Tag Archives: heart rate

Healthier Together Series: Cycle 2B. Physical Activity — Look at the numbers…

andres-urena-qSw5XKtUyus-unsplashToday’s Physical Activity notes:

Numbers are real and give us a way to compare and evaluate things. They can help us keep track and improve our behaviors and processes in business and manufacturing and industry and science. Numbers are also helpful in our health. We look at heart rate, blood pressure, temperature, respiratory rate. We have people rate their pain level. We use numbers in assessing our risks for various diseases – ie. cholesterol, fasting insulin, blood sugar, hemoglobin A1c (representing an average of our blood sugars over 3 months), etc.

One way to assess your physical activity level and your fitness is to look at numbers also. In an earlier post, I discussed perceived exertion and monitoring heart rate. I recommend using numbers to keep track of what you are doing and where you want to go. Numbers are easy to monitor and helpful in setting goals and assessing your progress. Today, I recommend getting an idea of your general daily activity level & assessing your current fitness level.

1. General daily activity level. Wear a pedometer or accelerometer or use an equivalent app on your smartphone or get the popular FitBit or Apple watch to get 5-7 days of numbers. Find out how active you are at baseline. If you workout regularly, wear it also when you are working out. If you do not workout regularly, then you will see how active you are at this time when you are not regularly working out.

It helps to get many days of numbers and average them out. (You can get the average steps in a day by adding up all the numbers and dividing that big number by the number of days you collected numbers.) If you are walking on average closer to 3,000 steps total in a day, that’s more like a couch potato. If you are walking 10,000 or more steps a day, you can say you are active and your body will have the healthy benefits of increased circulation.

The goal is to figure out where you are starting & see if you can increase that number by 10% every 2 weeks. (10% would be taking off the last number in your daily average. For example: If you walk 3,000 steps, you would need to increase it by 300 steps in a day at 2 weeks, so that you are walking 3,300 steps total in a day).

2. Assess your fitness. First, figure out your baseline heart rate. Ideally, you will check this when you have been sitting or even better, first thing on waking up. Use a heart rate monitor if you have one. OR You can figure it out on your own by doing this: Find a clock that shows seconds. Find your pulse on your wrist: palm up, on the thumb side, under your wrist crease and to the outside of that middle tendons on the wrist, you can feel your pulse. Some people gently feel their pulse in their neck. Count the number of beats in 15 seconds and multiply by 4. If you check it every day for a week, you will have a good idea of your baseline heart rate range.

As your fitness improves, this baseline heart rate actually will get lower. This is because regular movement & activity (often called exercise), strengthens your muscles including your heart, so it can pump more with fewer beats. It becomes very efficient with each pump. That’s why highly trained athletes often have VERY low heart rates.

Now that you know your baseline heart rate, you will find out how much time it takes for your heart rate to return to the baseline range after exercise or strenuous physical activity (when your heart rate was higher than your baseline). From the time you have finished your activity or exercise, time how long it takes your heart rate to return to your baseline. As your fitness improves, the time for your heart rate to return to baseline will become shorter. In other words, your heart can adjust that much faster and more efficiently to the demands of your body. This is fitness.

It is nice to assess these numbers every 4-6 weeks & write it down! It is SO motivating!


Photo by Andres Urena on Unsplash

Perceived Exertion & Heart Rates — How to use them

This doctor’s Perceived Exertion Scale

Scale of 1-10.
1 laying in bed or propped up
2 sitting up
3 standing
4 standing & / or jiggling
5 walking
6 brisk walk/slow jog – point of breaking a sweat, could keep doing this for hours; equivalent of 60% of max heart rate
7 sweating, still able to have a conversation; 70% of max heart rate
8 breathing faster through mouth, sweating more; 80% of max heart rate
9 not able to sustain for long time, breathing hard, conversation has to wait; 90 % max heart rate
10 hard as you can go, balls to the wall, takes concentration on working it…this is your personal maximum heart rate

Keep perceived exertion in mind…

I’m a fan of the heart rate monitor when I am working out. I like numbers. I use a polar heart rate monitor even though I don’t care to wear a chest strap. I have just found it is the most reliable and it is easy to use. If you work out at a gym, it will often “talk” to the motorized gym equipment like the treadmill, elliptical, stepper, stationary bike, etc.

Here is how I use my heart rate monitor. First, I rate my perceived exertion at the level of exercise I am doing – & see what my heart rate is. This lets me know my own heart rate zones for different levels of perceived exertion so I know how vigorous any activity is for me. Then, I look at what my heart rate is when I am going 10/10 & note that as my personal maximum heart rate. Then, I can figure out my approximate heart rate which correlates with each level of perceived exertion. Now, I can see how I am doing.

What I find is that as my fitness improves, I can do more for the same heart rate response. For example, I can walk 3.6 mph at a 4 degree incline on my treadmill and I am at a level 6 that correlates with a heartrate in the 120’s. Previously, when I first started my current exercise program, that same setting on my treadmill felt more like an 8 on perceived exertion and my heart rate was in the 160’s.

Also, as the fitness level improves, the time it takes for your heart rate to come back down gets shorter. In other words, your recovery time gets shorter. Instead of 10 minutes to cool down, it only takes 1 minute.

Finally, when you know what your resting heart rate is, you can objectively see if your body is under more stress (ie. fighting a brutal cold) & adjust your workout accordingly. So, given my resting heart rate is in the 50’s, if I have a cold & my resting heart rate is in the 70’s or 80’s, I know I may not want to exert myself too much. In fact, I can just gently walk slowly & see my heart rate will rise quickly. OR I can just do some stretches or some gentle yoga and make sure I am getting my fluids and taking care of myself in other ways.

We are all scientists when it comes to our own bodies. It helps to learn of more ways to understand what it is telling us. I suggest keeping a log of your observations. In this case, write the date & time, write down your activity (including duration and settings) and your perceived exertion and heart rate. I include my average heart rate and my maximum heart rate also. Then I include some notes about how I was feeling. I always finish with a positive note & then I review what I will do next time. Numbers make it easier to follow your progress. It’s so fun to look back on all of the successes!

In a future blog, I will discuss how to use this information to organize your workout plan – how to evaluate your workout and how much time you will invest into working out.

Photo by Markus Spiske/Unsplash

The Freedom to Choose

Today, on our nation’s birthday, I do not have to go to work. I appreciate my day is full of free choices. Every day, we make choices to move forward or to move backwards. Nothing ever stays the same. I choose today, to make choices that help me move forward.

I started my day choosing to wake up to my favorite alarm clock app. (It wakes me up when I am in my lighter sleep cycle in the 30 minutes prior to my goal wake up time. This makes wake up significantly much easier for me (as I am NOT traditionally a morning person).) Then, I threw on my workout gear & headed to the basement, my home gym. As I grabbed my water bottle, put on my heart rate monitor & started my music, I was already in such a good mood! I was awake to do something good for me and I have the ability to move my body. What a gift!

After warming up my muscles, I started lifting weights and enjoyed the quiet in the rest of the house while I was able to focus on my body and my health. I had time to notice how much easier some of the sets were, how my muscles were ever so slightly more defined; my mind felt clear and optimistic about the day and I thought of the many patients in the past few weeks who had talked to me about their health. Specifically, I thought of the patients who mentioned joint pain during their office visit. There were 3 groups of responses to joint pain.

Some patients stated they had joint pains and stated they could not exercise and were very limited in their lives because of it. Often, they had been told they had arthritis or some other joint issue that would never be fully better or would require an invasive intervention to “improve it.” They had somehow been convinced that it was never going to get any better. They were focused on the pain & had become a victim to the pain. Often, they would ask for a “band-aid”- like pain medication. They had given up on getting better, they just wanted to mask the pain, even if it meant creating new problems like constipation, nausea, dependence on medications, drowsiness, etc. Unintentionally, they were moving backwards, getting “worse.”

Several patients had joint pains and they were grateful that because they were doing some form of movement/exercise, it was not getting worse. They were grateful they COULD still move. They wanted to learn what else they could do.  They wanted their list of choices to move forward. They were focused on staying independent and working towards higher quality function from their bodies. They came for guidance & were eager to comply. If they were given a home exercise program, they would do it. If they were sent for physical therapy, they would do it. If they were sent to see a specialist, they would do it.  They knew they could make choices that could help them. They listened to their bodies and trusted they could make themselves better if they were given the right plan.

The third group of patients had joint pains and found that by choosing exercise (including yoga, home exercises, physical therapy, individual workout programs, working with a trainer, etc.), they had healed themselves or improved their pains. They felt grateful and powerful. They wanted to know what choices they could make, what they could do, to continue to stay healthy- how to improve their bodies even more. They were empowered and living life to their fullest.

As I moved onto my interval training, I considered it interesting that in my practice, these three different kinds of responses to joint pains were not correlated to the amount or duration of the pain. They were all about attitude and faith (or loss of faith) in their bodies. And of course, it’s about seeing they have choices and choosing to move forward, or backwards, every day.

As I increased and decreased the intensity of my interval training workout, I wondered how each of my patients would respond to the questions: Do you trust your body to take care of you? Do you listen to your body, understand the cues and respond appropriately? If not, do you just need to help learning? Do you believe your body knows how to repair itself and get better? Do you allow your body to recover, improve or heal by providing it what it needs- proper nourishment (what we put into our bodies), relaxation (such as meditation, journaling, emotional intimacy with another person(s))  and circulation of fluids (movement)? If not, do you want to learn what you don’t know?

If my patients have taught me anything, I have learned that we can make choices that move us forward or that cause us to slip backwards. I like forward movement better. I want that for my patients. My patients come to me because they know that, and they want help in seeing and making the choices to move forward.

In my practice, I show my patients their choices (if they do not already know them) and help them to see which ones will most likely allow them to move forward. I spend time teaching them ways to best nourish their bodies with nutrition and medication, if necessary. I have relaxation training sessions and I counsel on ways to safely circulate fluids and move our bodies. I try to give my patients more ways they can choose to move forward.

As I cooled down and stretched, I appreciated that we all have choices. We live in a country that cherishes our freedom to make choices and we have lots to choose from. Every day, we make choices about our health. We have the bodies we were given. Some were luckier than others. But we all can choose what to do with it at any moment. We can choose to trust our body will do the best that it can for us, if we give it what it asks for and needs. We have the freedom to choose every day.  As a physician, I recommend making choices that move you forward.