Opinion – It’s Right There: Pay attention to your limits

We have said and repeated in this blog that walking is a democratic activity, accessible to practically everyone, which is like eating and scratching, just starting and going out there, without fear of being happy. But it would be dishonest to claim that I never went further than I thought I could. A little bit of optimism mixed with porralloudness usually results in a hellish mixture. And they can be very bad for your health. Or, at the very least, the ego.

Dissatisfied with previous abuse experiences, I asked an experienced friend to go for a trail weekend with a backpack loaded with everything on the list sent as “essential items” for the ascent to Mount Roraima (2,810 m altitude) , already contracted. Weighing all that, the sum was around 13 kg, even eliminating some excesses that I had already identified with the naked eye. I suspected that not even in the wildest of my delusions I would be able to carry it all up the wall — have you guys ever taken a look at the face of this mountain? It was no wonder that the “emperor” of that global soap opera only arrived there by helicopter…

Give yourself the discount to the agency that they alert you with all the letters to the possibility (in fact, even a humanitarian recommendation) of hiring porters, Venezuelan Indians from the tribe that lives in the park that houses Mount Roraima, and who carry the hill up to 15kg for each tourist for a ridiculous daily rate which, at the time, was equivalent to R$10, yes, TEN REAIS. But the skinny person here wanted to test to see if she could handle taking it all alone, even with a known arthritic lumbar advising to stop being a beast.

So we went to test a hike that should reach Pico do Papagaio (2,100 meters of altitude), in Aiuroca, south of Minas Gerais. And it only took a few meters up the hill with all that stuff to conclude that, yes, I would hire a local porter to take my cargo backpack, so beautiful and ergonomic, to the top of Mount Roraima; and no, I didn’t have the slightest physical condition to carry all that stuff even in that much smoother access place. Allowing myself the humiliation of distributing part of the weight that should be mine among my friends (oh, and what friends, did I already say I love you?), I consoled myself thinking that, in the end, it would contribute a little bit to the battered economy Venezuela: the amount I would pay for ten days of hard work for the porter from the indigenous village of Paraitepuy was equivalent at the time (2017) to almost half of the country’s monthly minimum wage. Don’t console those who don’t want to.

And it was thinking about people like us, or, at least, like me, that the blog was to hear what Dr. Renata Castro has to say, specialist in cardiology and sports medicine, with a postdoctoral degree at Harvard University and bi- pan-american kickboxing champion, to know a little more about how our body works when called to an activity that is not usual for it. Is this as simple as it sounds or is it good to relativize? And she told us what she thinks of the so-called democracy of the practice of walking.

the look of medicine

1. Doctor, after all, is it true or myth that walking is an activity that works for everyone? Well, that depends. People think, oh, I’m going for a walk, it’s quiet, there’s no risk. It’s just not like that. For some, walking will be too light an exercise and maybe it won’t even bring as many benefits, because one of the principles of physical training is overload. That is, if you train too lightly, it will not generate the desirable adaptations in your body. For other people, it can be an extremely strenuous exercise, for example, for those who have heart or lung disease. So, it is always recommended that the person undergo a medical evaluation.

2. Even for a walk around the block? Of course, if you are a person without symptoms, without any complaints, without any disease, they can even start walking as a regular physical activity. There are even some self-assessment questionnaires, such as the Canadian PAR-Q (available in Portuguese at the link https://www.cepe.usp.br/wp-content/uploads/PARQ-site-CEPE.pdf). There are ten questions, and if you answer any of them with yes, you should see a doctor before starting the walk. Because many times, from this evaluation, we end up identifying diseases or alterations that the person did not even know about.

3. And does the weight of the backpack, when going on a trail, for example, or a picnic, really make much difference? Yes, it is very important, and we have known this for many decades, the impact of the so-called dead weight on energy expenditure in a walk or run. Dead weight is what you have to carry, but it doesn’t help you physically, whether it’s a backpack or the fat of the obese person. The weight of the backpack (or fat) will greatly impact the intensity of the effort and, therefore, how well the person will have to be in order to be able to take that hike or trail. This is a very important fact that people sometimes forget to consider. And here come the problems.

4. And how can a person assess the ideal weight for their backpack? The first thing is to know the speed at which you intend to walk, the slope and the characteristics of the terrain. And understand that our body works as if it had two engines, a 1.0, which takes you where you want, but you can’t step too hard, and a turbo that you use for some specific situations, like going up a slope, but you can’t keep the whole trip connected. So, the 1.0 engine we call aerobic metabolism, theoretically infinite. But, depending on the intensity, the effort, it alone is not enough – and then the body needs to turn on the turbo, which is the anaerobic one, which can only be used for a few minutes. So, we have to consider that the trail has to be below the anaerobic threshold, that is, below this demand for the “turbo” most of the time. There are tests that help to assess whether the person is capable of doing such a test, or expedition, carrying a backpack and how many kilograms.

5. And does the ergonomics of the backpack impact this performance? At first it wouldn’t have much influence, but if the shape bothers or makes it difficult to move, it will be more difficult, yes, because it will involve greater energy expenditure. It is not uncommon for someone to come to me for a performance evaluation and we identify equipment that is unsuitable for that person. The adequacy of equipment often requires biomechanical, physical therapy assessment by multidisciplinary groups.

6. Did you feel an increase in demand for patients who walked around without guidance in the pandemic and had problems? One important thing that I noticed more ostensibly with the pandemic is that there is a difference between being sedentary and having a sedentary behavior. A sedentary individual is one who does not meet the minimum recommendations for weekly physical activity recommended by the WHO (World Health Organization), which would be 150 minutes of moderate-intensity aerobic activity or 75 minutes of high-intensity, two weight training sessions. And, for those over 65, flexibility training.

But we see many people who wake up early, do their daily physical activity, even exceed the WHO minimum recommendation, but spend the rest of the day sitting at home office. And then, that’s what we call sedentary behavior. Several studies have already made it clear that it is necessary to break these periods without moving.

The ideal is that every hour the person moves, even for two minutes, because then they abandon the sedentary behavior, which is associated with obesity, increased abdominal circumference, cardiovascular diseases. And this has undoubtedly increased a lot, because of the prevalence of sedentary behavior.

7. Are apps that measure heart rate, distance and calories effective? I’m a big fan of these apps. I think they help a lot, motivate people a lot, but they have to be used with guidance – and there are a lot of mistakes. It’s no use buying a very expensive watch and going out doing random workouts, without guidance from the proper professional. As a sports doctor, I work a lot with this area of ​​physiology and guide my patients to use this equipment with guidance, together with a physical education professional.