The term “exercise is medicine” is often used to help convey why exercise matters for health.

That makes sense given an active lifestyle is linked to a lower risk of virtually all chronic health conditions - not to mention being critical for keeping us functioning well to get the most out of our years.

But I think the “medicine” metaphor actually misses something important.

Because if we treat exercise like a prescription, then we tend to think it’s something we only turn to when things go wrong. Like a disease to treat or a problem to fix.

When you think about it, we already treat many aspects of health as something to maintain or prevent. We brush our teeth before we have cavities and wear sunscreen before we have skin damage, mainly to help prevent these issues in the first place.

Exercise is no different, but we usually don’t think about it this way.

So, what if we thought about exercise as maintenance, not just medicine?

Because that may change not just how you think about exercise, but how you stay consistent with it too.

Disease often starts long before the diagnosis

Ageing increases the risk of virtually all chronic health conditions.

But, most diseases linked with ageing don’t appear overnight.

Things like heart disease, diabetes, cognitive decline, or frailty often only become obvious once they cause noticeable symptoms or functional problems, or result in a diagnosis.

But the reality is that many share underlying biological processes that change gradually, and often silently, over decades.

In research, we call these biological changes the “hallmarks of ageing.” And a new review article summarises how exercise may help counter up to 14 of these processes, including:

Chronic inflammation - inflammation is essential for responding to injury and infection, but can cause issues when persistently elevated.

Poorer protein recycling - our cells become less efficient at removing damaged or dysfunctional proteins and replacing them with new ones.

Accumulating DNA damage - damage to our genetic material can build up over time as our ability to prevent and repair it becomes less effective.

Changes to the gut microbiome - the “community” of microbes living in our gut can become less diverse, and change in ways that may affect metabolism and immune function.

Declining mitochondrial function - the structures our cells rely on to produce energy become less efficient and effective.

As these changes accumulate over time, they can make our cells and tissues less resilient, and contribute to the disease and loss of function we usually associate with ageing.

This is where exercise becomes important. Because rather than only helping manage the downstream consequences of ageing, exercise may influence many of the underlying processes long before disease or loss of function appears.

This is what I mean by exercise being maintenance, not just medicine.

The maintenance happening beneath the surface

Beneath the surface, our bodies are constantly repairing DNA, removing damaged proteins and cellular components, regulating inflammation, producing energy, and responding to stress.

In other words, there’s a huge amount of maintenance going on that we’ll never see or feel.

And the good news is exercise appears to help keep many of these processes working well as we age.

Even though it does so in a somewhat counterintuitive way.

Exercise is a strange kind of maintenance

It’s tempting to think of exercise in a similar way to maintaining your car:

You service it to stop damage accumulating before any bigger problems arise.

But this is where the “car” analogy starts to break down. Because when you use your car a lot, or drive it a bit too hard, it deteriorates faster.

Our bodies don’t work like that.

Exercise is actually a form of stress (in a physiological sense). When you exercise, you challenge energy supply, place mechanical and metabolic stress on your tissues, and temporarily disrupt your body’s internal balance.

In science we call this a disruption to homeostasis. And while that might sound bad, this temporary disruption is actually the trigger for repair and adaptation when paired with adequate recovery.

Because unlike our cars, our bodies have the capacity to adapt to become better at dealing with similar stress in future.

That’s why exercise can do more than just maintain what you have now, but actively increase your capacity and resilience as well.

This changes how we think about if exercise is “working”

Unfortunately, we’re drawn to the visible “results” of exercise.

Which means if we’re not losing weight, building muscle, lifting heavier or running faster, the all-too-common conclusion is nothing is happening.

Yet some of the most important effects of exercise are those we can’t see (or feel).

We can’t feel our mitochondria functioning better, or see improvements in how our cells deal with internal stress and damage.

And if we think about exercise as maintenance, it changes what consistency means too.

Because maintenance isn’t something you ever really finish. There’s no 12-week program after which your body is fully “maintained.” Instead, the benefits come from repeatedly giving your body the stimulus it needs to respond and adapt over a long enough timeframe.

This is also why missing the odd exercise session doesn’t matter much, nor does the occasional “hero” workout. Maintenance is more about doing enough, often enough, over years and decades.

Thinking about exercise this way makes it easier to see why consistency matters more than perfection.

So, think maintenance - not just medicine

I’m not saying exercise isn’t medicine - because it absolutely can be.

What I am saying is we shouldn’t have to be unwell or experience pain to see its value.

Exercise provides a powerful signal that helps our bodies maintain their capacity, respond to stress, and continue to adapt and stay resilient as we age.

So perhaps a useful way to help you take action with exercise this week is not to “fix” something that might be wrong…

But to look after everything that’s currently right.

Thanks for reading!

Until next week,

Jackson

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IMPORTANT:

The information contained herein is of general nature only and does not constitute personal advice. You should not act on any information without considering your personal needs, circumstances, and objectives. Any exercise program may result in injury. We recommend you obtain advice specific to your circumstances from an appropriate health professional before starting any exercise program.