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From The Desk Of Clarence Bass

Balancing The Risks And Rewards Of Exercise

Almost everything has a downside, and exercise is no exception. Overtraining not only stalls progress, it can cause serious harm.

Only a few people agree with Henry A. Solomon, M.D., whose 1984 bestseller The Exercise Myth charged: "The exercise fad is a folly and a danger." Solomon, a cardiologist, didn't quarrel with the fact that strenuous exercise is the only way to increase your physical capacity for work, but he was adamant that it "will not make you healthy" and "will not make you live longer." Most agree, however, that chronic overtraining can cause wear and tear on the body, and perhaps make us more susceptible to disease.

Exercise For Health And Longevity

Before getting to some specific dangers, we should say that the overwhelming weight of the evidence is on the side of exercise. "Exercise is not only the key to staying healthy, it can also reverse an important part of the aging process," said Dr. Miriam Nelson in Stealing Time: The New Science of Aging, the companion book by Fred Warshofsky to the three-part documentary film of the same name, broadcast earlier this year on PBS. Nelson, Associate Chief of the Human Physiology Laboratory at the Jean Mayer USDA Human Nutrition Research Center at Tufts University, says, "If we could package exercise up in a pill form it would be the single most widely prescribed medication in the world because it does so much for everybody."

Dr. Steven N.Blair, director of research, epidemiology and clinical application at the Cooper Institute of Aerobics Research in Dallas, interviewed in the January/February 1999 Nutrition Action Health Letter, was asked what benefits of exercise are the most certain. "Exercise can help you live longer and make you less likely to die of heart disease and stroke," he answered. "It can reduce the risk of adult-onset diabetes and colon cancer. And almost everyone believes that an active life should prevent obesity, though that hasn't been studied in detail." And that's only the beginning.

As the interview unfolded, Blair explained that exercise not only wards off life-threatening diseases, it strengthens your bones, helps you sleep better, reduces stress, prevents constipation, makes your immune system work better and generally improves your outlook on life.

Contrary to what some believe, Blair says that exercise in reasonable amounts doesn't cause arthritis; it actually protects and improves the functioning of arthritic joints. Sufferers who exercise report less pain and more mobility than non-exercisers.

On average, says Blair, a fit 65-year-old can function as well or better than an inactive 45-year-old. Miriam Nelson agrees--and goes further. She says there's an amazing difference between people who exercise and those who don't. The difference is especially apparent in her research comparing master athletes to their non-exercising contemporaries. "What we saw without exception was that these master athletes were about twenty or thirty or forty years younger, biologically, than their sedentary counterparts," says Dr. Nelson.

1951 Mr. America Roy Hilligenn, shown here in his mid-50s, says,
"I'm so healthy it's embarrassing. If I felt any better I'd have to see a doctor."

More Is Not Better

You can get too much of a good thing, however, as I said before. Overdo and exercise can turn around and bite you. This was confirmed in a study of Harvard Alumni by Stanford University's Ralph Paffenbarger. Dr. Paffenbarger found that death rates were lower for men who were involved in regular physical activity. The death rate declined steadily as the number of calories burned in physical activity increased - but only up to a point. Death rates began to go up slightly among men expending more than 3000 extra calories per week.

Dr. Kenneth Cooper, author of the landmark book Aerobics, believes that excessive, "distress" type training produces unstable oxygen molecules called "free radicals," which cause damage to the body. Free radicals have been linked to health problems including cancer, heart disease, premature aging and other maladies. (See my book Challenge Yourself for more details.)

On a more mundane level, it's long been known that overuse can cause wear and tear to the muscles, joints and connective tissue. Exercise and Health, the 1981 physician's textbook by Gregory S. Thomas, M.D., M.P.H., Philip R. Lee, M.D., Pat Franks and Ralph S. Paffenbarger, M.D., Dr..P.H., states that the most common "adverse affects" of exercise are "musculoskeletal." The authors didn't beat around the bush: "The problem is the application of force without adequate rest - the body's maintenance system cannot keep up."

Dramatizing the problem, Dr. Henry Solomon wrote in The Exercise Myth that there are a "small minority" of "exercise addicts" who exercise to the point where their injuries are "near-crippling" and "a frightening number" of exercise enthusiasts who "act contrary to reason and common sense, as though impelled by some demon of their own to disregard the signals given by their bodies." These highly motivated and well-meaning--but misguided--people, said Dr. Solomon, "tend to minimize the painfulness of their injuries and to disregard serious symptoms." Unfortunately, they pay for it in the long run with continuing aches and pains that may cut their athletic careers short and plague them for the rest of their lives.

Dr. Solomon's advice--avoid all exercise any more strenuous than a brisk walk--may be acceptable to some, but most people who enjoy strenuous exercise would probably prefer the more moderate and less-restrictive counsel offered in Exercise and Health.

Listen To Your Body

"The individual's responsibility," the authors wrote, "is to stay within the tolerance of his or her musculoskeletal system." Physicians, they said, should stress to their patients the importance of "listening to your body." In short, if it hurts don't do it!

My rule has long been, "If it hurts, don't do it."

People, of course, differ in their tolerance to exercise. Some require more rest than others for recovery to occur. Nevertheless, for everybody, young, old, fit and not so fit, "proper rest is vital to tissue recovery," the authors wrote. "Adequate rest means allowing exercised tissue to recover." Again, the key is to listen to your body. Don't push beyond your individual tolerance, and then rest until you are fully recovered.

In addition, the authors of Exercise and Health recommended strength training as a preventive measure. "Increasing muscle quality and quantity is helpful at any age," they wrote, "but it becomes more important with advancing age." "Aging joints are better protected by good-quality muscle surrounding them."

Needless to say, combining weights and aerobics increases the danger of overtraining and makes listening to your body and getting adequate rest all the more important.

Latest Research Findings

The advice offered in Exercise and Health is still as good as gold, but we've learned more about the potential risks of training hard too often. The latest information on the physiological, biomedical and psychological aspects of overreaching is collected in Overtraining in Sport, published by Human Kinetics in 1998. Thirty-three leading researchers, including editors Richard B. Kreider, Andrew C. Fry and Mary L. O'Toole, contributed their knowledge to the 17 chapters of the book.We don't have to get bogged down in the details, many of which are extremely technical and pretty dry, to glean the information that serious trainers need to know. The key points are easy to understand.

One of the most serious results of overtraining is suppression of the body's immune system. Numerous studies have shown that excessive training increases our susceptibility to infections. In fact, studies show that even short bouts of intense exercise can temporarily impair the immune response, and successive days of heavy training can amplify the problem. Studies by David C. Nieman, DR PH, have found an increased incidence of illness following prolonged, exhaustive exercise. Dr. Nieman, as a result, recommends not more than two maximum-intensity workouts each week.

Markers of immune suppression are abnormally low levels of lymphocytes and antibodies. Frequent colds are probably a signal that you are training too much and have a depressed immune system.

Overtraining also has a significant psychological impact. I've often noticed a deterioration in my mood state a day or two after an exhausting training session. This might seem to contradict the statement above that exercise generally improves your outlook on life. It does make you feel better but, again, only up to a point.

An accumulating body of research shows that exercise and physical activity promote a sense of well-being. However, like Dr. Paffenbarger's study of Harvard Alumni, the benefits turn negative when the training load crosses the line into overtraining. That was well documented in a 10-year study of University of Wisconsin athletes. Mood disturbances--tension, depression, anger, confusion, anxiety, lack of vigor--were found to increase significantly as the training load increased. Conversely, mood scores returned to normal as the training load decreased. Even brief periods of rest or taper were found to restore a more positive emotional state.

Individuals vary greatly in their psychological response to exercise, but it's safe to assume that you've exceeded your tolerance when you start to feel grumpy and unable to cope with life's normal travails.

Planning Reduces The Risk Of Overtraining

We've also become more sophisticated in finding ways to train hard and productively, without overtraining. The many authors of Overtraining in Sport repeatedly stress the importance of designing training programs to include both rest and variation in intensity and volume. Periodization, which is applied in Ripped 3, Lean For Life and Challenge Yourself--and discussed in article #8 on this site, provides a structured approach to training, with regularly scheduled periods of recovery. I won't go into detail here, except to say that one of the key elements of periodization is planned change. Training is done in cycles of gradually increasing intensity, followed by periods of lighter training. In each cycle the mix of volume and intensity varies. The basic idea is to push until you almost, but not quite, reach a plateau or sticking point, and then back off and begin again, with a different training emphasis.

Even if you don't want to go to the trouble of setting up a periodization plan, remember that something as simple as a few extra days of rest on a regular basis will go a long way to lower the risk of developing overuse problems.

The Best Defense

The authors of Overtraining in Sport say we still have a lot to learn about garnering the benefits of exercise while avoiding the risks. In the meantime, they leave us with these words of wisdom: Our best defense may be the "shield provided by common sense and observation."

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