Activity & exercise - what’s the difference and how to make ‘exercise’ work for you.
As an osteopath, I’m interested in how my patients use their body both at work & at home so that I can better understand how what they do, how they move, how they hold themselves, what they lift etc may be contributing to whatever it is they have come to see me about. It’s as important for me to know if you do knitting, watch-making, DIY or cleaning, gardening, hours of computer use, lots of sitting etc as it is to know that you go the gym daily or compete in triathlons.
Often in a consultation when I ask a patient what ‘activity’ they do, they think I mean ‘exercise’ ie “activity requiring physical effort, carried out to sustain or improve health and fitness” and many obviously feel awkward when they say they don’t do any! So that’s often the first area to explore in detail - it’s not about what you don’t do, it’s what you do, do repetitively and find difficult to do because of pain or restriction that will help me to help you with your problem.
Knowing what ‘activity’ you do guides my assessment of the way your body works - I may ask you to sit if your pain is with sitting or getting up from a chair, or walk or stand or bend, or replicate any other position where the pain occurs to give me and idea of what may be contributing to it - whether that’s a local problem or perhaps something elsewhere in the body (eg a limitation of movement in another joint, muscular tension from repetitive use or emotional tension affecting the way you breathe or hold yourself).
Often patients I treat are people that are ‘inactive’ - they don’t do much in the way of ‘exercise’ as defined above and they may not do much general activity either for various reasons - time poor due to a busy life (work, children, caring responsibilities); not in the habit of exercising or not confident or keen on going to the gym for example; concerned about the impact of exercise on their pain (anyone). So there can be lots of reasons why people find it difficult to get more active, but there are also lots of important reasons to do so, not least that the evidence is that the more active you are, the less pain you’ll be in and the lower your risk for chronic diseases such as heart disease, cancer, Alzheimers & many others.
So one of the key things I focus on as an osteopath when encouraging patients to be more active (because osteopathy is not just about giving physical treatment, but about supporting patients to be healthy) is that it’s really important to find an exercise that ‘works for you’. To show you what I mean, it’s probably easiest to give you an illustration using myself as the example!
My motivation is that I’d like to be fitter - I have a few health reasons for wanting to increase my physical fitness particularly my cardio-vascular fitness and also I like to have strategies to manage the stresses in my life and keep my mental fitness good too. In fact, as an osteopath I’m professionally obliged to make sure that I take care of myself and if I consider my physical or mental health potentially impacts on my ability to see and treat patients, to report myself to my regulator, the General Osteopathic Council.
My reasons for finding it difficult to get fitter are both practical and mental - for example, II find going to the gym really difficult to sustain because I find it boring; I don’t like swimming (poor swimmer, hate chlorine). I like Pilates & Yoga and they’re fantastic exercises but most of the classes I would like to go to are at a time of day that doesn’t work for me (mostly during the day when I’m working or in the evening when I like to be at home to eat dinner) or a they’re at a location that means too much time travelling or that cuts across work or family commitments. I’ve done a lot of Tai Chi & Chi Qong in the past, but there’s only one class locally and again, it’s not at a time that suits my routine.
I do one class a week which is Bellydance, which is fantastic - it works for me physically (I get a lot of what I’ve got before from Yoga & Chi Qong from it) and it works for me mentally - it’s great fun and social with a group of lovely ladies; there’s a memory element to it (learning the dances our teacher choreographs) and there’s a creative element to it (I’ve done a couple of dances with a friend in our end of term shows and I plan to do a solo this year). It’s at a difficult time for me (it takes a big chunk out of one of my working days) but I get so much from it that it’s worth me making the effort to go.
However one class a week is not really enough for me to get fitter, so I had to think about how I could fit an activity in that would give me ‘exercise’ physically but meet what I need mentally and be practical. The solution I’ve come up with is to walk twice a week (early on a Monday morning, so starting work a bit later) and early on a Friday (my day off).
The walk is from my house on the Isle of Portland out to the cliffs and the sea, down a flight of 150 steps (the down bit is easy!) then back up again - about 30 minutes in total with the steps back up being a higher intensity cardiovascular exercise. It’s never boring - the sky, the sea, the beach, the birds, the people I say hello to on the way are always different. I love being in nature, I’m always happiest there (and again, there’s a lot of evidence to suggest that being ‘in nature’ or ‘greenbathing’ enhances our mental wellbeing, so it’s something we all should be doing).
I can vary the walk if I want to - there are lots of alternative paths so I can for example do a ‘scramble’ to get back up to give some upper body workout as well as legs; or I can take a different route. But I can also measure progress by timing how long it takes me to come up the 150 steps every couple of weeks or so - I’ve cut about 20s off my time and I can do it in one go, compared with one stop on the way up when I started 4 weeks ago.
As an extra bit of mental health ‘exercise’, between the down & the up, I sit for 5 to 10 minutes on the beach, just breathing & listening to the sea with my eyes shut as a form of meditation/mindfulness/being in the moment - wonderfully calming & it sets me up for the whole day. So on every level, this walk exercise ‘works’ for me - mentally first & physically second; so much so that I’m think to try to add in another day on Wednesday, because it feels like such a long time between Monday & Friday!
I periodically video my walks (or a part of them) & I also record my meditation time which gives different video/soundscapes which I use in the clinic as my screensaver & which you can use if you would like to, in order to give yourself a bit of ‘time out’ or stress reduction - you can find my videos on my YouTube channel https://www.youtube.com/channel/UCC2Bp–qQoZs58AgTAyyIrg and some of my photographs on my Instagram page https://www.instagram.com/jurassiccoastosteopathy/.
So if you come to me as a patient, firstly you’ll understand that when I’m asking about activity, I don’t just mean exercise; and if we do talk about how you want to get more active by doing exercise, I’ll work with you to find something that suits you both mentally & physically so you can sustain it and really reap the benefits.