Exercising to relieve stress? Stop logging the miles!

"Man is so made that he can only find relaxation from one kind of labour
by taking up another."
- Anatole France

As a recovering chronic cardio queen, I often sacrificed sleep to get in another run in hopes of
"staying fit" during residency.

First up, I apologize for the lengthy gap between posts...I know people always say this when they haven't been posting, but in keeping with the theme of my blog, I wanted you to know that I have been prioritizing other things for my personal stress management. I just took the Anesthesiology board exam (the part-one "written" section, to be followed by an oral examination next spring). So glad that's over!

I'd like to put an idea out there that is contrary to what many people believe about exercise:

Running marathons isn't necessarily good for you.

While this may not seem to fit with our typical subject matter, I'm inspired to share my opinions with you on this topic because I am currently in the best shape of my life, let alone significantly fitter than my postop state (30 lbs heavier and WEAK) of one year ago! My life balance, from both a physical and mental standpoint, seems to really be in line lately. I know... the elephant in the room - the completion of my residency - is not lost on me as a major component of these changes. Exercise is definitely not the most significant variable in the fat loss equation. As trainer Skylar Tanner pointed out here, you must clean up your diet first, have a handle on your sleep/stress level, and then follow that with exercise in order to lose fat and reshape your body.

Caveats aside, exercise is of course a vital tool in our black bags for stress management and overall wellness. However, some types of exercise may be better than others for this purpose. The gist is this: there is a positive hormonal response (growth hormone release, increased insulin sensitivity) associated with lifting heavy things and trying hard for short bursts, whereas long, medium-intense cardio work may have a negative hormonal response (increased cortisol) over time that negates any benefits. Blogger and author of The Primal Blueprint Mark Sisson makes his case against chronic cardio, pointing out that the supposed stress-relieving benefits of endurance training can be offset by these deleterious hormonal responses. Dr. Doug McGuff, an ER physician and author of Body by Science, provides evidence in his book and this article for the advantages of high intensity training. Dr. Colin Champ looked at the issue from an evolutionary perspective here, with some study citations thrown in as well.

On top of all this convincing evidence, endrance training takes a long time! Short, high-intensity sessions can be relatively easy to implement for a busy medical trainee or any professional who wants to remain active. And as professionals are well aware, there is never truly an end to our training! We must constantly strive for balance in a demanding workplace! Spend the extra time with your family, meditating, or doing some other self-care activities that you've identified as effective for you.

What I'm Doing

Diet and stress/sleep (although very important to leanness) aside, I do not owe the recent changes in my body shape and composition to slogging through a race or logging miles on some piece of cardio equipment. I owe it to minimalist strength training and short interval workouts.

I used to be a Cardio Queen in my day. I dabbled in the weight room, but mainly lifted light weights in an effort to "get toned but not bulky". Having never been a true athlete, I've spent my life either being skinny-fat and (relatively) fat-fat but never lean or strong. Last December, I began a lifting program like this one from trainer Nia Shanks. (NOTE: There is a wealth of information just on the internet about whole-body weight training using compound movements. If you are more of a book person, I also recommend the New Rules of Lifting series). Without any particular strength objectives, I made it a goal to lift 3 days/week for approximately 30-40 minutes, doing only 5 compound movements per session. As for cardio, I did high intensity intervals on an elliptical machine once or twice on those three days. My interval spurts were only 10 minutes total of 30 seconds hard work with one minute recovery. Other than that, I took regular long walks around the neighborhood with my husband and dog. This is not speed walking mind you, but regular old people type walking! I took no spin classes, no aerobics, and until this summer hadn't even touched my bike since pre-surgery!

By mid-January, I had lost about 10 pounds and at least 5% fat (as measured by hand-held ultrasound)... by March, I had lost another 5 lbs and a few more fat %. I feel and look better than I did during my "healthiest period" at the end of medical school, before all this residency and brain tumor madness began! My strength, flexibility and balance in simple tasks are much better, and my rock climbing has improved. I recently climbed at my hardest difficulty level yet, and I have my sights set even higher!

Some of you may protest by professing your love for marathoning or long road rides or endurance competition of any kind, but I challenge you to think about why you really log those miles. On top of the conventional wisdom that endurance training is the bastien of physical fitness, it feeds into the cult of busy-ness that we perpetuate in our modern lifestyle. How many times have we heard that colleague complain about how busy or tired he is, with the veiled bragging about how he was able to do the Ragnar Relay last weekend? Do you want to relieve stress? Get stronger? Get leaner? In the long run, chronic cardio really does none of those things. Consider lifting heavy things and going hard for shorter time. Your body (and your joints) will thank you for it!


  1. Thanks for sharing Dawn. Did you buy the dvd's from Nia? I have been interested in trying some strength training. Thanks for pointing me in the right direction. Hope you are well!

    1. Thanks, Mindy! I am psyched you're interested in weight training, since I know you love the long races! I follow Nia's blog and all of the Girls Gone Strong group, but I didn't buy the DVDs. I'm sure they're helpful, but there are lots of ways to see demos of the exercises on the internet and in print. Good luck!

  2. Well, I got lucky stumbling upon this. I am currently a 2nd year medical student, and I constantly am trying to find ways to be more balanced. That being said, my specialty MUST be something conducive to my dreams of having an outside life for travel, family, etc. I appreciate the advice...do you have any concerning 2nd year with upcoming step 1? Just feels like a tough year in learning balance. Thanks!

    1. Kelly, Thanks for your comment and I'm glad you found PB.com! Each year of medical school, and resdiency for that matter, presents its own challenges in achieving balance. Just when you think you've got it down, the rotations change and you have a new situation! Keep an open mind as you progress through second and third year, but stay in touch with the personal values you mentioned when considering specialties. Take a look at some of my past posts for more thoughts on this. Regarding the boards, I'd say to start early (like next spring) with practice questions. Buy QBank or one of those services and make it a goal to just get through a certain number of questions each week. I hope this helps!

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  5. I just found your blog via MDA and am enjoying it immensely! I too, have been a runner and part-time gym rat for many many years (I am 50). I started having trouble with my hip and quit running for some time which made me sad and gain weight I discovered Crossfit as a way to strengthen and gain flexibility and it has worked like a charm. I love it! HOwever, I have committed to running a 1/2 marathon in December but after that....no more long distances for me. Those days are over.
    Love your blog!

    1. Thanks for your feedback, and welcome! Good luck in your upcoming race, but I think you have the right idea by mixing it up, esp with the Crossfit lifts!

  6. Hello Dawn, this is Val (aka "Dr J"); I'm a 48-yr old veterinarian & medullary thyroid carcinoma survivor...
    My nickname is akin to a bad joke: I was an inveterate jock in HS/college, now fallen into disrepair & obesity since I gave up my thyroid! (every ounce of body fat clings like concrete & I've had some interesting times w/regulation) I have been drawn to paleo/primal lifestyle although similar to you, I fight my addictions to sugar/chocolate/baked goods... I have seen some benefits in the minor changes I've effected, although no weight loss (yet).
    I look forward to skimming your archives in search of inspiration.

    1. Val, Thanks for your comments, and I hope you find more inspiration here! Thyroid regulation is so complicated... I feel your struggles but know you are on the right track! All the pieces of the puzzle (diet, lifting wts, sleeping more, stressing less, and tincture of time) were what finally helped things to change for me. Good luck!


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