We are seeing more people hiking, skiing, running into their 60’s, 70’s and 80’s. Life expectancy is increasing in our country. From the physical point of view let’s s explore what can be done to exercise in a sustainable manner and learn from past injuries. An important aspect of those aging well is that they remain active and are able to sustain the physical demands of the activities they like (for example walking, running, playing tennis, hockey etc.)
Firstly you need to have a good base to your pyramid which means to have an acceptable range of motion in all your joints. Secondly you need to be able to perform certain basic movement patterns, the “Performance” part of your pyramid. These may include squatting, lunging, pushing, pulling, hinging from the hips, rotating your trunk, standing on one foot, walking, etc.. Finally and no less important than the others you need the “skill” part of your pyramid, it pertains to form and technique during sports or physical activity.
The broader the base of your pyramid, movement and performance, the better your sustainability to withstand the stress of sports and physical activities over time.
In other words if there is no restrictions of movement and the basic activities in the performance section of the pyramid are done with competency and pain free, the more likely you are to maintain your skill over time. Is common to meet patients with a particular injury who focus too much on the skill of their sport but have a poor base. This scenario does not support sustainability, the pyramid has been inverted.
Some examples to illustrate this:
1) Swimmer in her 40’s with complaints of shoulder pain. Upon assessment is found she lacks 50% of rotational movements in one of her shoulders, she cannot turn her head towards her affected shoulder without pain in the neck and has some pain doing a push up. Is it worth working on her technique? The base in the pyramid is narrow, there are deficiencies in her mobility and there is pain associated with it. The ideal management would be consulting a physiotherapist, a movement expert, and address these issues. Focusing on skill development and/or getting stronger by doing push ups, chest presses, or increasing the intensity of her strengthening will likely lead to an unsustainable participation in her sport/discipline and possibly a worsening of her symptoms.
2) Healthy male golfer in his 60’s with complains of right buttock pain. He can hardly bend his spine backwards after a long drive and has poor right single leg balance. Is it worth at this point to take golf lessons to improve his technique/skill? Should the focus be on walking more or doing heavy squats? The focus should be on improving his base, restoring normal movement in his spine, and improving his motor control and stability of his right leg.
Excessive attention to skill training can be a waste of time when there is a lack of basic movement such as; a painful knee during squatting, a limited elevation of your arm, a stiff spine when putting on your socks, etc… All these deficiencies, if not addressed properly, can over time lead to a reduction of your physical activities and you making more incorrect compensatory movements down the road.
The broader the base, the better your sustainability to withstand the stress of sports and physical activities over time. That is why it is important to move in different ways and to train in different manners and in different situations. Training your body, it is like preparing for an exam. Should you just learn the answers for that one exam or should you learn the concepts in depth? The guidance of a physiotherapist, a movement expert, can help you to maintain your physical performance by treating those effects of past injuries and educating you on maintaining a broader base to your pyramid. Pyramid by “Movement” Grey Cook et al. 2011