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obligatory exercisers endanger their health

ILLUSTRATION BY STUART BRADFORD, THE NEW YORK TIMES

Many people have asked me why my knees were hobbled by arthritis long before I turned 60. Being born bowlegged gave them a start. But I made things worse by jogging daily for about 10 years and playing singles tennis for an hour nearly every day for more years than I can remember, until increasing knee pain forced me to cut back to three or four times a week.

Still, in winter, I went ice skating most days, and during the warmer months, I cycled 20km nearly every morning. About the only activity that did not damage my knees was lap swimming, which I did four or five times a week. I loved my activities and planned my life around them, scheduling my workouts around family and professional obligations.

When I couldn't do my daily activities -- typically two or three a day -- for reasons of weather, travel or closings of the facilities, I felt out of sorts, even guilty, and worried about gaining weight. Had I been assessed by a sports medicine specialist at the time, I would have scored high on the scale of exercise addiction.

To use a less pejorative and more accurate term, I was an obligatory exerciser, overly committed to an exercise routine probably to the detriment of my body if not to my psychological and social well-being.

While most Americans remain sadly sedentary, there is a small group of active people for whom exercise becomes something of an obsession, pursued despite physical injuries, damaged relationships and time stolen from work, family and social activities.

Do you remember Jim Fixx, author of the best-seller The Complete Book of Running, which sparked the fitness revolution? Fixx ignored signs of impending heart trouble and died while running at 52. An estimated 10 percent of runners are obligatory exercisers, according to a 1982 report in The Journal of Sports Psychology.

A classic example was described in the June issue of The Physician and Sportsmedicine by John Draeger and Alayne Yates, psychiatrists at the University of Hawaii, and Douglas Crowell, a sports scientist in Honolulu. They used "obligatory exerciser" to describe someone "who feels obligated or compelled to continue exercising despite the risk of adverse physiologic or psychological" consequences. These may include injuries caused by overtraining and social isolation. "When confronted with a decrease in performance, they will push their bodies harder to succeed," the experts wrote.

Aerobic activity that burns 2,000 to 3,500 calories a week is considered the amount of exercise to attain and maintain optimal health. This would entail 40 to 60 minutes of cardiovascular exercise four to six times a week. Beyond that, there are no added health benefits, but there is an increased risk of exercise-induced injuries.

Excessive exercise can damage tendons, ligaments, bones, cartilage, joints and muscles and not give minor injuries a chance to heal. Instead of building muscle, too much exercise can lead to muscle breakdown. Girls and young women may stop menstruating and start losing bone, as if they were in menopause.

But it is not so much the amount of activity that defines the obligatory exerciser as it is its effects. Some people's bodies can handle more physical stress than others. While there is no clear definition of obligatory exercise, there are telltale signs that exercise is becoming too important to a person, including anxiety, apathy, chronic fatigue, decreased appetite, depression, hostility, mental exhaustion and mood changes.
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