Seeing my mother-in-law again

Recently, I saw my mother-in-law after some time apart.
She had been concerned about losing strength in her legs and hips. She also had pain around her knees and ankles and had been visiting a manual therapy clinic two or three times a week for massage and other care.
Over the past several months, however, something changed.
She began attending a nearby day-service program centered on exercise, and since the summer she has been able to go regularly about twice a week. There she walks on a treadmill, uses a stationary bicycle, and follows guided exercise videos. Staff members supervise the sessions, with rest breaks during the roughly three-hour stay.
When I saw her recently, she told me that her body was moving so much better that she no longer felt the same need to have it massaged. She also said that the pain in her knees and ankles had become barely noticeable and that her appetite had improved. She looked more energetic to me as well.
Of course, one person’s experience cannot establish that exercise caused these changes. What we can say is that the period in which she began exercising regularly coincided with the period in which she began noticing these improvements.
That alone was interesting to me.

From receiving care to actively moving

What struck me was not that massage is “bad” and exercise is “good.”
There are times when receiving treatment, care, or help from another person is necessary and valuable.
But there is a difference between having someone work on your body and actively moving your own body.
Walking. Pedaling. Standing up. Sitting down. Moving the arms and legs.
During movement, muscles, joints, nerves, breathing, circulation, and balance all participate together.
Watching my mother-in-law, I found myself thinking again about the shift from simply having something done for us to using our own bodies.

Exercise involves more than muscles and joints

Our understanding of exercise has changed considerably in recent decades.
Skeletal muscle is not only tissue that produces movement. It is also being studied as an endocrine organ that releases biologically active substances and communicates with other tissues.
Some muscle-derived signaling molecules are called myokines. Researchers also use the broader term exerkines for molecules released from multiple tissues—including muscle, bone, liver, and adipose tissue—in response to exercise.
We still do not fully understand everything that happens throughout the body when we exercise.
But it is becoming increasingly clear that “moving the body” involves much more than simply moving muscles and joints.

Movement still matters as we grow older

WHO physical activity guidelines recommend regular physical activity for older adults, including aerobic activity as well as activities that emphasize strength, balance, and coordination.
This does not mean that everyone should exercise in the same way or do as much as possible.
Age, fitness, illness, pain, and living circumstances differ from person to person. For people with medical conditions or a risk of falling, exercise may need to be adapted with advice from a physician, rehabilitation professional, or other appropriate clinician.
In my mother-in-law’s case, having staff nearby may be one reason she can continue safely and confidently.
Creating an environment in which a person can keep moving may be just as important as the exercise itself.

Even five minutes can be a beginning

My mother-in-law’s program involves a roughly three-hour stay with exercise and rest periods. I am not suggesting that five minutes of movement produces the same effects.
But someone who has been largely inactive does not need to begin with a long or demanding workout.
WHO guidance emphasizes that some physical activity is better than none, and that people who are not active should begin with small amounts and gradually increase what they do.
So for someone who rarely exercises, I often suggest a very simple starting point:

Begin with five minutes of comfortable movement.

The time we spend receiving treatment is small compared with the time we spend living in our own bodies.
Sometimes we need someone else’s help.
But moving our own body is also one of the basic forms of self-care available to us.
Seeing my mother-in-law looking more energetic reminded me of something very simple—and very important.