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Exercise is Medicine initiative stresses your level of physical activity as a vital sign | CNN

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Exercise is Medicine initiative stresses your level of physical activity as a vital sign | CNN

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Has your doctor quizzed you about your level of physical activity? If so, you can thank Exercise is Medicine, a global health initiative managed by the American College of Sports Medicine.

Created in 2007, the initiative encourages health care providers to assess patients’ physical activity during visits, plus include regular exercise when designing care plans. The amount and types of exercise that medical professionals recommend should be based on each person’s current health and ability.

The philosophy behind the initiative is simple: Physical activity promotes optimal health. Regular movement also helps to prevent and even treat various medical conditions. Overwhelming evidence links physical inactivity to poor health and high health care costs, according to a 2020 article in the American Journal of Lifestyle Medicine. The study concluded that health care and fitness programs should be merged.

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In addition, people who were moderately to vigorously active for at least 150 minutes per week had nearly half the health care utilization compared with those who were sedentary, according to a study done by Salt Lake City-based health care system Intermountain Health that was presented at the 2019 annual meeting of the American College of Sports Medicine and accepted for publication.

The study also found the active people had half the total cost of health care compared with the sedentary folks, defined as those who engaged in one minute per week of moderate to vigorous activity, said Dr. Elizabeth Joy, chief medical officer at health technology company Lore Health and chair of the EIM governance board.

Unfortunately, while EIM has expanded and achieved many successes, only 22.9% of adult women and 17.8% of adult men were advised by health care professionals to increase their physical activity levels, according to the 2022 US National Health Interview Survey, Joy noted.

With the average primary care visit lasting less than 20 minutes and with health care providers needing to cover many issues, it’s not surprising that so few are addressing physical activity, Joy said.

“It takes very little time to write a prescription,” Joy said. “It takes a whole lot more time to do evidence-based behavior-change counseling.”

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Despite EIM’s lack of progress in the doctor’s office, it has created numerous programs, initiatives and exercise prescriptions to help people outside of it.

EIM now includes Exercise is Medicine on Campus, for example, a program that helps colleges and universities promote and assess physical activity among students, faculty and staff. To date, more than 200 US schools and over two dozen international education institutions participate.

The EIM-OC program at Grand Valley State University in Grand Rapids, Michigan, has achieved gold status, said Amy Campbell, associate director of recreation and wellness, which means the university routinely assesses and promotes physical activity on campus. The university offers perks such as free personal training via its exercise science majors, plus a wealth of group fitness classes and wellness coaching.

While some of these offerings were in place before GVSU signed on with EIM-OC, Campbell said the university is working more collaboratively to stress the importance of physical activity.

“The CARE team (which connects distressed students to support services) now always asks students, ‘What do you do outside of class? Are you staying physically active? What are activities you enjoy?’” Campbell said. “If they see an opportunity to work with our department, they’ll reach out. For example, if someone can’t afford to participate in an intramural program, we’ll make sure they have access.”

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There’s also Moving Through Cancer, the first disease-specific initiative within EIM. The initiative assists with exercise and rehabilitation programming for those living with cancer and beyond. Most people who are physically active during cancer treatment have less severe side effects, feel better more quickly after treatment and, in some cases, have a lowered risk of their cancer returning, research has shown.

EIM also created the Rx for Health Series, which provides exercise prescriptions for people with a wide variety of common chronic conditions, such as Alzheimer’s, depression and anxiety, osteoarthritis, and heart failure.

“If you’ve had a heart attack, you’re at far greater risk of having another one if you spend most of your time on the couch versus going for a walk,” Joy said. “The couch is more dangerous than your walking shoes.”

While EIM will continue to educate health care providers and students in health care fields about the importance of assessing patients’ activity levels and creating physical activity prescriptions, it’s also looking at other options.

“People don’t respond well to being told to do something,” Joy said. “Rather, people are more likely to engage in and sustain healthy behavior changes when done within their community. If someone’s family, neighborhood, faith-based community or even work environment is supportive of regular physical activity, they’re likely to be more active.”

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Absolutely, said Gerren Liles, a certified personal trainer and owner of Gerren Liles Vision Fitness in New York. Various New York City companies have brought in Liles to teach fitness classes for their employees, and he has seen the benefits.

“It’s always good to unite people into working out,” he said. “That can inspire people to take charge of their fitness. It would be great if companies would invest in fitness, if schools would create programs and events for students and even parents, and if media and movies were all promoting physical activity.”

“Healthy behaviors are contagious,” Joy said. “We also have some personal responsibility around physical activity — to really think about how we influence the people around us.”

So the next time you head out for a walk, Joy said, invite a friend or neighbor along.

Melanie Radzicki McManus is a freelance writer who specializes in hiking, travel and fitness.

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Boutique Fitness Is Redefining How Americans Work Out. Which Drop-In Classes Are Worth Booking?

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July 1, 2026

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Boutique Fitness Is Redefining How Americans Work Out. Which Drop-In Classes Are Worth Booking?


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I pushed myself too hard at the gym – and ended up in the hospital

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June 30, 2026

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I pushed myself too hard at the gym – and ended up in the hospital

In January 2025, I attended my first bootcamp class.

I had spent the day hunched over my laptop, anxious and craving an intense workout that would dispel my worries. I booked the class at a nearby gym, and the five-star reviews promised the all-consuming exercise I wanted: “Militant style instructor, but very motivating,” read one. Another: “Hardest workout of my life; extremely rewarding.”

The gym was no-frills – just a room with a mirror. After a standard warm-up, we did four sets of lateral shuffle push-ups across the floor, interspersed with standing, weight-bearing exercises.

When my turn came, I dropped to plank position and started doing steady, shallow reps, focusing on my form.

But caution soon fell away. Upbeat music was booming and someone was always advancing beside me. When the instructor encouraged us to lower all the way down, I obeyed, even though my form suffered. I had rarely done more than a handful of pushups at a time, and in the final set, I was exhausted, collapsing on every rep and barely prying my torso off the floor.

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The rest of class was a blur. I became nauseated, told the instructor I needed to pause, and stepped outside to suck cold winter air into my lungs.

Back in the studio, I sat on the sidelines and waited for the dizziness to recede before slinking to my spot for the core section and cooldown.

Later that night, I felt what I thought was typical post-workout muscle soreness. I was satisfied; the ache was proof of a successful workout.

But the next day, lifting my arms to wash my face was exhausting. Searing pain kept me awake that night. Two days after the class, my arms were so stiff I couldn’t raise them more than a few inches, even to brush my teeth.

When I Googled my symptoms – pain, weakness and a new one, dark urine – something frightening came up: exertional rhabdomyolysis, a condition wherein extreme exercise causes muscle cell contents to flood the bloodstream, potentially overwhelming the kidneys. One article warned that debilitating pain after a new, intense activity was a sign to visit the emergency room.

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I went to the ER but suspected I was overreacting. After all, the internet always offers the worst possibility.

Doctors use bloodwork to test for exertional rhabdomyolysis; typically, they diagnose it if a patient has too much of a muscle enzyme called creatine kinase (CK) in their blood – at least 1,000 units per liter, or five times the normal range. However, there is little consensus on this number, says Dr Barry Boden, an orthopaedic surgeon at The Orthopaedic Center in Maryland, who specializes in sports medicine. Some recent guidelines suggest that only higher amounts – as much as 10,000 units – warrant diagnosis and inpatient treatment.

My CK count was so high the machine in the emergency room couldn’t measure it; a nurse had to do a second blood draw and send it to a more precise lab. They put me on an IV drip and eventually reported the exact number: 57,000.

Thus began my seven-day hospital stay. My mom and sister traded shifts, acting as my arms for the week – scrubbing my teeth, feeding me, washing my face. I had never felt so helpless and irresponsible. What had I done to myself?

What is exertional rhabdomyolysis?

Normally, during exercise, muscles tear a little and then rebuild. There may be a little extra CK in a person’s blood as a result, which healthy kidneys can filter out.

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But excessive exercise can harm muscle cells so much that their contents – including CK and a protein called myoglobin – overload the system. “When the cell membrane starts to break down, the chemicals within the muscle cells start to get released, which can cause damage to other organs around the body,” said Boden. “ If there’s enough of those chemicals from the muscle that reach the kidney, it can cause damage to the kidney.”

The symptoms are muscle pain (even while at rest), weakness and dark urine, though few people experience all three. Treatment involves early and aggressive administration of IV fluids to help the kidneys filter the toxins. It’s possible to manage a mild case with at-home oral hydration, but it’s always important to consult a doctor because mild symptoms don’t always mean low CK elevation, said Dr Petr Schlegel, a CrossFit trainer and professor at the department of physical education and sports at the University of Hradec Králové in the Czech Republic.

Exertional rhabdomyolysis is dangerous and fatal in very rare cases; researchers estimate that 10% of patients develop acute kidney injury (AKI), and some suffer other serious complications.

How common is exertional rhabdomyolysis?

Before I had rhabdomyolysis, I had never heard of it; I thought the worst that could come from a workout was a broken bone or a regurgitated lunch. I now know it can happen to anyone, although people with certain conditions, such as sickle-cell trait and hypokalemia, are predisposed. Despite the common misconception that only unfit people can get it, even elite athletes are susceptible.

 “Anybody can get it – anybody that’s pushed to an extreme, taking a big jump in their exercise level, or doing something they’re not used to doing,” said Boden. “Everybody has muscles, and if the muscles are damaged enough, you can develop rhabdomyolysis.”

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Boden authored a study estimating there were over 40,000 exertional rhabdomyolysis cases in US hospitals from 2000 to 2019. But he said it’s impossible to get a precise count, as no organization collects the data.

This number is likely an underestimate, as the condition is probably under-reported, said Schlegel. Since the symptoms closely resemble those of delayed onset muscle soreness – the normal ache people expect after a workout – individuals may not seek care.

Data indicate exertional rhabdomyolysis is on the rise. In Norway, Australia and the US, researchers have observed an increase in hospital records between the 2000s and 2010s. This year, hospitals in a Canadian province reported a surge in cases.

Researchers suspect the popularity of high-intensity workouts is behind the rise. They are efficient and produce measurable progress, but are risky if misused, said Schlegel: “Evidence suggests that high-intensity exercise, especially when combining strength and endurance elements, carries the greatest potential to induce [exertional rhabdomyolysis].”

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Can you prevent exertional rhabdomyolysis?

Prevention guidance has been pretty consistent since the earliest studies from the 1960s: vary exercises to avoid overloading one muscle group, incorporate rest, and gradually build intensity when starting something new or after time off.

Starting low is especially important when targeting large muscle groups – such as biceps, triceps and quads. “It’s that hyperintense going from zero to 100, really intense workouts of large muscle groups, that puts people at risk,” said Dr Bryant Walrod, a sports medicine physician and the head team physician for the Ohio State Buckeyes. Weight matters, but so do reps; an outrageous number of low-weight exercises or calisthenics – hundreds of pushups or squats, for example – is the trigger in many cases. Walrod also advises doing a different kind of workout from one day to the next.

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Eccentric exercises like push-ups – where muscles lengthen – are particularly likely to cause injury. In a 2024 article about how to prevent rhabdomyolysis in student athletes, the National Federation of State High School Associations called push-ups the “No 1 cause” of rhabdomyolysis. In April, Texas families filed a lawsuit against a charter school after 20 children were hospitalized after hundreds of pushups.

Walrod said collegiate sports professionals became more vigilant about prevention after University of Iowa football players were hospitalized with exertional rhabdomyolysis in 2011. “That case spurred better control of workouts, better monitoring, and better input from the trainers and strength coaches.”

“Where we see most of the cases is that athletes are being pushed or threatened or punished [contrary to industry standards],” said Dr Rebecca Stearns, COO at the Korey Stringer Institute for preventing sudden death in sports. Coaches are not exercise physiologists, and even when well-intentioned may not have adequate training to prevent overexertion, said Boden.

Similarly, there’s no guarantee fitness instructors understand the risk. “People may be going in unconditioned and doing too much too soon,” said Walrod of these classes. CrossFit incorporated prevention into its trainer curriculum after reports of severe cases among participants, but in general, class participants should self-monitor.

How do you identify overexertion?

I was discharged from the hospital with a firm instruction: no exercise except walking for a month. I had to learn what an appropriate challenge felt like – how to self-monitor, discern between safe discomfort and overexertion, and advocate for myself. But when is hard too hard?

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Unfortunately, sensing that something is wrong is a subjective measure; there is no universal metric.

“I never have a very satisfying answer to that, but I do think it’s a line we need to be vigilant about always, and it changes from day to day,” said Dr Natalia Petrzela, author of Fit Nation: The Gains and Pains of America’s Exercise Obsession, longtime fitness instructor, and professor of history at The New School.

“You know your body the best, and if you feel like something isn’t right, it’s time to speak up,” said Walrod. Sports medicine physicians advise people to stop exercise immediately if unusual pain occurs; in the event that there is excessive muscle breakdown, it’s critical to stop the movement right away.

Speaking up in a class setting can be difficult. Many feel self-conscious about pausing or modifying activity, especially if an instructor is singling them out. Petrzela said that she motivates participants in her class but also expresses a key caveat: “Only you know what you can do today.” She said this language “helps [them] find that very important and difficult-to-discern line”, adding that this nuance might get lost in classes with less experienced instructors who give inflexible instructions.

During that fateful class, I ignored the alarm bells. Maybe I was desperately chasing endorphins or wanted to prove to myself that I wasn’t weak. Ironically, my arms atrophied to below baseline as a result.

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Over a year later, I’m still building my strength back – but not at bootcamp. I opt for low-impact methods such as barre and pilates where I can modify if needed, and there is no need to keep pace with others.

Sometimes I tell instructors about my medical history, so they understand what’s happening if I pause. Verbalizing it also reminds me to be careful. Finally, I avoid anything new or especially difficult when I’m having a hard day.

Fitness culture taught me that pain is gain – but now I know that’s not always true.

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Fitness Point: The Small Weekly Investment That Could Transform Your Health – KT PRESS

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21 hours ago

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June 30, 2026

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Fitness Point: The Small Weekly Investment That Could Transform Your Health – KT PRESS

Fitness Point gym has state of the art machines to help in health exercises.

KIGALI – There are 10,080 minutes in a week. Health experts recommend that adults spend at least 150 minutes of moderate-intensity physical activity each week in order to build a healthy body.

For those who prefer structured workouts, three one-hour gym sessions amount to just 180 minutes, less than two percent of the time available over seven days.

It is a surprisingly small investment for something associated with better heart health, stronger muscles, improved mental wellbeing and reduced risk of many chronic diseases.

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That simple idea found an unlikely ambassador recently when Rwanda’s Minister of Health, Dr. Sabin Nsanzimana, reflected on a birthday gift he had given himself.

“Healthy habits are the best gifts we can give ourselves,” he wrote after completing a demanding hike to the summit of Karisimbi volcano.

Many people may admire the endurance behind the journey but perhaps the most powerful part is the reminder that good health is rarely built through one extraordinary achievement. It is built through habits repeated week after week.

The Growing Urban Philosophy

A lady working out at a Fitness Point gym located in Gacuriro.

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Every evening across Kigali, people filter through the doors at various Fitness Point’s branches carrying laptops, gym bags and the fatigue of another workday to quietly bring that philosophy to life in a different setting.

In Remera, Gacuriro and Kimihurura, some arrive before sunrise, squeezing in a session before the office. Others come long after business hours, determined to honour a promise they made to themselves despite packed schedules.

They are not training to conquer volcanoes or prepare for competitions. Most are simply trying to become healthier than they were yesterday.

As work becomes increasingly desk-based and daily routines leave little room for movement, the challenge is not understanding that exercise is important. It is finding a way to make it part of ordinary life.

For many, that begins with putting just three appointments on the calendar each week.

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Consistency Better Than Intensity

Jean Baptiste Muganza, a Kigali-based physiotherapist and frequent guest at Fitness point, says one of the biggest misconceptions he encounters even in his work is that meaningful health improvements require extreme effort.

“People often believe they have to exercise every day or spend several hours in the gym before they can see results. In reality, consistency matters much more than intensity,” he says.

A structured routine done regularly, he says, delivers far greater benefits than occasional bursts of very demanding exercise. And the benefits extend well beyond appearance.

“We see improvements in cardiovascular health, muscle strength, posture, flexibility and energy levels. Regular exercise also plays an important role in managing stress, improving sleep quality and reducing the physical effects of spending long hours sitting,” he explains.

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Ironically, he says, the hardest exercise often happens before anyone touches a treadmill or lifts a weight.

“The biggest challenge isn’t completing the workout. It’s building the habit. Once exercise becomes part of your weekly routine, it stops feeling like an obligation and becomes part of your lifestyle,” Muganza says.

Leading by Example

Rwanda’s Minister of Health, Dr. Sabin Nsanzimana recently took a hike to the top of Karisimbi volcano as a birthday gift to himself.

That change is becoming increasingly visible at Fitness Point, where trainers say members are arriving with goals that seem less visible but perhaps more valuable than just chasing dramatic body transformations.

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Many are seeking something lower stress, better mobility, freedom from persistent back pain, improved fitness and enough energy to keep pace with demanding jobs and family life.

The gym itself has gradually evolved into more than a room filled with equipment. Before work, it offers a fresh start. After work, it becomes a place where the pressures of the day give way to movement.

Between those moments, friendships are formed, routines are strengthened and small victories accumulate, one workout at a time.

That is perhaps why Minister Nsanzimana’s message resonated with so many people. Healthy habits are gifts not because they require extraordinary effort, but because they reward ordinary consistency.

A birthday hike or a workout at the gym may inspire thousands, but the habit that made it possible was almost certainly built long before that day.

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For most people, good health may begin in a neighborhood gym, during an evening workout after work, or in the simple decision to dedicate less than two percent of an entire week to taking care of the one body they have.

Sometimes, the smallest investment of time turns out to be the one with the greatest returns.

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