What has been surprising to me is that most patients WANT to talk about it. They frequently reference that they are walking, they want to walk or they hope to walk. It has been a great conversation generator. In addition to that it has given me the opportunity to talk about studies that illustrate how good walking is, or more generally, how important exercise is to well-being and longer living.
There are numerous studies linking improvement in depression with physical activity and a list of several of them can be found here. Thanks to direct-to-consumer ads, especially on TV, patients often have a magical idea of how anti-depressants work. When we talk about the number of side effects associated with these drugs, especially weight gain, medications become much less appealing.
Another important discussion often begins with how many patients have been told to stop moving because their back/knees/hips hurt. This is bad advice and it often comes from medical professionals. Of course it is USUALLY necessary to quit activity with an acute injury but if you stop too long muscle atrophy sets in and joint stiffness occur. More and more studies point to how important it is to keep moving. Denise Mann writes about this in a great article on WebMD entitled "Dealing With Osteoarthritis? Try WebMD's Joint-Friendly Walking Program".
Brisk walking (defined as a 15-20 minute mile) can reduce heart disease (NEJM), improve function in osteoarthritis of the knee (Annals of Int Med), and prevent the development of diabetes (J of Epid), among other health benefits.
To sum up I want to introduce a video I first saw in Dr. Mandrola's blog because it is entertaining and educational: