By The Nation
Dr. Thanathip and Archan Surasak talk about physical exercise and its positive effects on every age group.
Dr. Thanathip, how important is exercise in today’s internet age?
Exercise is essential for good health. Humans began as hunter-gatherers and still need a lot of physical movement on a daily basis. More people today live in air-conditioned buildings and we’re glued to our computers, maybe spending 10 hours a day in front of the screen. Our bodies have become stiff due to the long hours of sitting.
Basically, we need a lot of interval workouts to loosen stiff muscles in the neck, shoulders and other areas to stay healthy. We also need to do cardiovascular activities to keep the heart healthy, strengthen our muscles and maintain a good physical balance. We should be able to literally maintain our balance while standing on a log, but most of us lack this potential.
However, I have noticed something. When I was in medical school at Chulalongkorn University about 30 years ago, I would jog regularly in nearby Lumpini Park, and there were few other runners. Today, jogging and running are very popular, and we even see so-called “overuse injuries” resulting from excessive exercise.
On the other hand, there are more and more obese people due to improvements in oncome, the over-consumption of sugary foods and other factors. These are two extreme groups – obesity and over-exercising. There are fewer people on the middle path, so it’s like a pendulum swinging to the extreme left and right.
What do you mean by “overuse injuries”?
It means we are over-using our bodies. The people who love to exercise represent our main topic for today, those who over-excise and work out for too many hours. The other group don’t work out at all, and their overuse injuries come from working long hours in a chair, resulting in aching shoulders and upper arms. Some muscles are overused, some not at all. Overused muscles bring the risk of overuse injuries. If the injuries come from sports or too much working out, the muscle fibres will be damaged and you get aches and swelling.
Aching shoulders and upper arms are quite common and some people turn to traditional massage for relief. Is it a good solution?
In fact, we should look at the root cause. The aches could result from an inactive lifestyle. If you’re sedentary, you need more physical movement on a daily basis. That’s the real solution to the underlying problem. Professional massage might bring temporary relief, but it’s best to take frequent breaks from the computer to do brief sessions of simple exercise.
Thai traditional massage is regarded as a national treasure, but you need experts to do it properly. And massage only relieves the pain. To cure it, you need to get back to the basics – being physically active more.
Heat therapy has become popular in dealing with overuse injuries caused by improper exercise. What is your opinion?
In short, heat therapy is common among Thai people. Many people would just turn to medication and other heat methods to ease muscle and other pains. Heat therapy is common here, with many simply using balms or embrocation liquids, hot-water bags or heating pad to ease pain, but this is only superficial heat. My advice is to avoid heat therapy in the first day or two of feeling overuse injury because the heat increases blood flow to the affected area and worsens the injury. It’s better to use cold therapy initially, such as an ice bag, as long as the chill is not extreme.
On day three or four, you can use heat therapy to help the body repair damaged tissues by increasing blood circulation in the area. Some people think the more heat the better, but you have to be careful about inflammation, again by making sure the temperature is not extreme. People with chronic diseases such as diabetes must avoid extreme temperatures in coping with overuse injuries. Judge according to how you feel – If the heat becomes unbearable, just remove the source, then reapply, and so on.
Dr Thanathip, jogging and running have become quite popular in Thailand, with many running events and mini-marathons organised. Could we begin seeing more over-exercise?
Running is an aerobic exercise good for your heart, but regular runners should have a wearable gadget to measure heartbeat and other indicators to ensure a healthy session.
The rule of thumb is that maximum heart rate should be 220 minus your age. If you are 50, the max rate is 170, and you should achieve about 80 per cent of this rate during aerobic exercise. Anything higher is considered a hard-core endurance exercise while a lower range is mainly for fat burn, not for the cardio purpose.
Aerobic exercise is essential and you should do it on a regular basis, say, 3-4 times a week. If you stop, the effects will decrease in two weeks.
So we should consider our age and monitor heart rate through wearable gadgets or calculate the perfect rate by yourself. You have to pay a little for your health. Moreover, you have to work out regularly and monitor the heart rate as an indication for proper exercise level.
In terms of calories, you should burn at least 1,500 per week, or 400 calories per session if you exercise four times a week. You can burn around 400 if you run for nearly an hour.
I work on a running machine and lose 300 calories in around 30 minutes.
That means your body is fit.
However, it quite hard works out for me. If I do running outdoor, I have to adapt to the current condition. But the main subject is proper exercise.
What is your advice for avoiding overuse injuries?
Basically, you calculate the suitable duration and intensity of the exercise based on age and other factors. Sometimes you may want to achieve higher performance, but make sure you’re not going too fast or overdoing it. That’s a future topic – what to do if injured.
Dr Thanathip, can you say more about the sedentary lifestyle?
There are two major groups among the so-called Gen Y and Gen Z populations. The first are physically inactive and generally overweight or even obese. They prefer an easy-going lifestyle, eating and spending hours on digital devices. If they do exercise, it might be not enough. The others are quite strict in their diet, eating lots of veggies and low-fat foods.
Can you give advice on increasing motivation?
The first group might lack incentive to work out regularly. The most important factor is probably social. If you’re surrounded by friends who don’t exercise and enjoy eating, you’re not going to be motivated to do otherwise. Maybe you need a new environment.
Dr Surasak, what if someone isn’t motivated to exercise?
Some people need the inspiration to live longer for their loved ones, so this could be a powerful incentive for regular workouts. Some adults wish to stay healthy so they can take care of their parents in old age, while others want to exercise so that they live long enough to see their kids reach adulthood. Self-motivation is key to sustained regular exercise and helps people stick to it when they lose the will.
Many people can’t sustain their exercise habit even after they’ve spent money on equipment at home. After a brief period, the machine goes unused.
When I finished medical school at age 25, I weighed 82 kilograms. Twenty years later I was 93kg – 10kg overweight – even though I ran 2.5 kilometres every other day. It’s a challenge to keep the weight down.
Eight years ago, an in-law introduced me to biking and I spent Bt20,000 on a new bike. In the first month I did 2,000km every morning and evening and lost 7kg, the first time since med school my weight dropped. That was a big inspiration for me and I returned to running again. Today I weigh 84kg and can easily maintain it.
In short, inspiration and self-motivation are key to sustainable physical workouts.