By Werner W.K. Hoeger, EdD
Starting and sticking to an exercise program is not an easy task. About half of the people who start an exercise program give it up within the first six months, including those who take up walking for exercise. One way to raise your chances of keeping with a walking program, however, is to choose a noteworthy goal, such as completing a 5-kilometer (a “5K” or 3.1-mile) walkathon, particularly one that raises awareness and funds for a cause that’s important to you. (To find a walkathon you want to participate in, see “Walking With a Purpose.”)
Goals serve as strong motivators. Enlisting others to join you in your training and your quest to complete a walkathon will further increase your chances of taking the necessary steps to meet that goal. And having a plan is important, too.
With that in mind, we have provided a sample, 12-week training plan that can help you get in shape for a 5K walkathon. But before addressing the training program for your walkathon, it is important that you understand the concept of intensity of training, or how hard you should push yourself during aerobic exercise (exercise that requires oxygen to generate energy) to improve your fitness level.
To build fitness safely, the intensity of training during your training walks should be between 40% and 70% of your heart rate reserve. This is a measure of how fast your heart should beat while training. To determine your heart rate reserve, subtract your resting heart rate from your actual measured maximal heart rate (determined during an exercise stress test) or from an estimated maximal heart rate. If you do not know your true maximal heart rate, you can estimate it by subtracting your age from 220.
Resting heart rate is obtained by counting your pulse either on the inside of the wrist over the radial artery (thumb side) or over the carotid artery at the front of the neck. Place two fingers (not including the thumb, which has its own pulse) over the artery and count your pulse for 30 seconds, then multiply by 2, or count your pulse for a full minute. (Check out “Measuring Your Pulse” for more information.) The standard way to measure your resting heart rate is in the morning before you have gotten out of bed. Measure your resting heart rate this way for a week, then take an average of all your results for an accurate assessment of your resting heart rate.
To figure out approximately how many heartbeats per minute you will have at 40%, 50%, 60%, and 70% of your heart rate reserve, multiply your heart rate reserve by these percentages, then add your resting heart rate to each of these values. For example, if your maximal heart rate is 170 and your resting heart rate is 76, the training intensities in beats per minute are as follows:
40% training intensity =
[(170 – 76) 0.40] + 76 =
114 beats per minute
50% training intensity =
[(170 – 76) 0.50] + 76 =
123 beats per minute
60% training intensity =
[(170 – 76) 0.60] + 76 =
132 beats per minute
70% training intensity =
[(170 – 76) 0.70] + 76 =
142 beats per minute
To ensure you are training at the appropriate intensity, check your pulse during exercise, slowing (but not stopping) the activity to do so and counting for 15 seconds. Then multiply the result by 4 to obtain the rate in beats per minute. (Your heart rate will stay at the same level for about 15 seconds, at which point it will decline rapidly.) You can increase the accuracy of your exercise heart rate assessment through the use of a heart rate monitor, available at most sporting goods stores or through the Internet.
Another way to monitor your exercise intensity that doesn’t require taking your pulse is to use the Rating of Perceived Exertion Scale. On this scale, 0 means no movement at all, and 10 means a maximal, all-out effort. The numbers in between represent light, fair, somewhat hard, vigorous, hard, and very hard exercise. The exerciser rates how hard he feels he is working based on his shortness of breath, leg tiredness, and overall tiredness. The 40% to 70% training intensity suggested for walkathon training is roughly equivalent to working at a light to vigorous perceived training intensity.
After you start your exercise program, your resting heart rate may slow down as your heart becomes stronger. For this reason, it’s a good idea to reassess your resting heart rate every two to three weeks and adjust your training intensities accordingly, since they are based on your resting heart rate. You will probably see the largest decrease in resting heart rate in the first few weeks of training. While your resting heart rate and target training intensities may change, your maximal heart rate will not change much with training.
In general terms, to improve your fitness level through aerobic exercise, you need to train three to five days per week for 20 to 60 minutes, in the 40% to 70% training intensity range. If you have not been doing any aerobic activities up until this point, walking 20 consecutive minutes may be a challenge for you. In this case, the 12-week training program for a 5K walkathon will allow you to gradually condition your body to walk for an extended period of time. Before you start, however, get your doctor’s OK. While brisk walking is safe for most people with diabetes, it’s nonetheless important to make sure you have no conditions that could be worsened by an exercise program.
If you have been exercising and you regularly accomplish the training program outlined for a given week (for example, you already do the workout described for week 4 on a regular basis), you may start your program with the following week’s schedule.
A few more considerations before you proceed to the walking program: To improve your walking stride and technique, always walk slowly for a couple of minutes to warm up and do some gentle stretches of all major muscle groups prior to each exercise session. (See “Stretches For Walkers” for more information.) Avoid taking steps that are too large. To increase your walking speed, take smaller, faster steps. If you are going to walk above a light level of exertion, warm up gradually, increasing your walking intensity to the target level over three to five minutes. Similarly, at the end of the exercise bout, gradually cool down by decreasing your walking intensity to the light level.
A pedometer is an excellent tool to monitor your training walks as well as your daily physical activity and help keep you motivated. Pedometers are small mechanical devices that are used to count footsteps. Wearing one throughout the day gives you a fairly accurate tally of the total number of steps you take each day. In this way you know whether you’re meeting your goals, surpassing them, or need to do more.
The more accurate your pedometer, the more satisfying it is to use. Some low-cost pedometers available at retail stores are relatively inaccurate, but you can obtain a good pedometer for about $25. (Ratings are available online and can be located by typing “pedometer ratings” into a search engine.) To verify a pedometer’s accuracy, take 50 steps while wearing it; if the pedometer count is within 10% of 50 (45 to 55), the device is considered acceptable. Keep in mind that all pedometers are less accurate at very slow walking speeds (slower than 30 minutes per mile), which don’t create enough lower-body movement for the pedometer to accurately register the steps taken.
On average, adults in the United States take about 5,700 steps per day. To be considered active, the general recommendation for adults is to accumulate, through all daily activities, 10,000 steps per day. Between 5,000 and 7,000 daily steps is considered low activity, and between 7,500 and 10,000 is viewed as “somewhat active.” Purchasing and wearing an accurate pedometer can help you assess your current level of activity and what you need to do to move up a category.
Aerobic activities typically cause a drop in blood glucose level, so if you plan to exercise one to two hours after a meal, you may need to reduce the dose of oral medicine or insulin you take with that meal. If you are going to exercise more than two hours after a meal, you may need to eat a snack beforehand to prevent hypoglycemia (low blood glucose). Checking your blood glucose level before and after exercising is the best way to determine what adjustments to make in your diabetes regimen to accommodate the effects of the exercise.
If your blood glucose is above 300 mg/dl, you should approach exercise cautiously. If you have Type 1 diabetes and your blood glucose is above 250 mg/dl, you should check your blood or urine for ketones, the presence of which may indicate that your body does not have enough insulin available to use glucose for energy. If no ketones or only a trace of ketones are present, it is OK to exercise, as long as you feel well. However, you should check your blood glucose again after 15 minutes and stop exercising if it has risen, because of the risk that it will continue to rise. If more than a trace of ketones are present, treat your blood glucose and wait until the ketone level goes down before exercising.
Dehydration can have a negative effect on your blood glucose level, heart function, and athletic performance, so you should consume adequate amounts of fluid both before and after exercise. Drink about 8 ounces (one cup) of water prior to starting each walking session, and bring a water bottle with you on your walks so you can sip as you walk, particularly on hot days.
Numbness in the feet due to diabetes-related nerve damage (neuropathy) can make it difficult to tell if you’ve injured your feet during exercise, and walking on an injury can cause it to turn into a more serious problem. When you exercise, wear shoes designed for walking that fit well and are comfortable and socks that wick moisture away from your feet. Socks made from wicking fabrics such as Dri-Fit, Coolmax, and Sorbtek can help prevent blisters. Wearing a sock liner (available at many hiking shops) inside a regular sock can also help prevent blisters by reducing friction. After exercise, always check your feet for redness or blisters and call your doctor if any foot problems develop.
Setbacks are inevitable when pursuing a long-term goal, so remember to be flexible and to not get discouraged if you don’t always meet your daily goals. If it’s raining or too cold, you may not be able to walk outside. Instead, walk at the local mall or choose a different activity such as swimming, stair-stepping, or cycling for an equal amount of time. You will still get an aerobic workout, and cross-training (doing a different activity) can help to prevent repetitive-strain injuries.
Once in a while you may miss a workout. If so, all is not lost. If you are following the walkathon training program and miss a 50%-intensity workout one day, skip the workout and keep going with your program the next day. If you miss a workout that is above the 50%-intensity level, do it the next day in place of the 50%-intensity workout. If you’ve missed only one or a few workouts, you can probably just restart your program with the next scheduled workout. But if you’ve missed a week or more, you may need to restart at a lower level of intensity, since your level of fitness declines over time with no exercise. If you’ve missed workouts because you were ill, you will probably need to restart at a much lower level than where you left off. In that case, let how your body feels be your guide. Exercising too hard when you’re recovering from an illness is counterproductive.
The important thing is to get started again (at an appropriate level of intensity) and keep your long-term goal in mind. As you accomplish your fitness goals, reward yourself for a job well done. Treat yourself to a movie and healthy dinner, a weekend away, a new suit, or a new pair of shoes, for example. And don’t forget the biggest reward of all-the impressive health benefits that come from an active lifestyle.
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