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Making Exercise Part of Your Routine : The Rest of Your Life


 

Brooke Jackson, M.D., describes herself as a “late bloomer” to the notion of exercising on a regular basis.

Her turning point came in 1997, when she moved to Houston for her Mohs fellowship at Baylor College of Medicine. One day she spotted a newspaper ad placed by a group of local runners.

“The ad said, 'We'll train you to run a marathon,'” Dr. Jackson recalled. “I had no intention of ever doing a marathon. I had never run a race in my life. I just figured it would be nice to get out with a group of people and run a little bit. I'd be happy getting up to 5 miles.”

Only 6 months later, she found herself at the starting line of her first marathon, “wondering what I had gotten myself into,” she said. “I had such a good time doing it that I went back the next year.”

After running her second marathon and completing her Mohs fellowship, Dr. Jackson moved to Chicago's South Side in 1999 to set up a dermatology practice. One of her first priorities was finding a group of people to run with. “A couple of nights a week, most running stores will have a group of people that will go out and run 3, 4, or 5 miles,” she said. “I joined that group. That's how I met my husband.” She also formed a marathon-training group as a way to meet people and inspire others to exercise. In that first year, 75 people joined the group. By 2003, the number grew to 400.

The way she sees it, running is a “great way to meet people and take care of yourself, too. I'm a firm believer that until you take good care of yourself, you really aren't in the position to take care of anybody else.”

The clinical benefits of even moderate exercise–like a brisk walk–are well known, but few physicians make concerted efforts to incorporate it into their daily routine, said Tedd Mitchell, M.D.

He described the fitness levels and habits of physicians, priests, preachers, and rabbis as “abysmal” compared with that of the general population because of the service-related nature of their work. In those professions, “it's all about everyone else, not about you,” noted Dr. Mitchell, an internist who is vice president of the Cooper Clinic in Dallas.

One reason physicians as a group may not exercise “is because inconsistency is built into your schedule,” he said. “You have call; that affects your routine. Your day-to-day schedule is not that of a banker, so it makes it more difficult to follow any type of routine consistently, whether it's exercise or good nutrition.”

He shared the following tips that he and his associates share with patients who attend the Cooper Clinic:

Know the “FIT” principle of aerobic training. “F” stands for frequency of exercise sessions; “I” stands for intensity of the exercise, and “T” stands for length of time per session.

Of the three variables, frequency is the most important, said Dr. Mitchell, who is also a member of the President's Council on Physical Fitness and Sports.

“Think of exercise as another medication,” he said. “If you're not taking your medicine regularly, you don't get the benefit. It's the same thing with exercise. From a frequency standpoint, if your weight is not an issue and all you're after is some health benefits, exercising three times a week is okay. However, if you have any tendency toward high cholesterol, triglycerides, blood pressure, weight, or stress, you need it five times a week.”

Once you establish the frequency, the next most important variable is the length of time you exercise. “Thirty minutes is great,” he said. “You can walk for 30 minutes or jog for 20.”

Intensity is the last variable you tackle. Consistent, moderate exercise is what you're after. “Physicians tend to work out infrequently and hard,” Dr. Mitchell said. “That formula is backward for the benefits, but it's just right for pulling hamstrings.”

Exercise in the morning. People who routinely exercise in the morning are more likely to do it long term compared with people who try to exercise at other times of the day, “because you can control the morning schedule better than you can control anything else,” Dr. Mitchell said.

“Even the surgeons can do this. Rather than always taking the 7 a.m. time slot in the [operating room], give yourself an 8 a.m. time slot and get the activity done,” he said.

Nicolette Horbach, M.D., started working out at a local gym with a personal trainer 4 years ago. She meets with the trainer at 7 a.m. on 2 days during the workweek. “I plan to see patients on those days at 8:45 a.m. instead of at 8 a.m.” said Dr. Horbach, a urogynecologist in private practice in Annandale, Va.

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