1. A presentation at NAVS
Summerfest 06/28/12
Stephan Esser MD
www.esserhealth.com

2. Exercise:
Myths and
Misconceptions
Stephan Esser MD
www.esserhealth.com

3. If you are over the age of 40 or have
any chronic diseases or have a
personal history or strong family
history of heart disease, sudden
cardiac death or the like then you
should NOT begin a new exercise
program without first consulting your
primary physician.

4. Goals
• Set some Ground Rules
• Provide basic Definitions
• Dispel common myths
• Discuss frequent misconceptions
• Provide tools for change

5. Defining Exercise
• Exercise:
– movement of the body resulting in the
enhancement of health and improvement
of function

6. #1
Exercise is of no real value to
my health

7. • I am a vegan…. I just don’t need to exercise
• I don’t have any health problems
• I’m healthy the way I am
• I’m skinny, I don’t need to exercise
• I’ve never exercised before why would I start
now?
• That’s why they make medicine
• Hello “drive through”
• Aren’t we supposed to “conserve energy”?

8. Actual causes again

9. Exercise and Physical Health
• Reduces risk of
– Heart Disease ≈ 40%
– Obesity: ≈ 30-100%
– Stroke ≈ 50%
– Type 2 Diabetes ≈ 50%
– Hypertension ≈ 50%
– Disability delayed ≈15 years
– Colon Cancer ≈ 25-40%
– Breast Cancer ≈ 20%-44%
– Osteoporosis ≈ 20+%
• As many as 250,000 deaths per year in the United
States are attributable to a lack of regular
physical activity

10. Physical Health Cont’d
• Improve Balance
• Reduce Fall risk
• Improve Systemic Circulation
• Accelerate Skin Healing
• Bowel Regularity/  risk diverticulosis
• Improved Energy/Resilience

11. Exercise and Mental Health
• Regular Exercise:
– Reduces risk/severity of:
• Depression
• Anxiety
• ADD/ADHD
• Alzheimers Dementia
– Improves:
• Mental Clarity, test scores, focus

12. Exercise and Emotional Health
• Regular Exercise:
– Increases Self Confidence
– Teaches skills to manage adversity
– Enhances Self Esteem
– Develops Discipline
– Encourages Goal setting and self awareness

13. #2
Exercise is the fix for everything

14. • I can eat all the McDonald’s I want
• I run 4 miles a day and hit the gym every other
day……… bring on the Dairy Queen
• I’m going bald….maybe I need to exercise
• See this tumor….if I run far enough it will
definitely shrink.

15. • While exercise does have multi-system, multi-
modal benefits there are many, many times
where exercise is NOT the answer
• Acute Trauma
• Progressive Cancer
• Progressive Neurologic Impairment
• “Weird stuff”
• Too soon

16. #3
Exercise means pink spandex, going to a
gym, sweating with a bunch of people I
don’t even know or like!

17. Categories
• Leisure time Exercise: organized sports,
running, gym activities, rehabilitation etc.
• Lifestyle Exercise: activity incorporated into our
daily pattern of life
– eg: parking in the distant portion of the parking lot rather then the first
bumper, taking the stairs instead of the elevator etc.

18. #4
I’m too old to exercise

19. • I’m just taking it easy now
• I’ve paid my dues
• Now is the time to relax
• Don’t want to work myself too hard
• I spent my whole life go-go-going
• I’m too old for “that”
• Those days are past

22. • “A review of biologic changes commonly
attributed to the process of aging
demonstrates the close similarity of
most of these to changes subsequent to
Disuse and Aging
a period of enforced physical inactivity.
The coincidence of these changes from
the subcellular to the whole-body level of
organization, and across a wide range of
body systems, prompts the suggestion
that at least a portion of the changes that
are commonly attributed to aging is in
reality caused by disuse and, as such, is
Walter Bortz MD subject to correction. There is no drug in
current or prospective use that holds as
much promise for sustained health as a
lifetime program of physical
exercise.”(JAMA 1982;248:1203-1208)

23. CDC Exercise Stats
• <20% of all adults achieve recc. Levels
• > 60% of adults are not regularly active
• By age 75 1:3 men and 1:2 women engage in NO
physical exercise

24. Aging and Exercise
• Reduces Disability
• Prolongs Independence
• Slows Aging
• Reduces risk of multiple Co-Morbidities
• Reduces All-Cause Mortality
• Reduces Medication use, Hospital Admission
• Etc………

27. • “You have to work at living, period. You’ve got
to train like you are training for an athletic
event. Most older people just give up. They
think, “I’m too old for that,” because they
have an ache here or a pain there. Life is a
pain in the butt; you’ve got to work at it.”
- Jack LaLanne -

29. #5
I’m too young to exercise

30. • I don’t want to stress my childs body
• My child needs to rest inside more
• It’s too hot/cold etc to stay active
• All that running around is too much for little
Johnny
• He needs to save his energy
• Working out will “stunt his growth”
• Exercise will make Janie look like a Johnny

31. • 50% of all youth ages 12-21 are not vigorously
active on a regular basis
• 1 in 3 children overweight or obese
• Rates of Type 2 Diabetes sky-rocketing
• Rates of medication use, hospitalization

32. • 1. All adolescents should be physically active daily, or
nearly every day, as part of play, games, sports,
work, transportation, recreation, physical education,
or planned exercise in the context of family, school,
and community activities.
• 2. Adolescents should engage in three or more
sessions per week of activities that last 20 minutes
or more at a time and that require moderate to
vigorous levels of exertion.

34. #6
No Pain, no Gain

35. Depends

36. Not good pain
• Chest Pain
• Joint Pain
• Pain that radiates
• Pain associated with neurologic changes
• Pain with swelling
• Pain that fails to improve with appropriate
measures
• Pain that compromises other systems function

37. “Good Pain”
• Muscle “pain” while exercising
• Muscle soreness 1-2 days after exercise
• Moderately labored breathing during activity
• The opposite of the other page

38. #7
You have to exercise really hard or
there is no benefit

40. Talk Test:
-Easy: Can Talk and Sing
-Moderate: Can Talk but not sing
-Intense: Can’t talk or sing

41. #8
Pregnant Women Shouldn’t
Exercise

42. “ 30 minutes or more of moderate exercise a
day should occur on most, if not all, days of
the week “

43. In Pregnancy
• Exercise
– Helps reduce backaches, constipation, bloating, and
swelling
– May help prevent or treat gestational diabetes
– Increases your energy
– Improves your mood
– Improves your posture
– Promotes muscle tone, strength, and endurance
– Helps you sleep better
– Weigh less to start, gain less weight during pregnancy
and tolerate labor better than do sedentary women.

44. Factoids
• Pregnant women should NOT:
– Downhill ski
– Contact Sports
– Scuba Diving
• Not the time to start new moderate to
aggressive exercise programs
• Is the time to continue usual regimen or begin
a new gentle regular habit

45. “Pregnant women shouldn't exercise or lift anything.” I roll
my eyes at this one every time…………… I view labor as the
Olympics, so I prepare to win gold - eating healthy,
stretching, aerobic exercises for stamina, and lifting for
strength. All of these have aided me in quick labors and
smoother recoveries. However, when I eat awful or more
conventional and let the Olympic training subside, my
labors are more painful and recovery is more strenuous.
It's no wonder so many women lose control of their
weight while being pregnant and afterwards. They
haven't trained for the Olympics of natural birth, but have
waited as spectators for a medicated painless birth and
now they are left with a whole lot of extra weight to lose
and little time to lose it in with a newborn to take care of.
MB “Mother of 8”

46. • Already active ….stay active
• Interested in starting…check with
physician
• Start low…go slow

47. #9
Exercise costs too much

48. • I can’t afford a gym membership
• I live too far from a gym
• I don’t have room for gym equipment in my
house
• I can’t afford new shoes, clothes etc..

50. #10
I have a bad shoulder….I can’t
exercise

51. “Many people have arthritis and rheumatism;
they get bum knees, a bum back. A lot of guys
get a little pain in the toe or knee and then they
won't exercise. Well gee, you have 640 muscles
in your body. There may be a few exercises you
can't do, but there are hundreds you can
do !”
Jack Lallane

52. #11
I don’t have the time to exercise

53. • I work double shifts…not gonna happen
• Between my job, the kids…no way
• I commute 2 hours and work 8 hour days

55. Response
• Remember Lifestyle and Leisure time
definitions
• Be creative
Even small amounts
• Be proactive count!
• Be optimistic

56. #11
I have a disability, I can’t exercise

58. #12
Resistance Training

60. Basic Principles
• Progressive Overload is needed:
– Gradual increase in stress upon the body results in
increases in tolerance and eventual plateau
– SAID (Specific Adaptations to Imposed Demands)
– Greater Demand = Greater Adaptation within
genetic potential

61. “Eating alone will not keep a man well; he must
also take exercise. For food and exercise……
work together to produce health.”
Hippocrates
Regimen 400 BC

62. “Exercise is just as essential as a rational diet”
Dr. William Esser N.D. DC.

63. Transition

64. Stages of Change (Prochaska and DiClemente)
1: Pre-contemplation
2: Contemplation
3: Preparation/planning
4: Action
5: Maintenance
6: Permanent Maintenance
(Termination)

65. My Reasons to Exercise
• Feel good in my skin
• Increase energy, Reduce stress
• Increase my confidence, discipline
• Be a role model, socialize, family time
• It’s fun, I love to sweat and work hard
• I love challenges
• Reduce disease risk
• Lower disability risk
• Maintain independence

66. What are your reasons?

67. My Reasons NOT to Exercise
• Time
• I’m tired or lazy
• Inconvenience (I forgot my clothes etc…)
• Money (shoes, travel, racquets)
• Other priorities
• Hate Change
• Don’t know what to do
• I’m Injured

68. What are your reasons
NOT
to Exercise?

69. “Physical fitness can neither be
achieved by wishful thinking nor
outright
purchase.”
Joseph Pilates

70. You are never too old to set another goal
or to dream a new dream
C.S. Lewis

71. Defining Success
• What is success for you?
• Are such goals achievable, legitimate?
• What will you do if you fail to “succeed”?

72. Setting Goals
• Specific
• Measureable
• Achievable
• Realistic
• Timely

73. Establishing Priorities
• Potential responsibilities, limitations
• Discover balance
• Be dynamic, flexible

74. If you have decided
to start or increase
your activity level…….now what?

75. FITT
• Frequency
• Intensity
• Time
• Type

76. Lasting Change
• Track your efforts and progress
• Re-visit your goals regularly
• Adjust to meet your needs
• Thrive!

77. Conclusion
• Exercise is a powerful component of health
• More wide ranging and powerful then any
“medicine’s” effects
• An ancient intervention with little to no cost
• Should be pursued as a part of regular
“healthcare”: with the advice of a physician

79. “There’s a book, Profound Simplicity, that has
nothing to do with health, but this is exactly
what “our” system is—profound simplicity. It
is profound in that it holds the truth in all its
splendor within itself and still it is so simple
that unfortunately most people are
unimpressed by the truth.”
Dr. William Esser ND
NH Keynote Address 1980

80. “First say to yourself what you would be; and
then do what you have to do”
Epictectus
Greek Stoic Philosopher AD 55–AD 135

81. Thank
You!
Stephan Esser MD
www.esserhealth.com

82. Enjoy more powerpoints and
educational resources at
www.esserhealth.com