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Introduction
A study by the Department of Health and Environmental Control in South Carolina showed that HIV patients who exercised three to four times per week were less likely to develop Aids than those who did no exercise at all. It not only slowed HIV progression, but increased blood counts as well.
Getting enough exercise is sometimes rather difficult. Many people have negative connotations with gym lessons at school and instructors who would have been better off in an army boot camp. But there are many other more pleasant ways of getting enough exercise.
When you start exercising, there are a number of things to consider, including your current level of fitness, where you are in your HIV treatment and which type of exercise is appropriate and enjoyable for you. If you start doing something which is too strenuous, you won't enjoy it and chances are that you will abandon all exercising efforts. So the choice of exercise is crucial.
It is very important to set realistic goals. If your goals are over-the-top, such as wanting to do a fun run within two weeks of starting to exercise for the first time in your life, the only thing you will achieve is to demotivate yourself.
Exercise can play a big role in controlling some of the side-effects of HIV.
Why is exercise good for you? There are many reasons why exercise is beneficial to everyone, including people who are HIV positive.
Exercise increases stamina, decreases body fat and total cholesterol, while increasing HDL – the "good" cholesterol. It reduces blood pressure and decreases resting heart rate. It also increases the lungs' ability to absorb oxygen. It decreases the incidence of some cancers as well as general anxiety, tension and depression.
When not to exercise
Before you start exercising, you should be aware of your state of health. You should learn to distinguish between a general feeling of tiredness and serious fatigue or illness.
If your joints are swollen, you are feeling dizzy, feel feverish, have open sores in your mouth or elsewhere, feel nauseous or have vomited, have diarrhoea, or have blood in your urine or stools, it is not a good idea to exercise.
If you suddenly feel excessively tired in the middle of a workout, it is not a good idea to continue exercising. If this continues, get to your doctor and discuss your exercise routine and possible adjustments to it.
Starting off
Start off slowly as your body needs time to adjust to the additional stress you are placing on it. Take a day off if you really feel tired, but whatever you do, don't stop exercising.
It is important that you set goals that are realistic, measureable and attainable. The fastest way to demotivate yourself is to set unrealistic goals, which could lead to your stopping exercising altogether. It is also important that you remain well-hydrated during exercise. Drink water before you start, while you exercise and after you have finished exercising.
There are several different components to fitness, which include cardiovascular training, flexibility training, resistance training, balance training and mind-body training.
Cardiovascular training
Cardiovascular training is usually fairly mild exercise that uses the major muscle groups for a fairly long time – at least 12 minutes, depending on your state of health - and which raises your heart rate. These activities can include running, walking, swimming, cycling and aerobic dance among others.
Take care not to over-train, otherwise you could start losing lean body mass. But in moderation, this type of exercise can help to control your blood pressure, blood lipids, blood sugar and stress. If you overtrain, you could start suffering from depression, sore muscles, weight loss, insomnia and general fatigue. Such symptoms are unfortunately very similar to worsening HIV symptoms, so if you experience any of these, cease your training. If the symptoms go away, you know you have been overtraining. If they don't, get to the doctor.
Start off slowly, once or twice a week for five to ten minutes, especially if your T-cell count is between 200 and 500. If you are starting off, walking and stationary cycling are probably the best. If your T-cell count is more than 500, you can exercise two or three times a week for 15 – 20 minutes at a time.
If your T-cell count is below 200 you would not want to overstrain yourself. Start gently with about five minutes of exercise two to three times per week. Do what you can, but stop if it makes you feel overtired.
Resistance training
Strength training can help you to add muscle mass, or develop the muscle mass you already have. This is important as the proteins in muscle play an important role in your body's immune system. Muscle wasting is a huge problem to many people with HIV and resistance training can slow down or reverse this process. Resistance training will increase the size of the muscle fibres all over the body.
What is resistance training? It entails moving a force, such as weights or other objects, or the body itself (as in yoga and T'ai Chi).
Resistance training should be done three or four days per week, including 10-12 major muscles or muscle groups in your training session. You should lift eight to 12 repetitions for two or three sets. A repetition is a single contraction of the muscle through its complete range of motion. You should rest for at least a minute between sets.
Don't overdo it in the beginning, especially if you have not done resistance training before. Start off with one set of 8-12 repetitions for three weeks and gradually increase the number of sets to two or three as you get fitter.
The groups of muscles that are worked when doing resistance training include the back, the chest, the shoulders, the arms, the legs, the stomach muscles and the erector muscles of the back and neck.
Flexibility training
As people grow older, they lose flexibility. Nevertheless, flexibility training is often the most neglected part of someone's workout. These should be done before you start your other training, but they can also be done on your non-exercising days.
Flexibility training allows you to get so much more out of your normal training sessions. Stretching exercises can play a vital role in helping you maintain your muscle mass and your muscle tone. Stress management and pain control are added benefits to regular flexibility training.
You should always warm up first before doing stretching exercises. If you don't warm up first, and stretch cold muscles, you risk injuring them.
Stretching includes static stretches (with very little movement) and movements that go through the full range of motion. Each stretch should be held for 10 to 30 seconds and you should breathe deeply during each stretch.
Balance training
Balance training is often easiest to do with a partner. HIV medication often affects your neuromuscular activities. Balance training simply entails putting your body in positions that challenge your sense of balance. It could be as simple as standing in the middle of the room with your eyes closed. You could also stand on one leg and change the positions of your arms – all of this retrains your muscles and nerves to balance again. This can be done daily, but you should have supervision.
General tips
Make exercise a priority. A halfhearted attempt at an exercise programme will be of little benefit to you.
Consult your doctor. Embarking on an exercise routine without consulting your doctor could be disastrous – you could, in fact, be jeopardizing your health.
No pain, no pain! Exercise should be enjoyable. If you are terribly exhausted or you get muscle cramps or other aches and pains, you could be overdoing things. Stop what you are doing and rethink your exercise schedule.
Every other day. If you are HIV-positive, your body is already under a lot of stress – don't push beyond certain limits. Exercising every other day will give your body time to rest and also time to adjust to the new exercise routine.
Find something you like. It is always easier to stick to an exercise routine if you enjoy what you have chosen to do. To prevent boredom, you can also choose more than one type of exercise and alternate these.
In the comfort of your own home. Exercise classes can be a great way to meet people, but they aren't for everybody. Or maybe you feel you'd like to join one, but would prefer to start on your own first. There are many exercises you can do without leaving home. These include stretching, balancing, certain aerobic exercises and exercises to improve flexibility. Keep in mind, though, that the best way to learn how to do an exercise effectively, is to get instruction from a pro.
Adjust your programme. Don't be rigid about your programme – adjust it according to how you feel on any particular day. The important thing is not to give up.
