Inside Health Exercise Special

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Radio 4’s Inside Health returned for a new series last week with a special edition on exercise.  There were some interesting findings, which may be of interest to anyone who is trying to be more active, or to those who already exercise on a regular basis.  If you’d like to listen to the half-hour programme, you’ll find it here.  Not enough time?  The key points from what was discussed are summarised below:

  • According to Philip Conaghan, Consultant Rheumatologist and Professor of Musculoskeletal Medicine at the University of Leeds, weak muscles rather than damaged joints are behind many aches and pains. Generalised joint pains are common.  Often they’re the sort of pains that give five to 10 minutes of morning stiffness that gets worse as the day goes on, so the more you load your joint the more pain you get.  These are termed mechanical joint pains. The root cause of a lot of that pain could be some joint damage, but for most people it’s muscle weakness driving the pain.  Muscle loss can lead to the tendons in the joints overworking, which in turn can result in tendonitis.
  • There is excellent trial evidence that proves muscle strengthening reduces joint pain.  It’s not so important what exercise you do, so long as you’re doing something.  When you’re very weak it’s best to start with just one or two things you can do every day for 30 or 60 minute bursts.  Exercises to strengthen muscles are highly beneficial in alleviating mechanical joint pains.  You can rebuild muscle at any age, but it’s not a quick fix.  It takes time and regular exercise.
  • People are often concerned they will damage their joints faster if they exercise. They are worried about the pain they experience when they exercise.  Conaghan recommends getting strong first to avoid damaging the joints.  For example, lying flat, doing straight leg raises or using a squeeze ball to strengthen your forearm, won’t damage the joints.  He says it will hurt when you start doing it, but muscles ache after they do appropriate exercise and that’s the sort of ache we’re looking for. When you get a bit stronger low weight bearing exercises should be added.  So, for example, for very weak patients, walking laps in a swimming pool is highly beneficial – it’s non weight bearing and it’s fantastic exercise for the lower limb muscles.  Then as you get stronger you might move to an exercise bike or a cross-trainer where the impact is very low.
  • True arthritis pain in the joint may not be reversible, but will still reduce a significant amount with muscle strengthening.

Alex Soth

  • Being weak and out of shape doesn’t just affect how you feel, it can influence your chances of recovery from serious illnesses like cancer.  There were concerns previously that if you’re unwell you should rest and that will help you recover, but studies have demonstrated that exercise has a protective effect against at least four different types of cancers.  Movement, exercise and mobilisation early after either surgery for cancer, or during treatment has been shown to improve your long term outcome.
  • Dr Denny Levitt, Consultant in peri-operative medicine and critical care at the University Hospital Southampton cited a recent study which suggested that about 10% of post-menopausal breast cancer in Australasia could be attributed directly to physical inactivity, i.e. one tenth of the cases of breast cancer can be related to being inactive.
  • World Health Organisation and UK government guidelines suggest that we should be doing around 150 minutes of moderate intensity exercise each week.  Moderate intensity exercise would be going for a brisk walk or a cycle ride.  You should try and do this in bouts of exercise of around 30 minutes, so five times a week, 30 minutes of exercise.  Alternatively with high intensity or strenuous exercise such as running or playing a game of football, only 75 minutes of exercise a week would be sufficient to reduce your health risks.
  • Sanjay Sharma, Professor of Clinical Cardiology at St George’s, University of London says, for joggers and runners, the sweet spot for maximum reward in return for minimum effort –  in cardiovascular terms at least –  lies around training for about 2-2.5 hours a week, at speeds ranging from 15 minute miles, to around eight minute miles for faster athletes.
  • The NHS Couch to 5K app is a useful way to get non-runners into running.  The app takes you from being able to walk and not go very far to being able to run a 5K race.
  • A study suggests that people in the UK aged between 65 and 74, only 20% of men and 17% of women are getting enough exercise.  That falls after the age of 75 to only 9% of men and 6% of women.
  • There are some excellent studies looking at the effects of exercise in elderly frail people.  They suggest that exercises concentrated on strength, balance and some weight training, as well as walking activities, help to improve mortality rates, as well as cutting down on the number of falls.

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