Exercise...What Works and What Does Not

 Jennifer Morris, MD

ABPN, ABOM

                        

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Exercise...the very word elicits emotional reactions ranging from joy to visceral dread...reflecting the swath of our relationship with the topic. Reasons for not exercising range from lack of knowledge in the how, to lack of time, to lack of motivation. Today I'm tackling the latter two; the "how" will be addressed in later editions (stay tuned!)

But first, a brief overview of exercise. There are four fundamental types of exercise, each which serves to accomplish different benefits:

1. endurance-e.g. walking, dancing, biking, swimming, climbing stairs, playing sports, running; these serve to improve blood pressure and cholesterol, improve sleep quality, and may reduce the risk of inflammatory illnesses like heart disease and type 2 diabetes. The physical activities guidelines for Americans recommends 150 minutes of  moderate or 75 minutes of vigorous exercise per week. (1)

2. strength training--e.g. weights, resistance bands. These serve to maintain muscle and bone mass, and should be undertaken at least twice a week

3. balance exercises--e.g. tai chi, yoga, standing on one foot, heel-to-toe walking, lunges, squats (which also incorporate strength). These serve to  prevent falls and injuries and are important for every day activities

4. flexibility--e.g. stretching, pilates, yoga. These aid in  preventing injury and  reduces body aches, these types of exercises also increase range of motion

Incorporating exercise into your day can be challenging. Even with mindful attention to our schedules, the days seem to fill and exercise drops out (motivation may play a helping hand in this.) To build any habit, a strategy is required...new habits are built mindfully.  With that in MIND,  these strategies have been helpful to others:

1. Set specific time to exercise. Don't wait until you are motivated to exercise; motivation is unreliable and can be developed by just starting exercise. More on this in a minute.

2. Choose something fun, or at least tolerable, such as walking, outdoor games, exercise, sports games, classes, hiking, or dance

3. set accountability strategies: a class, a partner, an electronic device (like a smart watch)

4. start modestly, work up to longer times if desired

5. utilize short segments for exercise; 10 minutes here and there add up

Still can't find the time?  Consider a time audit, like this:

begin with what we are all offered, a 168 hours a week

Allocate hours to these categories:

work:                                     ________

sleep: (need 8 hours/day)      ________ 

commute:                              ________

errands/groceries/chores:      ________

family time:                           ________

other:                                     ________

the rest is time that might be committed to exercise (and other mindfully-chosen activities) rather than tik-tok, mindless tv, etc.

EXERCISE MOTIVATION:

Motivation can be fleeting, and often feels to mismatch our need and potentially psychologic desire for exercise. Fighting this motivation deficit is challenging, and is probably the number one barrier to starting an exercise program. With this in mind, lets fight forward. These strategies are worth a second look: 

1. be willing to be bad at it at the beginning. According to Christine Carter (2), being good requires effort and motivation be equivalent. Waning motivation causes us to do the easiest thing (avoid exercise in this case.) New behaviors require a lot of effort, but if we are willing to lower the bar (start running with one minute of running rather than 15 minutes of running) it is easier to match motivation with need. Allow motivation to develop WITH exercise rather than BEFORE establishing a new exercise routine. 

2. Remind yourself that doing one is better than doing nothing...this aids in building the HABIT of exercise, and fosters new neural connections. Walk 5 minutes rather then telling yourself its 30 minutes or nothing. This creates a new life pattern and new brain connections that encourage exercise. 

3. Set routines in motion to create a HABIT of exercise, rather than happening into exercise

4. Accountability, as above, can fill the gaps where motivation lags. My I-Watch reminds me that I have committed to a particular running program...my psychological need to complete tasks does the rest. Others might benefit from the accountability of  walking with friends, a dedicated gym class, or a workout partner...just as iron sharpens iron and so forth. 

Exercise is challenging both to initiate and to continue. However, the health benefits of exercise: stress reduction, memory improvement, depression and anxiety improvement, and increased resilience lead exercise to be one of the most powerful mental health tools available.

Physical Activity Guidelines for Americans, 2nd edition. https://health.gov/sites/default/files/2019-09/Physical_Activity_Guidelines_2nd_edition.pdf  accessed 7/24/24. 

Carter, Christine. Here's how I finally got myself to start exercising. https://ideas.ted.com/heres-how-i-finally-got-myself-to-start-exercising/ accessed 7/24/24.