For many people living with a long-term illness, being told to “get more active” can feel less like helpful advice and more like a heavy weight to carry, according to a study published in the medical jour al JAMA. Now researchers are urging healthcare professionals to rethink how they raise the subject, saying the right kind of conversation could make a real difference to whether patients feel able to move at all.
The message comes from Alessio Bricca and Søren T. Skou at the University of Southern Denmark and Central and West Zealand Hospital, together with Julie Midtgaard from the University of Copenhagen and the Mental Health Centre Glostrup.
Physical Activity Doesn’t Have to Mean the Gym
One of the biggest misconceptions, the researchers say, is that “exercise” only means structured workouts or breaking a heavy sweat. In reality, small everyday movements count too, and for people managing pain, fatigue, or other symptoms, those small movements may be exactly the right place to start.
“Many people believe that physical activity only counts if it involves intense exercise or structured workouts. But for many people living with chronic illness, it is about finding small everyday activities that feel manageable and meaningful in their lives,” said Alessio Bricca, associate professor at the Department of Sports Science and Clinical Biomechanics at the University of Southern Denmark.
Even five extra minutes of daily activity that leaves you slightly out of breath could make a real difference for adults who are otherwise not very active, according to one international study highlighted in the paper.
Guilt Doesn’t Help Anyone Move
Conversations about exercise can go wrong when they leave patients feeling judged, guilty, or like they simply aren’t trying hard enough. The researchers warn that this can be counterproductive.
“If patients feel they are being met with guilt or expectations that it is simply a matter of willpower, it can make it harder to get started. Living with chronic illness often involves pain, fatigue or other barriers that need to be taken seriously,” said Julie Midtgaard, professor at the Mental Health Centre Glostrup and the University of Copenhagen.
Rather than pushing unrealistic goals, they suggest healthcare professionals should offer reassurance, practical suggestions, and support that help patients approach movement with more self-compassion.
Words Matter More Than We Think
The language used in medical appointments can quietly shape how patients feel about their bodies. Terms like “wear and tear” or “degeneration,” or comments that suggest exercise should be easy, can make some people more hesitant to move. On the other hand, supportive and reassuring language can help patients feel more confident about being active.
Simple everyday activities can be the easiest place to start. “Activities such as a brisk walk, taking the stairs or short bike rides are all types of physical activity that may be easier to integrate into everyday life,” said Søren T. Skou, professor at the University of Southern Denmark and Central and West Zealand Hospital.
Beyond the physical benefits, movement can also help people reclaim a sense of normality. “Physical activity can also help people regain routines and a sense of control in everyday life while living with illness,” Skou added.
Practical Tips for Better Conversations
The researchers suggest healthcare professionals try to:
- Ask permission before bringing up physical activity
- Focus on small, realistic changes rather than ambitious goals
- Help patients find activities that actually fit into their lives
- Offer reassurance and practical guidance instead of pressure
- Acknowledge that pain, fatigue, and uncertainty are genuine barriers
- Encourage activities that feel meaningful to each individual
The Bigger Picture
The overall message is a shift in tone: from “you should be doing more” to “let’s find something that works for you.” For people living with chronic illness, that change in approach could mean the difference between feeling stuck and taking that first small step, whether it’s a walk around the block, a few flights of stairs, or a gentle cycle to the shops.
As the authors put it, conversations about physical activity should focus more on possibilities than limitations, and help patients find ways of being active that feel realistic and meaningful to them.
Midtgaard J, Skou ST, Bricca A. Communicating With Patients About Physical Activity. JAMA. Published online August 06, 2026. doi:10.1001/jama.2026.6083