I just took an on-line course called Stress and Your Body. The professor, Robert Sapolsky, is one of my favorite science writers and teachers. But, the whole thing left me feeling down. Stress can wreak havoc on your body. A little anxiety starts a cascade of hormonal and physiologic changes that is well, unnerving. But there's a silver lining. There are some ways you can manage stress, and one, which makes me particularly happy is exercise. Yeah, I do a lot of it - I love to exercise. But I learned something new about exercise and stress.

Exercise only works to manage stress when you do it often - virtually daily. And you have to commit to 20 - 30 minutes of exercise, not a quick push up here and a sit up there. The thing that I never thought of, but makes sense, is that, to be effective for stress management, exercise has to be voluntary. Okay, that might be tricky.... If I insist you exercise, and you hate to do it, your stress goes up, not down.  

In an elegant study of rats on running wheels, one rat ran as much as he wanted, which was a lot of running. We'll call him the happy rat. An adjacent cage had a second rat on a running wheel, but his wheel only moved every time the happy rat ran. He was doing the exact same amount of exercise, but not doing it voluntarily. And his stress hormones were through the roof - much higher than those of the happy rat.

So how do you start to love exercise? How can exercise be a part of the solution to decrease your stress?

First, establish an exercise cue, and then tie it to a reward. We are social animals. Brene Brown would say that we are wired for human connection.

 If you don't like to exercise, mix it with something social, something that satisfies that yearning for human connection, and voila, you just went on a 3 mile walk with a friend and it was painless. It's kind of like surrounding the pill you have to take with peanut butter. Pretty soon, you've connected the reward of social connection with something that used to be drudgery and you've made a new habit.

But what about the cue? If walking with a good friend is the reward, then a cue could be a pre-set alert on your phone that you are meeting your friend in 10 minutes.

You now have a weekly date on your calendar that cues you when it's time to go, and a reward of quality social time. Attach that to your exercise, and miles and miles can go by before you even know it. 

As PTs we are often asked to recommend running shoes for patients. So before you go to the running store, consider this:

Myth #1: Preventing injury is a matter of finding the right shoe. There is no shoe that magically prevents injury. And no one shoe is great for everyone. So at the running store, run long enough to get a good feel for how the shoes work for you before you buy them.

Myth #2: Shop for shoes based on your foot type. Most running stores will tell people who pronate that they need a motion control shoe. They will tell people with high arches they need more cushioning in their shoe. Three large studies showed that matching footwear to foot type did nothing to prevent injuries. So while you might be steered in one direction based on your foot type, it's more important to find shoes that fit well and feel good.

Myth #3: Running shoes decrease running efficiency.  Shoes add weight to your feet, and adding weight demands energy. But when CU researcher, Rodger Kram, evaluated running efficiency of experienced barefoot runners in lightweight shoes vs. unshod, he found running barefoot increased energy consumption 4% with each step. The research team surmised that shoes provide a degree of cushioning, and without shoes, leg muscles contract to create the same cushioning effect; so the metabolic cost of the activity goes up.