Making Exercise Healthy Medicine

Why Fitness Isn't Working

Exercise is Medicine?
Not All Exercise is Good Medicine. Not All Medicine is Healthy.
Here is How To Make Exercise Healthy Medicine


© Jolie Bookspan. MEd, PhD, FAWM
Named "The St. Jude of the Joints" by Harvard School of Medicine clinicians
Director  Neck and Back Pain Sports Medicine
and the  AFEM - Academy of Functional Exercise Medicine

Copyright & Reprint Instructions       Protected by Copyscape Plagiarism Checker



Hello. You are on one page of my large, free, no-ad web site (, for information and tools and fun ways to make your life better, fitter, healthier. I worked years in experimental physiology, sports medicine, biomechanics, and related hard sciences. I developed these methods through years of research in the lab, collecting data on thousands of students and patients, and make my methods available for a better world.

This article shows you how to quickly stop several major sources of injury and pain. Then you no longer will get the pain and your neck, shoulder, knees, and upper back can heal and you won't get stiff and sore in the first place. It summarizes common reasons why fitness - as an industry and fad practice - is often done in ways that are not healthy.

Not all exercise is medicine. Not all medicine is healthy. We change that. It makes no sense to spend money on unhealthful "health food" and to cause tightness, poor posture, and injurious body mechanics by doing things you call "exercising for health." It also is not helpful to "go do exercise" then use injurious movement habits to do "real life" the rest of the day. Much cost, time, and worry currently spent in medical treatments are unnecessary, and often unhealthful. Get better and the world will be better.

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A Short History of My Work To Develop These Methods (skip this to go straight to getting fitter in the article below)
This information is not just copied from someone else who said it, or something I heard in a gym or in exercise science school. I am the scientist who researches what really happens. This is what I found through years of work. I started lab research studies in the 1970s to find why conventional exercises weren't getting our military and athletes as fit as they could be and why injury rates were so high. I saw that health info was not being applied to how people move and live. I applied it. My people became fit as a lifestyle and mission capable, not just gym-fit. When I was working on studies of the human body during immersion for combat swimmers, the experimental subjects, the lab physicians, and others in the lab kept coming in with injuries and general ill health from their fitness practices. Exercises their own trainers, physical therapists, and doctors gave them did not work or made them worse. I fixed them up. Their doctors and trainers started calling me (calling the lab actually, as I don't have a phone) asking how I fixed them so well. They (and their physicians) started taking classes with me. In the 1980s, class participants asked me to write everything down for them. I was surprised. I thought they should have taken notes. I typed information sheets for them. More doctors came to me after taking my classes, saying they knew their standard Patient Handouts were ineffective exercises. They asked me to make handouts for their patients. I was surprised. Again. I thought they could do that themselves. I typed Patient Handout sheets for them. I kept collecting data like a good scientist, doing studies to test and retest methods, and develop better ones. When the internet came out, I sent handouts electronically, instead of photocopies. In the 1990s I typed everything in several training manuals that became books. One is Health & Fitness In Plain English - How To Be Happy, Healthy and Fit for the Rest of your Life. After two different publishers, the new THIRD edition of How To Be Happy, Healthy and Fit... eliminates wrong things previous publishers added over my objections. Another book is Fix Your Own Pain, with patient stories in every chapter showing why patients get better, or don't, and why. Several more books of my life's work tell how to make life pain free, stronger, and more fun. Each book is different. 

I have seen fitness and rehab myths and fads come and go, but these methods remain effective over time. Limited Classes and Private Appointments to train directly with me, and certification for top students. More about me in Adventures.

To keep this quick and easy for you, much is shortened. Use this summary to get better now, and get the books and eBooks for the rest while you keep getting better:


Info in this article copyright © Dr. Jolie Bookspan from the books.


You know that being fitter helps your health.  You buy health food and eat low fat or low carbohydrate diets, go to the gym, do exercise videos, or have a trainer, but aren't losing fat weight. You buy special equipment and beds, get acupuncture and massage but your back still hurts. You buy health food and pills for energy, try gizmos, hypnosis, and yoga. You're still stressed, tired, achy, and not in good shape. Articles, books, and breaking news stories talk about this mystery. Medical conferences keynote the issue of increasing obesity when more people are exercising and dieting than before. What is going on?


A Mystery?

To many people, fitness means stopping your "real life," changing clothes, driving to a gym, and doing uncomfortable things without similarity to movement they make in daily life. 

To hear fitness experts say it, "fitness as a lifestyle" means "working out" at a gym or at home several days a week. But then you go back to "real life" - slouching, sitting around, bending wrong all day, poor posture, walking heavily, sitting round-shouldered, taking elevators, driving everywhere while sitting slouched, and avoiding all movement.

At the gym, you do squats with a trainer for an hour (paying to learn proper form and upright back), then bend over wrong to put the weight down when you're finished. You do lunges for your legs in exercise class, then bend wrong to pick up your things when you leave. You work with weights to isolate your arms and never learn how your entire body stabilizes a weight so you hurt your back opening a window. You work on a treadmill or elliptical trainer holding the sidebars, and sprain your ankle when you go out to walk on regular sidewalks. You haven't trained balance and stabilization muscles for normal terrain. You sit hunched in bad posture waiting for your exercise class to start. In modern life, exercise is something you go and specially "do," then destroy your health the other 23 hours a day.
What To Do Instead? The human body was designed for daily activity, and was active through the eons. Today in much of the "developing world" people commute by bicycle, lift and carry loads all day, sit and rise from the floor all day, and meet in the park every morning and afternoon for social physical activity. They are mostly lean, fit, and mobile to their last years. This is a big and inspiring area of rethinking and retraining your entire understanding and body involvement for fitness and health as a real and ongoing lifestyle - how you function (need to move for real), Make those healthy patterns for your real life out of a gym - retrain actual daily function. Following are a few samples.


Your Abs

Most people want "ab" exercises but have no idea what abs really do when you stand back up again, or how they help your back or posture.>Using abs does not mean sucking them in, or tightening them, or "pressing them to your spine." That is an outdated and ineffective practice. If you don't believe that, go ahead and tighten your abs just they way they tell you to. Press your navel to your spine. Make it good and tight. Now breathe in fully.

You can't move or breathe properly with tight muscles. You wouldn't want to tighten your nick and call that healthy exercise or tighten your legs and try to run. Using your abdominal muscles means using them to move your back into healthy posture when you stand up, away from letting the low back slouch back into an arch. You don't tighten them any more than you would want to tighten to bend your finger or elbow to scratch your nose.

Increased inward curve in the lower spine is called swayback, hyper-lordosis, and slouching. When you allow hyperlordosis, you allow the weight of your upper body to rest on the joints of your lower back, pinching and compressing lower back structures at an unhealthful angle.

Trainers and exercise magazines often teach exercises done with the hip tilted out in back and the lower back over-arched. They may explain it as proper form or even a way to "support the back," however, it is a large contributor to lower back pain. Even though many fitness instructors use the phrase "neutral spine" they show too much arch in the low back. Look at most fitness magazines and you will see this bad posture. Many aerobics instructors, personal trainers and yoga instructors are my patients because their back hurts.

The "experts" say to strengthen your abs with crunches so the strong muscles will support you. Strengthening is not what will fix the bad posture called hyperlordosis that causes the pain. Plenty of people with strong muscles stand terribly and exercise with their lower spine overly-arched. It's like having brains and not using them. Crunches do not work your abs the way you need for real life. They do not train you how to use your abs to hold your lower back in healthy neutral position when you stand up again, and they practice poor, rounded posture, even when done properly. It is the same hunched over posture that you do over your computer and steering wheel all day that made your back ache in the first place.

What To Do Instead. Learn neutral spine. Learn what constitutes overarched lumbar spine - called swayback and hyperlordosis.

Over years of research in this area in the lab doing studies with thousands of patients and students, I have identified several ways people increase the inward curve of the lumbar spine. In short, they either allow the pelvis to tilt forward instead of keeping it vertical, and/ or they allow the upper body to lean backward instead of holding themselves upright and vertical.

A few ways to check. Start with standing sideways looking in a mirror where you can see yourself at least from the knees up to your head.

 - 1. Look at the seam of your pants, or skirt, or any imaginary line from the side of the leg to the middle of the hip bone. It should not bend forward when you stand. See if your belt line tips downward in front. It should be level.

 - 2. Stand up and reach your arms high overhead. See if you increase the inward curve in your lower back, or tilt your pelvis, or lift your ribs, or lean your upper body backwards, or push the hip forward.

You should not be so tight that you increase the inward lower back curve when you raise your arms.

The Ab Article on Fixing Lower Back Pain When Standing and Running has a complete instructional on how to fix overly arched hyperlordosis back to neutral spine. Tightening the abs and strengthening the ab sand core ares not what changes hyperlordosis or "supports" the lower back. You move your hip and spine voluntarily and deliberately which uses core muscles to move you, then hold neutral. That is how you "support" the lower back.

Backpacks and handbags don't make you arch your back or have bad posture. The problem is when you are not using your ab muscles to counter the pull so that you don't let the bag arch you backward. Maintain posture when carrying things. Don't lean back, hunch forward, or hike your body to the sides to carry the weight, use your muscles. Your bags and packages could be a built-in ab and back exercise. Many people hunch forward for a few "ab exercises" then stand, walk, reach, and lift in arched postures. Use your abs while standing up to keep your hip tucked enough to prevent this bad arching posture. The familiar pressure on your low back will stop.

Put this technique to use with all you do. You will get a free, all day abdominal and core muscle workout while you stop back pain from hyperlordosis . Instead of "doing crunches" for ten minutes and not using your abs the rest of the day, use your abs to move your back to good position and keep it there all the time - when you are standing and lifting things overhead, to put groceries away, pull off your shirt overhead, wash your hair in the shower, and lift weights at the gym. This is functional use of abs to hold neutral spine. This is part of the method called The Ab Revolution™. For how to use your abdomen and core functionally, plus fun exercises to work your abs both functionally and more than you have ever done, without crunches, read my article about The Ab Revolution or get the book.

Your Back

You wake up and sit slouched at the edge of the bed, bend over the sink to wash, sit round-shouldered at breakfast, while commuting to work, and at a desk. You bend forward at the waist to pick up things all day. At the gym you curl forward with crunches and toe-touching. You bend over the dishes, the lawn mower, the vacuum cleaner, and slump to watch television. You go to sleep for the night with your head pushed forward on pillows. You are mystified when your back, neck, and shoulders ache. You call it stress. You go to someone and say, "My back hurts, can you give me a stretch to fix it?"

They suggest bending over to touch your toes, or bringing your chin to your chest, or your knee to your chest, sitting on the floor and leaning over to touch your toes, sitting in a chair and leaning forward with your chest on your thighs, touching your elbows in front by rounding your back, curling up in a ball, or others that promote more rounding and more pressure on your back. Your posture becomes stuck slouched. Your discs eventually bulge under the relentless push.

You say it feels comfortable to slouch? When your muscles are so weak and tight that good posture feels unnatural, that means you need to strengthen and stretch to be comfortable, not slouch to be comfortable. But isn't it natural to slouch? As natural as wetting your pants, but you learn to hold it even when you don't feel like it. Are you rounding your back and holding your head forward right now sitting and reading this?
What To Do Instead: Most back pain is simple mechanics, and just as simply remedied if you stop the constant and injurious process of bad body mechanics. Don't let your shoulders round when standing and sitting. Use your muscles to hold you in comfortable, upright posture when you stand, sit, and walk, and move. That burns calories and tones you while preventing back pain. Use your legs not back for lifting and bending all day. Bending knees while keeping torso upright saves your back and strengthens your knees and legs at the same time, when done properly. Use shock absorption to walk lightly, and use your body all day, not just sit. First thing in the morning, don't sit on the bed. Turn face down, propped slightly on your elbows for a moment or two. Don't force or pinch your back. Then get out of bed without sitting. Turning face down isn't for everyone, but for many people it helps you start your day straighter and healthier. Click for summary of fixing your own back pain.



For many, stretching means wrapping your foot around your ear or bending forward to touch your toes. Some of these same people don't have the flexibility to simply lie down flat without a pillow under head or knees, or stand against a wall with the back of their head touching. Their back and shoulders are too rounded. Their hip is too tight. Many stretches promote the original problem, like more forward rounding.  Most people don't have the hamstring flexibility to sit properly without their hip tucked under and back rounded. Instead of stretching their hamstrings to sit properly, they sit and stretch rounded because tightness makes it more comfortable that way. Other stretches are plain bad for you. They promote poor posture and load joints with your body weight, like shoulder stands in yoga, the hurdlers stretch, and lifting your arms up in back of you.

What To Do Instead: Flexibility training should address normal posture. Tight chest muscles pull you into round-shouldered postures. Pull your shoulders back when standing to stretch the front of your chest. Remember that slouching is a stretch - but a bad one. Your back becomes overstretched and rounded. Don't add to that by doing all your stretches with more forward bending. Don't bend over from a stand to stretch your legs. You know picking things up that way is bad for your back. It doesn't magically become good for you by calling it an exercise. Stretch your hamstrings by lying on the floor and lifting one leg up, keeping your back straight and shoulders and neck relaxed. Click for healthy stretching info.


Balance Ability

Balance is easily and highly trainable, but usually forgotten. Good balance is crucial for ease of movement, independence, variety of activity, and preventing falls, ankle sprains, and slips. Injury and disuse diminish balance - simple use-or-lose. Vicious cycles grow of poor balance, injury, and decreasing activity because of inability and fear of activity.

What To Do Instead: Balance needs to be functional - meaning how you need it in real life, not just standing on a balance machine in a gym or rehab facility. Examples of basic, low-level functional balance needed for health, include ability to put on hosiery and shoes while standing, to step over a pile of clothes and toys on the floor without falling or spilling a cup of water, descending narrow basement stairs holding a laundry basket in both hands without holding the railing, and rising from a chair and the floor without using your hands. Average balance - can you leap over a puddle or hole in the street and land lightly on the other foot, or safely climb a stepladder without hands and change an overhead light bulb without holding on? High functional balance skill examples are ability to walk though a rushing rocky stream and rescue a child on a rock.

Think of all the fun you wish you could do in real life that needs real balance. Practice and be ready to go!


Health Foods

Major sellers in "health" food stores are "fat burners" and various energy potions. You may buy them because they are "natural" and "herbal." That does not mean they are harmless or non-addictive. Caffeine, cocaine, and nicotine, for example are naturally occurring plant substances. Many energy and diet products contain stimulants like ma huang and ginseng. Be careful if you think there won't be problems because they say: "Used medicinally in China for over 5,000 years." Opium was used medicinally too.

Stimulants can have serious side effects of raised heart rate and blood pressure, erratic heart rhythms and chest pain, plus any of several nervous system effects like insomnia, tremors, anxiety, or seizures depending on dose, even if you have no history of heart trouble. Add coffee and cigarettes, with a few alcoholic drinks (to calm you), and any prescription medicines, it is a wonder that more people aren't suffering cardiovascular effects and road rage.


What To Do Instead: If you think you need stimulant drugs, look at your health habits and determine why you don't function without them. Taking them can produce a vicious cycle of dependence and fatigue, and a cycle of being too stimulated to sleep well at night. A brisk walk or other short exercise will "pick you up" more than a candy bar or drug. For weight loss or to increase energy, it is safer and quicker to just go out and exercise.



Would you drink drain cleaner? What if it tasted good or were low-calorie? Many people do the equivalent -- eating foods more unhealthy than smoking cigarettes, like donuts, fries, cream sauces, most fast foods and packaged snacks, and refined sugar. Sausage and processed bread for breakfast. Candy and coffee. Lunches of fast food, a large supper at night, and unhealthy snacks, saying you "have to have a little fun". The result is fatigue, hunger, crankiness, weight gain, and sleeping poorly at night from the late protein and meal. If you think eating something unhealthy is "having a little fun" think if you would say the same about heroin or banging your head with a hammer. Many people find these enjoyable activities. Resist. Discipline is good exercise.

Most people eat far more calories, fat, and simple sugar than they think. Candied yams, glazed vegetables, and buttered lima beans isn't "eating healthy vegetables" it's fat and sugar--bad for your teeth, bad for your heart, and bad for the rest of your body. A sweet drink with "added vitamins and calcium" is not a health food, it is sugar water. French fries and mashed potatoes are not "eating healthy vegetables." Ice cream and cream sauce is not ok because, "you need a little fat in your diet."

You need oil in your car, too, but that much and the wrong kind will kill your engine. Even if you ate only steamed vegetables, grains, nuts, seeds, and fruit with no added oil, you would still get enough fat from natural, healthy plant oils. You'd have to eat only unhealthy sugary processed foods to exclude food fat, which many people seem to make an effort to do.

Most packaged food in stores, and prepared food in restaurants, are full of bad sugar (not healthy complex carbohydrate), and unhealthy amounts and kinds of fat. Even if you want to eat less refined sugar, which is a good idea, you don't have to eat more fat to do that. The "low-carbohydrate" diet craze is not magic chemistry. You lose pounds when the restrictive diet lowers calories, and as your muscles shrink, you lose much water in the first two weeks. Eating all that fat is still not healthy. Losing weight is not the only part of a diet. You need health. The American Heart Association still recommends no more than 30% of your calories come from fat to protect your entire cardiovascular system. Grilling meat increases cancer-promoting compounds.

Getting carbohydrate in your diet is not supposed to mean junk food and simple sugars, but fruits, and vegetables. Diets excluding healthy complex carbohydrates don't provide the chemical energy to do exercise, or manufacture calming compounds and the important vitamins and cancer fighting "phytochemicals" only found in fruits and vegetables.

What To Do Instead: There is more to nutrition than fat or carbohydrate. Fruits and vegetables (not processed with sugar, sauces, fried in corn oil, stripped of their natural fiber, or exposed to high heat) provide many dozens of important anti-inflammatory, cell building, mood stabilizing, and disease-fighting compounds you won't get in vitamin bottles. Don't confuse the complex carbohydrate of vegetables with unhealthy simple sugar. Don't eat white bread and white rice thinking it is good, while shunning vegetables as fattening starch. White rice and white flour noodles are part of the "hour later you're hungry again" phenomenon - stripped of fiber and complex carbohydrate to keep your blood sugar even. They are little more than junk food and raise blood fat just as eating fatty food. "Eating carbohydrate" should mean the healthy, complex carbohydrates of vegetables, legumes, fruits, and whole unprocessed grains, not the simple sugar of candy, donuts, and fast food. It's healthy to have a "low simple-sugar diet" but that does not have to mean a "low carbohydrate" diet. Don't go overboard eating whole grains, as with any food. Too many calories from any source is how you gain weight and expose your body to constantly varying insulin levels from overeating.You do not need as much carbohydrate when not exercising. Save grains for hard exercise days.

For breakfast get complex carbohydrates, healthy fat, and protein from raw nuts like almonds and walnuts, and fresh uncooked fruit, instead of processed sugared cereal. Add whole oatmeal or rice if you are going out for long exercise. Eat the washed skins of fruit like apples. The peel is nutritious and the fiber keeps blood sugar more even. Throw oranges and other whole fruit with raw nuts and fresh grated ginger in the blender to make your own juice. Keep the pulp in juice. Without it, you're drinking little more than sugar water.

Vegetables are important, healthy protein sources. There is no need to carefully mix certain ones to get complete protein. Use seasonings instead of junking up otherwise good food with oil and sauce.

"Fitness water" is hype and marketing. Make your own. Throw some grapes in a blender of water. Simple. An orange with cinnamon. Carry in non-plastic containers. Plastic uses high degree of fossil fuels and is found to leach chemicals into the product.


The Mystery is Simple

People aren't doing what they think. They exercise in ways that don't help but injure, they eat far more fat, sugar, and unhealthy food than they know, and live a daily life without movement for normal activity. Getting fit is not, "Do three sets of 10," "Park further away" and "Drink more water."

The very thing we regard as exercise advice, "Exercise at least 30 minutes a day, three to five days a week," is the root of the problem because it separates exercise from the rest of your life.

When you're a child, you're told "Sit Still! Be Quiet! Eat Everything on Your Plate!" Now as an adult, it's suddenly "Get Moving, Don't Eat So Much, Say Something Profound!"

It's time to realize that muscular activity is health and should be used for regular life including just standing up properly. Using your body is like the being a moral person. You're supposed to do it all the time, not just during your hour of worship.  Health is not something you go and do 3-5 times a week. It is moving, stretching, bending, lifting, and using your brain for your daily life.



Fun Things To Do Next:

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Adventure Medicine  - Higher, faster, stronger, smarter, funnier.

Fix Your Pain With Fitness as a Lifestyle (Functional Fitness). Not reps of exercises or purchasing training "plans" and devices, but how you move all day, making your daily real life into your own mental, emotional and physical playground of strength mobility and health for knees and the rest of you.

More Free Fix Pain Articles on This Web Site. Fix Back Pain, Knee Pain, Leg, Foot, Hamstrings, more. Click the Clinical Page and scroll down to "Start Right Now."

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The Fitness Fixer - Dr. Bookspan IS The Fitness Fixer. My column ran on Healthline from 2006 to 2010. After that, they took them all away in favor of their own articles that sell medicines and treatments, The BlogSpot archives still have some of them. Check for articles on Achilles pain, foot, shoes, orthotics, knees, back, nutrition, and more by alphabetical listing.
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Books and eBooks

All my books together cost less than your pain killers,and show you how to stop needing them and be healthier than before. Fun, easy to read, illustrated, immediately helpful. More book descriptions and info, signed books straight from the author, eBooks, Kindle, and more CLICK my BOOKS page:


         ALT =[“The Ab Revolution 4th Edition by Dr. Jolie Bookspan. Replaces all eariler editions. Available from author web site”]     

ALT =[Diving Physiology in Plain English - new eighth edition 2021 with Blue Cover and white text: by Dr. Jolie Bookspan]  


Healthy Martial Arts
Top level book for all athletes to train thinking, spirit, and top performance. Healthy Martial Arts is the top of the line book (of my books) for exercises and athletes. Sun Tzu's "The Art of War" is the classic strategy manual in business and power. "Healthy Martial Arts" is the strategy manual for your life. For everyone, not only martial artists, who want to move, live, eat, and be happy in healthy ways. Direct from Amazon - Healthy Martial Arts.

Fix Your Own Pain Without Drugs or Surgery
Neck pain, back pain, shoulder and hip pain, knee pain, ankle and foot injuries, wrist pain, and "when everything hurts," featuring actual patient stories in every chapter. Many common exercise contribute to pain and aren't natural movement patterns. Learn fun healthy ways to get healthy movement back as part of your real life.

Print edition from Amazon.
Print and eBook Instant download from the publishers, Healthy Learning and Coaches Choice:

Stretching Smarter Stretching Healthier
Fun, innovative, immediately useful. Almost 200 simple fun line drawings zero in on each concept.
Print and Kindle from Amazon and instant eBook download from Kobo Books.

The Ab Revolution Fourth Edition - No More Crunches No More Back Pain  Print 4th Edition.
Core training the way your body actually needs. Part 1 - Learn neutral spine to stop a major form of lower back pain. Part 2 - Apply Part 1 for functional strengthening from simple moves to the toughest you can get. Parts 1 and 2 let you get started quickly and clearly. Details on the anatomy and physiology are expanded and moved to Part 3, plus other improvements in photos and organization in the 4th edition.
Click for print edition from
Also available in Kindle.

Health & Fitness THIRD Edition
Fix pain plus healthy living - How to be happy healthy and fit for the rest of your life. One book with everything to get started. More photos, clearer descriptions than previous editions.

Order directly from Amazon.
Print and eBook Instant download from the publisher:

Diving Physiology In Plain English
New BLUE cover edition. The diving cult classic! Replaces old GREEN cover edition. Signed collector copy direct from the author. See this and more diving and hyperbarics books on the BOOKS page.

Have fun!




Don't worry about people stealing your ideas. If your ideas are any good, you'll have to ram them down people's throats.
- Howard Aiken

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