How to exercise efficiently.

Updated: Jul 18

We all know exercising is good for us. And most of us have exercised at some point in our lives. I ask every single patient if they exercise, and most tell me yes. But then when I ask them what do they do for exercise I discover that a good majority are not really exercising: I go for a walk, I walk my dogs, I do yoga, and my favorite one: I golf. Now, having been to a few golfing trips with my friends (disclaimer, I do not golf, I watch them play while I sip on a beverage) I have seen first hand that for 99.99% of people golfing is not exercise. They simply sit in a golf cart with a beer in hand and go from one green spot to another (if you are one of those 0.001% that actually walk it, kudos to you).

My wife and I after the Musselman Ironman 70.3 race this past weekend in Finger Lakes NY.

So, let's talk about what exercising is and how you can do it efficiently.


In order to count as exercise you need to 1) raise your heart rate and maintain it for at least 30 minutes, 2) engage your muscles and bones. Lets discuss each briefly:


1) Raise your heart rate: The cardiovascular benefit of exercise comes from working the heart and blood vessels. As you exert force on your muscles they need more oxygen delivered and more carbon dioxide (the by product of energy metabolism) removed, so your heart has to pump more blood to your cells in order to deliver more oxygen and remove more waste. The carbon dioxide in turn needs to be exhaled out of your lungs. So, with exertion your heart rate and breathing rate go up. This in turn is an exercise for the heart and lungs muscles themselves. So, when you maintain a physical activity for at least 30 minutes, you are also exercising your cardiovascular system for the same time. This leads to stronger heart, blood vessels and lungs. As your heart gets stronger it needs to pump less frequently (since with each beat it can pump more blood), your blood vessels also become larger and carry more blood, as a result your heart rate and blood pressure go down. Some elite athlete's have heart rate in the 30s, their heart can send the same amount of blood by beating 30 times per minute instead of a typical 60-80 beats per minutes. And although we may never reach that level, but even a few drops in heart rate and blood pressure have tremendous long term health benefits.


2) Work the bones and muscles: Any meaningful exercise requires you to use your muscles. In addition to its cardiovascular benefit, stressing muscles and bones causes the release of various hormones and signals that lead to stronger bones, joints and muscles. A good weekly exercise regiment should encompass your upper, lower and core muscles. Weight bearing exercises lead to stronger bones and reduce risk of osteoporosis (old age brittle bones), they also engage your muscles and improve your balance, lower risk of falls and arthritis. One area that a lot of people miss is the core muscles. And no, I am not talking about six packs, which are more superficial muscles with good cosmetics, rather the deep muscles in your abdomen and back that help you with your posture, balance and coordination.


Now you can see why golfing, walking your dog or even most gym work outs (doing 10 reps of any exercise and then daydreaming before another set) are not effective ways of exercising. They do not maintain an elevated heart rate and for most part do not stress your muscles and bones.


An effective exercise regiment keeps your heart rate up while working your muscles.


Here are a few simple examples:


Running, biking or jogging: keeps your heart rate up and exerts pressure on your leg and core muscles. You should include some core and upper body workouts for full benefit. You can do this at the end of your run or you can stop 3-4 times in your run. I sometimes stop every 10 minutes and do squats, push ups and a one minute plank hold. Running past a park or playground? Hop on those pull up bars.


Swimming: great for keeping the heart rate high and working both upper, core and lower body muscles. However, since swimming is not a weight bearing exercise you must add some dry land work outs to stimulate your bones. These could be as simple as air squats, lunges and push ups after or before your swim session.


Basketball, soccer, tennis, or any other sport that keeps your heart rate elevated. Sorry, baseball does not count as you spend most of your time standing idle. Just be sure to include some core and strength exercises before or after.



Gym workouts; I like gyms, they are a great place to exercise, socialize, learn new work outs and get motivated. But if you are going to the gym you have to have a plan. Just walking in and going from one machine to another is a waste of time. So, know exactly what you are going to do, and try and mix some upper, lower and core training. In order to add cardio, you have two options: you can either do 30 minutes of a cardio workout before or after your strength training, or you can combine the two by doing intervals. In intervals you do multiple exercises back to back, take a short break and do the set again. The key is that you do these reps rather quickly and don't take any breaks from one exercise to the next. By mixing upper, lower and core you allow one muscle group to rest while another is working without taking a break, hence your heart rate stays elevated. Orange theory and High Intensity Interval training are two popular program that utilize this method.


Here is an example you can easily do at home or gym:

30 seconds or 10 reps of each, back to back with no rest.

air squats

push ups

Side mountain climbers

box jumps or lunges

pull ups (if you are new, use the gym pull ups that have a leg rest, these take some of your weight off and allow you to ease into pulls ups)

Plank hold or any variation of a swill ball core exercise.

Rest for 1-2 minutes, repeat 3-4 times.


Note: I love Swiss ball core exercise, they are a great way to avoid injury and get a really good core work out. This video is one of the best I have come across, if you really want to work the cores, do this video 2-3 times a week, you can do 1 minute of each move ( as much as you can in one minute) or 2-3 sets of how many reps you can do of each.


One last word about gyms. Try and avoid the machines. Machines have fixed range of motion, I have two issues with this 1) it is working on one muscle group only, you rarely use an isolated muscle group, you always need. to use your core to balance yourself while pulling or pushing, the machine takes the element of instability away and does not engage your core. 2) machines have a pre-set range of motion, so your joints are forced to move in that dimension, but we each have unique joint range of motion, so I personally do not like machines. So, instead use free weights, kettle balls, and resistance bands.



To summarize, an efficient exercise needs to have at least 30 minutes of aerobic activity and stimulate your upper, lower and core bones and muscles. In the next blog I will explain the various heart rate zones and how each one can play a different role in your exercise regiment. For more information and exercise samples see HLMD comprehensive guide to exercising.



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