We live in a world where we have become accustomed to prescriptions. Your blood pressure is high, and your doctor writes a prescription. Your cholesterol is elevated, and there may be a medication for that. You have pain, inflammation, difficulty sleeping, or another medical problem, and often there is something that can be prescribed to help. You take the prescription to the pharmacy, someone fills it, and you take it home. But there is another prescription that may be one of the most important prescriptions you will ever receive.
Exercise.
And there is something very different about this prescription:
No one can fill it for you.
A doctor can recommend exercise. A physical therapist can teach you exercises. A personal trainer can design a program. Your spouse can encourage you. Your children can worry about you. Your friends can invite you to walk with them.
But eventually, you have to move.
No one can do the repetitions for you.
No one can walk the miles for you.
No one can strengthen your legs for you.
No one can improve your balance for you.
No one can build your cardiovascular endurance for you.
That is what makes exercise such a unique prescription.
Exercise Is Medicine—But You Have to Take It
We often hear the phrase “exercise is medicine.” There is good reason for that comparison. Regular physical activity can contribute to better cardiovascular health, stronger muscles and bones, improved mobility, better balance, healthier body composition, improved metabolic health, and greater functional independence. But imagine receiving medication from your doctor, bringing it home, placing it on the kitchen counter, and never taking it. Would you expect it to work?
Probably not.
Exercise works much the same way.
Knowing that exercise is good for you isn’t enough. Joining a gym isn’t enough. Buying a treadmill isn’t enough. Purchasing resistance bands isn’t enough. Watching exercise videos isn’t enough. Eventually, you have to take the medicine. The difference is that this medicine comes in the form of movement.
Your Prescription Has to Be Filled Every Week
One of the biggest misunderstandings about exercise is believing that what you did years ago somehow protects you today. Someone might tell me, “I used to run.” That’s great. Someone else might say, “I lifted weights when I was younger.” Excellent.
Maybe you played football, basketball, baseball, or tennis. Maybe you spent decades doing physical work.
All of those experiences matter.
But your body responds primarily to what you are asking it to do now. Strength that isn’t challenged can decline. Cardiovascular fitness can decrease when it isn’t trained. Balance can deteriorate when it isn’t practiced. Power—the ability to produce force quickly—can diminish as we grow older. That means the exercise prescription isn’t something we fill once.
We refill it continually.
Every walk is another dose.
Every strength-training session is another dose.
Every balance exercise is another dose.
Every squat, row, step-up, press, or bike ride is another investment in the person you want to be five, ten, or twenty years from now.
The Prescription Changes as We Age
At 25, exercise may be about appearance, sports performance, or lifting heavier weights.
At 45, it might become more about maintaining health and controlling weight.
At 65, 70, or 80, the meaning of exercise can change dramatically.
Now we are talking about independence.
Can you get out of a chair without pushing yourself up with your arms?
Can you climb stairs?
Can you carry groceries?
Can you get something off the floor?
Can you catch yourself when you stumble?
Can you walk through an airport?
Can you play with your grandchildren?
Can you continue doing the activities that make your life enjoyable?
These are not bodybuilding questions.
They are life questions.
This is why I believe exercise for older adults should be viewed as preparation for life. We don’t strengthen our legs simply to have stronger legs. We strengthen them so they can continue carrying us through the world. We don’t practice balance because standing on one foot is impressive. We practice balance because someday we may trip over a curb and need our body to react quickly. We don’t train cardiovascular fitness just to see a better number on a watch. We train our heart and lungs because we want the capacity to walk, travel, work around the house, and live an active life.
There should always be a why behind the exercise.
Your Trainer Can’t Do It for You Either
As a personal trainer, I can create a program. I can select exercises. I can modify exercises around limitations. I can explain which muscles are working and why a movement matters. I can encourage someone when motivation is low. I can provide accountability.
But there is one thing I cannot do.
I cannot exercise for my client. That responsibility ultimately belongs to the person standing in front of me. And I actually think there is something empowering about that. Your health isn’t completely outside your control. You have an opportunity to participate in it. Every time you choose to move, you are casting a vote for the person you want to become.
You Don’t Need a Perfect Program
Sometimes people never begin because they believe exercise has to be complicated. It doesn’t.
You don’t necessarily need an expensive gym membership or sophisticated equipment.
You need consistency.
Walk.
Strengthen your legs.
Push something.
Pull something.
Carry something.
Practice balance.
Move with purpose.
Challenge your cardiovascular system appropriately.
Then come back and do it again.
A modest program performed consistently will usually accomplish far more than an elaborate program performed for two weeks and abandoned. That is why behavior change is such an important part of fitness. The challenge isn’t simply knowing what exercise to perform. The challenge is creating a lifestyle in which exercise becomes something you regularly do.
Start With the Dose You Can Handle
Every prescription has an appropriate dose. Exercise does too. More isn’t always better. Someone beginning an exercise program doesn’t need to train like an athlete. An older adult returning after surgery, illness, injury, or years of inactivity may need to begin gradually and, when appropriate, work with healthcare or qualified fitness professionals.
Maybe your starting point is ten minutes of walking.
Good.
Maybe it is five sit-to-stands from a chair.
Good.
Maybe it is a few minutes on a recumbent bike.
Good.
The starting point isn’t nearly as important as the direction you are moving. You can build from there.
Ten minutes becomes fifteen.
Five repetitions become eight.
A light resistance becomes a slightly heavier resistance.
A difficult flight of stairs gradually becomes easier.
Progress doesn’t always arrive dramatically. Sometimes it creeps into your life quietly. One day you realize you’re walking farther. You stand up more easily. You aren’t holding the railing as tightly. You carry the groceries inside without thinking about it. Those small victories are evidence that the prescription is working.
The Prescription Is Waiting
There are many things about aging that we cannot completely control. But we can influence how we prepare for it. Exercise cannot guarantee that we will never become sick, injured, or physically limited. It isn’t a magic pill. It is something much more practical. It is an opportunity. An opportunity to maintain strength. An opportunity to protect mobility. An opportunity to improve physical capacity. An opportunity to remain engaged in life. An opportunity to fight for independence. Your doctor may recommend it. Your family may encourage it. Your trainer may design it.
But ultimately there is only one person who can fill this prescription.
You.
So perhaps the most important question isn’t: “What exercise should I be doing?”
Maybe the better question is:
“What am I willing to do consistently so that I can keep doing the things I love?”
Because the exercise prescription is already sitting in front of us.
We just have to take it.