‘You’re never too old to start exercising’
Exercise won’t cure a chronic illness, Dr Noel McCaffrey of ExWell tells Eva Hall, but it can increase mobility, reduce pain and boost mental health — and the less active you are before you start, the bigger the benefits
Clare Quinn is counting down the days until gyms reopen. She does exercises you have possibly never heard of: chair aerobics, weights with a rollator, stretches targeting specific feet muscles. She’s now doing these at home via online classes. But it’s not the same when your gym buddies — people who have overcome as much as Clare — aren’t by your side.
Clare isn’t training for a marathon or triathlon. Rather, she’s training her brain to help her live with a chronic illness, as are all of her classmates in ExWell Medical’s group sessions.
Clare was diagnosed with Parkinson’s in 2018, and referred to ExWell by one of the many neurologists she’s seen since then.
Founded and run by former Dublin GAA All Star Dr Noel McCaffrey, ExWell specialises in exercise for medical purposes. Clients must be medically referred and usually have a longterm illness, such as Parkinson’s, diabetes or a heart condition.
“Chronic illness affects 40pc of the population and affects 80pc of people over 65,” says Dr McCaffrey. “Long-term illnesses are extremely common and they tend to cause people to become less physically active.
“There’s no reason for people with long-term illnesses not to exercise. Being physically inactive contributes to a great deal of your unwellness.”
Clare, diagnosed with Parkinson’s at just 56, wasn’t entirely sold on the idea of group exercise at first.
“When I was diagnosed, I was shocked,” the mum-of-two says. “You hear people say ‘my granny had that’ — Parkinson’s seemed to be an older person’s illness. I didn’t really know what it involved or what my life was going to be like.”
Parkinson’s disease is a progressive nervous system disorder that affects mobility. There is no cure.
Used to an active lifestyle — “spontaneously getting on the bus, going places” — Clare was getting used to her new normal. “I had slight tremors in my fingers and sometimes experienced internal tremors. My posture was off, my foot was dragging and I had no swing in my right arm.”
The medical assessment of Clare was swift when she first presented with symptoms. But an official diagnosis took about 12 months and the acceptance of having a chronic illness took even longer.
“I didn’t want to see anybody. There are other people worse off than me but at that moment I didn’t feel that way. I withdrew from going out as symptoms became more evident.”
She first met Dr McCaffrey at an ExWell induction in DCU. The not-for-profit social enterprise, which is funded through the Social Innovation Fund Ireland, has a team including physiotherapists, physicians and athletic trainers, as well as a specialist advisory board.
“I thought ‘how could I do exercise, I have a stick?’”
Clare took a seat at the back and noticed one person in a wheelchair. Dr McCaffrey told the group of about 20 people that chronic illness is not a barrier to exercise and that any exercise can be adapted to suit a person’s needs. He says this applies to anyone, even those without illness.
ExWell focuses on three core elements: aerobics, strength work and balance and core stability. “All three are important,” Dr McCaffrey says. “No matter what your level of mobility is, everybody can do something.
“It’s never too late to get started. We’ve seen people in their 90s starting a strength programme and the gains they make are in the thousands of percent, so it’s true to some extent to say that the frailer you are, the greater the gains you’ll make.”
As well as the physical improvements,
‘If I do a session a day now it gives me a lift as well as flexibility. My legs can be very rigid, so when I do certain exercises I notice my perseverance going a little bit further than it did before’
“I was completely stressed and extremely worried, I didn’t want to walk up stairs for fear I’d have a heart attack,” recalls Adrian, 69.
He had approached gyms before but found that they were ill-equipped to deal with “a man of my age”.
“I hadn’t a clue what ExWell was. When I was told a Dr Noel McCaffrey was coming down, I was expecting the usual consultant in a pinstripe suit to give me a lecture on something nice and easy, such as pass the parcel. When this fine specimen of a man, in shorts, a sweatshirt and runners walked in, it was totally unexpected,” says Adrian.
“ExWell is a course developed specifically for a guy like me. None of us know what’s going on in our bodies and I realise now that psychologically I wasn’t doing as well as I was physically.”
Adrian does a range of aerobics exercises using a treadmill, plus strength and conditioning with weights and boxing and even basketball.
He has learned how to monitor his heart rate and what his limits are for working out, and why certain exercises work different muscles around the body.
Dr McCaffrey says people with chronic illness are often under the impression working out will make their condition worse.
“If you don’t exercise, your muscles waste and get weaker, and over time your fitness will reduce,” he says. “The impact of that is that you lose mobility, you become socially isolated, you lose motivation and your mental health deteriorates.”
When a patient is referred to ExWell, a number of self-administered tests to measure strength, aerobic fitness and quality of life are carried out at home. An exercise programme is designed around these results, and the patient joins group classes.
Each patient will have a regular check-in with a staff member to discuss progress. The patients are monitored, and after three months are retested.
“We expect to see an improved function within six weeks,” says Dr McCaffrey. “A recent survey we did showed that 60pc of people in our class experience some pain every day. In 25pc of those cases, the pain improved since they started the exercise programme. Having aches and pains is not a barrier to taking part in regular exercise. We don’t want to give you pain that’s getting worse or that keeps you awake at night, but we can’t take the approach that if you have pain that means you shouldn’t exercise, because that’s not true.
“Everybody can do it — we can transform your life without fixing the illness.”
For more info see www.exwell.ie