Ask the Doctor: How to Start Exercising

Learn some of the facts and myths about exercise to get the best results.

This week's question comes from Judy:

"I would like to start exercising on a regular basis, but I'm not sure what the best way to begin is. Cardio or weights?  How often?"

This question has no easy answer, but a lot of people ask this type of question and often get a variety of answers.  Any quick search on the internet on this topic will come back with confusing and conflicting information, some from reliable sources and some from not-so-reliable sources.  My answer to this question has developed through lots of research and years of my own personal experience - so some of it is a little biased.

There are a lot of factors when it comes to starting an exercise program including exercise and athletic history, injuries, weight and medical history.  As we've seen on shows like The Biggest Loser, people with a variety of medical conditions have gone on to rid themselves of weight, medications, and serious medical conditions. Any plan will have to be tailored to your needs. For example, if you've had a heart attack in the last year, you may not want to jump right into high intensity interval training (HIIT) or train for a marathon. 

So, in answering this question, let's make some assumptions: there is no medical or health reason as to why you cannot exercise and there is no injury that will aggravate a condition or get worse with exercise. If someone is really overweight, any high impact exercises will have to be limited to reduce risk of injury to joints. On The Biggest Loser, it isn't uncommon to have the contestants unable to participate in challenges or certain exercises due to stress fractures, for example. 

Avoid weight machines

There are some things I absolutely recommend when giving advice to my patients. One of those recommendations is to never use weight machines.  Using myself as an example, I used machines at a gym when I lived in Georgia. Most of the machines are pretty adjustable to many different body sizes and lengths, but I realized that maybe my particular body size isn't what the manufacturers had in mind - I'm 5'2".  So, I had a hard time adjusting some of the machines to fit my leg or arm length comfortably. In order to use the machines, then, I had to compensate and do all kinds of weird things to actually move weight.

Also, your body is then stuck into isolating muscle groups when you use the machines. Let's use a leg extension machine as an example - the purpose of this machine is to strengthen the quads, the muscle group on the front of the thigh. Sure, you're strengthening your quads, but from a functional perspective, you're just making them look bigger and get only slightly stronger. Because the quads are isolated in the machine, you're taking out the other muscle groups that help the quads out during a normal movement. Instead, a great and simple exercise for the quads is to do some kind of a lunge.

When you do a lunge, not only are you strengthening the quads, but also muscles that stabilize and support the hips, the glutes, spinal erectors (muscles in the back), abdominal muscles, and maybe even hamstrings depending on the depth of your lunge.  As an added bonus, you're having to focus on balancing, strengthening neurons in your brain. Basically, you're getting way more bang for your buck when you use functional movements, free weights, or resistance bands instead of machines.

Strength and cardio training

Another recommendation I always give: use both strength training and cardio in your exercise routine. Cardiovascular exercise on a bike, rowing machine, or running is so vital to strengthen our heart and lungs. Strength training improves the function and quality of our muscles so we can do our daily activities without stress or pain and supports our joints, reducing the likelihood we'll get injured.  It's important to do both.

I see so many women in particular at gyms that just get on the treadmill and that's it. Aside from the benefits of strength training to our health, if we're trying to lose weight and fat, strength training is the way to do it. You burn more calories in the long run when you add muscle. A fear that I've come across, however, is that women don't want to strength train because they don't want to get bulky. Let's debunk that myth: the majority of women will have a hard time gaining bulk. This is because women have more estrogen than men; so if women really want to gain bulk, there's a lot of things they have to do to get there. 

Develop a routine

In terms of frequency of exercise, information on this varies greatly. To start with, develop a program you know you'll stick with. If you've never really exercised before, 6 days a week may seem like an impossible chore. So perhaps start with 3 days a week for 30-45 minutes. However, there are people like my husband that just have to exercise 5-6 days a week right from the start.  I would recommend 3 times a week for 30 minutes at a minimum - but make it count.  Keep your heart rate at a good pace the whole time.  As you get more fit, add frequency and/or time spent exercising.

Enjoy exercise

It's also important to do something you know you'll enjoy, this will help you stick with your exercise routine. If you love boot camps and need someone to make you exercise, there are a couple of great programs in Clawson. If you enjoy playing racquetball, go play racquetball. I trained in karate for 14 years because that's what I loved to do. There's a great martial arts program right here in Clawson and another in Hazel Park that I can vouch for. Exercise doesn't have to look like lifting weights or running until you pass out for it to count. My husband and I also train at CrossFit Reviver in Rochester Hills, which is a great program if you enjoy challenging yourself.

Set goals

Also, goal setting and tracking your progress can help keep you on track and motivated to keep going. Another important thing to consider when developing a routine is to change it up. If you do the same thing day in and day out, not only will your muscles get used to it, but your brain gets bored. Then our brain actually makes our body function more effectively to reduce the amount of work we put in - basically resulting in a lower caloric burn and conserving fats and proteins. Humans are built to conserve energy and our body constantly adapts to the stress we put on it if we do the same thing all the time. 

Overall, keep it simple. We don't need thousands of dollars of equipment to get more fit, but sometimes we do need some help figuring out what to do and how to do it. Any exercise done improperly will cause injury over time, so get help and advice if needed. Make sure you develop a program consistent with your needs and what you know you will do. Consulting a health care professional is also important before beginning any program.

Thank you for reading, and if you have any questions you'd like answered, please submit in the comments or email me at QureshiDC@gmail.com.


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