5 Ways to Overcome Barriers to Exercise Adherence

When it comes to exercising, we have our usual litany of excuses and some of the familiar ones include:

• “I don’t have enough time.”
• “I am too out of shape.”
• “I am too sick.”
• “I already get enough exercise.”
• "I don't have the right kind of equipment"
• “Exercise is boring.”
• “Exercise is painful.”
• “I am too embarrassed.”
• “I am afraid that I might fall.”
• “I am too tired.”
• “I will look silly.”
• “I am afraid I will hurt myself.”
• “I am too old.”
• “It is too cold or too hot.”
• “I will not do it right.”

If you find yourself using one of the above excuses for not exercising, then one of two things is happening here. First, you may be making wrong assumptions about your ability to exercise (e.g., I don’t have enough time, exercise is boring or painful, or I am too embarrassed). Second, if the issue is genuine (e.g., it is too cold or too hot, or I don't have the right kind of equipment), then you may not have done enough to find a solution. While changing your wrong assumptions and problem-solving appear to be the common sense approaches to overcome barriers to exercise adherence, here are a few other practical strategies that can help you keep up with your exercise routine. 

1. Determine the Type, Intensity, Duration and Frequency of Physical Activity/Exercise

Type: What type of exercise program you choose depends on your experience with that particular exercise in the past. If you have enjoyed brisk walking or swimming, then you are more likely to stay committed to that activity. If you are more of an indoor person and enjoy using your treadmill, elliptical, or stationary bike, then that is the way to go for you. For some people strength training offers greater satisfaction. Power lifting is not the only way to do strength training; resistance bands –cheap strips of elastic that loop around arms or legs – can also be used for this purpose. Other strength training exercises that don’t require any equipment include push-ups, sit-ups, squats, and lunges. Dancing, Zumba, and Pilates offer other options for exercise. It doesn’t matter what form of exercise you choose as long as you choose something that gives you a sense of mastery and accomplishment. Forcing yourself to do something just because others are doing it is never helpful.

Intensity: There are guidelines on what constitutes the different levels of intensities of exercise. The Centers for Disease Control and Prevention (CDC) recommend 150 minutes per week of moderate-intensity aerobic activity or 75 minutes a week of vigorous-intensity aerobic activity. Of note, CDC also recommends combining these aerobic activities with muscle-strengthening activities at least two days a week. Although this may appear a lot, the good news is that you can do 10 minute stretches of these exercises to meet your weekly goal and spread it throughout the week. A simple way to determine the level of intensity (moderate versus vigorous) when choosing an exercise program is the talk test (Yeung et al., 2010). The rule of thumb is that with light-intensity exercise you can sing; with moderate-intensity exercise you can hold a conversation; with vigorous-intensity exercise you are too out of breath to carry on a conversation.

Duration and frequency: Once you have determined the intensity of your exercise, the next step is to plan the duration and frequency of the exercise program based on the aforementioned CDC guidelines. If you cannot tolerate vigorous-intensity exercises, choosing moderate-intensity exercises such as brisk walking, riding a bike over level ground, pushing a lawn mower, doing water aerobics, or playing doubles tennis may be the way to go. Most modern treadmills and ellipticals can monitor your heart rate and some also have variable settings to offer you the intensity of exercise you desire. If you find calculating the “correct dose” of exercise too taxing, then just do 30 minutes of physical activity (aerobic or anaerobic) three times a week as recommended by some experts (Nyström et al., 2015). Or, you can be a “weekend warrior” and cram your 150 minutes of exercise into the weekend. 

2. Make Exercise a Good Fit For You

All too often people start an exercise program only to quit it days later. The four most important attributes of exercise that you need to consider for it to be a good fit are as below (Chalder et al., 2012):

Flexibility: You have to choose a physical activity that you can fit in your schedule in terms of its frequency, duration, and the time of the day when it is carried out. Also, keep in mind the intensity of the physical activity as starting with a vigorous activity when your body has not been conditioned to sudden physiological changes will only get you discouraged.

Opportunity: Look for opportunities that are easily accessible. Broaden your view about what counts as a health-enhancing physical activity. Simple activities such as walking will help you overcome a sedentary lifestyle. 

Sustainability: Choose activities that can be built into routines and become part of your lifestyle. For example, if daily brisk walks are something that you can do routinely, then go for it.

Ownership: To enhance your commitment and motivation to continue a physical activity, monitor your progress and recognize that it is your efforts and decision-making that have led to your success.

3. Gradually Work Toward Your Target

After you have chosen the type and intensity of your program, you can develop an activity plan or a log for your exercise program. This would include day, activity, duration, and any comments about the activity. Simply relying on will power may not be sufficient to launch an exercise program, which is why a specific and detailed plan of implementation is helpful. Start slow and build up gradually based on your tolerance for the intensity. If you are prone to easy fatigability, you may want to start with moderate-intensity exercises for two minutes at a time until you reach your goal of 10 minutes. Before you start, you can warm up by doing some stretches for five minutes. A word of caution is that people with chronic lung conditions who use the “Talk Test” to gauge the intensity of the exercise may feel more out of breath even at lower intensity exercise. If you are in pain or are getting out of breath too soon or feeling dizzy, then either you are overdoing your exercise or doing it incorrectly. If this keeps happening, it may be helpful to seek the advice of a personal trainer. The saying “no gain without pain” is not applicable here and any pain is a signal from your body that it needs a break.

4. Monitor Your Progress

As with any new project, you want to know whether it is on track to meet its goals. In this context, the goal is whether you have reached the level of intensity and frequency of exercise you have chosen. While keeping an eye on your goals, do also pay attention to keeping yourself hydrated when exercising and eating healthy to provide fuel for your muscles. If you cannot maintain your exercise regimen and skip a few days, don’t let feelings of guilt or shame so overwhelm that you quit the whole thing. Get back to your routine the following day. Furthermore, don’t overdo exercise; too many people start out an exercise routine working out too hard leading to physical and mental exhaustion that makes them quit early. Wearables that track your physical activity are a good way to monitor your progress, especially counting your daily steps. In this context, recent research suggests that taking at least 7,000 steps per day is associated with a lower risk of mortality and, surprisingly, taking more than 10,000 per day doesn't confer any additional health benefits (Paluch et al., 2021).

5. Make Exercise Fun and Not a Chore

When you embark on a new path, you need a goal and also motivation to complete your journey. The same is true with exercise. You may start off with a lot of enthusiasm, but it may wane over time, partly because it has become routine and lost its novelty. Staying committed to an exercise program is challenging and a few tips to keep you motivated are as below:

• Join an online exercise community. 
• Invite friends or family to be a part of a group exercise program.
• Listen to music or watch your favorite television program while exercising.
• Try new exercises and mix and match them with old routines.
• Enjoy the process of working out your muscles rather than focusing on achieving a target heart rate.
• Reward yourself when you achieve your goal.
• Having a strong sense of purpose in life is positively correlated with healthy behavior, including exercise (Hooker & Masters, 2016). For example, an individual who is exercising to lose weight so that they can spend more quality time with their children is more likely to stay on their exercise regimen as it fits in their larger life goal of being a good parent.

The adage “Go for the smiles, not miles” will help you stay committed to your exercise program. To learn more about evidence-based self-management techniques to improve your mental health, check out Dr. Duggal's Author Page.

HARPREET S. DUGGAL, MD, FAPA

REFERENCES

Chalder, M., Wiles, N. J., Campbell, J., Hollinghurst, S. P., Searle, A., Hasse, A. M., … Lewis, G. (2012). A pragmatic randomised controlled trial to evaluate the cost-effectiveness of a physical activity intervention as a treatment for depression: the treating depression with physical activity (TREAD) trial. Health Technology Assessment, 16(10), 1-164.

Hooker, S. A. & Masters, K. S. (2016). Purpose in life is associated with physical activity measured by accelerometer. Journal of Health Psychology, 21(6), 962-971.

Nyström, M. B. T., Neely, G., Hassmén, P., & Carlbring, P. (2015). Treating major depression with physical activity: a systematic overview with recommendations. Cognitive Behavior Therapy, 44(4), 341-352.

Paluch, A. E., Gabriel, K. P., Fulton, J. E., Lewis, C. E., Schreiner, P. J., Sternfeld, B., ... Carnethon, M. R. (2021). Steps per day and all-cause mortality in middle-aged adults in the coronary artery risk development in young adults study. JAMA Network Open, 4(9):e212416.doi:10.1001/jamanetworkopen.2021.24516

Yeung, A., Feldman, G., & Fava, M. (2010). Self-management of depression: A manual for mental health and primary care professionals. Cambridge, UK: Cambridge University Press.