Fitness
Health and Wellness: Five reasons to ditch the pills and embrace exercise as medicine
Our bodies are built for movement, yet modern life has us sitting far more than we should. Compared to our ancestors, we’re moving less and sitting more – sometimes for over half the day. While fitness trackers and smartwatches encourage us to stand and get more steps in, it still doesn’t seem to be enough to counteract the effects of a sedentary lifestyle.
Physical inactivity has now become a major health issue, and the consequences are clear: less movement leads to more musculoskeletal issues and chronic pain (among other things). And the unfortunate reality is that most folks turn to pain medication for relief, despite research increasingly pointing to regular exercise being just as effective and far healthier.
Here are five reasons to ditch the pills – and embrace exercise instead – as a powerful form of medicine to manage musculoskeletal pain naturally.
Exercise mediates pain
The way we perceive pain is complex. Many assume it’s a direct response to physical damage or injury – but it’s not that simple. The perception of pain involves numerous physiological and psychological factors that the brain must interpret. Depending on your general health, past experiences, and mental health condition, this can vary quite drastically from person to person. In other words – it’s your brain that decides how much or how little pain you experience.
Because of this complexity, external factors like exercise (and also pain medication) can alter how we perceive these signals. When we exercise, our bodies exhibit an increased tolerance towards pain, and a lower perception of pain intensity. This phenomenon is called “exercise-induced hypoalgesia” – and it works by closing down the gateways that allow pain signals to enter the brain. Certain medications can do this too, but when you exercise, you’re doing it naturally.
Exercise helps inflammation
Inflammation is a normal part of your body’s healing process, and it occurs when inflammatory cells travel to a place of injury. However, if inflammatory cells stick around too long, it can result in chronic pain and irritation. This is where exercise can really help.
When you exercise, your body experiences minor physiological stress, which triggers your body’s natural inflammatory reaction. During the inflammatory process, certain proteins called anti-inflammatory cytokines are produced. These protein chemicals help to modulate the body’s inflammatory response – ultimately reducing the level of inflammation associated with your pain. Inflammation can be both good and bad. When you exercise, you are creating “good” inflammation, which will naturally help to ease your pain.
Exercise stimulates endorphins
Ever wonder why a quick walk outside or a strenuous gym workout magically makes you feel better? It’s not your imagination. It’s something called endorphins – neurotransmitters released by your brain to alleviate pain and promote pleasure.
Endorphins are considered your body’s natural “opioids” because they interact with the same pain-inhibiting receptors in your brain that drugs like morphine do. But unlike morphine, endorphins are triggered naturally and don’t come with harmful side effects like addiction, drowsiness, or mental fog. Exercise stimulates the production of endorphins, boosting your mood, reducing stress, and giving you access to your very own stash of natural, healthy painkillers.
Exercise improves your mental health
Exercise and mental health share a powerful connection. It’s virtually impossible to influence one without the other.
Regular exercise stimulates the production of various mood-boosting chemicals, including endorphins (that we just spoke about) along with serotonin and norepinephrine. Aside from helping to control pain, endorphins are also considered a “feel-good hormone”.
They trigger feelings of positivity that, once again, are similar to morphine. Serotonin and norepinephrine are instrumental in alleviating symptoms of depression and anxiety. Therefore – when you exercise – it’s virtually impossible not to feel better. And since we know that pain is controlled by your brian – anything that improves mental health is going to contribute positively to your relationship with pain.
Exercise as a prescription
OK – so we’ve discussed the multitude of positive effects that exercise has on pain perception, inflammation, and mental health. But what if you’re currently suffering from an injury? Is it possible to still use exercise as a pain reliever? The short answer is yes. But it’s challenging to do on your own. You can’t just google “best exercises for back pain” and expect good results.
When it comes to using movement or exercise to rehab an already existing injury – it needs to be carefully prescribed.
For all the reasons already discussed, physical activity will still help you modulate pain – but you must consider the role exercise is going to have on any potential tissue damage. With weakened or damaged tissue, exercise is still an effective pain reliever, but it has to be prescribed or you risk worsening your injury.
For these reasons, I always recommend working with a movement expert who truly understands the nature of musculoskeletal pain and tissue healing. If you start a general exercise routine because you want to feel better – I applaud you – just make sure you’re getting your desired result.
But if you start exercising to help with pain and don’t experience any noticeable improvement – or you catch yourself modifying to work around your pain – then it’s time to enlist the help of an expert. Otherwise, you risk ending up on pain pills, which is exactly what we want to avoid.
Dr. Carrie Jose, Physical Therapist and Mechanical Pain Expert, owns CJ Physical Therapy & Pilates in Portsmouth and writes for Seacoast Media Group. To get in touch – or to request a free Discovery Visit to explore a solution for your pain or injury with a mechanical pain expert – visit www.cjphysicaltherapy.com or call 603-380-7902.
Fitness
Sit-ups vs crunches: The core exercise that actually builds stronger abs
If you’re a little hazy on the difference between sit-ups vs. crunches, you’re not alone. They both strengthen your core, but the details on how they differ and the benefits of each can be confusing.
“The main difference between the two is that unlike a sit-up, in a crunch, the lower back never leaves the floor,” explains Katharine Glazer, CPT. Basically, a crunch is a more targeted and isolated exercise that only works your rectus abdominis (primarily your upper abs).
A sit-up, on the other hand, has a larger range of motion and targets multiple muscle groups at the same time—rectus abdominis, hip flexors, transverse abdominis (deep core muscles), obliques (side abs), and lower back muscles. By raising your torso fully off the ground, you’re recruiting more muscles.
There’s a lot more to know about the great crunches vs. sit-ups debate. Keep reading for the benefits and risks of both sit-ups and crunches, plus how to nail your form and which one deserves a slot in your routine, according to experts.
Meet the experts: Olivia Amato is a certified personal trainer and bike, tread, boot camp, and strength instructor for Peloton. Katharine Glazer is a certified personal trainer. Amanda Hart is a NASM- and ACSM-certified personal trainer and holistic health coach with 12 years of fitness experience. Kristina Earnest, CPT, has more than a decade of experience leading cycling and strength classes and founded Kristina Earnest On Demand.
Sit-ups vs. crunches: Which move is better?
That depends on the muscle(s) you want to target, Glazer says. “Every body has unique demands and requirements, there is no one size fits all.”
- If you’re looking to get the most bang for your buck and work multiple muscle groups at once, then sit-ups have an edge.
- Aiming for intense muscle isolation instead? Crunches could be your jam.
- But, some trainers actually prefer other abs exercises over sit-ups and crunches (more on that soon!).
Benefits of sit-ups
- Work *multiple* muscle groups. Sit-ups help you sculpt your abs (and more!) from lots of angles at once when done with proper form, says Olivia Amato, CPT, a Peloton instructor.
- Improve stabilisation. When you engage your core muscles, you’re improving your balance and steadiness, otherwise known as “stability,” says Kristina Earnest, CPT. With sit-ups, you’re lifting your whole torso from the ground which engages your balance-focused muscles like your abs, hip flexors, legs, back, and neck, adds Glazer.
- Better posture. Sitting and standing a bit straighter is a bonus of engaging all those stabilising muscles, Amato adds.
- Increase flexibility. Sit-ups, when done properly, loosen up both your spine and your hips. That motion helps to increase flexibility, explains holistic health coach Amanda Hart, CPT. Better flexibility snowballs into other perks, like leveled-up performance and fewer injuries.
How to do a proper sit-up
- Lie on your back with knees bent at 90 degrees and feet flat on the floor. Place your fingertips on the back of your ears, with elbows bent and pointing out to the side.
- Take a deep inhale, then exhale as you contract your core muscles and lift your torso off the ground. Continue until your chest is as close to your thighs as possible. (Though if you don’t make it all the way there, no worries!)
- With a smooth and steady motion, inhale as you lower back down to the starting position. That’s 1 rep. Start with 10 reps and add as you feel more confident.
Form tip: “I love doing sit-ups when I have a table to anchor my feet on or a workout buddy holding my feet down with their hands,” says Amato. “This usually ensures proper form because you don’t have to worry about keeping your feet on the ground on top of everything else.”
Sit-up variations to try
Boxer sit-up
- Start lying on your back with your knees bent, feet flat on the ground, and hands in fists at your chest.
- Take a deep inhale, then exhale as you contract your core muscles and lift your torso off the ground. Continue until your chest is as close to your thighs as possible.
- Punch forward, fully extending your left arm with the knuckles facing forward and palm facing the ground.
- Repeat with the right arm.
- Slowly lower back down to the floor. That’s 1 rep.
Sprinter sit-up
- Start lying on back with hands by sides and legs extended straight on floor.
- Explosively sit up, bringing right knee toward chest, right arm back, and left arm forward at a 90-degree angles.
- Reverse the motion with control and repeat on the other side. That’s 1 rep.
Slam ball sit-up
- Lie on your back with your legs bent and feet flat on the ground.
- Hold the slam ball above your chest with your arms fully extended.
- Engage your core muscles and elevate your torso to perform a sit-up. Hold the slam ball overhead as you bring your body up to a seated position.
- Lower yourself back to the starting position, making sure you keep the entire motion controlled. That’s 1 rep.
Benefits of crunches
- Strong upper abs. Crunches isolate the upper abdominals and are great when aiming for high rep counts, says Amato. “I find that crunches are a move I can do continuously because they’re a simple, low-impact exercise,” she explains.
- Easy to master form. “With crunches, you just need to focus on lifting your head and shoulders off of the floor while supporting your neck, so it’s easier to get the move down and perform without feeling muscle pain,” says Amato.
- Low risk of injury. Crunches involve a small range of motion, so the risk of injury is also small. Lift higher up off the ground and your hip flexors might begin to activate, putting stress on the spine, Hart says. The minimal movement required for crunches allows you to strengthen your core without putting strain on your back.
How to do crunches with proper form
- Lie on your back with knees bent at a 90-degree angle, keeping your feet flat on the floor.
- Place your fingertips on the back of your ears, elbows bent and pointing out to the side.
- Take a deep breath in, contract your core muscles, and then lift only your head and shoulder blades from the ground, exhaling as you rise. (Keep your chin tucked, but not touching your chest, and let your head be heavy in your palms to put more work into your abs.)
- Inhale as you lower to starting position. That’s one rep. Start with 10 reps and, if you feel like you’ve got the hang of things, keep goin’ for 20 to 30.
Pro tip: “Crunches can sometimes feel repetitive, but I find that when they do, I just add a twist—pointing one elbow toward opposite knee—to spice things up or crunch to the beat of a song,” Amato says.
Crunch variations to add to your routine
Bicycle crunch
- Lie on your back with knees at a 90-degree angle and feet flat on the floor.
- Place your fingertips on the back of your head with elbows bent and pointing out to the side.
- Exhale and bring right elbow to left knee while extending right leg straight, rotating torso, and bringing left elbow to touch the ground.
- Inhale as your return to start and repeat on opposite side. That’s 1 rep.
Reverse crunch
- Start lying on back with hands by sides and feet lifted off the ground at a 45-degree angle, toes pointed. Press your lower back into the ground and keep your arms at your sides.
- Brace your core, push down into arms, and exhale as you curl your knees toward your chest until hips lift off mat.
- Inhale and slowly return to the starting position. That’s 1 rep.
Frog crunch
- Lie on your back with your arms extended at your sides.
- Bring your feet into a tabletop position, with your heels pressed together.
- Extend your legs out at a diagonal, keeping your heels close together.
- Bend knees and bring heels back toward your body. That’s 1 rep.
How do other ab exercises compare to crunches?
It’s clear crunches and sit-ups are worth your time, but that doesn’t mean they’re always the gold-standard. In fact, some trainers prefer other abs exercises like planks. Why? “Both crunches and planks have the ability to engage the rectus abdominis and the obliques, however, the plank also targets the erector spinae, glutes, hip flexors, quads, and deltoids, which makes it an excellent compound movement and more bang for your buck,” says Earnest.
What’s more, crunches and sit-ups can put significant pressure on the neck, says Earnest, which you won’t experience as much in a plank.
It’s also worth incorporating rotational core exercises into your routine since they strengthen your lower back, increase mobility, and work the obliques, says Earnest. This includes any exercise with a turning motion of your body such as Russian twists, wood chops, and reverse bicycles.
So, are crunches or sit-ups a better workout?
Both can help you build abdominal strength, and each exercise comes with its own set of pros and cons. Assess which might be best for your skill level and safety, then get to work.
Keep in mind, there’s a greater risk of injury with sit-ups: “The problem with sit-ups is that it’s very difficult to do the exercise correctly without rounding the lower back, which increases stress on the lumbar spine,” explains Glazer.
For this reason, “trainers tend to have their clients avoid sit-ups to decrease the risk of injury,” she says. That’s also why Hart prefers crunches. “There is less flexion and extension of the spine, which means less chance for injuries,” she says.
Crunches are super beneficial when it comes to sculpting the top of your six-pack, but that’s actually *also* their downfall. Crunches *only* target your upper abdominals. “The problem with crunches is that since the hips and legs are stationary, you’re not fully activating the lower abdominals, nor are you engaging the obliques,” Glazer explains.
Bottom line: Crunches and sit-ups both come with pros and cons. And there are a plethora of other abs exercises to consider working into your routine as well.
Madeline Howard is a writer, editor, and creative based in Brooklyn. Her work has been published in Esquire, Nylon, Cosmopolitan, and other publications. Amongst other things, she was formerly an editor at Women’s Health. Subscribe to her newsletter ‘hey howie’ at madelinehoward.substack.com.
Andi Breitowich is a freelance writer who covers health, fitness, relationships, beauty, and smart living. She is a graduate of Emory University and Northwestern University’s Medill School of Journalism. Her work has appeared in Women’s Health, POPSUGAR, Food & Wine, What To Expect, Cosmopolitan, Men’s Health, and elsewhere. As a former collegiate pole vaulter, she loves all things fitness and has yet to meet a group workout class she doesn’t like.
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Fitness
Exercise Boosts Brain ‘Ripples’ Tied to Learning and Memory
While exercise is known to improve memory, scientists have mostly studied this effect by using behavioral tests or brain imaging methods like MRIs, says Michelle Voss, PhD, one of the study’s authors, a professor, and the director of the Health, Brain, and Cognitive Lab at the University of Iowa in Iowa City.
But she says these approaches can’t precisely identify where “ripples” originate, particularly in the deep brain structures like the hippocampus, a part of the brain strongly connected to memory and learning, she says.
The current study, published in Brain Communications, recorded electrical activity directly, using surgically implanted (intracranial) electrodes. “This allowed us to observe how exercise changes the brain’s memory circuits in real time,” Dr. Voss says.
20-Minute Bursts of Exercise Increase Brain Ripples
The participants performed a 5-minute warm-up and then rode a stationary bike for 20 minutes at a pace they could maintain. Researchers recorded their brain activity before and after the biking session.
The electrodes showed an increased rate of so-called sharp-wave ripples from the hippocampus and connections with cortical regions of the brain, which are involved in learning and memory.
“Sharp-wave ripples have long been known from animal studies to play a central role in memory,” Voss says, adding that recent studies using intracranial recordings in humans also support the importance of ripples for human memory.
“Our findings are the first to show that exercise can modulate these ripple signals in the human brain,” she says.
Researchers also observed that larger increases in heart rate during exercise were associated with larger changes in ripple activity in cortical networks, Voss adds.
What’s Already Known About Exercise, Memory, and Learning
Exercise helps build connections between neurons, which deepens and strengthens brain networks, Franssen says.
Physical activity also improves metabolism, which improves insulin sensitivity, helping blood sugar regulation and giving the brain a “more stable and reliable supply of fuel,” Dr. Perlmutter says.
“This is critically important because the brain is an energy-intensive organ, consuming roughly 20 percent of the body’s energy despite representing only a small fraction of body weight,” he adds.
The Research Has Limitations
Voss says researchers were careful to “exclude signals that contained epileptic activity. However, of course, we can’t statistically control for the accumulated effects of having epilepsy on the brain.”
The exercise-brain ripple patterns observed in the current study also closely match those observed in healthy adults using noninvasive brain imaging, such as MRI, she added.
“That convergence across very different methods is one of the strongest indicators that the effects are not specific to epilepsy, but reflect a more general human brain response to exercise,” Voss said.
Researchers also didn’t directly test memory performance, Voss notes. “While hippocampal ripples are strongly linked to memory processing in decades of neuroscience research, the next step will be to measure how exercise-related changes in ripples relate to memory performance in the same individuals.”
Future studies should also compare exercise with other everyday activities, such as sitting quietly or light movement, to determine how specific these effects are to aerobic exercise at the intensity that was studied, she says.
Satisfy Your Brain’s Exercise Craving
It’s never too early or too late to start exercising for brain health, Franssen says.
People of any age, from grade-school children to people in their nineties, can benefit from increased physical activity, Perlmutter says. “My recommendation is to consider taking advantage of the connection between physical activity and brain health across the entire range of human aging.”
Any type of exercise is great, Franssen says, but especially “repetitive behaviors,” like swimming, jogging, and walking.
“Sometimes we let the hugeness of putting in a huge fitness routine get in our way,” she says. “Having a little exercise snack every so often is also very important to improving cognition.”
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