Helping someone become active after stroke
If someone you care about has had a stroke, you may want to help them become more active again — but not know when to encourage, when to step back or how hard to push. From my own experience, the answer wasn't somebody forcing me back into exercise. It was having support while I gradually rebuilt confidence for myself.
Start with where they are now
One of the biggest mistakes we can make is comparing somebody after a stroke with the person they were before it.
Perhaps they used to run, play sport or go to the gym.
Perhaps they weren't particularly active at all.
Either way, the useful starting point isn't what they could do six months or ten years ago.
It's what they can safely and confidently do today.
Every stroke recovery is different
I was fortunate that my physical recovery was relatively quick. That makes my experience very different from somebody dealing with significant weakness, mobility problems, balance difficulties or communication problems.
Stroke can also affect vision, cognition, coordination, confidence and energy levels.
So there cannot be one exercise timetable that works for everybody.
Don't underestimate fatigue
One of the things that surprised me most after my stroke was how quickly I could become exhausted.
Shortly after leaving hospital I went to a garden centre with my elderly parents.
I became so physically and mentally tired that they had to help me back to the car.
Before the stroke, I was fit and active. That experience made me realise that recovery wasn't simply a question of muscle strength.
Activity can start very small
Becoming active doesn't necessarily mean joining a gym or going for a run.
Depending on the person's abilities and professional advice, progress might begin with everyday movement.
Move
Begin with whatever appropriate movement the person can currently perform.
Repeat
Consistency can matter more than trying to make one session impressive.
Build
As confidence and ability improve, activity can potentially progress with appropriate guidance.
Sometimes confidence is the biggest barrier
After my stroke, I was particularly concerned about returning to exercise.
My stroke had happened around two hours after a HIIT class. Logically, that didn't prove the exercise had caused it — but emotionally the association was difficult to ignore.
When I was eventually medically cleared to exercise again, the physical ability to move wasn't my only challenge.
I had to trust my body again.
My wife didn't push me — she came with me
When I started running again, my wife came with me.
She was there in case I became unwell.
That was reassuring because one of the fears in my mind was: what happens if something happens again while I'm out exercising?
She didn't need to coach me or tell me how fast to run.
Her presence was enough.
Encourage — don't force
Family members understandably want recovery to happen as quickly as possible.
You can see what somebody used to be capable of and desperately want that person back.
But repeatedly telling somebody they should walk further, exercise more or try harder can turn encouragement into pressure.
Stroke recovery can already leave somebody feeling that their body has let them down.
They don't also need to feel that they're disappointing the people around them.
What practical support might look like
Go with them
A walk or appropriate activity may feel less intimidating with somebody trusted alongside them.
Make it normal
Activity doesn't always need to feel like rehabilitation. A walk somewhere enjoyable still counts as movement.
Notice fatigue
Don't assume reluctance means laziness. Stroke fatigue can be a very real barrier.
Celebrate progress
Improvement that appears small from the outside may represent a major achievement to the person recovering.
Let them lead
Where possible, allow the survivor to regain ownership of their own activity rather than making every decision for them.
Ask for help
Physiotherapists, stroke teams and other appropriate professionals can help establish what activity is suitable.
Support shouldn't become permanent protection
Immediately after a stroke, wanting to protect someone is completely understandable.
My family were frightened by what had happened to me too.
But as I recovered, they generally allowed me to start doing things for myself again.
For somebody capable of regaining independence, doing everything for them indefinitely may eventually become another barrier.
Don't assume their best days are behind them
This is something I feel strongly about because of what happened in my own life.
My fitness today doesn't look the same as it did before my stroke.
I do less cardio and much more resistance training. I've learned more about exercise, qualified as a personal trainer and become noticeably stronger and more muscular.
There are still things that frustrate me — particularly my cardiovascular ceiling — but in other areas I'm better than I was before.
It may eventually be an opportunity to improve old habits
Once somebody is medically stable and ready to think beyond the immediate recovery period, a stroke can prompt wider questions about health.
Depending on the individual, there may be opportunities to become more active, improve diet, address smoking, reconsider alcohol intake, improve sleep or take greater interest in long-term health.
But this needs sensitivity.
A stroke survivor shouldn't be made to feel blamed for what happened to them.
The focus should be on what can potentially be improved from today onwards.
Know when encouragement isn't appropriate
Family support doesn't replace medical or rehabilitation advice.
New or worsening neurological symptoms, significant deterioration, unusual chest symptoms, fainting or other concerning symptoms shouldn't be treated as something to “push through”.
Likewise, somebody with significant mobility, balance, cardiovascular or other medical issues may need individual professional guidance before progressing activity.
If you're trying to help someone you love
You don't need to become their personal trainer.
You don't need to have all the answers.
In the early stages, they may simply need reassurance, patience and time.
Later, they may need somebody to walk beside them, encourage them or remind them how much progress they've already made.
Eventually, the best support may be helping them regain enough confidence that they don't need you beside them every time.
Not sure how to help them move forward?
Stroke Health Fitness is for families and partners too. If you're trying to support someone who has had a stroke, we can help you think about where they are now, what they want to regain and what their next steps might look like.
START HERE SUPPORTING SOMEONE