Why the gym matters to everyone not just the physical culturists!

The other day I was explaining to a veterinarian how the fitness and strength programme that he was about to embark on would likely impact on his life. As part of this explanation I got to talking about how, in my physiotherapy practice, the vast majority of problems that I see arise primarily from a reduction in condition (for this purpose strength/fitness level = condition). He agreed that he saw similar traits in the pets that he treated.

We went on to discuss how this spectrum consisted of elite performers in perfect health at one end and disease and ultimately death at the other. Depending on the demands of your life the threshold for function/dysfunction lays at a different place on this spectrum to maintain a reasonable quality of life. In addition, there would be a critical threshold on the spectrum beyond which there may be deterioration in condition. This spectrum, as I have been calling it, closely reflects the work of John Travis (1972) measuring degrees of wellness with his Illness-wellness continuum.

Strength and fitness training can put a buffer between you and a poor quality of life. The closer you are to this critical threshold the less it would take for your function to reduce and for you to drop into dysfunction. This is commonly seen where the elderly are admitted to hospital in a low state of condition and when immobilised in a bed then struggle to recover as their condition deteriorates further.

Interestingly I wasn’t the only one thinking about this continuum this week. The Lancet published a piece suggesting that the standard advice of 150 minutes a week of moderate activity to maintain health might for some people be unrealistic. In fact, the minimum amount of moderate activity required to reduce all-cause mortality seems to be about 90 mins a week or 15 mins a day. Now in fairness they published this in October 2011 but for whatever reason (it is January after all and New Year’s resolutions are still fashionable) it was announced on the radio the very morning after I had had my earlier conversation. Maybe they were in the gym that morning? Even if they were not eaves-dropping on my conversation, exercise was the topic of a recent web chat that I follow (#Physiotalk on twitter) so if our medical/healthcare fraternity are worried about our lack of exercise then we should be too.

Now I’m all for raising everybody’s fitness, strength and health levels and it’s unusual for me to discuss the minimum amounts of exercise required as I’m usually more concerned with what is optimal or best. However, the study by Mandic et al. (2009) shows that fitness only need be improved minimally to half inactivity related mortality.  

With an aging and increasingly frail population there is a growing number of individuals approaching the aforementioned critical threshold. To that end it is important to know what would be required to improve the lives of so many of our fellow humans. To improve the health and fitness on a large scale would take an emphasis in society on exercise as bodily maintenance. Similar to brushing your teeth - with the negative outcomes associated with failure to do so being equally as stark. We know that if you don’t look after your body by exercising it then it will undoubtedly fail sooner rather than later.

In addition to societal exercise norms people often present with additional barriers to exercise, these barriers can be psychological, physiological or merely perceived, their effects are always the same, a resultant abstination from exercise. In all but the most serious cases these barriers are usually eminently surmountable. Simply not wanting to exercise is no longer acceptable where the outcomes for not exercising are dire.

In modern gyms there is often suitable expertise to help idividuals to overcome these barriers with some gyms offering specialist trainers,coaches and physiotherapists who serve to make exercise safe accessable for all. Now before you say it, yes gyms may seem scary, and yes you could exercise anywhere, but we do have a lot of equipment and expertise in our gyms and we may be able to help you move one or two places along that fitness and health spectrum away from the critical threshold and towards a healthier, fitter and stronger you.

Pete