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Exercise: A Tradition to Take to Heart


Exercise is such a powerful mechanism for improving health and performance, but what does it take to establish exercise as a core part of our daily lives?

It would be wrong for me to propose an answer that ignored the volume of scientific literature on exercise adoption and adherence. However, if I am permitted to borrow from popular psychology, I could at least advance an idea.

About half of North Americans display some measure of compulsive traits in their personality. If that compulsion is physical activity, these people tend to become regular exercisers. Their motivation for exercise comes from their need to create order in their lives and to take control of their circumstances to ensure "safe passage" through life. You can probably recognize these types of exercisers among friends or patients.

Another group could be labeled compliers. These people exercise because they are told to, because their friends do, because it is socially acceptable, because they want to lose weight, or for any reason other than a compulsive drive. They tend to be fair-weather exercisers, and their track record for commitment and perseverance is often dismal. They tend to live their lives in the immediate. When things are going well, they have the perfect balance between work, social activities, private time, exercise, and so forth. But when the inevitable immediate pressures arise, their balance is quickly disrupted. One of the first things to go is exercise.

A final group is the enthusiasts. These people love sports. They tend to focus on a few sports, are often competitive, and own lots of sports equipment. Enthusiasts sometimes need to hide their love for sports, because it may not be compatible with their job, image, or social life. Their primary goal is to have fun. They have experienced the wonderful feeling of being active in nature, with friends, or in solitude. They have many fond memories of days at the ocean, in the mountains, or in the woods. Enthusiasts may leave their exercise or sport for a while, but they always come back—not because they have to but because they long to. Enthusiasts' primary motive is not health; it is sheer enjoyment.

So then, how do we tailor exercise recommendations to fit the very different drives in these three groups? As the opening song of Fiddler on the Roof proclaims: "Tradition!"

Everyone enjoys traditions. Favorite places to go or Thanksgiving dinners with the family provide stability throughout the course of our lives. Likewise, over a lifetime, exercise with friends and family establishes traditions that anchor us. Just as current recommendations for exercise emphasize the micro-accumulation of all types of exercise in a given week (from walking stairs at work to a tennis match), so exercise and sports traditions represent the macro-accumulation of health benefits: the twice-yearly ski vacation, the weekly morning walks with a spouse or best friend, the annual hiking trip.

Exercise incorporated into traditions transcends whether or not we are compliers, enthusiasts, or compulsives—but we need to motivate each type differently. Compulsives need the reassurance that they can spend their precious time exercising without penalty or price. Compliers need the support of those around them to share in their tradition. And the enthusiasts . . . ah yes, the enthusiasts. They can plan the traditions and ask the compulsives to execute on the details. The compliers will always show up.

Social traditions mean a lot to me, and they seem to mean a lot to others, too. If we, as a nation, begin to incorporate physical activity in all of our traditions, perhaps we can weave social change into the fabric of national health.

Gordon O. Matheson, MD, PhD