Fitness
The Medical Minute: How to get started with physical fitness
The first hints of summer are in the air along with the lure of the outdoors. But maybe after a long winter of hibernating inside you don’t feel ready for it.
May 2, 2024
You aren’t alone. Only 24% of adults in the U.S. met the 2018 Physical Activity Guidelines for Americans for aerobic and muscle-strengthening activities, according to the U.S. Centers for Disease Control and Prevention.
The complex, high-energy world of burpees, hydration systems and interval training might seem inaccessible to the beginner. How do you even start to get in shape?
Breianna Hummer-Bair, a clinical exercise physiologist at Penn State College of Medicine, says your road to physical fitness needn’t be so intimidating. You don’t need pricey equipment or hours and hours of difficult workouts that turn you into a pile of sore muscle and sweat.
Do I even need a gym?
“No, not necessarily,” Hummer-Bair said.
In fact, if you’re just getting started with trying to get fit, you couldn’t have picked a better time of year. Let the outdoors be your gym.
That doesn’t mean reps of curls with boulders or chin ups on tree branches. Nor do you have to join the sweat-soaked runners you might see streaking past on a warm day.
“In general, just being outside is a good thing,” she said. If you have children, go outside and play with them. Take the dog for a walk, or just take your stroll sans pooch.
“We don’t necessarily count them as exercise, all those small things that we do where we’re not necessarily going to a gym and setting aside an hour of time,” she said. “All those little activities add up and count as exercise and physical activity, just not in the way we all typically think about exercise.”
What if you’re just set on joining a gym? What kinds of things should you look for?
“You want to find a place where you’re comfortable,” Hummer-Bair said. “You want to find a place with good cleanliness protocols that you can follow so you don’t get sick and can continue to exercise. But you also need to find a place that has a variety of options for you.”
Don’t lock yourself in, Hummer-Bair said. For example, don’t join a gym that specializes only in yoga if you aren’t sold on the idea of yoga yet. “If you’re just starting you might not know what you’re interested in,” she said.
Look for options with cardiovascular equipment ― treadmills, stair-steppers, elliptical machines and stationary bicycles ― and choices for the kinds of available resistance training you might try, both free-weights and machine.
Some gyms offer classes. You might like the group atmosphere and it could open you up to exercises you never tried before.
Don’t be afraid to try a gym and leave to find another one if you don’t like it. “A lot of times we give up and say, ‘Oh, I’m just not a gym person,’” she said. “Well that’s not necessarily true. Perhaps you just haven’t found the right gym.”
What kinds of questions should you ask the staff?
“I would ask if there are trained fitness professionals there,” Hummer-Bair said. Ask about credentials. Some gym staff members are fitness fanatics. Maybe they’ve obtained a certificate online. Nothing wrong with that ― their experience can come in handy.
Others, like Hummer-Bair, have obtained college degrees in exercise and can draw from a deep well of knowledge to keep you safe and help you achieve the goals you’re looking for using proven, scientific methods. A degree in exercise physiology or kinesiology can definitely be an asset to a newbie. That doesn’t mean you should avoid a gym where the staff has those same kinds of credentials. Instead, you’ll find some staff members have specialized training in specific types of workouts, and those can be helpful, as well, Hummer-Bair said.
Ask about the cleanliness rules. Does the staff regularly clean the machines? Do they require members to wipe down their equipment after they use it?
What kinds of clothing and apparel do you need?
“You don’t need to go out and buy a whole new wardrobe,” Hummer-Bair said.
Start with a comfortable pair of stretchy pants or shorts and a top that will keep you cool. “You want to be comfortable and be able to move,” she said.
Body image is a major reason some people avoid the gym and skip working out altogether. “You want to be covered as much as you need to be so that you’re comfortable,” Hummer-Bair said. “You don’t need clothes that are too loose or too tight so that you feel self-conscious. If you’re not comfortable you’re not going to be able to do the exercises in a way that they’re supposed to be done, safely.”
You’ll need the right kind of footwear for the activity you’ll be doing, and there are tons of options. Here again, Hummer-Bair suggests trial and error. Find a footwear retailer that can work with you on what works best for you based on your activity and physiological needs.
OK, you’ve got your stretchy pants and your sneakers and you found your gym. What are we doing to get fit?
“It doesn’t have to be a lot, especially if you’re just starting out,” Hummer-Bair said. You don’t have to transform yourself into a gym rat ― one of the people you see spending two or three hours straining over weights or sprinting on treadmills.
Starting out slow is key, she said. If you go too fast right out of the gate, you wind up with sore muscles, at best. At worst, you might seriously injure yourself.
But here is where it gets exciting ― you have tons of options. You can bike, hike, run, play frisbee, skip rope, swim or dance. You can do it at home, in the park, on a mountain top, at a friend’s house or at the gym. In an online community, in a class or by yourself.
“There are so many opportunities,” Hummer-Bair said.
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The Medical Minute is a weekly health news feature produced by Penn State Health. Articles feature the expertise of faculty, physicians and staff, and are designed to offer timely, relevant health information of interest to a broad audience.
If you’re having trouble accessing this content, or would like it in another format, please email Penn State Health Marketing & Communications.
Fitness
‘I’m a neuroscientist – these are the 3 best workouts for slowing cognitive decline’
‘Exercise is usually viewed through the lens of physical appearance, the number on the scale and the size of your jeans,’ says Dr Ramon Velazquez, neuroscientist and scientific advisor at Mind Lab Pro. ‘But you cannot move your body without moving your brain. Exercise is not primarily a body intervention – it’s a brain intervention, and the changes you see in your waistline or muscles are side effects of what’s actually going on neurologically every time you move your body with intention.’
Indeed, while a huge body of research shows how crucial movement is for physical health – from protecting our hearts to reducing cancer risk – an increasing number of studies are highlighting the significant cognitive benefits of exercise, from boosting memory and reducing dementia risk to restoring neuroplasticity (the brain’s resilience in adapting to new information, behaviours and sensory input).
But what exactly should that look like in practice? And how should you structure your weekly routine to maximise the brain health benefits of exercise? Dr Velazquez has the answers below.
The workouts
Zone 2 cardio
‘Zone 2 cardio is the most underrated form of exercise. People usually dismiss it because they feel like they aren’t doing enough if they’re not drenched in sweat or gasping for air,’ says Dr Velazquez. ‘It’s a type of activity where you move at a pace that elevates your heart rate, but you can still have a conversation with the person next to you.’
Indeed, a recent review of more than 258,000 people found that even low- to moderate-intensity exercise performed for less than 30 minutes twice a week improved general cognition, memory and executive function (the mental processes involved in planning, focus and decision-making) in as little as one to three months. Dr Velazquez recommends light jogging, swimming and cycling. ‘From a neurological perspective, this type of exercise consistently increases blood flow to the brain over a prolonged period of time,’ he explains. ‘This is important because it helps deliver nutrients to the regions that are most vulnerable to ageing.’
Such exercise, adds Dr Velazquez, also supports the glymphatic system – the brain’s waste clearance system that removes proteins and cellular waste linked to neurodegenerative diseases such as Alzheimer’s.
Strength sessions
‘Strength training is also extremely important for longevity. Strong muscles produce and release hormones and signalling molecules that directly influence the brain,’ says Dr Velazquez. ‘Muscle mass starts declining from your mid-thirties via a process called sarcopenia, and as the muscle disappears, so does the neurological signalling it produces.’
Two to three weekly sessions is the minimum needed to make a difference, he adds. ‘The sessions don’t need to be long – 45 minutes of focused, compound movements is enough.’ Think: squats, deadlifts, rows and presses – ‘exercises that recruit large muscle groups and produce the strongest possible neurochemical response’.
VO2 max training
‘VO2 max – the maximum amount of oxygen your body can consume and use during intense exercise – is now one of the most powerful predictors of long-term survival ever identified in the research,’ says Dr Velazquez. ‘Most people assume that blood pressure and cholesterol are the numbers worth paying attention to when it comes to how long they are going to live, but VO2 max is more predictive than either of those – a low VO2 max is not just a fitness problem, it’s a mortality risk.’
To improve this metric, Dr Velazquez advises introducing high-intensity exercise – where you’re working at near-maximum capacity for short bursts – once or twice weekly, adding that ‘a simple and highly effective routine would be 4-6 intervals of one minute at hard effort followed by two minutes of recovery’.
‘It will be uncomfortable, but that’s the feeling you need to chase to make this exercise effective, and the physiological stress of those intervals drives adaptations that are cardiac, vascular and neurological.’
Example weekly workout routine
‘Zone 2 is the base of the pyramid, VO2 max training is the peak. You cannot build a high peak without a wide, solid base, which is why all three pillars work together,’ says Dr Velazquez, who gives an example of an effective weekly routine below.
Monday
30-45 mins strength, eg, squats, deadlifts, rows, presses.
Tuesday
Zone 2 workout, eg, light jog or swim.
‘The key is finding an enjoyable activity that raises your heart rate, but not to the point where you’re gasping for air.’
Wednesday
30-45 mins strength.
Thursday
Zone 2 workout.
Friday
30-45 mins strength + VO2 max training afterwards.
Saturday
Longer zone 2 workout (around 60 mins).
‘I would suggest working out in nature, since a natural environment and exercise are a perfect combination for lowering cortisol.’
Sunday
Rest day.
‘Rest is not the absence of progress, it’s a necessary part of keeping the progress going.’
‘The brain responds to every single session. It’s tracking the pattern, not the performance. And the earlier in life you establish that pattern, the more of your brain you get to keep.’
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Hannah Bradfield is a Senior Health and Fitness Writer for Women’s Health UK. An NCTJ-accredited journalist, Hannah graduated from Loughborough University with a BA in English and Sport Science and an MA in Media and Cultural Analysis. She has been covering sports, health and fitness for the last five years and has created content for outlets including BBC Sport, BBC Sounds, Runner’s World and Stylist. She especially enjoys interviewing those working within the community to improve access to sport, exercise and wellness. Hannah is a 2024 John Schofield Trust Fellow and was also named a 2022 Rising Star in Journalism by The Printing Charity. A keen runner, Hannah was firmly a sprinter growing up (also dabbling in long jump) but has since transitioned to longer-distance running. While 10K is her favoured race distance, she loves running or volunteering at parkrun every Saturday, followed, of course, by pastries. She’s always looking for fun new runs and races to do and brunch spots to try.
Fitness
best ellipticals for a low-impact full body workout
Although it may seem straightforward, there are some key steps you should follow when using an elliptical. Elyse Miller, an iFIT trainer and elliptical class instructor, shared some insight on the key things to keep in mind when hopping on one of these machines.
Stand up straight: You must remain upright while on an elliptical. Miller says you should stand in a tall, upright position with an engaged core by tucking your hips forward. This will also activate your glutes and keep tension away from your lower back. Your upper body should be relaxed as well. “Relax your shoulders and leave elbows soft without locking them,” Miller said.
Additionally, your front leg should feel like a natural stride forward and your heel will slightly lift as you rotate ahead. “Your hands should remain neutral while holding the handles on the elliptical, but don’t squeeze them tight,” she said, adding that once you have the form down you can mix things up. “For example, angling your toes out will work your inner thighs or moving your hands up and down the handlebars will target different muscles in the upper body.”
Hold onto the handles: One of the unique aspects of an elliptical is that it lets you work your full body at once. To get the most out of your workout, you’ll want to make sure you’re holding onto the handles as you pedal. This will allow your upper body to get the blood flowing as well. “Since elliptical arm handles are long, you can easily change the hand placement as needed for different heights or to target different upper body muscles,” Miller said.
Don’t slouch over: If the resistance is too high that it’s causing you to sacrifice your form, change up the intensity. “Reduce the resistance to maintain a strong, confident posture,” Miller said, adding, “don’t get stuck in the circling rut — make sure to try out intervals, resistance changes and level shifts rather than zoning out and going through the motions.”
Keep your feet on the pedals: Naturally, your body is going to move with the forward motion of the elliptical when your arms and legs are involved. Make sure to keep your feet sturdy and flat on the pedals as you go through the motions.
Fitness
Very difficult and extremely cool: how to start doing pull-ups
The pull-up has long been seen as an important fitness metric. From 1966 to 2013, public middle and high school students in the US were required to do pull-ups as part of the presidential fitness test (an evaluation Donald Trump has considered reinstating). US Marine Corps members were long required to perform pull-ups as part of their regular physical fitness test, and prospective UK Royal Marines must complete a minimum of three to four pull-ups before they are eligible to join.
There is no definitive data on how many adults can perform a proper pull-up, but two things are clear: they are very difficult and look extremely cool.
“When a new client comes to see me, the most common exercise they say they’d like to be able to do is the pull-up,” says Emily Schofield, a certified personal trainer at the training company Ultimate Performance. “Achieving that first proper rep is one of the most satisfying milestones you can reach in the gym, because it’s a genuine, hard-earned display of strength, coordination and control.”
Do you want to literally and figuratively flex on others at the gym? Here’s how to start doing pull-ups.
What is a pull-up?
To perform a pull-up, a person starts by hanging from a bar with their arms fully extended and feet off the ground; this is also known as a dead hang. From there, they pull themselves up until their chin is over the bar, and then lower with control.
“Done well, it’s a controlled, deliberate movement,” says Schofield. “There’s no kicking, jerking or relying on momentum.”
What are the benefits of pull-ups?
Pull-ups build upper body strength, particularly in the back, says Mathew Forzaglia, certified personal trainer and founder of Forzag Fitness. “It also helps develop core stability, which prevents the body from swaying during consecutive reps, and improves grip strength,” he says.
The muscles most engaged by the exercise, according to the Cleveland Clinic, are the latissimus dorsi (or “lats”) – the large, broad, fan-shaped muscles which stretch from the bottom of the back to below the shoulder blades – and the trapezius (or “traps”) – the triangle-shaped muscles that run from the neck to the mid-back. They also engage shoulders, forearms, biceps, triceps and abdominal muscles.
When Schofield performs a pull-up, she says she focuses on not just using her arms: “Putting too much emphasis on your biceps to execute the move will make you tire quickly and diminish how effectively you’re targeting the lower back,” she explains, adding that the lats should be doing the heavy lifting.
In addition to looking impressive at the gym, pull-ups also help with functional strength. Because pull-ups force the body to work as a single unit, they improve “strength, coordination and neuromuscular control”, as well as helping with posture, improved performance on other lifts, and a more balanced physique overall, Schofield says.
Can anyone do a pull-up?
For the most part, yes.
Many women in particular seem to doubt this. And can you blame them, when the New York Times once published an article titled, Why Women Can’t Do Pull-Ups? (Granted, the article was controversial at the time, and several outlets and blogs published rebuttals.)
Schofield says many women she works with “instantly dismiss the idea they’ll ever be strong enough to perform a pull-up”. But she emphasizes that neither age nor gender should be considered a barrier to the exercise.
“I train a client who is in her 70s and she can perform a full set of eight pull-ups with greater strength and control than people half her age,” Schofield says.
Some people need to be especially careful when performing pull-ups, Schofield says – specifically those with shoulder injuries, elbow painor any type of upper-body joint issue.
“In those cases, I’d always prioritize rehab and strengthening work before attempting the exercise,” she says.
How do you do a pull-up?
One of the most common mistakes people make when it comes to pull-ups is jumping straight on to the bar, Schofield says. Most people will need to build up a base of strength before they can successfully perform the exercise.
To do this, prioritize exercises that strengthen the muscles you will need to perform a pull up. These include:
Forzaglia also recommends inverted rows using TRX straps or a barbell set up in a squat rack. “This helps build the foundational pulling strength needed to progress,” he says.
Even if you can’t complete a pull-up, it’s worth spending time on the bar, Schofield says: “That might mean attempting partial reps, holding the top position, or controlling the lowering phase.” All of these help the body learn how to coordinate the movement, she explains.
Regardless of gender, building to a full pull-up can be a slow process. Countless programs claim to be able to teach people how to do a pull-up in 30 days. That might be possible for some. But achieving a pull-up depends on a number of factors, including baseline fitness, bodyweight and physical build. Although the above exercises are all relatively safe, it is a good idea to work with a certified personal trainer who can offer the best personalized guidance. And encouragement.
“Because pull-ups are difficult, people tend to avoid them when they struggle. But that’s exactly when they should practice them the most,” Schofield says. “The key is to practice, practice, practice.”
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