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Interviewer: Oftentimes much of the exercise advice out there seems to be tailored to those without limitations, leaving people who have some sort of limitations feeling left out and wondering how they could also pursue their fitness goals. Today we're going to explore the topic of exercising with limitations and discover how to make fitness inclusive for everybody.

Physical therapist Aaron Lowry, from the Ï㽶ÊÓƵ of Utah Health Craig H. Neilsen Rehabilitation Hospital, is an expert at helping individuals overcome obstacles so they can achieve their fitness goals even with physical limitations. I mean, that's what you do all day long, right? You work with people that have had some sort of an accident or incident and they're just trying to get back to kind of normal.

Aaron: Yeah, absolutely. A lot of our patients here have had an event in their lives that caused paralysis, and they're trying to live with paralysis, exercise with paralysis, and still, like you said, get back to normal so they can do all the things that everyone else does.

Exercising with Limitations

Interviewer: What are some of the common types of limitations that people face when it comes to exercise and physical activity? I mean, this can be hard for people who don't have any limitations to even kind of fathom that this could be an issue, right? So what are some of the things that you see?

Physical Limitations

Aaron: Yeah. A lot of our patients are in a wheelchair full time, and they can't stand. They can't walk. So they can't oftentimes use a lot of the equipment in the gym the rest of us do. And even if they can, it's not really adapted to be used easily by them. So they have to be creative and find ways to still exercise differently.

Interviewer: And then, outside of the rehabilitation hospital where you work, what are some other limitations, maybe not so major, that people struggle with when it comes to trying to get some exercise or physical activity?

Aaron: No, definitely there's a whole host of things with our bodies that can be suboptimal let's say, that can make implementing a program difficult. So it could be cardiovascular limitations. They feel like their endurance is too poor. They feel like they get tired just like doing their everyday thing. You know what I mean?

Interviewer: Right.

Mental Limitations

Aaron: That can be one. Physical limitations are real, but oftentimes mentally we feel like we can't do things that we can do. You know what I mean?

Interviewer: Yeah.

Aaron: And we're kind of our own worst enemy in our self-talk, where we say to ourselves we can't do things that we actually probably could start to do if it was small enough and we started small enough.

Interviewer: Do you find that individuals generally know what their specific limitations are and they understand how those impact their ability to exercise or get some activity?

Aaron: I think to an extent they do. But to an extent, you don't really know until you try, right? But the problem is we don't really know how to start trying. We don't know what tests on ourself to perform to know our limits. We're kind of speculating.

Interviewer: Sure, sure. So there could even be a limitation that you just don't think you can do it for whatever reason, but you've never really tried either.

Aaron: Yeah. And maybe you can't do it. But I like to put the word "yet" after that. You know? I can't do it yet.

Interviewer: Right.

Aaron: But I can start to build toward being able to do that. But it's knowing how to start that process that people often hit a roadblock because they don't know how.

Modifying Exercises for Specific Limitations

Interviewer: So if somebody is interested in getting started, like we just talked about, maybe somebody just doesn't think they can, but they've never tried, are there any sort of precautions that somebody should take or keep in mind when they're exercising with limitations, when they're starting out?

Aaron: It really is wise oftentimes to consult a professional in doing so. Like the commercials say sometimes, "Consult your doctor before starting an exercise program." Right?

Interviewer: Right.

Aaron: That's not a horrible idea, especially if you have a heart condition or something like that where you really want to have the guidance of a professional to make sure that you do the right amount at the right time. Additionally, if you have a physical disability, especially a paralysis event in your life or something else big like that, going to a physical therapist or someone else who's trained to like really understand how to adapt exercises for you is a great place to start.

Interviewer: So then if you went to a professional like that, they would perhaps take some of those exercises that you haven't been able to do because of your limitation and they can help you find a way to modify that for you it sounds like. Is that something that you do quite often, and can you give me an example of what that might look like?

Aaron: Yeah, totally. Like so say for example we have a patient that has a spinal cord injury that doesn't have use of their hands, but they want to strengthen their arms, right? They can't grip a standard-like grip to lift weights because their fingers are paralyzed, right? So they make specialized handles and gloves that a person can wear, that we can train them how to procure and how to use so they can still pull with their arms and push with their arms and do a lot of the regular exercises the rest of us could do. So modifying the way they interface the machine to still be able to use it.

Or there are specific machines that they make for people that have paralysis, where they have those things built into the machine. Or they may have like a big chest plate that the person can lean against while they pull on something, right? If your trunk is paralyzed, you can't use your back muscles to stabilize yourself while pulling a weight, right? So you need to have a way to have something to push against with your trunk so that you don't fall over while you're lifting, right? So a lot of specific machines have those built in so people that have disabilities can still use them and be safe.

The Importance of Consulting Expert Professionals

Interviewer: I think the thing I've learned from this conversation is that if you have a limitation, that's when it's really important to consult a professional.

Aaron: Yeah.

Interviewer: That's when it's really important because you just don't know what impact it might have if you decide that you want to start doing some sort of exercise, whether it's strength training or some sort of aerobic activity or playing some sort of a sport. It just really sounds like you should talk to a professional who can help you in your specific situation and make sure that you're safe.

Aaron: In general, that's true. And this is a big part of the reason why people that have a new injury, whether it's a spinal cord injury or a stroke or a heart attack or anything, right, when you first get back to life following your injury, it's really common for the doctor to prescribe physical therapy, one, for functional improvement, but two so you can learn how can I keep exercising into the future and maintain strength and fitness and injury prevention and all the other benefits with my disability.

Overcoming Mental and Physical Barriers

That being said, despite having a disability, you can still be an absolute beast in your physicality, right? Whether it's looking a certain way, being strong, doing competitive sports, like people get after it, right, if they really want to. So don't feel like that has to hold you back a ton because it doesn't. You can really do a lot of really cool things and really excel at your specific thing if you want to.

Interviewer: Don't let that limitation get in your way. I would imagine you see that a lot.

Aaron: Yeah.

Interviewer: That people come in and just the amazing things that they can do when they kind of start to realize, oh, wait, I can.

Aaron: Yeah, and it's really empowering when someone has that mental shift, right? In their mind they start to realize that I can still do a lot of really cool things. It takes a lot of work and it's hard. And it is, even more so than for the rest of us. But it can absolutely be done. And it's great to see someone have that limitation in their own mind removed. It's really empowering to see.

Interviewer: And I would imagine that if somebody does have any sort of a limitation, you would say it is imperative to figure out how to exercise and get activity. Talk about the importance of activity for even those that have limitations.

Aaron: Yeah. I mean, activity and exercise are important for all of us, everybody, right? But when you have a disability and already kind of have the deck stacked against you so to speak in regards to maintaining fitness because you can't do certain things anymore, it becomes extra important to do what you can do and do a lot of it. All of us as we get older, whether we're disabled or not, we start to lose function, right? But a lot of that decline happens way sooner than it has to simply because we stop moving as much as we could and we stop doing hard things regularly, right? And that just precipitates more and more decline that's even faster. And that's true for all of us, disability or not.