Why I am not able to do Exercise?

As a practising Cardiologist for the last 10 years, I have noticed a peculiar thing about our society. Majority of us don’t do Exercise. When we ask this to our Cardiac patients, a reply is, we are active the whole day, we do household work the whole day, I am walking the whole day in my factory, market etc. Is this considered exercise? I don’t think so. So let us go in detail of this and find out why as a society majority of us are not able to do exercise. Common reasons and questions to be answered are…

I am out of breath within 2 min

For the majority of homemaker females and office-based individuals in forties have this complaint of getting out of breath within 2 min of running or climbing a staircase and then they will go for full-body health checkup plans and cardiac check-up plans and all turn out normal. I am not against health check-up but want to highlight that they have Lazy Coolie syndrome.

Lazy Coolie syndrome

To understand this Lazy coolie syndrome, we will go through a Train example. Just imaging following example in your mind.

There is one luggage train with 14 coaches fully loaded with goods. It comes to a station where coolie workers will unload it based on the need of the station. The train will go away and another similar train will arrive.

In this example, the Train is our blood, Coaches are Hemoglobin, goods are oxygen, tracks are blood vessels and station means muscles. with each heartbeat blood(train) comes to working muscles(station) with all coaches(Hb) loaded with oxygen(goods) and what happens at the station? Coolies are lazy and the train goes ahead without delivering oxygen. Muscles fail to extract oxygen and they cry for help. The station master is alerted and he orders the train to come more frequently ( heart rate increase ) and load with more oxygen( breath faster). But the heart and lungs are not at fault. Our health plans check the whole railway system but lazy coolies escapes from radar.

This Coolie were active in the twenties and maybe in thirties but we have never gone for consistent regular exercise and that is the reason they forgot their job. They are there but in hibernation. we need to wake them up by a repeated call for oxygen. By restarting cardio exercise consistently, we are making our coolies efficient in unloading the train. and then what happens? The station master is happy, calls train less frequently ( heart rate is controlled and slow ) and asks not to load oxygen excessively (breath slow and rhythmically) and we continue to run for an hour with same controlled heart rate and with comfortable breathing. Our coolies are now efficient.

We don’t know what is exercise.

Many activities of daily life, like sitting, standing, walking are non Exercise Thermic activity. Simply stated its activity but not exercise.

I broadly categorise exercise into this four categories.

  • Cardio (Endurance) e.g. Running, speed walking, rope skipping, swimming, dance, aerobics
  • Strength e.g Weight training, gym exercise
  • Mobility e.g Flexibility exercise, stretching, asanas and Yoga
  • Pranayam Mainly Lung exercise.

Cardio exercise is all exercise which increases heart rate with the movement of the body. Strength exercise is all in which we remain a static and specific group of muscles contracts against a resistance. Mobility works on ligaments and muscle stretching and joint opening. Pranayam helps in lung muscles and lung strength aspects. All are good in its way and fulfil their specific purpose. You should choose the type of exercise based on your goal and your age and pre-existing cardiac and lung conditions. so that leads to us our next session which exercises to be done

which exercise

What is your goal? Usually, young adults have the goal of going to next level of fitness, middle-aged have lifestyle modification with control of sugar and Blood pressure and weight loss as their main goal, and elderly have the goal of remaining active. Choose your goal, and find out the best exercise you can do, take help of sports physiotherapist, find out the weak points in the body and correct them, correct the vitamin deficiency, ask for the scheduled plan for next 6 months and start exercise under their observation. Its a gradual learning process, but once done, gives lifetime benefits.

I suggest a combination of Running, weight training, and core strengthening exercise as a routine for the long term.

How much exercise

When we start any exercise programme, we are motivated and enthusiastic and we jump into it. but then soon realise we are doing too much or we are not able to maintain it without injury, fatigue.

Heart rate monitoring is the concept which you should learn at the beginning. Our heart rate increases in response to the level of exercise. If I am untrained, even with 2 min of running will increase the heart rate from 70 to 170, and that is the point where I will be out of breath and will stop.

Our target heart rate for 100% of exercise is equal to 220 Minus our age. so for a 40-year-old person, it comes to 220-40 that’s 180, and he should maintain the exercise level at 60 to 80% of the target heart rate for 30 min. Warm-up, start the exercise of your choice, monitor heart rate, stay at the level of exertion which increases your heart rate to 110 to 130, continue for 15 to 30 min, then cool down and stretch. Continue this for 5 days a week with rest days and recovery periods and then gradually increase the level of exercise over months, with the target being 100 % of target heart rate.


  • Yes, we need to stay motivated and it is possible. There are many ways to do this. I am mentioning some of these ways.
  • Surround yourself with positive and motivated people
  • Take help of habit cue, habit stacking, habit craving by a author James clear.
  • Take help of good mobile apps which can track your progress, make a plan.
  • Make people accountable and allow them to give punishment, like,
  • I will buy my wife a dress if I am not going to exercise continuously for 3 days, and then your wife will be waiting for that.
  • Use calendar and reminder/alerts
  • Don’t expect the immediate results, its like SIP with compounding which will take time

I fear to damage my joints.

It will rather protect it. Yes, you read it right. Exercise will strengthen muscles supporting joints, will improve the balance, will enhance proprioception (signals going to the brain from joint and muscle receptors- more data more control). Chances of accidental fall decreases and bone cartilages strengthen. So no need to fear of wearing out knees with exercise.

I may develop heart attack if I go fast ?

A middle-aged individual with strong family history, diabetes, high blood pressure, cholesterol and sedentary lifestyle venturing into high-performance exercise rapidly is not an ideal situation. He should have his health check-up done, his TMT should have been done, blood pressure needs to be controlled and checked during exercise also. Once the Treadmill is normal and there is a green signal by Cardiologist, the person can start slowly ( Heart rate 60% of Target heart rate ) and then gradually increase over a period of months.

If you are not predisposed to this risk factors and on moderate exertion, you are not having any symptoms of chest pain or dizziness or blackout, you need. not to worry. Listen to your body and respect the signals it gives.

I have a heart disease , how can I go fast?

Heart disease patients usually know their Echocardiography report, and if their heart pumping function is normal, and a treadmill is normal, then they can and they should go for exercise.

I suggest that heart patient, after having any major event, should start exercise under observation. Major hospitals do have cardiac rehabilitation centres and you can ask your cardiologist to arrange for this. The cardiac physiotherapist will make a plan for the same and under their observation patient can restart exercise and after a few weeks, they are usually confident and resume their at-home exercise.

At no point in life, exercise should be denied. They type and level of exercise may differ. Even in critical care patients, we do passive exercise to prevent blood clotting in static legs, to prevent skin sores.

So gear up friends, you can’t afford to lose this deal in life. start it early, keep on going to the next level and be the best version of yourself.

I will be glad to answer your queries and please leave a comment to improvise further

You can see the video of this talk at this link. Exercise and heart.

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