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When returning to exercise, build up gradually

It’s easier than you think to hurt yourself in the name of health, so when beginning an exercise plan, slowly build to a sustainable regimen

For doctors ministering to aging baby boomers, the welcome news is that many seem to be exercising more than they have in years. That is improving their cardiovascular and psychological health, but it’s also contributing to a parade of sore knees, back sprains, and other injuries.

Whether discovering the joys of fitness in mid-life, or attempting to reclaim athletic glory after decades of relative inactivity, boomers in their 50s and 60s tend to throw themselves into exercise with the same intensity they might bring to new jobs, hobbies, or grandchildren. Many, however, neglect the importance of working up gradually to a smart fitness regimen.

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“You need to build up,” said Dr. Paul Weitzel, attending physician at New England Baptist Hospital and managing partner at Boston Sports & Shoulder Center. “Going to the Zumba class and jumping up and down after not doing anything for 10 years, your body is going to react.”

Doctors advise those returning to exercise after years on the couch to curb their enthusiasm, refraining from swimming the extra laps, running the half-marathon, or pressing the heaviest weights until their middle-aged bodies have acclimated to the new stresses and muscle aches.

“In the ’80s, people had the ‘no pain, no gain’ mindset,” said Dr. Christopher Geary, chief of sports medicine at Tufts Medical Center. “Now people recognize that pain is no gain.”

‘In the ’80s, people had the “no pain, no gain” mindset. Now people recognize that pain is no gain.’

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Within the world of sports medicine, the conventional wisdom continues to evolve. Aerobic activity and good nutrition still are recommended, but they are no longer seen as sufficient. Doctors cite evidence that weight-bearing exercise for as little as 15 to 30 minutes a day also can bring benefits, helping to maintain bone density, especially in post-menopausal women.

But both aerobic and weight-bearing workouts can leave older athletes susceptible to a condition that has been characterized as “boomeritis,” episodes of tendinitis, bursitis, stress fractures, and meniscus tears.

To prevent injuries, Geary suggested newly active boomers start with neither running nor weights but with low-impact exercises such as stationary biking, stepping machines, or elliptical trainers, or with low-impact aerobic classes. Running and weight lifting can come later, but Geary said those activities should be undertaken carefully — and without Herculean illusions.

“Everyone knows people who say, ‘I didn’t train for the marathon, but I went out and ran it with my buddy,’ ” Geary said. “Those tend to be the exceptions rather than the rule. Everyone knows someone like that, but that’s because you tend to remember the story.”

Weitzel proposed starting with 30 to 40 minutes of walking, biking, ellipticals, or yoga three times a week, and working up gradually to 45 minutes to an hour. When moving to weights, he said boomers should do three sets of each weight with eight to 12 repetitions.

“People who first go back, they want to do cross-training,” Weitzel said, such as walking one day and exercising in the gym the next. “They want to stress their bodies in different ways. The people who get in trouble are the people who stress their bodies in the same way.”

Newly active boomers are encouraged to listen to their bodies, stretch before running or playing tennis, and “strengthen the core” — abdominal muscles, back muscles, and muscles around the pelvis — before exercising muscles in isolation during weight lifting. Deep squats, box jumps, and lifting with improper form are all activities that can lead to injuries.

In addition to having an exercise plan and a nutrition plan — containing the right mix of fats, protein, and carbohydrates — fitness-focused boomers should also have a “personal support” plan, whether it’s consulting a trainer or meeting a friend for a brisk jog at daybreak.

“The best way to do it is to have a workout partner,” Weitzel said. “You’re much more likely to get up at 6 in the morning if you know you don’t want to disappoint a friend.”

When it comes to injuries — and with boomers it always seems to come to injuries — the most common are bone, joint, and muscle problems caused by overuse. Runners may be vulnerable to achilles tendonitis, pain in the tendon that connects the calf muscle to the heel bone. Swimmers may fall prey to pain in the shoulder rotator cuff. Weight lifters are susceptible to patellar tendonitis, inflammation in the tendon connecting the kneecap to the shinbone.

The more people exercise, the more they are attuned to the difference between what sports medicine doctors call “good hurt,” sore muscles that will quickly heal, and more acute pain from an injury requiring medical treatment or rest. But even when advising patients on recovering from injuries, the conventional wisdom has been shifting over the past 15 years. Where doctors once recommended long periods of bed rest for back, hip, or other joint pain, many now advise people to resume exercising — trying different activities, walking rather than running, or lifting only light weights — as soon as possible. Doing so can accelerate the healing process, they say.

“We try to keep people as active as their pain allow,” Weitzel said.

RANGE OF MOTION

Baby boomers should follow a varied exercise regimen to maintain optimal health:

AEROBIC

Types: Running, walking, cycling, swimming, elliptical machines

Frequency - Moderate: 30 to 60 minutes, five days a week; Vigorous: 20 to 30 minutes, three days a week

Intensity - Moderate: sustained effort of at least 10 minutes; Vigorous: sustained effort of at least 20 minutes

RESISTANCE

Types: weight lifting, calisthenics, stairclimbing

Frequency: Two to three days a week

Intensity: Light to moderate, two to four sets of multiple repetitions

FLEXIBILITY

Types: stretching, yoga

Frequency: Three to five days a week

Intensity: Light to moderate, 30 to 60 seconds per exercise

NEUROMOTOR

Types: pilates, yoga, bosu ball, tai chi

Frequency: 20 to 30 minutes, 2 to 3 days a week

Intensity: N/A

SOURCE: American College of Sports Medicine

Robert Weisman can be reached at
weisman@globe.com
.

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