Caring for a Disabled Person and the Carer’s Health.

Every person needs movement, from the very beginning of our lives right through to our final day. We would all like to stay physically able until the very end. Movement is the best medicine for most ailments and the recipe for healthy, happy ageing, with body and mind kept in the best possible condition.

A healthy life without movement is not possible. It is worth remembering that, whether we feel well or have been affected by an illness, physical activity is an essential factor in achieving the best possible condition. Very often in my work I come across a situation where one person falls ill — for example, comes in for rehabilitation after a stroke — and their partner devotes themselves entirely to caring for the person who is ill, completely forgetting about their own health and their body’s needs.

I understand that, with round-the-clock care, it is hard to find the time and motivation for your own exercise. It can be particularly demanding during neurological rehabilitation stays, when the carer accompanies their loved one at every stage. But this is about something more important — it is a kind of investment. The time we set aside for exercise will improve our own fitness, give our mind a moment to breathe, and improve the quality of our life. And after all, a better quality of life for us also means a better quality of life for the loved one we care for. Let us look after our own health just as we look after our loved ones.

The activity I am suggesting today need be neither time-consuming nor exhausting. Nordic walking is the perfect answer. It is a form of recreation invented in Finland back at the beginning of the twentieth century. It is a particular walking technique using special poles. Originally it served cross-country skiers, so that they could train all year round. However, it also works excellently as a health-promoting form of exercise for people of all ages.

Why do I recommend Nordic walking?

• Age, your previous level of activity and your body weight make no difference here.
• The intensity can be tailored to the individual’s abilities.
• The only equipment you need is poles, shoes and clothing suited to the weather.
• The location is entirely up to you: the seaside, the mountains, the forest, the park and any walking route.
• The activity is carried out at an aerobic intensity, involving most muscle groups, so it increases overall energy expenditure.
• It reduces the load on the ankle, knee and hip joints during walking.

Through the body’s aerobic activity, Nordic walking has a beneficial effect on the cardiovascular system, lowering blood pressure and reducing both the resting and the exercise heart rate. It also increases the uptake of oxygen by the tissues. Studies have shown that during this kind of exercise the muscles are engaged to a degree similar to that in a triathlon — considerably more than in the popular activity of jogging.

The high involvement of the muscles of the upper trunk and the large range of movement while walking improve the mobility of the upper spine and ease tension in the back and shoulders. Working with the poles also engages balance and coordination, the training of which is also important in cases of gait and balance disorders. By reducing the load on the joints, this activity is also recommended for people who are overweight or obese.

In truth, Nordic walking is a pleasure. We set our own route, pace, time of day and training partner. The exercise should be at an aerobic pace, meaning the heart rate should not exceed 140 beats per minute. It should be a relaxed walk during which you can comfortably talk to the person walking beside you. As your training progresses, you can increase your walking speed and enjoy the improvements.

The session should last at least 30 minutes. The optimal length is between 40 and 60 minutes. Ideally you would go 5–6 times a week, but any activity is better than none. As for choosing equipment, it is best to visit a sports shop that stocks a range of Nordic walking poles and to take advantage of expert advice.

Walking technique

• Posture: while walking, your back should be straight, your stomach drawn in, and your elbows relaxed and fairly straight, but not stiff. When walking faster, you can allow your body to lean slightly forward.
• Take your steps starting from the heel, rolling through the midfoot and pushing off from the toes. They should be a little longer than usual.
• Arms and legs work in alternation: left leg with right arm, and vice versa. Move your arms naturally, up to about navel height.

How to get started?

• Walk a short distance without poles, speeding up and slowing down. Allow your body to move naturally and observe how your arms work.
• Grip the poles halfway along their length and add the alternating arm movement to your walk. Your arms should be relaxed, and the movement should come from the shoulder joint, not the elbow.
• Slip the pole straps onto your hands and, without gripping the poles tightly, walk while making sure that your legs and arms work in alternation.
• Repeat the walk while holding the poles, trying to let them plant naturally. Do not bend your elbows. Close your hand when the pole is in front, then open it, allowing the pole to trail behind.
• Finally, add a push-off from the pole and a gentle rotation of the shoulders.

In summary, physical activity is needed by everyone, at every age, regardless of sex or body weight. Nordic walking need not be a dull, exhausting workout. It is an appealing way to spend time in the fresh air and to relax, with a beneficial effect on the body. Carers may also find it helpful to read our article on the mistakes made by patients and carers in the stroke rehabilitation process. Let us look after ourselves just as we look after our loved ones.

Rafał Ulatowski, MSc

Physiotherapist. Contact: kontakt@normanrehabilitacja.pl.