Move well before moving more to achieve physical activity for life.

Today is World Physical Therapy Day, and the theme is Physical Activity for Life. Swedish physiotherapy association recently published a report 'Tre lyft f?r 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 demotivates 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. Poor movement is quite possibly a pre-clinical milestone that is too easily ignored, albeit a key ingredient in achieving prevention rather than cure of costly lifestyle diseases.

Sports medicine aims to keep athletes on the field and playing at their best by using movement analysis to inform individualised recommendations - for prevention and return to play. 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 is demanding it, the technology is available, and the health economics make sense. Could it be that healthcare workers are stuck in their traditional ‘ways of doing things'and this is simply getting in the way of progress for everyday people?

We frequently test blood, psychology, and DNA, but rarely biomechanics. Strange, considering that good function enables a good quality of life, and a long list of health benefits that could improve our blood values, mental health and even our DNA. The movement system (Sv - r?relseapparaten) 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 to government and insurers. It is about time all physical therapists implemented 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 23 billion kronor per year, why is there no mandatory digital inspection of movement and balance in the ageing 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 need good function to maintain a high quality of life and contribute to society through family, work and recreational activities. Our movement experts, such as physical therapists and personal trainers, need the tools and the incentive to upgrade from analogue shotgun approaches to a digital sniper approach for targeting movement related problems. These disorders affect 1/3 of the population!

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 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 their clients move, and how they 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 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!

Glenn Bilby

Human Movement Scientist

Physiotherapist

CEO Qinematic