How doctors squeeze in exercise, and how you can, too


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Benjamin Levine, M.D., plays tennis as part of his fitness routine.

In October 2016, I received an interesting interview request from TCTMD, an online resource administered by the Cardiovascular Research Foundation. The publication set out to determine whether doctors practice what they preach when it comes to recommending physical activity to patients.

The organization found that nearly 70 percent of participants reported meeting the American Heart Association (AHA) recommendations for physical activity – 30 minutes of moderate-intensity exercise five times a week or 25 minutes of vigorous-intensity exercise three times a week.

I was pleased to see these results. I may be a bit biased, but I think cardiologists as a group tend to be the healthiest specialists. Orthopedic surgeons are probably up there as well, but while they may be stronger, we’re faster!

The truth is, we all struggle to squeeze in exercise sometimes. Just like many of our patients, we don’t always feel like hitting the gym before going into the office or putting in 30 minutes of exercise after a full day of work.

Life can throw all sorts of obstacles in our path toward fitness. The TCTMD asked doctors about the reasons we were unable to exercise on a given day, and I suspect you’ll recognize some of our answers:

  • Work (61 percent)
  • Family commitments (17 percent)
  • Fatigue (9 percent)
  • Injury or illness (8 percent)
  • Other (2 percent)
  • Lack of facilities (2 percent)
  • No interest (1 percent)

How I fit exercise into my daily routine

When life gets busy, exercise often is the first task to be sacrificed. But physical activity needs to be a part of daily personal hygiene. Just as I take time to brush my teeth and take a shower every day, I take time to exercise.

My exercise routine has encountered many hurdles over the years, but I’ve remained dedicated to doing whatever it takes to get in a workout. For example:

When my children were young, I’d exercise after they went to sleep, sometimes quite late at night.

After a long day in the lab or hospital, I look forward to exercising as soon as I get home, perhaps in front of a Dallas Mavericks (or Rangers, or Cowboys … ) game, or just chatting with my wife (she has to do the chatting if I am doing intervals). Dinner may have to wait, but I don’t care about a hard and fast “schedule.”

I switch things up so I don’t get bored with a particular exercise.

How to get started with an exercise routine

The first and most important thing you need to start and maintain an exercise routine is motivation. If you can’t find an activity that motivates you or that you enjoy, it’s likely you won’t sustain it.

Everyone finds his or her own motivation to get and remain physically active. Some incentives I’ve heard include:

  • I want to be able to play with my kids or grandkids, or feel more youthful.
  • I had a health scare and want to get and stay healthy.
  • I want to fit into my pants.
  • I want to lower my blood pressure or cholesterol.
  • I want to run a marathon.

Once you find what motivates you, just get moving. It all starts with a single step. Acclaimed running coach Joe Vigil used to say, “If you want to run a mile in four minutes, you have to be able to run a quarter-mile in one minute.” Similarly, if you want to be able to walk around the block, first you have to walk to your mailbox.

I know personally that illness and injury can sidetrack us at times. But exercise is highly scalable. We can help you find something that you can do within your particular limitations.

My exercise ‘prescription’

My physical activity recommendation differs slightly from the AHA. I advise that everyone include physical activity that varies in exercise and duration four to five days a week.

Here’s the weekly exercise “prescription” I recommend and personally follow:

  • 1 day: Longer activity. Take part in an exercise that lasts an hour or more. This could be a higher-intensity activity such as tennis or a Zumba class, or it could be a lower-intensity option such as a long bike ride or playing golf. Find something you enjoy. You could do it with a friend or spend the time meditating alone.
  • 1 day: Interval training. High-intensity interval training alternates periods of high-intensity exercise with a recovery period. I like to do “4x4”s, which involves doing an exercise as hard as I can for four minutes, then recovering for three minutes. I repeat this four times. But you also can do shorter intervals, such as one minute or 30 seconds (though you have to do more of those …). As long as you’re going all out, as hard as you can go for that period of time, you’ll get the benefit. One rule of thumb I use is that by the end of the interval you should be ready to stop (and looking forward to doing so!), but by the end of recovery, you should be ready to start the next one.
  • 1 day: Strength training. This doesn’t mean you have to lift big, heavy weights. You could take a Pilates class or use your body weight to do exercises such as push-ups, squats, or planks. Strength training can be combined with another activity such as an easier endurance effort, or it can be done on its own day.
  • 2-3 days: Moderate activity. For 30 minutes, exercise at moderate intensity – or vigorously if you want to push it. With moderate activity, you should break a sweat and be a little short of breath, but you still should be able to carry on a conversation.

A few caveats

Take a few precautions to exercise safely:

  • If you haven’t exercised in the past and are older than 35, you should consult your doctor before you start working out.
  • If you are just starting to exercise, begin gradually and work your way up so you don’t injure yourself right off the bat.
  • If you experience chest pain or dizziness with exercise, stop what you are doing and speak with your doctor.

Remember, your “moderate” or “vigorous” intensity may not be the same as your partner’s or friend’s. Start where you can and work your way up.

And if you have one of those days on which the last thing you want to do is work out, remember that your doctor has those days, too. But if I can overcome them, so can you!