“Plank? Is that a board?” asked my patient. I had been encouraging her to start doing exercises to strengthen her core in order to stabilize and support her back. My hope was that over time, these exercises would lessen the need for pain medicine. There are times for words and there are times for action. So I got down on the floor and demonstrated one.

Thinking back on the conversation (and many others like it), I’m surprised that amidst all the news articles and TV segments celebrating the benefits of exercise, many of my patients wouldn’t recognize the inside of a gym if their lives depended on it. Which, we’re learning, they indeed may.

Since I started my rheumatology practice 13 years ago, I’ve borne witness to countless exercise fads, flops, and frenzies. But maybe more importantly, wedged as my efforts were between building a practice, two pregnancies, and moving to the suburbs, I actually tried a lot of this stuff out.

As a child of the 1970s, when exercise typically happened on a court or on a field, I was admittedly a slow convert to the celebrated “gym rat” status. But ever so steadily, I crossed over. And when I did, my body transformed. As most over-scheduled, over-stretched moms, dad, teachers, bankers, lawyers, etc. will tell you, “It’s the only thing that kept me sane.”

These days, there is no shortage of strong scientific evidence supporting the benefits of regular exercise. And yet, in spite of this, my very rudimentary, unscientific estimate of the percentage of my patients with musculoskeletal conditions who do something to benefit their body? Probably no more than half. This, in a population where engaging in regular physical activity and maintaining a healthy body weight can be game-changing. And where not doing so is counterintuitive, detrimental, and highly cost-inefficient.

So here’s my new solution: After I stand up and brush off the dust, I make a pact with all of my patients. If they commit to moving more and eating less, I’ll sign on to be their virtual gym buddy and perpetual cheerleader. I may not be able to be with them when they do these things, but during their time with me I will listen to, council on, and loudly applaud their efforts at self-preservation. Just as I’m making them accountable for doing these things, so am I making myself accountable for supporting these actions and for helping them help themselves. Because I can demonstrate a plank for you until the cows come home, but it surely won’t help your back.

Natalie Azar is a rheumatologist who blogs at The Doctor Blog.

Image credit: Shutterstock.com