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Well my friends, it’s time for me to garner some reader feedback so that I can improve your blog experience.

What I’m looking for here is either comments or emails letting me know what you, as the reader, would like to see on my blog.

Is there certain information you’d like to see me discuss?

Are there any specific injuries or rehab protocol you’re curious about? Are you interested in more performance based blogs?

Would you like me to go more in-depth with greater detail?

Or are you looking for simple, straight-forward posts?

More video? Audio? Pictures?

Shorter posts? Longer posts? Guest posts?

Here’s your chance to let me know how I can help you!

Yours in movement.
Dev Chengkalath

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

The second point brought up in the previous couple posts relates to the risks of too much sitting and limiting everyday, non-exercise activity.

I’ve already spoken about the dangers of sitting in a quite a few of my previous physiotherapy blog posts, so I won’t belabour that point.

What I will say is that even for those who are fairly physically active, prolonged sitting will still cause problems, the same as it will for those who are more sedentary.

This is where NEPA comes into play.

NEPA or Non-Exercise Physical Activity (I’ve talked about it as NEAT or non-exercise activity thermogenesis previously) is all the other movement you do during your day that doesn’t count as exercise. The “everyday life activity”. This is where that leisurely stroll, the housework, and yes, even the fidgeting comes in to play.

Why is NEPA important?

Think of it this way…It’s a lot easier to get a few minutes of NEPA frequently throughout the day than it would be to set up an intense exercise activity regularly and consistently through your day.

If you can increase your non-exercise physical activity by 15-20 minutes a day in spurts of 1-2 minutes at a time, over the course of your week you will have added around 2 hours of increased movement. And most of you won’t even notice the added bouts of 1 minute movement.

It won’t interrupt your day.

It won’t cost you much in terms of time to take the stairs instead of the elevator, but the health benefits multiplied over a long period of time can be significant.

This takes me back to an article I was emailed some time ago.

According to that article, in the past 150 years non-exercise related calorie burning has dropped by about 2000 calories a day.

Yup.

2000.

That’s the same number that is used as the baseline total daily calories for calculating percentage of daily values for nutrient requirements in American food labeling.

150 years ago, we used to burn more calories with non-exercise related activities than we are supposed to take in daily today.

Now that’s something to think about.

Yours in movement.

Dev Chengkalath

In my humble opinion and using my knowledge as a physiotherapist, the solution to the above noted problem is quite simple.

But as I’ve stated many times before, simple does NOT mean easy.

To recap the previous blog post, there are two behaviours and their resulting effects that need to be addressed to stave off the dangers of prolonged sitting.

These are:

1. The benefits of regular moderate to vigorous intensity physical exercise

2. The risks of too much sitting and limited non-exercise everyday life activity

In today’s post, I’ll take a deeper look at the first point and offer what I believe are realistic actions you and any other reader of my blog can take immediately and without significant changes to your life.

It’s been proven over and over again that regular physical activity, typically undertaken at a moderate to vigorous intensity, as noted above, has numerous health benefits to the various body systems including the cardiovascular system, the neuromusculoskeletal system, the endocrine system, the neurological system etc.

Intense Physical Activity

Key words: moderate to vigorous intensity.

So taking a leisurely stroll around the block, walking to the corner store, going up some stairs, doing housework…just won’t cut it as exercise. These are typically not intense enough and don’t last long enough to stimulate the body the way a more focused exercise regimen would.

The thing with exercise is that you have to do it to get the benefits and you have to keep doing it to keep the benefits.

The other thing with exercise is that most people do it in one big burst (e.g. early morning before heading off to work) and then remain sedentary the rest of the day.

A better option may be to do smaller bursts of higher intensity physical activity, frequently throughout the day.

Here are some options of how you might be able to fit in multiple bouts of exercise-based physical activity:

-Early morning high intensity interval program combining resistance training and cardiovascular training for 30-45 minutes.

-Lunchtime body-weight workout for 15-20 minutes just doing lunges, squats, push ups, burpees or other equipment free movements.

-Post work exercise class for 30-45 minutes – just find one you enjoy!

-Join a recreational or competitive sports team for an activity that you love.

-Take your kids out to the park and play those games you used to love to play, have races, climb and jump around.

-Schedule it and respect it like you would any other appointment.

As you can see, with a little imagination, the physical activity possibilities are endless!

The objections:

I know many people will tell me that they don’t have time for the above amount of exercise in their day.

I don’t buy it.

It’s not that they don’t have time, it’s that they haven’t prioritized their health.

Cut out 1 or 2 television shows and you’ve just gifted yourself an extra half hour to an hour of exercise time. Or if you just can’t give up on the reality TV shows, do some exercise during the commercial breaks.

Want to find some more time in the morning? Stop pressing snooze 3 or 4 times in the morning and you’ve got another 15-20 minutes.

If you have kids and you take them to their various extra-curricular activities, use the time that you’re there to do some quick exercise. While watching little Timmy’s hockey practice, why not use that time to lunge around the rink?

It may look strange, but you’ll be the one improving your health. Plus that will probably also get you away from the pop and chips from the concession stand.

While this is by no means an exhaustive list of how you can find exercise time during your day, it should give you a place to start.

If you have any other ideas on how to fit in exercise drop a comment and let me know.

Yours in movement.

Dev Chengkalath

In my practice as a physiotherapist in Toronto, I see a lot of people come through the clinic doors with various aches and pains.

Very few of them are acute injuries, while many of them are overuse or repetitive stress/strain in nature.

While undertaking a clinical history during the assessment, I’ve noticed that for a vast majority of people, the one dangerous (in)activity that they do on a regular basis for prolonged periods of time is sitting.

The Dangers of Sitting

And most people unknowingly considered this a fairly benign part of their daily life.

As I’ve stated before, this typically starts in the morning at the breakfast table (for those that even have breakfast!), then continues on with the commute to work or school, then the sitting continues until lunch where more of this dangerous sitting business will take place.

Then, after lunch, most people will return to their desks, chairs and various seating apparatus to carry on with the same form of sitting that they completed all morning. At the end of the workday, the seated and sedentary commute home is initiated.

And with the arrival at home, the television is switched on for some well deserved post-work relaxation before supper, which will take place while seated. Post-supper, the same posteriors are plunked back down in those plush couches for some more TV viewing.

Then the same process takes place the next day. And the day after that. And the day after that.

While the above may not apply to everyone, there are a significant number of people who would have no difficulty in seeing their daily routine played out as noted.

I know this happens because these are the same stories I hear in my clinical physiotherapy practice everyday.

Here’s the rub…

This pattern of inactivity which plays out in millions of lives every day has fairly serious health consequences.

I recently came across an editorial press release for the British Journal of Sports Medicine entitled: “Are we facing a new paradigm of inactivity physiology?” that nicely sums up some of these dangers.

In the editorial the authors discuss how recent studies have suggested that long periods of sitting and “whole-body” inactivity (what we term sedentary behaviour) are “strongly associated with obesity, abnormal glucose metabolism, diabetes, metabolic syndrome, cardiovascular disease (CVD) risk and cancer, as well as total mortality.”

I don’t know about you, but I definitely feel that those are some pretty serious consequences from the simple act of sitting for too long.

The authors propose their new paradigm which consists of the following four tenets:

1. Sitting and limiting non-exercise activity may independently increase disease risk

2. Sedentary behaviour is a distinct class of behaviour with specific determinants and effects on disease risk, separate from the behaviour of leisure-time exercise.

3. The molecular and physiological responses in the human body of too much sitting are not always the same as the responses that follow a bout of additional physical exercise.

4. People already insufficiently physically active will increase their risk even further by prolonged sitting time.

As the authors conclude, there are actually two behaviours (and their resulting effects) that we need to address:

1. The benefits of regular moderate to vigorous intensity physical exercise

2. The risks of too much sitting and limited non-exercise everyday life activity

So what can you do about it and how can you avoid these serious dangers of sitting for too long?

In the next few blog posts, I’ll work through the above two issues and give you some simple tips and strategies that you can immediately incorporate into your daily life to help stave off these deadly sitting related health issues.

Yours in movement.

Dev Chengkalath