Exercise is medicine? Most of the time for most; but not always for all

Abstract

Based on extensive research on the relationship between exercise and health, exercise as a form of medicine is a powerful concept of growing popularity within health care, academia and policy. Proponents of this exercise is medicine (EiM) movement frame exercise as a panacea for a variety of health issues and uncritically promote exercise as good for all. Two clinical populations particularly influenced by the EiM agenda are spinal cord injury (SCI) and arthritis. The purpose of this research was to explore how individuals with SCI and arthritis personally make sense of their exercise experiences. Data were collected through semi-structured interviews with 10 participants with SCI and 20 participants with arthritis. Following a thematic narrative analysis, three patterns were identified across the whole data-set. These were: (1) exercise and restitution; (2) exercise and pain; and (3) exercise and pleasure. Taken together, these results provide new knowledge regarding the impact of exercise that both align with, and contrast, the dominant EiM discourse. When exercise is perceived as ‘medicine’, stories of exercise participation spoke of cure, and restitution, rather than health and well-being. Pain was an unwelcomed side effect of exercise participation for some, and had a detrimental impact upon motivation and engagement. Lastly, a focus upon the medicinal benefits of exercise did not reflect the multiple pleasures experienced through exercise participation. Thus, health professionals, academics and policy-makers need to prescribe to more ethical forms of exercise promotion that may lead to more efficacious, person-sensitive interventions.