One reason some Black women don’t work out regularly is because they worry about maintaining their hair. Now, a new study published in the Journal of the American Board of Family Medicine suggests that most primary care doctors encourage physical activity, but don’t understand how hair care can be a barrier to a fit lifestyle among their African-American female patients, reports The Ohio State Wexner Medical Center

According to the Centers for Disease Control and Prevention, 56% of Black women, age 20 and older, are obese, which puts them at greater risk for heart disease, diabetes and stroke. However, these conditions could be managed with physical activity.

For the study, researchers surveyed doctors, nurse practitioners and physician assistants in the family medicine department at Ohio State. Of the study’s participants, 95% reported sometimes or often engaging in discussions about exercise with Black female patients. But 76% of these participants said they never included assessments for styling or maintaining hair in those discussions, and just 34% expressed being comfortable addressing such topics.

Physicians need to have conversations with Black women patients about how hair care interferes with their ability to exercise to help them find solutions so they can stay physically active, suggested Sophia Tolliver, MD, MPH, a family medicine doctor at the medical center and a clinical assistant professor at The Ohio State University College of Medicine, who led the study.

“It’s going to come down to increasing education about African-American hair, African-American females’ cultural practices when it comes to hair and how you can counsel a patient in an office visit about decreasing that barrier,” Tolliver said.

For Black women who want to exercise more, Tolliver offered the following tips to help preserve hairstyles while exercising: Start with a low-impact exercise, such as walking, to minimize perspiration; try protective hairstyles, such as braids, twists, buns or extensions, for workouts; and schedule more strenuous workouts on the days you plan to wash your hair.

Click here to read how many dermatologists lack medical expertise in treating Black people’s skin and hair problems.