Establishing an exercise routine is difficult whether or not you have a disability. Time, money, motivation, and confidence can pose hurdles for almost everyone. But additional obstacles confront people with limb difference and other disabilities. And that is unfortunate, because it’s especially important for us to stay active. Exercise can reduce social isolation, depression, pain, and other problems that amputees commonly face. So even though we face high barriers to fitness, we have a strong imperative to try to overcome them.

Here are the five biggest obstacles to physical fitness I’ve faced as an amputee—and how I got past them.

1. Setting realistic fitness goals

At a time when there are new approaches to fitness being promoted every day, navigating the resources to get started can appear daunting. As a starting point, I trust the CDC’s recommendations for adults with physical disabilities or chronic conditions: 150 minutes of moderate-intense aerobic physical activity each week, with two days a week of muscle-strengthening activities. Aerobic physical activities include walking, wheelchair rolling, biking, running, and swimming, among others.

Start with a realistic goal: Try to walk one mile several days a week. You can build this into your daily routine, so it’s not an extra time burden. Log the mile while walking your pet, catching up with a friend, running an errand, or just getting a dose of fresh air and sunshine. When I want to get a cup of coffee in town, I ride the bus in and walk the mile home.

If you’re traveling by wheelchair or bicycle, pick a distance that feels right. Or turn the walk into a jog or a run, if that’s what you prefer. The point is to make the time to move on a regular basis — and to strike a balance that doesn’t leave you exhausted.

If, like me, you love to swim for exercise, try an online search for local community pools that offer pool passes. I take advantage of the pool hours at my local YMCA. There are often options for private/group swim lessons or club practices.

2. Feeling self-conscious about your body

One major concern that held me back from pursuing physical fitness was poor body confidence. As a higher above-knee amputee, I walked with a limp, felt unsure of my strengths and weaknesses, and was intimidated by fitness spaces and workout culture. I did not know how to adapt my body to exercise.

I could have continued holding myself back out of fear—fear that I would look silly in any workout, fear that I would not be able to adapt to workout equipment, fear that I would embarrass myself at sports clinics. But who was left behind in the end? Only me. The only person responsible for reaching my fitness goals was me. Consider this: No one is thinking about your body as much as you are. And your body is only going to do what you challenge it to do.

I follow the social media accounts of various people who compete in adaptive sports, and I’ve always been impressed by their ability to keep showing up to competitions and pushing their bodies to new capacities. I knew I could never match their athletic ability, but I could match their persistence and keep showing up—at the pool, at the climbing gym, at the fitness center, or at the park with my running leg. I gradually moved further outside my comfort zone, gaining more confidence in my body as I discovered what it was capable of. I learned to love that process. I even started to feel proud of my body.

You don’t need confidence to show up. Show up first, to whatever fitness opportunity excites you. The confidence will come later.

3. Lacking motivation to maintain a workout schedule 

Growing up, I didn’t want to dedicate a lot of time to athletic training and competition, but I still wanted to be physically active. Sound familiar? But you don’t have to be training for a marathon or an Ironman triathlon to find motivation; you don’t need to have a coach or a nutrition team. Just start with one reasonable fitness goal that excites you, and compete against yourself. That becomes your motivation.

For me, I wanted to challenge myself to run and swim several times a week. I had to do it near home, at times that fit into my work schedule. It couldn’t be a major priority for me. But I could still take it seriously. I did that by attending Challenged Athletes Foundation running clinics and incorporating their tips and feedback into my at local park. I did the same with my swimming.

Finding recreational athletic groups that meet consistently can also be helpful for sustaining your motivation. When I became interested in rock climbing, I joined the Adaptive Climbing Group. The group gathered at the same location at the same time, every week; that schedule held me accountable. Consistency doesn’t need to be a strict daily regimen. You can focus on manageable weekly routines. (And having friends that check-in on those helps, too!)

4. Getting the right equipment (and the knowledge to use it) 

For a long time, I avoided working out because I wasn’t sure what equipment I needed or how to use it. Eventually I reached out to my local recreation center and set up a consultation with one of the personal trainers. She showed me how to use dumbbells and resistance bands, and we created sets of exercises and stretches that I could do on my own. I purchased the bands so I could use them at home, and I visited the gym for access to the dumbbells.

If you are interested in learning more about how to use gym equipment with your disability, I recommend having a conversation with one of your local gym’s staff members. Even if you do not plan to pursue personal training sessions, a one-time meeting allows you to learn how to safely use treadmills, rowing machines and other equipment on your own. Alternatively, you can ask for lessons from friends who are comfortable with gym equipment.

For some fitness pursuits, regular workout gear won’t work for amputees. But various organizations provide grants to help you obtaining the technology you need to run, bike, ski, or participate in wheelchair sports. I received Challenged Athletes Foundation grants to get my first running leg and bike, and there are many other opportunities out there. Start with Amplitude’s Community Resource Directory, which lists more than a dozen organizations that help amputees acquire sports-related prosthetic technology.

5. Dealing with pain and discomfort 

Workouts push our bodies into uncomfortable territory. We are exercising different muscle groups that aren’t used to working as hard, so it is common to feel sore. But workouts should not be painful. So if your workout habits are causing you pain, it is important to speak to your prosthetist, so they can check the fit and alignment of your prosthesis to ensure it’s meeting your needs. It might be that some portions of your workout are easier to do without your prosthesis.

Similarly, you might find certain seated or standing positions to be uncomfortable during a workout. If so, work with your prosthetist or PT to find adaptations that allow you to push your body with more ease. I have adjusted parts of my workouts to be completed while sitting, as opposed to standing, to put less pressure on my knee and lower back.

If you make adjustments but continue to experience pain during workouts, you should consult your physician. They can determine if you have acquired any injuries that need to be treated.

Alexandra Capellini is a resident physician at the University of Michigan Hospital in Ann Arbor.