What Should An Exercise Program Include?

This past week was pretty eventful in my life and my rehab. Thursday, I decided to celebrate my birthday by getting in 1000 steps/year of my life. I hope I can still do this when I am 50, 60, 70…. But even if not, 37,000 steps was quite the accomplishment considering the long road it has been for me to this point. I am not running yet, but the elliptical and spin bike are lifesavers, I have been able to get back to doing boot camp style workouts without many modifications, and we even went on a rather snowy hike with the kids this weekend and I wasn’t in a panic. I am still not where I want to be (obviously, since running isn’t happening yet), but I still think I have enough now to celebrate. 

So, I guess it’s also a great sign that this week, I didn’t feel inspired to post anything based on my own recovery. Instead, I wanted to answer a question that I get a lot as a physical therapist:

What should I be doing in my exercise program to “be healthy”?

Not everyone wants to be a runner (crazy as it may seem to some who are reading this). I have always been a big believer that running can be for every body type (though some have to really want it to push through the obstacles and barriers to be able to run). It isn’t, however, the only way to achieve fitness and even if you are a runner, it doesn’t mean you are doing all the right things to be in your best physical shape.

You can run and run and run, but if that’s all you do, you will not reach your best potential- whether you are the top athlete in the country, or just trying to “get in shape”, your body needs more than high impact cardio to be strong and fit. 

So what are the key components of an exercise program?

According to the Physical Activity Guidelines for Americans 2nd edition:


The average adult should strive for 

  1. At least 150 minutes (2 hours and 30 minutes) to 300 minutes (5 hours) a week of moderate-intensity (fast walk or light jog)
  2. Or 75 minutes (1 hour and 15 minutes) to 150 minutes (2 hours and 30 minutes) a week of vigorous-intensity aerobic physical activity (run/interval training or other high intensity cardio)
  3. Or an equivalent combination of moderate- and vigorous-intensity aerobic activity (alternating days of higher and lower intensity running, cross training, etc.). 
  4. Preferably, aerobic activity should be spread throughout the week (no weekend only warriors)

There are amazing health benefits, backed by extensive research to show that aerobic exercise is important (“Yay!” call out all the runners). Here are some of the things that can be reduced with these levels of exercise as listed in this same document: 

  • All-cause mortality
  • Diseases such as coronary heart disease, stroke, cancer at multiple sites, type 2 diabetes, obesity, hypertension, and osteoporosis;
  • Risk factors for disease, such as overweight or obesity, hypertension, and high blood cholesterol
  • Physical fitness, such as aerobic capacity and muscle strength and endurance
  • Functional capacity, or the ability to engage in activities needed for daily living
  • Brain health and conditions that affect cognition, such as depression and anxiety, and Alzheimer’s disease
  • Falls or injuries from falls. 

Aerobic exercise is amazing! Those are the cardio recommendations and a lot of people think that’s where the important information ends. “Just run/walk/cardio”, but there is more!

They further recommend:

  1. Adults should also do muscle-strengthening activities of moderate or greater intensity and that involve all major muscle groups on 2 or more days a week, as these activities provide additional health benefits. 

They mention in the full document, though not in the summary, the importance of balance and flexibility training in a well rounded exercise program. 

Why is it important to do more than just cardio?

While cardio should make up a large portion of an exercise program to gain the most cardiovascular benefits, by including these other important pieces, you can gain even greater benefit:

  1. Strengthening program (can be body weight, weights, or even something like a boot camp style training program): The key is to put an increased load on the muscles to allow them to tolerate higher levels of load. Does that make sense? Lift heavy things so that your body can lift heavy things. This can improve bone density as well as prevent injuries from daily activities or from other forms of exercise, such as running. It can also help improve your form and decrease fatigue on those long or intense runs. When your body is stronger, it can tolerate more loads without getting injured!
  2. Flexibility program (Yoga, static or dynamic stretching program): When your muscles and joints are more flexible, they can tolerate more range of motion without getting an injury. Without consistent training in flexibility, muscles can tighten after doing other forms of exercise, making them at a higher risk for tearing or causing strain at insertion points. Stay limber to stay healthy!
  3. Balance training (essentially anything that challenges your balance- single leg training, standing or doing exercises on unstable surfaces- can often be incorporated in with other parts of your workout): The more we practice balance, the more our bodies will be able to adapt to perturbations. This can look like improved ability to manage tricky steps on a trail run, or even decreased risk for falling as an older adult. Balance is an important and essential part of fitness that will naturally decrease with age if not utilized, trained and challenged. 

So there you have it! I hope that even if you have a love of all things cardio (like me!) that you make sure to include some strengthening, flexibility and balance into your weekly exercise routines.

Leave a Reply