For the reluctant, self-conscious and the tired – barriers and how to overcome them

You might be surprised to read that sometimes I don’t fancy exercising. Sometimes do not want to get cold/hot/wet etc and sometimes I simply cannot be bothered. I’m too tired and want to loaf around on the sofa.

There are some classic barriers to exercise that are very commonly experienced, and that are totally understandable for someone who has had a cancer diagnosis. Alongside tiredness (see also my chapter on fatigue) I often find that people are afraid that they will do the wrong thing and might injure themselves or exacerbate side effects. Some examples of this are around wounds after surgery, stomas and ostomies, people experiencing neuropathy – numbness or tingling – in their extremities, and those whose heart or breathing is impacted by their cancer treatment. It is more than reasonable to be cautious.

Confidence tricks

Some people are very, very self-conscious about the prospect of exercising anywhere, and perhaps even more so about doing it outdoors or in a public place. They are embarrassed or think they will be judged. Fair enough. I would not be so glib as to advise that anyone who would be judgemental of a fellow human exercising does not, matter. (They don’t, though.) However, here is one observation. I stand around in parks and open spaces with clients all the time and very often they are doing an exercise while I look on, encourage them, or hold the stopwatch. I often notice the reactions of passers by and almost always, they are positive. Sometimes people will offer a couple of words of encouragement or say ‘I need to do that’ as they pass. I truly find they are rarely negative.

Running as a uniboober

When I first went back to exercising after my surgery, I was very self-conscious. I normally opted not to wear a prosthesis (it would get sweaty and irritate my scar). I thought that everyone would notice that I was running with a one-sided bounce. As time as elapsed, I have realised that people really aren’t looking, and I have also developed a level of resilience: it is none of their business anyway. That level of bravado has taken a little while to develop, but it is there now. I have also found that some running tops leave more to the imagination than others and that a running backpack even more so.

Time

A lack of time is a very commonly held reason and finding time when you are also tired can be doubly difficult. For those that struggle with time, I would suggest looking for opportunities that are either time-efficient, or convenient. So, if you can use a journey you regularly do and convert it to your exercise – the work commute, or after the school run, it might be easier to fit it in and make it habit. If there are not good facilities to shower and change at work, then walking or running home can work. It also acts as a de-stressor, a gentle come down, ahead of the rest of your day or evening.

Types of exercise that are time efficient are often ones that involve quick bursts of activity, such as a HIIT session, or using a spinning bike. For the reluctant and self-conscious, you can do HIIT in your living room, or garden – it doesn’t need to be in a gym-based group. Using a skipping is also a wonderful option for the time strapped and it is something you can do little and often and build up. @kathyjumps is someone I follow on social media. She started skipping to regain her confidence and to lose weight after giving birth. Whenever her babies slept, she would skip. She is now impressively fit and posts imaginative, fun, realistic films of her routines, with coaching notes. Check her out on Instagram.

Do it with a buddy

If you want to start, or go back to exercising, then getting some support can be really helpful, especially if you don’t know how to start. (There is a chapter on this). If you can enlist a friend or family member as your exercise buddy, you will spur each other on. Or join a group – such as those operated by Maggie’s Centres and Macmillan Move More. There’s some convincing evidence to show that you’re more likely to stick to your intentions if you exercise with other people rather than alone , and you’ll get the added bonus of social support from kindred spirits :‘Group exercise classes offer a less intimidating approach to fitness. Not only can it be a place where participants learn helpful ways to increase their daily activity, but they also have the opportunity to fellowship with other patients who are in a similar stage of treatment.’[1]

Do what you love

Of course, some people just do not like to exercise. For many the idea of going to a gym is an anathema. Fair enough. Instead, I’d recommend looking for other ways for your body to move – dancing, gardening, active daily living. Alternatively, find something new and learn, through coaching if need be, to do it well, as that can help build confidence and a sense of satisfaction at the same time as helping you to feel fitter and stronger. I have, for example, taught boxing to many people, particularly women my age and above, who simply didn’t have the opportunity when they were younger. It is highly satisfying, and a great workout.

There are some people who have a lifelong dislike of exercise, stemming from their experiences in school sports, or through other enforced exercise. The trick here, I find, is to make it enjoyable, and often, therefore, non-competitive. It is one of the reasons that parkrun appeals to so many – anyone can do it, everyone is welcome, and the only person you’re competing against is yourself, if you want to. I remember once training with a client who was just coming to the end of her time in the British Army. Over a period of time she learned to love running, against her own expectations. Beforehand, at school and in the army, running had always been under duress, but she found that if she didn’t pressurise herself in the pursuit of speed, and if she allowed herself walk breaks, she actually enjoyed it. Another of my clients, exercising after breast cancer, has become an accomplished croquet player. Although croquet is a gentle sport, it also requires a great deal of control and so her training programme is geared around her strength and fitness to help her play at her best.

The photo I used for this blog post is me doing what I love: running along a huge, empty Cornish beach. And that, my friends, I believe is the key to lifelong fitness: finding an activity that you love to do.

What to do if you are having a ‘down day’ or are struggling to get going.

There are some tricks I have learned in order to convince myself (and others) to ‘just do it’.

  • Put on your kit. Even if you don’t go and exercise straight away, it should help prompt you.
  • Allow yourself to just do a little bit. If a whole workout, or session feels too much, it is fine to change your plans and opt for something that feels less overwhelming. Sometimes I tell myself I will go for a run but will intend to keep it short. Invariably once I get going, I do the full distance anyway.
  • Make it feel like a treat. A bit of ‘me time’. Go somewhere different, or beautiful, for your exercise rather than the usual route. I sometimes run one way along the river Thames, then catch a boat home marvelling, like a tourist, as we pass under Tower Bridge.
  • Have something indulgent or nourishing waiting for you at the end: a soothing bubble bath or particularly good cuppa. I find that a really good, gooey chocolate brownie works well.
  • Sometimes, you might simply need a day off, and this is absolutely fine. Perhaps have a good stretch or do a little yoga but do please cut yourself some slack if you need to. I hope that exercise becomes a habit for life and for that to be practical and sustainable, sometimes you do need to rest and put your feet up. I often run better, and much stronger, if I have had a couple of rest days.

And on that note, I started writing this when I was trying to get myself off the injury bench after a bout of shingles, so I will sign off, and go get my running shoes on.


[1] Wonders KY, Stout B, Ondreka D (2016) A model approach to group exercise in cancer survivors. Phys Med Rehabil Res 1: doi: 10.15761/PMRR.1000102

[2] https://www.nhs.uk/conditions/sports-injuries/treatment/ accessed 22/11/2020

[3] Exercise Guidelines for Cancer Survivors: Consensus Statement from International Multidisciplinary Roundtable

CAMPBELL, KRISTIN L.1; WINTERS-STONE, KERRI M.2; WISKEMANN, JOACHIM3; MAY, ANNE M.4; SCHWARTZ, ANNA L.5; COURNEYA, KERRY S.6; ZUCKER, DAVID S.7; MATTHEWS, CHARLES E.8; LIGIBEL, JENNIFER A.9; GERBER, LYNN H.10,11; MORRIS, G. STEPHEN12; PATEL, ALPA V.13; HUE, TRISHA F.14; PERNA, FRANK M.15; SCHMITZ, KATHRYN H.Medicine & Science in Sports & Exercise: November 2019 – Volume 51 – Issue 11 – p 2375-2390

[4] McNeeley et al Cancer rehabilitation: recommendations for integrating exercise…2006

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