The World Health Organisation recently ranked sitting as the 4th biggest killer I understand. I’m sure most people in health and fitness would agree that we need to move more and sit less for a multitude of mental and physical health benefits. Yet it seems that when it comes to the elderly or those with neurological conditions like Parkinson’s disease, we want to sit people down, whether it be to improve strength, cardio, mobility or whatever other aspect of physical fitness. Often, poor balance is cited as the reason.
Clearly there are cases where people are incapable of standing at all if they have completely lost the use of their lower limbs. However, I recently encountered somebody with Parkinsons who was walking 30 minutes three times daily and yet was doing most of his ‘prescribed’ cardio and strength training seated, because of his ‘poor balance’. I’m sorry but I just don’t get this at all – surely the object should be to improve his balance by getting him on his feet, not letting it get worse by sitting him down?
Now I am the first to admit that I know nothing about such conditions and I’m sure many would say that I should leave this to the ‘experts’. However, he was keen to get my input so I asked him to stand barefoot and tell me if he could feel anything at all in his feet (clearly he must otherwise he couldn’t stand surely?) He replied that he could feel a little in his big toes and a little in his heels, but nothing else. I got him to work a very soft spongy massage ball into the soles of his feet for a couple of minutes. I then asked him what he felt. He replied that he could feel most of his foot, including his arches.
We spent a couple of further minutes with a ball between his ankles doing heel raises. He said ‘that’s funny, I can feel my calves now!’ His calves were completely wasted away, despite all the walking, and was slapping the ground with his feet when he walked because he had clearly been unable to activate these muscles, for whatever reason and not prejudging the issue.
We spent a further 5 minutes or so standing on one leg, lightly holding a rail, while we began to address his posture and put him more upright. He said he felt stronger and that his legs were working better. We put him into walking gait and posture and gait were much improved – he left smiling.
My point is that I know very little about this condition and yet we were able to achieve all of this in less than half an hour, simply by stimulating the nerves and muscles of the feet, activating the windlass mechanism of his feet and calves and getting him into an upright posture. Nobody seems to have thought about improving his balance by addressing these really obvious things – the system says he can’t balance so he needs to sit, rather than improve it by looking at his feet. Nobody had looked at his feet before.
Feet are like these really unsexy irrelevant appendages that are best hidden away in shoes! And yet they are our only contact with the ground since we became bipedal. EVERYTHING starts with the feet – if you can’t perform an exercise while on two legs, it is pretty much useless from a functional point of view!
It’s crazy that people are going to the gym and often only standing to go from one station to another! I see people, especially older, immobile people, but often younger physically capable people, go from rowing machine to bike, to seated machines, to floor ‘core’ exercises. I almost never see anybody take their shoes off to feel the floor or perform any kind of single leg standing exercise to improve balance.
Part of the problem is, I think, that we have tried to break fitness down into its component parts, rather than looking at it from a whole body functional point of view, which is clearly what counts, unless you are doing something incredibly specialist like bodybuilding. We know that the elderly and those with neurological conditions benefit from better cardio, more strength, more flexibility etc., so we have tried to isolate these elements and work on them individually in a ‘safe’ environment. So we can sit them down to row or do bicep curls, or perhaps perform a stretch, etc. Unfortunately the sum of these parts is not a whole functional person.
Being comfortable bipedal is one of the fundamental things that distinguishes us from most other mammals and perhaps our greatest asset. The expression ‘can’t see the wood for the trees’ comes readily to mind. We have so many specialists looking at the individual parts of the body and everybody looking for a quick and easy fix to localised pain caused by decades of lifestyle abuse.
As soon as you take a step back and look at the body from a distance, instead of under the microscope, you get to see the global movement patterns and dysfunctions, very quickly and easily. Then you wonder why nobody else can see it but are instead rushing mystified to the physio or chiropractor or sports massage therapist for what can never be more than a sticking plaster if the underlying causes are not tackled.
These causes are usually postural – previous injury, lifestyle factors like sitting, technology, footwear, occupation, a particular sport etc. They need to be addressed but you will not succeed in reversing a lifetime of damage rapidly and anybody offering you a magic solution is lying. However, I do believe that the human body is so incredibly adaptable that a great deal can be achieved in a relatively short space of time with a progressive, consistent approach, usually working from the ground up.
I don’t know how much of the neurological damage involved in Parkinsons and other such diseases can be improved, but I do believe that getting people on their feet, preferably barefoot, but also through new technologies such as Naboso insoles (see link) would be a good starting point.