In 35 years of medical practice, I've heard them all. All start the same way: "I can't exercise because..." And they all end with a statement that seems perfectly reasonable. Indeed, many are legitimate problems, and a few are nearly insoluble. But most barriers to exercise can be overcome with a little thought, a little effort, and a good dose of motivation.

Here are some of the excuses I've heard from my patients and some tips for dealing with them.

1. "I don't have the time."
It's the most common excuse, and it's a real problem for many of us. Life is busy, and you'll never find the time to exercise. But you can make the time. You can climb stairs, walk from point A to point B, and find many other physically active ways to accomplish your daily tasks. You can divide up your stretching and strength training so it takes just a few minutes a day. And you can also make time for designated exercise.

Give up some sleep; exercise will make you more energetic, and it will help you sleep better, so you won't miss the shut-eye. Walk with your friends instead of meeting them for coffee or lunch. Spend some of your lunch hour walking. Do more on weekends, holidays and vacations, but do something important for your body and your health nearly every day.

Be creative and crafty: you can make exercise happen. For perspective, remember that 30 to 45 minutes represents just two to three per cent of your day. And in the final analysis, it's a remarkable bargain, since you'll gain about an hour of life expectancy for every 30 minutes of regular exercise. In a sense, exercise will allow you to turn energy into time. You don't have to be an Einstein to see that exercise matters -- not relatively, but absolutely.

2. "I don't like to exercise."
Give it time. The first steps are hardest, but if you stick with exercise for three months, it's likely you'll come to enjoy it. Remember that you don't have to walk, much less run. Everybody likes some form of physical activity -- and the more you do, the more you'll like.

3. "It's boring."
This is an easy one. See "I don't like to exercise" to understand that many interesting options are available. And there's much more you can do to stay amused.

• If you like company, exercise with a friend. Moderate exercise will allow you to chat to your heart's content.

• If you like to watch TV or movies, put a treadmill or stationary bike in front of your TV and DVD player.

• If you like to read, try newspapers, magazines or books while pedalling a stationary bike; if you find it hard to focus, buy large-print publications.

• If you like music, hook yourself up to headphones and a portable player. You can also "read" with your ears: rent, buy, or borrow a book on tape and turn it on while you exercise. For extra motivation, listen to the book only during exercise; there's nothing like an engrossing tale to make the time fly.

• If you like pets, walk a dog.

• And if all else fails, just remind yourself that convalescing from a heart attack or colon cancer surgery is significantly more boring than the exercise that will keep you healthy.

4. "I'm too fat."
It's true that exercise is harder for people who are obese than for the svelte set. But it's also more important, and it's an essential activity for sustained weight loss. Pick a low-impact activity, start out easy, and build up gradually. One caveat: although swimming has many advantages for people who are overweight, it does not promote weight loss as well as land exercise does.

5. "I'm embarrassed."
Get an appropriate machine and exercise in the privacy of your home. Chances are you'll gain the confidence to go public as you get in shape. To speed that up, take a look at the runners in a local road race. They come in all shapes and sizes, and some of the most awkward looking are mighty speedy. Think of the clumsiest exercisers that you've seen; if they can exercise, so can you. If you don't know any athletes who qualify, feel free to think of me!

6. "I don't have the money."
Another easy one. Physically active daily tasks are free -- in fact, you'll actually save money by washing the car or mowing the lawn yourself. You can walk in good street shoes, and when you move on, you can find walking shoes for a low price at outlet stores. Look for off-brands and factory seconds, but be sure they fit well and give you plenty of support and cushioning. Use towels instead of a mat for floor exercises, and buy inexpensive iron weights or elastic bands for strength training. If you need instruction or prefer group activities, check out your local high school, Y or community centre.

7. "I have bad feet [or legs]."
Use your arms. Many health clubs have arm ergometers for upper-body exercise. Try aquatic exercise or low-impact land activities. Best of all, see a podiatrist, an orthopedist, or a physical therapist to get help with your feet and legs.

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Excerpted from The No Sweat Exercise Plan: Lose Weight, Get Healthy, and Live Longer by Harvey B. Simon, M.D. Copyright 2006 by the President and Fellows of Harvard College. Excerpted with permission from McGraw-Hill. All rights reserved. No part of this excerpt may be reproduced except with permission in writing from the publisher.

8. "I have to watch my kids."
If they are infants or toddlers, exercise at home while they nap; pedal a stationary bike while they play or read. Push them in a stroller while you walk. Join a gym that has day care. And when they're old enough, get them involved in a game of tag or hopscotch, or build an obstacle course and race them through it. Plan family activities that will get you all moving, such as biking or swimming.

9. "I don't know how."
Sure you do. Almost any physical activity counts. Even if you've never mounted a bike or held a racquet, you can walk, climb stairs, and do simple strength and flexibility exercises. You can also learn new skills from books, videos and lessons.

10. "Something always comes up at work, and I get home too late to exercise before dinner."
Another common problem. Exercising after dinner is not a good solution, since a full stomach will put extra stress on your heart and circulation. Try to get in a walk or a trip to a nearby gym at lunchtime. Many enlightened companies provide exercise facilities on site; see if you can get your employer to consider adding one -- it's good for morale, and it will cut down on health-care expenses and absenteeism.

Unfortunately, corporate policy is not in your control. Fortunately, however, you can control your own schedule. For many of us that means getting up early enough to exercise before work. You have most control over your schedule before the demands of work and family kick in. And you won't miss the sleep nearly as much as you think. Be particularly careful to warm up thoroughly before early morning exercise, since adrenaline levels, blood pressure, and cardiac risk all peak in the wee hours.

11. "I used to exercise and I felt better. But for some reason I stopped."
Start over, and this time make exercise a part of every day. Keep an exercise log to make sure you don't fall off your bike again.

12. "I get plenty of exercise."
Perhaps. If so, you have my congratulations. But if it's wishful thinking, take steps to make your perception a reality.

13. "My neighbourhood is not safe."
Exercise in your home or travel to a better location. Walk at the mall, join a gym, or walk before or after work or at lunchtime. If you can make time, you can make a place, too.

14. "I'm afraid I'll get arthritis."
You won't -- or, at least, you won't get it from exercise. Moderate exercise in the No Sweat venue is easy on the joints. In fact, even high-impact sports like running are safe for joints. Most studies find no link between running and arthritis, and some actually report that long-distance running is associated with a substantial reduction in the risk of musculoskeletal problems and disability.

15. "I have heart disease [or diabetes, arthritis, or other medical problems]."
You will need medical clearance before you exercise, and you will probably need an individual exercise prescription. Cardiac patients, in particular, should have stress tests and, if possible, supervision in a cardiac rehab program as they learn to monitor themselves. All in all, though, some form of exercise is suitable for most patients, and exercise is actually an effective treatment for many conditions.

16. "I'm too old."
Not likely. Old age is not an illness, but it does require modifications. It's never too late to start; before you use the calendar to cop out of exercise, remember that frail institutionalized octogenarians benefit from strength training. Exercise will actually make your body "younger" at any age.

17. "I'm too tired; I don't have enough energy."
It may be the worst excuse of all. Inactivity produces fatigue and lethargy. Exercise promotes vigour and energy. Try it and see. You may have to drag yourself out at first, but if you stick with it, in time you'll have to hold yourself back.

18. "It hurts."
Most likely you're doing too much too soon or too little stretching and warming up. Learn how to prevent, recognize and correct common exercise-induced aches and pains. If you can't do it yourself, get professional help. Exercise should not be painful, and No Sweat exercise shouldn't even feel hard.

19. "I get winded."
That's exactly why you need to exercise. And always remember to warm up, start out gradually, and pace yourself properly. Healthy people should never huff and puff during moderate exercise.

20. "Jim Fixx."
Even if you don't remember the tragic case of the jogging guru who died while running in 1984, you've probably heard of someone famous who has had a heart attack while exercising. It's rare, but it gets plenty of press. In fact, regular exercise will sharply reduce your risk of heart attack and sudden cardiac death. Moderate exercise is even safer than intense activity, but it's still serious business.

People have lots of reasons for not exercising -- but doctors have many more reasons why exercise should be woven into the fabric of daily life. View exercise as an opportunity, not a chore. Be grateful for all the options and opportunities at your disposal. Above all, consider your priorities. If good health is a high priority for you, exercise will become one, too. Make it happen.

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Excerpted from The No Sweat Exercise Plan: Lose Weight, Get Healthy, and Live Longer by Harvey B. Simon, M.D. Copyright 2006 by the President and Fellows of Harvard College. Excerpted with permission from McGraw-Hill. All rights reserved. No part of this excerpt may be reproduced except with permission in writing from the publisher.