exercise for the non-exercisers
To exercise or not should be a no-brainer. There is sufficient evidence from scientific research that exercise can prevent non-communicable diseases like cancer, heart disease, depression, and more. In light of the current pandemic and our “new normal” way of life, not only can exercise make recovery from COVID-19 easier, but also prevent the onset of “post-covid syndrome” which could entail easy fatigability, shortness of breath, unexplained joint pain, cough and chest pain. Not to forget, post-lockdown syndrome, that those of us who are stuck at home without social interaction will face – low grade depression, anxiety, stress, unexplained aches and pains.
Important to keep in mind however, that just like you can’t have mac and cheese without cheese, you simply should not exercise without the right amount of sleep, recovery, hydration, an adequate diet and mental and emotional well-being.
That sentence is heavily loaded because sadly, how do work-horses like ourselves find time for self-care?
I hate exercising. I don’t know where to begin? What do I start with? How much can I exercise without leading to repetitive stress injuries? I was trying to increase my running mileage but I injured my knee. I’ve started playing golf, now my shoulder hurts. My back hurts from sitting for too long, what should I do? I wake up with a stiff neck, help. Why do I feel sore the day after I exercise?
As a physiotherapist, my simple answer to all your questions is.
‘Your exercise supply is inadequate for your body’s demands’.
But if I delve more into detail, I uncover that most of us set unrealistic, unattainable goals that are not customized to our liking, leading us to give up halfway. Does that sound all too familiar?
In competitive sport, training can be divided into 3 phases – conditioning, transitional and competition. Simply put, the athlete is taken through each rung of training - periodization, specificity, overload and individuality in order to adequately meet the demands of the sport.
Similarly, we all have an envelope of function – a representation of our tissues ability to deal with load. To simplify it further, load exceeding or falling short of that envelope can lead to injury or the perception of injury. This envelope is not just influenced by physical factors but also intrinsic and extrinsic factors. Think about it - does your neck hurt when you’re sitting for 10 minutes or after hours of sitting in a prolonged position?
So if we put together the principles of training in competitive sport and our envelope of function; we can safely construct our bodies’ thresholds to injury. Not all of us need to exercise, we all just need to be physically conditioned for the lives we lead.
Our focus should be on getting an equal balance of different types of training vis-à-vis aerobic and anaerobic endurance, weight, and plyometric and technique into our routines.
For those of you who find it hard enough as it is to find time for exercising, this may seem grossly absurd but let us break it down into 4 steps.
Step 1: Identify your “sport” or activity you love to do
For example: Spinning, running, tennis, golf, weight lifting, soccer, skiing, snowboarding, swimming, etc.
Step 2: Identify your training loopholes
For example: I love to run and I get 5 runs in a week but I don’t really do any strengthening?
I love to lift weights but I don’t spend any time on cardio.
I hate to exercise in general but I don’t mind spinning, I just don’t know where to start?
I love playing golf over the weekend but I don’t have time to work on my upper body strength.
Step 3: Set a realistic goal to overcome these loopholes
For example:
|
Runners |
Weekend warriors |
|
|
Day 1 |
Run |
5,000 steps |
|
Day 2 |
Rest |
Rest |
|
Day 3 |
Lower body strengthening |
5,000 steps |
|
Day 4 |
Run |
Rest |
|
Day 5 |
Run |
10,000 steps |
|
Day 6 |
Rest |
Strength training |
|
Day 7 |
Run |
Strength training |
Step 4: Gradually increase training volume and frequency
The word “gradual” is key. I get a ton of patients from bootcamps and HIIT classes who end up injuring themselves because they did too much too soon. The problem is not with the classes themselves; the problem is with the incorrect identification of our baseline thresholds.
And then, perhaps the patient who has lost faith in physical therapy because he has reached a plateau with strengthening or keeps reinjuring himself. His exercise program has simply not progressed adequately. He has been underloaded for too long.
The following plan is for people who want to start exercising but don’t know where to begin. For the rest of us who need help with training volume and progression, please see a professional who is aware of the basic principles of exercise programming but also takes into account your sleep, recovery, diet and mental well-being (All the factors that influence your envelope of function).
Insert following plan:
|
Day 1 |
Day 2 |
Day 3 |
Day 4 |
Day 5 |
Day 6 |
Day 7 |
|
|
Week 1 |
1k steps |
2k steps |
4k steps |
5k steps |
rest |
7k steps |
10k steps |
|
Week 2 |
2k steps 30 squats |
rest |
4k steps 30 squats |
rest |
6k steps 30 squats |
rest |
10k steps 30 squats |
|
Week 3 |
5k steps 10 squats 10 wall push-ups |
rest |
10k steps 5 squats 5 wall Push-ups |
rest |
10k steps 10 squats 10 wall-push ups |
rest |
rest |
|
Week 4 |
5k steps 10 squats 10 table push-ups 10 crunches |
rest |
10k steps 10 squats 10 table push-ups 10 crunches |
rest |
10k steps 10 squats 10 table push-ups 10 crunches |
rest |
10k steps 10 squats 10 table push-ups 10 crunches |
Cool Down: 10-15 minutes of yoga
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About Shraddha Bhatia, PT, DPT, OCS
Shraddha Bhatia, PT, DPT, OCS is the director of physical therapy at the concierge medical practice, The Health Center at Hudson Yards, an affiliate of the Mount Sinai Health System. She is an American Physical Therapy Association (APTA) granted Board-Certified Orthopedic Clinical Specialist, a certification attained by less than 8% of physical therapists’ in the country. Shraddha’s focus areas include but are not limited to pre/post-operative rehabilitation, sports rehabilitation, neck and back pain, rotator cuff injuries, labral tears, muscle strains, post-concussion syndrome, ACL rehabilitation and ankle/foot injuries. She works as a consultant for the USTA women’s pro circuit covering a few tournaments every year. She also provides pelvic floor rehabilitation for women with pelvic pain/urinary incontinence, diastasis recti and pre/post-natal care. She takes special interest in treating tennis players and the running population.
Shraddha is a graduate of New York University having previously completed her Bachelor’s degree from Mumbai, India. She is certified to treat low back pain from the McKenzie Institute. She is an active member of the New York chapter of the APTA.
In her free time, she likes to practice yoga, play tennis or take dance lessons.
About The Health Center at Hudson Yards
The Health Center is a state-of-the-art membership-based health care facility located at 55 Hudson Yards with an integrated care team specializing in primary and urgent care, physical therapy, behavioral health, dermatology, gynecology, pulmonology, and more.
Sources:
https://enhancephysiotherapyaw.com.au/2017/10/12/the-envelope-of-function/
https://www.richmondrehab.com.au/blog/physiotherapy/the-envelope-of-function
Clinical Sports Medicine – Karim Khan and Peter Bukner 5th Edition.
To learn more about The Health Center at Hudson Yards or to register at a discount, visit www.healthcenterhudsonyards.com. For questions on membership or insurance, email membership@healthcenterhudsonyards.com or call 646.819.5100, ext 1.
