Spine Expert’s Exercise Advice to Doctors and Patients

The role of exercise and physical activity throughout life as preventive medicine was emphasized by Stanley A. Herring, MD, at the North American Spine Society (NASS) annual meeting. His message to spine specialists attending NASS centered on the need to educate patients about the benefits of physical activity and exercise before developing lower back pain or other spinal disorder.
doctor holding a stethoscope, with a fitness room shown in the backgroundDoctors are pushing the message that exercise is preventive medicine. Photo Source: 123RF.com.

Why Exercise and Physical Activity Is Important

Approximately 80% of people in the United States do not meet physical activity guidelines for aerobic or strength exercise, placing them at risk for future health problems. Thus, physical inactivity is “an urgent public health priority,” and a leading cause of death, obesity, and disability, explained Dr. Herring, who is Clinical Professor in the Departments of Rehabilitation Medicine, Orthopaedics and Sports Medicine, and Neurological Surgery at the University of Washington.1

How Much Exercise Do I Need?

For health benefits, adults should exercise at a moderate intensity for at least 2.5 hours per week (eg, brisk walking, water aerobics, dancing, gardening, tennis, and biking) plus at least 2 days of muscle strengthening activities like lifting weights or using resistance bands, according to current recommendations.2 Children and adolescents ages 6 through 17 years should participate in 1 hour or more of moderate-to-vigorous physical activity daily.

To reach these goals, make small changes in your exercise level over time. Breaking exercise up into short 10-minute intervals over the day can help build up your strength.

Finding Free or Low-Cost Exercise Options

Talk to your doctor about what kinds of exercise you like to do and ask your doctor to write a prescription for exercise based on your health, fitness level, and preferences. Also, ask about what local exercise programs are available.

“We’ve developed Exercise RX, which lists no-cost or low-cost centers that provide evidence-based exercise in each community [Seattle, WA areas],” as well as free online exercise videos and apps, Dr. Herring said. “We now have 50,000 people enrolled.”

In addition, Dr. Herring discussed The Daily Mile campaign in which elementary school children and their teachers walk or run for 15 minutes each day, with no training or equipment required.

“We are measuring to see what The Daily Mile does for academic performance,” he explained. “We hope it is gateway to fitness.”

The Benefits of Exercise on Cancer Risk, Heart and Bone Health

Exercise lowers the risk for 13 types of cancer regardless of whether people are overweight/obese or smoke.3 In addition, exercise programs can lower the risk of death from heart disease as much as or more than heart medications, except for use of diuretics in the treatment of heart failure.4

In addition, the recommended 2.5 hours per week of moderate-aerobic intensity is linked to a reduced risk for the following conditions:5

  • Bone thinning (osteoporosis)
  • Dementia
  • Depression and anxiety
  • Fall and fall-related injuries in older adults (reduced mobility)
  • High blood pressure (hypertension)
  • Type 2 diabetes
  • Weight gain

Benefits of Exercise in Children and Adolescents

“In children, there is no question that physical activity improves muscular strength, motor coordination, bone, mood, and brain structure and function,” Dr. Herring said. Physical activity also helps prevent the following childhood diseases: type 2 diabetes, asthma, hypertension, atherosclerosis, fatty liver disease, sleep apnea, and depression.

“Importantly, if you’re active as a kid, you have a much greater chance of being active as an adult,” Dr. Herring noted. “Unfortunately, on average, kids spend approximately 7 hours and 12 minutes a day sedentary [inactive],” Dr. Herring explained (see Table).
Table. Inactivity Rates and Obesity in US Children and AdolescentsThe rates of inactivity and obesity in children and adolescents in the United States.“Only approximately one-quarter of children in the United States meet recommended exercise activities for their age group, and less than half of children have adequate cardiovascular fitness,” Dr. Herring said. “There is no question that inactivity–both directly and indirectly–leads to lifelong serious issues.”

Promoting Life-Long Wellness

“I think we are making a huge mistake if we don’t promote wellness from birth,” Dr. Herring concluded. “If we don’t do that, we’re coming in too late in the game to affect disability.”

“There are a lot of reasons that people aren’t healthy, but 50% is accounted for by health behaviors,” Dr. Herring said. Exercising, not smoking, and a healthy diet “can make a big difference on patient outcomes, including people with back pain.”

Dr. Herring has no relevant disclosures.

Updated on: 11/22/19
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