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Health & Exercise Forum


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Feb 27, 2023

Part I of II

People will often ask me, "Is there such a thing as an exercise rut?" They want to know why they do not seem, to be improving with their exercise program?... they exercise 3-4 times a week for 30 to 45 minutes and they feel frustrated and STUCK in a rut. While initially responding favorably to exercise, after 6 -9 months or more, they do not notice progress in weight loss, strength, tone, endurance or daily function.

Here are a few suggestions on how to improve or get more out of a “stale” exercise program.

Step one is to build an exercise program that is grounded in the basics. Next, Step two, which begins after the basics have been mastered, includes the components necessary for a healthy mind, body and spirit connection and translates into functional activities of daily living including work and leisure sports.


Make sure your routine has all three fundamental components of a well-balanced exercise program:

  1. Cardiovascular
  2. Strength
  3. Flexibility Training

While each component offers its own specific benefit, the combination of all three cooperatively provides unique value. Too often, fitness enthusiasts concentrate on the exercises they LIKE or are good at more than the ones they NEED. A well-balanced program includes what you like and need!

In fact, recent studies show that those performing all three components surpassed those performing one or any combination of two of the training types when tested for efficient:

  • oxygen uptake (VO2 Max)
  • production of HDL (good cholesterol)
  • lower body fat percentage
  • lower blood glucose levels


Cardiovascular exercise is any activity that raises your heart rate and respiratory rate. This type of exercise strengthens the heart muscle and the muscles that assist in breathing. When these muscles are stronger, they in turn work more efficiently to deliver oxygen to your muscles and other parts of the body. Ultimately, these oxygenated muscles can work harder and longer to burn fat during exercise and at rest.

  • Examples of Cardiovascular Exercises: 
    • Running
    • Brisk Walking
    • Swimming
    • Biking
    • Rowing
    • Elliptical Training
    • Stepper Training

*Most experts recommend at least 30 minutes of sustained cardio, 3-4 days per week. However, recent studies support the notion of performing 10-15 minutes, twice daily, 4 days per week. For those “stuck” in a fitness rut, to advance your program, cardio should be performed 5-6 days per week for 45-60 minutes.

Improving a Cardio Exercise Program:

  • Alternate Types of Cardio: run walk one day, bike the next, and use the stepper or elliptical a third day.
  • Alternate Direction: when using equipment that allows changing direction such as the elliptical or treadmill, go forward for 5 -10 minutes then backwards for 3-5 minutes, even if you have to slow the speed down.
  • Alternate Intensity: interval training for cardio can be invaluable to improve benefits. Interval training includes performing 1, 2 or 3 minute bursts of high intensity cardio followed by a 2 or 3 minute recovery at a slower speed and lower resistance. 15 to 20 minute intervals should always begin with a warm-up and end with a cool down.


Strength training is an activity that provides any type of resistance to muscle contraction to build strength in the muscle. The resistance can be without movement against an immovable object such as pushing against a wall (isometric) or with movement such as lifting up or lowering a weight down against gravity (isotonic/dynamic). There are two types of isotonic muscle contraction; concentric, which involves raising the weight against gravity as the muscle shortens and eccentric which involves lowering a weight against gravity as the muscle lengthens.

A standing biceps curl is an example that incorporates both concentric and eccentric contractions. A progressive strength training program includes all three types of muscle contraction. By using the classic bicep muscle curl these photos will demonstrate all three types of muscle contraction:

Isometric Bicep Muscle Curl – pull up on door knob without allowing any movement of the arm.
Concentric Bicep Muscle Curl – raise a dumbbell up against gravity as the muscle shortens.

Eccentric Bicep Muscle Curl – lower a dumbbell slowly (4-6 seconds) against gravity as the muscle lengthens.

Improving a Strengthening Exercise Program:

  • Incorporate the use of all three types of muscular contractions in the program. Perform one set of exercises using isometrics as a warm-up followed by a typical weight training program. Then, consider performing one set using only eccentrics (lowering the weight). To do so, a training partner may be necessary to help lift the weight up before it is lowered eccentrically.
  • Vary the Weight: warm up with lighter weight and gradually progress.
  • Vary the Speed: one day lift and lower to a 10 count and the next increase the speed to a 2 count – even if requires using a lower weight.
  • Vary the Types of Resistance. Mix up the routine with exercise bands, dumbbells, weight lifting machines and weighted balls. Also, incorporate using the weight of your body (push ups, planks, lunges).
  • Vary Body Parts. One day exercise the upper body and the next the lower body. Include core exercises for both.

Sources: National Institutes of Health; American Council on Exercise

Model: Heather Holzman

EVERY MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!” Next Week: Read Stuck in an Exercise Rut…Part II of II!

This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email:

Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopedic and sports physical therapy. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at Geisinger Commonwealth School of Medicine

For all of Dr. Mackarey's articles visit: Mackarey's Health and Exercise Forum!