It’s never been more important for us to get the right amount of exercise, not just for our physical health, but our mental wellbeing. The good news is, a little can mean a lot! We talk to a couple of experts about the benefits of exercise done in baby steps.
There’s no escaping it. Exercise is something we all need to do. Study after study shows the benefits of physical activity for our bodies; it improves heart, joint and bone health, helps as a weight management tool, and reduces our risk of chronic disease.
Moving is also great for our minds, with not just improved mood and mental health, but better memory and brain power, which becomes even more important as we age.
Yet the pandemic has had an impact on many people’s physical activity. A CSIRO study of 4000 people showed 66% of people felt their exercise had worsened during COVID.
However, for those of us who shudder at the thought of pulling on the runners, working up a sweat, or huffing and puffing at the gym, there’s good news.
A little exercise adds up to a lot. And the littlest exercise of all is incidental exercise.
Incidental exercise is the physical activity we do as part of our day-to-day lives. The walk from the carpark to the train station, or from the tram stop to the office. Walking the kids to school. Vacuuming the house. The little pop-ins to other people’s desks. Wandering through a shopping centre on a Saturday.
A lesson many of us learned, thanks to the recent phenomenon of ‘COVID kilos’, is that incidental exercise makes a world of difference, according to women’s health physiotherapist Cath Willis.
It’s all that incidental exercise and physical activity that helps to usually keep people’s weight down and help with their general health,”
Cath Willis, women’s health physiotherapist
“So I think anecdotally there was a general increase in people gaining weight and losing fitness because they weren’t doing all of that incidental exercise.”
“I think most of us will admit to gaining a kilo or two during lockdown.”
Ms Willis’ views are echoed by the Head of the Musculoskeletal Unit, Monash University and Head of Rheumatology, Alfred Hospital, Professor Flavia Cicuttini, who says that while “eating and snacking” increased for many people, “a lot of incidental activity was lost” not just from people working from home, but from the additional work that lockdown created – especially for women.
“There’s also been more home-schooling and housework to do,’” says Prof Cicuttini. “There are some people who have had more time to spend on themselves, because they’re not driving to and from work and stuff like that, but I’m not sure a lot of women have, because the [research] I’ve seen suggests women carried a lot of the extra work.”
Her comment is supported by the 2020 Jean Hailes National Women’s Health Survey, which showed women aged 25-44 found themselves busier during COVID; more than 19% reported an increase in home duties, 16.6% reported longer working hours and 14.6% managed home learning for children.
It’s clear – many of us need to move more. So where do we start? Literally one step at a time, says Prof Cicuttini – especially if we’re older, or nursing existing injuries such as a troublesome knee. Less is more when it comes to getting started, as big goals or too-specific advice can both lead to disappointment.
“It’s always bothered me that we give people very clear directions … ‘you should lose 5% of your weight, you need to walk 20 or 30 minutes three or four times a week’,” says Prof Cicuttini. “In an ideal world we’d have everybody with a BMI [body mass index] of 20-25, walking three times a week, but we need to be careful that we don’t put people off. When you give very firm directives like that, you run the risk you give people permission to fail. ’If I can’t do that amount of exercise, or lose that amount of weight, what's the point?’.
“There is a point. I think we should have the philosophy ‘how much exercise should you do? Just a little bit more’. This is like Rockefeller, who was the richest man in the world, when he was asked how much money is enough, he answered ‘just a little bit more’. It strikes me that it’s quite a good philosophy for exercise as well!
“So, if someone can walk 100 metres, great. If they walk 100 metres every day, you’ll probably find that after a week they can walk 120 metres ... and so on.”
Injuries such as a “big inflamed knee” of course need treatment, says Prof Cicuttini. But we know that long-term rest isn’t the answer. In fact, both she and Ms Willis warn that resting too long can result in the loss of muscle mass, which in turn can lead to more problems.
“We know from big research studies that we start to lose muscle mass within weeks, if not days, of stopping exercise,” says Ms Willis.
Prof Cicuttini says than in two weeks of inactivity, an older person can lose around 7% of muscle mass.
“If you stay sitting down or resting until a joint gets completely better, the muscle wasting that will occur will result in major problems,” she says. “The muscle wastage and weakness happens in a few days. The original problem the person has may settle down, but as there will now be muscle weakness, when the person goes out for a walk they are more likely to jar other joints like the knee or ankle because the muscle support is not very good.”
So how do we get moving if we’re sore? Do it with support, such as walking aids, says Prof Cicuttini.
“Often people will hobble along with a sore knee, but as that one settles down, the other one starts hurting because it’s compensating,” she says. “Or your back starts hurting because you’re walking in a funny way.
Walking aids are important because you want people to keep moving as much as they can, but you want them to be safe and not fall over.”
Prof Flavia Cicuttini, Head of the Musculoskeletal Unit, Monash University
She suggests using a walking stick, walking poles or a crutch to help yourself to get moving. And if you use a walker, use its seat to break up your exercise if you need to. “You go around the block. If you get tired or your joints are a bit sore, you stop and sit down,” she says.
Ms Willis says other physiotherapists had reported that lower-back injuries were very common during and after lockdown due to people losing general strength without regular exercise, and increasing activities such as gardening.
Neck injuries also increased from people working at home, with many sitting at kitchen and dining tables without a good work 'set up'.
Ms Willis says women need to be aware of a “trifecta” of factors that can affect them after menopause.
“Bone density can decrease, muscle strength can decrease due to the hormonal changes, but also you can start to have bladder control problems,“ she says.
She paints an all-too common picture. “The real issue can be for women, they wake up in the middle of the night desperate to go to the toilet, they hop out of bed and try to rush to the toilet in the dark, their muscle strength is weaker, their balance is less reliable, and they trip and have a fall and fracture something because they’re in a rush to get to the toilet,” she says. “So there can be that real follow-on effect with those sorts of symptoms.
Ms Willis encourages women to visit a women’s health physiotherapist to avoid such possible life-changing accidents. “There are usually very simple things you can do to reduce prolapse symptoms or urinary incontinence,” she says. “And then they can feel more confident to go and exercise.”
Of course, the idea is to try to avoid such health issues before they become problems. Ms Willis says the key to a healthy postmenopausal life – which for many women “is a much bigger proportion of their life span” – is to prepare for it.
“If you go through menopause at 50 and live until 80-85, that’s a much larger chunk of your life that you need to be aware of exercise,” she says.
Yes, exercise is the way to avoid the postmenopause trifecta. “Good exercise to prevent weight gain, strengthening exercise to prevent muscle loss, balance exercises to prevent falls and things like [using weights] to help maintain bone density,” says Ms Willis.
The good news is, it’s never too late to start. And starting small is best. During Women’s Health Week, we encourage all women and girls to start making small changes, one step at a time, towards improving their health.
And with physical activity, it really is – literally – one step at a time.
For more information on getting active, visit https://www.jeanhailes.org.au/health-a-z/healthy-living/physical-activity-exercise
To learn more about how to work from home without hurting yourself, visit https://www.jeanhailes.org.au/news/working-without-wincing
