Exercising with Long Term Conditions: How to make it safe & achievable.

In England, one out of every three adults is living with at least one chronic health condition, such as Type 2 diabetes, hypertension, osteoarthritis, cardiovascular diseases, obesity, and cancer. 

Individuals with a long-term health conditions are twice as likely to be inactive. 

Various obstacles can make it more challenging to stay active. Some people worry about the safety of physical activity or exercise. Others are unsure about what type of exercise they should engage in. Many have not exercised for years, lacking both the motivation and the necessary support to begin. 

Why you should exercise with a long term condition.

Physical activity is not only associated with a reduced risk of many long term conditions, but it is also one of the primary treatment strategies for almost all of them. 

Evidence shows that exercise can prevent and help to manage conditions including:

• Diabetes

• Some types of cancer

• Cardiovascular disease

• Hypertension

• Osteoarthritis

• Back pain

• Mental health conditions

• Dementia

• Chronic pulmonary disease

• Asthma

Exercise can reduce the risk of different conditions significantly:

https://www.gov.uk/government/publications/health-matters-physical-activity/health-matters-physical-activity-prevention-and-management-of-long-term-conditions

Physical activity is as good or better than treatment with drugs for many conditions, such as type 2 diabetes and lower back pain, and has a much lower risk of any harm.

Physical activity can also benefit those who have Musculoskeletal conditions. However, many people with MSK conditions often mistakenly believe that physical activity will make their conditions worse. The more conditions you have, the more you need to improve the core aspects of fitness:

• strength

• stamina

• balance

  
  

You can read more about this in this previous edition of Health Matters on productive healthy ageing and MSK conditions and healthy ageing consensus statement developed by PHE and the Centre for Better Ageing.

Is it safe?

A large research review and expert clinical consensus statement published in the British Journal of Sports Medicine in 2022 concluded that physical activity is safe, even for people living with multiple long term conditions, and the benefits far outweigh the risks.

Another more recent review of systemic reviews (one of the highest levels of evidence) evaluated the results from 990 randomised controlled trials. It concluded that exercise has a positive benefit in the majority of long term health conditions.

These studies emphasise the importance of reassurance, support and education on the benefits of exercising with a long term health condition and dispelling the myths around it.

They also acknowledge that everybody is unique and should have individualised starting points, depending on a person’s current activity level and building up slowly.

Walking on a forest trail with supportive shoes

Top Tips to build a consistent exercise habit

1. Start Slow and Build Gradually when exercising with long term conditions

Jumping into intense workouts can increase the risk of injury or flare-ups. Instead, begin with gentle movements and increase intensity and duration over time.

• Begin with 5 to 10 minutes of walking or stretching daily.

• In a group setting, take the lower options offered and build up the duraing gradually. Take the breaks offered to you.

• Add 1 to 2 minutes each week as your endurance improves.

• Include rest days to allow your body to recover.

  
  

Tracking your progress helps you stay motivated and recognize when to adjust your routine.

2. Prioritise Safety During Exercise

Safety should always come first when exercising with long term conditions. Keep these tips in mind:

• Warm up and cool down: Prepare your muscles and joints with light activity before and after exercise.

• Listen to your body: Stop if you feel pain, dizziness, or excessive fatigue.

• Stay hydrated: Drink water before, during, and after workouts.

• Use proper equipment: Wear supportive shoes and comfortable clothing.

• Modify exercises: Adapt movements to avoid strain or discomfort.

  
  

If you experience new or worsening symptoms, contact your healthcare provider.

3. Choose Activities You Enjoy and Can Maintain

Exercise doesn’t have to be a chore. Finding activities you enjoy increases the chance you’ll stick with them.

Group classes or exercising with a friend can add social support and make workouts more enjoyable.

Zestforlifefitness Functional Strength with Swiss Balls.

4. Incorporate Strength and Flexibility Training

Building muscle strength and maintaining flexibility help support joints and improve daily function.

Aim for two strength sessions per week, with rest days in between. Flexibility exercises can be done daily or as part of your warm-up and cool-down.

5. Manage Flare-Ups and Adjust Your Routine

Long term conditions often come with periods of flare-ups or symptom changes. During these times:

• Reduce exercise intensity or switch to gentler activities like stretching or breathing exercises.

• Focus on rest and recovery.

• Avoid pushing through pain or fatigue.

6. Track Your Progress and Celebrate Achievements

Keeping a simple exercise journal or using an app can help you monitor your activity, symptoms, and how you feel. Celebrate small victories such as:

• Increasing your walking distance

• Holding a yoga pose longer

• Completing a full workout without pain

  
  

Recognizing progress builds confidence and encourages consistency.

7. Seek Support and Professional Guidance

If you’re unsure where to start or how to adapt exercises, consider:

• Working with a qualified exercise specialist experienced with long term conditions.

• Joining support groups or community programs tailored to your needs.

  
  

Professional guidance ensures your exercise plan is safe, effective, and tailored to your goals.

References:

Reid, H. et al. (2021) ‘Benefits outweigh the risks: a consensus statement on the risks of physical activity for people living with long-term conditions’, British Journal of Sports Medicine, 56(8), p. bjsports-2021-104281.

Dibben, G.O. et al. (2024) ‘Evidence for exercise-based interventions across 45 different long-term conditions: an overview of systematic reviews’, eClinicalMedicine, p. 102599.

https://keepingstrong.co.uk/exercising-with-a-long-term-health-condition/#:~:text=References,10.1016/j.eclinm.2024.102599.