Movement: It’s What’s for Dinner

Stephan Esser MD, USPTA

Health is an Experience!

Who am I?

Tenets of Health•Plant Based Diet•Exercise•Sleep•Emotional Poise•Sunlight•Clean Water and Air

Tenets of Health•Plant Based Diet•Exercise•Sleep•Emotional Poise•Sunlight•Clean Water and Air

• Motion is Lotion

• No Pain No Gain

• Use it or Lose it

Why one and not the other?

• We figure one “extreme” is enough

• We doubt the innate value of exercise

• We lack the knowledge

• We have the same excuses as others

– Time, cost, location, discomfort, previous injury

• What is it for you?

Goals

• Explore the facts– Exercise is the 2nd pillar of good health

– Exercise is not some extreme fad

– Exercise is:

• Empowering

• Preventive

• Treatment

Goals

• You CAN be more active

• You CAN improve your:– Speed, strength, CV health, flexibility, balance– Function– Quality of Life

“Eating alone will not keep a man well; he must also take exercise. For food and exercise……

work together to produce health.”Hippocrates

Regimen 400 BC

A brief history of exercise

Ancient Awareness

• Early observations – Hippocrates (460-370 B.C.)• “if we could give every individual the right amount of

nourishment and exercise, not too little and not too much, we would have found the safest way to health”

– Cornelius Celsus (ca.10-60)• “take exercise: for whilst inaction weakens the body,

work strengthens it; the former brings on premature old age, the latter prolongs youth”

• Those who Exercise • Those who don’t

Defining Exercise

• Exercise:–movement of the body resulting in the

enhancement of health and improvement of function

Movement

• Leisure time Exercise: organized sports, running, gym activities, rehabilitation etc.

• Lifestyle Exercise: activity incorporated into our daily pattern of life – eg: parking in the distant portion of the parking lot rather then the first

bumper, taking the stairs instead of the elevator etc.

Forms of Exercise• Cardiovascular

• Strength/Resistance Training

• Core Stability/Balance

• Flexibility/Coordination

• The Power of Exercise

Exercise and Physical Health• Reduces risk of

– Heart Disease ≈ 40%– Obesity: ≈ 30-100%– Stroke ≈ 50%– Type 2 Diabetes ≈ 50%– Hypertension ≈ 50%– Disability delayed ≈15 years– Colon Cancer ≈ 25-40%– Breast Cancer ≈ 20%-44%– Osteoporosis ≈ 20+%

• As many as 250,000 deaths per year in the United States are attributable to a lack of regular physical activity

Physical Health Cont’d

• Improve Balance• Reduce Fall risk• Improve Systemic Circulation• Accelerate Skin Healing• Bowel Regularity• Improved Energy/Resilience

Exercise and Mental Health

• Regular Exercise:– Reduces risk of:

• Depression• Anxiety• ADD/ADHD• Alzheimers Dementia

– Improves:• Mental Clarity, test scores, focus

Motion is Lotion

If…then

• If………– Having Adventures counts– Playing with children/grandchildren– Competing in a sport– Recreational activities: Sight seeing, Bird

watching, Hiking etc– Your figure matters– Your sexual life matters– Preventing/Managing/Reversing common

diseases

Then Exercise Should be part of your life

Then Exercise Should be part of your life

My Meal

?

Perceived Complexities

• Can I safely Exercise?

• Will I injure myself?

• What kind of exercise should I pursue?

• Do I need to do weights, Cardio, flexibility

• How do I exercise? What is correct form?

• Should I hire a trainer, a heart monitor etc?

SimpleMinimal CostOne step screenValidated

“I exercised once, but found I was allergic to it. My skin flushed

and my heart raced. I got sweaty and short of

breath……… Very dangerous.”

“I exercised once, but found I was allergic to it. My skin flushed

and my heart raced. I got sweaty and short of

breath……… Very dangerous.”

What Kind of Exercise Should I Pursue?

GROW

• Goals

• Reality today

• Options

•Will

Present Recommendations

• Cardiovascular:

– 150 minutes of moderate-intensity exercise per week.

Present Recommendations

• Resistance Training:

– 2-3 days per week

– All major muscle groups

– 2-4 sets of each exercise

– 48 hours in between sessions

Present Recommendations

• Flexibility:– 2-3 days/week to improve range of motion

• Balance:– 2-3 days/week

GROW

• Goals

• Reality today

• Options

•Will

• Resources

People• Structured:– Doctors: MD, DO, ND, DC, AP, DOM etc– Physical Therapists– Training: Personal Trainers/Group Classes– Life Coaches etc

• Unstructured:– Friends/Family– Work-Out Buddy

Places

• Parks• Gyms• Country Clubs• Lakes• Oceans• Your House:– Backyard/Frontyard/Garage/Living Room etc

• ANYWHERE and EVERYWHERE

Electronics

• Online Apps• Pedometers/Accelerometer• Jaw Bone• Fit Bit• Fit Bug• Nike Fuel

Stuff

To Do • Identify Goals

• Target Exercise to help achieve these

• Use your resources to increase likelihood of success

• Re-evaluate

Use it or Lose it

Aging

• CV: C0 by 20-30% by 65

• Resp: FVC by 40-50% by 70

• Muscle: 30% Strength 40% Muscle by 70

• Bone: 1% per yr after 35

• Connective: Nerves slow, lose elasticity

So we

are all

falling apart!

Disuse

• Bedrest:

– BMD, increased bone resorption– muscle mass and strength– muscle fiber size– fatty infiltration of muscle–Impaired O2 exchange– Cardiac function, efficiency

 

“A review of biologic changes commonly attributed to the process of aging

demonstrates the close similarity of most of these to changes subsequent to 

a period of enforced physical inactivity………………a portion of the 

changes that are commonly attributed to aging are in reality caused by disuse and, as such, are subject to correction.

There is no drug in current or prospective use that holds as much promise for

sustained health as a lifetime program of physical exercise.”(JAMA 1982;248:1203-1208)

Walter Bortz MD

Disuse and Aging

• “You have to work at living, period. You’ve got to train like you are training for an athletic event. Most older people just give up. They think, “I’m too old for that,” because they have an ache here or a pain there. Life is a pain in the butt; you’ve got to work at it.”

Jack LaLanne

No Pain, No Gain

Depends

Not good pain

• Chest Pain• Joint Pain• Pain that radiates• Pain associated with neurologic changes• Pain with swelling• Pain that fails to improve with appropriate

measures• Pain that compromises other systems function

“Good Pain”

• Muscle “pain” while exercising

• Muscle soreness 1-2 days after exercise

• Moderately labored breathing during activity

• The opposite of the other page

Stages of Change (Prochaska and DiClemente)

1: Pre-contemplation

2: Contemplation

3: Preparation/planning

4: Action

5: Maintenance

6: Permanent Maintenance (Termination)

My Reasons to Exercise• Feel good in my skin• Increase energy, Reduce stress• Increase my confidence, discipline• Be a role model, socialize, family time• It’s fun, I love to sweat and work hard• I love challenges• Reduce disease risk• Lower disability risk• Maintain independence

What are your reasons?

My Reasons NOT to Exercise

• Time• I’m tired or lazy• Inconvenience (I forgot my clothes etc…)• Money (shoes, travel, racquets) • Other priorities• Hate Change• Don’t know what to do• I’m Injured

What are your reasons NOT to exercise?

Conclusion

In Conclusion

Motion is Lotion

Use it or Lose it

No Pain No Gain

“There’s a book, Profound Simplicity, that has nothing to do with health, but this is exactly

what “this is”—profound simplicity. It is profound in that it holds the truth in all its

splendor within itself and still it is so simple that unfortunately most people are

unimpressed by the truth.” Dr. Wil l iam Esser ND

NH Keynote Address 1980

Conclusion

• Exercise is powerful “medicine”– Prevention - Reversal– Management - Function

• Exercise should be a part of every health plan• Identify your Goals

– Confirm they are Reasonable/Sustainable

• Identify and harness your resources• Thrive

Thank You!Thank You!