Depression, diabetes, back pain: physical activity is often at least as effective as medicine. Seven examples of how exercise heals.

Sometimes life puts obstacles in your way that are so great that you cannot get them out of the way. Almost two years ago Gabriele Merz (name changed) faced such an obstacle. She no longer filled her job in the marketing department, the working atmosphere was bad, and her colleagues weren’t communicative. In addition, there were private problems, their marriage drifted towards a low point. “I lost my inner balance,” says Merz, 38, today. The depression consumed her strength. Some days Merz just lay on the sofa in front of the television and let life flicker by. “In the evening I didn’t even know which programs I was watching,” she says.

It cannot be said that she jumped in the air at the thought of running therapy. During this time, she was taking medication and waiting for an appointment for a discussion. “But I thought I’d take a look at this run,” says Merz. “It couldn’t get any worse.”

When exercising, patients notice that they can do things on their own.  After eight weeks of running, symptoms often improve more than after many sessions
When exercising, patients notice that they can do things on their own. After eight weeks of running, symptoms often improve more than after many sessions

Depression and running

So she drove to the meeting point on a cold day in March, her old jogging shoes on her feet and a bunch of fears in her head. “I was afraid of weakness and I was afraid of the group.” Merz used to like jogging, but since she was struggling with the depression she had barely moved – and gained 15 kilos. “At first I felt like a walrus trudging through the forest.” But after the first hour she felt how good the exercise in the fresh air was for her. “After the lesson, I was more satisfied than I had been for a long time,” she says. The more she came to training, the easier it was for her to run. And the more she ran, the fitter she became in everyday life. “When walking, patients understand that they can do things on their own.

Stöckel, 48, is a psychological psychotherapist and trained running therapist. With the help of a special program, depressed patients learn to jog for 30 minutes at a time. First, the running and walking phases alternate every two minutes, then the running proportions are gradually increased. Stöckel has had good experiences with running therapy for people with mild depression. “These people take every step on their own. So they can’t be as bad as they think,” she says. The therapist discusses the positive changes in the sessions and transfers them to other areas.

Motivation and movement in life

Gabriele Merz also felt how she blossomed parallel to nature. The snow melted in the forest, and the first spring flowers were sprouting in the meadows. And she felt how movement came into her life again through running. She separated from her husband, moved into a new apartment and looked around for a new job. And when she trotted through the forest before an interview, she liked to play a mind game: “I said to myself: If you can hold out a minute longer, tomorrow will be a good appointment.” It worked. Merz has a new job that she really enjoys. She stopped taking the medication. And she’s still jogging, up to ten kilometers three times a week. Because she has a new goal: “I would like to take part in a half marathon.”

Weight and waist circumference can be reduced with a walking program of five to six hours a week
Weight and waist circumference can be reduced with a walking program of five to six hours a week

Diabetes and going for a walk

The expert: Jörg von Hübbenet heads the project area sports and exercise diabetology at the sports medicine institute of the University of Hamburg. He is convinced of the benefits of walking:

“Everyone swears by jogging – I don’t. Many of my patients with type 2 diabetes are obese. Should I put them in a brightly colored balloon silk suit and send them to run around the Alster? Never. First of all, that’s undignified. And second, they wouldn’t create.

That’s why I prefer to say: ‘People, take a walk! The effects of brisk walking are considerable: Weight and abdominal girth can be reduced with a walking program of five to six hours a week. In addition, blood pressure and cholesterol levels drop. The most important thing, however, is that the harmful long-term sugar in the patient’s blood also decreases.

In type 2 diabetes , the insulin receptors on the cells have become sluggish. As a result, their blood sugar level is permanently increased, and this damages the organs. Physical activity improves the transport of glucose into the cells and the blood sugar level returns to normal. Studies have shown that type 2 diabetics can lower their medication doses through a healthy lifestyle and need to inject insulin less often .

But still, a lot of my patients don’t get their butts up. They are as sluggish as their receptors. Maybe they should be advised to get a dog. He needs exercise every day, then they can’t avoid going for a walk. Incidentally, this also applies to prevention: if you have a dog, you are pretty safe from diabetes. “

Cycling can be easily integrated into everyday life and often helps to switch off
Cycling can be easily integrated into everyday life and often helps to switch off

Obesity and cycling

The non-athlete who became a cyclist: Philipp Osten, 23, currently weighs 74 kilograms. His goal is to break the 70 kilo mark this year.

“I was 17 years old when I decided that I had to change my life. At that time I weighed 85 kilograms and was 1.65 meters tall. A friend recommended Moveguard, a sports and nutrition program at the Cologne Sports University I changed my diet, I started jogging, but above all I discovered cycling . The sports university is around 25 kilometers from my home town. At first I always took the bus, but soon I switched to my bike. Every day I sat in the saddle for practically two hours, one hour there and one back.

Cycling 50 kilometers a day is a challenge for a non-athlete. But I persevered. How? By racing against myself every time. ‘Today you can cover the distance faster than yesterday,’ I said to myself. What I liked best was that I could completely switch off while cycling. Just kick and don’t have to think about anything. And it really helped: I lost 25 kilograms in 18 months. I was proud!

But then I stopped doing sports again, me idiot! And soon I had the pounds back on. When after a year the scales even showed 120 kilos, I pulled the emergency brake for the second time. I got on my bike again and rode almost 50 kilometers every day, even though I had meanwhile started studying mechanical engineering alongside my work. But I made it through again. This time I lost 50 kilograms within a year.

Now I have sworn to myself that it will never come to that again. With a little discipline in eating and cycling, I want to try to maintain my weight permanently. And maybe even take something off. “

When dancing, the bones are subjected to more diverse loads and thus all the more resistant

Osteoporosis and dancing

“Dancing is the perfect sport for osteoporosis, ” says Johannes Pfeilschifter, Professor of Internal Medicine at the Alfried Krupp Hospital in Essen. He raves about the turns, ups and downs and the different foot positions that make dancing a strength and coordination training with a low risk of injury. Arrowshifter comes to people with fractures, for example in the thigh or in the vertebrae. Her skeleton was too weak to withstand everyday stress. But after rehabilitation, Pfeilschifter likes to send his patients to the dance floor.

In Germany up to seven million people are said to suffer from osteoporosis. For a long time it was thought that it mainly affects women, but now every fifth osteoporosis patient is a man. Various studies have shown that a lack of exercise is the main cause of this disease.

All around strengthened by dancing

“Most bones can be strengthened through physical activity,” says Pfeilschifter. Even if osteoporosis has already been diagnosed. Because the skeleton is “incredibly dynamic” and is constantly being rebuilt. With the right training, you can have a positive influence on this process well into old age. Pfeilschifter: “The more diverse you load a bone, the more resistant it becomes.”

So anyone who just walks, swims or jogs is not immune to osteoporosis. Sports with a high level of strength and coordination are useful – such as dancing. “In doing so, a different part of the body is stressed with almost every step,” says Pfeilschifter. The so-called osteocytes in the bones react to this: They then instruct the corresponding cells to strengthen the bone in the stressed areas. Result: unlike a marathon runner, whose thighbones are only strong in the front and back, dancers have a thighbone that is reinforced all around.

Preheated air, exhaling against the water resistance and a constant rhythm when breathing mean that the performance of asthmatics in water is twice as high as on land
Preheated air, exhaling against the water resistance and a constant rhythm when breathing mean that the performance of asthmatics in water is twice as high as on land

Asthma and swimming

Sports scientist Bettina Schaar studies the effects of training on various clinical pictures at the German Sport University Cologne. She advises asthmatics to go to the swimming pool.

Ms. Schaar, why do you recommend people with asthma to go to the swimming pool?

Bettina Schaar: Asthmatics can strain themselves more in water than outside in the air.

How so?

Firstly, the air in the indoor pool is preheated, which is particularly beneficial for stress asthmatics – because cold air often causes them to have seizures. Secondly, breathing out helps against the water resistance: The bronchi are held wide and the bronchial muscles strengthened. Thirdly, when swimming you breathe in a constant rhythm; breathing too fast is not possible. The result: an asthmatic’s performance capability is twice as high in water as on land.

But that alone is not a cure for asthma.

But studies have shown that the so-called shortness of breath threshold in trained asthmatics is much higher than in untrained people. In the case of experienced people, the bronchi do not close as quickly under stress. You are less likely to have an asthma attack and therefore have to take less medication. They also get fewer infections and have more air available after exercising.

How often do you train with the asthmatics? They should do something three times a week. Once or twice in the water and once on land, 60 minutes each would be good. In addition to swimming, we also offer aqua fitness and jogging. We train at intervals and at a rather low intensity, but with longer stress phases.

With segmental stabilization, the "deep system" is awakened with coordination exercises and a lot of concentration
With segmental stabilization, the “deep system” is awakened with coordination exercises and a lot of concentration

Back pain and weight training

Martin Kottmeier can well remember how he suddenly felt this stabbing pain in his back last spring. At that time, the carpenter stacked oak beams. “From one second to the next I couldn’t move,” says the 51-year-old. The diagnosis: herniated disc. “Not unusual for my job.” Kottmeier had been prepared that one day his cross might go on strike. What he didn’t expect were the exercises his doctor and physical therapist used to prevent surgery. Because at first they didn’t demand a drop of sweat from him.

Segmental stabilization is the name of the therapy Kottmeier used to train at the Am Michel back center in Hamburg. “We had to wake up the deep system first,” says his doctor Joachim Mallwitz. These are the very deep abdominal muscles that also stabilize the spine. When the back shows signs of wear and tear or after a herniated disc, these muscles sometimes simply “switch off”.

First, Kottmeier had to complete coordination exercises. They are not sweaty. But because the brain is not used to tensing these muscles at will, you have to concentrate hard. Mallwitz describes with a picture what the patients should do with their body: “Imagine that your navel is pulled by a thread from the stomach through the body to the back.”

Only when the deep system wakes up from its sleep after a few weeks of training does work with the “superficial system” continue. Then the straight and oblique abdominal muscles and the back muscles are strengthened through strength exercises. The therapy lasts until the muscles can sufficiently stabilize the spine again. “The second part was more exhausting,” says Kottmeier. But it was worth the effort: he is now working as a carpenter again.

Patients should do 20 minutes of more intense activity two to three times each day, with 20 percent of the time devoted to strength training
Patients should do 20 minutes of more intense activity two to three times each day, with 20 percent of the time devoted to strength training

Heart attack and general exercise

The cardiologist Ulrich Hildebrandt is the chief physician at the St. Irmingard Clinic on Lake Chiemsee. He recommends regular exercise for heart patients.

Mr. Hildebrandt, what is your advice to patients who come to you after a heart attack?

Move, move, move! Because sport works like a vaccination: if you irritate the body, it adapts and tries to better protect itself from the stress.

You have to explain that.

Through exercise, the cells in the vessel wall “learn” how to better withstand the forces of the blood flowing through them, and they become more stable.

Can exercise actually replace bypass surgery?

Regular physical activity can prevent many bypass surgeries and implantation of supports in vascular constrictions. One study shows that more intense endurance activity of more than 90 minutes per week can reduce mortality by more than 39 percent in the first six months after a heart attack.

But doesn’t a heart attack indicate that the body is overloaded?

Heart attacks during exercise usually only occur if one is active less than three times a week. Those who do something every day do not have an increased risk of stress. Sport is only dangerous if you do it too seldom.

Which disciplines do you recommend to your heart attack patients? Any kind of endurance activity, for example walking, dancing, climbing stairs. I recommend 20 minutes more intense activity two to three times a day for patients. 20 percent of the time should be used for strength exercises. In the beginning you should only train at medium intensities, later maximum heart rates can be reached for a short time. With appropriate breaks, even longer periods of stress are not a risk.

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