"You need to exercise more."
"Sitting is the new smoking."
"Have you considered joining a gym?"
Many people who visit their healthcare professionals are familiar with these sayings. Very often physios, doctors, and personal trainers will repeat the same message over and over with little result. Many patients live with pain, poor health, fatigue, and other symptoms of a sedentary lifestyle and return year after year, visit after visit with no change. As healthcare professionals we get frustrated and patients become even more frustrated with their lack of progress.
We know the numbers on health and sedentary behaviour. In a study by the CDC in 2015, sedentary behaviour was responsible for 131 billion dollars in health care costs. A 2015 study by Dr. David Alter at the University of Toronto found that sitting for long periods can increase the risk of cardiovasular disease, cancer mortality, all cause mortality, and the risk of type 2 diabetes. So why aren't our patients changing?
A lot of people hear the quotes above and feel overwhelmed. It's easy to recommend exercise when you live an active lifestyle. But we forget that for those on the receiving end, who are not used to making activity a part of their day, the messages are dizzying. They want to move, they want to be pain free, they want health, but they don't know where to begin.
So here are few of principles to share with patients, and, if you are a patient, for you to internalize to make it easier to start the journey to better health and happiness.
1) Physical activity is anything that makes your body move
This can be: Gardening, walking, biking, pacing, jumping, swimming, yoga, household chores, recreational sports and the list goes on.
2) All you need is 150 minutes of moderate intensity movement per week
I know, I used the 'i' word. People hear the word intensity and want to run away. What is moderate intensity anyway?
It's as light and basic as: gardening, household chores, walking your pet, or carrying groceries (<20kg). There. That doesn't seem so bad right?
I know an office worker that managed to get his 150 minutes of moderate activity by printing documents on the farthest printing station from his desk, or pacing while on the phone. Any way you can sneak it in works. It does't have to be 150 minutes straight. It can be accumulated over 10 minute bouts. Just get your weekly minutes.
3) Movement shouldn't hurt
This is a big one. So many people are used to living with pain. They feel that it is their 'normal'. But movement shouldn't hurt. The no pain no gain principle is a dangerous one as all pain is not created equal. Find ways to move that are pain free. If you can't, or your pain is limiting your quality of life, go see your physiotherapist.
4) Less is more
Everyone knows that gym memberships and attendance increase in January. You know what else increases? Injuries. And the two are related. Some people are gung ho about becoming more active and take on more than their body is ready to handle. We have a fitness industry trying to convince us that fitness happens overnight. The ability to exercise, or, our work capacity, must be built up with time. When starting, start slow and increase duration, weight, distance, and speed carefully and gradually. Your physiotherapist is a movement expert and is a great place to start. The worst thing is someone ready to make a change having to wait due to an avoidable injury.
So there it is. Getting the health benefits of physical activity is easy. Ignore the people at the gym who seem like they slept in the squat rack, or the people you see jogging on the street. For many of them it is a lifestyle that they enjoy. Some people like woodworking, some people like movies, some people like running, cycling, and strength training.
Don't let the fitness industry fool you into thinking that the gymrats shall inherit the earth. If the goal is to be healthy and have less pain, start with the 150 minute principle, anything else is just gravy.