Getting in shape doesn’t require expensive gear or the latest fad workout routine. All you really need is your own body. With it, you can build muscle and maintain heart health by doing calisthenics. You probably remember sweating through pushups, situps, jumping jacks and other such exercises in physical education class. There is evidence that those exercises are beneficial to adults, too.
“Light resistance exercise, like calisthenics, is so important,” says Cindy Bailey, PT, DPT, director of the physical therapy program at the hemophilia treatment center (HTC) at Orthopaedic Hospital of Los Angeles. “The better the musculature you have, and the better your joint control, the fewer the bleeds.”
Bailey defines calisthenics as any exercise in which you use your own body to provide resistance. Calisthenics should be part of a larger exercise regimen, though, that includes more than one type of workout, says Kim Baumann, MPT, a physical therapist at the Center for Bleeding and Clotting Disorders at the University of Minnesota, Fairview Medical Center in Minneapolis. “Ideally you should have cardio, stretching, strengthening and balance components to your exercise program,” she says. “Each component does not need to be done at each exercise session, but should be incorporated into a weekly routine.”
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Baumann first focuses on balance with her patients. She starts with a simple exercise called a single-leg stance, which is performed by shifting all your weight onto one leg and slowly bending the opposite knee until that foot is just off the ground behind you. Hold that position for one minute. The other leg is forced to compensate, which helps to develop balance and stability while working your core muscles. As you get used to the exercise, Baumann recommends standing on progressively less stable surfaces, from a solid floor to carpeting to a pillow, to further improve your balance.
Baumann also encourages her patients to try jumping jacks and jumping rope, which are lower-impact. “Jumping jacks are a great way to get your body moving,” says Nate Johnson, 37, who has severe hemophilia A. “They are not hard on my knees because there’s no real pounding.” Johnson is self-employed and lives in Andover, Minnesota.
Old-fashioned pushups help build upper body strength, primarily your chest muscles and your triceps, using nothing but gravity and your own weight. Pushups also work your core muscles, such as your abs and glutes. And because they can be done in several ways, pushups can be tailored to just about anyone’s abilities and limitations.
“Some people with elbow and shoulder problems may not be able to tolerate the full body weight of pushups. Instead, they can do standing pushups against a wall or on their knees,” Baumann says.
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Adapt the Exercise for You
Johnson has come up with a way to make pushups work for him. His left elbow doesn’t straighten completely, and he has trouble bending his right wrist. “Doing them on my knuckles instead of with my palms down really helps,” he says.
For people whose joints don’t permit them to do any actual pushing up, just holding the pushup, or plank, position without moving strengthens core muscles and helps develop stability, Baumann says. This kind of exercise, in which a static position is held, is called isometric. Like pushups, most calisthenics can be tweaked to accommodate any limitations. “We teach patients how to adapt to each of their target joints,” Bailey says. “We get creative.”
Having a good teacher is crucial. As with any exercise, if calisthenics are not done right, the risk of injury skyrockets. Bailey and Baumann start their patients off slowly, giving them time to adapt to the unfamiliar movements and making sure their form is correct.
For squats, for example, Bailey has her patients start by doing them against a wall, which they can use for support. Press the small of your back into the wall and place your feet about 1 to 1½ feet away from it. Then, slide down to a sitting position and back up again. As you build strength and increase the number of repetitions, you can hold the squat for several seconds. “Each repetition is held until muscle fatigue,” Bailey says. “In other words, until the muscles are shaking and feel like they are about to give out.” The next step is to move into an open area, where the squats not only work your muscles, but also develop your balance.
Another excellent exercise for the lower body is the lunge, which promotes stability, flexibility and strengthening of your quadriceps, glutes and adductors. Stand with your back straight and take a big step forward, bending your front knee about 90 degrees. Keep your weight on your back toes as you drop your back knee so your lower leg is parallel with the floor. Hold the position long enough to stabilize yourself.
Baumann starts her patients off doing five to 10 lunges on each side. “Use your body’s response as a gauge. If you cannot fully complete the last few reps with good form, you should stop,” she says. If you can tolerate it, you can do lunges forward and backward, either walking forward or backward with each step as a lunge. “Lunges can also be done in a static position where you lunge forward and return to the starting position.”
Always consult your physical therapist before starting a new exercise routine. Your PT can help you pick the best and safest exercises for you. “You want somebody to look at the areas you want to work on as well as your problem areas and to discuss the results that you want to achieve without damaging yourself,” Baumann says.
The goal is to be able to work out for 45 to 60 minutes at a time, Bailey says. That includes five to 10 minutes of warm-up, followed by 20 minutes in which you work on pumping up your heart and then another 20 minutes staying in that heart-pumping zone. Finally, slow your pace and let your body cool down for about five to 10 minutes. “Let your body be your exercise equipment,” Bailey says. “Be progressive, but not too aggressive.”