Exercise with discretion

The fitness sector has seen rapid growth over the last few years, only to stagnate and fall back as a result of the socio-economic situation caused by the pandemic. Over the last few years, the area has been promoted on the basis of promises, almost exclusively related to the body. ‘Exercise for everyone’ is one of them! But what kind of exercise? Can the structure of an exercise programme be the same for everyone? Or are we already considering the differences between those looking for performance, aesthetics or health? Or a bit of all of them! Is there a solution that is reasonable and integrative? These are the questions for the reader to reflect on, according to their own reality.

The perspective from which we observe and value exercise is fundamental, because it is through this perspective that we will condition our practice. This applies to both the professional and the practitioner. Knowing that we live in an era in which average life expectancy continues to rise, new challenges are emerging, particularly those related to the senior population. With increased longevity also comes the demand for a higher quality of life, directly associated with greater or lesser health capital.

Over the last few years, exercise has come to occupy a prominent place in strategies aimed at increasing quality of life and promoting people's well-being. The concept of well-being itself has become increasingly comprehensive, encompassing mental/cognitive, social-cultural and economic domains and, inevitably, another related to physical functionality.

The longevity paradigm creates new challenges related to a greater incidence and prevalence of chronic conditions. How can physical exercise contribute positively to this reality? Recognising its protective capacity in the primary, secondary and even tertiary prevention of various diseases and syndromes is certainly not enough.

So, if on the one hand the clinical area is fundamental in the pharmacological optimisation of these conditions, on the other hand, physical exercise can be seen as an adjunct in the promotion of health and quality of life for populations. Does this make sense?

Is ‘exercise for all’ the way forward? I fear that this could be a path where exercise is devalued due to the perpetuation of generic formulas that don't take biological individuality into account. Could there be a path that valorises exercise without implying its decline? I believe so, but this requires a professional conscience that values criteria and prescriptions based on scientific evidence. This critical attitude needs to be fostered in the institutions that train professionals, and then valued in the labour market. Is fitness moving in this direction or are there other alternative paths?

I hope that the reader has had time to reflect on the questions I've been asking throughout this commentary, and that this has sensitised them to the importance of physical exercise, particularly when prescribed on the basis of scientific evidence and a critical attitude.

To conclude this article, if you'll allow me, I challenge you to think about the following: what kind of medicine is exercise? (I hope you'll allow me this comparison) And what type and dose is right for you! And exercise, what is that anyway? Yes, if we're going to prescribe you a drug, we need to know a bit about pharmacology, in this case human physiology (muscular, articular, neural), anatomy, as well as biomechanics (mechanics applied to biological structures), just to name a few of the areas that exercise professionals need to be educated in and know how to think about.

Finally, and resolving some of the tension on the subject, I believe that exercise can and should be for everyone! For this to happen, the stimulus must be individualised for each particular case. There are few conditions in which exercise is not recommended, and even in more complex cases such as oncological conditions, arrhythmias or other conditions, it can be adapted. The complexity of the physiological phenomena associated with exercise requires respect for the context, the active ingredient and the dose of this medicine.

The value of conscious exercise has been increasing, thanks to many professionals and schools that value a practice based on a critical attitude and scientific knowledge. Is fitness doing the same? Are self-styled health clubs complying with this conscious dehydration? Can the rigour that is demanded when we talk about a practice based on evidence and individualisation be a reality? What do you think?

Exercise for everyone, but with discretion!

Good reading and good training.

Professor Eduardo André

Exercise Physiologist