Finding a Balanced Exercise Routine

Brian Gould, DO

With the holidays just around the corner maybe if us are thinking about how to prevent the extra pounds the holidays frequently bring. One great way to maintain, or even drop a few pounds is starting an exercise routine. It’s important to recognize the overall physical and mental benefits of exercise—and how best to start a new routine while minimizing risk of injury.

The benefits of regular exercise are almost endless. Even moderate activity has been shown to increase muscle mass, enhance immune system efficacy and decrease the risk of infection. For people with diabetes, regular exercise helps to regulate blood sugar more effectively and can reduce the need for medication; for people with depression or other mental health disorders, regular exercise can help regulate mood; and for pre- and post-menopausal women, exercise can reduce the onset of bone demineralization and osteoporosis.

Even people living a sedentary lifestyle can achieve healthy results from regular physical activity. A well-designed study of first-time marathon runners published in the Journal of the American College of Cardiology showed that “training for and completing a marathon even at relatively low exercise intensity reduces central blood pressure and aortic stiffness—equivalent to a ∼4-year reduction in vascular age.” In essence, this study shows what we’ve known for a while, that any sort of moderate activity over a couple of months decreases vasculature rigidity, which in turn reduces the risk of coronary artery disease and other heart disorders.

The American College of Sports Medicine and the U.S. Centers for Disease Control and Prevention recommend people follow a two-fold approach to regular exercise: (1) engage in moderate intensity physical activity for a minimum of 30 minutes at least five days a week, and (2) engage in some sort of activity to maintain or increase muscular strength and endurance at least twice a week. Although most of us certainly understand the first component of needing to move our bodies regularly, many of my patients don't fully understand the second component, keeping our bodies strong.

Weight training actually has more of an effect on blood sugar regulation than cardiovascular exercise; it helps to build muscle as it increases your basal metabolic rate (the amount of energy to maintain your body), so you burn more calories on a daily basis without increased effort. Strength training helps the body utilize and store blood sugar in a more efficient way, providing an important tool for controlling (or avoiding) disorders such as diabetes.

Weight-bearing exercises also help to decrease demineralization and bone thinning. We generally stop building bones in our late teens or early 20’s, then the slow, gradual decline in bone mineralization start to speed up and left unchecked, can potentially lead to osteoporosis. That's why I recommend some degree of weight bearing activity to individuals over the age of 40 to help prevent things like hip fractures and falls. It’s important to note that even walking or gentle lifting can be considered weight-bearing—the key is simply regular resistance that causes the muscles to work.

When starting a new routine, it’s important to understand that exercise is not a quick fix. Many people dive into a new workout routine and either burn themselves out or succumb to injury. I recommend that people go slowly and develop sustainable exercise routines that maximize the benefits while minimizing the risk of injury. A good rule of thumb for cardiovascular and aerobic exercise is that you should be able to carry on a conversation but not be able to sing a song. You want to be able to talk without losing your breath but be breathing hard enough to prohibit you from singing your favorite tune. It is also important to rest and give your body time to recover. There should be a day a week without vigorous activity. This is a good day to focus on flexibility. Stretching is good to do every day but having a day where you spend 2-60 minutes on flexibility can go a long way in injury prevention and preventing chronic pain.

Lastly, it's important to understand the difference between soreness and injury. Many people who begin a new exercise regimen feel tender and sore a few days after the first workout. This is perfectly normal, but it causes people to think they’re injured so they stop working out altogether. In fact, the soreness is a good thing; it shows that the body is working properly and you are making positive changes to your muscles. Over time, the muscles will get used to whatever the activity is, and that soreness will eventually go away.

So, start simple. Make goals. Long-term goals are great, but when first getting started, keep the goals short and attainable, like walking four times throughout the week. As time goes on, the body will acclimate, and long-term goals will start to become clearer. The important thing is to keep at it and keep it sustainable.