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Being active with your transplant

Getting fit

Physical activity – why it’s important

Exercise is any movement of our bodies that uses energy. Studies have shown that exercise has many disease-fighting effects and can actually extend our life span.

Exercise is usually described as being moderate or vigorous. Moderate physical activities include walking briskly at 5.5km an hour, hiking, dancing, cycling (less than 15km an hour), or gardening. Vigorous activities include jogging/running (8km per hour), swimming laps, biking (more than 15km per hour), aerobics, team sports like touch football or heavy yard work like chopping wood.

Because vigorous activities increase your heart and breathing rates enough to make you sweat, they are considered aerobic exercise. Aerobic exercise helps reduce the risk of heart disease, diabetes and cancer.

In addition to exercise, you may also benefit from working with a physical therapist or personal trainer to learn how to include strength training or resistance training into a workout routine.

Strength training exercises burn energy, strengthen bones and muscles. Dumbbells are a great way to start training. Strength training exercises are usually done at least twice a week where weights are lifted 8 to 15 times (repetitions or “reps”). Lifting should be stopped before the muscles get tired. If your doctor recommends strength training, you’ll be instructed to start slowly, and gradually increase reps/amount of weight you lift.

Double-lung recipient Kate Phillips.

To estimate how much energy is used in everyday activities, exercises and sports, click here.

Some transplant medications may cause muscle weakness, so be sure to talk to your transplant team before beginning any strength training exercises.

It is important to stay flexible to decrease your risk of pulling muscles and breaking bones. Strength or resistance training exercises use muscles in repetitive motions against resistance. Riding a stationary bike or exercising on a rowing machine are examples of resistance training. Other types of exercise that can be helpful include stretching exercises like yoga and Pilates.

When can I start exercising after transplant?

It’s important to talk with your transplant team about the best time to begin increasing your activity level. This will depend on how well you’ve recovered, what type of organ you received, and any complications you may have during your recovery period. Some patients may begin exercising in the hospital with a physical therapist, and can discuss a plan that’s right for their recovery in the outpatient setting.

Kidney recipient Lincoln Greaves and liver recipient Richard Hayes.

How can I increase my activity level?

After you have a doctor’s approval, there are many simple things you can do every day as you recover:

  • Stretch arms and legs before you get out of bed every morning
  • Hold onto the sink with both hands after brushing your teeth and do leg squats at a comfortable level
  • Climb one or two flights of stairs instead of riding the elevator
  • Lift small weights or do stretches while watching the evening news or listening to music
  • Be mindful if you have the type of job where you’re sitting at a desk. Find ways to build time to walk throughout your day. For example; try parking farther away from your office or other destinations to increase the distance you need to walk; or walk during your lunch break
  • When the weather is too hot or cold for enjoyable outdoor exercise, increase your activity indoors (like walking at an indoor mall)

It’s recommended that every transplant patient leave the hospital with an exercise program as part of their treatment plan.

What kind of exercise is best for me?

Any physical activity that uses energy counts as exercise. You can walk, swim, ride a bicycle, lift weights, play golf or tennis, participate in yoga classes or even do housework as exercise.

Any physical activity that you can do is beneficial; will improve your overall health, make you feel better and can help control stress. Recipients can also participate in the Australian Transplant Games, which are for people of all ages and fitness levels and a great way to meet other transplant recipients as well.

You could also start a walking group. Check out the Heart Foundation‘s guide to getting active.

Is there anything I should be concerned about during exercise?

It’s important to follow the exercise guidelines that your transplant team has discussed with you. The rule of thumb is not to lift anything heavier than 2 litres of milk in the first month following surgery. Lifting, pushing, or pulling too much weight within 4 to 6 weeks after surgery may cause hernias to develop through weaker sections of any abdominal incisions. Additionally, some transplant medications can cause poor wound healing or delay wound healing – so take your time.

Although you’ll be able to participate in a variety of activities as you recover, most transplant units advise patients to avoid activities that risk direct hits to your body such as boxing, football or ice hockey.

If you ever experience any intense pain, chest pain or shortness of breath, you should stop exercising and seek medical attention or advice. Even months or years after a transplant, exercising when you have a fever is not a good idea. If you have joint pain that worsens with activity, do not exercise. To be healthy and fit is an important goal, but using common sense is just as vital. Listen to your body! If you feel like you’ve done too much, do a little less the next time you exercise, then slowly build up again.

How much daily exercise should do?

Planning is a key word. Like most important things in our lives, we have to make time to do things that are important to us. Once you’ve recovered enough to return to work or other routines in your life, it may become more difficult to find time to exercise. Plan ahead and make this a priority in your day.

Start with a manageable intensity and amount of exercise or activity that is approved by your doctor. You should be able to carry on a conversation easily while exercising. As you become more comfortable, gradually add two to three minutes to your routine to build over time.

With increased strength and endurance, you should aim for 20 to 30 minutes of physical activity or exercise daily. Strength training sessions such as lifting weights can be shorter with days in between for muscles to recover. You can spend longer on aerobic exercise sessions like walking briskly.

What if I get bored?

The key to a successful exercise program is variety. Changing your exercise routine will not only be easier on your muscles and bones; it’ll keep you from getting bored. A variety of routines, or ‘cross training,’ is a strategy professional athletes use to improve their endurance and performance. As a transplant recipient, you can also use that concept to your advantage.

Remember: all activity counts!

Feel Fit and Enjoy Life!

Transplantation has given you a second chance at life. Enjoy feeling better and increasing your activity. Although your ability to exercise will depend on your health after transplant, most recipients are able to achieve a normal activity level compared to their peers. Some are able to achieve a high level of activity and participate in competitive sporting events. Many recipients participate in the Australian Transplant Games, and the World Transplant Games for the camaraderie of enjoying sports with other transplant recipients. No matter what your level of fitness, regular exercise is important for your general good health and wellbeing.

For more information, tips and ideas on how to be physically active, visit Australia’s Physical Activity And Sedentary Behaviour Guidelines.

Heather Edgell received her kidney transplant over 30 years ago.

Kidney recipient Trent Mulley at a Fit For Life! camp for recipients.

Acknowledgements

This content was adapted from What you should know: Diet and Exercise after Transplant, International Transplant Nurses Society (ITNS), 2010. ITNS is the first professional nursing organisation to focus on the professional growth and development of the transplant clinician. ITNS offers nurses a forum for learning about the latest advances in transplantation and transplant patient care. To access more transplant education materials for patients and healthcare workers visit itns.org.