The Importance of Movement Every Day

 


When I think of all the years I lived with MS before I began making the changes that I teach in this book, one of the things that seems the most unsettling to me now is how little I moved.

In fact, I tried my best not to move.
That's because my balance was so poor that even the simple act of walking could lead to falling and injury. Ultimately, I chose to use a cane for assistance, and as a young physician, wife, and mother, this was very embarrassing for me. I didn't want my children, my husband, or my patients to see me with a cane, to view me as someone who was having so much difficulty just getting around. In the early days, I would try to hide my illness by forcing myself to go without a cane. I was supposed to be helping others, and I didn't want anyone to feel sorry for me or be distracted from their own issues by having to think about mine.

I now regret all that time and energy I put into hiding my condition, and I wonder if my readiness to change might have come sooner if I'd been willing to accept where I was, been honest with myself about it, and worked from there.

If you are suffering from a chronic illness and the very thought of physical activity is frightening to you, I can relate. Looking back, I sometimes wonder how I knew I was ready to start moving more, much less start an exercise routine, but after my blueberry aha moment and resulting diet change, I knew the next thing I needed to address was movement. Doing so was not easy, and outside of my husband I had almost no support. My doctors advised against it, as much of the medical thinking at the time was that people with MS should limit exercise, out of fear that doing so could actually exacerbate the disease. 1 This is not surprising when you consider that in my own case, my MS symptoms would actually worsen when I tried to exercise. For example, if I peddled on a stationary bike for even five minutes, I would begin to lose feeling in both legs. My initial reaction would be to stop, in fear of hurting myself.
For people with MS and other demyelinating diseases, worsening symptoms can occur when the body's temperature is elevated as in exercising, going in a sauna, or even being outside on a hot, sunny day; this is known as Uhthoff's syndrome or phenomenon. 2 What I didn't know then, but would soon figure out, was that by doing a little each day, and building on it over time, I could overcome this.
When I first started, my husband had to help me get on the bike every morning (when I placed my feet in the pedal straps I could not even feel them!). I was only able to complete a few minutes of pedaling before my body temperature would rise, Uhthoff's syndrome would kick in, and my MS symptoms would emerge. After my husband helped me off the bike, I had to sit for fifteen minutes drinking cool water as a shower of pins and needles continued through my body.

Early on, I was concerned that even this short regimen might be worsening my MS. It sure seemed that way. Over time, however, I noted less and less difficulty. Today, I run, hike, or walk every day, typically three miles in the morning. Twice a week, I work on strength conditioning—my regimen consists of push-ups, planks, squats, burpees, and dumbbells. I never could have imagined in those early days that I would make it to this level of fitness, but this willingness only came after I accepted where I was, and became willing to start from there, no matter how small.

I am now a firm believer in the importance of movement when it comes to achieving optimal health. However, I definitely understand the obstacles facing many of us when it comes to adding exercise and movement into our lives. For me, it strikes me as especially ironic that I am such a proponent of movement and exercise when I consider the fact that for much of my life, well before I had MS, this was not the case.

Growing up, no one I knew would have described me as an athlete. Those who knew me as a kid are shocked that running is now a part of my movement routine. That's because back then, I developed a near hatred for running, largely due to the fact that I was so slow compared to other kids. I remember in elementary school, when it came time for organized footraces, we were divided into two groups: the fast kids and the slow kids. I was always in the latter group, and my nervous hope was simply that I would not finish last.

Furthermore, coming from an immigrant family, formal exercise wasn't something that was important to us culturally. Going to the gym or pool was largely seen as a leisure activity, something we had neither the time nor money to do. I see now how experiences like this would affect my view of myself as someone who is not “athletic,â€‌ and consequently influence my movement habits as I got older.
When I think back to my formative years, it's clear that societal messages and cultural views influenced my actions around movement and exercise. Just as we discussed in the last chapter on food, this messaging can affect our personal choices in whether we choose to exercise or not, but unlike food, the messages we get in these areas can be more subtle and harder to spot.

Let me explain. As young children, almost all of us moved and exercised. Of course, we didn't call it that—we called it playtime. We chased each other in games of tag, swung on the monkey bars, and jumped in a swimming pool whenever the chance presented itself. But for many of us, as we grew older, this playtime, and more importantly physical movement in general, fell by the wayside. Always the curious scientist, I wanted to know why this occurs for so many. Was it just a consequence of growing up? If so, why do some people continue with exercise and movement and others do not?

When I talk to my patients who haven't been regularly physically active in years, one of the most common themes I hear is that at some point in their lives they adopted the idea that exercise and movement are something best done by those who are “athletic,â€‌ and that this was simply not how they would describe themselves. When I dug deeper, I found that those who were even just a little overweight often said that going to the gym felt more like an exercise in negative self-judgment and comparison than a means to improve their physical health.

If you are someone who doesn't have a regular exercise routine, I'd invite you to consider how societal and cultural messages may have affected your ideas about topics such as exercise and physical movement. If you've had personal experiences like I did growing up, or if you see those fitness models on television and immediately go into comparison and self-shaming, my hope is that by the end of this chapter you will feel differently about physical movement and exercise. To begin this shift, I'd like to dispel a popular yet mythical idea about exercise as a cure-all.

I recently had a patient referred to my practice, a sixty-one-year-old man whom I'll call Jim, who had just had a stent placement for a 90 percent blocked coronary artery. Jim had been living on the edge of a mortal cliff—in danger of having a massive heart attack at any moment that most certainly would have ended his life in a matter of minutes.
Yet you never would have guessed that by looking at him.

Here he sat in front of me, looking as slim and fit as the models we see in gym membership advertisements and bragging about his physical accomplishments. He said his friends joked he had the body of an Adonis, and his employees at the multimillion-dollar business he owned referred to him as Iron Man. When I reviewed his medical history, I learned that he had been an avid college athlete, breaking records at the Ivy League school he attended, and had continued this athleticism after college, running several marathons over the course of his life.

Do you want to know how he celebrated after those marathons he ran? With steak dinners, alcohol, and cigars. As I probed further, I found he also spent eighty to one hundred hours a week at the office in what was an incredibly high-stress environment, lived alone after a nasty divorce from a few years earlier, and hadn't talked to his adult kids in months. Does this surprise you? Not me. Sadly, I see cases like this all the time.

Distorted social norms falsely lull some of us into believing that high-level athleticism is the trump card when it comes to achieving optimal health. Loosely put, the idea seems to be, “If I can do all of these superathletic things and I look like the models in the ads, then my health must be great.â€‌ So this messaging can not only lead to feelings of shame for people who run slower than others or have different body types, but can also mask serious health problems hidden behind a “healthy-lookingâ€‌ body, just like Jim's.

So often when we think of physical activity, we think of it in terms of improving how we look. We are bombarded with cultural images that tell us that health and beauty are dependent on small waists or huge muscles, but this is the skin-deep view of exercise that advertisers want us to see. The truth is that the positive effects of movement go far beyond appearances, as exercise improves our sleep, our mood, and our metabolism. These are just a few of the benefits you're likely to feel almost immediately. The long-term benefits include increased bone, brain, and heart health, all of which lead to significant increases in longevity and healthier, happier lives.

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