• Dr. Robert

Clambering up the Slide I Spent 10 Years Sliding Down…

This is what I felt like 8 weeks ago - a frumpy penguin (we shall call him Ambrose...)

This blog article is purely my thoughts on getting myself back in shape after many years of letting things slide (it was more like an avalanche…). This article should not be construed as specific health advice to any individual, but merely my thoughts and perceptions on my own health and fitness. I do not wish to go into too many specifics, as everyone’s health and exercise needs are different, so I have limited my ramblings to general concepts with a few details thrown in for good measure. If it's been awhile since you've exercised and you have health issues or concerns, it's a good idea to talk to your doctor before starting a new exercise routine.

For those who may have been following my comments on Facebook recently, I have been engaged in a home exercise program. As of today (6/17/2018) I have completed week 8. My decision to start exercising and following a healthier lifestyle was based on many factors, such as carrying too much weight, a history of injuries to my hip and ankle that necessitate ongoing rehabilitation, and wanting to be around long enough to see my children graduate, get married, etc. Not being a hypocrite to my patients was also a great motivator (I hate the “do as I say, not as I do” attitude, but I had fallen foul of it myself). The tipping point was seeing a side profile photo of myself, with a protruding belly, rounded shoulders, forward tilted head and a slumped posture – I looked like a frumpy penguin. Oh, the humanity! In my defense, I had been involved in a desk job for 10 years that took almost everything out of me, physically and emotionally. I was, indeed, in a rut and totally deconditioned. I clambered out of the rut a year ago, but it has taken until now for me to sort myself out and to think about what I want to do with the rest of my life. Being a logical fellow, I put extensive thought into what I specifically wanted out of an exercise program, and how it would integrate with my positive healthy lifestyle choices (no point exercising to exhaustion if you are still pigging out on cookies every chance you get). Much of what follows is common sense, and I have borrowed ideas from several sources, but I have put my own twist on them.

Motivations, Goals, Actions and Consequences

1. Consequences

Yes, I included consequences. I have my reasons. I will start with consequences, because that, in theory, is where we want our destination to be. Then I will go back to motivations and work my way forwards. There will be quite a bit of overlap. There is a method to my madness, but that may also suggest that my method involves madness. So be it.

We tend to shy away from the idea of consequences, because we view them in a negative light. Maybe it is because of all those times our parents shouted at us that there would be consequences to our, admittedly, often stupid actions. Breaking the law should, rightly, result in consequences. But consequences can be, and often are, good. The consequence of a fair day’s work should be a fair day’s pay. The consequence of obeying the law is that you don’t end up in a prison cell. Sometimes we don’t understand the long-term positive impact of the consequences of our actions, but instead dwell on the short-term (and short-lived) negatives, and thus become discouraged. Ironically, becoming discouraged may prevent us from enjoying the good long-term fruits of our labors, as we may give up at the first stumbling block. When it comes to exercise, we know that the consequences of working out should be improved “health and fitness” (a phrase sorely in need of definition – but that is for another article), increased function, decreased pain, and improved contentment with life. We see these as positive consequences. It is up to each individual to choose the positive consequences that they want from exercising, dieting, etc., then decide if they want to put the effort into obtaining those consequences. Understanding consequences is one of the cornerstones to being motivated.

2. Motivations

If you are comfortable where you are in mind and body, then there will be no motivation to change. A large part of motivation should be about realizing what is uncomfortable with your current situation and body habitus - you have to put yourself in a position where you compare the negative consequences of your current lifestyle with the positive consequences of exercising, dietary changes, etc. Over the past 18 months I looked at the consequences of continuing a job I didn’t like (a 40-hour-per-week desk job working at home), poor eating habits, awful sleep hygiene and a total lack of physical exercise and mental stimulation. It was not a pretty sight (think of the frumpy penguin mentioned above). To be honest, my lifestyle was a slow-motion train wreck, negatively impacting me and those around me that I love. I had to look at the negative consequences of what I was, and was not, doing, and then decide on what positive consequences I wanted for myself. By comparing the negatives with the positives, I quickly came to realize the destructive nature of my conduct and how far away I was from where I wanted to be. This made me extremely uncomfortable, as I knew that I had to make major changes in my life to be able to obtain the positive consequences that I wanted, but the discomfort of making necessary changes was much less than the discomfort of staying in the rut I was in. Now, 18 months later, I have quit the job that was slowly destroying my soul, I am now engaged in treating patients (which gives me a true sense of contentment – my patients are awesome), I am sleeping at least 8 hours a night, my diet has improved dramatically, and I have been able to get back into exercising. I am joking and laughing with my wife and children, and I am a much nicer person to be around (so I have been told). So, we know the consequences we want, and we are motivated to push towards those consequences. We need a plan…

3. Goals

By determining what consequences we want, we can plan and devise goals that can push us in the right direction, noting that goals can and will change over time. Our goals should be reasonable, achievable and logical, and should always keep us focused on the desired end results. We should also try and have more that 1 or 2 goals and have a good mix of short- and long-term goals. If we limit the number of goals we are trying to reach, then we can get demoralized if we reach a plateau with those particular goals. I currently have 3 major consequences I want to reach, a handful of minor consequences (which will most likely change over the next few months) and 10 goals that I believe are pointing me in the right direction. I have yet to fully formalize my goals, but I am getting there as I learn my current capabilities and assess how far and fast I can push myself in a safe and controlled manner. One thing I decided early on was that, while wanting the consequence of decreased body fat, I did not want to focus on a goal of weight loss. Too often people focus too heavily on one consequence, and therefore on one goal. In the case of weight loss, their focus is on losing a lot of weight quickly, and they often follow the current fad diet. They lose weight, feel pretty good about themselves, then discontinue the diet and, over the coming months, wonder why all the fat is coming back. Been there, done that, ate the box of cookies. My plan is to slowly build muscle, which would have the natural byproduct of decreasing my body fat in a slow, controlled and, most important of all, sustainable manner (even while resting, the more muscle you have, the more calories you burn). While there have not been any spectacular changes over the past 8 weeks regarding my weight (my scales indicate that I have only lost about 2 pounds), my waist size has gone down by a couple of inches, my chest measurement is now more than my waist measurement, and the extent and distribution of body fat is changing for the good. The only changes I made to my diet include cutting down on unnecessary carbohydrates/starches, and slightly increasing my protein intake. If anything, I may have slightly increased my calorie intake to allow me to exercise at my current level.

4. Actions

You have sorted out where you are (point A) and where you want to be (point B), and now have an idea of how to get from A to B without deviating over to C, D, E or, in a worst-case scenario, Z. At some point talking the talk must become walking the walk (or jogging the jog - you get the idea). That said, I have had to treat plenty of people who threw themselves into exercise without appropriate planning or achievable goals. I was talking to an ER physician a short while ago, and they told me that they see quite a few young males stumble into the ER because they have started an intense CrossFit program and have developed rhabdomyolysis (rapid breakdown of damaged skeletal muscle), which can result in acute renal failure. An exercise program that might kill you does not sound like a good thing to me. Planning your exercise program must take into account the level of exertion you are willing to put in, physical and mental limitations, the amount of time per day you are prepared to set aside for exercising, the accessibility of exercise equipment, etc. My exercise program involves a lot of baby steps, as I can no longer exercise at the same level of exertion as when I was in my 20’s, and my recovery time is much longer. I do not like these facts, but I have to accommodate them into my exercise program. I am slowly working out what I can and can’t do, what I should be able to do over the coming months, and what I should avoid at all costs. It takes time, energy, sweat and patience. Efficient planning, which should be ongoing and integral to your actions (which is why I do not have a separate heading for planning, as it bonds goals and actions together), is how we maximize gains while decreasing the risk of injury. Efficient planning also keeps our mind on the consequences we seek, the goals we wish to achieve, and the actions we need to perform get where we want to be.

I know that was a lot to read through, and I do tend to waffle quite a bit, but I hope that you might be inspired to be healthier and to exercise. Keep it simple, keep it safe and keep it fun.

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