Dan Michael
Dan Michael

Thinking about a worst-case scenario for your movement may sound morbid, but for the purpose of this article, let us assume that for this scenario it is not resulting in any death.

For some, having a movement catastrophe might mean an over-exertion event during a sporting event or practice. Others may experience a rare obstacle in the home or a chance event in public going about their daily lives. Either way, all of us will at some point come up against an unpredictable event that explores the limitations of our movement capacity, and the question you might ask yourself is, “Am I ready?”

How I approach these kinds of problems is to do a holistic evaluation, which can include the patient’s environment, activities, physical condition, psychological state and movement health history. A holistic evaluation needs to be performed because it provides a window into where problems are likely to crop up. For example, in your environment there may be things that prevent you from moving well, exercising like you should or obstacles that pose unusual hazards. The activities you perform on a day-to-day basis may be where you are challenged the most and pose a potential for an overuse event, or it may be that you are building towards an under-use injury by living a sedentary lifestyle. Also, our psychology can change how we move, how we posture, and all of it can cause aberrant biomechanics. Living in a chronic state of stress, depression or anxiety can be the thing that pushes your body past the limit and even make you more sensitive to pain or stimulus. Finally, your movement and health history are most commonly where the main issues reside, such as any past injuries you’ve sustained, surgeries, chronic health issues you may harbor or lack of experience moving well.

How to solve the movement “worst-case scenario” problem and provide movement security has changed in recent years. We used to discuss “injury prevention” as if we could somehow predict these scenarios with some level of certainty, but we now know that humans are terrible predictors of the future, and predicting injuries is no exception.

Alternatively, we now believe that focusing on “injury resilience” is the best approach. The fact of life is that things often happen to us that are out of our control, and your best strategy is to control the things you can and be resilient to the rest. You become resilient by identifying and managing your risks while maximizing your resiliency at an acceptable, reasonable and individual level.

These ideas are better demonstrated by a fictional example: We could say her name is Mary, who is a senior and lives in a three-bedroom home with her husband and a small dog. She plays a leisure sport three days per week and does yoga twice a week. She goes for walks every day but doesn’t quite meet her 10,000 steps a day goal. She has regular medical checks for a chronic thyroid condition that is well managed with medication, and she is post-menopausal. She has had two children and enjoys traveling to visit them throughout the year, but she is unable to manage heavy suitcases since she had a back injury eight years ago lifting a suitcase out of the car at the airport. Now heavy lifting is done by her husband.

Mary knows that her balance is not very good, and she struggles to get up and down from the floor because of knee pain that comes and goes and is managed with over-the-counter medication and rest. She takes vitamins when she remembers and has a family history of cardiovascular disease and arthritis.

Through the example of Mary, it is clear that she has tremendous opportunity for increasing her injury resilience and improving her health profile. Weight-bearing exercise for those at risk of low bone density — osteopenia and osteoporosis — is known to slow, stop or, in some cases, improve bone mineral density in senior populations. Moving, and moving well, is a top treatment for osteoarthritic conditions, and learning effective movement strategies as well as improving the performance of the soft tissues around the area promote resilience to movement stress and strain. It is also clear that there is a spinal issue that has gone untreated and potentially undiagnosed, and there is fear avoidance behavior preventing Mary from heavy lifting. Regarding supplements, Mary likely lives in the Pacific Northwest and is at a risk of vitamin D deficiency and even with supplementation may still be deficient. Ideally, Mary would consult with her healthcare team to address these issues proactively and implement strategies that are practiced on a daily and weekly basis.

If you are unsure how to think about your risks, or don’t know how to prepare for a worst-case movement scenario, contact your healthcare team to assess your unique situation.

If you don’t yet have a healthcare team, or are in need of a provider to act in a movement health capacity, contact our office, and one of our capable providers would be glad to meet with you, assess you and make a recommendation specific to you and your health needs.