Ashlee Williams, MD: Exercising is one of the best things you can do for your health. Physical activity can lower the risk of chronic medical conditions, help with weight loss, improve sleep, and boost your self esteem. The right fitness plan and knowledge about how to structure an exercise routine, can help you make it a regular part of your life.

Today, we discuss ways that you can start a fitness routine and stick to it. Welcome to the Healthier You podcast. I'm Dr. Ashlee Williams, and today I'm talking with Dr. Jennifer Gourdin, a Sports Medicine Specialist at Kaiser Permanente, about how to build and maintain a healthy exercise routine. Dr. Gourdin, thanks so much for being here.

Jennifer Gourdin, MD: Thank you, Dr. Williams. I appreciate you inviting me to have this discussion.

Host: Yes, we're so excited. Okay, so let's start. How much exercise does the average person need?

Jennifer Gourdin, MD: So, according to the U.S. Department of Health and Human Services and recommendations from the American Heart Association, adults need about approximately 150 minutes of moderate aerobic activity per week, or 75 minutes of vigorous aerobic activity per week, in addition to strength training two to three days per week.

So when we refer to moderate aerobic activity, that means the type of activity that you are able to talk when you're doing it, but it's difficult to sing your favorite song. So that could be brisk walking, light jogging, water aerobics, or biking. When you talk about vigorous aerobic activity, that is activity that you're basically out of breath when you're doing it.

So I like to do high intensity interval training and typically that type of training, HIIT training, is also what we refer to it as, that will make you out of breath. So that's a type of vigorous aerobic activity. Or you could do jumping rope or running at a brisk pace. Those would be your vigorous type aerobic activities. And then your strength training. And strength training can be done with weights or with resistance bands.

Host: Wow. Sounds like there's quite the variety of things that we can do. So what would be a good exercise goal to set for myself?

Jennifer Gourdin, MD: Well, I think the main goals that you, no matter what your goal is, whether it's to lose weight or to build muscle, you should always want to improve your cardiovascular fitness. So that's how well your body takes in oxygen and delivers that oxygen to your muscles and the rest of your body. You should also want to improve your strength, your flexibility, and the range of motion in your joints.

I think if you hit all of those goals, then your overall fitness will improve and your quality of life will improve. If you're someone who is new to exercise, you want to start with short term, small goals and kind of build on that. So, for example, if you want to be able to do 25, 50, or 100 push ups, maybe you tell yourself, okay, I'm going to work towards doing 10 push ups over the next two to four weeks.

And, maybe you start out doing those 10 push ups. Maybe that's even challenging to do as well. And so I think it's also important for patients to know that there are modifications to most exercises to make it a little bit easier and a more attainable goal for you when you're first starting out.

So again, with the pushups, you know, if it's hard for you to do 10 pushups, maybe you, in the plank position, maybe you widen your legs, or maybe you go down on your knees and you start there doing as many pushups as you can, and you just build upon that. So setting small goals that you can reach within a month or two months will help you to achieve the larger goals, which again, I said would be to, you know, improve your strength, build muscle, improve your cardiovascular fitness and your overall mobility.

Host: I love it. I love to hear that I can start at 10 and somehow end up at a hundred pushups.

Jennifer Gourdin, MD: I know, right?

Host: Okay. So what are the essential parts of an exercise routine?

Jennifer Gourdin, MD: So I think most exercise routines, it's important for them to include not only cardio, strength training, stretching and flexibility and recovery. So we already kind of talked about the cardio piece; you want to do either the 150 minutes of moderate aerobic activity or 75 minutes of vigorous intensity activity.

And then your strengthening is just going to be two to three days per week. And you can do that. It could be body weight strengthening. Holding planks or you're doing situps or you can do things with lightweights or you can do exercises with resistance bands. Those will all help you to build your strength. And then stretching. I think that's a major part of exercise routines that patients often forget or kind of skimp over, but it's a really important part. And when I talk to my patients about stretching, I like to first emphasize the importance of dynamic stretching. So dynamic stretching is what you want to do when you're warming up to exercise.

That is things like plank walkouts, high knees, toe taps, lunges, you're taking your body through ranges of motion, but you're also stretching the muscles when you're doing that. So you're actively stretching. Whereas static stretching, which is the more traditional stretching that most of us are familiar with, where you're, you know, bending over and touching your toes and you're holding that position for 10 to 15 seconds.

Those type of stretching exercises are best to do at the end of your workout as a part of your cool down. Because your muscles are warm, you're going to get more of a stretch, and it will also help improve your flexibility. So stretching is a very part of exercise routines. And then recovery.

We need to have at least one to two days of recovery, especially after the days that you do your strength training workouts. It's important to give your body a rest and allow your muscles to recover and you know they may feel sore when you first start working out or when you increase the intensity of your workouts and that's okay.

But if you give your body adequate rest, like a rest day, you should be able to recover adequately and then exercise the following day. And your performance and how you feel with the workouts after your rest day is normally better. You feel really good. You feel re-energized, which is really important.

Host: Yeah. I think a lot of people do forget that rest and recovery day. It's really also very important to the workout.

Jennifer Gourdin, MD: Yeah, because you can easily get burnt out, especially if you're new to exercise. You might start this extreme exercise routine and then after about a month or two, if you didn't really take adequate rest and recovery, you just get burnt out and you lose steam and you're more likely to kind of give up on your workout routines and your commitment that you made.

Host: Right. And I love that you don't necessarily need equipment to do a workout, right? You can use your own body weight. But if you were to recommend equipment that you would need to start a workout program, what would you recommend?

Jennifer Gourdin, MD: I think that's a really great point because, you know, I'm a working mom, so my time to get to the gym, I really don't have the opportunity to do that. So most of the time when I'm working out, like most people who, you know, are moms or have busy work schedules, you're working out at home. So you're not going to have all the fancy equipment, but I think some key things that you can have would be a yoga mat. Also, maybe some light weights. If you don't have light weights, resistance bands are a great option because they give that same kind of effect that lifting weights does. But, you know, it's easy to store. It doesn't take up a lot of space. It's safe to, they're safe to have around kids, that kind of thing.

So resistance bands, a yoga mat. If you do have light weights, that's also helpful. And I think that's a great starting spot for home equipment.

Host: Right. So as a fellow working mom and for all the other working moms out there and anyone else that's trying to stay motivated, how do you stay motivated to continue the workout?

Jennifer Gourdin, MD: Yeah, that's a really great question, Dr. Williams I think. I think some of the things that help me stay motivated is having a community. So, having friends or people that I work with, co workers or people, that are also interested in the same fitness goals that I'm interested in and they can help to hold me accountable.

You know, you're more likely to do something if your friend is going to come along for the walk, or if they're going to come along with you for the gym. And even now with fitness apps that you can use at home, I use some as well. One of the ones that I use, my friends can actually join and we can do virtual workouts together.

So I don't feel as though I'm alone. If you're married or you have a significant other, partnering with them can also help to keep you motivated. Another thing I really like to do is involve my kids. So if it's on the weekend and I'm trying to get a workout, I'll turn on like kids' workout videos and something that they can do as well. And I'll just do it with them. Maybe try to do it at a higher intensity just so I can burn calories and work up a sweat. But that works out great for me. Also dancing, turn on your favorite music and dance around with their kids.

That helps. Incorporating things in your day to day. So, you know, if you're having to clean the kitchen, maybe you're doing some wall pushups or some calf raises while you're doing that, or you're sweeping more vigorously than you would normally sweep. I mean, if you just keep your body moving, I think, that's just a great way to remain active and to keep yourself motivated.

I think also using like Apple watches or Fit Bits or fitness bands are also helpful to keep you motivated because you can track your progress, you know, how many steps you took that day, if you have a goal of how many steps you want to take, so that can help to hold you accountable. And then the last thing I would share would be if I'm in the middle of a workout or if you're in the middle of a workout and you need something to kind of help keep you going, help keep you motivated when you get to that point of wanting to give up, develop a mantra for yourself.

For me, I'll say transformation. To me that word means I'm doing this because I want to transform something about myself, something about my body that I want to be better or different, or I'll say, I'm built for this, or I got it, you know, and just saying that out loud; mentally can help to get you back into it and help you to keep going a little bit more and push a little bit harder.

Host: Yeah, I totally agree. I think part of the motivation is the mental part of it, right? Like how do we get ourselves there to actually work out and continue working out? And I think having, being surrounded by family and friends and having people to support you and motivate you is also very, very helpful. Totally agree. And you also touched on some really great points, you know a lot of my friends and family and my patients, even myself, I'll say, I don't really have the time to work out.

So what do I do then? And I love the tip about, sweeping a little harder or just putting things in the day to day, that you're already doing and just putting a little more effort in it. Do you have any other tips on how to include workouts in our day to day when we just don't have the time?

Jennifer Gourdin, MD: I think when we're at work, using a sit-stand desk is helpful. Get yourself up and moving more. Taking the stairs instead of the elevator can also help to get your heart rate up. If you have a lunch break, going for a walk to pick up your lunch or just going for a walk outside is, is a nice way to incorporate more exercise. Or just taking a five minute break in the middle of your day to say, okay, let me stand up, let me do some wall push ups, let me do some jumping jacks, just something to get your heart rate up for a couple of minutes are all easy, quick, effective ways to get your body moving more.

Host: I love it. I'm going to start doing wall pushups. How many should I do?

Jennifer Gourdin, MD: Start with 10.

Ashlee Williams, MD: 10? Okay. And then to a hundred, right?

Jennifer Gourdin, MD: Yes, if they get to 100, let me know. Let me know when you get there.

Host: All right. Well, thank you for this great information, Dr. Gourdin. We learned a lot about the importance of exercise and how to build a routine and how to stay motivated. Here are five important takeaway tips.

One, there are many ways to achieve the recommended 150 minutes of moderate exercise each week. 2. When creating an exercise routine, be sure to include key elements. A warm up, cardio, strength training, and stretching. And also, make sure to take those couple of days to rest and recharge. 3. Set SMART exercise goals. Make sure they're specific, measurable, achievable, relevant, and time based. 4. Everyone loses the motivation to exercise from time to time. Think about the type of physical activity that feels fun to you. Then encourage a friend to work out with you. It really helps keep you motivated. And five, even if you don't have time for a workout each day, you can still be active.

Take the stairs whenever possible. Set a time to remind you to stand up at least once an hour. Grab a jump rope or a resistance band and take five minutes to get your heart pumping. For more exercise tips from our experts and other health advice, visit kp.org/doctor and listen to more episodes of Healthier You wherever you get your podcasts. If you enjoyed this episode, be sure to share it with others who may find it helpful. Thank you, and from all of us at Kaiser Permanente, be well.