Now as we approach the end of February most of us are experiencing that perennial feeling of guilt that our New Years resolutions are nothing but a distant memory. It’s a well known fact that the UK’s health and fitness sector do over 80% of their business in December and January. Whether it is to loose weight or to run the London marathon most of our resolutions involve increasing our exercise levels. So why is it so hard to keep such straight forward resolutions? Well, this is also a problem faced by physiotherapists all over the country while prescribing exercise therapy and keeping patient motivation going. Although there is no quick-fix answer to address this problem there are some factors that when considered can help.
Poor “locus of control” is a commonly quoted psychological characteristic that is associated with lack of exercise adherence. In layman’s term this means people who fail to recognise the important role they themselves play in their own health and wellbeing. No one else will make the time or do the exercise for you. The long-term prognosis of many patients I see in clinic is dependent on them taking partial responsibility for the treat of their condition/injury.
When exercise is prescribed by your therapist or health professional the “prescription” is just as important as the exercise itself. Just like medication, if you fail to undertake the prescribed amount then it wont have the desired effect. Conversely, if you do too much there maybe side effects such as overuse injuries and/or fatigue.
Adherence to an exercise plans requires firstly the acceptance that exercise is not merely an activity but it’s a life style choice. This therefore will require a time commitment to undertake. This is the point where most people fail. Even with the best will in the world, if you are working a 60+ hour week you are going to struggle to commit to exercise let alone have the energy to do any.
Set yourself short and long term goals. Establishing these will set you up throughout your exercise plan. They not only help you monitor progress but they also motivate you in those dark days 3 or 4 weeks in when every muscle in your body is screaming for just one week off.
Goals should be achievable over an appropriate period of time. Unrealistic goal setting will put you at risk of overuse injuries, which is a great excuse to stop exercising. So if you haven’t run in 20 years don’t expect to do a 4 hour marathon without at least 4 months of progressive training!! Seeing progress in your health and wellbeing is the best way to stay motivated, without short and long-term goals this is very difficult.
Exercise doesn’t always have to be an individual quest for “human physical perfection”. Making the move from three nights socialising in pub with your mates to three evenings on a cross-trainer can be a lonely experience. So chose something that is interesting and enjoyable. If passing out in bikram yoga, shaking your hips in zumba or letting all that stress out in body combat is your thing, exercise classes are for you. For some, finding a well run class is the ultimate answer to exercise motivation. Class benefits include social support, motivation, mastery and most importantly social “blackmail” (everyone has someone in the class they want to be like or know they should be better than).
Exercise when preformed therapeutically or recreationally can be transformative in anyone’s life. The problem is it’s often in direct conflict with our ever-shrinking spare time. Physical, psychological and lifestyle benefits are well documented. It is the health professionals’ responsibility to prescribe appropriate exercises and help formulate appropriate exercise goals. However, the ultimate responsibility is with you so don’t give up on that resolution yet!!
David J Bevan (MSK Physiotherapist, Physiolink)