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152 SECTION|· WHAT T○DOW| TH THE|NF○ RMATION too fast, too frequently. The latter is the most common cause of injury in most of the activities and sports used for regular exercise, such as running, fast walking, cycling, and swimming Intrinsic injury can be prevented by the use of proper equipment and correct technique. The risk of extrinsic injury can be significantly diminished by taking certain, mainly common sense, safety precautions, such as always wearing a helmet and never wearing a radio headset while riding a bicycle Overuse injury can be prevented by choosing a sport along with a workout schedule that are suitable to the exerciser, and by maintaining moderation in distance, intensity, and speed. The risk of a variety of pathologic problems is increased when a previously sedentary person engages suddenly in intense exercise or when a regular exerciser suddenly increases exercise intensity Therefore moderation and gradual change, if changes are to be made, are as always, good counsel GETTING UNDERWAY Recommendation"versus"Prescription Many clinicians use the term exercise prescription when discussing regular exercise with their patients. The term hails from the disease and medical models and appeals to many clinicians, especially those new to using the intervention. Prescription, however, usually means telling a patient to do something for a limited period of time. Regular exercise is by its very nature voluntary. No one can be forced to do it. Regular exercise requires more than just the temporary extra expenditure of time required to establish most other positive lifestyle changes such as engaging in healthy eating, achieving weight loss, and ' stopping cigarette smoking. For example, all people spend time food shopping, cooking, and eating. After learning about what changes to make, healthy eating requires only that the time be spent differently. After undergoing smoking cessation unseling and quitting tobacco use, no extra time need be spent again, Inless relapse occurs. In contrast, regular exercise requires a permanent commitment of time that would be otherwise spent doing something else. Of course, the maintenance of any successful behavior change requires constant attention for the rest of one's life, to a greater or lesser extent. However, in order to be most effective in counseling their patients to become regula exercisers, clinicians need to recognize the ongoing time commitment that regular exercise requires Therefore, because of its special nature, exercise cannot be prescribed like a drug. Rather, the clinician is recommending the effort to become a regular exerciser. The clinicians goal should be to develop a respectful and supportive partnership with their patients, using advice and counseling to assist them
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