More exercise, please

Imagine you've been feeling a bit depressed for several weeks and decide to see your doctor, expecting a prescription for antidepressants or maybe a referral to a psychologist. Instead, your doctor, after establishing that there does not seem to be any medical reason for the depression, says, "I'd like you to walk briskly for 30 minutes every day."

Unusual? Yes. Silly? No.

A classic study from the late 1990s showed that exercise was just as effective as a standard antidepressant in relieving treating major depression.* Yet most doctors continue to prescribe drugs rather than exercise.

A while later, you visit your doctor again, this time for persistent lower back pain. Your doctor says, "I have an exercise program that should fix that problem."

If your doctor prescribes exercise for all sorts of maladies, then he might be Jordan D. Metzl, whose book The Exercise Cure was published last year. Metzl is a sports physician in the US, and also a committed athlete, having competed in numerous marathons and triathlons.

The Exercise Cure has advice on a range of ailments, including heart disease, hormonal problems, musculoskeletal problems, cancer and psychological problems, with specific regimens for each. Metzl also includes workout programs for beginning, intermediate and advanced exercisers.

Metzl cites the results from relevant research that backs up his recommendations, although citations to the original studies are not included. From my previous reading, though, everything he claims rings true - for example the study comparing exercise and antidepressants.

Injuries from exercise

Can you do too much exercise? Certainly. One of the risks is overuse injuries. Runners typically have problems with their ankles, knees or hips. Tennis players may have wrist and elbow problems.

In case of an exercise-related problem, there is no better source that Metzl's 2012 book The Athlete's Book of Home Remedies. Indeed, I think it is the better book of the two. You can search for a particular set of symptoms, for example with shoulders or hips, and find a likely syndrome.

Metzl provides a short description of each problem and then various ways of treating it, for example "dynamic rest" (exercise that doesn't involve the injured part of the body), stretching and applying ice, and ways to prevent the problem. He tells when to call a doctor. There are numerous illustrations in an attractive format, making for a user-friendly volume.

As well, The Athlete's Book of Home Remedies offers advice on a host of other problems, from black eyes to haemorrhoids, as well as sports-specific advice, and provides exercise and diet programs. Even if you're not an athlete, you'll find many helpful hints.

Tell your doctor about these books. Maybe next time you'll get a prescription for exercise.

Brian Martin
16 March 2014

I thank Kathy Flynn, Nicola Marks, Ben Morris and Melissa Raven for helpful comments on a draft.

Metzl's books

Jordan D. Metzl with Andrew Heffernan, The Exercise Cure: A Doctor's All-Natural, No-Pill Prescription for Better Health & Longer Life (New York: Rodale Press, 2013).

Jordan D. Metzl with Mike Zimmerman, The Athlete's Book of Home Remedies: 1001 Doctor-Approved Health Fixes & Injury-Prevention Secrets for a Leaner, Fitter, More Athletic Body! (New York: Rodale Press, 2012).


* James A. Blumenthal et al., "Effects of exercise training on older patients with major depression", Archives of Internal Medicine, 159 (1999), pp. 2349-2356.

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