Exercise Is Crucial for a Longer, Healthier Life

Looking fit and running faster and longer are just small benefits compared with the real stakes involved in exercise, stresses Anne Z. Hoch, DO, Medical College of Wisconsin Associate Professor of Physical Medicine and Rehabilitation.

Exercising regularly is critical to warding off obesity and its frequent companions - conditions such as diabetes and heart problems that shorten your life span, says Dr. Hoch, who practices at the Froedtert & The Medical College of Wisconsin Sports Medicine Center.

With the stakes so high, every adult needs to recognize how regular exercise contributes to their health. "People know it intellectually, but don't make exercise a priority," Dr. Hoch notes. Only about 15% of US adults are engaging in a healthy level of regular exercise, recent studies show.

Getting Started
Along with making a commitment to exercise, it is also vital to assess one's medical condition and goals in devising the right exercise program and choosing the right regimen, including the optimal equipment.

Often, the hardest part is simply getting started. That's because people tend to set their initial expectations too high, says Dr. Hoch. "Start out doing things you're successful at, and stick to it," she says. "If you're trying to do too much, you're not going to be compliant with the program, so you need to start out gradually, and build up." For example, a brisk 30-minute walk each day will quickly start to produce cardiovascular, aerobic benefits.

Dr. Hoch suggests working toward a minimum goal of working out 20 to 60 minutes three days per week, as recommended by the American College of Sports Medicine. This would also include weight-lifting twice a week, working 10 muscle groups for at least one set of 10 repetitions.

Importance of Weight Training
The weight training component is not aimed primarily at men who want Arnold Schwarzenegger-sized biceps, but is especially important for women, who are more likely to have osteoporosis as they age. "Strength training is needed to counteract the normal decline in bone density that comes with age," Dr. Hoch says.

"Girls form their peak bone strength from ages 11 to 16, and hit their peak of bone density at 25," she notes. "So after that point, it's very important to continue working with weights because it is so vital in maintaining bone density."

For men, weight training similarly provides aerobic benefits and overall health, and strengthens the torso. "Building up the core's strength helps to prevent distal injuries such as ACL (anterior cruciate ligament) and patellofemoral pain (felt under and around the kneecap), " she notes.

For those getting started on weight training, Dr. Hoch recommends using the weight machines now widely available at gyms and fitness clubs. "You can gradually increase the weight on the machines when you're lifting and keep a close measure of how you're getting stronger."

Typically, there will be a notable difference in the amount of weight you can move during the first three weeks of using weight machines, simply because you're getting more familiar with the equipment. "This involves an increase in the neural drive that stimulates muscle contraction. But during weeks three through five, you will start to see actual muscle hypertrophy (expansion of muscle mass due to the growth of individual muscle cells)."

Developing strength in the body core helps to account for the increasing popularity of two very different physical disciplines, Pilates and yoga, says Dr. Hoch. "Pilates"-type exercises use equipment that causes very rapid movements, building torso strength and quickening reaction times. In contrast, yoga takes advantage of smooth, flowing movements. Both methods help develop flexibility and strength in the torso.

Precautions
Dr. Hoch has some important advice for those who are ready to begin an exercise program. First, consult your doctor if you have a chronic condition such as heart problems, arthritis, diabetes, high blood pressure, or Marfan's Syndrome, with the latter being especially important in children. Other warning signs that call for consulting a doctor are chest pains, dizziness, or fainting after exercise.

Second, avoid over-exercising, such as lifting weights for the same muscle groups every day. "Doing it daily really increases your injury risk," notes Dr. Hoch. "So if you like using weights every day, alternate upper-body exercises one day with lower-body exercises the next."

Exercise Equipment
A Medical College study evaluated several different exercise machines. "We asked, if you want to be aerobically active, which is the best machine?" Dr. Hoch explained. The results, with the best listed first:

1. Treadmill
2. Stairstepper
3. Rowing machine
4. NordicTrack
5. Aerodyne (A stationary bike with mobile arms for upper extremity strengthening, compared to a stationary bike that has only traditional leg cycling.)
6. Stationary cycle

For a workout with maximum aerobic benefits, exercise equipment needs to be selected with an eye to both developing strength and endurance in specific areas while taking into account the strains it may cause in other areas. For example, knee pain is a frequent side effect of both the treadmill and the Stairstepper. The rowing machine may bring on back pain. The NordicTrack (which simulates skiing motion) can produce hip pain. Knee and buttock pain can result from both the Aerodyne and static cycle.

"The most important thing is to find an activity you love, and keep at it. Realize you have to make exercise a priority, start out slowly, and try to make it social so other people are reinforcing you."

MCW Health News presents up-to-date information on patient care and medical research by the physicians of the Medical College of Wisconsin.