Exercising with Medical Conditions with Iyad Salloum

Mark: Hi, it's Mark Bossert. I'm here with Iyad Salloum of Insync Physio in North Burnaby, and we're gonna talk about exercising with medical conditions. How you doing Iyad? 

Iyad: Good, Mark. Thanks for doing this.

Mark: So is there. I'm sure we're probably talking about things like heart disease or diabetes or other medical conditions. Should you exercise when you have these kind of conditions? 

Iyad: Yeah, that's primarily the topic. I've seen a huge influx of people who kind of come to see me for, let's say like a sore back. And you know, there's really often conditions that can happen from a reduction in activity versus an increase in activity. So like just aches and pains that we get just from being in prolonged positions. So just being a bit more sedentary. And then, you know when I suggest the idea of an exercise program to get them up and moving, they are often shocked or surprised by the fact that they do have options to do that and that they could be done safely.

And I think really, If we think about like the main kind of things that most people will have of a certain age. So we see a lot of people, for example, who have high blood pressure and are on medication to control that. Or some form of other kind of cardiac conditions. And then we also have like, you know, your other metabolic syndromes like your diabetes and a few other things that could really, really impact your response to exercise. And also like your energy levels and your ability to participate. 

So often we see people get kind of a bit more concerned and worried about like, well, I don't want to go too hard. What if I hurt myself? Which is completely reasonable and this is where I guess working with us could be a really helpful thing for them.

Cuz we can kind of walk them through it step by step and kind of build up kind of a tailored program to help them get back to whatever you wanna get back to. 

Mark: So a thought that occurs is what, and the exercise program could be just lifting weights, it could be going for a walk. It could be it could be stretching and yoga type things, or Pilates. I imagine that with your background, more medical training, medical oriented training, you can provide a more complete package of training for someone to be maybe safer. 

Iyad: Absolutely. So one of the things like you wanna think about is like, I'll give you an example. More recently, we worked with somebody who had had a heart transplant, and they were telling me how they had a tough go initially when they were trying to start exercise because they felt like they couldn't warm up fast enough. And that's actually something that could happen because when you have a heart transplant, you rely on a different system to get your heart rate elevated and kinda more excited.

And this is something that usually is reviewed upfront. However, imagine like you're going through a heart transplant, it could be a bit overwhelming to kind of try to absorb all that knowledge in that kind of, preoperative phase and maybe the first rehab phase that they, they have to do after surgery.

So then kind of review some of the energy systems, so they'd have to target and some of the strategies that they'd to do to go about a warmup. Also, the cool down, they said they crash after exercise. And they're following like a stock program that was given to them. So we were able to take that, look into their medication. We consulted with their physician obviously about what's appropriate, what's not. What are kind of things that they foresee being an impact. And then based on that it gave a very specific exercise program. 

We used their smartwatch that they had on their hand to help keep them in his zone of exercise that everybody's happy with both medically and also the person themselves. And then based on that, we were able to progress them. And now they have a nice exercise program. They really like cycling, so we just built it around cycling. 

Obviously we wanted to make sure that they also have enough capacity in their muscles and in their other areas that need to be engaged during that activity. So it's not just gonna be, oh yeah, here's a heart rate. I want you to stay below and have at it as much as you wanted. It was very much based on the measurements and based on where they wanna go. And then we built the program from their goals working backwards to fill in the gap. Yeah, it was quite interesting. 

And then the other thing is like, yeah, the medical training does help for sure. We monitor things like blood pressure. We're gonna monitor things like heart rate. Sometimes in certain conditions if somebody has some issues, for example, like COPD, which we don't see too often in the community, but in the hospital, we'll monitor a few things like how much is their blood oxygen saturation and things like that, because we need to be safe ultimately. 

So we don't wanna necessarily, give them something good at the expense of something else. So we try to kind of be a bit more of a reasoned approach, but also like, ultimately the goal is safety. And that's where we see a lot of those clientele and people really feel more comfortable working with somebody with more of a medical background in that case. 

Mark: So it feels like the overall message, is exercise is still important, even if you have a medical condition. In fact, that might even be extremely important. 

Iyad: Absolutely. And this is where I guess our understanding has changed over the years. It used to be that you have a condition, you don't wanna ever exercise or simulate or exert, but we've found more recently with quite a few studies that this is quite safe. But it has to be done in the right way. 

So we follow very safe, let's call them mobilization guidelines, to kinda get people up and running. And then also the other thing is we have found like one of the physicians we work with, we kind of built a program for one of their clients and we were able to really enhance how they responded to their diabetes medication just with the exercise program.

So that was quite significant. And then they felt more energetic and they felt less lethargic and all that stuff because the way diabetes works is like an uncontrolled level of blood sugar and one of the ways you control blood sugar is not just through the liver but also through your muscles. So we were able to build a specific program that addresses a little more kind of on that peripheral side, so they're able to help regulate that blood sugar.

So then even though they were still on medication, that response was much more pronounced for them. And they were happy because now they felt like, oh my God, I have had this type two diabetes and I can't do anything. And when the options kind of open up for them, it is quite a freeing thing because you start doing things that you normally wouldn't do.

So this person hadn't traveled in a while because they were worried about what would happen to them. So I think like really comes back to that independence and just being able to trust your body to handle what you want it to handle. So that's where we come in and help out with obviously our healthcare colleagues who are in the medical system as well.

Mark: If you have a medical condition and you want expert advice on an exercise program that will actually help you move and feel better about, you're not limited, you're not restricted because you have a condition. Maybe a little bit, but not as much as perhaps you've assumed. The guys to see are Insync Physio, you can reach them in North Burnaby, you can book right on the website, insyncphysio.com, or you can call them (604) 298-4878. Or in Vancouver (604) 566-9716. You can book for either office. Thanks, Iyad. 

Iyad: Thank you.