Resuming exercise: here are some mistakes to avoid

Resuming after being stationary for a long time could be complicated, due to a deteriorated physical condition and the increased risk of injury and trauma: Pirelli interviewed Francesco Confalonieri, a sports doctor and a specialist dietician and exercise planner, asking him for advice and tips on resuming sporting activities.

"I have almost always been involved in training and nutrition for top athletes, many of whom have participated or are set to participate in the Olympics. Over the last six years, aside from this, I have also begun to focus on exercise and nutrition for everyone, dealing with prevention and therapy to improve health through the right exercises, lifestyle and nutrition”.

"For many people, it has been a period of inactivity and sedentary life, while many others have been exercising at home, but in the wrong way. During lockdown, so many people downloaded various on-line training sessions from websites, YouTube channels and often the quality was good, but in my opinion it caused more problems than benefits. Exercise only works when it is done properly”.

"If we are resuming, or even starting from scratch, we must follow three basic rules, which are old but still completely applicable today: individuality, graduality and continuity. Individuality means setting up a training plan based on an assessment (with an expert) of an individual's personal characteristics, such as goals, organisation, and risk factors. The latter are especially important with older people, to understand if there are any metabolic, cardiovascular or muscular-skeletal problems, which are the most frequent. Graduality means that exercising is only effective when you gradually work up intensity and effort with time; here I believe the 30% rule is effective: if you have three days a week to exercise, you start with one day of training, if you have three hours during the weekend, you train for one hour. This way, you can gradually increase the amount and quality of your workout over time, without risking your enthusiasm waning and then stopping altogether. That's where point three comes in, continuity: for a workout and a diet to be effective, you must be continuous and consistent over time, otherwise the effects will be more negative than positive”.

"I am definitely in favour of it. I usually recommend three activities to resume: walking (including Nordic walking), cycling or swimming. Cycling is perfect, but the fundamental thing is to go to someone who can get us seated correctly: the posture of your back, hips, ankles and knees is crucial. From a training perspective, cycling is great to increase your efficiency and health at the cardiovascular level or to strengthen muscle tone in your legs (this is a way to prevent many pathologies in the over 50s). If you only want to lose weight, cycling is good, but the important thing is your diet and implementing the right eating habits”.

"Before we begin, we must exclude serious specific risk factors, such as advanced coxarthrosis or lumbosacral disease. It is better to avoid surfaces that may stress your joints, such as cobbles, whereas in terms of which bicycle to use, when resuming, I would recommend a city bike, which is very flexible because it allows you to cycle around the city but also to cycle for longer during the weekend”.

"Ours is an intelligent organism, and exertion is a sign of suffering: it means that our body is unwell. I make my patients use the Borg scale of perceived exertion: I tell them to start exercising gradually, for example a fifteen-minute bicycle ride, and to make a note of the type of exercise, the duration, how tired they felt from zero to ten and any pain they felt the day after. Exertion should never exceed 7 or 8. Based on these parameters, their level of activity can be gradually increased”.

"Yes, a number of specialist assessments are required. It is a treacherous disease, which, even if contracted in the asymptomatic form, can have consequences on the lungs and on you general physical efficiency. I recommend what is required for competitive sports by the Sports-Medicine Federation, in other words a maximum stress test with a measurement of oxygen saturation, and possibly a Colour Flow Doppler. A CT scan of the lungs is also important to see if there is any chronic inflammation, just to be on the safe side. Covid-19 is anything but the flu“.

"In order to exercise, you must always eat properly and it is absolutely untrue that you should fast. It is important to have an adequate carbohydrate intake, so if you do sports in the afternoon you have to eat carbohydrates for lunch, if you exercise early in the morning, in the evening before dinner (which should basically be protein-only), you need to add some carbohydrates to fill up your glycogen stores. Also, to tackle exercise with a stable blood sugar level, I suggest eating some biscuits with a cup of tea, a nutrition bar or a fruit tart half an hour before you start. In fact, if you are hypoglycaemic when you exercise, your body uses your muscles as an energy source, which makes exercising bad at the metabolic level, because you aren't burning fat and sugar, but your actual muscles, with consequent loss of muscle tone”.

"The psychological benefits are immediate, and this is very important, because they also boost your immune system. If you exercise correctly, you feel better mentally as soon as you resume. From a fitness perspective, however, the average period is eight weeks: you should feel decidedly better after this time”.