The Exercise Prescription

For many, physical activity is a lifestyle choice that they have chosen to incorporate into their lives.

It’s an opportunity to look great, meet new people, be adventurous, and push yourself beyond boundaries you never thought were possible. But did you know that exercise can also be a prescription? That’s right, and if it were up to me, I’d mandate that every doctor in Canada learns how to prescribe exercise. Wouldn’t be great if you went to the doctor for anxiety and instead of writing you a prescription for a drug, he writes you a prescription to a specific exercise program, or even better, refers you to a qualified personal trainer? Well maybe that will be the law one day, but for now, you the reader must recognize that personal trainers know how to prescribe exercises to manage many common health related issues.

For example, let’s take consider a case study. Sally is a 38 year old receptionist at a dental clinic and works a typical 40hours a week. At home, she manages two adolescent kids and a husband who works the same hours as her. Recently, Sally has had a check-up with her doctor and discovered that she had a blood pressure of 136/91. The doctor tells her that she is pre-hypertensive and should start exercising in order to reduce her blood pressure to normal levels. According to the American College of Sports Medicine, the correct exercise prescription for Sally would be the following.

Exercise prescription for a hypertensive or pre-hypertensive individual:

• Exercise sessions for 5-7 days a week for 12 weeks

• Each session should be anywhere between 30-60min

• Low intensity, approx. 40-59% of HR Reserve

• Resistance training should be anywhere between 60-80% of 1RM and should be supplied to complement the cardiovascular training program. Resistance training should never be the primary focus of the exercise program.

Key Considerations:

• Individuals under hypertensive medication can see a sudden drop in blood pressure upon exercising. Caution should be taken to ensure intensity is increased gradually. Exercise sessions should include prolonged warmups and cooldowns to minimize the risk of exercise induced hypotension.

• Depending on the severity of the hypertension, the individual’s blood pressure might need to be monitored at various stages of the exercise session.

• Ensure breathing is being performed correctly throughout the duration of the exercise session and avoid doing the Valsalva maneuver.

• Avoid doing isometric exercises

As a pre-hypertensive individual, Sally can expect to see a decrease of 3 to 4 mm Hg in systolic blood pressure and 2 to 3 mm Hg in diastolic blood pressure just from this exercise prescription. Now if she combines that with a healthy diet, she can expect to see an even bigger drop in her blood pressure.