Am I in Good Health?Monday 23 July 2018
Am I in good health?
On Saturday 14th July Charles and I are taking part in a 6 person relay swim around Jersey. This is an endurance event that will test us physically and mentally. With only a few days till the event, one starts to question whether our training and fitness are up to the task. With this in mind I was lead to ponder the meaning of a question that is on our New Patient Form: "Do you consider yourself to be in good health?".
What is good health?
If you don't have the 1948 WHO definition of 'good human health' to hand here it is:
"a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity".
As a chiropractor it is unlikely that I will see many patients enter my clinic who can claim to be in a state of "complete physical" wellbeing, but I try to set them on the right path by the time they leave.
Without reference to the WHO definition I would happily have stated that I was in good health - not suffering from an illness, not overweight and I have pretty good cardiovascular fitness. But, watching my two boys jump around and roll about on the floor I saw their movements were fluid and uninhibited as they got up (repeatedly). They weren't interrupted with moans, groans and awkward pain avoidance postures. Can I do this? Can my patients do this? Would the ability to move from lying on the floor to standing without pain or crutch be a better measure of good health than the aspirational WHO definition? I think it is. We start and end the day by getting up and lying down, so the ability to do it with ease, like a child, is something that is measurable, obtainable and desirable.
I later considered my new definition of good health when assessing a new patient. Mr J, a 50 year old male, no underlying illness, no medication, goes to the gym three times per week where he predominantly lifts weights. He confidently claimed that he was in good health. He looked in good shape and according to his account had a healthy diet.
I asked Mr J if he could get up from the floor without using his hands:
"No chance! I haven't been able to do that for as long as I can remember. I'm always tight when I get out of bed and I have to ease myself out slowly. To get off the floor I have to get onto one knee, use my hands and push myself up" was the reply.
So, Mr J can repeatedly bench press 150kg but he can't get up from the floor or out of bed without using his hands, straining and groaning. I doubt that Mr J is an isolated case- many people accepting reduced range of motion as part of the aging process. If we are to live longer active lives, we need to ensure that our bodies remain mobile.
I now encourage patients (who are free from injury that would preclude it) to practice this movement pattern: lie supine on the floor, relax then slowly and gently get to your feet, without using hands and whilst exhaling. Then gently reverse the movement pattern to supine lying again and repeat. A common mistake that people make is to hold their breath when moving to a standing position or exerting themselves. Holding your breath creates tension in the body and restricts movement, so remember to exhale. A toddler's breathing and movement is relaxed and unrestricted- this is what we should all be aiming for- to move and breathe like a toddler.