There is always a reason not to exercise. Being dedicated to exercise and staying healthy is extremely hard. For starters, it takes time to exercise, and the payoff of exercise is not immediate. Often, doing the necessary workouts seems to hurt. However, after getting into the routine, suddenly one realizes they hurt less. Everyone does need to exercise just to maintain a healthy body. When one has a chronic condition, it becomes more work, but it is also more important just to keep everything working in the best possible shape.
As a pain doctor, I often preach about exercising. It is one of the most important aspects of pain treatment. It is written about in most textbooks on pain. I used to talk about it less, but after having more problems with my own back, and seeing the effect on others who took exercise seriously, I began to be more vocal. The first step is committing to your health and to exercise. This means that you have to be dedicated to meeting a definite exercise goal and have a means to monitor whether you met the goal. A starting goal would be those by the American Heart Association for physical activity in adults. They include moderate to intense aerobic activity for 30 minutes, 5 days a week. Better, would be 25 minutes vigorous activity 3 days and moderate muscle strengthening 2 days a week.
What Counts as Exercise?
To count as exercise, it should be outside the realm of the activity that is being done for your employment. The reason is physical activity has a direct positive affect on the brain; maximize this by not distracting it from possible negative thoughts about work. One should also keep track of your exercise to see if you are meeting your goals. A fitness tracker, such as an app on your smartphone or a Fitbit, keeps one honest on whether you are meeting your goals.
I have had problems with low back pain. My lumbar spine has one very bad disc and severe spinal stenosis with pinching of the nerve roots. Once I became serious with a good exercise routine, management of my back pain improved. It is not easy to be consistent, but the reduced pain and better sleep is worth it. To get my exercise done, I need to do it before work, at the beginning of the day. Fortunately, I am a morning person, but I am awake before 5 a.m. to get it done. My goal daily is at least 30 minutes of moderate activity and 10,000 steps on my tracker.
The exercise routine I follow is during the week is 3 days of intense core and whole body strengthening with 2 days lighter core strengthening and intense aerobic activity. I exercise for about 45 minutes, combining strength and aerobic routines. On the weekends, one day usually I do a full strengthening routine with a full aerobic workout; the other day is light core and aerobic exercise. Every day I will do core strengthening, usually 10-20 minutes, with rubber tubing and floor exercise. Core exercises have greatly decreased the low back and leg pain, making it minimal most of the time. Aerobic conditioning keeps the overall endurance adequate to be active throughout the day.
If one wants to be healthy, one has to do the work to keep healthy. There is no free ride, not even for the doctor. There are sacrifices to be made to stay healthy, like getting up early in the morning. The pay off, less need to complain about your pain, fatigue, and health.
Thomas Cohn, MD
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