New to Exercise? Here's How to Start.

A few weeks ago we heard from Debbi Omizo Banis from Body Resolution who gave us some awesome advice about muscle imbalances and maintaining motivation to exercise. Now we will hear from my long time friends Sarah and Craig Smith. This physical therapist couple speaks to those of you starting a new workout routine and looking for some guidance.New To Exercise? Here’s Where to Start.Tell us a little about what you do and the types of people that you work with.Sarah: I practice physical therapy at Carondelet St. Joseph’s Hospital inpatient rehabilitation unit. I also work in the aquatic therapy department, and women’s health department. I work with both orthopedic and neurological conditions, seeing many people with joint replacements or spine surgeries/injuries, people who have sustained strokes or traumatic brain injuries, as well as people with amputations.Craig: I am a physical therapist at Proactive Physical Therapy, an orthopedic outpatient clinic. My patients normally have pain caused by injury to the muscles or joints and I use manual therapy combined with therapeutic exercises and motor control training to return them to their prior level of function. I am also a researcher investigating injury screening and prevention in athletes.What is your exercise philosophy?Set yourself up for success. Find something you enjoy and do not start with an overwhelming goal or regimen. Many people who decide to start on a workout routine make the mistake of thinking they have to start with something like 6 days a week for an hour every day. This is too much of a life adjustment, and you risk injuring yourself from overwhelming your body. The willpower that is needed to accomplish activities is not infinite. Willpower by Roy Baumeister details this concept. If exercise is not a habit, every time you force yourself to go workout, you are using the finite source of willpower. By taking small steps, the ‘drain’ is limited. Once the exercise is formed into a habit, the drain on willpower subsides and more willpower can be applied elsewhere.Here are our recommendations:

1. Start with achievable goals and do not increase the amount until you are ready. Try for 2-3 times a week for 30 minutes each. The World Health Organization recommends 75-150 minutes of moderate intensity exercise per week. If you are new to exercise this is an achievable goal to work towards slowly.
2. Once this gets easy, bring in an additional day, or increase the duration of your workouts.
3. Enjoy the process and experience as much as you can until you find something you are passionate about, and want to improve on over time.

What is the best workout someone short on time could do?Body weight exercises are this is a great way to start. No weights, no equipment, just your own body. Focus on functional exercises that target the back and side of your hips such as your glutes core strength, upper back exercises. That being said, no one body is the same. To find out what is best for you, visit a physical therapist for an evaluation. They can determine your individual deficits and any impairment that you need to focus your exercises towards. This is crucial if you already have pain or discomfort with activity.What is the best workout someone new to exercise could do?Any workout that does not cause an injury is best for people new to exercise. There is an overwhelming amount of exercise videos and advice on the internet. People advocate strongly for running while others push lifting heavy weights. However, these are not the best places to begin, as the risk for injury is high with these types of intense workouts. Our recommendation is to begin at a level that is challenging but not injurious.Sarah: The population that I work with is primarily over 65 years old. Many of them have never had an exercise routine. However, it is never too late to start, and the sooner you get started, the better your chances are of avoiding chronic pain or injury.One of the most common deficits that I find is lack of balance control. I can’t tell you how often I hear someone say, “My balance has never been good.” To prevent falls and major injuries, attention to balance should be a part of your regular exercise routine.Craig: As part of my practice, I often perform comprehensive running evaluations. During a run, you take thousands of steps with 2-3 times your body weight driving through your legs, knees and feet. There is a large risk for injury for those new to running and coupled with my exposure to many runners with a wide range of running abilities I am leery of recommending running as a part of a new exercise routine. My suggestion would be to add walking or hiking to allow for a safer mode of exercise. If running is your goal, come meet with me first and have your gait analyzed. The worst thing to do when beginning an exercise routine is to get hurt and not be able to continue.What are the biggest challenges we face to achieving excellent physical fitness/health? People get discouraged when they don’t see immediate results with exercise, specifically weight loss. Instead, focus on the positive way you feel after you exercise or the health benefits of exercise. If you refocus your motivation, you are more likely to stay engaged.Time is also a big challenge. Life is busy and to avoid compromising your exercise routine, exercise has to be a priority. You have only one body; treat it with respect and know that it is worth the time.What is the best way to fall in love with working out?Try as many different forms of exercise that you can, then pick 3 to 4 that you absolutely love. The more that you find that you like, the more likely you are to work out.. Set goals for these forms of exercise. Whether that is improving time, increasing weight or repetitions, entering competitions and placing higher in your age group, distances accomplished, or decreasing amount of rest breaks needed.Also, find someone or a group that you can exercise with; someone that will keep you focused on your goals, and keep you honest when working towards these goals. You are less likely to miss a workout if someone is waiting for you.What are some of the most important reasons to exercise regularly?This is a difficult question to answer, as there are numerous health reasons to exercise regularly. Here are just few:

• High without drugs - We are ‘wired to run’ according to a study by Raichlen et al (Raichlen 2012). These authors found that we receive a neurobiological reward for running.
• Strength and flexibility - As physical therapists, we see this everyday in our work with people. If you work out at a level you can handle and remain consistent, you will see improvement in your overall strength and ability to move.
• Injury prevention - Specific exercises targeted at posture, motor control, endurance, and strength reduce the likelihood of injury during exercise, at work or at home.
• Brain health and memory - Exercise induces growth of the nerves in the brain. This is powerful and relatively new development shows older adults can slow the progression of cognitive decline (Yau 2014).
• Bone density - Osteoporosis and Osteopenia are diseases in which the bones become brittle. Loading through lifting or walking has been shown to halt and even reverse the loss of bone density (Todd and Robinson 2003).
• Quality of life and sleep - The argument could be made that it is impossible to be happy without good sleep and exercise improves sleep quality. A study by King et al. found that a 16 week exercise intervention group versus a wait-list controlled group showed significant improvements in all self rated sleep values (King 1997).
• Stress relieving - In a book, Why Zebra’s Don’t Get Ulcers, the author Robert Sapolsky made the case that too much or too little exercise has negative effects on the body. A consistent and moderate approach to exercise is a better way to go and has positive effects on mental health.

Thanks Sarah and Craig!