Exercise is a Miracle Drug.

“Exercise is a miracle drug. I’m such a believer that it’s the key to health, wellness and longevity that I prescribe it to every patient I see. It’s the most powerful, readily available drug in the world, and it’s free.” Sports Medicine Physician Jordan Metzl expresses his support for physical activity as an intervention to mitigate the effects of almost any adverse health condition.

Many conditions that we as Physical Therapists treat could, if done correctly, be prevented by regular physical activity, as well. If a drug were invented that could do for human health everything that exercise can, people would fight to get their hands on it. It would be the most valuable pharmaceutical ever developed.

There are an unlimited number of benefits behind increased daily movement and PA that have been established in people of all ages, including:

  • Decreases risk of premature death due to coronary heart disease
  • Decreases risk of developing Type II Diabetes
  • Decreases risk of developing hypertension or high blood pressure
  • Reduces blood pressure of those who already have hypertension
  • Decreases risk of developing breast and colon cancer
  • Helps maintain healthy weight
  • Builds and maintains health bones, muscles and joints
  • Decreases number of falls in older adults
  • Reduces mortality rates compared to sedentary populations
  • Reduces arthritis symptoms and delay progression of Osteoarthritis
  • Increases self-esteem, promotes mental health, prevents depressive illness, and possible protective effect from cognitive decline
  • Possible increase in brain cell growth which enhances learning and memory (animal studies)
  • Possible link to increased capacity for learning and academic achievement in students
  • Reduces frequency of tobacco, drug and alcohol use among physically active
  • Reduces direct medical costs among Americans by $76.6 billion (regular moderate exercise)
  • Reduces workplace short-term sick leave by 6-32% and increase productivity by 2-52%

While many are aware of the physical and aesthetic benefits of exercise, not everyone realizes the significant positive impact on mental health. Physical activity has a role in management of severe mental illnesses in its ability to lessen symptoms and also potentially extend the life in these populations.

The European Psychiatric Association (EPA) has issued recommendations for supervised physical activity as a potentially effective intervention for individuals with severe mental illnesses, such as schizophrenia, bipolar disorder and major depression. According to researchers, those with severe mental illnesses face an increased risk of early mortality by as much as 10 to 20 years, with physical disorders accounting for as much as 70% of those early deaths.

In its latest edition of nationwide guidelines for physical activity (PA), the Department of Health and Human Services state “adults should move more and sit less throughout the day.” 80% of all Americans are not meeting current PA recommendations, a failure that is contributing to the prevalence of a host of chronic health conditions. Regular PA reduces your risk for many chronic diseases, including prostate and breast cancers, dementia and brain strokes, and is considered to be as effective as taking medication for many conditions.

The new guidelines emphasize the concept that some amount of PA is better than none in preventing disease and extending life, no matter an individual’s age. The revisions to the PA guidelines are the first in 10 years, and they do not significantly alter the goals for adults. Instead, the new guidelines further reinforce the benefit of PA at any level by removing the statement that activity must occur for at least 10 minutes to be effective. The Department of Health and Human Services recommendations for physical activity vary by age and are as follows:

Children and adolescents (6 to 17 years): 60 minutes or more per day of moderate-to-vigorous PA; with at least 3 days of muscle- and bone-strengthening PA per week

Adults: 150 minutes per week of moderate-intensity PA, or 75 or more minutes per week of high-intensity PA is recommended for adults; at least 2 or more days per week should include muscle-strengthening activities.

Older adults: If possible, 150 minutes per week of moderate-intensity PA, tempered by an individual’s “level of [PA] relative to their fitness,” and a clear understanding of how various chronic conditions can affect the ability to reach PA goals. No matter what PA level is achieved, activities should include balance training, aerobic, and muscle-strengthening activities.

A brisk walk, gardening, housework and cycling count toward the recommended 150 minutes of moderate aerobic exercise a week. If you are struggling to fit a gym routine into your schedule, yet you would like to begin incorporating more movement into your day, you can start with some of the following simple changes:

  1. Organize a walking group with coworkers during lunch or meet friends in the park. Bonus: fresh air and being social without food and drink.
  2. Get off one stop earlier on the bus or subway
  3. Choose one meal a day and walk for 10 minutes after it. Walking after eating regulates blood sugar and helps weight loss.
  4. Walk your dog rather than letting them out in the backyard
  5. Choose a parking spot in the back of the lot, further from the front entrance of your work or store
  6. Walk around the track or field while your kids play sports
  7. Walk to breakfast, lunch or dinner.
  8. Take the stairs instead of the elevator
  9. Drink more water. This will ensure you take breaks often to use the restroom (great tactic for mental clarity) and also keep you hydrated!
  10. Return your missed calls while walking

I am sure you have heard the phrase, “physical activity as medicine” at least once before. After reading through some of the general benefits of increased physical activity and simple ways to fit more movement into your day, one must be convinced.


This information is for informational purposes and is not intended to be used in place of seeking individualized care from a healthcare professional.




Sallis JF, McKenzie TL. Effects of health-related physical education on academic achievement: Project SPARK. Research Quarterly for Exercise and Sport 70(2):391-5.

Physical Activity May Decrease Mortality Risk in Frail Older Adults, Says Researchers. PT in Motion News. October 30, 2018.

European Psychiatrists Recommend Physical Activity in the Treatment of Severe Mental Illness. PT in Motions News. November 9, 2018.

Are you Drinking Enough Water?

Drinking water is crucial to staying healthy and maintaining the function of every system in your body, including your heart, brain, digestion and muscles. Water acts a lubricant, shock absorber, building material and solvent. Water is essential for body temperature regulation through sweat, nutrient transport, waste product removal, and maintaining fluid balance. In the summer when it is hot and people sweat more, they often don’t get enough fluids. Air travel also negatively effects hydration status due to low humidity levels in the airplane cabin.

Elderly populations are at a higher risk of dehydration as a result of physiological changes and age-related decline in fluid intake. Children are also at a higher risk of dehydration as they have increased heat gain from the environment. This is due to greater surface area-body mass ratio compared to adults, increased heat production during exercise, decreased ability to dissipate heat via sweat, and decreased sensation of thirst compared to adults. Pregnant and lactating women require additional fluid intakes to avoid dehydration, as well.

Clothing, equipment and larger body size can increase sweat rate and thus dehydration risk, along with environmental conditions such as hot, humid environments and altitude. Furthermore, athletes may be more prone to dehydration during the beginning of training season. However, repeated exercise in hot environments helps the body adapt to heat stress and will result in greater sweat volume, lower electrolyte concentration of sweat, and lower temperature for onset of sweat.

Thirst may not be a reliable indicator for fluid needs and those with great sweat losses may not voluntarily drink enough fluid to adequately rehydrate. Therefore, a systematic approach to fluid replacement is necessary. For every pound of weight lost with exercise, a pint of fluid is required for replenishment (Essentials of Strength and Conditioning). Fluid guidelines differ for children and adults. The recommended water Adequate Intake is 3.7 L (125.1 oz) for men and 2.7L (91.3 oz) for women per day (Food and Nutrition Board, Institute of Medicine, National Academies). During activity, children weighing ~88 pounds should drink 5 oz cold water or flavored salted drink every 20 min during the event whether they are thirsty or not (American Academy of Pediatrics). All sources of fluid (coffee, tea, juice, soda, food fluid, etc) contribute to meeting a person’s water needs.

During exercise, sweat output can’t keep up with increases in core body temperature unless fluids are consumed. Sweat losses that exceed fluid intake can quickly lead to a hypohydrated state with subsequent increase in body temperature, decrease in blood plasma volume, and increase in heart rate and perceived exertion. Mild dehydration can greatly affect performance, resulting in increased fatigue, decreased motivation, neuromuscular control, accuracy, power, strength, muscular endurance, and overall function.

All electrolytes, including sodium chloride, potassium, magnesium and calcium, are essential to muscle contraction and nerve conduction. Increased loss of electrolytes with significant sweat production could alter performance. When large quantities of hypotonic fluid are consumed, lots of urine is produced long before the person is hydrated. Likewise, athletes who exercise intensely or for many hours and hydrate with only water or a no- or low-sodium drink may dilute their blood sodium levels to dangerously low levels, called hyponatremia. Hyponatremia leads to intracellular swelling and the athlete may present with HA, nausea, vomiting, muscle cramps, swollen hands and feet, restlessness, and disorientation. Some athletes need to replace sodium losses with higher-sodium foods and add electrolytes to drinks. Fluid intake shouldn’t exceed sweat losses to avoid hyponatremia (for example, athletes should not weigh more after workout).


Article written by Dr. Jessica Khani, PT, DPT, CSCS


The information provided is not medical advice and is not intended to be used in place of seeking advice from a professional.



Dietary Reference Intakes for Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein, and Amino Acids (2002/2005) and Dietary Reference Intakes for Water, Potassium, Sodium, Chloride, and Sulfate (2005). National Academies.

American Academy of Pediatrics, Committee on Sports Medicine and Fitness. Sports Medicine: Health Care for Young Athletes. 2nd ed. Elk Grove Village, IL. American Academy of Pediatrics; 1991:98.

Haff, Greg. Triplett, Travis. Essentials of Strength and Conditioning. Fourth edition. Champaign, IL: Human Kinetics, 2016. Print.