Editor’s Note: Shianne L. had over 15 years of experience as a personal trainer, and CSRF was honored that she gave us insight into the connection between this experience and the challenges of Cushing’s. We regret to share that Shianne passed away early in 2018. You can read Shianne’s personal story.
CSRF: What exactly does a personal trainer do?
Shianne: Personal trainers work with individual clients to meet their goals of physical fitness and health. Some people are under the impression that you only see a personal trainer if you want to gain strength. That is not true. Of course, I do see clients who have a personal goal of developing more defined and extremely strong muscles, but I see many healthy clients who want to start an exercise routine to lose weight. I also see clients who are not in excellent health and want to maintain or rebuild their everyday function. Some clients want to increase strength with hopes of decreasing pain levels. Personal trainers are certified by several different nationally ranked associations and some may have additional education in related areas. For example, I have a degree in Exercise Science or Kinesiology, which is the study of human movement. Others may have education in Athletic Training or Physical Therapy.
CSRF: Do you think a personal trainer could be helpful to someone who has Cushing’s or is recovering from Cushing’s?
Shianne: Yes. Needless to say, those who are impacted by Cushing’s need to ask their doctor before starting a new exercise program. Since each patient is different in terms of muscle weakness, daily function, pain, joint issues, osteoporosis and weight, it is difficult to generalize an approach for regaining physical fitness. However, in most cases, this will involve starting very slowly and gradually increasing physical activity. One general thing I can suggest, which is the approach I took, is that whatever your activity levels were before surgery, you should attempt to get back to that “norm” slowly. Following surgery, I think most people, including me, want to rest and don’t have the energy to move much through the first few months. I did rest for a few weeks but started with light yoga and walking as soon as I could with the goal of gradually working back to my starting point. Start with what you can do and gradually increase. An example would be to walk 1 block, then 2 blocks, then 3 blocks, etc. You do not want your joints and muscles to lose range of motion and mobility. Simply bringing your shoulders, elbows, hips and knees through normal range of motion will keep the body from just shutting down and resting.
CSRF: How would you approach a client with extreme weakness and limited mobility?
Shianne: I know many Cushing’s patients have difficulty getting up from a chair. If that is the case, one place to start, taking into account joint considerations, is to simply use rising from a chair multiple times as exercise. Use your arms to help push you up if need be. Do this several times in a row. Count the number of times in a row that you can comfortably stand up and SLOWLY sit back down, then increase the number of times each day! Tighten your abdominal muscles to support your back and try to lower yourself and sit down slowly.
Choose other moves that mimic your everyday life. Do them several times in a row, slowly, in a controlled environment so that when you go to do them in your regular life, the move is not so foreign to the body. You could sit in a chair and rotate your torso slowly as if you are reaching for something in the back seat of your car. Or sit in a chair and slowly rotate your torso to the side to pick up a pen off the floor. It sounds simple but if you do it repeatedly, then your body gets familiar with which muscles to recruit for each movement so that it does not lock up when you go to do it suddenly during regular life. Any daily activities that are difficult can be used repetitively to make that activity easier. Another example would be to step up on one stair and down, while holding on to something if need be.
For clients who are weak, I also like exercises that use resistance rubber bands; they come in different colors and tensions. Those who are not weak can also benefit as resistance can be increased as strength increases. Many exercises can be done sitting or standing with these bands for arms, legs, shoulders, etc. They can be wrapped around a foot, door knobs, a pole, or stair banister. If you are trying to do this yourself, most “kits” come with some suggested exercises. Each day you should be increasing either the number of repetitions, level of intensity, or duration of exercise. For example, choose an exercise with the band and the first day start with 10 easy repetitions, then try for 12 the next day, building up to 15-20 before going to the next level of resistance band.
Some motions that I think are particularly important include a pushing motion, a pulling motion (a row), and a squat (or slowly sitting and rising from a chair). Also a plank exercise can be done on the knees or at easier angles which engages the entire torso and core muscles of the mid-section. The pushing motion and pulling motion can be done with the bands. The row is extremely important for posture. Sit upright and pull your shoulders back and down as if you were standing at attention in the military. Do this motion several times a day as you are driving, standing or walking! Everyone looks and feels better when they are standing up tall! As for squats, some will not be able to do squats because of joint or strength issues, but the bands can also be used to strengthen leg muscles in a low impact manner.