Ask the Pharmacist

Q) I want to start getting back into an exercise routine. Is there a single best exercise I should do?

A) It feels like we are always harping on the benefits of exercise no matter what subject we happen to be touching on that week. There is a good reason for that. It is perhaps the one thing we can all participate in, to some degree or another, that has a multitude of benefits, fits all budgets, and when performed properly, has no side effects.

In truth, if we ever develop a pill that has even half the benefits of being physically active, we should put it in the water supply! In a perfect world, exercise has the greatest benefit when we engage in various forms of it so that we focus attention on different muscle groups as well as build strength and improve our cardiovascular system.

In reality, a lot of people have neither the desire or perhaps the inclination to participate in a well rounded program. For those people, if asked to suggest one simple exercise that everyone can do to some degree and provides the most benefit for the time spent, it would be hard to argue with performing squats. In many ways squats are a near perfect exercise for the vast majority of people according to many experts.

There are some people with lower body or back injuries who should consult with their doctor or physiotherapist first but even many of these people can, and should, do them. The reasons why are manyfold. First of all, a squat is a whole-body exercise. The muscles worked by a squat include:

· Calf muscles
· Hip flexors
· Abductor
· Hamstrings
· Abdominal muscles
· Quadriceps
· Buttocks
· Obliques

For those of us who need a refresher on anatomy, that list includes upper, lower and perhaps most importantly, muscles in your core area that are so important for back health and proper bladder functioning. But you are not just building strength in those areas.

Because a squat is a dynamic exercise, they help to improve and maintain the flexibility, stability and function of our hips, knees and ankles which often wear out long before the rest of our body does. So squats do not just strengthen muscles but also tendons and ligaments. They’re also effective for improving bone density since they are a weight-bearing exercise and are considered one of the most effective strength training exercises for burning calories both while performing them and afterwards as they speed up your metabolism.  They’re also effective at improving our sense of balance which is critical in minimizing the potential for a fall.

Most importantly, being able to squat is one of the keys to living and aging well. When we clean the house, garden, converse with a toddler or even sit down in a chair we need to squat. With time and disuse, many of us find all of these tasks awkward, uncomfortable or even impossible. Squats can be done at home and do not require any gym type equipment.

The key to getting all of the aforementioned benefits is to take your time and ensure you perform them correctly. If you’re new to squats, the simplest and safest way to start is with what is commonly called the box squat. For this type of squat you will require a sturdy seat (chair, stool, bench or bedside) that is high enough that when you sit on it your thighs are parallel to the ground. Place your seat a few feet from a wall and, using the wall’s straight lines, align your body and face the wall with the seat behind you.

Your stance can vary depending on comfort but your feet should be hip and shoulder-width apart. Turn your toes slightly outward (between 5 and 15 degrees) to help you maintain your balance. Your heels need to be touching the floor and they should remain planted throughout the move. Posture is critical. Keep your core tense (like when you inhale but you do need to continue to breathe throughout this exercise), your chest and head looking straight ahead and your back straight (i.e. neither arched or humped). You can clasp your hands in front of your chest for balance or place them on your hips or resting at your side. Bend your knees slowly and through a count of 5 slowly lower yourself until your buttocks just touch the seat of the chair.

Initiate the movement by sending your hips back and bending your knees as far possible with your head and chest pointing at the wall rather than the floor. Aim to get your thighs as close to parallel to the chair or floor as your knees go even lower if mobility allows. Your knees should not buckle in or splay outward and ideally not go past your toes. Try not to sit on the chair but just barely touch it with your buttocks and then push through your heels to stand back up once again in a slow and controlled manner lasting about a 5 count. Just do what you can. It is not a useless exercise if you cannot get all the way down to the chair.

As well, perform them safely. If balance is an issue, place something near you that you can rest your hand on to steady yourself. Within these guidelines, find the movement that feels right for you. There is no absolute best form for everyone.

With time, feel free to challenge yourself if you’re able to by adding dumbbells or a medicine ball or looking up the many variations in this exercise such as the goblet squat or the weirdly named land-mine form. Whatever you do, just do it (thanks Nike!). As one expert stated, “The squat mimics so many physiological tasks of daily living, that the biggest mistake you can make with squats is to not start squatting.”

Need one more reason to stay active, whether it be squats or some other form of exercise. A new study out of South Africa based on over 65,000 people found that even moderate levels of exercise (which are below the guidelines of at least 150 minutes per week) cut the risk of a COVID infection leading to hospitalization by 13%, ICU admission by 20% and a 21% lower risk of dying of it. As the BA-2 wave comes sweeping down upon us, this is just more food for thought. For more information about this or any other health related notes, contact your pharmacist.