CHALLENGING TIMES?Previous generations did not have to cope with the processed foods, unsaturated fat and sedentary lifestyles of today.
I was invited recently to get involved with CongRegation Technology Festival in, you guessed it, Cong. The weekend centres on an ‘unconference’, whereby all attendees give short presentations on their chosen topic to small ‘huddles’ in various venues around town. This year’s theme is ‘The Future’, which naturally got me thinking of the future for physiotherapy, and my place in that.
In preparing my own presentation, I looked for some inspiration in the topics of others, and noticed how often the idea of looking to the past in order to assess the future arose. I think that is what most branches of the medical, health and fitness industries need to be doing; taking heed of the positive and negative lessons of our past, and only changing things that need changing, or indeed unchanging the things that don’t work. In the words of Albert Einstein, ‘Everything should be made as simple as possible, but not simpler’.
From a physiotherapy perspective, there are already signs of such changes happening in the field. Early research that showed a link between the deep abdominal muscles and back pain led to an obsession with core stability exercises and ‘activating the core’ before doing anything at all. I’ve lost count of the number of people I’ve met who used to walk around pulling their stomach in all day long in the hope of protecting themselves from back pain!
Studying the last remaining hunter gatherer tribes, and getting a glimpse into our past, I believe gives a better indication of what we should be doing. These groups report almost no back pain, and yet none of them have ever tried to activate their core. Why? They have to walk everywhere, squat rather than sit and don’t lock their feet into ill-fitting shoes that compromise their balance. All pretty good for core stability! Of late, physiotherapy research and treatment is tending more towards a whole-body approach, rather than obsessing about the specifics.
Learn from the past
Would the medical world benefit from a look back? Very much so. In recent times, medicine has tended to be about medicating. There’s a prescription for almost everything, and in some ways as consumers, we expect that. The obvious example here is Type 2 diabetes. US statistics show that less than 1 percent of the population were diabetic in 1958; by 2008 that figure had risen to 18 percent, with the most rapid rise coming in the last 20 years.
I firmly believe that rather than relying on drug companies to solve this problem, we should be looking back 50 years to see where the differences lay in terms of diet and lifestyle. Everyone’s favourite bad guy here is sugar, but that is far too simplistic. What about the processed foods and unsaturated fats that have become far more prevalent? And my own favourite, the inherent laziness of society? All work is automated and everyone drives everywhere.
A study published in 1984 found that diabetic Australian Aboriginal men who temporarily reverted to a traditional lifestyle showed either marked improvements or complete normalisation in sugar and fat metabolism. They either got rid of, or significantly improved, their diabetes with a combination of weight loss, reduced fat intake and increased physical activity. Not a tablet in sight. Unfortunately in Western society, we are relatively cash rich and time poor, and would rather take a tablet and hope for a cure than take ownership of our own problems.
It is this ‘cash-rich, time-poor’ cohort that drives the fitness market as well. We all want our six-week bikini body and the industry knows that, so they cater to it with high-intensity classes that get results quickly, but that aren’t sustainable in the long term.
Looking back again, Arthur Lydiard, who is widely regarded as the greatest distance-running coach of all time, had a rule that all athletes completed a six month aerobic phase – with no track or high-intensity sessions – every year. If we look at the top African runners, they have all run huge distances over the course of their lives, constantly building a base from which they can take the next step in their racing careers.
The high-intensity work in both these approaches is the icing on the cake, not the cake itself. Perhaps that’s why the top African runners look healthy at the start line, while the European athletes look haggard.
Is the future bright, then? Sure. As long as we don’t try to write the past off as the dark old days.
> Andrew O’Brien is a chartered physiotherapist and the owner of Wannarun Physiotherapy and Running Clinic at Westport Leisure Park. He can be contacted on 083 1593200 or at www.wannarun.ie.