Get Physical

Get PhysicalIf offered a pill that would help them reduce stress, increase sleep, lose weight, tone up, lower blood pressure, manage cholesterol, improve mood, and reduce the risk of cancer, heart disease, diabetes, and stroke, most people would take it. Daily.

The good news is, there is such a pill.

It’s called exercise.

“Exercise is medicine,” says Dr. Debi Siljander, a board-certified family practice doctor in Monterey who is fellowship-trained in sports medicine.

“Exercise can be fun, but it also is the best medicine we can take to get better or stay well. That’s why it is so important to help people understand the value of exercise and the multiple benefits of regular participation in an exercise program.”

Siljander recommends a four-pronged approach to exercise.

The first prong is a balanced diet. Like a car given the proper fuel, a body given the right amount of quality nutrition will run better. A good start is to eliminate trans fats, reduce saturated fats, increase fiber, and consume five to six servings of fruits and vegetables per day, Siljander says.

The second prong is aerobic exercise.

Any consistent, prolonged activity that increases the heart rate and core body temperature, such as walking, running, swimming, or cycling, is aerobic.

The third prong is anaerobic exercise — exercise that tends to be brief and intense and doesn’t require large amounts of oxygen, such as weight lifting. Performed two to three days per week, this resistance-type training helps maintain and increase lean  muscle mass, which burns calories more effectively. It also helps ward off osteoporosis and strengthens bones.


Dr. Debi Siljander

Dr. Debi Siljander, board certified family
practice doctor with a fellowship in sports

“Many women worry about developing massive muscles through strength training,” Siljander says. “They actually don’t have enough testosterone to do that. The idea is not necessarily to create a Popeye muscle, but to strengthen and tone the muscles.”

Stretching is the fourth, and often overlooked, prong. Stretching can increase flexibility and help maintain range of motion in joints. It also may help prevent injuries. Stretching should be done daily and before and after a sport or activity, Siljander says.

Finding a form of exercise you enjoy is critical to success. If you don’t like it, you won’t keep doing it. Finding the right place is important, too. Some people are motivated by joining a gym, others find it more convenient and less expensive to get their exercise at home or outdoors.

Before diving into any exercise program, getting personalized expert advice is recommended.

“It is always a good idea, when starting a fitness program, to consult medical and exercise professionals,” says Eric Coley, a registered nurse at Community Hospital and an exercise physiologist.

“It is important to get clearance from your doctor that you are healthy enough to exercise. And most gyms have trainers who can help tailor a workout to individual needs.”

One of the biggest mistakes people make, says Coley, is to start out too hard, too fast, or for too long a session. To avoid injury or overwhelm, which could end the exercise program before it has a chance to take root, Coley recommends beginning with a comfortable, easy pace or intensity that allows you to carry on a conversation as you exert yourself.

“Start by going for a walk, either outside or on a treadmill,” he says. “Go for 30 minutes, three times a week, with a goal of increasing it, over time, to 45 minutes, five days a week. Start with a low to moderate intensity and build from there. You get more done by taking a more moderate, controlled approach than if you jump right into it with weights that are too heavy, inclines too severe, or resistance too strong. You may survive it, but you won’t return to it. And injury is a great excuse to give it up.”

Because people are creatures of habit, Coley says, we like to establish routines, get into a regular program we can count on and complete with a sense of accomplishment. If it is too hard or too inconvenient, we won’t stick with it.

But if it is a program we can live with, grow with, and enjoy, we will persist and benefit from the investment.

“I look at exercise on a whole continuum,” he says. “You can work your cardiovascular system by exercising at moderate intensity, say, on a treadmill.

And then you can add intervals of shorter periods of time at a burst of higher intensity to build strength. By working with various machines, you can get a good aerobic workout while also focusing on strengthening specific body parts. The clearer you are on your fitness goals, the better your chances of creating the right exercise program to help achieve them.”



Coming soon. Peninsula Wellness Center

Community Hospital’s Peninsula Wellness Center, opening soon in Marina, will provide a place for physical activity in a monitored setting. For more information about the center and how to join, please call (831) 883-5656.

Physical activity guidelines

U.S. Department of Health and Human Services

Ages 6–17

  • 1 hour or more of physical activity daily
    Most of the 1 hour or more a day should be either moderate- or vigorous-intensity aerobic activity*
  • Vigorous-intensity activity along with muscle- and bone-strengthening activity at least 3 days per week **
  • Ages 18–64

  • 2½ hours a week of moderate-intensity, or 1¼ hours a week of vigorous-intensity aerobic activity, or an equivalent combination of moderate and vigorous aerobic activity. Aerobic activity should be performed in episodes of at least 10 minutes, preferably spread throughout the week.
  • Additional health benefits are gained by increasing to 5 hours a week of moderate intensity aerobic activity, or 2½ hours a week of vigorous-intensity activity, or an equivalent combination of both.
  • Muscle-strengthening activities 2 or more days per week that involve all major muscle groups.

  • Ages 65 and older

  • Follow the guidelines for ages 18–64.
  • If this is not possible due to limiting chronic conditions, be as physically active as abilities allow and avoid inactivity. Older adults should do exercises to maintain or improve balance if at risk of falling.

    * Aerobic activities that can be done at a moderate or vigorous level include walking, dancing, swimming,
    jogging, riding a bicycle, tennis, and golf.
    ** Muscle-strengthening activities include exercises using exercise bands, weight machines, hand-held weights, calisthenics, gardening (digging, lifting, and carrying), some yoga, and some t’ai chi.