I Can't Exercise Because...
Almost every day I hear the discussion of why people perceive that they can’t exercise. This is usually followed by a discourse on how they can’t lose weight. If I were to believe everything that is told to me in the office I would conclude that the people of this country are related to air plants. Neither I, nor any nutritionist can resolve the situation for people that are unwilling to look at their own behavior or what is on the plate. The simple fact of the matter is that you will gain weight if you eat more calories than you use.
All is not lost, however, for those that have limitations in exertional capabilities due to ankle, knee, hip or back problems. Sometimes simple solutions can make a big difference.
For many years I have observed that the perception not being able to exercise may be due to correctable causes. The most common of these is an exploration of what the problem is. The most correctable problems are related to the back and lower extremities. I can use myself, and my office staff as examples.
As a young man I was quite physically active and participated in many sports. An injury to my knee, however, impeded continued running. I was offered surgery at the time but opted for physical therapy (actually a good choice, my knees remain free of scars). But I did not resume running for many years as I was limited by my perceived knee problems. In an effort to get myself into better shape many years later, I bought a set of running shoes and found that the newer design actually gave quite good support and permitted me to return to running. The experience of many physiatrists and orthopedists had been used to design shoes that eliminated a perceived disability.
Using this knowledge, I have been able to return people, including my own staff, to active participation in sports. Many are quite surprised that a simple change in footwear can resolve a problem with a back, knee or ankle. But this shouldn’t come as such a surprise if you think about it. No one would plan to spend the day walking with a rock in his or her shoe. It would be too uncomfortable for the foot, and if we did it, we would end up with a limp that would eventually hurt the knee, hip or back. Anyone that starts out to wear high heels will recall that it isn’t so easy to get used to. Yet we do get used to wearing things on our feet that may not be the best for what we need to do. It is important to remember that shoes should be comfortable as soon as you put them on. If they are not, they are not for you. Recognizing this as a possible cause for exercise limitation may be all that is necessary to help some people burn off those extra calories.
For those that may be helped by this suggestion, I recommend a visit to a store that specializes in running shoes (and watches you walk or run) so that you can be properly fit. Running shoes are excellent for walking, but not for playing basketball or tennis. Wear what is appropriate. If the running shoe or a good walking shoe doesn’t help, it is sometimes useful to consult with a physiatrist (specialist in rehabilitation medicine) or sports medicine orthopedist. The shoe may not be the problem, it is made for the "average" person. Sometimes an orthotic (a device that fits your particular foot better) can be molded to your foot and placed inside the shoe to ease the and redistribute your step in a way that will provide pain relief)
For those that are initially helped by change in footwear but relapse it is important to note that due to modern material, shoes may look fine and still be worn out. No matter how good they look, no heel or sole has been made yet that can be expected to last 5 years.
Larry Weinrauch is a cardiologist in Watertown, Massachusetts and is affiliated with Mount Auburn Hospital. He wrote for HealthCentral as a health professional for Heart Health, High Blood Pressure, and High Cholesterol.