Starting a Fitness Program

Exercise, training, and flexibility for improved fitness and athletic performance


Scott A. Rodeo, MD

Attending Orthopaedic Surgeon, Hospital for Special Surgery
Professor of Orthopaedic Surgery, Weill Cornell Medical College

The importance of a regular, structured fitness program cannot be overstated. There are obvious cardiovascular, musculoskeletal, and even psychological benefits to physical fitness, and regular exercise also has important effects on athletic performance. 

Optimizing Your Fitness Program: Exercise, Training, and Flexibility

In general, the best types of exercise engage multiple large muscle groups (legs, abdominal, chest).

An optimal fitness program includes a mix of both aerobic exercise for cardiovascular fitness and resistance training for development of muscle strength and endurance. Different exercises should be done on different days, which allows time for recovery for specific muscle groups and also helps minimize the risk of overuse injury.

Flexibility is also critically important for optimal muscle function and injury prevention, and thus regular stretching exercises should be part of the overall program.

Aerobic Exercise

Swimming, cycling, using an elliptical machine, and jogging are typical aerobic activities that are highly effective in developing aerobic fitness.

Impact activities such as running place higher stresses on joints such as the knee and hip, and thus individuals with arthritis and joint pain are better served by low impact activities such as swimming. Swimming has the benefit of also using multiple muscle groups in both the upper and lower extremities.

Strength Training

Resistance exercise is necessary to build muscle strength and endurance. This is done with light weights, resistive elastic bands, or various machines.

If you are starting a strength training program for the first time, it is best to work with a fitness professional to review proper exercise form. A program should initially start with lower weights/resistance to build muscle endurance. As strength improves, higher weights are used to continue to develop strength.

In addition to working the arms, chest, and legs, "core" strengthening is also very important. The core muscles include abdominals, low back, hip, and pelvic areas. Improved core strength helps posture and also helps many athletic activities, such as throwing a ball, swinging a golf club or racquet, running, and jumping.

Injury Prevention

As a new exercise is started, there is always some risk of overuse injury.

Any new exercise or activity should be started gradually to allow the joints, muscles, and supporting structures to adapt to the new loads. If there has been a prior joint injury, it may best to review the planned exercises with a physician prior to beginning a new program. The individual should carefully monitor for joint pains as the exercise program is begun.

Cross training, whereby different exercises are done on different days, is an important way to avoid overuse injury.

An important reason to begin an exercise program is to gain fitness in order to minimize the risk of sports injury. Establishing muscle strength, endurance, and flexibility is the single most important factor in preventing common sports injuries such as “runner’s knee” (patellofemoral pain), rotator cuff tendonitis in the shoulder, or tennis elbow.

Pain with exercise should initially be treated with a brief period of relative rest, ice, and non-steroidal anti-inflammatory medications. If pain persists despite this initial treatment, evaluation by a physician is recommended.


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