Exercise – it matters!

Liz Hewett
Accredited exercise physiologist, Liz Hewett explores the difference between exercise and physical activity, the importance of exercise to the health and well-being of nurses and midwives, and the fitness challenges experienced by some in the profession.

If you’re reading this article, there’s a good chance you are a nurse or midwife interested in exercise. You may be in the twilight of your career, midway into it, having a career break or a student, graduate or early career nurse/midwife. Whatever stage you are at exercise and physical activity are important to your health and wellbeing.
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women stretching in a pilates class

Exercise vs. physical activity
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You may notice I use the terms “exercise” and “physical activity”. Are they the same thing?

Technically, they aren’t. According to the World Health Organization, physical activity is any movement produced by skeletal muscles that requires energy expenditure and includes anything active from sport to gardening or housework.

Exercise is a type of physical activity, structured and prescribed specifically to improve aspects of physical health, like strength or aerobic fitness.

Both physical activity and exercise are good for us, in an amazing number of ways, for both health in the here and now, but also long term. If exercise was a pill, everyone would gladly take it every day, as it is full to the brim with the good stuff.

How much do we need?
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We should all be accumulating over 150 minutes of moderate physical activity a week, or 75 minutes of vigorous physical activity. Twice weekly strength training can also prevent nasties such as cardiovascular disease or osteoporosis. 

What’s the difference between moderate vs. vigorous exercise? 
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Moderate physical activity involves a moderate amount of effort and a noticeable increase in heart rate.

Examples are:

  • brisk walking
  • dancing
  • gardening
  • housework
  • active involvement in games with children, and
  • carrying/moving loads <20kg.

Vigorous physical activity involves a large amount of effort, rapid breathing and a substantial increase in heart rate.

Examples are:

  • running
  • fast cycling or swimming
  • uphill walking
  • aerobics
  • competitive sport
  • heavy manual labour e.g. digging, and
  • carrying/moving loads >20kg.
But I’m a busy nurse or midwife
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Where does that leave working as a nurse or midwife? “I’m on my feet all day” is a common refrain from my nursing clients. You may be on your feet all day, but are you really walking or moving at sufficient intensity to meet the definition of moderate or vigorous intensity?

Duration is important, too. Anything is better than nothing, but you do have to be moving for several minutes at a pace brisk enough to elevate your heart rate to reap any benefit.

Being a nurse or midwife requires you to be strong and injury-free throughout your career.  The only way this can be achieved is through regular strengthening exercise outside work. Lifting or moving the odd patient, whilst demanding, is not done with sufficient frequency to build your strength.

A typical nursing or midwifery shift would not be active enough to substitute the need for physical activity outside work. The good news is that experimenting with exercise and physical activity is a big part of the fun of exercise. Embedding exercise into your life should be as natural as those things you do to benefit your health – just like cleaning your teeth!

Strategies for incorporating exercise into your life
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Take a moment to reflect on what types of exercise and movement suits your lifestyle and personality best.

Do you prefer to exercise alone or with others?

Some people prefer solo activities. Introverts need time on their own to replenish their energy so they can go back into the world of communication and human interaction.

Other people find exercising with someone else helps with their commitment and motivation, as well as providing a distraction from the physical exertion. If you are impacted by COVID-19 restrictions this could mean committing to an online class with a friend so you can both join in from your respective homes.

There are also online groups that organise meet-ups, for example, there are some women only groups for walking at various times of the day and night, depending on what works for you. You can often find these on Facebook.

For those living in parts of Australia where they can attend in-person exercise classes, gyms, sports venues or group sessions – lap it up and enjoy it on behalf of those who are unable to!

You don’t even need to leave the house
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Exercising at home may be a good option for you, here are some of the advantage and disadvantages:

Advantages – no travel, low cost, freedom to choose when you do your exercise, still open if your state has COVID-19 restrictions! Absence of intimidating fitness environments or perceived peer pressure/body image negativity.

Disadvantages – Lack of space or privacy issues with family or housemates, disturbances by pets and/or children, lack of equipment, and procrastination can be an issue due to the lack of structured timetables or set times.

Possible solutions to the disadvantages could include getting your family/housemates on board by setting aside time and/or space for exercise/movement. Move your cat or dog to another room while you are working out.

Equipment for the home can be purchased inexpensively and need not take up much room. Suggestions: exercise mat (>10mm for hard floors), resistance bands in multiple colours, micro bands are small looped bands that are great for upper and lower body work, dumb bells are versatile too; ankle weights can also double as upper body weights if they can be wrapped around the wrists securely.

Get out and about
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If working out at home doesn’t appeal to you there are loads of other exercise options you might like to try:

  • Fitness centres: walking into a gym can be an intimidating thing to do, but using a gym has advantages for nurses and midwives. Most gyms have long opening hours so are ideal to work around your changing rosters, are relatively inexpensive compared to other activities. If group fitness is your thing, then check out the larger gyms with extensive timetables to suit your ever-changing schedule.
  • Yoga, Pilates, barre, dance, martial arts: if the idea of a hot, sweaty gym doesn’t seem appealing, you may be interested in engaging your mind whilst you move. By combining strength, flexibility and balance training with control and coordination, these activities have everything we need for physical health.

How did past experiences with exercise make you feel? Identify any positive memories and emotions as well as negative ones. What worked well for you? What didn’t go so well and why not? Acknowledge both sides to guide you towards movement and exercise you enjoy and the environment that suits you best.

Struggling to exercise?
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If you struggle to exercise, reflect on why. Often we are harsh and self-critical, describing ourselves as lazy, when there may a valid reason, e.g. you’ve finished a week of nights, are exhausted, and the last thing you can think of is physical exertion. Are you really lazy, or perhaps finishing a draining set of shifts is not the time to expect yourself to be very physical?

A kinder response could be to walk outside to get fresh air or do something gentle, like yoga or Pilates. Plan and schedule a day or two as rest and recuperation days. Be kind. Be practical.

Often what we critically tell ourselves are excuses are actually valid barriers or reasons why exercise is hard to do.

Some frequently heard reasons for people not exercising:

  • I don’t have time
  • I’m too tired
  • I don’t feel fit enough
  • I need to lose weight first, and
  • I don’t have the money for: joining a gym/Pilates classes/join sports club.

I’ve also heard a lot in my career are that people are waiting for something to happen before they can start something new like exercise. Some examples:

  • I don’t feel fit enough to join a gym
  • I’ll start exercising next year after I finish studying
  • I’ll wait until I’m less tired, or
  • I’ll wait until I have more energy.

The difficulty with this approach is that we may always be busy, and commitments can increase as we get older and life changes. Any stage of your life is the perfect time to set yourself up as a regular mover and exerciser.

Yes, you will be tired from shift work/study/part-time work/family commitments. In reality, that will not change. Being active doesn’t have to be this big commitment that we need lots of time or money for. Start with small achievable bits of movement, be kind to yourself and if life gets in the way, start exercising again.

Get motivated
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Mustering up the motivation to move can be hard if it’s dark, cold, too hot or if you’re tired. It may help to remember how good exercise can make you feel afterwards. Remember, or explore through trial and error, how different types of exercises make you feel, and this may help you get out of bed or off the couch. An exercise or movement session can make you feel more: alive, energised, relaxed, less tired, less stressed, invigorated, ready to face the day, taller, stretched. Yes, even if you were tired beforehand.

One of the most common reasons people exercise is to lose weight or to change the way you look. Now, this can be perfectly fine, but it is also a reason why some individuals struggle with exercise and can be one of the contributing factors for people stopping exercise. Find motivation to exercise other than your appearance to make physical activity a part of your everyday life.

Explore, recognise, acknowledge, accept and embrace movement in your life. Now is the perfect time in your life to delve into making movement a regular part of your routine and self-care.

Liz Hewett is an Accredited Exercise Physiologist, Strength & Conditioning Coach and Pilates teacher with over 20 years’ experience.