As an orthopedic surgeon, I often see injured patients in situations when we know a surgery such as an ACL reconstruction or knee replacement can offer them a solid chance at the return to an active lifestyle. The majority of adults that we see in the office, however, have not had any trauma or injury—they have more run-of-the-mill aches and pains. (No, you didn’t sleep wrong.) These folks often think that a “simple” surgery will get them back to their sedentary, pain free life.
This is not the case. I often have to explain that a significant portion of adult joint or tendon pain is due to the effects of poor overall health and lack of movement, as opposed to any mechanical issue such as a meniscus tear. The human body is a complex set of interrelated processes—one system affects all of our other systems, and very few issues within the human body exist in isolation. (To take just one example, the incidence and progression of osteoarthritis is much higher in people with metabolic diseases such as fatty liver and diabetes.) Along these lines, pain is often a symptom of a sedentary lifestyle—like other machines, the human body rusts and seizes up if it’s sitting still.
The cure for a sedentary lifestyle is simple: Move more. Movement is crucial for maintaining health and well-being. Regular physical activity helps control weight, reduces the risk of chronic diseases such as heart disease, dementia, type 2 diabetes, and certain cancers, and improves mental health and mood. But I’ve noticed that, while most people recognize that it would be better to exercise, they also believe that to be fit, they must engage in intense, strenuous activities that they may not enjoy or feel capable of maintaining. They understand the need to work out, but the thought of sweat, pain, exhaustion, and hauling themselves to the gym turns them off. It doesn’t have to be that hard, and one of the simplest and most accessible forms of exercise—walking—often goes underappreciated.
Despite the rants of a few loud social media know-it-alls, walking is indeed exercise. It confers significant benefits for all-cause mortality, fitness, and overall health. If a medication could deliver these results, we’d all be on it.
In fact, I often write a walking prescription in the office. It’s straightforward: Get out 2-3 times a day for 20 to 30 minutes. On the weekends, try to do one longer walk. If you’re motivated by numbers, as little as six to eight thousand steps per day yields impressive results. The associated decrease in rates of heart disease, dementia, type 2 diabetes, is upwards of 15-30%. Many of my patients have gone on to lose significant weight; more importantly, they found that walking was the gateway to other healthier lifestyle choices that they ultimately adopted.
This might seem like too little exercise for you—that’s very possible. Keep it up, if so. But a common issue in my office is that people do not recognize that their fitness levels are declining. Aging-related loss of fitness occurs slowly over time. Far too many believe this is a problem specific to the elderly. It’s not. Are you short of breath on stairs? Can you do 20 or more chair squats in 30 seconds? 20 pushups? The effects of aging begin to accrue in our 40s, even if you may not begin to notice them until far later.
