May is Mental Health Awareness month, which is an opportune time to discuss the therapeutic benefits of exercise. From injury recovery to improving mental health, exercise brings measurable physiological benefits. It is well established that active individuals are physically healthier than their sedentary counterparts, enjoying increased bone density, cardiovascular endurance, improved body composition, balance, and coordination.
Exercise is not always thought of as a therapeutic modality, but when considering the field of physical therapy, it is evident that exercise does promote healing. Therapeutic exercise refers to targeted movements prescribed to correct muscular imbalances. However, the therapeutic effects of exercise are not limited to the physical. Regular physical activity brings improvements in mental health.
Good mental health is built on a very basic foundation: ensuring that the body is adequately rested, nourished, and hydrated. (For the purposes of this article, the focus will be on rest and recovery; nutrition and hydration deserve separate consideration.) While the exact mechanisms are not known, we do know that regular exercise increases the amount of time spent in deep sleep each night, which the body and brain need for adequate recovery. Waking up refreshed each morning better equips an individual to manage daily stressors, whereas fatigue from poor sleep adds another stressor and negatively impacts brain function. This increases vulnerability to conditions such as anxiety and depression.
Exercise also improves cognition, providing improved capacity for learning and memory. Imaging studies of the brain have shown that in moderately active individuals, there is greater neural plasticity, which means that the brain is better able to adapt to new situations based on prior experiences. This is because exercise stimulates the release of chemicals that increase the connections between different areas of the brain. As a result, processing input and creating an appropriate output occurs more quickly. Enhanced connectivity also protects against age-related cognitive decline, which is a risk factor for developing other psychological conditions.
In addition to improving sleep and neurological function, exercise can be used as a management tool for diagnosed psychological conditions. The action is similar to that of an anti-depressant; though we are not ingesting anything to affect brain chemistry, we are creating physical changes that can reduce the severity of psychological symptoms. Exercise itself is a stressor on the body, which can help to inoculate against other, external stressors. It may seem counterintuitive that adding stress to the body will lead to resilience, but in response to physical pain or stress, the body releases chemicals called endorphins. Endorphins reduce the perception of pain and provide an overall “good” feeling in the body. The regular release of endorphins provides another method of “stress-proofing” our brains and bodies. High stress levels in other contexts become more tolerable.
If anxiety or depression is present, exercise provides an opportunity for mindfulness. The physical sensations can provide grounding input, as focus is shifted from psychological discomfort to the feel of the ground beneath the feet, the wind on the skin, or the smell of the outdoors. There are opportunities for grounding when exercising indoors, including the pressure of a barbell or dumbbell, the feel contracting muscles, and regulating breathing. Research shows that the extra weight of a barbell or dumbbell activates the calming centers of the body, as does rhythmic, deep breathing. When the nervous system is malfunctioning, as it is in the case of anxiety or depression, such grounding input can help to bring it back to its “normal” state.
It may seem ironic to focus on the stress-reducing effects of exercise, when finding time for an exercise routine can be a huge stressor itself! The good news is that an intensive, time consuming routine is not necessary to reap the mental health benefits of exercise. Five, thirty-minute bouts of moderate intensity exercise per week is adequate. Moderate intensity means that heart rate increases 50-60% from its resting rate. The thirty-minute bouts do not have to be consecutive, so going for a ten-minute walk three times per day will bring mental health benefits.
Further, it can be overwhelming to pick an exercise plan and get started. With exercise, it is always advisable to start slowly. The most convenient way to begin is by going for daily walks, and outside is ideal. Even if the weather is not perfect, getting outside is a great way to practice mindfulness and allow the brain and body to adapt to a changing environment, such as hills, uneven ground, and steps.
While physical therapists are not mental health providers, we are able to assist and mentor patients and clients who are unsure where to begin when initiating an exercise routine, whether for physical or mental health benefits. Physical activity is in no way a substitute for any medication or counseling but is an additional tool in management. If you are interested in increasing your physical activity level without risk of injury, or have uncertainty as to the best type of exercise for you, please reach out to Dr. Kopko with any questions regarding health and wellness programs.