In general, I will say that movement is good. For example, if all you can do is walk 20 minutes a day at lunch, then that is better than not exercising at all. However, in my experience, I have heard a lot of excuses or false reasonings on why someone having a musculoskeletal problem doesn’t need advice on exercise.
- “I don’t need to work out because I work hard at my job.” Exercise is different than work. At work, you are focused on completing a task. You don’t have the time to focus on how you move or what muscles you are using. Exercise is when you can focus on yourself, how you move, and what muscles you are using.
- “I don’t have time to workout.” The American College of Sports Medicine recommends 1.5 hours of exercise a week. There are 168 hours in a week. That is less than 1% of hours available in a week. This is the equivalent of a little over 20 minutes a day. That could be a lunch break at work, before work (my preference), or a family walk after dinner.
- “I can’t afford a gym membership.” Did cavemen have a gym? No. I am a huge believer that exercise should be accessible to everyone. That is why I design exercises that can be done without extensive exercise equipment. Walking and running is free. So are pushups, burpees, step-ups, etc. In fact, if you have a chair, you can exercise most major muscle groups with this article.
- “Exercise machines are better and safer.” This myth came out of the thought that exercise machines can isolate muscle groups are strengthen them more efficiently without increasing your risk of injury. In fact, most experts now propose functional exercise (exercise that emulates the way that we move in real life) because we do not do tasks with a single muscle group. We need to train muscle groups to work together so that when we do a demanding activity in real life, the muscles have “seen” this similar movement during exercise and can say “oh yeah, I know how to do this”, and get the job done. Also, exercise machines do not decrease the risk of injury. In fact, many machine exercises put the person in a sitting position which is known to put excessive stress on the spine and increase your risk of injury.
- “NO PAIN, NO GAIN!” THIS IS THE WORST! This myth comes from the idea that it must hurt to break down muscles in order to build stronger muscle. First, although exercising muscle to fatigue can accelerate the build up of new muscle, given adequate recovery time, however, pain is not the same thing as fatigue. I know of no research that shows pain is needed to build muscle. Second, this gives the exerciser the false expectation that they must feel pain in order to get stronger. In fact, pain can be a warning sign that you are injuring tissue, like a disc in your spine; and when patients are new to exercise, they are often times afraid of pain (who isn’t?) and so hearing this oft quoted phrase scares them away from the much need rehabilitative exercise program that will help them, ironically, out of their pain.
- “Physical therapy doesn’t work for me.” This myth often comes from past experiences when patients have experienced physical therapy only involving electrical stimulation, TENs stimulation, therapeutic ultrasound, heat packs, ice packs, etc. This feels good temporarily but wears off after you remove the treatment. We call this “Shake & Bake” shops. None of these treatments do anything for chronic low back pain and if a clinic is only offering this, that is a warning sign that you need to find a new clinic. Physical therapy is great for showing a patient how to start an exercise program that works on increasing your flexibility and strength, without increasing pain. If you have difficulty, they can show you ways to personalize exercises for you. They may utilize some modalities (listed above), along with massage, manipulation, traction, etc, but all this is geared towards helping you tolerated rehabilitation exercise. In short, who treats you is more important than what they treat you with.
- “Just give me a list of exercises to do.” For the most part, no exercise program is dramatically better than another, especially today when there are so many options: pilates, yoga, CrossFit, P90X, Zumba, etc. Research shows that none of these programs are more risky at causing injury than another program. However, I view exercise programs as tools. Some tools work better for some jobs than others. Furthermore, not all exercise programs are good for everyone. For example, when you have an injury, you need to find the right exercise that works for you; this often takes some trial and error to find an exercise that targets the right muscles without causing pain (see #5). That is why a standard exercise sheet doesn’t work, especially in people recovering from an injury.
Well, that is enough ranting for now.
Valley Sports & Spine Clinic
Giving you Back your Life
Dr Ethan Colliver