Even as gyms, yoga studios, and fitness centers reopen around the country, people with chronic health conditions—considered a high-risk population during the COVID pandemic—aren't likely to be going to them. That means many are still exercising at home, or not exercising at all. To inspire others to stay active, we asked four Brain & Life readers about their fitness routines and how they stay motivated.
Before his stroke in 2018, Gregory Koscielski led a very sedentary life. "I was a purchasing agent and sat in front of a computer all day. I was also overweight, which wasn't good for my heart," he says. The stroke was followed by a heart bypass operation and other health complications; he was so weak he had to use a walker and could barely stand. But after a month in a rehabilitation center and weeks of at-home physical therapy, he started to feel stronger. And once he was cleared for all physical activity, Koscielski embraced it. "I like to exercise now," says the 70-year-old from Munster, IN. And the pandemic hasn't slowed him down. Over the summer he cut the grass, swam in his pool, gardened, and lifted three- and five-pound weights in the basement. And now he goes to a cardiac rehabilitation center three times a week. "The first day, I was a noodle, but now my muscle tone has returned," he says. "I won't be posing for a muscle magazine anytime soon, but I'm getting better every day—and that's motivating."
Koscielski's blood pressure has lowered to normal, his stamina is increasing, and he's adding more weights on the machines he uses at the center. "I have a chart that shows my progress. My physical therapist and occupational therapist love me because I'm improving so much." He is excited to remain active through the winter and looks forward to hitting a golf ball next spring. "Before my stroke, I was a little too laid-back about exercising," he says. "Not anymore."
Neurologists encourage all patients to exercise. "Physical activity is increasingly recognized as important in preventing or delaying progression of neurologic disease," says Bruce I. Ovbiagele, MD, FAAN, associate dean of the San Francisco VA Healthcare System.
Tom O'Donnell, a 57-year-old drugstore manager in Durham, NC, started running after he was diagnosed with a low-grade brain tumor in 2009 and doctors cautioned him that he might never walk again after surgery. "I wanted to have a memory of running fresh in my mind, just in case I wasn't able to run again afterward," he says.
O'Donnell kept up his running following the operation and all through chemotherapy and radiation. Since his diagnosis, he has completed 29 marathons. Running changed everything for him, he says. "I became more aware of my diet; I was sleeping better and less stressed throughout the rest of the day," says O'Donnell. "It also strengthens my mind." While his local races and marathons have been canceled due to COVID-19, O'Donnell continues to run an average of seven to eight miles daily.
Brian Wallach, a lawyer based in the Chicago suburbs, was already an avid exerciser when he was diagnosed with amyotrophic lateral sclerosis (ALS) in 2017. He ran track in college and has always kept fit at the gym, so becoming a couch potato was not an option, even with a debilitating and progressive disease. "The days I work out, I notice that my muscles feel stronger and walking is easier," says the 39-year-old. On top of that, Wallach says he feels "sharper, clearer, and to some degree happier."
Before the pandemic, Wallach worked with a Pilates instructor and a personal trainer several times a week to improve his strength and balance—two things that ALS diminishes. After social distancing guidelines were implemented, Wallach ordered a stationary bike and a treadmill so he could continue on his own. He eventually started virtual sessions with his trainer and added stretching to his regimen to engage multiple muscle groups at once. "With ALS, when your muscles decline and degrade, they don't come back. So it's important to keep moving without overdoing it," Wallach says.
On any given day, Wallach devotes 30 to 45 minutes to cycling, walking, or physical therapy, in between work and looking after his two young daughters. It's his family who motivates him to exercise even on the days he'd rather not. "I want to stay in the best shape possible because I want to be here for as long as possible," he says. Although his legs frequently tense up and can make it hard for him to walk without a cane, they're still strong—and Wallach is trying to keep them that way. "I want to be around when there's a cure or a treatment for this disease," he says.
For Shannon Green, a visit to the Cleveland Clinic a year after she was diagnosed with Guillain-Barre syndrome in 2014 gave her a reason to exercise. "Had I known my pain was worse from not moving, I would have started a wellness program a lot sooner," says the author of Chronic Pain Hacker, a book she self-published this year. With the help of a physical therapist, Green's routine includes movements designed to calm her central nervous system and keep pain at bay. One move in particular involves rocking back and forth on her hands and knees to stretch her piriformis muscle just above the upper thigh, which eases her hip pain. Yoga and walking at least 8,000 steps a day also help manage her symptoms.
During quarantine, the 45-year-old, who lives in Austin, TX, has been motivated to exercise because she sees benefits beyond her physical health. "Early on in March, I noticed that my depression was a lot worse on the days I didn't walk," she says. "The more I walk, the better I feel physically and emotionally." She tries to exercise in the morning to set the tone for the rest of her day. Friendly competitions with her husband and 13-year-old son to see who takes the most steps get her fired up.
Dr. Ovbiagele notes that exercise helps manage risk factors for stroke and other medical conditions, such as high blood pressure, elevated cholesterol, and diabetes, and it strengthens blood vessels. "I always tell my patients that the best stroke is the one they've never had, and regular exercise helps reduce the likelihood of experiencing one," he says.
For somebody who has experienced a stroke, exercise can optimize muscle function and aid in recovery. For other neurologic conditions such as multiple sclerosis, Parkinson's disease, and traumatic brain injury, it can improve gait, balance, and flexibility and reduce tremor. And exercise stimulates the release of endorphins, which boost mood and alleviate depression, says Dr. Ovbiagele.
"You can't prescribe exercise as you can a medication, but the social (virtually) and mental engagement of it make people feel better," says Ergun Y. Uc, MD, professor of neurology at the University of Iowa. "Evidence continues to accumulate that exercise can improve things like blood vessel health, circulation, and cardiac health, as well as increase helpful chemicals in the brain—which are all great things."