Running, Exercise and Health Care Reform

Well, today is off to a great start. I managed to get outside and hit the concrete at 5 a.m. for my five-mile running tour of the neighborhood. And that’s the first time for me running outside since late January. I’ll admit it. I miss the quiet, the ability to mull things over in my little brain, and the endorphin rush that builds on heart-pounding activity and fresh air.

Saying that, I recognize that I’ve reached the age where I have to make some changes to a routine that has been pretty compulsive set for 30 years. I worry now about slipping and falling — even in good weather. It’s increasingly difficult to get all the body parts working in frigid conditions. And I have a chronic foot injury that ain’t going away. So the reality is that I’m going to be spending more time indoors, chasing the belt on the treadmill and grinding away on the elliptical.

Does that really matter?

Well, in two words: yes and no.

Gina Kolata addressed this issue in her NYT Personal Best column, “Winter Training: Faster and Safer Indoors?“:

The sad answer, exercise researchers say, is that you really cannot get the same training effect with indoor substitutes. That’s not to say that indoor training is useless, but rather that it has real limitations, with differences that sometimes are subtle, but significant.

“I think most athletes know that,” said Peter R. Cavanagh, an exercise researcher at the University of Washington in Seattle. “That’s why they are out there in all seasons.”

The most obvious difference with indoor exercise is a lack of wind resistance, Dr. Cavanagh said.

So for those training for a marathon, you might find the transition from the flat surface of the treadmill to Heartbreak Hill a little difficult.

Still, there comes a point where even the elite athletes have to consider an alternative to being outdoors in potentially dangerous weather. From Kolata’s article:

Other athletes say that there comes a point when an indoor alternative is better than a workout in cold, icy weather. That’s what drove Brian Sell to buy a treadmill.

Mr. Sell, an elite marathoner who ran in the 2008 Beijing Olympics, trains in Rochester, Mich. He bought a treadmill four years ago, after he had fallen a few times on icy roads, injuring himself so badly he could not train at all while he healed.

“I probably fall at least once a year here in Michigan,” he said. “My injuries ranged from a bruised hip to a pulled groin. That time it took three weeks to get back. I said, ‘If I was doing this on the treadmill, I wouldn’t have missed three weeks of training.’ ”

Mr. Sell continued, “If it’s really icy out or if it’s negative 10 degrees and you are doing an easy six-miler, it probably makes a lot more sense to do it on a treadmill than to risk hurting anything.”

Mr. Sell — all I can say is woot. I’ve been fretting over this for a month and you’ve made me feel like less of a wimp. Oops. I digress.

Anyway, I read that NYT article about indoor training  last week and thought about it this morning as I pushed off on the concrete. For most of us, in the long run, does it really matter how we exercise? Nope. The key is to just keep moving — and as I get older, I’m convinced that is more and more important. Do something. Do it consistently. And hey, so something that you enjoy — for as long as you can.

And as evidence, consider this article in the NYT by Jane Brody, “Even More Reasons to Get a Move on“:

In a commentary on the new studies, published Jan. 25 in The Archives of Internal Medicine, two geriatricians, Dr. Marco Pahor of the University of Florida and Dr. Jeff Williamson of Winston-Salem, N.C., pointed to “the power of higher levels of physical activity to aid in the prevention of late-life disability owing to either cognitive impairment or physical impairment, separately or together.”

“Physical inactivity,” they wrote, “is one of the strongest predictors of unsuccessful aging for older adults and is perhaps the root cause of many unnecessary and premature admissions to long-term care.”

They noted that it had long been “well established that higher quantities of physical activity have beneficial effects on numerous age-related conditions such as osteoarthritis, falls and hip fracture, cardiovascular disease, respiratory diseases, cancer, diabetes mellitus, osteoporosis, low fitness and obesity, and decreased functional capacity.”

Prez O and members of Congress appear to be nearing the finish line on some form of health care reform. And I’ll admit that I would be hard pressed to opine with any certainty on what the latest proposal(s) contain — despite the millions of words that have been written and spoken on the subject.

So I wonder if the reform measures take into account the benefits of exercise — and what effect keeping people out of the health care system could have on costs, access, treatment and so on.

If they don’t, we’re missing an opportunity. Exercise, whether indoor or out, matters to all of us.

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