The number of times I have watched a healthcare professional give advice to patients that they don't follow themselves is incredible. Personally, I find it difficult to take advice from anyone that doesn't show me they are proficient in that area. Why should a patient perform 30 minutes of exercise a day? Why should they go on the DASH diet, stop smoking, eat healthier foods, or spend more time outside when their provider doesn't? We need to be better at practicing what we preach. There are a lot of problems in healthcare, one being that there isn't nearly enough focus on prophylactic interventions for things like diabetes, hypertension, and obesity. Many pharmacists could tell you when a patient should start a statin, what intensity to recommend, common adverse reactions, how and when to take it, and what kind of response to expect. They might even be able to tell you how it's metabolized. But how many can recommend a regimen for improving cardiovascular fitness, explain how to start a weight baring exercise routine, or can reasonably guess the macronutrient and caloric breakdown of any given meal? Not to mention, how many providers spend time on this information before their patient is pre-diabetic? You often see recommendations in SOAP notes like "refer to a nutritionist", but how many times does that actually happen? The point is, the more people that have a good understanding of this information the closer we will get to solving problems like the obesity epidemic. If you didn't know a problem existed, here are some stats on diabetes from the WHO:
"The number of people with diabetes rose from 108 million in 1980 to 422 million in 2014. Between 2000 and 2016, there was a 5% increase in premature mortality from diabetes. In 2019, an estimated 1.5 million deaths were directly caused by diabetes. Another 2.2 million deaths were attributable to high blood glucose in 2012." (World Health Organization, April 2021)
This post is meant to help you become a more consistent runner while working a busy schedule. Some of these tips can be applied to other types of exercise as well such as weightlifting, swimming, and cycling (whatever you're in to!). It also serves as a source for when your patients say, "Doc, I just don't have time for exercise!"
1. Fighting Against Procrastination: Exercise is one of the most procrastinated activities I can think of. Just thinking about going on a run while you lay in a comfortable bed can be a painful experience. One of the problems is that there is no deadline for exercise. We get very good at meeting deadlines. We know when a test is going to occur, when an assignment is due, and what time we have to be in a meeting. It's much harder to perform tasks without deadlines like exercising, dieting, or starting a passion project. One of my favorite videos on this topic is a Ted Talk by Tim Urban, which I highly recommend you watch:
When it comes to procrastination, the hardest part tends to be starting. Once you get things going, they usually continue without nearly as much effort. You just have to fight the mental battle upfront and practice some diligence. One tool you can employ against procrastination is to make a plan (in essence, a commitment or deadline) to run on certain days of the week. Making a plan might seem daunting, but you can find many free running programs online if you are interested. Be sure to read tip #5 if you decide to follow a program. Another helpful tool is to set the bar low. Many people dislike the thought of setting the bar low, but what it really means is to have realistic expectations. By all means, don't sell yourself short, but you're not going to be running a marathon in 3 weeks time if you just started your running journey. Having realistic expectations and setting mini goals along the way can help you stay motivated and avoid discouragement.
2. Maintain Consistency: Consistency is key when it comes to running and exercise in general. Making a schedule to follow can really help you stay consistent and it also ensures that you are able to fit things properly into your busy life. Personally, I have a set of "non-negotiables" in my life. These are the things that really matter to me, but that I would undoubtedly ignore if I wasn't careful. Things like reaching out to friends, calling my parents, spending time with my wife, and getting some exposure to the outdoors are all things that I highly prioritize. You have to come to the realization of what is actually important. I can very naturally slip into a career focussed, obsessive mindset, and often times do. You just have to make sure you can check yourself and not live a life of regret. Even if your schedule is packed, I'm sure there is something there that wanes in comparison to the importance of your health and longevity. Exercise has been one of my "non-negotiables" for a very long time now. It's is a completely free way to increase your confidence, ability to focus, mental health, and efficiency at work or school. Not to mention it helps fend off just about every cardiovascular disease you can think of. There can also be amazing emotional benefits from running. A runner's high is very real, and you can quickly become addicted. Employing this non-negotiable mindset for running, or exercise in general, allows you to make consistent progress and really enjoy the process.
3. Prioritize Easy Runs: A common mistake that people make when they start their running journey is that they go way too hard. You should start easy. If you're going to maintain consistency, you can't be brutally sore after every run. A good rule of thumb is for 80% of your runs to be easy runs. What is considered an easy run? There are a lot of ways to look at this, one example being that you should be running at a conversational pace. This means that you could be easily having a conversation with someone that is running with you. Don't have a running buddy? Try singing! If you are lucky enough to have a heart rate monitor, then you can really get technical. An easy run would be considered something near zone 2 training. Zone 2 is a heart rate zone that is based on your maximum heart rate. To roughly calculate your maximum heart rate, take 220-(your age). For example, I am 24 years old, so my max heart rate is 220-24 = 196 beats per minute (bpm). To calculate your zone 2 heart rate, take your max heart rate x 0.7 and by 0.8 or 70% and 80%. For me, 196 x 0.7 = 137 bpm and 196 x 0.8 = 157 bpm. So when I go on an easy run I can try to match a heart rate of 137-157 bpm or just sing along to whatever music is playing in my headphones. The other 20% of runs can be more difficult endeavors such as a tempo run or simply running in higher heart rate zones. Ever hear this conversation in a doctor's office?
4. Track Your Progress: Tracking your progress can be a huge motivator and help you stay consistent. You might be tracking the time it takes you to run a mile, your total weekly distance, or even your body weight. It really depends on the goals that you've set for yourself. You are likely going to make progress very quickly, especially at the beginning, so make sure you're aware of what's happening! There are a number of great running apps which can be downloaded on your phone to help with this (Strava is my favorite app for running and cycling). Also, if you have the budget, a good fitness watch can go a long way in tracking your progress as a runner and has the added benefit of monitoring your heart rate and many other metrics. I've had a Garmin Fenix 5 for close to 4 years now and absolutely love it.
5. Listen to Your Body: Like I said before, you won't get anywhere if you're too sore to run. Worse yet, pushing too hard can easily lead to injury, something that I have fought with many times. When you get into a certain mindset it's very easy to ignore this tip and just push through pain. Please don't! Avoiding injury is essential to progress. You need to make sure that you are giving your body enough time to rest and recover between sessions. This becomes very important if you are following a running plan that you found online. These have great value and can really help you get started, especially since many of them are free. BUT, don't take them as gospel. If your body is telling you no, then take the day off. Feel free to move runs around in your week as well. If you're too sore to run on Wednesday, then just push that run back to Thursday or Friday. This is not the same as your mind telling you no, and I'm not talking about an excuse to be lazy. Laziness and procrastination are exactly what we and our patients should be trying to avoid. I'm also not saying that being sore is a good excuse to skip out on exercise for the day. You just need to distinguish between common soreness and being on the cusp of injury. This is something you'll get a feel for as time goes on, assuming you can stay consistent. The goal is to be cognizant of what your body is capable of doing, and watch as its capabilities grow!