Why Exercise is Non-Negotiable for Movement Longevity (NRE Principle 2/5)
Why Exercise is Non-Negotiable for Movement Longevity (NRE Principle 2/5)
As I’ve written in Why Movement is Medicine, one of the fundamental pillars of Neural Re-Education (NRE) is exercise. And in my most humble opinion—based on decades of clinical experience and the best of current research—it’s urgentthat every doctor prescribes exercise to their patients, regardless of age. Yes, every patient.
Now, I hear the arguments about waiting for perfect clinical guidelines on exercise timing, dosage, and methods. But let me put it simply: the urgency is to start moving, and start now. We don’t need to wait for the perfect prescription. The research is clear—any movement is better than none.
Exercise: The Final Pathway to Neural Plasticity
Exercise or movement isn’t just about fitness; it’s about neural plasticity—your brain’s ability to rewire itself. We now know that movement stimulates the brain in ways that few other activities can. Every time you move, you’re not only strengthening your muscles, but you’re also retraining your brain. Movement is one of the Big Five health essentials and a core part of NRE.
Think about it this way: once we’ve re-educated the body into a pain-free movement pattern through therapy, we need to strengthen that pattern with exercise. This is the only way to solidify new neural connections and ensure lasting change.
The Essential Role of Exercise in Pain Management
Many patients I see are in pain, often hesitant to engage in exercise. And as a clinician, I respect that. Pain, fear of injury, or a bad experience with exercise can stop people in their tracks. But the science behind exercise for pain management is robust.
Once a patient has re-learned a movement, the next step is to build on that movement with appropriate exercises. Research shows that movement-based interventions, including gentle stretching, yoga, Pilates, and proprioception exercises, can effectively reduce chronic pain and prevent its recurrence. Whether it's walking, cycling, or even breath work, exercise in all forms is critical. Studies from recent years have strongly supported the link between regular physical activity and both reduced chronic pain and enhanced functional outcomes in musculoskeletal disorders .
Tailoring Exercise to the Patient
Some patients just don’t enjoy exercise—and I respect that too. But here’s where neuroscience education comes in. Often, the dislike for exercise stems from negative experiences in the past. Educating patients about different forms of exerciseis key. Whether it’s basic stretching, home Pilates, or even deliberate cold exposure and breath work, there’s something for everyone. It’s about finding what works for the individual and ensuring consistency.
In my practice, I recommend starting small, no matter the patient’s pain or fitness level. As they begin to move, they realise that exercise doesn’t have to be gruelling. Small, consistent steps lead to big neural changes.
My Personal Exercise Routine
I like to lead by example. Here’s what a typical week of exercise looks like for me, designed to promote both brain and body health:
Zone 2 Cardiovascular Training – Running or cycling for 90+ minutes. Zone 2 training is a low-intensity, long-duration exercise that enhances cardiovascular efficiency while being easy on the joints.
Zone 2 Training (Shorter) – A 60-minute session, again focusing on low-intensity cardio.
Tempo/High-Intensity Training (Zone 4/5) – I commit to at least 30 minutes of more intense cardiovascular training. This is where the heart gets a workout, and your VO2 max increases.
Core Strengthening/Pilates/Yoga – Core strength is crucial for spinal health and balance. Pilates or yoga exercises focus on core stability, flexibility, and proprioception (your body’s sense of movement and position).
Strength Training – Lifting weights or bodyweight strength exercises, ensuring that all major muscle groups are covered.
& 7. Varied Training – Depending on my goals, I vary the final two days. Sometimes I focus on mobility, other times on additional cardio or strength work.
The key is not the specific routine but the consistency of movement. Whether it’s a patient just starting with gentle stretching or someone looking to refine their performance with high-intensity intervals, the principle is the same—exercise helps the body re-learn, adapt, and thrive.
Conclusion: Start Now, Adjust Later
The takeaway message? Start now. It doesn’t matter what kind of exercise you do or how long you do it for. What matters is that you move. Every bit of movement is pushing you towards neural plasticity, better brain health, and a longer, more active life. We don’t need to wait for the perfect clinical guidelines to come out—we already know enough to act.
If you’re a patient in pain or simply haven’t found an exercise you enjoy, I encourage you to start small. Movement is one of the three pillars of NRE, and I’m confident that by committing to even modest changes, you’ll begin to see a profound difference in both your body and your mind.
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References:
Kim, E. H., Crouch, T. B., & Olatunji, B. O. (2017). Adaptation of behavioral activation in the treatment of chronic pain. Psychotherapy, 54(3), 237. https://pubmed.ncbi.nlm.nih.gov/28661164/
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Attia P. How Does VO2 Max Correlate With Longevity? Peter Attia. Published April 1, 2022. Accessed August 6, 2024. https://peterattiamd.com/how-does-vo2-max-correlate-with-longevity/
Malik S, Dinesh K, Salhan D, et al. Estimation of Fertile Window and Determination of Ovulation Time Using Salivary Fern Test. *J Hum Reprod Sci*. 2019;12(1):38-44. doi:10.4103/jhrs.JHRS_108_18.
Shaffer J (2016) Neuroplasticity and Clinical Practice: Building Brain Power for Health. Front. Psychol. 7:1118. doi: 10.3389/fpsyg.2016.01118. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4960264/
