photo of geriatric runner

The prevailing, common sense, advice in medicine used to be that if some body part was weak, you should rest it. It made sense, that is unless you thought about it a bit more deeply. People who had suffered heart attacks were told to rest, even sent to bed for the first two weeks. If you hurt your neck in an auto accident, we would slap a soft foam collar around your neck to give it a rest and make you feel better. If you strained a tendon, the advise was (and sometimes still is) just rest and it will get better. The problem is that sitting around is not a long term solution. I mean, how many athletes achieved world domination by sitting on their butt, resting all day?

EVERY one of those examples, has lots of brother, sister and cousin diseases/injuries where the same approach, the common sense of “just give it a rest”, has been proven wrong. The concept is entirely mistaken. The latest discovery along these lines has to do with lung disease.

Chronic obstructive pulmonary disease (COPD) is a common condition caused by cigarette smoking and diseases such as emphysema and chronic bronchitis. With the passage of time, patients suffering from COPD develop progressively worsening breathing problems. Understandably, these individuals become increasingly inactive. A study published last month, of 6,000 California patients who were hospitalized for COPD in 2011 or 2012 gives us hope about a simple intervention to improve the health of these individuals. Those who got any moderate or vigorous exercise where 30% less likely to end up back in the hospital. If they got more than 150 minutes of moderate or vigorous exercise a week, they were even less likely to be readmitted.

The bottom line is that “use it or lose it” is the truth.

For the sake of complete disclosure, we can’t forget that this is a balance. There is a time to cut back, A BIT and FOR A LITTLE WHILE or to CHANGE.

My damaged joints prevent me from pursuing the kinds of exercise I used to love doing every day. They send me to the gym, to the pool or to some other place where I can get the exercise I MUST do to preserve the physical capabilities I still have. Those capabilities are lessened in some ways, but greater in others. I can’t dream of running marathons any more but I am much more useful at moving heavy furniture. There is wisdom in recognizing your limits. However, the graceful adaption demanded of us is most effectively achieved through vigorous effort.

As his father was dying, Dylan Thomas wrote to “rage, rage against the dying of the light”. Dylan Thomas himself died young. His words were inspiring and very cool in an overdramatic kind of way, but “rage” is not the way to go.

My dear, dear great-grandmother taught me a better lesson in this regard one brisk winter’s day in Minnesota. She was 94 at the time. We went for a walk. As we started up a hill I quickly saw that it was a struggle for her. I said that to her and asked if she wanted to head back home. She said “No” and kept on struggling. I said “You are stubborn”. She said “No, I’m not”. After we walked a bit further, I said “How about determined?”. She said, “Thats right. We can go back now”.

Don’t give up. Don’t give in. But don’t be foolish either.

Written by 

Michael Carlston, MD is an internationally recognized authority in the integration of conventional and complementary medicine in clinical practice, as well as medical education, research and organizational consulting. Practicing in Santa Rosa, California, Dr. Carlston was voted “Best General Physician In Sonoma County, California” by readers of the Sonoma County Independent newspaper and also named one of the outstanding physicians in the Bay Area by San Francisco Focus Magazine. With 30+ years in private practice, his expertise is in nutrition, homeopathy and sports medicine.