Introduction
This is a collection of information that I think would have been beneficial for me to receive upon discharge from hospital. Some of this I knew already (yet was not told), but there are things I did not discover until much later, and I would have achieved more if I had known them. It is written as a guide for someone with limiting lower limb injuries who has just come home from a long stay in hospital, but there is lots of general fitness advice that should be useful for any sedentary person looking to get it better shape. There are many links to external resources, and you should not expect to absorb everything in any short amount of time. It is intended to be read through once, then referred back to over time as you learn and progress.
Table of Contents
Swimming in a Sea of Uncertainty
While returning home after an extended stay in hospital is an exciting occasion, it is to be expected that you will feel at least somewhat overwhelmed by the daunting change in dynamic. Up until this point, you will have had a team of professionals working with you daily, dedicated solely to the goal of rebuilding your body to a level where you can safely manage in a home environment. Now, although you will no doubt have regular check-ups and ongoing physiotherapy, the day-to-day responsibility of pushing yourself forward and improving falls largely upon your own shoulders.
For the first few weeks, just getting through the day will be challenging enough, and you should not worry if you are too exhausted to deal with much beyond the basics tasks of existence. However, sooner rather than later, you will need to make a start towards the vague goal of getting better, and in this guide I will provide an overview of the different concepts that are necessary to understand if you want to give yourself the best chance of making a successful recovery. I must stress that I have no qualifications apart from my own experience. The advice that I give will be very general, and you should adapt it to your specific situation after consulting with the relevant doctors and physiotherapists. I will assume that you are working on your injured areas under the guidance of professionals, and provide fitness advice with an upper body focus, including novel exercise ideas that you can begin experimenting with on your own.
Exactly what will define a successful recovery depends on the specifics of your injuries. Since I was told from the beginning that it would eventually be possible for me to walk unaided, more than anything else that has been the overarching goal driving my training. Over time though, it has become less about this or any specific goal, and more generally about achieving the peak fitness that my body will allow. In the end, that is all that rehabilitation is: becoming as fit as possible within the limitations of your injuries. If you work towards this goal in a balanced way, the finer details will take care of themselves. Even if you have been given a particularly grim prognosis, cautiously working towards fitness goals is still something I would highly recommend. If it had eventuated that I was never able to walk any significant distance again, all the hard work I put in would have be worth it, just to be able to sit with reasonable posture and beast around in a wheelchair.
It is important not to think of your body’s current state as being solely a result of your injuries, but rather as a combination of your injuries and the complete lack of fitness that the rest of your body now has. Even if you have injuries that you will never fully recover from, by focusing on the parts of your body that can be bettered, you can make drastic improvements in its overall condition, and minimise the impact your injuries have on your life.
If you have never been the sort of person to care much about fitness, then getting started can be a pretty intimidating task. The fitness industry has caused a lot of harm by presenting its product as something that requires a bunch of weird tricks, odd gimmicks, and elaborate workout plans. We are bombarded by so much unnecessary detail in an attempt to sell magazines, that it is forgiveable to think that fitness is some complex beast that only a small percentage of people can tame. Fortunately, when it comes down to it, there is nothing particularly tricky about getting in shape. It can be difficult to be disciplined and stick to a routine, sure, but the concepts involved are very simple, and prolonged repetition of the basics will take you a long way. There are endless nuances to how an advanced athlete can structure their training, but as a beginner it is unproductive to worry about them, and you should instead focus on optimising the other factors in life that influence your progress, like diet and recovery.
In terms of general fitness resources, Reddit and its many fitness-focused subreddits often make a good starting point. They usually have fairly comprehensive wikis and FAQs that should answer most of the questions a beginner will have about a specific discipline, and they are fairly welcoming communities for the most part, provided you have actually put in the effort to read their resources before asking questions. If you have any beginner queries, direct them to the dedicated threads that appear during the week, as you are more likely to get bad advice if you post in the inappropriate place and make the regulars less motivated to help you. The wiki of /r/Fitness should be your first port of call, as it is full of quality information. However, due to the size and broad, beginner-oriented nature of the community, some of the advice given in the comments there can be questionable at times, so it is better to stick to the niche subreddits for discussion where possible. Once you have absorbed everything in the wiki, browse through the related subreddits list, and repeat the process for any subreddits that interest you.
If you are reading this from a position as dire as mine was, then take extra caution with everything. My body has improved so much over the last few years that it is very hard to accurately recall exactly what it was like and tailor my advice accordingly. Some of my suggestions might be too ambitious for a while yet, and you should not feel discouraged if everything is very overwhelming. Keep the faith and do what you can. It gets a lot better.
Building a Baseline
For any completely untrained beginner, increasing your cardiovascular conditioning (cardio), flexibility, and strength are all very important if you wish to achieve a healthy balance of fitness. Of these, cardio is the easiest to improve, but also the quickest to disappear if you become inactive. Strength and flexibility take a lot longer to develop, but once you have attained a good level with them, it is possible not to focus on them for periods without losing much progress. The simple act of living life and interacting with your environment in the way a strong, mobile body allows is enough to maintain your gains. As long as your diet is in check and you are not bedridden, your muscle is not going to go anywhere fast.
Commencing Cardio
A decent baseline of cardio will go a long way in improving general well-being and overall energy levels, and it is something that is worth prioritising at the beginning. The better your cardiovascular system is functioning, the easier it will be to get through the day and successfully complete the other necessary areas of rehabilitation. If you are able to walk, then simply focusing on increasing the distance and speed at which you can is the most basic way to improve your conditioning. To progress at a reasonable rate you will soon need to do something more intense than this, although that can be difficult if running and riding are out of the question. For uninjured people, the Couch-to-5k program is a good starting point. Regular cycling or swimming are also options for something easier on your joints.
Something I did in the early days, both at inpatient rehabilitation and at home, was to use an arm-cycle. While I could walk with elbow crutches, the amount that I could do before becoming a wobbly mess was insufficient to rapidly improve my conditioning. By doing High Intensity Interval Training (HIIT) on the arm-cycle, I was able to get a really intense, time-efficient workout that quickly improved my cardiovascular capabilities. Since then, I have grown strong and mobile enough to manage on a treadmill and exercise bike, and now I use them as the primary way to do cardio. HIIT on an exercise bike is another excellent workout that cannot be beaten for efficiency. I think a good goal to aim for is doing five days a week of cardio, with two or three of these days spent on HIIT if possible. HIIT will build strength to a greater degree than steady-state cardio, so it is also useful in that regard.
The specific workout I did on the arm-cycle, and later on the exercise bike, was a three minute warm-up, followed by ten sets that were made up of twenty seconds at maximum intensity plus forty seconds at a very leisurely pace. After this I did another easy three minutes as a warm-down. I found this to be a good balance between intense and not too intense for a disabled person to manage. I think I started with three or five sets and worked my way up from there. If HIIT sounds too intimidating, just do 10-15 minutes at a steady pace for now, and gradually add the occasional burst of intensity.
Results Through Reclination
As well as cardio, the other thing you should aim to do as soon as possible is set up a comfortable rehabilitation station that allows you to relax and recuperate from your daytime efforts. A recliner chair is by far the best thing to use for this purpose, since, as it turns out, there is no end to the fitness activities that you can undertake from one. A soft couch or bed might seem tempting, and you could still actually do a fair amount from there, but a recliner chair with plenty of room to the sides will provide the perfect balance of exercise potential and comfort. Ideally you want a chair that is as firm as possible without defeating the purpose, to ensure that there is enough support to encourage good form. A good home theatre setup will also be essential. Watching television will quite literally be the most productive thing to do with your evenings, since it will leave your hands free for fitness endeavours.
The advice I was given when I left inpatient rehabilitation was to spend as much time as possible sitting upright to aid in recovery, which I did, but in retrospect that was a terribly inappropriate thing to say to someone in my situation. Sitting up, with all the pain it involved, was a task that demanded all of my attention and was very draining. I would have been far better off spending all of my spare time in a recliner chair, nicely medicated, therefore with faculties available for exploring my body instead of doing my best to ignore it. The chair would have needed to be on raisers for me to safely get in and out of it, but doing so would have been worth the hassle. The exercises I could have done would have improved my fitness a lot more than slanted sitting did.
Analysing Anatomy
A process of upper body exploration is a very important one to begin, and the simplest tool to aid you in this is a set of dumbbells. There is no need to be a big man on campus; two 1kg dumbbells will remain useful for a very long time, and a 500g pair is worth having at the beginning too. Some 1.5kg, 2kg and 3kg dumbbells will also be beneficial, mainly for loaded stretching at first, but anything beyond that will be too heavy to be useful for physiotherapy-oriented work. Without a light enough weight, it will be hard to isolate specific muscles without other muscles trying to help. With the right weight in your hand, however, you will be able to successfully complete your task: Identify all the major muscles of the upper body, and use the dumbbells to isolate them and train their various functions. You can achieve a lot just by playing around and exploring what you are capable of, and you should begin doing so immediately, but to make the most of your time it is necessary to have a reasonable understanding of anatomy.
If you were an average first-world citizen before your accident, then it is almost certain that your body was plagued with the various muscle imbalances that a sedentary lifestyle brings. A serious accident will not have helped things, and it is best to assume that all of your muscles are shortened and weakened. As a result of this, none of your joints will currently be moving through anything close to resembling the full range of motion they are capable of, you will be suffering from various impingements, and it will be impossible to comprehend your potential capabilities by exploration alone. The only way to successfully remedy extreme deficiencies by yourself is to develop an in-depth understanding of your muscles and how they are meant to function. Then it will be possible to gradually bridge the gap between your current state and that understanding.
This is a fairly involved task, but there is plenty of information freely available online. The Wikipedia page for anatomical terminology contains a lot of knowledge, although it is too dense to be very useful when you are completely unfamiliar with the topic. The individual pages for each muscle, bone and joint are also worth browsing once you understand some of the basic terms. There are various videos available on YouTube, but I highly recommend an edX course about the anatomy of the upper limb as a starting point. It is an archived course, but all the videos and lecture notes are still available to use. A lot of the first week will go over your head the first time you watch it, and it is not all relevant, but it is still worth viewing to start to become familiar with the terminology. You can safely skip the second week unless you are an aspiring student of medicine, but the remaining videos that cover the different muscles, bones, and joints of the upper limb are essential viewing for anyone serious about fitness. Repeated watching and review of the notes will go a long way in developing your understanding of the upper body’s natural movement patterns, and give you the knowledge required to properly understand form cues in future strength training efforts.
Dumbbell Discovery
Eventually, I will try and produce some resources that introduce the most important anatomical concepts and how to apply them from a recliner chair, but for now an exercise list will have to do: wrist curl, reverse wrist curl, biceps curl, arm raise, lateral arm raise, shrug, internal/external rotation, incline chest press, triceps extension, shoulder press, incline dumbbell fly. These are all exercises that can be done with dumbbells from the comfort of a recliner chair. (Some in a slightly non-traditional manner, for example the curls will need to be done with your arms hanging over the side of the chair.) Depending on your injuries, you might not be able to do them all, but they are listed roughly from easiest to most challenging, so start with the first few and take it from there. If any exercise is painful then skip it for the time being, but as long as you are cautious and use a light weight it should be possible to avoid injury. Remember, this is a process of exploration. Do not rush through things. At the beginning, just aim to do a few exercises here and there without really pushing yourself, and do so up to six days a week. Start with a dumbbell no heavier than 1kg for all of the exercises, and when targeting smaller muscles, like with wrist curls and arm raises, 500g will probably be appropriate.
Eventually, it will be better to settle into a structured routine. When you feel ready, start doing a more focused workout three days a week, and avoid doing strength work on the days in between. Aim for 2-3 sets of each exercise, and work in a repetition (rep) range of 10-15. Focus on isolating the appropriate muscles, which you will learn from the aforementioned resources, and develop the mind-muscle connections required to correctly execute the movements. It is normal to progress quicker at some exercises than others, and when 3x15 of a certain movement gets easy, increase the weight for that exercise. I would recommend doing them one arm at a time at first, taking note of how the two sides of your body differ, while focusing on performing a controlled, full range of motion (to the extent that is possible). After a while, also do both arms at once sometimes, and focus on remaining as symmetrical as possible when you do. By training one arm at a time you can get by without much rest (as long as you do not get out of breath), but make sure to wait 90 seconds before targeting the same muscle again. Doing all the exercises as a circuit is worth trying, too. (That is, do one set of each exercise with minimal rest, then do that again, and again.) Once you are comfortable with the exercises, it should be possible to get through them all absent-mindedly while watching television, but you should still direct as much focus to them as you can.
When you have some understanding of anatomy, there are various cues that can enhance the exercises. During biceps curls, focus on depressing and protracting your scapulae, keeping them like that throughout the entire movement. This will help ensure that it is only your biceps working to move the weight. After each rep, briefly pause and focus on extending your elbow (straightening your arm) as much as possible. Extending your wrist and letting the weight pull on your arm can aid in this. When performing the different arm raises, experiment with having your forearm pronated, supinated, and neutral. (For the lateral raises, that means palm down, palm up, and palm facing forward.) This will work the different heads of the deltoid to varying degrees. There are lots of different ways you can slightly vary the exercises, so cautiously play around, and develop an internal understanding of how all of your muscles work together to go with the theory.
There are many more nameless exercises you can also do, so get creative! Hold your arm out straight to the side with a 1kg dumbbell balanced on your fingertips, thereby strengthening your finger extensors and stretching out the palm of your hand. Once you can confidently keep the dumbbell in position, then protract and retract your scapula while keeping the arm straight to develop a feel for the muscles involved in those movements. Perform a static hold in the top position of an arm raise with a 1-2kg dumbbell in each hand. Focus on engaging your core and protracting your scapulae while letting the weight of the dumbbells pull you forward. You can actually get a pretty good core workout in a recliner chair that way, especially with a slightly heavier weight. Let your arms fall to the side with a 2-3kg dumbbell in each hand, depress and protract your scapulae, and let the weights pull your arms towards the ground. This will help you learn to engage your pectoralis minor, while also providing a nice stretch throughout your arms. These are just examples. Explore and discover your own novel movements to help your cause.
Getting a Grip
Grip training is another thing that is very easy to do from a recliner chair, or, as is also the case with some of the above dumbbell exercises, even a bed. If you are reading this from hospital, then, first of all, kudos for being so motivated. Secondly, start grip training now! For a long time my grip was a weak point that affected how far I could comfortably walk with crutches, and if I had realised how useful grip training is while I was still in hospital, then that probably would not have been the case. Unfortunately, everyone was too focused on my pelvis to think to mention it to me. /r/GripTraining is a useful resource, but I will say here that both of the aforementioned wrist curls are a good start, and you should begin extensor band exercises as soon as possible. Pinch grip is a good thing to train as well, with static holds of 30-60 seconds using a 1kg dumbbell being a simple starting point. (The video demonstrates a hub pinch grip. You can also pinch two smooth weight plates or heavy books together to train a regular pinch grip.) Working on your crushing grip with a gripper is possible, too, but make sure you begin with a really easy one that is designed for physiotherapy use. There are also lots of different stretches and dynamic movements you can do.
Something not so obvious that grip training will lead to is being able to stretch a surprisingly large amount of muscles quite easily from a recliner chair. By holding the end of a dumbbell with a hub pinch grip, dangling it above or behind your head, letting its weight pull on your arm, and then moving your body about in various ways, you can stretch your forearm, biceps, triceps, deltoid, rotator cuff, latissimus dorsi, trapezius, pectoralis major, pectoralis minor, serratus anterior, and even your obliques! Some other minor players too. Your grip will give out long before you can target all those muscles without proper conditioning, though, so the sooner you start training it the better. (As always, be very cautious if you try this as a beginner. Getting a dumbbell into an awkward position behind your head where you cannot support it is a good way to injure your shoulder.)
Manual Massage
Self-massage is another very useful tool that becomes much more effective with a strong grip, but you can also achieve a lot with a weak grip and a few implements. A tennis ball is a good start, since it has a fair bit of give in it, and anything firmer will be too painful when your muscles are extremely tight. By placing a ball between your upper back and a recliner chair, you can push yourself into it, slowly move around, and thereby give yourself a comprehensive massage that helps your muscles to relax. When you come across any tight spots, pause and apply pressure for 10-30 seconds. This will be at least somewhat painful at first, but it should feel good when the muscle relaxes. If you are extra sore the next day, it means you have done too much. Once you know your limits, you could easily devote an hour each day to this, spending a few minutes on one area, then gradually moving the ball around your entire upper back. Once you have become used to the tennis ball, switch to a lacrosse ball for a more forceful effect. A foam roller is also very useful. Lying on a bed with your legs hanging over the side and putting the roller under your upper back is a simple starting point. Use a soft foam one at first, but a firm model will be more effective if you can handle it. When looking for a firm roller, avoid the cheap ones, as they will break easily. I have received good value out of my rumble roller.
Finding Flexibility
If you do not yet have strong enough forearms to do loaded stretching from a recliner chair, then you might need to make more of an effort during the day to work on your flexibility. Ideally, you need to work on both passive flexibility and active flexibility (often referred to as mobility). Passive flexibility refers to the range of motion an external force can apply to a joint and its muscles without causing injury, and it is most commonly improved by static stretching. Active flexibility refers to the range of motion a joint can go through solely under the influence of the muscles that act on that joint, and it is most commonly improved by dynamic mobility drills. Strength training will also help to improve mobility over time if done correctly, and the light dumbbell exercises mentioned earlier can be thought of as mobility work as much as strength work. The programs Starting Stretching and Moulding Mobility are two beginner routines you can look to for inspiration, and /r/flexibility is also a good resource. Kit Laughlin and Kelly Starrett are two very knowledgeable people to look to for professional guidance, and Antranik’s Mobility Project has links to lots more resources, including some of their material.
A more general recommendation is to have long, rather casual sessions where you gradually explore your body and its limitations. Just lying on a mat for an hour, slowly moving your arms around, and experimenting with different stretches and positions can be incredibly useful. In the end, the only person who can tell for sure what you can and cannot do is you. While you should of course listen to the advice of your doctors and physiotherapists, it is also necessary to develop your own understanding of what movement patterns you are capable of. What exactly sets off your pain and should be avoided? What areas are incredibly stiff but seem to have potential for improvement? What novel positions can you discover that will allow you to target the muscles around your trouble spots in a way that does not aggravate them? By answering these questions, you will acquire the knowledge necessary to minimise the risk of further injury as you slowly improve your body.
Helpful Habits
You should also focus on developing habits that you can integrate into daily life to help better your body in some small way. When sitting in a chair, focus on deep breathing and maintaining as good posture as possible. As a passenger in a car, do some self-massage with your hands or a lacrosse ball. When you brush your teeth do it with the best damn form that you can manage. These sorts of things may seem insignificant, but over time it all adds up, and it will help you achieve your goals as soon as possible. My parents are quite used to me flailing randomly at the dinner table as I go through limbering motions, and I sometimes find myself subconsciously stretching in the morning in bed before it has fully dawned on me that I am awake and a new day has begun.
In Search of Strength
While focusing on cardio, flexibility and light strength work, your over-arching medium term goal should be becoming fit enough to follow a more comprehensive beginner strength training routine. Even if you are months away from being able to do this, you should start doing some research and familiarise yourself with the concepts involved so you can jump into it when the time is right. Having a strong, well-balanced musculature is an essential part of being a truly healthy individual. The difference it makes in how freely and easily you are able to interact with your environment is immense, and the benefits cannot be overstated. Male or female, if you are in search of health and well-being, to work towards fitness goals without making strength training a significant area of focus is to do yourself a great disservice.
Once possible, a full strength routine should become your primary concern, and it is okay to stop doing as much cardio for a while if you have to. It is still vital to do as much flexibility work as possible, but strength training will maintain or even improve cardio to some degree, and it is not the end of the world to let cardio slip for a while. Ideally you should still do some moderate-to-intense cardio at least once a week, if you can manage it. An easy 20-30 minutes on an exercise bike on the days after strength training can also be worth doing, as it serves as a form of active recovery by promoting blood flow.
Routine Recommendations
If you have previous experience training at a gym, then it might be appropriate to return to this sort of routine. However, if you are not already experienced and confident in this environment, then a bodyweight routine might be more suitable, which is what I do. Bodyweight strength training is more than capable of building the amount of muscle that most people would desire, especially when combined with some relatively light dumbbell work. Watching a video of a male gymnast doing a rings routine is all the proof you need of the possibilities.
Being able to train from the comfort of your own home can be a lot less intimidating than going to a gym, and also a lot more convenient. This last point is especially important if you are injured to the extent I was. There was quite a long time when just getting into the car and going somewhere took a substantial amount of energy out of me, and if I had to go anywhere external to do my strength training, then I would have struggled to maintain the degree of consistency that I have.
The general goals of bodyweight fitness also coincide more with those of rehabilitation. The focus of both disciplines is to master control of your body through an increasing range of movements, by building strength and improving the range of motion you can safely express this strength in. While you will not build muscle as quickly as a perfectly executed barbell routine would allow, correctly performing lifts when you have postural deficiencies is impossible, and a bodyweight routine can make for a much simpler, safer starting point.
In terms of an exact routine to follow, the Recommended Routine (RR) curated by /r/bodyweightfitness is as good as any, and better than most. All the information you need to become strong and athletic is freely available on their wiki. If I was to condense this entire article into one sentence of advice for an uninjured person, it would be: “Follow the RR to the best of your ability while doing as much cardio and extra flexibility work as you can manage.” There are apps available that make it very easy to follow along with the routine and track your progress.
If strength training is completely unfamiliar to you, then it will take a while for you to digest and understand everything. Read through their training guide, FAQ, and the entire routine. Then read through them all again the next day. Refer back to them if you are unsure about something. To fully understand why the routine is structured the way it is, read through the excellent Basic Programming Principles section that is part of their Concept Wednesday series of articles (the other articles are worth reading eventually, too). They are written by a qualified personal trainer, and reference studies to back the claims being made. After a month or two, it is worth going over everything again, as there will most likely be some details that slipped through, and it should make more sense once you have a bit of experience under your belt.
If you are not already in reasonable shape then you will not be capable of following the whole routine right away. That is okay. You can introduce things bit by bit, and as you grow in confidence, you will be able to build up to following the whole thing to the best of your ability. A good starting point is to just do the mobility-focused warm-up, bodyline drills, support hold, push-ups, and rows. A block of firm foam to put your feet on will make some of the exercises easier to manage if you have a wonky pelvis. L-sits are great too, even if you are only able to focus on the scapula depression and core-bracing aspects, and squats are essential if you are uninjured. Do not even think about doing pull-ups or dips anytime soon. You will be better off continuing some of the dumbbell exercises that were introduced earlier instead. Shrugs, biceps curls and lateral arm raises are the best choices
Some ways to consider deviating from the structure of the RR at first are to not pair exercises and take longer rests between sets. When I was first starting out I had nowhere near enough fitness to maintain such short rests, not to mention the effort involved positioning myself for each exercise. By resting five minutes between sets, and only focusing one exercise at a time, I was able to get a better quality workout than I could have managed with shorter rests. The main reason that the RR pairs exercises with ninety seconds rest is to reduce the time the routine takes to complete, but if you are committing yourself to overcoming a serious injury, then time should not be an issue. The general consensus seems to be that for strength gains, 3-5 minutes is the ideal resting time, so there is nothing wrong with having a longer rest if necessary. It can also aid mindful practise of technique to only focus on one exercise at a time in the beginning.
If a physical book is more your sort of thing, I can recommend the comprehensive Overcoming Gravity by Stephan Lowe. It is quite dense and can be a bit daunting for a total beginner, but it contains a wealth of knowledge regarding how to progress and structure your training. The second edition has recently come out, which I am yet to read, but it is meant to have made a significant improvement in how accessible it is for a beginner.
Essential Equipment
While you will still need some equipment to follow a bodyweight strength routine, it will be nowhere near the amount required to safely do weight training at home. The essential things to buy are a set of gymnastics rings and a dip frame. Depending on where you live it can be hard to find a place to hang rings, but hanging them from a door-frame pull-up bar can be done as a last resort. Rings are easier on your joints than a bar for pull-ups and rows, since they can rotate to compensate for poor mobility. However, their instability makes pushing exercises a lot harder, which is why a dip frame is important. It will be a very long time before you are strong enough to do ring dips, and a proper frame makes it much easier to start working on your support hold and ease into doing the exercise safely. While you can improvise using counter tops or certain chairs, these methods often provide a reduced range of motion, and can encourage poor technique. A stable frame that lets you confidently move your body around is much more useful. Eventually, once you are strong enough, you will be able to do a comprehensive upper body workout with nothing but the rings. A decent mat might also be required, depending on where you work out and how much padding you need. I had to use something very soft and thick initially to minimise pain, but you generally want something as firm and thin as you can tolerate.
Long-Term Goals
Once you are able to consistently stick to a strength routine and feel confident that progress is being made, then there is not much else that needs to be done. Once you are on top of the basics, the rate that you can learn about fitness will greatly outstrip the rate you will progress. A completely untrained beginner should be able to stick to a well-programmed bodyweight strength routine for at least a year without needing to deviate from the given progressions. During this time you can start to read about more advanced topics, but resist the temptation to make any significant changes to your strength work. Put any extra energy towards flexibility.
The human body only has a finite capacity to build new muscle, so progress will be slow. Significant changes will be measured over months and years, although if you pay close enough attention you will notice at least some small improvement week to week in strength and flexibility if not physique. You should avoid looking at the sorts of dramatic transformations that magazines and shady advertisers peddle to the public. What someone who already has a great deal of muscle and a complete understanding of their body is capable of is not applicable to a beginner in the slightest. Misleading lighting and other deceptive techniques are also often used.
I think a good arbitrary long-term goal to work towards is being able to do three sets of eight pull-ups and three sets of eight dips, both with a full range of motion. You might not think this to be that difficult, but it will take an untrained person a very long time to achieve truly perfect form with these exercises. As I write this, after three years of training, with interruptions and an absolutely terrible starting point, my form is still imperfect. I can do three sets of five of both exercises with okay form, but I still have a lot of room for improvement, and I do not know how much longer it will take to reach a point where I can comfortably rip out three sets of eight without feeling like my form could be significantly bettered.
A Framework for Success
As a beginner, it is best to assume that your form will be terrible and your strength extremely sub-standard. While it is tempting to resist this fact, adopting a humble attitude is the key to framing the goal of getting fit in an achievable way. In the end, there is nothing special about being able to do pull-ups and dips with perfect form. They are basic strength moves that any biomechanically normal human is capable of. When trained from a young age we are capable of far more exceptional feats. However, if you have gone through life without ever focusing on fitness, then chances are that your body has become unable to execute these basic moves at all, let alone with good form. This is largely due to sociological factors that encroach upon a person’s natural development.
Almost every human is born with the innate capacity for athleticism. Unless you are one of the unlucky few born with a severe deformity, degenerative illnesses, or other such condition, then you have inherited the blueprints for a high performance machine sculpted by the endless iterations of evolution. Unfortunately, thanks to the comforts of modern life, it is becoming increasingly uncommon for people to reach adulthood with this capacity remotely close to being realised.
We go through our developmental years hunched over desks, perhaps mimicking the poor movement patterns of parents, and often spend long periods being sedentary. Throw in some sporting injuries and a general culture of sacrificing the body for performance, and it is easy to see why the average first world specimen arrives at adulthood with muscle imbalances and postural deficiencies that go largely unacknowledged. The human body is fantastic at adapting to the circumstances it is presented with, and it will happily accept a gradual reduction of its capabilities without doing much to make you aware of what is happening. Once I was onto the fourth month of lying in bed unable to sit up beyond thirty degrees, that felt alarmingly normal. By the same mechanism, after a lifetime of reduced mobility and muscle imbalances, you will think your current state to be normal and not pay it much thought.
While it may be disheartening to think that your body is incapable of properly performing basic strength moves, it can also be quite an empowering thought. The implication is that to become a strong, healthy individual, you do not need to achieve anything out of the ordinary or be blessed with any great athletic gift. All you need to do is fulfil your biological potential for a well-balanced, muscular body. By simply training yourself to a level where you can confidently perform these basic moves to perfection, you will have built a strong, mobile body, and provided your diet is in check, a reasonable physique. Achieving this will almost certainly take longer than you expect, but if you consistently do the right things you will eventually get there, and it is absolutely worth the effort. To enable this to happen, it is necessary to throw away your current conception of what a normal human being is capable of. Instead of being happy with what is currently sociologically ‘normal’, you must work towards achieving true biomechanical normality: a body that is capable of expressing strength through a full range of motion without impairment.
Other Optimisations
Building strength is a slow enough process as it is, so you should try to do everything within your power to maximise the gains you receive from your hard work. It is important to perfect your diet to the greatest degree possible, and also optimise the other areas that affect your ability to recover from your workouts.
Caloric Concerns
To give yourself any chance of becoming truly fit and healthy, you need to have your weight under control. This remains true for any uninjured person, but if you have severe lower limb injuries this is absolutely non-negotiable. You cannot be over (or under) weight without severely impinging upon your success and rate of progress. My recovery has taken long enough with a fairly meticulous diet, and I shudder to think how much slower it would have been otherwise. With the state my lower half is in, any unnecessary kilogram will only add to the strain on a set of limbs that are already going to struggle to last me for the rest of my life.
Fortunately, much like fitness, diet and nutrition is a lot simpler than the health food industry would have you believe. When strictly speaking about losing or gaining weight, the most important thing by far is the amount of calories you consume. To optimise recovery and build muscle it is important to get a good balance of macronutrients (fat, carbohydrates and protein), and to remain in good health you need a diet that provides appropriate levels of micronutrients (vitamins, zinc, iron, etc); however, when specifically speaking about changes in weight, calories are the key. While extra exercise will burn some extra energy, you can eat an hour’s workout in a minute, and calories are the dominant concern to the extent that they should be your sole focus when looking to change your weight. The fluctuations in my weight after the accident demonstrate this nicely.
When my weight dropped from 79kg to 53kg over two months, it was because I consumed less calories than my body needed. I struggled to keep any food down for over a month, and my energy requirements were higher than normal while my body tried to repair itself. When I finally managed to start eating more, and clawed my way back up to 80kg, it was because I was consuming more calories in a day than my body burned, which was a good thing given the situation.
When my weight marched onwards up to 93kg, it was because I continued to consume more calories than my body strictly required. I was largely bedridden, and the eating habits I had adopted to get back to my normal weight became superfluous. This gain in weight was less than ideal, but understandable given the circumstances. The temptation to indulge in comfort food was hard to resist after such a long time in hospital, and I did not have enough willpower to cut back to a diet appropriate for maintaining weight while bedridden for the majority of the day. It would have been possible, though. If I ate nothing but the meals provided to me by the hospital, I am sure my weight would have plateaued at a healthy level.
When I stopped putting on weight, it was because I realised how fat I had become, stopped eating rubbish, and let my body draw from a healthy diet and its fat stores for energy. I was also burning a bit more energy than before with my efforts at rehabilitation, and the weight came off quite quickly. Since then I have had no trouble maintaining a healthy weight despite being physically disabled.
While it is important to remain compassionate towards yourself or any others with weight problems, it is even more important not to deceive yourself into believing anything other than the fact that there is no purely physiological reason for a person to be significantly overweight. There are a lot of other factors that can make it more than understandable for a person to be obese. Mental health issues, being instilled with poor eating habits growing up, medication increasing appetite, a busy life, social pressure, the immense irresponsibility of fast food companies in making recent generations think that eating gigantic portions of nutritionally bankrupt food is normal, the list goes on. None of these change the fact that it is possible for any person to maintain a healthy weight if they adopt and maintain appropriate eating habits. If you are actually one of the very rare people with an extremely slow metabolism, that does not make a lean body impossible — just a bit harder.
General Diet Tips
Specific nutrition advice is beyond the scope of this article, but everything you need to know is freely available online. Stay away from fad diets and anything that is not a set of eating habits that can be sustained long-term. I am lucky in that I was raised with generally good eating habits and my mother always made an effort to cook healthy food. If you have reached adulthood not knowing what a healthy diet consists of, then it is worth tracking what you eat for a while with MyFitnessPal or a similar tool. Doing so will enable you to see exactly how many calories are in the foods you eat, and the balance of different foods you need to consume to get the appropriate levels of macronutrients and micronutrients. Once you have done this for a while and developed a feel for what a healthy balance of food is, it should be easy to maintain a reasonable diet without tracking exactly what you eat.
A good resource to learn more about nutrition is the Simple Science Fitness website, and, as with everything, Reddit has communities for people trying to lose or gain weight. If you are overweight, then getting down to a healthier range should be one of your first priorities. If you are relatively lean and focusing on building strength, then you should start eating a slight excess of calories to maximise muscle growth. I have been seeing good results from the slow bulk that I have been doing recently. In the last six months, while training, my weight has increased by about 1kg a month, and this has seemed like the perfect balance of building strength while minimising fat gain. I would advise against putting weight on any quicker than that as a beginner doing bodyweight training. Save experimenting with a quicker bulk until you are working at a higher level, if at all. To achieve weight gain of 1kg a month you need to eat a surplus of approximately 250 calories a day, which requires some diligence, but it can be done without counting calories once you have an understanding of what your body needs.
Weighing yourself regularly will make fine-tuned weight change much easier to achieve, and no matter what your goal is, I highly recommend weighing yourself every day at exactly the same time and tracking your weight on a graph. Fitness apps and smart scales make doing this incredibly easy. Your bodyweight fluctuates a lot day-to-day depending on waste levels and water weight, and weekly data points are insufficient to paint an accurate picture of how your weight is progressing. You do not want to think that the 1kg of fat you lost during the week did not happen because last night’s Thai food made you retain an extra 1kg of water weight. That only leads to discouragement. Try to avoid getting too caught up in how your weight changes day-to-day, and keep in mind that any dramatic daily fluctuations are largely unrelated to fat. By learning over time exactly how your body reacts to different stimuli, you will be able to take a lot of the mysticism out of the weight change process, and being able to analyse the hard data every few weeks makes it easy to tweak your diet as necessary.
I have found Intermittent Fasting (IF) to be a very useful approach to eating, and I would especially recommend it as a way to control your appetite when losing weight. While the name may make it sound like a fad diet, do not dismiss it right away. At its simplest, IF just means that you only eat during a set window of the day, and remain in a fasted state for the rest of it. A common split is 16 hours fasted with an 8 hour feeding window, which equates to skipping breakfast and eating a normal-to-large lunch and dinner. If you are used to eating a breakfast that is full of simple carbohydrates, then this might seem unthinkable, but your body will soon adapt, and still getting the satisfaction of a large meal every day makes losing weight seem like less of a chore. Refrigerators and pantries are fairly recent inventions on the scale of evolution, and your body is more than capable of supplying you with energy throughout the day if you only eat two healthy, well-balanced meals. A lot of people find that after a few weeks they hardly ever feel hungry, as their bodies stop expecting a constant barrage of easily-accessible energy and adopt better resource management skills. Black coffee with no sugar will not break your fast, and it can help to curb your appetite in the morning during the initial transition. Chewing gum can be useful too.
Personally, I think it is worth tending towards thinking of food as a source of fuel and nothing more. I can understand that this viewpoint might not be for everyone given the extreme levels to which society currently glorifies food and its consumption, but it can simplify life a great deal to think about what you eat in the same way you think about oxygen and water. Use a low-calorie vice instead, and just eat what your body requires without getting too caught up in the taste or ritual.
Recovery
Diet is the most complex of the optimisations that will affect how you progress at fitness, but there are other areas such as stress and sleep that are also very important. It can be hard to relax when you are in pain and trying really hard not to be too disabled, but cannabis will help a lot in that regard if not with sleep. If that sounds too out-there for your tastes then maybe try meditation. Wearing yourself out will go a long way towards getting a good night’s sleep if you can find the right balance between exercise and pain. Over the last few years, I have always slept better when working out compared to when I am on a break. This guide has become far too long already, so I will end by suggesting a Concept Wednesday article on recovery that offers some more advice on these topics.
If you have made it this far, then well done! I hope I have provided enough resources to keep you busy for a very long time, and given you the confidence that there is no end to the ways you can work towards fitness, even with severe limitations.
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