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The Exercise Plan Everyone Can Follow

The following exercise plan is going to work for you, whether you are a couch potato or already exercise every day. The plan consists of two types of exercise. One will be exercising your heart, called aerobic exercise. The other will be muscular fitness, or anaerobic exercise. You will be doing both, but aerobic is the most important because that is the one that keeps your pump working at its peak. Everyone can fit into a particular phase of the plan.

Heed the warnings about being inactive. Inactivity, the couch potato syndrome, is an independent risk factor for heart disease. Inactivity is not a zero on the health scale; it is a minus.

Exercise strengthens your heart.

It lowers your heart rate.

It lowers your blood pressure.

It lowers the oxygen demand of your heart muscle.

Do it.

Aerobic Exercise

Aerobic exercise not only strengthens your heart muscle but also helps you lose weight, lower your blood pressure, and decrease your risk of heart attack, stroke, diabetes, and even some cancers.

Aerobic exercise is so important because it keeps your most physically important organ going at top efficiency. The stronger the pump, the easier it is to get blood flowing throughout your body. Remember my telling you about anatomy class that first week in medical school? Why were the muscles of some heart walls only a few millimeters thick while others were ten to twenty times thicker? That was back in medical school, but when I started my surgical rotations through cardiac surgery, I began understanding what made the difference. The heart muscle is just like any other muscle. If it is forced to exercise at least at a minimum on most days, the muscle grows thicker.

Strengthening your heart muscle is similar to strengthening your biceps. The more you exercise it, the thicker and stronger the heart muscle gets. If you put a work force on the muscle, it responds by getting stronger. The more the work force you place on your heart, the more times it will beat per minute during that work force. When you die, you want the pathologist to look at your heart and remark how thick and strong that muscle looks.

Jogging is one of the best ways to strengthen your heart because it keeps your heart at an elevated sustained heart rate for a specific period of time. You will agree with this statement after we review the following report written in the journal Archives of Internal Medicine.

The study, which began in 1976, involved twenty thousand men and women. Their ages ranged from twenty to ninety-three. The study compared a subgroup of joggers to a subgroup of non-joggers. What differences they found between the two groups is significant. The joggers were asked about their jogging intensity and speed and the time they spent jogging each week. The investigators based their results on the ones who jogged between one hour and two and a half hours a week. (That’s thirty minutes a day, two to five days a week.) The intensity of this jogging group was not that great, but what was impressive was how much better off they were than the group that did not jog at all.

There was a significant increase in life expectancy for the group that jogged. The study showed that the risk of death was reduced by 44 percent in the jogging group. That number jumped out at me, but the next point is what really got my attention. The data showed that jogging was linked with an added 6.2 years to the life expectancies for men and 5.6 years to the life expectancies for women.

This study clearly shows the importance of exercise. But the real question is, Why does jogging actually extend your life? The answer is found in many studies that explain that jogging raises HDL, which in turn protects your arteries.

Not only does it extend your life by giving you more HDL police car molecules to carry off the LDL splinters stuck in your arteries, but also helps extend your life by preventing obesity and increasing bone density, as well as by improving psychological function and lowering your triglycerides.

The most significant reason exercise such as jogging extends your life is that it strengthens your heart muscle. The reasoning goes like this: the best exercise you can do to strengthen your heart is to sustain a significantly high heart rate for a thirty-minute interval. Multiple trials show that maximum strength of your heart muscle is obtained by keeping the heart rate above the eightieth percentile of your maximum rate during that interval. Most of the reports are based on individuals who run five or six days per week. It is easy to figure the eightieth percentile number of your maximum heart rate. This is a rule of thumb way to do it, but it is very workable.

Take the number 220, subtract your age, and that will give what your maximum heart rate should be. That doesn’t mean your heart will stop if you go one beat over, but it is a good number to work with. Then, take 80 percent of that maximum heart rate number to obtain the number you should aim to sustain during your exercise period.

After reading several articles concerning sustaining my heart rate above the eightieth percentile, I bought the first of several pulse counting wristwatches I have owned over the years. I began a jogging routine of running three miles and have persisted in that routine ever since. Your resting heart rate is the bottom-line test of how strong your heart muscle is. It wasn’t long before my resting heart rate was in the 40 to 44 range. After years of exercising above my eightieth percentile, I’m dying to know how thick my heart muscle is but not necessarily willing to let some medical school anatomy professor find out for me anytime soon.

Set thirty minutes a day as your aerobic exercise period, whether you are walking or jogging. If you haven’t jogged before, begin with a brisk walk for thirty minutes a day. No matter where you are on the fitness continuum, the important word is begin. Your walk can be done on a track or a treadmill or a path, then slowly increase your pace over several weeks. Then jog intermittently for several-minute intervals during your brisk thirty-minute walk and you will eventually end up with the full half hour—jogging or running. All the while, you are keeping your heart rate above your eightieth percentile, and your heart is getting stronger and stronger.

Any way you look at it, exercise is a great investment—with a payoff of adding 6.2 years to the life expectancies of men and 5.6 years to the life expectancies of women.

There is a good self-test to determine if you are exercising enough to get your heart muscle working at peak performance. You can do it after you finish your brisk walk or fast jog, or whatever you are doing that gets your heart rate above the eightieth percentile range. After finishing your thirty minutes, count your pulse at the end of one minute and again at the end of two minutes. As your heart muscle gets toward optimum strength, your pulse rate will drop more and more dramatically just after completing your exercise. You will know your heart muscle is at its peak performance when you find that your rate drops twenty-five beats by the end of the first minute after completing your aerobic exercise and drops an additional fifteen beats by the end of your second minute.

Again, these are round numbers, but they will give you a great indication as to how well you are doing with the aerobic portion of your exercise routine. When you get your heart muscle to the strongest point, you will consistently hit the twenty-five-beat decrease after the first minute and the fifteen-beat decrease at the end of two minutes after completing your jog or run.

Aerobic Exercise Plan

The plan is based on thirty minutes a day, six days a week. It has been shown that cardiac strengthening exercise for more than thirty minutes does not significantly further improve the strength of your heart. You can run longer, but don’t think of it as significantly helping your heart more than if you ran for only thirty minutes.

Let’s begin with a plan to get you moving if exercise is new for you. If you cannot jog yet, simply begin with a thirty-minute walk every day at a steady pace for a one-week period. The following week, move to a faster walk, and eventually to a brisk walk. On a treadmill, a brisk walk is three to four miles per hour. Committing to a thirty-minute walk may be the most significant decision you ever make. You will have “begun.” The goal will be more vigorous activity, but don’t let that discourage you. Do what you can do and keep working to improve. Your initial goal is being able to jog for two minutes. Then you move into the regular plan below.

Not long ago I was sitting in a lounge chair on the beach watching an obese woman in her midthirties walking approximately fifty yards and then running as hard as she could for about fifteen strides. She repeated this time and again all the way down the beach. I wanted to jump out of my chair and go congratulate her on her exercise program. It may have been her first day; I don’t know. But she was doing something about getting in better health.

So don’t feel discouraged when we discuss more vigorous exercise. It doesn’t matter where you are on the exercise continuum; just commit to starting a thirty-minute program. Remember, there is much more to it than just how vigorous your exercise is. Your thirty minutes of exercise sends a huge message to your brain about your commitment to eating the proper foods and getting to your ideal weight, no matter how fast you are moving. The main thing is to commit to your own thirty-minute exercise program and get started with it.

Even if you already exercise regularly, the following plan is also for you. You can fit yourself into this scheme no matter what your exercise status happens to presently be. However, if you are a couch potato, you must begin with a commitment to begin walking for thirty minutes and then advance to a brisk walk. The chart below is the next step after you have conquered the thirty minutes of brisk walking. It begins with a two-minute jog followed by twenty-eight minutes of brisk walking. See where you fit and get started.

Thirty-Minute Walk/Jog

Week	Day 1	Day 2	Day 3	Day 4	Day 5	Day 6	Day 7
1	2 min jog 28 min brisk walk	2 min jog 28 min brisk walk	2 min jog 28 min brisk walk	3 min jog 27 min brisk walk	3 min jog 27 min brisk walk	3 min jog 27 min brisk walk	rest
2	4 min jog 26 min brisk walk	4 min jog 26 min brisk walk	4 min jog 26 min brisk walk	5 min jog 25 min brisk walk	5 min jog 25 min brisk walk	5 min jog 25 min brisk walk	rest
3	6 min jog 24 min brisk walk	6 min jog 24 min brisk walk	6 min jog 24 min brisk walk	7 min jog 23 min brisk walk	7 min jog 23 min brisk walk	7 min job 23 min brisk walk	rest
4	8 min jog 22 min brisk walk	8 min jog 22 min brisk walk	8 min jog 22 min brisk walk	9 min jog 21 min brisk walk	9 min jog 21 min brisk walk	9 min jog 21 min brisk walk	rest
5	10 min jog 20 min brisk walk	10 min jog 20 min brisk walk	10 min jog 20 min brisk walk	12 min jog 18 min brisk walk	12 min jog 18 min brisk walk	12 min jog 18 min brisk walk	rest
6	14 min jog 16 min brisk walk	14 min jog 16 min brisk walk	14 min jog 16 min brisk walk	16 min jog 14 min brisk walk	16 min jog 14 min brisk walk	16 min jog 14 min brisk walk	rest
7	18 min jog 12 min brisk walk	18 min jog 12 min brisk walk	18 min jog 12 min brisk walk	20 min jog 10 min brisk walk	20 min jog 10 min brisk walk	20 min jog 10 min brisk walk	rest
8	22 min jog 8 min brisk walk	22 min jog 8 min brisk walk	22 min jog 8 min brisk walk	24 min jog 6 min brisk walk	24 min jog 6 min brisk walk	24 min jog 6 min brisk walk	rest
9	26 min jog 4 min brisk walk	26 min jog 4 min brisk walk	26 min jog 4 min brisk walk	28 min jog 2 min brisk walk	28 min jog 2 min brisk walk	28 min jog 2 min brisk walk	rest
10	30 min jog	30 min jog	30 min jog	30 min jog	30 min jog	30 min jog	rest

Again, the plan takes thirty minutes a day, six days a week. Warm up and stretch before you jog and again after you walk or jog. By the way, I know there are reports that you don’t need to stretch before you run, but the same people still say you should walk five minutes before taking off running. I haven’t found much comment in the leading medical journals about all this, so I still like to get my muscles and ligaments stretched out completely before putting them to work.

Your jog pace is up to you and your ability. If you are already active, your plan is simply to enter the above scheme at your present exercise level. If you aren’t yet jogging for thirty minutes, count the minutes you can jog and fit that time into the above plan. As an example, if you are able to run ten minutes without stopping, you fit into the week five plan. Then progress from there as the plan moves on to week six.

For those who complete week ten, when you are jogging for thirty minutes, plus for those who already can jog for thirty minutes, the second stage of the plan takes over. At that point, you change from thinking time to thinking distance, going from minutes to miles. You go from having a goal of thirty minutes to a goal of three miles. After being able to jog thirty consecutive minutes, you begin focusing on increasing your jogging pace. Use three miles as the limit for distance. If you can run three miles in less than thirty minutes, you can stop at the three-mile point, even if the time is less than thirty minutes.

Set your own personal goals. But above all else, get off the couch and get started.

Heart Strength Indicator

The best indicator of cardiac strength is your resting heart rate. Lie down for at least ten minutes and then take your pulse to find your resting heart rate. The stronger your heart muscle, the lower your resting heart rate will be. A normal resting heart rate is usually stated as 72, but a strong muscle doesn’t have to contract as often to pump the same volume of blood as a weaker muscle, thus a slower pulse beat per minute. The stronger your muscle, the lower your resting heart rate is. If your heart is near perfect strength condition, your rate will be in the 40 beats per minute range.

A strong heart doesn’t have to contract as many times to pump the same amount of blood throughout the body as a weaker heart. Now think of that same principle all night long, while your body is at rest. The normal sequence is for the heart muscle to contract and then get to rest after each contraction. If the normal heart rate is 72 times a minute to pump a certain amount of blood through your body, it is getting to rest only the amount of time between each of those 72 beats. An exercised heart muscle can pump the same amount of blood, contracting only 40 times a minute, as a nonexercised heart that pumps 72 times a minute. That leaves a longer time interval between each beat for the exercised heart to rest. It is getting to rest almost twice as long beating 40 times a minute as a normal heart beating 72 times a minute.

Even I could run a marathon if I got to stop and rest numerous times throughout the race and still finish with the same time as everyone else running.

Your resting heart rate is an excellent way to know whether you are exercising the amount you need to get your HDL to the highest level. Whether you swim, cycle, or jog—outside or on a treadmill—increase your heart rate by exercising to strengthen your cardiac output ability. Test that strength by counting your resting heart rate.

Anaerobic Exercise

The anaerobic part of your exercise plan can be varied enough to fit your personal taste. If you go to a gym, you have numerous machines to choose from. If you exercise at home, you can get some basic light weights and a weight bench. A wraparound ankle belt to use for leg extension exercise is also good to have. You can use rubber resistance bands or weights that wrap around your ankles with Velcro.

As you age, unless you do something about it, time will take a toll on the quality of your muscles. If you do not do the strength training of anaerobic exercise, your muscles will become weaker. That will lead to more difficulty in handling everyday tasks, more chance of falling and of bone fractures, and you will even become more fatigued doing your normal everyday activities. You will become older and older. Most people get less active as they become older, but from a physical standpoint, you don’t have to.

About 70 percent of the strength you lose is due to a decline in physical activity. You can avoid this by doing anaerobic exercises to keep your muscles strong. Don’t fall into the trap most people do as they get older, the trap of becoming more sedentary. Begin your anaerobic exercise program to keep your muscles toned and strong. You will walk better, have better posture, and feel better about yourself. Your muscles are responsible for every move you make. The stronger the muscles, the easier to live the life you want to enjoy.

This anaerobic plan focuses on strength training. You have seen pictures of younger individuals with huge bicep muscles, their chests and necks looking like an engine coming toward you, and their abs looking like well-built, firmly padded ladders. They get that way with anaerobic exercise. Such individuals are strengthening each muscle repetitively, until each muscle fiber enlarges. They are not making any new muscles. They are just developing the individual muscle fibers that are already present, to the fullest extent.

Even though the cardio part of the exercise program should receive at least 80 percent of your attention, the anaerobic program should not be taken lightly. It is important for balance, for movement, for coordination, and for overall agility. It is one of the best ways to slow the decline of muscle mass that occurs as you get older. It is best to start an anaerobic exercise program as early as possible, but it is never too late to begin.

Not only does exercise improve your muscles, but it is also the number one way you can stimulate bone density. Exercise stresses your muscles, but it also places stress on your bones. That is extremely important because it helps to increase bone density and reduce the risk of osteoporosis. If you are on a calcium supplement of some type, ask your doctor if you need to continue it if you have an exercise program.

There are many programs for each set of muscles, and I will leave the specifics up to you as to what you want to incorporate into your strategy for exercise. But your overall aim is to complete one set of exercises for each of your major muscle groups. There are many ways to do this, but work on something you can do that includes your shoulders, chest, back, arms, abdomen, and legs. Keep it simple and write down a routine.

Legs

Starting with the lower body, one of the most significant exercises to protect your knees is leg extension exercise. If you go to a gym, there are specific machines where you can slide the front of your ankles behind a padded bar and then extend the bar by straightening out your legs. This stresses the quadriceps muscles, which are the large group of muscles on the front of your thighs. The reason it is so important to exercise these is that they end in tendons that strap around each side of your knee. Think of it as an exterior steel cage surrounding your knee, protecting those smaller, finer ligaments located within your knee joint. It is the inner ligaments that become torn so easily and cause so much difficulty.

If you don’t go to a gym, you can buy ankle weights, which you wrap around your ankle. Sitting in a chair, lift and fully flex your knee and grasp your leg behind and just above your knee. Then repeatedly extend your knee from that position.

Arms, Shoulders, Lateral Chest, Back

These exercises can be performed with weight lifting machines or with free weights. You can flex your biceps with a repetition of weights in each hand. The same weights can be used laterally for chest muscle strength and directly overhead for shoulder strengthening exercises. Push-ups are another good exercise to add to your overall routine.

Here is one rule of thumb to keep in mind with weight lifting: if you are using free weights, select a weight—or a resistance level if you are using a machine—that feels heavy enough so that by about the twelfth to fifteenth repetition you are barely able to finish it. Some may be able to begin with only 2 or 3 pounds. That’s fine, just continue to progress and you will eventually find a comfortable weight you can do on a regular basis. As your muscles strengthen with continued exercise, it will surprise you how you progress.

Core Muscles

Most people focus on their arms, shoulders, chest, and legs. But you use the core muscles of your body to coordinate movement every time you take a step or reach up to get a glass out of a cabinet. Your core muscles in the midsection of your body make all kinds of adjustments to support your body as it moves. They are the foundation all these movements are built upon.

Again, if you go to a gym, you can use their machines designed specifically for this. The basic one is where you sit with your back to the weight machine and pull two straps over your shoulders and bend forward, pulling a certain amount of weight against your abdominal muscles.

At home, many do crunches, where you lie on your back and raise your shoulders off the floor and repeatedly tighten your abdominal muscles. A variation of that is to lie on the floor with your shoulders and feet both raised so you are resting solely on your buttocks. This is followed by repeatedly pulling your knees toward your chest as you extend your arms forward, much like a rowing motion.

Back Paraspinal Muscles

So many people complain of difficulty with their backs. Yet in exercise books you will find very little written about how to strengthen the muscles of your back. And to top that off, many of the exercises focus on stretching the back muscles by leaning forward. That stretches the back muscles but doesn’t flex them. The muscles that hold your back erect are located on each side of your spine. And, of course, they are located on the back side of the spine. If you bend forward, you are stretching these muscles. You are not flexing them except when you straighten up your back after bending forward. To add strength to these muscles, they need to be flexed. The following is the best exercise I have found to strengthen your back.

I learned it in the Air Force. After completing surgery training, I served for two years at the Air Force Academy Hospital in Colorado. While I was there, they allowed officers to participate in the cadets’ free-fall parachute jump school once a year. You had to be able to run three miles at a seven-minute-a-mile pace to be accepted, so you had to be in excellent physical condition to take the course. It was the only place in the United States where the very first jump was a solo, free-fall jump, with a ten-second delay before opening your chute.

The jump school class lasted several weeks. You did simulated jumps from towers, learned the proper techniques of how to reach for your pull line to deploy the chute, and learned from what seemed like at least a thousand death-defying instructions. The only thing we didn’t have to learn was how to pack our chute, because they had a trusted expert who did that for us. (It was my guess that they were afraid we wouldn’t do it properly and the chute wouldn’t open.)

One of the most significant aspects of the jump was the posture for your free fall. Your back had to be arched back as much as physically possible, and that routine had to be ingrained in your mind. It was important because you had to flex your back, extending it to the max, and hold it for the ten-second, free-fall count. It looked like an exaggerated swan dive. This was the one aspect that had to be practiced repeatedly. They gave us an exercise to practice several times throughout the day, not only at the school setting but also anywhere else we could, as well as at home in the evening.

Position yourself on your stomach on the floor or on a bench. Spread your arms out from your sides until they are near 90 degrees from your body, and then raise your chest and shoulders upward by pulling your head up and back as hard as you can. At the same time, raise your feet, knees, and legs off the floor. You end up almost in a U shape with just the front of your hips touching the floor or bench. That position flexes the paraspinal muscles, those muscles that extend up each side of your spine. As you hold that position as long as you can, those muscles are actually lifting the weight of your chest and legs off the floor.

If you perform that exercise every day, those muscles will strengthen, just like you strengthen your biceps by flexing them as you bend your elbow while lifting the weights in your hand. You will be glad you prepared your back muscles if you ever do a first jump and your parachute doesn’t open. You will need to hold, locked into that position, while you find your emergency pull cord and pull with all your might. That is why I know this exercise works on your back. My chute didn’t open on my first jump. I have often wondered who the “trusted expert” was who packed my chute that day.

This back exercise is an excellent one to begin practicing. The result will be that you will find yourself walking more upright, back arched properly, better balanced with your shoulders pulled back, and a new gait in your step.