This article is going to be a little different than our usual format. Rather than highlighting an exercise, answering a rehab question, or breaking down complex pathology, this article is going to focus on how to build and maintain good habits. Our goal as physical therapists is almost always to change a patient’s habits in some way. Regardless of what has led a patient into physical therapy or to starting a [P]Rehab program, their goal is often to decrease pain, increase function, and reach their body’s full potential, which typically happens by a change in habits! As the new year approaches and many people consider their New Year’s Resolutions, I thought this guidance would be particularly timely.  Atomic Habits by James Clear is a New York Times bestseller that highlights some simple strategies to build and maintain good habits while eliminating bad ones. This article will highlight some of these strategies along with their application to fitness and rehab. We are here to discuss everything related to the concepts of atomic habits by James Clear, including implementing healthy lifestyle changes you can start today!

 

What are Atomic Habits?

One of James Clear’s first examples in his book is the story of the British cycling team who broke a 110 year drought of Tour de France losses by focusing on a strategy of “the aggregation of marginal gains” in which they looked to find ways to improve by 1% knowing that over time this would lead to a more significant increase.

The strategy worked – eventually leading to five Tour de France victories in six years. The idea of an ‘atomic habit’ is that small improvements, when compounded over time, can lead to massive changes. As they note in the book, habits are the “compound interest” of self-improvement leading to a snowball effect that can either work for you, or against you.

 

Build Healthy Lifestyle Habits Training With Prehab!

Fitness is not about using such a high intensity that you are unable to get off the floor afterward. We are all about hard work, however, we want to make sure you are able to work out across the lifespan both safely and effectively. The number one reason why people no longer participate in an exercise program is due to injury, let’s prove that statistic incorrect by using a fitness program with the intended goals of getting you in shape while avoiding injury! To do so, the first 4 weeks are meant to load your tissues to create a movement base this ready to take on the next 8 weeks. Let’s also make sure that we are not just addressing the physical you but are helping you become healthier by giving you methods to decrease your internal load via positive self-talk and gratitude practices.

 

How does this apply to [P]REHAB?

The principle of compounding interest is a crucial one, and one that I highlight for patients all the time. Take for example the patient who is recovering from an ACL reconstruction with limits in their knee flexion. At two weeks post-op, they have 30 degrees of knee flexion with the goal of reaching 140 degrees of knee flexion in the next month or to achieve symmetry with their uninvolved side. Gaining 110 degrees of knee flexion can feel like a daunting task! It will likely hurt the patient to push them into 35 degrees of knee flexion which will lead to more stiffness and muscle guarding that may actually make them lose range of motion! So how in the world are we supposed to get them to 140 degrees!?

Well, if their knee can bend to 30 degrees comfortably, after 1 minute of knee flexion exercises it will likely bend to 31 degrees without too much pain. And if that patient works on that motion 5x throughout the day – they’ve gained 5 degrees of range of motion today! In one week of slow, consistent work toward their goal they will have gained 35 degrees of knee flexion! With consistency, they will achieve their goal of 140 degrees of knee flexion in 3.5 weeks! Therapists and patients alike – please don’t crank on your or anybody else’s knees! Make it a habit to spend 1 minute, 5x/day and comfortably achieve your goals by using “the aggregation of marginal gains” to your advantage!

READ: HOW TO REGAIN KNEE FLEXION AFTER SURGERY

For many patients, the 1-3 hours a week you might spend in a physical therapy clinic will only produce meaningful change if you’re able to use the principles and education you receive to change your habits the other 23 hours/day, 7 days a week. Regardless of your injury or training level:  strength, range of motion, agility, balance, and weight loss, are only achieved through consistency and the best way to achieve consistency is to make it a habit!

 

How to form an exercise habit

One of the most profound lessons I gleaned from this book is that changing your habits is not about setting a goal and sticking to it, but about changing the way you identify yourself. This means that if you want to start exercising in the New Year, don’t set a weight loss goal for the first month, don’t say you are “trying to get in shape”, rather decide that you are someone who consistently exercises. As the author notes: “Research has shown that once a person believes in a particular aspect of their identity, they are more likely to act in alignment with that belief.”

If you identify as someone who exercises – you WILL find a way to exercise. But if you identify as someone who is trying to get in shape – you will TRY to get in shape – but you’ll likely fail.

 

Sore From A Hard Workout? Watch This To Recover Faster

 

How to change your identity: The secret to showing up

“Whatever your identity is right now, you only believe it because you have proof of it.” is a quote that really stuck with me. As the author notes, each time you perform an action you are casting a vote for your identity. This means that if you exercise for a week straight, you will start to identify as someone who exercises regularly. If you have back pain that is limiting your function, don’t set the goal of healing your back starting January 1st. Identify as someone who takes care of their spine, act accordingly, and try to improve the function of your low back 1% a day. Changing your focus to forming a positive habit, rather than achieving a long-term goal, allows you to enjoy the success of acting in accordance with your identity each day, while the compounding benefits of your hard work begin to accumulate. The paradigm shift of focusing on your identity will not only help you build a new habit, but it will also help you maintain that new habit through all of the ups and downs that life throws at you.

 

Habit Stacking

Early on, when trying to establish a new habit, pairing it intimately with a habit you already have can be extremely helpful. In this regard, it helps to be really specific. Tell yourself that you will workout immediately after your morning coffee, rather than “after work”. Creating the habit of coffee: workout; coffee: workout; coffee: workout creates a level of automaticity that will cut out distractions and make working out the simplest choice. Clinically, when patients struggle to consistently perform their exercises, I have found that they have an easier time remembering when I suggest they do so while they brush their teeth. Most people brush their teeth 2x/day for about 2 minutes apiece, without much thought or effort. For most patients with Achilles tendinopathy, 4 minutes of calf exercises a day will form a habit that will start to improve their symptoms in a few weeks. Moreover, once a habit is formed and you’ve “casted enough votes” for your new identity as someone who cares about the health of your Achilles – you’ll likely start to act in accordance with this new identity and start to spend more time rehabbing that ankle!

 

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Habit Tracking: ‘Never break the chain’

Now that we have established that focusing on creating a habit is the key to long term health and fitness, let’s talk about some strategies for maintaining a habit. A habit tracker is a simple but successful way of tracking progress and increasing motivation to stick with a new habit. In its simplest form, this can simply be a calendar on your fridge with an ‘X’ through each date that you performed your exercises. This can help you maintain a habit for two primary reasons:

• The satisfaction of checking something off your to-do list provides you with a positive reinforcement that will make you want to repeat the action.

 

• The visual cue of a week or month’s worth of checked boxes will provide you with more evidence to support your new identity as someone who exercises, cares for the spine etc.

 

• This provides you with motivation to “never break the chain” and to get back on track by checking boxes after missing a day.

 

Imagine looking at a row of checked boxes without wanting to check the next box. It might seem like a silly thing, but the magnetic pull of a visual cue can make a huge difference.

 

The Secret of Starting Small

The final and perhaps most important lesson I learned from this book is the secret of starting small. Starting a new exercise routine, changing your diet, or finally addressing a nagging injury are ominous enough tasks on their own. When you add in the time commitment accomplishing these tasks will likely take – it can feel next to impossible! For this reason, it is crucial that you make your new habit as small of a time commitment as possible. James Clear calls this his “two-minute rule” in which no new habit should take up more than two minutes of your time. I will take this a step further and say to start with one minute. No matter how busy you are, you can always afford to spare an extra minute. And while one minute of exercise might not be enough time to address all of your health concerns, it’s enough time to establish a habit. And, as we have noted above, habits have a tendency to snowball. Once you have formed an exercise habit and you start to automatically perform your 1 minute of daily exercise, it is extremely likely that you will begin to expand this habit into a more meaningful routine.

LISTEN: LEARN THE KEYS TO PROGRESSIVE OVERLOAD!

 

Closing Thoughts

Creating positive sustainable habits is the key to long term improvement of your health and wellness. Some tips for creating and maintaining exercise habits include:

• Focus on establishing a habit that is consistent with someone who cares about their long term health and fitness first, rather than striving toward a particular goal.

 

• Utilize a habit tracker (or X’s on a calendar) to provide visual proof of your new identity as someone who prioritizes their exercise routine consistently

 

• Utilize “habit stacking” early on to pair your new exercise habit with a prior habit such as brushing your teeth or your morning coffee.

 

• Start small – begin by exercising for 1 minute each day for 2 weeks – this low barrier to entry will allow you to establish a habit without much of a time commitment and will likely lead to a snowball effect once the new habit becomes more automatic.

 

 

About The Novel Atomic Habits

If you would like to learn more about the novel Atomic Habits by James Clear, click on the link HERE!

 

Become More Consistent and Purposeful With Your Fitness Programming

Fitness is not about using such a high intensity that you are unable to get off the floor afterward. We are all about hard work, however, we want to make sure you are able to work out across the lifespan both safely and effectively. The number one reason why people no longer participate in an exercise program is due to injury, let’s prove that statistic incorrect by using a fitness program with the intended goals of getting you in shape while avoiding injury! To do so, the first 4 weeks are meant to load your tissues to create a movement base this ready to take on the next 8 weeks. Let’s also make sure that we are not just addressing the physical you but are helping you become healthier by giving you methods to decrease your internal load via positive self-talk and gratitude practices.

 

References

1. Clear, J. (2019). Atomic Habits An Easy and Proven Way to Build Good Habits and Break Bad Ones.

 

About The Author

Tommy Mandala, PT, DPT, SCS, OCS, CSCS

[P]Rehab Writer & Content Creator