Hey everyone, Dr. Chris here. This one is about the foundations of fitness — what actually keeps you healthy over the long run.
There is a big gap between what most people think it takes to be fit and what it actually takes. A lot of what gets sold to you is unnecessary. This is my attempt to strip it back to what matters.
My goal as an orthopaedic and sports medicine surgeon is to give people the tools to look after themselves. I want to keep people out of my office. I have more than enough patients.
I own a gym, so this may sound odd coming from me: a gym is a good place for structure, support and like-minded people, but it should not be somewhere you need in order to stay healthy. You shouldn't need my gym, or any gym. Here is why.
Principle 1: Health has to be a priority you act on
Most people start out healthy and, looked after reasonably well, stay that way for a long time. That is not a guarantee. People get sick and have accidents, and plenty of illness has nothing to do with how you live. But a meaningful share of what I see in clinic is avoidable, and staying ahead of it takes deliberate effort, because the default modern environment works against you.
So first, make health an actual priority rather than a stated one. Most of us put work, appearance and everything else ahead of it.
Second, educate yourself about what fit and healthy actually means. Nobody else is going to do that for you. The people in the medical system are stretched thin and don't have the time.
Third, get to know your own body. If you feel off, ask why. What changed — food, sleep, workload, training? Then adjust. I suspect a lot of people have never really known what feeling well is like.
Fourth, cut down on the things that reliably cause harm. Smoking is the clearest one. Alcohol, sugary drinks, and a diet built mostly on ultra-processed food are all worth reducing. I would rather be specific about those than vague about "toxins."
Mental health counts too. Chronic stress has real physical effects. Be deliberate about who you spend time with and how much you give to social media. If something consistently makes you feel worse and you can remove it, remove it.
Principle 2: The body is built to move all day, not just for an hour
This is the most important thing on this page. We sit far too much, and an hour in the gym does not undo a day spent sitting. Structured exercise and general daily activity are two separate things and you need both.
Part of why this matters is how your body handles blood sugar. Muscle takes up glucose when it contracts, and movement spread through the day helps keep blood sugar and insulin from sitting elevated. Long unbroken periods of sitting do the opposite. Poorly controlled blood sugar over years is central to type 2 diabetes and contributes to cardiovascular disease. I don't want to oversell it as the single explanation — inactivity also costs you cardiovascular fitness, muscle mass and bone — but it is a real mechanism and a useful one to understand.
Food factors in here as well: what you eat, how much, and how often all affect it.
What I'm describing is not more working out. It is incidental movement — walking, cycling, gardening, jobs around the house, recreational sport, even fidgeting. Frequent, low to moderate activity spread across your waking hours.
How to get it: set a timer at work and stand up every half hour, even for thirty seconds. Do a few squats. Walk to the far water fountain. Take the stairs. Park further away. Bike to a friend's place. You have heard all of this framed as burning calories. The better reason is that breaking up sitting time is good for your metabolic health in its own right.
Find things you enjoy. Take a dance class, play road hockey with your kids, plant a garden. Just don't rely on your workouts alone.
Principle 3: Use your workout time on your weak areas
Most of us are weak somewhere specific — backs and hips from sitting, or a shoulder or knee from repetitive work or a sport. Prioritize what you actually need rather than what you enjoy.
If you are active through the day, that changes what your workouts need to look like. You still want strength, mobility and aerobic work, but you need less dedicated cardio if you are getting it from cycling, walking, swimming and sport. An hour a few times a week aimed at your weak points plus general strength and mobility is a reasonable target on top of an active day.
One thing I suggest to patients and gym members is to give the back of the body more attention than the front — upper and lower back, glutes, hamstrings. Most of us do everything in front of us and sit for the rest, so that is where the deficit tends to be. To be clear about the confidence level: this is a sensible way to balance out how you train. I can't tell you it will prevent injury. No single training tweak has been shown to do that.
Principle 4: Vary what you do
Doing one activity to the exclusion of everything else is how overuse injuries happen. Spreading load across different tissues and patterns is well reasoned and worth doing.
Athletes are not the model here. I have done a lot of knee scopes and ACL reconstructions on football, hockey and soccer players and on runners. Competitive athletes train to compete, not to stay healthy, and they accept injury risk as part of that trade. If you don't want a hip or knee replacement at fifty, you don't have to take the same trade. Being fit does not mean training until something breaks.
Tip 5: Train for real life
Work the patterns you actually use: pushing, pulling, squatting, hinging, balancing, rotating. If you want to move better day to day, practise the movements that day-to-day life asks for.
Tip 6: Keep loading progressively as you age
Muscle mass, bone density, coordination and proprioception all decline with age. Progressive resistance training slows the muscle side of that, and it is one of the best-supported things you can do in your fifties, sixties and beyond. Loading through impact — skipping, jumping, brisk walking — supports bone density, provided your joints tolerate it.
The practical point is not to do the same exercise with the same weight forever. Push a little past comfortable and add load gradually. Balance that against variety: you want enough stress to adapt, not so much that one structure keeps breaking down. If you keep getting hurt doing something, that is information. Change what you are doing.
Tip 7: Train balance, and take falls seriously
A hip fracture in an older adult is a serious event. One-year mortality after hip fracture is commonly reported at roughly 20 to 30 percent, and higher in men and in people with other medical problems. I want to be precise about what that number means: it is mortality after a fracture, not after a fall. Most falls do not cause a fracture. But the ones that do are life-changing, and the risk climbs steeply with age.
The encouraging part is that this is one of the better-supported areas in the whole field. Balance and strength training genuinely reduces fall risk in older adults — that is not a marginal finding. Train balance deliberately, keep strength training, and add some quick, reactive work if your joints tolerate it.
Tip 8: Aim for movement quality, not completion
Rather than getting a workout over with, work on doing the movements well. Quality over quantity. Better control of your body is worth having on its own terms, and it makes the training itself more useful.
Tip 9: Slow down at the sticky points
Don't rush the parts of an exercise you find hard. Those positions are where you are weakest, and working through them deliberately is how they improve.
Tip 10: Train in more than one direction
Most of us favour forward movement and the front of the body. Move forward, backward, sideways and rotationally. Life does not happen in a straight line, and it is often an unfamiliar position that catches people out. Widen the range of positions you are comfortable and strong in — gradually. That last word matters. Being able to force your body into a position is not by itself a reason to load it.
Tip 11: Spend some time out of your shoes
Get out of what I call foot jail. Time barefoot at home, in the yard, or during strength work is reasonable and worth doing. I'll be straight about the evidence though: the claim that going barefoot strengthens your feet is plausible but not established, and it has not been shown to prevent injuries. What is well established is that transitioning too quickly causes them, metatarsal stress fractures in particular. So don't go hiking or running barefoot after years in shoes. Build up over months. And skip this entirely if you have diabetes, neuropathy, or poor circulation in your feet — reduced sensation means you can injure the skin without knowing it.
Tip 12: Hang from a bar
Hanging is a position most adults have abandoned. It builds grip strength and it is good for shoulder mobility and upper body strength. Start with short holds and build up, particularly if you have a history of shoulder trouble.
Tip 13: Don't neglect the small joints
Wrists, ankles, fingers, toes, neck. If you have ever had a broken toe, a broken wrist, or a stiff neck, you know how much function you lose. They are worth training deliberately rather than assuming they will look after themselves.
A quick word on food
Eating well has to be a priority alongside training. Make time to cook, pay attention to portions, and keep what you eat close to its natural state where you can.
Michael Pollan put it about as well as anyone: "Eat food. Not too much. Mostly plants."
Food is a much bigger topic than I can cover here. If you change a few things, start by cutting soda and juice, and reducing alcohol and refined sugar. Those are good places to begin.
The short version
Educate yourself. Move more across the whole day, not just at the gym. Break up sitting time. Train your weak points. Keep loading progressively as you age. Train balance. Do a variety of things you actually enjoy. None of it is complicated. It is just ongoing.
If something hurts and isn't settling, or you are not sure where to start with a specific problem, get assessed. A plan built on your actual examination beats a general list every time. Our team in Ottawa can help you get started.
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