Establishing an exercise routine is difficult whether you have a disability or not. Time, money, motivation and self-confidence can be obstacles for almost anything. But additional obstacles face people with limb differences and other disabilities. And that’s unfortunate, because it’s especially important for us to stay active. Exercise can reduce social isolation, depression, pain and other problems that amputees often face. So even though we face high barriers to fitness, we have a strong imperative to try to overcome them.
Here are the five biggest fitness obstacles I’ve faced as an amputee and how I overcame them.
1. Setting realistic fitness goals
At a time when new approaches to fitness are being promoted every day, wading through resources to get started can seem daunting. As a starting point, I trust the CDC recommendations for adults with physical disabilities or chronic conditions: 150 minutes of moderately intense aerobic physical activity each week, with two days a week of muscle-strengthening activities. Aerobic physical activities include walking, rolling in a wheelchair, cycling, running and swimming, among others.
Start with a realistic goal: try to walk a mile a few days a week. You can build this into your daily routine, so it’s not an extra time burden. Go a mile while walking your pet, catching up with a friend, running an errand, or just getting a dose of fresh air and sunshine. When I want a cup of coffee in town, I take the bus and walk a mile home.
If you are traveling in a wheelchair or by bicycle, choose the distance that suits you. Or turn your walk into a run or jog, if that’s more your thing. The point is to make time for regular movement—and to strike a balance that doesn’t exhaust you.
If, like me, you enjoy swimming for exercise, try searching online for local community pools that offer pool passes. I use the pool lessons at my local IMCA. There are often options for private/group swimming lessons or club training.
2. Feeling self-conscious about your body
One major concern that kept me from getting into physical fitness was low self-esteem. As an above-the-knee amputee, I walked with a limp, was unsure of my strengths and weaknesses, and was intimidated by fitness spaces and exercise culture. I didn’t know how to adapt my body to exercise.
I could have continued to hold back for fear of looking silly at any practice, fear of not being able to adjust to the exercise equipment, fear of embarrassing myself at sports clinics. But who was left behind in the end? Just me. The only person responsible for achieving my fitness goals was myself. Consider this: No one thinks about your body as much as you do. And your body will only do what you challenge it to do.
I follow the social media accounts of various people who compete in adaptive sports, and I’ve always been impressed by their ability to still show up at competitions and push their bodies to new capacities. I knew I could never match their athletic ability, but I could match their tenacity and continue to show up in the pool, at the climbing gym, at the fitness center, or at the park with my running leg. I gradually moved further outside my comfort zone, gaining more confidence in my body as I discovered what it was capable of. I learned to love the process. I even started to feel proud of my body.
You don’t need confidence to show up. First, show up at any fitness opportunity that excites you. Confidence will come later.
3. Lack of motivation to maintain the training schedule
Growing up, I didn’t want to devote a lot of time to athletic training and competition, but I still wanted to be physically active. Sounds familiar? But you don’t have to be training for a marathon or an Ironman triathlon to find motivation; you don’t have to have a coach or a nutrition team. Just start with one reasonable fitness goal that excites you and compete against yourself. It becomes your motivation.
For me, I wanted to challenge myself to run and swim a few times a week. I had to do it close to home, at times that fit into my work schedule. It cannot be a top priority for me. But I could still take it seriously. I did this by attending Challenging Athletes Foundationruns clinics and incorporates their advice and feedback into my local park. I did the same with my swimming.
Finding recreational athletic groups that meet regularly can also be helpful in keeping you motivated. When I got interested in climbing, I joined Adaptive Climbing Group. The group met at the same location at the same time every week; that schedule held me accountable. Consistency doesn’t have to be a strict daily regimen. You can focus on manageable weekly routines. (And having friends sign up for it helps too!)
4. Getting the right equipment (and the knowledge to use it)
For a long time I avoided working out because I wasn’t sure what equipment I needed or how to use it. Eventually I reached out to my local recreation center and arranged a consultation with one of the personal trainers. She showed me how to use dumbbells and resistance bands, and we created sets of exercises and stretches that I could do on my own. I bought bands to use at home, and visited the gym to have access to dumbbells.
If you are interested in learning more about how to use gym equipment with your disability, I recommend speaking with one of the staff at your local gym. Even if you don’t plan to do personal training, a one-time appointment allows you to learn how to safely use treadmills, rowing machines, and other equipment on your own. Alternatively, you can ask for lessons from friends who are comfortable with gym equipment.
For some fitness activities, regular exercise equipment will not work for amputees. But various organizations provide grants to help you get the technology you need to run, bike, ski or participate in wheelchair sports. I received grants from the Foundation for Challenged Athletes to get my first run and bike leg, and there are many other opportunities. Start with the Amplitudes Community Resource Directory, which lists more than a dozen organizations that help amputees acquire sports-related prosthetic technology.
5. Dealing with pain and discomfort
Exercise pushes our bodies into uncomfortable territory. We’re exercising different muscle groups that aren’t used to working so hard, so it’s normal to feel sore. But the exercises should not be sore So if your exercise habits are causing you pain, it’s important to talk to your prosthetist so they can check the fit and alignment of your brace to ensure it meets your needs. Some parts of the exercise may be easier to do without the brace.
Similarly, you may find certain sitting or standing positions uncomfortable during exercise. If so, work with your PT Prosthetist to find adaptations that allow you to push your body more easily. I have adjusted the parts of my exercises to be done sitting instead of standing, so that I put less pressure on my knee and lower back.
If you make adjustments but still experience pain during exercise, you should consult your doctor. They can determine if you have sustained any injuries that need treatment.
Alexandra Capellini is a resident physician at the University of Michigan Hospital in Ann Arbor.
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