Hip Flexors are More than Trouble Makers

Do you have low back pain that has been around far too long? Hip Flexors may be a contributing factor, so learn what they are and why they matter.

To put it simply, the hip flexors are a muscle group that works together to bend the hip, bringing the legs up towards your chest. If only it was that simple none of us would have low back pain, knee pain, pelvic floor issues, groin tightness, etc. The list can go on and on connecting the hip flexors to some pain or dysfunction. But the hip flexors are so much more than trouble makers, in fact, they are three very powerful muscles, the psoas and iliacus (often referred to as iliopsoas, pronounced like illy-oh-so-as) and rectus femoris (our main thigh muscle) We would be lost without them all work in concert to produce movement like kicking, walking, sprinting and dancing. These muscles are largely focused on bending the leg at the hip but the psoas muscle also helps to turn our hips outward like a ballet dancer (external rotation) and bend our trunk forward to pick up a box. The iliacus muscle also contributes to turn the hip out, but it is big helper in getting you up from laying on your back and swaying side to side like you are dancing at high school prom. Rectus Femoris has two purposes it bends the hip and straightens the knee (not shown in the image). The images below show how the muscles attach to the body.

Hip Flexors: psoas and iliacus

Tight hip flexors can put additional pressure on your spine that can contribute to lower back pain. They can also cause some exaggeration in the curve of your lower back which we often call sway back.

If the hip flexors are not working optimally, other muscle will try to jump in and do some of the work. The body is very good at coming up with compensation patterns to keep us moving. Other muscles that may start to do more work than they should include the glutes (butt muscles), the core (deep tummy & back muscles) and the pelvic floor (your pee stopping muscles). An imbalance in use of these muscles can result in some muscles overworking, while others are “underworking”. The result can be low back pain, strained posture, sacro-iliac ‘SI’ joint pain and pelvic floor issues.

The pelvic floor muscle group (muscles that make up the floor or bottom of our torso) plays an extremely important role with regards to support and stability of reproductive organs and other internal organs. Without the pelvic floor muscles all our organs would fall down because of gravity. Issues can occur if extra stress is placed on the pelvic floor muscles (sometimes related to shortness in the hip flexors). The pelvic floor muscles may start to “overwork” which may lead to an inability to “relax” this muscle group which can lead to potential pee leakage (incontinence) and/or low back or pelvic pain. On the other hand, the pelvic floor muscles may start to “underwork” as a result of mixed signals coming from other, overworking muscles. This can also lead to leakage, bowel incontinence and pelvic organ prolapse, where the organs start to fall down due to gravity and lack of support.

So, do you pee a little when you laugh, cough or sneeze? Do you have low back pain that seems to never really go away with trying many different treatments? Do you feel a ‘fullness’ in your pelvic floor that gets worse with long periods of standing? Well, a thorough assessment, stretching and strengthening routine with this added awareness of how some of the muscles in the lower body function would be a great place to start tackling some or any of these issues!

Don’t Let the School Grind, Grind YOU!

As October starts, the back to school grind winds to a close and we all start to settle into the routines of the coming months. It may be time to talk about staying healthy while you’re a student.

There are the basics, like remembering to wash your hands regularly, now that you’re back in close quarters with a bunch of other humans, so you avoid sharing any germs with one another. Sleep hygiene also becomes important, as parents have to re-adjust their schedules to make sure kids get to school on time and adult students have to get used to the reality of 8am class times. Let’s not forget the long term stuff as well, like muscle aches that happen when you are stuck in a classroom for hours on end with ergonomically questionable seating. Students also run into issues prioritizing self-care when balancing multiple deadlines and course work. Academic pressures can result in students experiencing higher levels of depression compared to the general population, and in some cases can go as far as burnout. Parents can struggle with the added stressors of daily after school programs and scheduling and the ever stressful forgetting cupcakes or signing the field trip notice.

Let’s start tackling the physical issues: The time demands of student life can make it difficult to maintain a consistent workout schedule, and some weeks eating a balanced diet goes out the window because you’re lucky if you can grab a slice of pizza before your next class. Add all that to increased time sitting in awkward positions in chairs and desks that often seem designed for 5 minutes of sitting only. All these are a recipe for sore muscles and unfamiliar aches and pains.

Here are a few basic tips that we have found can help (the Lab Health team is as close to experts on this a possible as we have a collective 3+ decades of post secondary experience to draw from)

Plan Ahead. Map out your semester so you know where the major deadlines are, when you are going to be in a time crunch.

Find meals that are quick, easy, and at least semi healthy

E.g. hardboiled eggs, frozen pre-cooked chicken with salad mix, etc. This website https://www.budgetbytes.com/ has provided some really tasty meals that are simple and budget conscious. Consider investing in a slow cooker (They are often found for ok prices at thrift stores) – they are both a time and a money saver when you’re stressed out.

If money is an issue (which student doesn’t have this issue?), consider checking out volunteer opportunities with student organizations who pick food for food banks and allow their volunteers to keep a portion in return (add to the resumé AND FREE food, too!). http://gleaning/Lifecyclesproject.ca/signup

If you have a sport/activity you are interested in or passionate about, consider joining a club or student organization. The social aspect can help keep you going.

Take a water bottle with you – dehydration just sucks.

Keep moving. If you are one of those people who is able to sit through a whole class without fidgeting, you are amazing. But you should still consider moving despite your superpower. Sitting still for long periods of time can result in sore muscles and can do long-term harm in terms of muscle imbalances and eventually osteoarthritis. Stretch breaks, shifting positions and begin active between classes and study sessions can all help.

One trick that is great is you can convert your notes to word documents and then have your phone or other smart device read them to you while you go for a walk or work out. It is call Kinaesthetic learning and the research says the information will last with you longer and you can study while being active!

Mental health. As for burnout and depression some of the tips above can be help. The key thing to remember is that academia/post secondary school is a snippet in time just like any other phase in your life, it too shall pass. Try your hardest, have fun and make sure to take some time to remember the reason you are there. Keep in mind that school exists to evaluate you and your understanding of a particular subject. It is important to maintain ties to aspects of your life where you feel accomplished or the constant grading of school can be wearing. It is also important to recognize that the feeling of being not enough or overwhelmed is very common, and that most academic institutions have counselling services available to their students at a reduced price or free.

Student life is hard, often overwhelming and expensive. It can also be rewarding, fun, and provide some of the best times or your life. It can help you to pursue career, life opportunities and relationships that you might not have otherwise experienced or developed. So remember, the crazy weeks will happen and the deadlines will pass and it will all be ok. Some weeks, no amount of planning or determination will stop you from feeling like the workload is getting the better of you. So order that pizza, study your face off and remember that tomorrow is another day.

University of Victoria Mental Health Support Resources:https://www.uvic.ca/mentalhealth/home/immediate/index.php

Camosun College Mental Health Support Links: http://camosun.ca/about/mental-health/students.html

Royal Roads University Food Bank and Mental Health Links:http://www.royalroads.ca/current-students/food-bank http://www.royalroads.ca/current-students/counselling-services

To Foam Roll or NOT to Foam Roll??

Is Foam Rolling going to be the NEW cupping of the 2018 Winter Olympics?

PyeongChang 2018 is on the brain, all over media and everywhere around us. This might remind you of the Summer Olympics of 2016 when Michael Phelps created quite a stir with his use of cupping for his shoulders and back. Athletes are always looking for an advantage on and off their playing field. They can’t always have their team of therapists around them and neither can you! So many people use foam rolling or trigger point balls to help with their pre and post training performance.

What is Foam Rolling? Foam rolling is the use of a stiff, smooth or nubbley foam/padded cylinder to ‘mush’ out soft tissue. It feels very uncomfortable… which makes us feel it might be needed. It definitely does not follow the fail safe adage “if it feels good do it” because it does not feel good, immediately. However, if you give it a try, even every other day for for a few weeks, you’ll notice it hurts less and you tolerate it better.

But does hurting less actually mean that you have caused a beneficial physiologic change? Like increasing range of motion, decreasing tightness and improving performance? You may hear people claim foam rolling reduces fascial (skin-like covering on muscles) restrictions, increases length of muscles, tendons, IT Band etc, improves strength output and the list goes on.

What does the peer-reviewed research say about foam rolling? We’re not sure if foam rolling does cause any of the above claimed physiological changes, but the latest research does tell us that foam rolling is effective in reducing pain perception after post workout soreness or delayed onset muscle soreness (DOMS) (Romero-Moraleda et al. 2017). Self-massage (assuming foam rolling falls into this category) has also been found to significantly improve stretch tolerance and flexibility when compared to a normal held stretch (Capobianco et al. 2018). Foam rolling even shows decreasing muscle sensitivity through muscle brain pathways, which may explain post-rolling improvements in range of motion and pressure tolerance (Young et al. 2018). However, like anything there is also a whole host of research that disagrees or finds that foam rolling has no significant positive effects.

So how do we decide whether it is right for us or not?  Some examples of situations where foam rolling may be appropriate are:

  1. Do you feel you have more tightness on one side compared to another, in the thigh for example?
  2. Do you have one-sided pain?
  3. Do you get really sore after a workout, in your calves for example, and want something to do after your workout to try and reduce this?

How do you foam roll? You may be among the crowd that looks at the foam roller and has no idea what to do with it, but would like to try without looking like a fool in the process. I have many patients say they have seen people using it in the gym and cast an awkward stare while trying to figure out what they are doing. They have even gone to Youtube for video instruction avoid looking silly. Check out ours below to learn how to roll the calf. Or you may be of the group that has figured out a few things that work for you, but would like to know some new tips and tricks. No matter what group you fall into, below are a few easy to follow instructions to get started.

DOs

  1. ROLL large meaty muscle bellies ​​examples: calves, thighs, glutes, hamstrings
  2. ROLL every other day, no more than 2-5 mins to start
  3. Stay below your shoulders and above belly button

DON’Ts

  1. DO NOT Roll over bones close to the surface examples: shin bones, hip bone, knee cap, elbow, sitting bones
  2. DO NOT roll your LOW BACK
  3. DO NOT roll your tummy or chest

MAIN MESSAGE Try foam rolling every other day or after your workouts for 2-5 minutes for at least 2-3 weeks and notice if you feel better or not. If you don’t then don’t waste your time. If you do, then keep it up and maybe try new areas of the body to foam roll, like the lats or the middle back!

Check out our foam rolling video for how to progress from basic to more advanced calf rolling! As always, if you have any questions comment below or email at [email protected]

Turn Back Time: choosing your priorities instead of having them chosen for you.

Yes, we know you’re thinking “Don’t you know I would have done the exercises if it was that easy??!!!” One of the biggest concerns we hear from our patients trying to complete their exercise or postural homework is not being able to find the TIME.

We get it, you’re busy and you’re human, so when family, work, household, school, relationships, sport, hobbies, health issues, meal planning, vehicle maintenance and caregiving get in the way we understand; it all takes time. The idea of adding one more thing to your already packed schedule is a daunting request because in addition to your HOMEWORK, we also want you to prioritize some time for some occasional downtime, R&R, and maybe just once in a blue moon, sleep.

We do our best to make sure that what we ask you to do can actually fit into your schedule as it stands. For example:

  • Postural or core exercises you can do while sitting at your desk,
  • Ankle stabilizing you can do while sitting down to catch up on reading or while watching your favourite TV show
  • Balance training works great while you’re brushing your teeth or waiting for the kettle to boil

These are some ways we try to help you recover and improve without having to find extra hours in your day.

So how to do you go about making the ‘choice’ to take back your time? Well, firstly, you need to list all of your ‘duties’. For example, picking up the kids, going to coffee with a friend, making homemade cupcakes for the whole class on your child’s birthday, always supervising the neighbourhood kids when they’re out playing in the street, taking on the extra tasks at work when you are already overloaded, completing your physio homework everyday, etc. If you have a partner get them to do a list as well. Not so you can say my list is bigger than yours, but so you can equitably go through the lists to make sure you both have things that build you up or fill up your bucket!

Once you have made your list, itemize it based on three categories:

  • I must do this (things that just got to get done and it HAS to be ME, like going to your job!)
  • I love doing this (things that fill up your bucket)
  • You can do this (‘you’ can mean anyone, the neighbour, the partner, a grandparent, the child, etc.)

Some things that fill your schedule are inevitable, like work (unless you’re independently wealthy or have a sugar mama). The same goes for basic household maintenance and food: they have to happen, but take in the consideration of delegating some of those task and transitioning them to another capable human. Just remember, relinquishing the task will give you time. Try and somewhat ignore the execution (it will get better and closer to your standard) and don’t forget to be happy in the task’s completion!

If you have children or any other dependents, they will also demand a certain percentage of your time and sometimes that may fall into your ‘I love doing this’ time. This can be used as a teaching and transitioning opportunity. Kids thrive on boundaries and clear expectations so even though they are very young, children can have tasks that help the household run (not chores)!

Just remember it is freeing to acknowledge to yourself that you haven’t made that coffee date with so-and-so for three months because it is not really a ‘I love doing this’ task. Recognizing that you would rather eat with your family than shred those last 15lbs down to your ‘goal’ weight is important. Knowing that for you, getting at least seven hours of sleep matters more than meeting people for drinks at 10pm. With clear boundaries and social supports, some of the burden of those ‘I must dos’ can be managed on your schedule while the, ‘you can do this’ task delegation, can free up time from your schedule for those ‘I love doing this’ tasks!

After itemizing, make sure you organize how to give up/transition the ‘you can do this’ tasks to the appropriate winners. Also, make sure you have at least one ‘I love doing this’ on your list everyday. Finally, make sure that your ‘I must do’ list matches the ‘I must do’ list of your partner.

Summary

  1. Make your duties list (it may be extremely long)
  2. Itemize the list by the three categories
  3. Put your itemizing in to action, transition and shuffle tasks that need to be shuffled

Basically, this is about getting to know yourself, and what you prioritize. When you take a step back and recognize that many of the unreturned phone calls, emails, or event invites sitting at the edge of your consciousness are things you simply don’t love/need to do. Prioritizing opens up the possibility of making conscious choices in how you spend your time. Instead of getting caught up in the never ending deluge, you can pick your path. And maybe, just maybe, you’ll actually get to do some of the things you ‘love’ with a little time for a few physio exercises thrown in along the way!

SUMMER SKIN SAFETY

Making skin checking super simple. Learn the ABCDE’s of skin freckle and mole checking. Sometimes the biggest issue is being able to see those spots on your back that you just can’t get to. Just follow these simple rules to know when to see your doctor to get checked out. Skin cancer prevention starts with sunscreen, covering up and limiting peak sun hour exposure!

melanoma asymmetry

A = Asymmetry

Look for moles that lack an even shape. If one half of the mole is different than the other half.

melanoma border check

B = Border

Look for moles that have jagged or rough edges.

skin cancer check for colour

C = Colour

Look for moles that do not have the same colour all over.

D = Diameter

Look for moles that are larger than a pencil eraser (6mm).

mole check for changing shape and size

E = Evolving

Look for moles that are changing or evolving.

Make sure to check your skin on a regular schedule. Plan it around when you change the oil on your car or on the first day of every new season, spring, summer, fall & winter. Pick something that reminds you at least every couple months. Put a reminder in your phone!

Road Trip: Stop neck and arm pain at the pass

Whether you are driving your ‘big rig’ or your family car, van or truck, use the posture that best suits neutral spine alignment.

Neck or rather arm pain is very common when driving! Everyone thinks it is due to how their arms are up on the steering wheel or that they are gripping too hard or that gravity is reducing the circulation. All of these things are possible but if they were the case, the feeling should go away completely when you bring your arms into a more relaxed driving position or when you change activities.

What can commonly be occuring is that you might be experiencing ‘referred’ feelings coming from your neck or your shoulder.

What is a referred feeling (pain, tingling, numbness, etc.)?

Referred feelings are sensations that are felt in an area that is not the origin of the feeling. For example, most people have heard of Sciatica. This is a referred feeling often but not always coming from irritated nerves in the lower back and then causing downstream feelings like pain in the thigh, calf, ankle, etc. You can also get referred feelings from tight muscles.

So how do we tackle referred feelings?

Most often there is an irritant or two in the activities that you may do everyday. Unbeknownst to you the way you are doing those activities, stretches or postures you might be contributing to the referred feeling sticking around way too long! Pay attention to the feeling when it is really subtle and what activity you are doing at the time. Make a mental note to avoid that activity for a least a week and see if that decreases those annoying referred feelings. For example, it might be as simple as not crossing your legs or putting your hand on your hip.

So how do we get rid of the neck and/or arm pain while driving?

Try these Three Tips:

1. Make sure your seat is at about 100 degrees of incline

+ So set the backrest not perfectly straight but not sloped way back

2. Make sure the back of your head is touching or nearly touching the head rest

+If it is a long way back and when you get your head there and you are looking up to the ceiling then just try to keep your chin tucked in and get as close to the head rest as you can while still having your eye level with the horizon (see below)

Driving Posture

3. Make sure your arms have at least a little bend in them

+Your arms should not be fully extended where your elbows are locked, they should have at least a relaxed bend at the elbow

Neutral Driving Posture

Enjoy your summer road trip and remember to get out and stretch your legs and enjoy the sights, the viewpoints and the monuments.

Have a GREAT Summer and drive SAFELY!

Spinal Stenosis, What???

Are you experiencing pain in your back with walking? Stiffness in your back in the morning that lasts for less than 30 minutes? Are you more comfortable leaning on a grocery/shopping cart? Are you getting symptoms like numbness, tingling or pain down either one of your legs?

OR

Have you seen your doctor for back pain and been told you have Spinal Stenosis?

All of this can sound foreign and scary especially if you haven’t had back pain before. What this article sets out to do is to give you comfort that there is a lot you can do to manage your symptoms and keep your quality of life. If you are not sure what is causing your back pain consult a Physiotherapist or Physician for help.

What is Spinal Stenosis?

Spinal Stenosis/Foramen stenosis is the narrowing (stenosis) of the opening (foramen) on either side of the spine where the nerve comes out that supply our sensation and muscle movement.

Spinal Stenosis Low Back Pain

Reasons why Spinal Stenosis occurs:

  • Age
  • Natural change in the spine over time
  • Loss in disc height between the vertebrae
  • Arthritis around the back joints (bulkier joint with some boney growths (osteophytes))
  • Family History
  • Sedentary Lifestyle

Most commonly we see spinal stenosis in the neck (cervical) and low back (lumbar).

Why do I feel pain, tingling or numbness in my legs or arms?

Often this can be related to the Spinal Stenosis where the nerve that innervates the affected arm or leg is irritated where it exits through the foramen at the neck or low back because it is being encroached on by the smaller nerve opening (foramen). There are also other causes like, Multiple Sclerosis, pinched nerve, nerve damage, tumour, Diabetes, etc. Make sure to check with a clinical professional if this is occurring.

Why does my back feel worse with walking?

Walking keeps the curve of your spine in an backward arched position which causes more closure of the foramen (the holes on either side of the spine where the nerves exit from).

Why do I feel better leaning on a shopping cart or counter, etc?

When you bend forward, you mechanically open the foramen in the spine taking pressure off the irritated structures. Although this helps, you can’t always walk leaning on things everywhere you go.

What can I do to help reduce my pain?

MOTION IS LOTION…keep moving.

YES, this is the answer for a lot of things. You may feel like you should listen to the pain and in some cases this is true (consult your Physiotherapist or Physician to know if this is the case) but often you just need to gradually get moving.

What can I do that is safe that will help TODAY?

You can start practicing seated forward bends. Do 5 in a row and complete them many times throughout the day. Practice this when you go for your next walk, if your symptoms increase, stop at the next park bench and bust out 5-10 seated bends as shown below. These should make your Spinal Stenosis symptoms feel BETTER (i.e. less back and/or leg pain), if they don’t then STOP and consult your Physician or Physiotherapist.

Low back pain exercise

Repeat 5x times in a row throughout the day

There are other things that you can do to help with increasing your tolerance for longer distance walking and other activities. If you have success with these forward bends, then you would likely benefit from seeing your local Physiotherapist to learn more tricks like this to help manage your symptoms and to keep you moving!

What do Laughing, Jumping and Sex have in common?

Urinary incontinence (or peeing yourself) is very common but should not be considered just a normal part of ageing. If you have always had this issue or are just new to this embarrassing issue then let us provide you with a little more information.

There are 6 main types of incontinence, try to figure out the one that BEST describes your situation:I avoid coughing, laughing, or doing exercise (running or jumping) because I get some leakage.

  • this is called Stress Incontinence

As I get home or before my soccer game or before a presentation at work I feel like I have to pee really badly and I rush to the toilet and sometimes don’t quite make it.

  • this is called Urge Incontinence

I have to pee a lot throughout the day but only a little bit comes out.

  • this is called Overflow Incontinence

I just cannot hold my pee in at all and I can feel myself peeing but I can’t do anything to stop it.

  • this is called Total Incontinence

I have trouble moving around my house or out in public because of my walker or wheelchair and I just can’t make it to the bathroom in time.

  • this is called Functional Incontinence

I feel like a few of the above statements apply to me

  • this is called Mixed Incontinence

Now that you know what type of incontinence you likely have, you are better equipped to start tackling this problem.

Do you take your kids to these new trampoline parks but you can’t join in for fear of a major embarrassing incident? Have you had to change your whole life to accommodate your leakage? Are you tired of having to make excuses as to why you can’t do something because you are embarrassed by the leakage? Do you have to wear leakage protection that costs a lot and doesn’t always fit right?

These are all great reasons to get checked out TODAY by you local Pelvic Health Physical Therapist to see what you can do to take back your life. Take the STRESS out of INCONTINENCE.

Pitch Out Injuries – FIFA 11+

The 2018 World Cup is upon us! If you are anything like the team at Lab Health, your competitive juices will be flowing. You’ll too want to hit the pitch with your friends and try and recreate the magic of your favorite players!

Since we are rehab professionals…. The World Cup causes us to think about the soccer injuries we see in clinic. Because of that, this is the perfect time to talk about injury prevention before hitting the field. After all, the best cure is prevention and exercise is the best prevention!

A quick background…

Some of the most common injuries in soccer involve knee ligaments (ACL, MCL etc.), ankle sprains, groin, hamstring and calf strains. These injuries can range from minor to severe and can potentially keep an athlete out of the game for an extended period of time. In fact, up to a quarter of a million Anterior Cruciate Ligament (ACL) injuries happen in Canada and the US each year (1) potentially leading to significant time away from soccer and increasing their risk of developing osteoarthritis later in life. Yikes!!

Fortunately, research shows that with consistent proper ‘neuromuscular training’ (I know, big words make us glaze over but this one is important so bare with me) can reduce many soccer related injuries. Luckily, there is a FANTASTIC resource for neuromuscular training and injury prevention specifically for soccer that is freely available with a quick Google search (or by clicking here for the PDF) called FIFA 11+.

What is FIFA 11+?

FIFA 11+ is a simple warm up program for soccer players aged 14 and up. It contains a well laid out series of neuromuscular exercises aimed at building proper strength and form to help decrease the number of soccer related injuries.

The program was developed by a team of experts and backed by research proving the program’s effectiveness. Studies have shown a 29% decrease in training injuries, 37% decrease in match injuries and up to 50% decrease in major injuries for those who stick to regular implementation of these exercises (2 or more times per week) (2).

Not only has FIFA 11+ been shown to significantly reduce the injuries in male and female players, consistent implementation has other benefits as it has been shown to improve muscle strength, coordination and performance (3,4).

How long does it take to complete and how often should I do it? Do I need fancy equipment?

All you’ll need to complete this warm-up is an open field or gym, a ball, a buddy, a few cones, and 20 minutes of your time! It’s recommended that you complete this warm up before every training session (or at least 2 times weekly) and a shorten version before every game.

Some of the exercises don’t look all that different from what I already do?

The program is designed to replace your current warm-up. Although the exercise are not anything new or groundbreaking, the real benefit is realized with commitment to consistently completing the warm-up with attention to proper form and control during the exercises. FIFA 11+ provides a step-by step guide with useful pictures demonstrating proper form that will help prevent potentially harmful joint movements. Check out the video below for an example of what we are talking about.

This is an example of good form while performing a FIFA 11+ jumping exercise. Notice how she is landing on the balls of her feet, hips and knees have sufficient bend and her knees stay in line with the middle of the feet. All of this allows for proper support and control at the knee and ankle joints.

Would this benefit me if I play other sports?

Yes! A recent study has shown the benefits of regular adherence to FIFA 11+ has decreased the number of injuries in elite male basketball players (5).

Summary

If you are a young soccer player or older recreational player, consider replacing your current warm-up with FIFA 11+. You will start to see the benefits with committing to twice weekly for 10-12 weeks! Start incorporating these exercises early, often and continue them throughout your playing days to reduce injury! If you would like some guidance on form, frequency and force of these exercises see a Physiotherapist or Kinesiologist familiar in neuromuscular retraining to help keep you playing your best and preventing injuries!

References

  1. Campbell, C. J., Carson, J. D., Diaconescu, E. D., Celebrini, R., Rizzardo, M. R., Godbout, V., … & Constantini, N. (2014). Canadian Academy of Sport and Exercise Medicine Position Statement: neuromuscular training programs can decrease anterior cruciate ligament injuries in youth soccer players. Clinical journal of sport medicine, 24(3), 263-267.
  2. FIFA 11+.
  3. Barengo, N. C., Meneses-Echávez, J. F., Ramírez-Vélez, R., Cohen, D. D., Tovar, G., & Bautista, J. E. C. (2014). The impact of the FIFA 11+ training program on injury prevention in football players: a systematic review. International journal of environmental research and public health, 11(11), 11986-12000.
  4. Bizzini M, Dvorak J. FIFA 11+: an effective programme to prevent football injuries in various player groups worldwide—a narrative review. Br J Sports Med 2015;49:577-579.
  5. Longo, U. G., Loppini, M., Berton, A., Marinozzi, A., Maffulli, N., & Denaro, V. (2012). The FIFA 11+ program is effective in preventing injuries in elite male basketball players: a cluster randomized controlled trial. The American journal of sports medicine, 40(5), 996-1005.

BMI, Scale, Measuring Tapes…which to trust!

BMI is not the only measure of health: fat vs. function.

Many or most of us truly understand the internal struggle of being a lifelong yoyo dieter, someone who would love to be a few pounds lighter, fit into a smaller pant size, have a flatter stomach, etc. We all understand the magnetic strength of the scale and how obsessive we can get over the number on the screen. However, the ongoing trend among medical professionals to use body mass index (BMI) over the scale’s number, as a primary indicator of health and fitness, is not capturing the whole picture either. 

BMI is a simple measure of your height to weight ratio, calculated by taking your weight in kilograms and dividing it by your height in meters squared (kg/m²).  What it can offer is a basic idea of whether you fit into a normal weight category. Since the measures are easy to get, BMI offers a simple shorthand for busy professionals to make quick decisions. What BMI does not take into consideration is your muscle mass, overall body composition (proportion of fat, muscle mass, bone density, etc.) or any other useful health markers. 

There are many informal but just as valuable health markers that we can easily measure ourselves. For example:

  • Being able to walk up a flight of stairs without getting winded?
  • Getting up off the floor without help?
  • Completing regular activity (3-5x/week for an accumulate 150 minutes/week)?
  • Ability to lift your groceries?
  • Walking up or down stairs without pain?
  • Reaching over your head? 
  • Maintaining blood pressure within normal healthy range?
  • Being able to do things that matter to you without being limited by your body?​

The reality is, being substantially overweight can cause an individual to have trouble with many of the scenarios above. However, many people who technically fall into the overweight and obese range on a BMI scale have no problems with most or all of those same things. So the issue becomes: What should we consider as appropriate health markers? The number on the scale or how well you can complete functional activities?

This is in no way an argument for being obese. There are huge risk factors associated with carrying 40+ extra pounds on your frame, from increased load on your joints to a greater risk of diabetes and other diseases. This instead is a discussion for people dealing with the frustration of being within a healthy range of function and body composition, but cannot see it reflected through BMI or a number on the scale. 

There are better metrics on which to measure your health, fitness, and wellness are functional abilities and goals. Keep your focus on functional fun tasks that will make a difference in you everyday life, like…

+ If your knees hurt every time you squat to pick something up or go up and down stairs, then working to build strength and stability around the joint to prevent the pain is something tangible and attainable. Not to mention the huge boost to your quality of life when moving around your house gets easier and less painful.

+ If walking a few blocks to the grocery store is out of the question because you get winded or can’t carry your groceries home, then working to increase your cardiovascular ability is huge. 

If you’re already someone who doesn’t have to think about taking your dog out for an hour long walk, then maybe it’s the ability to hike up Mount Finlayson without getting rubber legs by the time you get to the bare rocks near the top that would be a better metric for your fitness. Or increasing your deadlift personal best, or lowering your 500m split on the rowing ergometer, or running a 10k in 45 minutes or less, etc. 

The point is, the number on the scale and BMI are not valid singular measures of  health and fitness and there are better indicators of your overall health for you and your health professionals to measure. Many athletes are considered to be overweight by definition of their BMI simply because their muscle mass increases their overall density for their height. All of this is not to ignore that losing a substantial amount of weight is a huge accomplishment too, it takes a huge amount of work, discipline, and drive (and even more-so to maintain that accomplishment). It is simply to acknowledge that there is an ongoing excess of focus put into a number on the scale, instead of on the ability of the individual to live and enjoy their life. BMI and weight loss is one part of a broad spectrum that make up one’s health.

So, stay strong, stay active and try to not let a number define you! ​​Thank you for reading and we’d love to hear your thoughts in the discussion below!