Jo (not her real name) came to see me again today. She was wondering what exercise she should do. Jo has issues with osteoarthritis, diabetes type 2 and obesity. “Have you tried walking?” I asked. “Yes, but my knees hurt, and I become short of breath, besides it is cold in the morning and I don’t have time in the afternoons.” was the reply from Jo. “What about going swimming? It will take the pressure off your knees.” I queried. “It is hard to get too the pool and is expensive and it is cold.” Jo retorted.
It then occurred to me to ask, “What would you like to do?”, “you’re the doctor, you tell me” was the inevitable reply.
As a doctor, often our role is that of an educator to assist in self-management of a person’s heath rather than the process of didactic information supply that I was engaged in. The is very true with the management of chronic health conditions. The patient often has a better understanding of their condition, the nuances and responses of their body, than the doctor. Jo understood, intellectually, that she should engage in a form of physical activity but did not realise the choice of activity was in her control.
Physical activity is an important part of health maintenance and improvement. Not just for those with chronic health conditions but also for those without. When asked which one is the best, may answer is “the one you will do”. There are specific health benefits associated with every activity, walking helps improve bone density, joint health, respiratory and cardiac reserves and psychological wellbeing. Resistance training, with body weight, rubber bands, gym machines or free weights all have similar benefits. Cycling, swimming, or for some people, walking to the end of the street, will all assist in improving their health. Find something that you can do and do it. There may be some discomfort involved, discuss this with you GP, but for most the short-term discomfort will settle, and the long-term benefit will be noticed.
Jo has started cycling a short distance each day. While there was pain on starting, she now has no pain and has noted that she is walking with less pain in the knees and less shortness of breath.