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Movement in Medicine 02 - why exercise is so important

Aug 18, 2022

In the first of this 2-part blog on exercise we discussed the fact that, by itself, exercise is a poor way to lose weight, but in conjunction with other lifestyle changes it can help in weight loss and improved quality of life. In this, the second blog regarding movement I hope to offer some practical tips, and reflect on my own journey and how I have had to  adapt my approach to exercise and movement over time.

As was shown in my previous blog, exercise has many important attributes including:

• Reduction of inflammation – a major cause of many of our modern diseases;
• Improved immune function;
• Reducing resting fight and flight hormones and;
• Relieving stress.

How to change

According to Dr Jeffrey Bland, 12 weeks is the average time it takes to make a real change in cellular biology and patterns of gene expression and that any programme should:

• Incorporate exercises that build endurance, strength and flexibility;
• Bring pulse and breathing into aerobic zone (calculated at 180 minus your age);
• Have minimal impact on joints and muscles and;
• Be something that you routinely do 5 to 6 days per week.

I would also add DO WHAT YOU FIND IS INTERESTING AND FUN, (since if you don’t enjoy it you won’t keep it up) – and keep it up – REGULAR ACTIVITY IS KEY.

Dr Bland also states that any programme should;
• NOT exceed your physical capabilities;
• NOT produce serious muscle or joint strain;
• NOT total less than 120 minutes per week (equates to around 20 minutes per day), and;
• NOT follow excessive physical demand with proper conditioning – a “weekend warrior”

He goes on to recommend purchase of a pedometer in order to track the number of steps walked per day – the goal being to get to a MINIMUM of 10,000 per day. This regime has been shown to improve cardiovascular function, psychological well-being, blood cholesterol and HDL levels (Bland, 2014). He goes on to comment that studies show after stopping a regular walking programme, insulin sensitivity decreases followed by a commensurate increase in angry fat – surmising that cellular communication processes from the altered physiological fitness is key in development of Type 2 diabetes.

There is an old saying in Chinese Medicine – “the door that never moves, rusts”. Lack of movement (especially when doing sedentary work that involves lots of sitting – e.g. computer / desk work / driving) is one of the main causes of chronic pain and dysfunction that I see in my clinic.  In addition movement can also be a great stress reducer and is shown to help in condition like anxiety and depression.

A personal journey - my early years


From a Traditional Chinese medicine point of view – the main thing is balance; do not try (especially in the early stages) to attempt what a twenty year old can do whilst you are in your forties, fifties or sixties - especially if you have not led a fit and active life and are starting from a sedentary base level. We all know of people who may have started extreme sports in their later years, however from a Yang Sheng (nourishing life) principle – too much exercise can be as bad as insufficient exercise.


In my youth I was very unfit and overweight – being the sole carer for my mother on home dialysis, most of my teenage years was spent at home. So in my early twenties (after my mother was able to receive a kidney transplant) I went to look for a way to improve this. 

 

I started attending a Tai Qi class – however at that time I was unimpressed with the very large classes and only receiving about 1- or 2-minutes instruction from the teacher for the entire session. So a quick magazine search (the days before Google and the internet!!) I saw an advert to “Learn Kendo in small classes – direct transmission”. The small classes interested me, and at 21 I started my almost 40-year relationship with my sensei Mike Finn at Elite Academy.

 

I must admit the only reason I lasted the first year was that I paid for my fees upfront and I was not going to waste that hard earned cash!!! However, after many months where I would arrive home with bleeding feet and blistered hands, my body morphology started to change and I actually enjoyed the numerous “bunny hops” we did around the dojo and the 500 cuts we did to warm up a Kendo session!! Perseverance and bloody-mindedness definitely helps!!

 

In my twenties I was spending probably 5-6 hours per day, 5-6 days per week training. My life was literally work train and sleep and I was fortunate enough to be able to spend quite a long time in Japan training with my teacher and his teachers. From a Chinese Medicine point the Yang energy in the body is at its maximum in your late twenties – you heal quicker and are more energised.

I progressed on to learn other skills, eventually gaining 3rd Dan Black Belt in Kendo, 3rd Dan Muso Shinden Ryu Iaido, 3rd Dan Shindo Muso Ryu Jo, 2nd Dan Tomiki Aikido and 1st Kyu Goshinjustu. However, meeting my wife and best friend of 35 years and wanting to spend more time with her and my children, shift work, studying and starting up a business meant that my early training regime couldn’t be maintained and had to be moderated – however to this day I try to train at home at least a couple of times a week, and when in London I still train with my teacher at his dojo on Fulham.

As Finn Sensei often pointed out to me -, fortunately we don’t life in a time where we have to fight every day to survive – however what martial arts does provide is a vehicle for respect, self-discipline and confidence.

 

Later life

 

Through studying acupuncture, I was introduced to Qi Gong and re-introduced to Tai Qi ( I try to do my Qi Gong exercises daily) however in my 40s and 50s with working away from home so often and studying at university I found that it was not easy to maintain a regular exercise regime.

 

After completing my Osteopathy degree and its emphasis on self-maintenance, now in my 60's I have since made a determined effort to maintain a regular exercise regime.  Whilst living up in Malvern I have been able to engage in my other interest – dancing. I believe that dancing has many things common with martial arts – timing, an appreciation of distance (between you and your partner – stepping on their toes is not conducive to a good relationship!!) and focus of mind – together with a good cardiovascular workout – win, win !!!


From  my ambulance service career as a paramedic, what struck me was the importance of balance in later years (as discussed below) and fear of falling.  I find the blend of martial arts, dancing and Yoga works for me and really does help with this.  Work allowing (when I am at home and not around the country) I try to dance 3 evening per week -  in Malvern (Wednesdays) and Ledbury (Thursday) evenings you will often see me with Steve at Coolmoves dance and fitness learning swing jive.  In addition I incorporate a 20 minute short Yoga routine together with my Qi Gong exercises almost every morning (usually before the dog-walking) - unless it is one of the days I attend the formal Yoga classes.

On Fridays my wife Judi and I travel up to Pershore with Paul and Tracey from Danceat8 for Latin and Ballroom – it is also great fun being able to engage in an activity with one's partner.


For further information on the benefits of dancing click here for an article by Phil Hardesty on 3 reasons why dancing improves heart health.

On Monday and Wednesdays whilst in Malvern, I also try to go to The Fold at Bransford where I attend Yoga classes with Melissa at Melissa Porter Yoga.. Mondays is the more challenging Vinyassa style and Wednesdays I attend the Yin Slow Flow with Judi– again, it is  great fun being able to engage in an activity with one's partner.

Maintaining your exercise programme

 

It can be challenging to maintain this activity whilst travelling around the country teaching, and maintaining a busy work schedule at home treating patients. However, simple steps I have found that help include:


1.  Taking the dogs out once or twice a day (morning and evening) when I am home – this can notch up 5-6,000 steps;

2. Try to instigate a daily routine - they say it takes up to a month for any practice to become a habit.  Personally I try to go to bed earlier and get up earlier.  This enables me to do my 20 minute Yoga, 20 minute Qi Gong and 20 minute core-strengthening exercises before taking the dogs out for their morning constitutional, and still have time for breakfast before off to the clinic.

2.  Simple things like

  • a.   Walking up the stairs (as opposed to taking the escalator / lift)
  • b.   Parking my van as far away from the service station in their car park and taking a long walk can help, and;
  • c.    Getting off the tube a station before the destination and walking that extra section.

3.  I have also

  • a.   invested in a set of kettle bells to engage in muscle strengthening and core exercises at home;
  • b.   purchased a set of bands that I carry with me to undertake some exercises in my motel room if necessary and have;
  • c.    membership with Anytime Fitness that allows me to pop into a gym anywhere in the country to do a workout

 

When I return to London, I always try to pop into the dojo to train and, when traveling elsewhere in the country, I often google a dance class around the country and they are always very welcoming.  When I'm down in London, on a Monday evening at Fulham I often try to go to Swingland for some Lindy and Charleston practice - all around the country there are dance classes with friendly people all too eager to welcome visitors.

It does take planning to maintain, however it is worth it. I look on exercise as an investment in my health and wellbeing – if I don’t make the effort for that investment – who will? I wish to be able to maintain a healthy life into my 70s and 80s and to engage with my children and grand-children (and possibly great-grandchildren) and in order to do that I need to keep moving. 


In the ambulance service I found that the elderly often became more sedentary for fear of falling over - this then reduced their balance and confidence which led to more sitting and less movement and being more prone to falls.  This spiraling downwards often led to a very great reduction in quality of life and increased fear. I firmly believe you are never too old to start, however the younger you start moving and the more it becomes a part of your daily routine, the better.

 

So, if you are not yet exercising –

  1. Find out what interests you and google any local groups / classes that you can join;
  2. Try to incorporate movement into your daily schedule – no matter how busy you are you can find 10-15 minutes to incorporate some movement in your life, and:
  3. Keep it fun - if it isn't fun, you won't keep it up.

 

To paraphrase an old Buddhist saying “every long journey starts with making that first step”.

 

REFERENCES

 

Bland, J (2014) The Disease Delusion – conquering the causes of chronic illness for a healthier, longer and happier life, Harper Collins, New York

 

Deadman, P (2016) Live Well, Live Long – teachings from the Chinese Nourishment of Life Tradition, Journal of Chinese Medicine, Hive


Hardesty, P (2022) 3 reasons why dancing will improve heart health - Ornish living.  Found at https://www.ornish.com/zine/3-reasons-why-hitting-the-dance-floor-will-improve-your-heart-health/

 

Pontzer, H (2019) Evolved to Exercise (The New Science of Healthy Ageing – Original paper published in Scientific American, 320 (1); 20-27 (January 2019), Scientific American, New York

Movement in Medicine 01 - why exercise is so important

by Alexander Brazkiewicz • 21 Jun, 2022
A very big problem is that we are led to believe that to lose weight one must exercise, and the more you exercise, the more weight you will lose. Recent evidence has shown this to be false – exercise is a poor way to lose weight HOWEVER it is vital for our survival.

Acupuncture & Tuina : Osteopathy and Functional Medicine – the synergy between East and West – part 01

by Alexander Brazkiewicz • 17 Jun, 2022
“The object of a physician is to find health; any darn fool can find disease”. This could easily be attributed to an ancient Chinese sage-physician (although the use of “darn” gives it away!!) but it was in fact attributed to A.T. Still, the founder of Osteopathy, back in the 1870’s (AACOM, 2022).

Acupuncture and Martial arts in the East and West -

by Alexander Brazkiewicz • 17 Jun, 2022
Classical Chinese Medicine was taught very differently than today, and in a very similar vein to classical Martial Arts: The student chose a teacher, and if he was accepted by the teacher had a very long apprenticeship, to prove (literally through sweat, blood and tears) that he (this was a very male-orientated domain) was worthy to receive instruction. This however is not a very useful business model, and is very manpower intensive, inapplicable to a university based system where the priority is to train a lot of people to a safe standard within a certain budget, and: As previously described, this can limit the knowledge base to those only personally experienced by the clinician When dealing with the classical oriental traditions, be it Chinese Medicine or Martial Arts, that context is everything; In China and East Asia (where the culture of ancestor respect and worship was prevalent) to write down procedures that contradicted those that were written down by their predecessors, bordered on sacrilege, and to openly criticise the written word, frowned upon . However in reality, the teacher / disciple relationship provided a clinical filter, the teacher would often say that 'this technique or point would be "more appropriate" than that point'. In martial arts, this filtering was more blunt - those who applied techniques that were less effective, had a very short lifespan and could not pass them onto the next generation!!! Those that wrote the medical texts came from a select group - termed the 'gentlemen physicians'. To be able to write these texts and to support oneself meant you had to come from a certain income stream, and their patients had certain requirements. I remember my teacher in China, Professor Wang Ju Yi who was both steeped in Classical Chinese Medicine but was equipped with a very enquiring (one would say 'Western oriented') mindset and who was willing to question (in a very respectful way) the classics discussed the history of channel palpation. In his opinion the physical palpation of the channels was commonplace in the time when the original classics were written. Although the classics were written between 1,500 to 2,500 years ago, no extant copies remain - the physical copies that are available today are usually Song or Qing dynasty copies and commentaries, which date from only about 1,000 years ago. However during the feudal period, the physical touching of patients (especially those from a higher social class) was frowned upon and emphasis placed on symptom taking, together with pulse and tongue diagnosis. He was of no doubt that the palpation was carried on by the lower class doctors who treated the general population - however they rarely wrote the books!!! On the plus side, the specialisations of pulse, tongue and symptom taking was raised to an entirely new dimension. For further insights into Channel Palpation click onto short 20 minute video below. Alternatively please go to the Applied Channel Theory website, by clicking here , where you will find numerous articles, podcasts and further resources.

RICE, PRICE or POLICE - revised thoughts on the management of acute injuries

by Alexander Brazkiewicz • 02 Jun, 2020
No, I haven't gone mad!! This is not about the cost of takeaway food to Law Enforcement Officers. What have these three acronyms in common - the answer is the evolving treatment of injury. We all are told of conflicting advice about what to do with an injury. "To ICE" or "not to ICE", 'To Rest' or "too much rest is bad for you". This blog hopes to answer some of those questions. If you are not familiar with the acronym R.I.C.E., it is the often used treatment for acute injury and stands for: R - Rest I - Ice C - Compress E - Elevate However this conflicts with the Chinese Medicine concepts of injury management.. The Classical Chinese Medicine (CCM) paradigm holds that pain is caused by stagnation - and whereas the CCM paradigm approves of Rest (in the early stages at least) and Elevation (to help in the reduction of swelling) it tends not use Ice or Compression, since it is felt that these two will increase stagnation and may slow the healing process. CCM prefers to utilise herbal poultices or plasters that are energetically cooling, but still promotes moving of Qi and Blood (including lymph and other fluids). If plasters were not available, then a cold compress in the initial stages could be used (but for no more that 5 minutes every hour) to help with the acute pain. This dichotomy often led to heated discussions between myself and some of my Western Medicine tutors - however it seems that the ICE model may be due for an upgrade !! Latest research seems to support the idea of Resting for the first 24-48 hours after acute trauma to stop further injury (Bleakley et al, 2012) - however too much rest can actually cause more harm than good (hence that is why many post-surgical regimes have patients up and mobile much sooner than was the case 10 or 20 years ago). It seems that excessive rest can cause joint stiffness and weakness and may lead to a change in biomechanics due to adaptation and compensation by neighbouring structures, increasing the possibility of re-injury. Again, according to that 2012 study the evidence supporting the use of Ice is mainly anecdotal (focusing mainly on its analgesic effects) together with the use of compression. As was pointed out by Dr Bahram Jam from the Advanced Physical Therapy Institute (Jam, 2020) humans have spent about 7 million years evolving an effective method of tissue repair post injury - initiated by the inflammatory response. Inflammation prevents further damage, stops infection and kick-starts the repair process (termed proliferation and remodeling). Blood vessels dilate and become 'leaky' (permeable) thereby; Allowing the arrival of white blood cells (leukocytes) to kill off any infection and to signal reinforcements (in the shape of cell eaters or macrophages) to help mop up the damage.; Any waste products and excess fluid are then removed by the lymphatic system - which (unlike the cardiovascular system) does not have its own pump and relies mainly on movement, skeletal muscle contraction and breathing for lymphatic drainage. Whereas icing modulates pain, it also limits muscle contraction (Bleakley, 2012) which may then also temporarily effect lymphatic drainage at the site. Ligaments and tendons, both of which have a poor blood supply normally, may be adversely affected by too much ice, which constricts blood vessels and theoretically may reduce healing. The ICE model was then revised to PRICE,. However the model currently in favour is P.O.L.I.C.E.: P - Protection - this aims to reduce further damage to the injured area by using devices (such as crutches, braces or supports - traditionally associated with rest) to avoid complete rest and still move, whilst protecting the area; OL - Optimal Loading - this refers to the start of gentle movement of the injured area. Controlled mechanical loading up-regulates gene expression of proteins that are used in soft-tissue healing (Bleakley, 2012) thereby prompting healing at a cellular level. The problem is that if tissues are stressed to much, too early further damage could be caused. Guidance can be given at the clinic regarding exercises that progressively load the area to promote healing and increase proprioception. Optimal Loading also prevents problems such as muscle tightness or muscle wasting that can happen form too much rest; I - Ice, applying ice (putting a towel between the ice pack and skin, avoiding ice burns) to the injured area for 10 minutes every 2 hours; C - Compression - gentle compression of the injured area with a bandage may minimise swelling - however insure there is not skin colour changes or pins-and-needles since it may be too tight; E - Elevation In addition, the use of Anti-Inflammatory pain killers (e.g. Ibuprofen) in the acute stages (usually 24-48 hours post injury) is now frowned upon since, as had been described, inflammation is required for the healing process and a key response to tissue damage. If necessary, paracetamol could be used for analgesia. Click here to download a brief advice leaflet, or look at the video below for further information.
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