Words of Wisdom - Best Practice for Best Results

Greet 2017 by getting fit and getting healthy – your future self will thank you for it. We sat down with Dr. Russ Petrie and Karri L. Knodel, MPAS, PA-C, ATC, for a Q & A discussion on exercising routines and habits.

Words of Wisdom – Best Practice for Best Results

The biggest roadblock for most exercisers isn't what exercises they do or don't do, it's whether or not they are consistent. So how often should people ideally work out per week based on their goals--be they to lose weight, build muscle, improve their heart health, etc? Let's lay out how often people need to work out for the results they want, and why.

"150 minutes per week of moderate exercise or 75 minutes per week of vigorous exercise" is a general recommendation regarding physical activity, but what sort of "results" come with this much activity? Improved heart health? General reduction of chronic disease?

• The American College of Sports Medicine has performed an extensive review of the literature, and it is well-documented that regular physical activity can decrease blood glucose, delay the onset of type II diabetes, improve blood lipids (cholesterol), lower blood pressure, and decrease overall cardiovascular events, such as heart attack. Type II diabetes has become a national epidemic, and combining weight loss with routine physical activity has been shown to decrease the risk of type II diabetes by as much as 58%. Regular physical activity has also been shown to improve the quality of life in our patients suffering from depression, as well as chronic pain syndromes such as fibromyalgia. Regular exercise additionally has been shown to improve sleep, mood and even improve or retard cognitive.

Why is consistency important when it comes to getting the most out of exercise? Both in terms of overall health and skeletal muscle hypertrophy?

• Consistency is important because the musculoskeletal system is generally an adaptive system, meaning the strength of our tissues changes in direct response to the forces placed upon them, both positively and negatively. As in skeletal muscle hypertrophy, the size of our muscle fibers increases in response to the volume of exercise so that the muscle may be better equipped to handle that same volume in the future. Unfortunately the opposite is true, as well. Consistent exercises results in building upon previous exercise. When someone stops exercising their body returns to a decondtioned (i.e. a weaker state). In general it takes longer to recondition (i.e. get into “shape”) than it takes to decondition.

Similarly, why is it important not just to consider the number of weekly minutes spent exercising, but also the number of workout days per week?

• For the same reasons as stated above.The biggest mistake many of our patients face is treating an exercise program as a finite event, meaning there is an end in sight. Adopting exercise as a permanent lifestyle change is most effective when it is incorporated as a daily or near-daily routine, rather than the "weekend-warrior" mentality. Seven one hour episodes of exercise per week is likely better than one seven episode per week.

How many days should people perform structured exercise per week for the following goals:

• Fat loss: 30 minutes or more of moderate cardiovascular exercise at least 5 days per week with resistance training 2-3 times per week
• Muscle gain: resistance training 3-4 times per week
• Overall health: same as fat loss

What recommendations would you give people on how to gradually increase their weekly exercise frequency?

• Start in bouts of 10 minutes, and use the Rate of Perceived Exertion (RPE) scale, which is an easy, subjective way to quantify exercise intensity on a scale of 0-10. Start with an RPE of 2-3. Once you can complete 30 consecutive minutes, increase to an RPE of 4. Generally speaking, during an RPE of 4 you should be able to hold a simple conversation with short sentences without getting out of breath.

Finally, how many workout days are too many? And how can people structure their workout days to make sure that they are getting the most out of every workout and not overtraining?

• The most important thing we recommend is to listen to your body. During an exercise program, rest is an important part of the adaptive system. We must allow our bodies the opportunity to respond and repair in response to the stresses we've placed on them. Rest days are a great opportunity to work on flexibility and balance. Exercising for two to three days with a rest day between can be quite effective. Additionally, it is important to work different parts of your body. For example alternating between swimming and cycling. Working arms and upper body one day and legs the next day. Also, alternating between weightlifting activity and aerobic activity and flexibility activity, helps avoid over stressing any one body part. This can help reduce injury. As we age our bodies take longer to adapt to physical activity so the alternating activities and the interval for rest should change. Impact activities can be damaging on joints over time.

U.S. News & World Report recently penned a piece on this topic as well, featuring insights from Dr. Russ Petrie. Read it here