Not only should an appropriate exercise plan work with your current health needs, it should also include activities you enjoy and be adjusted when you’re feeling more tired or your symptoms change, LeCavalier notes.
Think of your weekly exercise routine as a meal, suggests Jennifer Nash, DPT, an associate clinical professor at the University of Nevada in Reno. Aerobic exercise is the main course, strength training is the side dish, and balance and flexibility work “is the dessert people often skip but should not,” she says.
Keeping your care team’s recommendations in mind, here’s how each type of physical activity can help and how to implement them.
Aerobic Exercise
For people with CKD whose blood pressure is controlled and who have no new or worsening symptoms, the long-term goal is at least 150 minutes of moderate aerobic activity per week, or roughly 30 minutes, five days a week, says Marwa Ahmed, a National Academy of Sports Medicine certified personal trainer who works with people with kidney disease and is the founder of the BodyMind Coach, a coaching practice in Toronto.
Start with 10 to 15 minutes of walking or another comfortable activity three days a week, especially if you haven’t been active lately, LeCavalier suggests. You can split a 10-minute walk into two 5-minute walks if that feels more manageable, Nash says.
Here are a few aerobic activities to try.
- Walking It’s free, easy to start, and you can do it almost anywhere. Wear shoes with good heel and arch support, especially if your feet tend to swell, Nash says.
- Cycling A stationary or outdoor bike offers a low-impact option. If leg swelling makes running or jumping uncomfortable, cycling may be a good alternative, Ahmed says.
- Water Exercise Swimming, water aerobics, or moving in a pool may feel comfortable when your legs feel heavy, Nash says. “The water gently squeezes your legs like a soft compression sock and can feel wonderful.”
- Seated Cardio Seated exercises are a good way to stay active when standing is uncomfortable or your legs are swollen, suggests Ahmed.
As cardio activity becomes easier, gradually add time, Ahmed says. Short sessions count, so there’s no need to rush toward a full 30 minutes at first.
Check with your nephrology team before starting a workout routine if swelling is new or noticeably worse. If it increases during or after exercise, stop the activity, rest, and discuss it with your care team before working out again, LeCavalier advises.
Strength Training
Some beginner strength-training options Ahmed recommends include:
- Sit-to-Stands Sit near the front of a sturdy chair with your feet flat on the floor, about hip-width apart. Lean slightly forward and slowly stand up. Once upright, lower yourself back into the chair with control.
- Wall Push-Ups Stand about an arm’s length from a wall and place your palms against it at chest height. Keeping your body straight, slowly bend your elbows to bring your chest toward the wall. Push back to the starting position.
- Resistance-Band Rows Sit on the floor with your legs stretched out in front of you, keeping a small bend in your knees. Loop the middle of a resistance band around the soles of both feet and hold one end of the band in each hand. Sit up tall, then pull the band toward the sides of your ribs, drawing your elbows back and gently squeezing your shoulder blades together. Slowly return your hands to the starting position.
- Heel Raises Stand behind a sturdy chair or at a counter, holding it for balance. Slowly lift both heels off the floor, keeping the balls of your feet on the ground, then lower your heels with control.
A physical therapist or qualified exercise professional can help you choose the right starting resistance and number of reps for your current strength, symptoms, and fitness level.
Flexibility and Mobility
- Calf Stretch Stand facing a wall with your hands against it for support. Step one foot back, keeping that leg straight and your heel on the floor. Slowly bend your front knee until you feel a stretch in the back of your lower leg. Hold for about 30 seconds, then switch sides.
- Shoulder Stretch Bring one arm across your chest. Use your other hand to gently support it above or below the elbow, holding for about 30 seconds. Switch arms and repeat.
- Shoulder Rolls With your arms relaxed at your sides, slowly roll your shoulders back and down. Keep the movement gentle rather than forcing your shoulders into a large circle.
If you prefer a guided activity, yoga is another option LeCavalier suggests, particularly when you want something less demanding than your usual workout.
Balance Exercises
For someone with C3G, balance work may be especially useful if illness, inactivity, or muscle weakness has made it harder to stay steady on their feet, says Ahmed, who suggests the following balance exercises.
- Tandem Stance Stand with one foot directly in front of the other, with the heel of your front foot touching the toes of the foot behind it. Keep a counter or sturdy chair within reach for support. Hold the position as comfortably as you can, then switch.
- Heel-to-Toe Walking Walk slowly in a straight line, placing the heel of one foot just in front of the toes of the other with each step. Practice alongside a counter so you have support if needed.
If you’ve fallen or feel unsteady, a physical therapist can determine what may be affecting your balance and show you how to safely regain it, Nash advises.
