Move Well Before Moving More - Physical Activity For Life
This was an article I originally published 2017-09-08. I found it worthy to republish it in connection with the blog post “If you don’t move it, you lose it”.
Today is World Physical Therapy Day, and the theme is Physical Activity for Life. Swedish physiotherapy association recently published a report ‘Tre lyft för Sverige’ about encouraging more movement in three primary areas: young people, workers and the elderly. They comment on the negative health trends that are associated with poor movement and inactivity.
The recommendations are rather common sense, such as increasing physical activity at schools, workplaces and in the homes of the elderly. This has been under discussion for a long time now, with several health professionals and researchers claiming that people of all ages simply need to move more to stay healthy. We think it is more complicated than that.
‘Just moving’ is better than nothing at all, but we should raise the bar a little, and make sure that people are ‘moving well’. Poor movement patterns can lead to injury and pain, which can demotivate participation in physical activity. We all know that being ‘too tired’, or ‘bad weather’ are poor excuses for avoiding exercise, but sitting on the sofa with comfort food is easily justified when ‘it hurts to move’. And this may very well be the beginning of behaviours that lead to lifestyle disorders such as diabetes and depression. If we dare to think prevention rather than cure.
Sports medicine aims to keep people on the field and playing at their best. It uses movement analysis and individualised recommendations for prevention and return to activity. Why don’t everyday children, workers and elderly get the same level of individualised advice as elite athletes? Prevention is certainly on the EU health agenda, the public want it, the tools are available and the health economics make sense. Could it be healthcare workers, that are stuck to their traditional ‘way of doing things’, that are getting in the way of progress?
We frequently test blood, psychology, and DNA, but rarely biomechanics. Strange, considering that good function enables a good quality of live, and a long list of health benefits that could improve our blood values, mental health and even our DNA. The movement system (Sv - rörelseapparaten) is consistently referred to as the one factor that can prevent or remedy so many chronic and expensive health problems (diabetes, depression, Alzheimer’s, osteoarthrosis, falls). A lot of money has been spent on researching and reporting this. Now it is time to do something about it, using a scientific approach to individualised exercise prescription, rather than cheap and cheerful analogue assessments and one-size-fits-all recommendations that frustrate both health seekers and health providers. We pay more attention to the longevity of our motor vehicles than we do our own bodies. Our cars have a regular roadworthy test (Sv - bilbesiktning), to detect and fix small problems that can lead to large and expensive problems. These measures are digital, standardised and fast. However, when it comes to the one and only ‘vehicle’ we were born with, the body, an inspection consists of some analogue ‘eyeballing’, scribbled notes, and a subjective opinion that launches into a clinical assessment or some pet recommendations.
Sweden has the lowest vehicle accident rates in the world, partly thanks to annual detection and prevention of functional problems in cars. It costs a few hundred kronor each year, but it saves tens of thousands for the owners, and billions for the nation. When something as obvious as falls in the elderly cost Sweden 23b kronor per year, why is there no mandatory digital inspection of movement and balance in the aging populations? The existing ‘fix it when it is broken’ mentality is bankrupting healthcare, whilst quality services are being paralysed by shrinking budgets.
It is not just athletes and cars that need to function well to remain healthy, and perform well. We all do, to have a quality lifestyle and contribute to society through family, work and recreational activities. Our movement experts, such as physical therapists and person trainers, need the tools and the incentive to upgrade from an analogue shotgun approach to a digital sniper approach when targeting movement related problems. To be injury free, and maintain a high quality of life, children, workers and the elderly need to move well, not just move more. Most movement experts have met a ‘knee patient’ that becomes pain free, but then develops recurrent back pain because they have altered their walking pattern. Most coaches have met a teenage girl with poor knee control, who tears a knee ligament playing soccer. Very few of them can show you objective evidence of how they move, and how they have progressed over time. This is hardly evidence-based practice.
Most general practitioners, and some physiotherapy researchers suggest that simply walking in the park three times per week will solve our problems. Indeed, it may be good for the soul, and easy on short-term health budgets, but it is too non-specific to help people move well, and therefore enjoy being active throughout their lives. Poor movement patterns stress the body, potentially causing new problems and unnecessarily exacerbate existing ones.
Move well before moving more!