Faster, Higher, Stronger

Since the Olympic winter games are taking place as we speak in beautiful Vancouver, British Columbia, I thought it would be a great time to discuss a topic that does crop up every so often in my physiotherapy practice in Toronto.

While watching the Olympic games, we can see incredible feats of athletic prowess and extraordinary examples of the constantly evolving boundaries of human performance.

With the constant chant for “Citius, Altius, Fortius” reverberating in their minds, athletic limits are being tested and achievement records are being broken.

So this begs the question: Is performance really healthy?

Just perusing the biographies of almost any of the elite athletes that have qualified to represent their countries at the highest level of competition, one can see an almost infinite variety of minor to serious injuries that these extremely conditioned individuals have overcome to reach their personal achievements.

Multiple knee surgeries, broken bones, concussions, separated shoulders, sprains and strains.

The list is essentially endless.

Now going back to the question regarding performance and health, here’s my take in one word.

NO…

And here are a few more of my words…

Performance is very seldom healthy.

Olympic Weightlifting Injury

Before I get pilloried on the internet, let me qualify that preceding statement.

In the pursuit of extremes, in the pursuit of redefining the boundaries of human athletic performance, in the pursuit of winning medals at the highest levels of competition, athletes must be in peak physical and mental condition and must undertake rigorous training programs.

But in order to do what has not been done before, risks have to be taken.

This is where limits are pushed, where boundaries are stretched.

This is where that razor thin line between risk and reward is often crossed.

Nodar Kumaritashvili

This is where, as was witnessed just a few short days ago, a young Georgian luger by the name of Nodar Kumaritashvili, lost his life in a horrific crash while he was pursuing his dream of winning an Olympic medal for his country.

I’ve always believed that the human body is capable of incredible feats.

And that as time passes, as science and technology advance, we’ll be able to perform at even higher levels.

But for most people, are these levels of performance required?

Do most people need to test the limits of their bodies?

When these athletes train to extremes, they constantly put their bodies at risk.

Risk of injury, risk of over-training.

At what point does the average human being decide that the risk is not worth the reward?

Or, when does one decide that they are okay with being just average?

Yours in movement.

Dev Chengkalath

I had the good fortune to have realized that the torch was actually going to pass right by where I live.

I was able to get the following short video clip from my balcony.

Even from that distance, there was something spectacular about the passing of the flame and the magical essence of the human spirit as expressed through sport.

It took me back  21 years ago to when I was a small child in Calgary, Alberta, Canada, watching that same fire burn as it was passed from torch bearer to torch bearer for the 1988 Calgary Winter Olympics.

Yours in the Olympic Spirit.

Dev Chengkalath

However, I would like to switch gears a little bit just because I’ve had a pretty incredible weekend and wanted to share it with you.

The old dog in the title of the post is me. And boy did I learn some new tricks this weekend!

Here’s the background story:

I’ve never been a big winter sports kinda guy. For most of my life, I’ve been telling anyone who would listen, and many who didn’t want to listen, that I’m allergic to the cold. It’s more than likely that this is the reason that I have only skied once in my life, on a school ski trip about 16 years ago.

Now fast forward to this past weekend:

It all changed!

I hit the slopes as an adult beginner trying to learn a sport that has at its foundation some of the things I most detest: ice, snow, cold.

For the record, this is NOT me

Would I be willing to deal with those frigid elements to learn how to balance precariously on a two, incredibly thin, parabolic boards strapped to my feet, while hurtling down the side of a mountain in the name of fun?

My weekend at Mont Tremblant started with a beginner skiing lesson with a very patient, and understanding gentleman by the name of Jean Landry, on a hill that at best had a max altitude of 40 feet with a kind and forgiving slope. He started with the basics: how to balance, how to stop, how to turn, and most importantly, how to get up when you fall.

And that was probably the most important lesson.

Because in life, there will be falls.

There will be tumbles.

Some worse than others. Some a little softer.

Some, like the ones I experienced at Mont Tremblant, which gently kicked up clouds of fluffy white snow. Some, like the ones that my body aches remind me of, which had enough force to smack my helmeted noggin into the icy hillside.

But after every fall, I learned to awkwardly shuffle, twist, turn and twitch until I was standing again. I would stumble robotically towards my skis which were designed to liberate themselves well before the point where my ankles snapped. I would clip them back on to my feet, and then dust off the snow that had made its way through my four or five clothing layers.

And before I would start down the hill again, I would take a quick, wide-eyed peek up  the busy ski hill and see the other skiers coming down towards me with the control akin to a rally car that missed a turn and at speeds that I’m sure the human body is not designed to experience outside of rocket-ship travel. When the coast was clear, I would point my skis back to the bottom of the abyss and start my journey over again.

And that’s when something amazing happened.

I learned to ski.

This old dog, learned a new trick.

Yours in movement.

Dev Chengkalath

Here’s a list of 10 things I learned (or re-learned) this week as they pertain to physical therapy, human movement and sometimes even life.

1. Human anatomy hasn’t changed, but our understanding of it has. The interconnectedness of the body is astounding and we’re just really starting to realize how this plays a much bigger role in physiotherapy, injury rehabilitation and performance training than previously thought.

2. Surrounding yourself with people who are passionate (and much smarter than you) is a great way to get inspired. And getting inspired is a great way to become better at your craft.

3. Always try to learn something new from every situation encountered. Once you learn it, apply it often so that it becomes internalized. This is also another great way to improve your craft.

4. Know your anatomy inside-out. And I don’t mean just the origins, insertions or innervations. I’m talking about functional anatomy, force couples, co-contractions, synergists and antagonists. Although knowing these won’t unravel all the mysteries of the body, it sure will help when trying to diagnose or treat complicated, multi-factorial and confusing cases.

5. Seek out the cause of the dysfunction, don’t just settle for treating the source of the pain. I wrote about cause vs source previously, but it’s always good to be reminded to differentiate between the two. Our current medical model often stops shy of actually discerning the root cause, while we look to deal with the source. This is not only short-sighted, but leads to poor long-term outcomes.

6. Always question why you do what you do. Don’t be happy with the status quo. But don’t complain either unless you’re willing to be the one to step up and initiate change. As Gandhi once said: ” Be the change you want to see in the world.”

7. The body is an amazing piece of biological machinery that can adapt to the most extreme conditions, incredible stresses or seemingly impossible challenges we place upon it. The mind, however, doesn’t always possess the same fortitude. Fortunately, this can be corrected.

8. Straight from the mouth of Shirley Sahrmann: “You get what you train.” To expand upon that elegant statement think about how you spend your days? Slouched? Slumped? Flexed? Why are you in pain? Think of it this way, your body is constantly under training, 24 hours a day, 7 days a week, 365 days a year. How are you training your body? That is the importance of the everyday.

9. When considering all that you know, it’s quite amazing to realize how much it is that you know you really don’t know.

10. I have the best job in the world as a physiotherapist in Toronto. I’m free to think critically, I’m constantly challenged and I love what I do. How many people can say the same?

Yours in movement.

Dev Chengkalath

As I stated in my last post, how is it possible that with the ever-growing body of available knowledge, with the lightning-paced expansion of medical science and with all the incredible technological advances, that we still fail our clients in modern medicine?

I feel as though I came close to some sort of an answer to the above just recently.

Or at the very least a brief glimpse into what could be part of the answer (or maybe a better way of putting it would be part of the problem!).

I know I started off by talking about chronic pain, but this realization could just as easily relate to almost any type of pain or injury.

In our hurried and hectic world, we’ve stopped treating the person and we’ve started treating just the symptoms.

The Search for Symptomatic Relief.

I realize that this isn’t exactly Earth shattering or groundbreaking news. I won’t be getting any CNN headlines with this one.

But I think a good number of people in the medical health professions forget this basic tenet, and I know I’ve been guilty of this as well.

This became very aparent to me these past few weeks when I was working with a new client. In the years that this client had been seeking the care and guidance of his various healthcare professionals for chronic pain, no one had ever asked this client what was going on in his life.

Every appointment, meeting, or test was set-up solely for the purposes of medical assessment rather than human interaction. This gentleman had seen everyone for his pain. However, all of his practitioners were too busy to actually talk to him. He’d been put through the gamut of diagnostics from MRIs to CT scans and everything in-between.

Sadly…

No one asked him what was going on in his life now.

No one asked him what was going on in his life when the pain started.

No one tried to discern any of the social or emotional stressors that would exacerbate or propagate altered pain responses.

Because that is what chronic pain usually is.

It is, in a very broad sense, an abnormal, painful response to non-painful stimuli. Things that shouldn’t hurt, do.

In modern medicine, we’ve become so disjointed and specialized that we’ve forgotten that everyday stressors do impact how our bodies respond to our environment. We forget the elegance that is the construction of our physical selves.

Whether you believe in creationism or in evolution or something in between, you would be hard pressed to deny that the body knows what’s going on inside itself.

Eventually, these distinct stressors are replaced by amorphous, diffuse stressors that no longer resemble the original instigator.

And this takes me back to what I believe are the top three causes of pain (be it low back pain, knee pain or any other type):

1. Lack of knowledge-What’s causing, contributing or exacerbating the problem?

2. Motor Control-How do we move? How do we stay still? How is our body awareness?

3. De-conditioning-Are we using aging as a cop out and letting our bodies degenerate? Can we tolerate physical stressors?

Drop your comments and let me know what you think

Yours in movement.

Dev Chengkalath