Health

I'm cramped in a New Jersey transit train seat like it's a sardine can. The train home from NYC is packed with a holiday weekend crowd. Some of them are returning Santas from SantaCon -- my personal favorite Santa sighting was a portly young man who was running down the street in Santa pants, boots, and hat while yelling into his cell phone. Somewhere along his inebriated meandering, he lost his shirt and was content to race through the 35 degree December weather while half naked. Ah, New York is a magical place at the holidays. Besides the people watching, the department store window displays and the Rockefeller Tree are personal favorites of mine.

While in NYC this weekend, we walked everywhere. Sure, the walking was punctuated with an occasional subway ride and lots of momentary pauses to look at rollerblading drunk Santas, but we were in NYC so we walked. How else to take in the sights?



We walked everywhere. In my 2 days in the city, I easily cleared my Fitbit goal of 10,000 steps each day. Between that, and deciding to eschew the elevators in favor of the stairs all weekend, I did some serious leg workouts. One of the biggest complaints or objections my patients have about incorporating exercise into their lives is that it takes time and feels like too much work. Yeah, I get that. Imagine a physician or PT telling you the following: "Leave your house before work (or go after a tiring workday) and travel by yourself to a crowded place, then get on a hamster wheel and move, then go back home. You are to repeat this everyday for the rest of your life. You can sit and binge watch Boardwalk Empire, play Call of Duty, use your iPad, or whatever else the rest of the time, but get your 30-60 minutes each day." Does anyone want to do that? I don't think so.

Fortunately, that way of thinking is slowly evaporating. It doesn't have to be like that, and better yet, it shouldn't. More and more medical evidence is emerging that shows that exercise can and should be incorporated into all facets of our daily lives, not compartmentalized into "running" or "gym" time. It is showing some alarming things. For example, even regular bouts of daily exercise (no matter how intense) do not fully "make up" for prolonged sedentary activity.

Here's a typical scenario I encounter all the time at work: Patient works an 8-10 hour day, mostly sitting all day while being marginally productive writing emails, on the phone, attending meetings, browsing Facebook or Twitter, or completing sporcle.com questions. Patient then comes home and works out at the gym or alone in the basement for 30-60 min before bed, lifting, biking, or rowing away like Frank Underwood from Netflix's House of Cards. Add up all their active time versus all their sedentary time. The cumulative weight of all their activity each week tips the scale heavily in favor of their sedentary time. All the patient sees is that they exercise every day and can't understand why they hurt, gain weight, feel tight, etc.

The above traditional paradigm of exclusive "exercise time" is beginning to emerge as a flawed method of thinking. Increasingly, there is a push to incorporate exercise and activity throughout the whole day, not keep it confined to gyms or "exercise time" only. I would consider exercise mixed throughout the day to be truly functional exercise because it is tied to daily function for a normal person like you and I. For most of us, our daily function is drastically different than for people with extreme demands of their body, such as Carli Lloyd, Kobe Bryant, Lindsay Vaughn, or JJ Watts.

I've written in previous articles about ways to incorporate exercise into your workday. Our daily activities away from our desk are also ideal places for exercise to happen. Stairs, walking, standing, getting up and down from chairs, pushing doors, pulling doors, or getting in and out of cars can be exercise. Unfortunately, as we have gotten more sedentary and gadget-dependent as a society, many activities on the above list have vanished. Doors automatically open, escalators bring us up and down stairs, and our jobs encourage us to work sitting down, even going so far as to cart food directly to our desks. While an overwhelming preponderance of research is not currently there, some rumblings have emerged recently about the benefits of standing desks or tread desks.

In my opinion, once enough research has been done showing how workers who stand for all or part of the day are healthier, more productive, and miss less time due to sickness and injury, some big changes will occur. It will become standard for all major employers to provide adjustable workstations. It will just make financial sense -- less injured or sick employees equals less days of labor lost -- and that will drive the change. It will also make healthcare system sense. Money can be saved, injuries and disease could be potentially mitigated, and health insurance premiums might decrease as a result. Employers save, employees save, and everyone wins.

In previous articles, we have discussed some ideas to improve this daily exercise activity. Ideas such as working on balance by standing on one leg while brushing teeth, drinking more water to force you to get up more and walk to the bathroom frequently throughout the day, taking the stairs at work, or even just using the non-automatic doors can all be ways to improve your activity level. Look for ways throughout your day and see what you can come up with in your daily routine. Be as creative as possible with this, even if it is something as simple as parking farther away to walk an extra 100 feet to the store. It can make a big difference.

Schools too, might benefit from standing desks or applying some of the above ideas. That's a different article though. For now, however, I'm still hunched up and unable to move while I dream a dream of a world without sitting desks. My left knee, right hip, and low back are all tight and my neck is stiff despite my fidgeting (I've written some of this standing up stooped below the luggage rack). Sadly, I'm still a captive audience growing ever more annoyed by the frat boy chatter from the Cowboys fans across the aisle riding down to Philadelphia for the Eagles-Cowboys game today. No, I'm pretty sure it's not a good idea to paint your chest and face with Cowboys colors then go to Lincoln Financial Field today for the game. But I'm stuck for 2 hours, so am making the best of it by tuning them out and annoying my wife with descriptions of how the tissues in my spine, legs, shoulders, and neck are tightening up and losing their flexibility during this train ride. She's trying to listen to her Serial podcast while politely humoring my rant.

We agree on one thing, though. We both can't wait to get home and go for a walk.

Danny Singles, PT, DPT, MA

Danny is a sports physical therapist who specializes in manual therapy. His clinical interests include injury prevention, working with sports and orthopedic injuries, pre and post surgical rehab, and working with the pediatric patient population. He attended the University of Delaware for his Doctorate in Physical Therapy. Currently, he works full time as an outpatient sports therapist and provides educational outreach through lectures at local schools and fitness centers. He can be reached at Elite PT in Hockessin, DE at: (302-234-1030) or emailed directly at: This email address is being protected from spambots. You need JavaScript enabled to view it.. He can also be followed on Twitter (@MoveEqualsLife) for current updates about health and wellness.