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Exercise is the most important thing you can do;

Exercise is more important than anything your doctor does.


“Physical activity is the closest thing we have to a wonder drug,”

Tom Frieden, M.D., M.P.H. Director of Centers for Disease Control, 2009-2017


Exercise is part of your treatment, probably the most important part. So it makes sense that we are going to keep track of your exercise just as we track other parts of your treatment program such as physical therapy attendance, surgical procedures, medication, etc. You need to keep track and report to us at each visit, how much aerobic exercise you are doing.


  1. We will ask you at each visit, for a report of how many minutes of aerobic exercise you are doing each week.

  2. We will want to know how many minutes of moderate level (walking or equivalent) and how many minutes of vigorous level (running/jogging or equivalent) exercise you have done in the last week.

  3. You should count any period of walking that is at least 10 minutes long, or any vigorous level exercise that was at least 5 minutes long. If you walked for 4-5 minutes you wouldn't count that, but you should add up all periods of walking that occurred in 10 minute or longer increments. 


Exercise should be first line therapy for most medical condtionsThere is no health problem that exercise won’t benefit. Exercise makes a person healthier and just as a rising tide lifts all boats, when you become healthier, everything gets better. The benefits of exercise are proven in thousands of medical studies. For example people that exercise live longer. 


Exercise works just as well as drugs for heart disease and diabetes.

The British Medical Journal published a study in October of 2013 that showed that patients who exercised, and did not use drugs (such as cholesterol medications) to treat their heart disease or diabetes, lived just as long as the people who took the drugs and didn't exercise. Of course patients can do both, but only if they understand the importance of exercise. The patients who had strokes and exercised lived much longer than the patients who didn't exercise.


Exercise beats depression.

Antidepressants are commonly prescribed and are now one of the 3 most prescribed categories of drugs, coming in right after painkillers and cholesterol medications.


Yet large medical studies show that exercise is more effective for depression than antidepressants.  Exercise works, and it should be the first treatment offered to every patient, particularly those with depression. Exercise is also very effective for anxiety, which many people with chronic pain suffer from.


Aerobic exercise prevents the mental decline associated with aging and reduces the frequency of alzheimer's. Exercise benefits diabetics. Diabetics have their life expectancy increased with exercise, and may cure the diabetes itself with regular daily exercise. Exercise causes weight loss which benefits diabetes, lowers cholesterol levels, and helps normalize high blood pressure.


Exercise for most patients is at least as effective as their pain medication and for many, exercise is more effective. Less patients would end up with chronic pain if they exercised daily. Patients with chronic pain will feel better and need less medication if they use exercise as a therapy.


A recent medical study of 866 seniors followed for 14 years found that the seniors who engaged in regular aerobic exercise had a substantial reduction in musculoskeletal pain. A recent study presented at the American College of Rheumatology found that patients with arthritis who exercised had a higher quality of life, less pain and reduced health care expenses.


The lead researcher said:

“Regular physical activity improves health and reduces mortality in the general population. Furthermore, physical activity promotes arthritis specific health benefits including improving symptoms, function and psychosocial outcomes, as well as reduced disability. Despite these benefits the majority of adults in the U.S. do not attain the recommended amount of physical activity.” 


After 2 years the patients who exercised had a higher quality of life, IE less pain and more functionality than those that didn’t exercise. The patients who did some exercise but didn’t meet the guidelines did better than the patients who didn’t exercise but not as good as the patients who met the guidelines.


Exercise prevents headaches.

People that have migraine or tension headaches also benefit from exercise. Aerobic exercise several times a week has been shown to reduce the frequency of headaches by about 50% and the remaining headaches are milder and don’t last as long. 



Aerobic Exercise 'Most Effective Weapon' for Fibromyalgia

For patients with fibromyalgia, exercise is more effective than drugs, according to Dr. Hauser, who is an expert in the field.

"There is no magic drug against fibromyalgia and, in my opinion, there will never be." "Aerobic exercise is the most effective weapon we have; healthy people profit from continuous physical exercise, and so do patients with fibromyalgia," according to Dr. Hauser who presented an overview of research on fibromyalgia treatment at the European League Against Rheumatism Congress 2014.


In summary, exercise is your friend. Regular exercise will improve your life in every way we can measure.


Exercise is the key to reducing your

chronic pain.

Walking is good for bad knees

"People with knee arthritis should be walking around 6,000 steps per day, and the more walking one does the less risk of developing functioning difficulties," said the lead author Dr. White, of a 2 year study published June 12, 2014 in Arthritis Care & Research of nearly 1,800 adults. For every 1,000 steps taken, functional limitations were reduced 16 percent to 18 percent.

Dr. White said "Walking helps reduce arthritic pain".

"This study just adds to the vast amount of research and common sense that tells us we need to get off our fannies and out the door," said Samantha Heller, an exercise physiologist at NYU Langone Medical Center in New York City.

Walking "is free and you already know how to do it," she added. 



Aerobic exercise elevates your heart rate. Think of activities that cause you to get out of breath. Walking, running, climbing stairs, swimming, bicycling, just about everything is aerobic.

The most frequently recommended exercise is walking, which is defined as moderate level aerobics, as opposed to jogging which is defined as vigorous level. For most patients a daily walking program is most practical. Simply follow your nose and keep walking for at least 10 minutes. If you are really debilitated try for at least 5 minutes to start with. You can increase later. If you check your pulse before and during you will find that your pulse increases. If not, then walk a little faster.


If you have uncontrolled high blood pressure, heart disease, family history of heart disease, or risk factors for heart disease, or any concern about starting a walking program, you may want to get clearance from your primary care provider before beginning this or any other exercise program.

However, Dr Barry Franklin (William Beaumont Hospital, Royal Oak, MI) states that:

“the cardiovascular benefits of exercise outweigh the risks for a vast majority of adults, especially if they engage in light-to-moderate activity. Asymptomatic men and women should be able to get active without consulting a doctor unless they have specific medical questions.”

Because the exercise we are recommending is just walking, IE moderate level activity, most patients should be able to start without specific medical clearance.

Furthermore, Dr Per-Olof Astrand, a pioneer in the field of physiology and exercise testing states:

"A medical evaluation is more urgent for those who plan to remain inactive than for those who intend to get into good physical shape."

So use your own best judgement and get medical clearance before starting if you feel you need it, and particularly if you are going to do vigorous level aerobics such as jogging or running.


The standard national recommendation is 150 minutes of moderate level exercise per week. This works out to be 30 minutes of walking, 5 days per week. Many patients may need to work up to that level, and that is fine.You should start with what is practical for you with your fitness level.

Avoid payback. For many patients, if they start too fast or make too much of an increase too soon, they will get what we call “payback”. Payback means you are so sore the next day that you can’t do any exercise. Better to start slowly and not get any payback.

Increase slowly. Ideally when you start an exercise plan, or increase your exercise level, if you do just the right amount you will have just a little increased soreness the next day. If the increased soreness is so slight, you can’t tell for sure if you really are more sore, but you think you MIGHT be a little more sore, that is just about the perfect amount of increased exercise. Keep doing that level for a week or so, and then make another similar increase. If you have just a very little increased soreness the next day, so slight you can’t be really sure, you are doing the right amount of increase. Keep up the gradual increases until you are doing 150 minutes of moderate level aerobics per week.

If you do get payback, skip the exercise for 1-2 days until you are back to your normal level of pain. Then try increasing your exercise about half as much as the amount that caused the payback. The key to starting an exercise plan is to start low and go slow.

Many people spend a lot time on their feet at work, but it is usually too stop and go to actually be aerobic. Remember for aerobic exercise to benefit you, it needs to be in minimum increments of 10 minutes. Most people don’t spend 10 minutes walking at work. So even if you are on your feet all day at work, you probably still need to start a daily walking program to get your aerobic exercise.


If ice and snow prevents you from walking in your neighborhood, most malls allow mall walking, often before the stores are open in the morning. The important thing is to make a plan that will work for you. Some people want to use a stationary bike or swim, etc. Any exercise is an improvement, and you should do what works for you.

Exercise increases endorphin production.

Endorphins are similar to narcotics. Endorphins relieve pain, and fight depression and anxiety. People with chronic pain have lower levels of endorphins than people without chronic pain. Aerobic exercise increases endorphin production. It is the increased endorphin level that improves your quality of life.

Exercise that requires you to support your weight causes a greater increase in endorphins than non weight bearing exercise. Walking, running or jogging are weight bearing and cause a greater increase in endorphins, and hence a greater improvement in how you feel than non weight bearing exercises such as bicycling, swimming, etc.

But any exercise is better than no exercise, so make your best plan and get started. One study reported on wheel chair bound senior citizens who were so debilitated the only exercise program they could do was to sit there and lift their leg up off the chair repeatedly. Even that program caused significant improvements in quality of life. We have had bed bound patients that did arm and leg lifts in bed. Some patients who have not been able to get out to a mall or other suitaable place for daily walking have developed walking programs in their own apartment or in the hallway. Thirty minutes walking in circles in your apartment is still aerobic and will benefit your pain.


It is all up to you.

Daily aerobic exercise is the single most important thing you can do to control your pain, but nobody can do it for you. 

Patient Reports

"I have to force myself to exercise, but it does jelp my pain!"

TS, Rochester

"My exercise plan really is making a big difference."

MH, Chehalis

"I resisted starting a daily walking plan. I wish I would have started sooner."

DW, Centralia 

Mall Walking- Consider your options.

A great option on a rainy day!

Here is a resource list of facilities and programs

available to everyone in the Chehalis area:

Open 24 hours. State of the art exercise equipment, group classes, personal trainers, pool, yoga, senior fitness programs, something for everybody.

2020 Borst Ave., Unit 2
Centralia, WA 98531

Phone: 360-736-1683

Open long hours. State of the art exercise equipment, group classes, personal trainers, pool, yoga, senior fitness programs, something for everybody.

91 SW Chehalis Ave.
Chehalis, WA 98532


Lewis County Mall

This Mall is open from 7:00 AM to 7:00 PM and has great parking. Nice place for Mall Walking on those cold wet days. 


This is a free, web based exercise program that has been shown to be effective at helping people improve their strength and fitness and reduce their pain. Designed for people that are 50+. 

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© 2014 · Content is Property Created by CW Jasper

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