Exercise as Medicine: The Devil is NOT in the Details

 
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We love exercise.  We love doing it (most of the time), we love talking about it, and we love helping others find joy in not only the participation of exercise but also the physiological benefits of it.  While we are known for promoting intelligently designed exercise programs to enhance athletic performance, we are also big proponents for physical activity’s ability to reduce all-cause mortality risk and improve overall quality of life.  However, despite the amount of evidence to show the importance of exercise to a person’s overall health, we recognize that there are a million and one reasons a person may have to not engage in regular physical activity.  While simply telling someone that exercise is good for them is unlikely to create any significant change in that person’s behaviors, we want to answer some of the more common questions we receive from clients when considering making exercise a regular part of their daily lives. 

How much exercise do I need to be healthy?  


Back in 2008 the U.S. Department of Health and Human Services recommended that all adults engage in 150 minutes per week of moderate intensity aerobic activity or 75 minutes per week of vigorous aerobic activity.  It also advocated for bouts to be no less than 10 minutes at a time.  

These recommendations were altered in 2018 with 2 significant changes

  1. Resistance training was added to the recommendations at 2 times per week, 2-3 sets per major muscle group, 8-12 reps per set at a resistance that would make it difficult to do one more repetition.

  2. Bouts of exercise no longer need to occur in increments of 10 minutes or more but can be amassed in whatever increments one chooses. 

So you mean I don’t have to exercise everyday?

Absolutely not!  If you want to exercise only on the weekends or if you want to do short sessions every morning just before work or school or perhaps for 30 minutes every night to end the day those are all perfectly fine options as well.  Yes, you read that correctly.  You CAN be a weekend warrior and still be healthy as long as you fulfill the physical activity recommendations.  If you choose to participate in more rigorous physical activity such as running, playing full-court basketball, or swimming then the amount of time you spend exercising can be reduced.  Alternatively, if you prefer to go for walks then you would need to amass more minutes throughout the week to fulfill the recommendations.  

What if I can’t meet the recommendations?

Studies show that health benefits can occur even with very modest amounts of physical activity so the best thing you can do is just get started doing something you enjoy.  A walk with a friend, taking the stairs more often, or chasing the kids around the park are all great ways to accumulate physical activity.  However, it is important to keep in mind that as you begin to make positive adaptations to your exercise routine it is likely that you will need more exercise time or more intensity to fulfill the recommendations to elicit positive health outcomes.  

Can I exercise too much?

Yes and no.  If we’re looking at exercise in and of itself, then the answer is no.  While you will continue to reap the health benefits of exercise the more that you do, the degree of benefit decreases after a while.  In other words, after a certain amount of physical activity it will require more intensity or time to gain just a little bit more benefit.  The good news is that even at 5 times the recommended amount there is no significant increase in health risk so the notion of overdoing it is a bit too reductionist in our opinion.  Having said that, we believe it is important to remind you that exercise does not exist in a vacuum.  The benefits of exercise are reaped when adequate recovery methods are in place.  For us to realize the positive effects of physical activity it is important to have sufficient rest, stress management tools, and adequate nutrition in place and as we have seen in the past few months of quarantine our caloric needs, restfulness, and stress levels can fluctuate from time to time.  

Are there better or worse exercises for certain people?

Not really.  There is no data to suggest that people of certain ages or health histories are better or worse off participating in certain exercises.  Similarly, there is no superior form of aerobic exercise.  What all this means is that you can lift weights at any age and running does not have any inherently superior traits compared to cycling or swimming.  The most important things to consider when choosing the exercises in your program are your interests and your goals.  Adherence matters much more than whether you use kettlebells, dumbbells, or barbells.  

What if exercise is too painful or uncomfortable?

While we must recognize that sometimes the journey to improve oneself can be an uncomfortable one the conversation of pain or discomfort as it pertains to exercise is one that is best discussed on a personal level.  Everyone’s pain experience is their own and what may not need to be a concern for one person might actually be a word of caution for another.  What we at Headquarters Physical Therapy pride ourselves on is the ability to have these conversations with each and every client we work with and to help them craft individual plans that suit their needs and goals while still respecting the dosage requirements to achieve positive health outcomes, whether it be in the context of injury rehabilitation or general health improvement.  

If you are looking for someone to understand your situation and help provide you with solutions suited for your goals do not hesitate to contact us directly to speak with a physical therapist. 

Kraus WE, Powell KE, Haskell WL, et al. Physical Activity, All-Cause and Cardiovascular Mortality, and Cardiovascular Disease. Med Sci Sports Exerc. 2019;51(6):1270-1281. doi:10.1249/MSS.0000000000001939

O’Donovan G, Lee I, Hamer M, Stamatakis E. Association of “Weekend Warrior” and Other Leisure Time Physical Activity Patterns With Risks for All-Cause, Cardiovascular Disease, and Cancer Mortality. JAMA Intern Med. 2017;177(3):335–342. doi:10.1001/jamainternmed.2016.8014

Jefferis BJ, Parsons TJ, Sartini C, et al. Objectively measured physical activity, sedentary behaviour and all-cause mortality in older men: does volume of activity matter more than pattern of accumulation? British Journal of Sports Medicine 2019;53:1013-1020.

https://www.hhs.gov/fitness/be-active/physical-activity-guidelines-for-americans/index.html#:~:text=For%20substantial%20health%20benefits%2C%20adults,or%20an%20equivalent%20combination%20of

https://www.cdc.gov/physicalactivity/basics/adults/index.htm