Fitness · Health

A Healthier, More Satisfying Second Half of Life: ‘Exercise Is Medicine’

This is the fourth in our two-months-long series (40 Things for Every Woman in Her 40s) of Medical Monday articles intended to be useful to all our readers, but pointed especially toward those in their 40s—that in-between decade in which hormonal change has begun but fertility is still possible. Our first article (ideas 1 through 5) focused on self-care; our second (ideas 6 through 10) emphasized the need to pay attention to psychological issues; the third provided tips on preventing and repairing skin damage; and this week the topic is ‘exercise as medicine.’

Our expert this week is James Wyss, M.D., P.T., is an Assistant Attending Physiatrist in the Department of Physiatry at the Hospital for Special Surgery. He completed his graduate degree in physical therapy at the University of Scranton. After completion, he returned to New York and practiced physical therapy in a sports and orthopedic setting for three years before pursuing a degree in medicine. He then attended New York Medical College and graduated with honors. He completed his residency in physical medicine & rehabilitation (PM&R) at Kessler Institute of Rehabilitation and a fellowship in Interventional Spine and Sports Medicine at Hospital for Special Surgery. —Ed.



14068249358_eb7538d570_zPhoto by Steve Baker via Flickr (Creative Commons License)

The 40s are certainly the decade for beginning a comprehensive exercise program, if you have not created one. The American College of Sports Medicine (ACSM) strongly promotes the concept that “exercise is medicine.” Their recommendations include 150 minutes of moderate intensity aerobic exercise per week and strength training exercises for all the major muscle groups of the body two to three times a week. These forms of exercise help to maintain endurance, cardiovascular and pulmonary health along with maintenance of normal muscle mass and bone density. Their more recent guidelines include recommendations for neuromotor exercises — yoga and tai chi to improve balance, coordination and agility — to be performed two to three times a week. These are recommendations that require a significant weekly time commitment — approximately 5 hours a week — but “exercise is medicine” and this is a major investment in your health. 

See More: “The Yoga of Turning 40,” by Jessica Caplan



Age 40 is the right time for women to develop injury prevention strategies to both maintain and continue to advance a personal exercise program. Find ways to warm up with 10 minutes of light activity that mimics the exercise you will be performing that day. Passive stretching before an activity (which we were all told to do in high school gym class) actually decreases muscular performance. So before jogging it would be wise to walk briskly, perform dynamic stretches/movements to wake up the knees and hips to prepare for running safely. Then perform passive stretching to improve flexibility during the cool down period, and include some time for walking to slowly decrease the heart rate to its baseline state. Cross training is another extremely important concept. Many athletes develop overuse injuries by performing the same exercises over and over again. Choosing a variety of exercises to perform each week will decrease the risk for overuse injuries. Runners can be susceptible to knee injuries, and swimmers can encounter shoulder injuries. (Mixing running and swimming can reduce the risk of both injuries.) The plan for avoiding overuse injuries includes proper warm-up, good posture and addressing muscle imbalances.




Many women reach their 40s with postural problems. This is certainly the time to change that. Good posture is an extremely important part of musculoskeletal health. Proper spine alignment is the foundation for healthy movement patterns. If your posture is poor consider seeking help from a physical therapist to correct muscle imbalances (tight chest muscles and weak shoulder blade muscles) and to relearn proper alignment of the spine (head over the shoulders, hips in line with the trunk – please add image of proper posture alignment). Once you have aligned your spine, you can begin incorporating core strengthening exercises that may help prevent injuries, like low back pain, and will improve your overall physical functioning.

See More: “Good Posture: How to Gain and Maintain It,” by Evelyn Hecht, PT, ATC



This is the decade to find a health care professional who will help you maintain good musculoskeletal health. Many medical specialists help patients maintain normal blood pressure, lower cholesterol and prevent heart disease, however, very few specialists focus on musculoskeletal health. General orthopedists, sports medicine specialists and/or physiatrists (doctor of physical medicine and rehabilitation) are potentially good choices when common sources of pain that may negatively impact your overall function occur. Low back pain, neck and shoulder pain, ankle, knee or hip pain can limit mobility and force a more sedentary, and a less-than-healthy lifestyle. With proactive medical care, recovery can be quicker and then key therapeutic exercises can be used to prevent injury recurrence. This allows the maintenance of an improved quality of life that includes participation in an ongoing personal exercise plan.


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