How an exercise rehab specialist became a brain doctor.
In the mid 1990’s, then a fairly young Post Rehabilitation Conditioning Specialist, I opened my first facility in the San Francisco Bay Area devoted to orthopedically sound exercise protocols, specifically for hip and knee replacement patients. I had been a trainer for about 10 years prior to that, and what I had found in running other gyms was a serious lack of expertise in the field of exercise as medicine—as protocoled treatment for specific medical conditions.
So, armed with my newly earned moniker and its associated skill set, I set up shop and started implementing post-rehab programs for all things orthopedic. Being new to a new field—a field viewed with some skepticism by the medical community and patients alike—I was vigilant about not straying outside the established protocols. So I documented every movement within every session, and dotted every “i” and crossed every “t” in my Physician and Physical Therapy progress reports. Basically, I was trying not to step on anyone’s toes.
The thing I learned, seeing an average of 12 clients a day, year after year, is that a lot of our success stories—the physical and mental improvements I documented every day—flew in the face of much of the current medical dogma of the time. We didn’t step on toes. We stomped them.
Rheumatoid arthritis: “No exercise: pharmacological intervention only.” [Wrong.]
Osteoarthritis pain: “No exercise: bed rest.” [Wrong.]
Cancer: “No exercise: Need to conserve energy for treatment.” [Wrong.]
Lymphoma: “Don’t lift anything heavier than your purse.” [Wrong.]
Cognitive decline, Alzheimer’s, Parkinson’s, stroke: “Well, you are born with a finite number of brain cells that will only decrease as you age, so not much you can do there.” [Wrong. Wrong. Wrong. Wrong.]
Today, we know that exercise is good for rheumatoid arthritis, osteoarthritis, cancer, lymphoma, and pretty much everything else. But the most important realization is about neuroplasticity, the ability of the brain to morph in response to stimuli, and neurogenesis, the regeneration of brain cells. Before the 1990s, and people like Swedish neuroscientist Peter Eriksson, the medical community did not recognize those concepts to be even plausible.
Now we know that exercise is the best way to:
Grow new neurons in the brain;
Integrate them into neural networks;
Increase cognitive function and decrease cognitive decline; and
Improve insulin sensitivity and decrease inflammation in brain tissue.
With exercise, you train your body to train your brain to train your body to—you get the idea. So how do you train even smarter?
Keep in mind that all human movement is a pattern. Getting out of a chair is a pattern of connected movements. So is making a cup of coffee, putting on your pants, and brushing your teeth. When we do something over and over again the same way, we are reinforcing a neuromuscular pattern. The upside to reinforcing a neuromuscular pattern, such as a baseball player taking 500 swings a day, is that we get really good at it. The downside is that we don’t get good at anything else. We adapt and stagnate. If our environment throws us a curveball, we may not be prepared to react—and that can mean injury. Even if we don’t get injured, we’re not forcing our brain to refresh itself with new neural networks. Fortunately, new networks can be as simple as a single change of step.
The neuroscience of exercise is analogous to the neuroscience of vacations. If we go to the same place every year, our vacations seem shorter—and refreshment diminishes—because our experiences are not different enough to create distinct memories. Twenty years of vacations fade into one blurred memory, and the twenty-first year feels almost over almost before it begins. By the same token, grinding out the miles on a treadmill, year after year, is much better than nothing, but not nearly so good as learning to salsa, to tango, and to swing on a trapeze.
One Step to Refresh Your Brain
Let’s say you have walked to the train every day for 20 years on your way to work. For 20 years, as you approached the stairs to ascend to the terminal platform, you have taken the first step with your right foot. So that pattern is firmly cemented in your neuromuscular memory. But tomorrow, you’re going to take that first step with your left foot, and by doing so you will open a new conversation between your brain and your body. You will start a fantastic neuromuscular dialogue where, in this instance, your muscles will make your brain a bit smarter and, should you choose to continue to lead with your left foot, your brain will reciprocate and make your muscles smarter! That is the conversation we all need to have—and keep having. You might want to skip to work. You might want to skip work and dance.