Exercise and Health

Yet another variation on “there are two kinds of people” is the folks who exercise and those who don’t. I certainly see this dichotomy in my patients who range from enthusiastic exercisers who are very fit to patients who know they should but have a very hard time making exercise an integral part of their lives. I hope this newsletter will provide some useful information for all of you, but I am specifically hoping that I can provide some encouragement and ideas for the non-exercise group.

If you already have a regular exercise program — meaning at least 30 minutes of aerobic exercise (as defined below) four times a week (every day is the best) — congratulations! Do let me know what you are doing, but you already have this element of preventive health care integrated into your life. Read this short article anyway, it may give you some new ideas.

For the rest of you, read on, and let's see if we can't come up with some solutions for integrating exercise into your life.

First, some of the basics

There are very few exceptions medically for initiating some form of exercise. In fact, it is critically important for most patients to exercise to tolerance to speed up and optimize their recovery. In any case, if you have a serious health disability, please confer with me or another medical professional before initiating an exercise program.

“Exercise,” broadly defined, includes flexion, strength, and cardio or aerobic. For most people, the more one can integrate all forms of exercise into one routine, the less time it takes. There are many ways to accomplish this; some forms of Yoga, routines like Zumba, sequential use of exercise machines, etc. The problem is that very few people will go to a facility come rain or shine and keep it up. They may subject themselves to “weekend warrior syndrome,” and perform types of exercise that induce injuries or just get tired of the gym experience. In fact, as all gyms are acutely aware, membership spikes with New Year’s resolutions and within two months precipitously drops off. What follows are my suggestions for an inexpensive program you can do at home. There are, of course, many other options, but this has worked well for many of my patients.

The core element of any exercise program is aerobic or cardio exercise. Without belaboring the point, let’s start with reminding ourselves of a few of the abundantly proven advantages of aerobic exercise to our health and wellbeing: significant reduction in risk for heart disease, decreased risk for several forms of cancer as well as significantly reduced risk for diabetes, obesity, dementia, depression, and age-related loss of functionality, plus, on average, you will live longer and have a higher quality of life.

Wow, sounds pretty good! So why doesn’t everyone embrace it? It certainly beats the alternative. There are a few common themes when I discuss this topic with patients that wrestle with maintaining a fitness program that I hope I can help with. The more common complaints are: “There’s no time, I’m busy.” “I never have exercised much and I don’t enjoy it.” “I’m confused about how much and what type of exercise is best.” “I don’t have space in my house for equipment.”

If you have never been able to sustain participation in gyms or exercise groups, let’s focus on a routine that you can do at home on a daily basis, if possible, but minimally four times per week. The core element is sustaining an aerobic level of exertion for 30 minutes. Rather than giving you the standard formulae, let’s keep it simple. You needn’t “huff and puff” but you do need to have a comfortable increase in your respiratory rate. For example, if you are walking briskly with a friend, you can still converse, but you feel your body heating up and a need to take deeper and more frequent breaths. That’s it! As your conditioning improves, exert yourself more, but it is not necessary to ever get to the “gasping for air stage.”

If you are lucky enough to live in an area where you can safely walk, one approach is to walk with hand weights. (Be aware that some exercise experts advise against this because of the possibility of failing with the hand weights.) However, if the walking surface is flat and you start with 2 lb. weights for women and 4 lbs. for men, it is a safe, inexpensive, and fun way to tone your body while you walk. If you search “heavy hands” on Amazon, you will find several options that will allow you to read about the science, the basic exercises, and also how you can integrate stretching into the routines.

Walking with hand weights can not only achieve aerobic conditioning for virtually any level of fitness, it can also provide resistance, weight bearing, and muscle toning for all of the major muscles. You simply start at your most comfortable weight and exertion level and advance as your fitness dictates.

Okay, but what about those days when it’s too uncomfortable to be outdoors? What can we use at home, that is light, doesn’t take up much space, is inexpensive, convenient, combines all three forms of exercise, and can be effectively used by the young and the elderly, the fit and the not-so-fit?

One recommendation that you might consider that is small enough to fit in a small apartment and can easily be carried onto a deck or patio in good weather or used indoors is the rebounder or mini-trampoline. When used indoors you can listen to music, audiobooks or watch a movie etc. and the time passes quickly. In general, look for the rebounders that use bungie cords instead of springs. They have a much better bounce and are also quieter. Two companies that make high quality rebounder of this type are Bellicon and Jump Sport.

The rebounder is suitable for all levels of fitness. It can be used for rehabilitation from injury and as an aid in recovery for patients compromised from poor health. Both of the rebounders mentioned can be ordered with support arms which will protect you from falls and help you ease into an exercise program if you have age or health related problems with balance or muscular weakness. Equilibrium will improve over time as well as your confidence and then the support arms can be removed which will enable you to easily move the rebounder indoors or out.

To summarize some of the health benefits of rebounding as noted by James White, PhD, Director of Research and Rehabilitation at the University of California at San Diego:

• Boosts lymphatic drainage and immune function;
• Increases bone mass and stimulates and improves muscle strength especially the lower body and abdominal muscles, and with small hand weights can tone and strengthen the upper body as well;
• Improves digestion, stimulates the internal organs and can be used as a way to amplify the effect of Kegel exercise to strengthen the pelvic floor and aid in recovery of incontinence in both men and women;
• More than twice as effective as running without the extra stress on the ankles, knees and hips given similar aerobic exertion;
• Increases endurance on a cellular level by stimulating mitochondrial production responsible for cellular energy;
• Improves balance by stimulating the vestibule in the inner ear.

The use of small hand weights can also be used as a “heavy hands” program while stepping in place and for stretching, squats etc. You will find this information readily available on YouTube and I can help you get started with a simple program. If you are under care when you begin a rebounding program, just tell me and I will be happy to coach you step by step relative to your physical condition. Done correctly, you can combine a full program of cardio, flexion and strength training in as little as 30 minutes four times a week. If you have the time, try to use your rebounder daily. Remember even a little bit counts. If you find it hard to start, begin with five minutes a day, you will notice that you will naturally be able to increase your time and exertional level.

Exercise is ideally done in the morning because it changes the set point of our metabolism and will improve alertness and stamina for the day. But you will derive similar benefits at any time including after work when you may fell stressed and tired. You will be surprised how effective a brisk workout invigorates mind body and body.

For my older patients, those suffering from serious health problems and overweight patients that are not used to exercise, please start slowly without hand weights but try to make a daily habit of doing what you can within your comfort zone.

Do not use hand weights without conferring with me if you have any problems with your arms, for example, rotator cuff tares, tendonitis, joint pain or restrictive range of motion. Once these problems are largely alleviated, these exercises can be therapeutic but can aggravate preexisting inflammation or injury. Once you have acclimated to the program, you should be much less vulnerable to these types of injuries. If you are injured, please stop the potion of the program that affects the injured area. If you are unable to resume within two weeks, it’s probably time to see me or another medical professional for assistance.

Make health a habit, you won’t be sorry.

Dennis R Tucker, PhD, LAc