Should 15,000 Steps a Day Be Our New Exercise Target?

Taking 10,000 steps per day is often suggested as a desirable exercise goal for people who wish to improve their health. But a new study of postal workers in Scotland suggests that that number could be too conservative and that, to best protect our hearts, many of us might want to start moving quite a bit more.

It has been almost 70 years since the publication of the London Transit Workers Study, a famous work in which researchers tracked the heart health of London bus drivers and conductors. They found that the conductors, who walked up and down bus aisles throughout the workday, were substantially less likely to develop or die from heart disease than the drivers, who sat almost constantly while at work.

This study was one of the first to persuasively show that being physically active could lower someone’s risk for heart disease, while being sedentary had the opposite effect.

Since then, countless large-scale studies have substantiated that finding, and at this point, there is little doubt that moving or not moving during the day will affect the health of your heart.

But precisely how much exercise might be needed in order to avoid heart disease has remained very much in question. The threshold of 10,000 daily steps, incorporated as a goal into many activity monitors today, has not been scientifically validated as a way to lessen disease risk.

So for the new study, which was published this month in The International Journal of Obesity, researchers at the University of Warwick in England and other institutions decided to refer back to but also advance and expand upon the results of that foundational Transit Workers Study by examining another group of employees whose workdays involve mostly walking or sitting. They turned to postal workers in Glasgow, Scotland.

The Glaswegian mail carriers generally cover their routes on foot, not by driving, and spend many hours each day walking, the scientists knew. But the mail service’s office workers, like office workers almost everywhere, remain seated at their desks during the bulk of the workday.

This sharp contrast between the extent to which the workers move or sit during the day could provide new insights into the links between activity and health, the scientists felt.

They began by recruiting 111 of the postal-service workers, both men and women, and most between the ages of 40 and 60. None had a personal history of heart disease, although some had close relatives with the condition.

The researchers measured volunteers’ body mass indexes, waist sizes, blood sugar levels and cholesterol profiles, each of which, if above normal, increases the chances of cardiac disease.

Then they had each volunteer wear a sophisticated activity tracker for a week, while at work and at home and during the weekend.

Afterward, the researchers determined how many waking hours each day the volunteers had spent seated or on foot. They also calculated how many steps each person had taken each day.

The variations turned out to be considerable. Some of the office workers sat for more than 15 hours each day between work and home, while most of the mail carriers barely sat at all during working hours.

These differences were echoed in the volunteers’ risk factors for heart disease, the researchers found. Those workers who sat for most of each day tended to have much larger waistlines, higher B.M.I.’s and worse blood sugar control and cholesterol profiles than those who frequently stood and moved, even after scientists controlled for age, family history, late-night shift work (which is known to affect heart health) and other factors.

The risks were magnified at the extremes. For every hour beyond five that workers sat each day, the researchers found, they added about two-tenths of a percentage point to their likelihood of developing heart disease, based on their cumulative risk factors.

Meanwhile, almost any amount of standing and walking reduced a worker’s chances of having a large waistline and other risk factors for heart disease.

But the greatest benefits came from the most exaggerated amounts of activity. Those mail carriers who walked for more than three hours a day, covering at least 15,000 steps, which is about seven miles, generally had normal body mass indexes, waistlines and metabolic profiles. Together, these factors meant that they had, effectively, no heightened risk for cardiac disease.

Of course, this study provides a single, limited snapshot of people’s health and lives. The researchers did not follow their volunteers for decades to see who actually developed heart disease. This kind of study also cannot prove that walking or sitting caused the differences in people’s risks factors for heart disease, only that there were associations between activity and risks.

But the findings do imply that there are good reasons to get up from our desk chairs and move, even more than many of us may already be trying to do, said Dr. William Tigbe, a physician and public health researcher at the University of Warwick who led the study.

“It takes effort,” he said, but we can accumulate 15,000 steps a day by walking briskly for two hours at about a four-mile-per-hour pace, he said.

“This can be done in bits,” he adds, perhaps with a 30-minute walk before work, another at lunch, and multiple 10-minute bouts throughout the day.

“Our metabolism is not well-suited to sitting down all the time,” he concluded.


What is Aquaboom?; Treating ACL and Meniscus Tears; Treating Tendonitis and Tendon Tears

Episode 17.15 with Hosts Steve Kashul and Dr. Brian Cole. Broadcasting on ESPN Chicago 1000 WMVP-AM Radio, Saturdays from 8:30 to 9:00 AM/c.

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Segment One (01:58): Matt Kredich, Executive Director at Tennessee Aquatics,Photos from AQUA BOOM's post Knoxville and USA Swimming; American Swim Coaches Association World Clinic Speaker. Matt describes the Aqua Boom training device for upper and lower body training and rehab using variable and progressive water resistance; converting a pool into a complete gym.

Segment Two (10:29): Dr. Cole and Steve talk about the causes and treatments for ACL and Meniscus tears in elite athletes as well as the general population.

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Segment Three (18:50): Dr. Cole describes the anatomy of tendonitis, the various types of injuries and tendon tears and the various treatment alternatives.

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Why Tai Chi Is As Good For You As CrossFit

Why Tai Chi Is As Good For You As CrossFit

You’ve probably seen groups of people practicing tai chi in a park, so you have some idea what it’s all about. Slow, mindful movements. No weights. Low intensity. The practice combines aspects of ancient Chinese medicine, philosophy and martial arts, and it’s the antithesis of most modern exercise programs that emphasize fast, vigorous activity.

Indeed, certain parts of tai chi are thousands of years old. But while tai chi may look mundane—even boring to some—experts who’ve studied it say its benefits are vast and hard to oversell.

Tai chi is a richly researched exercise, with health improvements ranging from better blood pressure scores to a sharper mind. “We’ve seen improved immunity to viruses and improved vaccine response among people who practiced tai chi,” says Dr. Michael Irwin, a professor of behavioral sciences and director of the Mindful Awareness Research Center at UCLA. During the past 15 years, Irwin has published more than a dozen studies linking tai chi to lower rates of insomnia, depression, illness and inflammation.

It holds up when compared to other more strenuous types of exercise. “Over time, we see people who do tai chi achieve similar levels of fitness as those who walk or do other forms of physical therapy,” Irwin says. One study in the American Journal of Epidemiology concluded that tai chi was nearly as effective as jogging at lowering risk of death among men. Another review in PLOS One found that the practice may improve fitness and endurance of the heart and lungs, even for healthy adults.

Part of that is due to tai chi’s soothing effects on the sympathetic nervous system (SNS), which tends to activate when a person is under stress. Much like aerobic exercise, tai chi seems to increase hormone and heart-rate measures linked with lower SNS activity, which could partly explain its ties to stronger hearts and lungs, Irwin says.

But how could such low-intensity exercise—something that involves movements with names like “cloud hands” and “lifting a lute”—offer these kinds of fitness perks?

“One of the most striking things we’ve found is that [tai chi’s] physiological impacts can’t be explained by its physical activity component,” Irwin says. It’s the mindful, meditative quality of tai chi that makes it so compelling, and that may explain the practice’s broad benefits.

Tai chi may also be a more approachable form of mindfulness training for those who struggle with the sit-and-breathe forms of meditation. “Directing attention to the body and pairing hand movements with balance and flexibility is easier for a lot of people than breath focus,” Irwin says.

Tai chi may be especially healthful for older or sick adults who can’t perform more vigorous forms of physical activity. Among these groups, the practice is associated with improved balance and mobility, reduced risk of falls and better reaction times, Wayne says. A study in the Journal of Rheumatology tied tai chi to reduced pain and stiffness among people who have arthritis. It may also improve kidney and heart function among people suffering from related health issues, according to another study in the Journal of Physical Therapy Science.

But maybe the most compelling reason to give tai chi a shot is its ability to strengthen the connections between your mind and body, which can help you move through life with greater awareness and pleasure. “You might enjoy exercise more than you did before because you’re more mindful of your body,” Wayne says. “Or you may avoid injury or falls because of body awareness.”

It’s a rare aspect of exercise. Unlike almost every other form of physical activity, tai chi demands focus, which is central to its meditative benefits. “Even with yoga, you can do it and have your mind be somewhere else,” Irwin says. “It’s very hard to do tai chi and not be present.”

By Markham Heid for  TIME Health


By Dev K. Mishra, M.D., President, Sideline Sports Doc, Clinical Assistant Professor of Orthopedic Surgery, Stanford University

Key Points:

  • Wearable technology is very popular for monitoring steps, energy expenditure, and movement patterns.
  • The devices can generally be divided into step counters, accelerometers, GPS based devices, and physiologic measurement devices. Many systems combine several elements
  • The accelerometer and GPS based systems are likely to be useful for the young endurance sport athlete wishing to aim for peak performance
  • If you are using one of these devices for training it’s important to work with a coach experienced in interpreting the data for you

Wearable technology for adults is very popular, ranging from monitors like the FitBit, wearable technologyApple Watch, heart rate monitors, etc. In general I think there’s value for adults who are really interested in objective data to help them drive their fitness objectives and stay on track. But what about at the youth sports level? Are there technologies that could be useful to the young athlete?

This recently published article provides a nice overview of the available technologies when viewed from the sports medicine clinician’s perspective. I’ll review the categories of devices and provide some commentary on usefulness for the young athlete.

Step Counters

These devices are properly called “pedometers” and measure the number of steps taken by the individual. For adults the commonly used number is “10,000 steps a day for fitness”. There is some published evidence that pedometers help youngsters achieve a baseline level of fitness but we have no evidence that it will be of use to the young athlete. My conclusion for the young athlete: very limited value in using a step counter.


These days many people carry around in their pockets a device that has some accelerometer functions: it’s called your smartphone. Beyond that, fitness specific accelerometers are widely available. This is where devices such as the FitBit, Nike Fuel Band, Jawbone UP, and others would reside. Accelerometers provide data that includes step counts but also much more such as heart rate, calorie usage, and sleep tracking. I’ve also seen several startup companies with wearable accelerometers that can track in real time and on the field movement patterns of the legs and arms. My conclusion for the young athlete: possibly useful for the elite athlete. When movement tracking of body parts becomes available I think this will have broader usage, such as looking at arm position in pitchers or knee mechanics with jumping.

GPS devices

Global positioning satellites are used with your smartphones to provide data to apps that give directions, like Google Maps. GPS wearable devices are also increasingly popular with sports applications, especially for endurance sport athletes and monitoring of entire teams. Wearable GPS monitoring is becoming the norm for adult elite collegiate and professional teams, and I’m seeing it more and more at the high school level too. Conclusion: useful for the young endurance athlete, likely to filter into youth team sports too.

Physiologic Sensors

These devices track body physiology measurements such as heart rate, body temperature, and respiration. Professional teams are using these devices frequently, and individual endurance sport athletes use these as well. These measurements are useful and likely helpful for the athlete looking to peak performance but one caution is that you need to have some knowledge in how to interpret the data. For professionals, this is the job of their training staff. For the young athlete particularly in endurance sports such as triathlon, cycling, or distance running the information could be very useful but it would be important to work with an experienced coach to help you interpret the data. My conclusion for the young athlete: possibly useful in limited circumstances.

Overall these devices have the potential to be incredibly helpful for the elite level young athlete, and could have benefits for the recreational athlete too. Many of them have a very strong “coolness” factor. We need more data in establishing baseline levels for the young athlete and for sure you should work with someone skilled in interpreting the data you receive. But they are here to stay and will likely undergo further refinements over the coming months.