Movement is Medicine.

Movement is medicine. In fact, movement is hands down the best medicine. Years of rigorous education—first as a personal trainer and now a doctor— plus firsthand experience as a competitive athlete have me convinced beyond a shadow of doubt. In the gym, I helped patients with COPD and heart disease boost their physical function and stamina such that they could finally play with their grandkids. While caring for sick patients in the hospital, I prescribed proactive physical therapy after seeing the deconditioning effect of even few days confined to a hospital bed. In clinic, I do everything from writing up basic exercise plans to creating behavior hacks to boost my patients’ activity levels. Innumerable articles and mountains of scientific research back me up. There is no better preventive measure or healing therapy than moving your body. That said, it is not so easy for your doctor to prescribe this potent elixir. 


The domain that promotes and teaches movement—the health and fitness industry—is largely removed and disconnected from the healthcare system. Despite efforts like Exercise is Medicine, physicians are not adequately relying on partnerships with health clubs and personal trainers to promote activity to their patients. A revealing study by a Pojednic and colleague suggests that even though many physicians view health clubs favorably, a lack of convenient referral mechanisms impedes a natural partnership. This conclusion resonates. In my medical weight management clinic at Brigham and Women’s Hospital, many patients come to me in search of a sustainable weight loss solution after years of on-and-off calorie restriction and yo-yo dieting. One of the most effective way to boost their metabolic rate and improve body composition is through dedicated resistance training. Unfortunately, I have no way to refer these patients to a reputable personal trainer to help them learn the proper exercises and movement patterns.


movement is medicine - woman walking

This disconnect is detrimental not only for “patients” with a formal diagnosis or medical condition; it is harmful for us all. By the time the medical system gives you a diagnosis, you are already sick as identified on blood work, an X-ray, or some other test. The ship has already set sail. Yet many chronic health issues could be discerned before a formal diagnosis and mitigated using movement as the cornerstone of therapy.  


Consider insulin resistance, the metabolic harbinger of nonalcoholic fatty liver disease and type 2 diabetes. Your average primary care doctor will not be able to pick this up on a routine blood test. Therefore, insulin resistance goes largely undiagnosed in the majority of the population until it spirals into metabolic syndrome. The most immediate and impactful therapy to prevent and reverse insulin resistance is to increase lean muscle mass—a physiologic sponge that soaks up blood sugar and reduces insulin requirements—through resistance training. Or consider dysthymia, a persistent, smoldering form of anxiety and depression. Numerous studies show that exercise, specifically aerobic exercise, is just as, if not more effective than selective serotonin reuptake inhibitors to counter depression.  To prevent dysthymia from erupting into a crippling depression, a physical activity plan is the essential prescription. And certainly, let’s consider COVID-19 and other infectious diseases. As I discuss here, exercise trains the immune system to efficiently combat pathogens and reduces total body inflammation. It must be a central tenant of a comprehensive risk reduction strategy. 


Perhaps you don’t (yet) have existing medical condition or significant risk factors. Movement is medicine for you, too. Movement sharpen your executive functions, enhances your productivity, improves your sleep, reduces your anxiety, and may even improve your eating behaviors. A proper training plan teaches you the subtle art of gradual progression by balancing a targeted and incremental overload with proper recovery. This is an apt analogy for success in life more broadly. 


Sure, your traditional primary care doctor can refer you to sports medicine or physical therapy once you are already in pain or injured. But what most people really need is a fitness prescription with a lifetime of refills. They need a program that continuously evolves and adapts to their fitness goals in the context of their current baseline, medical conditions, and life circumstances. They need an ongoing dialogue between their physician and their trainer to provide the proper pace of progression given their unique physiology, psychology, and performance goals. As long as the world of fitness and health care remain detached, millions of people will be denied this vital therapy. This is arguably medical malpractice. 


Here at VIM Medicine, movement is the mainstay of therapy—the keystone of a comprehensive health prescription. I’ve been fortunate enough to partner with a first-class facility and top-notch trainers at Lynx Fitness Club to smoothly and seamlessly incorporate clients’ training plans into a holistic health plan. 


At your most recent check-up (if you even have a primary care doctor…), perhaps your doctor listened with a stethoscope, looked down your throat, and checked your reflexes. This is often a cursory formality that says nothing about your level of physical fitness—the major predictor of your health status. At VIM Medicine, our version of a physical exam is what we call a Performance Evaluation. This consists of a comprehensive physical exam followed by postural and gait analysis, biomechanical assessments, movement screens, and a battery of test to evaluate different domains of physical fitness. We learn how you move—your strengths, your imbalances, your tight spots—in order to create a thorough and balanced training plan to support your fitness goals and long-term health.


We work to instill the belief that no matter where you’re starting from, your stage of life, or your experiences thus far, you are an athlete who need to train physically in order to perform and function optimally. Your best medicine awaits. Come join the movement (pun intended).



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Dr. Rich Joseph

Rich Joseph currently serves as the Medical Director of the Brigham and Women’s Hospital Center for Community Wellness in Dorchester and is a practicing clinician in the BWH Center for Weight Management and Wellness. He recently completed his residency in Primary Care-Internal Medicine at Brigham and Women's Hospital in Boston, MA. During his training, Rich helped to build a center for healthy lifestyle and fitness in the Blue Hill Corridor, co-chaired the Partner's Graduate Medical Education Council on Resident and Fellow Wellbeing, and authored articles on burnout, medical education, and the future of medical training. Rich received his medical and business degrees from Stanford University. He earned his B.S. from Yale University. Prior to his medical training, Rich worked as a CSCS certified personal trainer, helping numerous clients towards their health and fitness goals. His background in athletics and training informs his vision of holistic health and wellbeing. Rich aspires to help bridge the gap between the health and fitness industry and traditional health care to create a prevention-oriented and performance-focused model of care.

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