Dear Dr. Garner,
I am raring to get outside and start an exercise program. I haven’t exercised in about two years, but the park looks really inviting and I also feel that I have a better sense of balance when I exercise.
My daughter says I am too old to exercise. I am 81 and, aside from a little arthritis and a touch of diabetes, am in good shape.
Do you see any reason why I should not exercise?
Elderly Exercise Enthusiast in Elmhurst

Dear Elderly Exercise Enthusiast,
Your question brings up several interesting points. Is anyone too old to exercise? The answer to this question is definitely not! I was just talking about this with my good friends and loyal Tablet readers, Dr. Peter Mastrorocco and Ms. Rose Dunne.
Almost every study evaluating exercise in the elderly demonstrates benefits.

In a recent study of volunteers, aged 70-89 years old, the better a person adhered to an exercise program, the greater the improvement in physical functioning and balance.

The study enrolled volunteers who were sedentary and had a variety of physical health problems. More than half of these patients were able to engage in regular moderate exercise for more than a year. Those who improved the most reported exercising 150 minutes a week, or about 30 minutes a day, five days a week.
The improvement in balance is very important. Last year, over 15,000 people over 65, died from injuries sustained during a fall. A loss of ability to maintain balance was responsible for many of these falls. Those who exercised regularly had significant improvement in balance. Tai Chi was found to be particularly helpful in increasing strength and balance.

Balance problems can be caused by a number of different issues, and your doctor can help in identifying what the cause of your imbalance might be:
Some causes include:

• Vertigo in which stones become dislodged in your inner ear and there is an intense sense of dizziness.

• Infection of the inner ear can cause severe dizziness and imbalance.

• Menieres disease — unknown cause — may be worsened by alcohol.

• Medications — blood pressure and antibiotics may cause imbalance.

• Head injuries or mini strokes may cause a loss of balance.

• Poor blood circulation may cause imbalance

• Vision — loss of vision, wearing bifocals, or having cataracts can cause falls.

While not the focus of your question, I felt it important to mention some possible causes for feeling imbalance so that readers with the problem are alerted to discuss this very important issue with their doctor.

Getting back to exercise, it is important to prepare properly. Wear loose, comfortable clothing and well-fitting, sturdy shoes. The shoes should have a good arch support and an elevated and cushioned heel to absorb shock.

Since you have not worked out regulalary for two years, you should start slowly.
Start with exercises that you are comfortable doing. The saying, “no pain, no gain,” is not true for older or elderly adults. You do not have to exercise at a high intensity to get most health benefits.

I suggest walking as an excellent exercise to begin with. Slowly increase your level of exercise as the weeks go on.

You should do about 30 minutes of aerobic activity at least five days per week. Aerobic activity includes walking, swimming and bicycling.

You should also do resistance or strength training two days per week. Ask your doctor about using weights.

Warm up at least five minutes before each exercise session. Walking slowly and stretching are good warm-up activities.

If you are not feeling well, do not exercise. If you have a cold, flu or other illness, wait to exercise until you feel better.

If your muscles or joints are sore the day after exercising, you may have done too much. Lower the exercise intensity before the next session.

If you have any symptoms of chest pain, trouble breathing, light headedness or dizziness or nausea, you should notify your physician.

It is a good idea to visit your doctor to get a checkup before you start to exercise.

Now that winter has passed, just like you would do spring cleaning in your house, or get a checkup for your car, it is a good time to get a 10-point checkup for your body.

The following serves as a guide to exams your doctor may want to perform:

1. Cholesterol level - should be under 200, and HDL (good cholesterol - over 60 is very good) and LDL (bad cholesterol- under 100 is very good).

2. Breast exam and yearly mammogram.

3. Prostate exam and PSA blood test level if you are a man.

4. Colonoscopy if you have not had one for five years.

5. Consider a stress test, or CT scan of the coronary arteries to evaluate for possible blockages.

6. Pelvic exam to evaluate the uterus and ovaries in women and a rectal exam to evaluate the prostate in men.

7. Routine blood chemistry tests including blood sugar level.

8. Review of all your medications, both prescription and non-prescription.

9. Eye exam to evaluate for cataracts and visual acuity.

10. Skin exam, looking for melanomas or other cancerous lesions.

I wish you good luck in your new exercise program and hope that you serve as an inspiration to others to get out there and start exercising. Remember, ask your doctor before you start and if possible, schedule your 81-year-old preventive maintenance checkup now.

My wife and I exercise every day in Prospect Park and look forward to seeing many of our loyal Tablet readers out there as well.

Until next time, have a great week and be well, and I hope to see you tune into the Ask The Doctor Show, this Tuesday, April 1, at 8 p.m. on Ch. 97 on Time Warner and Ch. 30 on Cablevision.

Dr. Steven Garner is a Fidelis Care provider who is affiliated with New York Methodist Hospital, Park Slope. He also is the host of “Ask the Doctor,” the weekly cable TV show seen on The Prayer Channel.