In Sickness
I have a personal and professional mission to help people move. Helping them move with no pain while accomplishing their goals and enjoying life. Movement is everything. But we don’t give it the credit it deserves in our society today. Lack of movement (which could be considered “sickness”) is leading to many of the issues we face in medicine and movement health today. What would be reasons why someone is unable to move? First things that come to mind is physical size restrictions (obesity) or because it hurts (chronic pain). Here’s some food for thought:
- More than one-third (or 78.6 million) of U.S. adults are obese.
- A 2005 study published in the New England Journal of Medicine confirms that, given the current health trends, today’s young people are not expected to outlive their parents for the first time in U.S. history.
- Overweight and obesity rates have doubled among children and quadrupled among adolescents in the past 30 years.
- Annual health care costs of obesity that are related to disability are estimated at approximately $44 billion.
- Back pain affects 8 out of 10 people at some point during their lives.
- About 2.4 million Americans are disabled due to chronic back pain.
- Low back pain is:
- Second leading cause of lost work time (after the common cold).
- Third most common reason to undergo a surgical procedure.
- Fifth most frequent cause of hospitalization.
Obesity and chronic pain are not new issues. The solution to these issues is within grasp, however. We all know that exercise paired with a healthy diet is a proven way to lose weight and stay fit. So what are we missing here? Why don’t people just make a change?
My answer to this problem is that: THEY DON’T MOVE 
WELL.
What happens when we don’t move well?
- Chronic Injuries
- Degeneration aka. Arthritis
- Arthritis is a more frequent cause of activity limitation than heart disease, cancer, or diabetes.
- Limited Range of Motion
- Pain
Which all lead to…..EVEN LESS MOVEMENT.
Why don’t we move well? How has our movement gotten so “sick?” Humans have amazing physical abilities but we spend most of our time in cars, sitting at desks, or sitting at home. This sedentary lifestyle is changing everything from technology to medicine. It has caused a shift in the common types of injuries from the acute, high-force-trauma injuries to chronic, repetitive-motion trauma injuries. It’s changing the way we rehabilitate and treat our patients no matter the injury. For example, if a high school baseball player injures his shoulder, his posture during the 6-8 hour school day can make/break his recovery time. Along the same lines, if a patient has an hour each way commute to his 8-hour desk job and then hits the gym on the way home for an hour, he just trained his body how to sit for 10 hours, and how to move for one. See the problem?
IN MOVEMENT
So, how can someone regain control of his or her life and movement? Well, it’s a process. Just as it took many years to develop the diseases and dysfunctions, it will take time to restore healthy movement and function. In my practice, I address movement in the same order that we developed it. This means taking a look at how humans develop from infancy to adulthood and what movement patterns are learned at certain times. Movement patterns are a key link to finding and fixing chronic pain problems. We tend to look at the body with a “machinist” point of view.
For example: Someone injures his or her knee. The knee is examined with tests and imaging and as soon as there is nothing wrong with the structure of the knee, it should function properly right? WRONG. The body is a living, fluid, linked system of locomotion and while each piece does play a specific role, it is the combination of those roles that accomplish each movement. These movements are programmed into our DNA and are expressed with patterns that are stored in our central nervous system. Instead of the reductionist or machinist mind frame, we must take a more holistic view of human movement to truly make long-lasting changes. When addressing the body holistically, I look at four main parts to ensure each patient has functional motor patterns.
Mobility
The first thing to address is mobility. To be able to have functional movement, the range of motion of the joint(s) needs to be addressed first. In development, a baby is born with all the mobility in the world and must earn its stability. A joint needs to have a range of motion to control! It’s important to have a professional evaluate movement whether it be doing an orthopedic evaluation (when there’s pain) or utilizing tools like the Functional Movement Screen (when there’s no pain). Mobility work includes manual therapy, specific joint mobilizations and adjustments, foam rolling, dynamic warm-ups, among many others. Each patient/case is different and will benefit from different combinations of treatment.
Stability
Once mobility has been established in a segment or joint, it is important to then address the stability of that segment. This step is paramount to the long-term success of the rehabilitation process. If a patient is treated for a mobility problem without then addressing the stability, we’ve just introduced motion to the body that it might not be prepared to control. This is where training the motor pattern comes in. Dysfunctional patterns have taken time to set in, and reestablishing good patterns takes time, effort, and practice. This is accomplished with both supervised functional training in the clinic, at-home exercises, and coordination with personal trainers and strength coaches. Each patient is different, and it’s important to find the most challenging pattern that can be executed well, and continuing to progress as patient coordination improves.
Strength
This is where there’s the most general knowledge and usually where people start instead of addressing mobility and stability first. WITHOUT PROPER RANGE OF MOTION AND CONTROL, ADDING STRENGTH WILL ONLY STRENGTHEN THE PRESENT DYSFUNCTIONS. This reason (one of many) is the most important reason to get proper professional evaluation before starting an exercise program. This evaluation has to go above and beyond the basic physical. If you are going to load the joints of the body with weights for strength, the body better be biomechanically prepared for that weight or injury will occur. Period. It’s not a question of if, it’s a question of when. Once evaluated and cleared, each program should be different and geared towards the goals of the patient. This is why it is important for each clinician to have quality exercise and movement professionals to refer to and vice versa.
Performance
This is the fun part! Once the other three areas have been addressed – we get to talk performance! This is the sport or activity-specific tasks that the patient needs to accomplish in order to accomplish their goals. Performance goals include speed, power, agility, and durability. It doesn’t matter if the patient is a professional athlete or a grandparent wanting to play with his or her grandkids with no pain, each patient’s goals and expectations should be outlined and their rehabilitation program should be designed with those in mind.
Addressing each of the above components in the right order for each patient will not only lead to quicker results, but also results that are long-lasting and allows the patient the freedom that comes with functional movement and the chance to live their lives with more ability.
Our motto in our practice is: Movement is the Medicine… How’s yours?
Dr. MaryAnne Harrington is a Sports Chiropractor and owner of Maximum Performance Chiropractic. She holds an, M.S. in Sport Science and Rehabilitation, M.S. in Nutrition and Human Performance and is Active Release Technique® Certified. She can be reached my email drma@maxperformchiro.com
Sources for statistics:
- http://www.cdc.gov/obesity/data/adult.html
- http://www.nejm.org/doi/full/10.1056/NEJMsr043743
- http://www.cdc.gov/ncbddd/disabilityandhealth/obesity.html
- http://www.acatoday.org/level2_css.cfm?T1ID=13&T2ID=68
- https://www.healthypeople.gov/2020/topics-objectives/topic/Arthritis-Osteoporosis-and-Chronic-Back-Conditions
