist, he or she is not trained to provide individual advice or to recommend specific supplements or products.
    • Help you become an independent exerciser.
  • Ask about the trainer's goals. If he or she is traning part time while waiting for a break in another field, the person may not continue to be available.
  • Look for accreditation by a physical therapist organization. Check the program to see what is required for an accreditation. According to Smart Money magazine, industry experts point to the American College of Sports Medicine ( offsite link and the National Strength and Condititioning Assocation ( offsite link) as two of the most reputable organizations.
  • Ask for references - and call them.
  • The person's fee. 
    • A more expensive trainer does not necessarily guarantee better results. (Personal trainer fees are not usually covered by health insurance). 
    • You may be able to reduce the cost of a trainer if you create a group of at least two. In this win-win situation, each of you pay less than you normally would, and the trainer makes more money for the hour because he or she is charging two of you. For instance, if the trainer normally charges $60 an hour, she may be willing to reduce the cost to $40 each for two of you. She would earn $80 an hour instead of $60. (Note: Most trainers will accept such an arrangement even though they or the gym they work in don't advertise it).

If you are a senior, to find a personal trainer with senior fitness certification, go to


  • If a health club asks for your medical information, review the club's privacy policy. Also keep in mind that a trainer has no obligation to keep what you tell him or her confidential.
  • Before accepting a trainer's recommdation for a supplement or nutritional advice, it is advisable to check with your medical specialist to be sure thereis no conflict with any of the drugs you take or treatment you undergo.

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Exercises That Can Be Done In Bed

If you need to stay in bed, even small activities like stretching or moving your arms or legs can help you stay flexible, relieve muscle tension, and help you feel better.

Alternatives for exercise in bed include:

  • Use light dumb bells or elastic bands to exercise your arms and upper body.
  • Contract/tense each of your muscles, one at a time.
    • Hold the contraction for a count of 6, then release for 2 counts.
    • Repeat for a set of 10.
    • To keep track, start with your face and work your way down, or with your toes and work your way up.
  • Start and end with stretching. 

Resources to consider:

  • Carol Dickman's Bed Top Yoga,  available in DVD, audio and video cassettes at offsite link - stretching exercises based in Yoga.
  • Get Fit In Bed, Tone Your Body & Calm Your Mind From The Comfort of Your Bed, by Genie Tartell, D.C., R.N., Ted Kavanau, New Harbinger Publications, Oakland, CA 2006 (used copies can be purchased very inexpensively through such web sites as offsite link)

NOTE: Talk with your doctor or other health care provider before starting any exercise.

How To Monitor Exercise So It Doesn't Become Harmful

You can monitor the effect of exercise yourself through a variety of means such as measuring heart rate, the "walk and talk" test, or bad vs. good pain. The following content was provided by Julie Finocchiaro, DPT, Johns Hopkins Physical Medicine and Rehabilitation


You can check your heart rate by monitoring your radial pulse on your wrist. Normal heart rates are between 60 and 100 beats per minute.

Step 1.Calculate your maximum heart rate. As a general matter, you can calculate your maximum heart rate by subtracting your age from 220. For example, if you are 60, your maximum heart rate is 220 less 60 = 160.

Step 2. Set a target heart rate. For example, multiply your maximum heart rate by somehwere between 50% and 80%. For example, 50% of 160 is: 160 x .5 = 80.

Step 3. MeasureTo measure your heart rate as follows:

  • Put your index and middle fingers right on the pulse. 
    • Do not use your thumb. The thumb has a pulse in it which will be confusing.
    • Do no press too hard. It changes the pulse.
  • Ctep 2. Count how many beats you feel in one minute. 
    • You can count the beats for 60 seconds or
    • If your beat is steady, you can count the number of beats in 15 seconds and multiply times 4. 

NOTE: If the beat is irregular, let your doctor know.


Can you carry on a conversation while exercising? If you cannot because you are too short of breath - either slow down or stop all together.


"Bad pain" is when you have adverse symptoms such as one of the following:

  • Sharp, stabbing, or burning pain
  • Joint or bone pain
  • Numbness
  • Tingling
  • Chest Pain
  • Dizziness

"Bad pain" contrasts with "good pain". Good pain with exercise is when one of the following occurs:

  • You feel your muscles working
  • You have a mild stretching/pulling sensation
  • You have muscle fatigue or delayed onset muscle soreness which starts one or two days after exercise.

Resources for Additional Information About Exercise

The following are good places to start for additional information concerning exercise:

General Exercise

  • American College of Sports Medicine, P.O. Box 1440, Indianapolis, IN 46206 Tel.: 317. 637.9200, offsite link.
  • You can find a series of free brochures about different exercise subjects at: offsite link.
  • President's Council On Physical Fitness and Sports, 701 Pennsylvania Avenue, NW, Suite 250, Washington, D.C. 20004. Tel.: 202.272.3430, offsite link.

For People With Cancer

  •  Schneider, Carole M., Schneider, Roy D. Rees, Carolyn Dennehy, Susan Carter, Exercise and Cancer Recovery,  Human Kinetics Publisher, 2003

Cancer And Exercise

Scientific studies show that:

  • Physical fitness helps fight cancer.
  • Exercise is safe and cost effective
  • Exercise can improve function, qualify of life and indepence of people with cancer
  • Exercise is valuable before and after treatment -- and perhaps even during cancer treatment. For example, people who exercise have less fatigue, greater strength and better aerobic capacity, strengthened immune function and even lower rates of recurrence.

There are likely to be days during treatment when meaningful physical activity is not possible. Don't push it on those days. Take a break.

Classes: There may be specific exercise classes for people with cancer in your area.

  • Check with the American Cancer Society ( offsite link or Tel: 800.ACS.2345), your local YMCA and your local gyms. 
  • The LIVESTRONG program at the YMCA is free to cancer survivors. After the program ends, the YMCA offers discounted rates to cancer survivors who want to continue to exercise.

If there are no local classes for cancer survivors, consider starting one of your own. The American Cancer Society can suggest how to do that.

Trainers: The American College of Sports Medicine has a certification program for health and fitness instructors who work with cancer patients. To find a trainer in your area, go to, offsite link Click on "Certification."   Then click on "Find An ACSM Certified Trainer."  On the next page, scroll down to "ACSM/ACS Certified Cancer Exercise Trainer". (The program was developed with the American Cancer Society).  

Other professionals who can help develop exercise programs for your specific needs and situation are physical therapists, occupational therapists and exercise physiologists.


NOTE: If you have breast cancer, there are specific exercises for the affected area

HIV/AIDS And Exercise

AIDS health professionals emphasize a combination of moderate but regular aerobic exercise and weight-training as a basic fitness program. A regular cardiovascular workout has a direct impact on the immune system. The goal should be to maintain a steady level of exercise that doesn't tax the body.

AIDS experts often recommend swimming as the best exercise for someone who is HIV positive because it includes a combination workout. It strengthens the muscles and stimulates the cardiovascular system.

Be cautious when engaging in high-contact sports because of the potential of transmission of HIV through breaks in the skin or flowing cuts.

To learn more about HIV and exercise, see Fit Facts from The American Council On Exercise, offsite link

For information on HIV and yoga, see: offsite link

Diabetes And Exercise

While diet is the cornerstone of diabetes care, the role of exercise can be just as great.

  • Exercise can take some glucose out of the blood to use for energy during and after exercise, which lowers blood glucose levels.
  • Exercise helps delay or stop large blood vessel and heart (cardiovascular) disease. Cardiovascular disease is the leading killer of people with diabetes

For more information, contact the American Diabetes Association: offsite link