By: Dale J. Buchberger, PT, DC, CSCS, DACBSP
Just because most cardiovascular equipment is low-impact doesn’t mean they it is all injury-proof. There are several different types of cardiovascular equipment, including treadmill, stair stepper, elliptical, upright stationary bike, recumbent stationary bike, and rowing machine. Each one has its benefits and its disadvantages. Your choice of cardiovascular equipment should take into account any particular medical problem that you may have.
The first and most prominent disadvantage of all cardiovascular equipment is excessive cost. If you want to bring cardiovascular equipment into your home, it will be an expensive proposition. When it comes to cardiovascular equipment, you get what you pay for, but that doesn’t mean you can’t find a deal if you look for one!
Stationary bikes are a convenient way to develop cardiovascular fitness and lose weight. They are a good choice if you have injuries to the hip, knee, ankle, or foot. In order to lose weight, you will need to either cycle for an extended period of time or increase the intensity of the workout. If you have back pain, the upright bike may actually be better than the recumbent bike. The seat adjustment is key to the comfort of any bicycle workout. Fortunately, most upright and recumbent bikes have easily adjustable seats. Upright stationary bikes work well as a cardiovascular alternative to running if you have a variety of leg or lower back injuries.
Treadmills provide an avenue to perform weight-bearing cardiovascular exercise year-round in a controlled environment. Walking or running on a treadmill is more forgiving to the joints of the lower extremities than walking or running on the street. However, if you have lower back pain, you may want to avoid long periods of inclined running or walking. Perform short intervals of inclined walking or running with longer periods of flat walking or running instead. If you are planning on running a race, you should mix outside running with treadmill running. The rotating tread helps your legs through the gait cycle; therefore your hamstring muscles on the back of your thigh don’t work as hard. Training on a treadmill and racing outside can result in a leg injury.
Elliptical machines have become very popular because they afford you the opportunity to exercise your arms and legs in a non-weight-bearing method. If you have hip, knee, or ankle pain the elliptical can be a reasonable method to maintain cardiovascular fitness. If you have any type of back problem the elliptical can aggravate the pain. While the elliptical eliminates any pounding force it increases the rotational and shear forces through the lower back. The rapid rotation causes a wringing mechanism that can further injure the discs of the lower back.
Stair steppers can be a good choice for cardiovascular exercise and weight loss. They are low impact and can work the hips and core and can even help with balance. If you have good enough balance that you can use the stepper without using the handles your upper body will get a workout as well. However, if you have excessive degeneration in the hips or knees this may not be an option. If you have a back problem but can maintain an upright posture and avoid leaning on the handrails, this may be a low impact option for your cardiovascular needs.
Rowing machines can provide an effective total body workout. While rowing machines also provide a low impact workout, there are several physical requirements that you must possess in order to use a rowing machine effectively. First, you need to be able to sit for a lengthy period of time. If you have back trouble while sitting, this may not work for you. Good hip flexibility is necessary since your legs come very close to your chest while using a rowing machine. If you have degeneration of the hips limiting flexion, the rowing machine may not be the device for you. If you have chronic shoulder pain the rower may make this worse.
Most of the cardiovascular machines mentioned have two things in common: they are generally expensive to bring into the home and they can all be monotonous to perform for long durations. Keep in mind that if you have more than one problem area, you need to take these into account when choosing your method of cardiovascular exercise. Speaking to the healthcare provider that you trust the most with these types of decisions before undertaking this type of exercise program is worth the time. If you are recovering from a surgery make sure you ask the surgeon and/or physical therapist if you have reached a stage of recovery allowing return to cardiovascular exercise. You should not be shy about asking physical therapist any questions about returning to a regular exercise routine. As the patient, it is your right to choose a physical therapist with whom, you feel most comfortable discussing all aspects of your care.