Having A "Back To Baseline" Mentality Sets You Up For Failure

Many individuals that I treat initially have this as their goal following an injury. It sounds intuitive, right? It makes sense that when you go through injury or a painful condition that you are often thinking about how things were completely fine a couple weeks or months ago. Maybe even to the point where you took your pain-free state for granted and are now kicking yourself for doing so. Whatever the reason, you want to get back to the way things were before - aka: baseline. I'm going to explain why we need to strive to be better with this mindset.

Sickness-Wellness-Fitness Continuum

To dig into this topic, I want to start with a little background that is important to understand for this to make sense. That is the Crossfit corporation's sickness-wellness-fitness continuum. Basically, the more fit, healthy, and robust you build yourself as a human being, the less likely you are to have debilitating health conditions of any type - from physical injury to systemic disease processes.

As a physical therapist, I am primarily treating musculoskeletal injuries. That usually means I am seeing someone who has begun to have symptoms in a given body area due to those tissues being overloaded. In other words, whatever that individual asked their body to do in the previous days/weeks/years was MORE than the capacity of that tissue. For example, someone who needs to reach overhead repetitively may develop shoulder pain because their rotator cuff isn't resilient enough to withstand the repetitive load. Another example is an individual who has back pain from bending over and picking things up from a low surface. In this situation, the low back was not resilient enough to complete the task - either from too much weight, too much repetition, or both.

Building resilience and fitness is an important concept in patients that I see. However, I think it is even more important from a population health standpoint. As you may have already noticed in the instagram post, common vital signs are considered in this model including blood pressure, bone density, and triglycerides. These metrics are essentially a measure of how efficiently your body is functioning and we know that the more "fit" an individual is, the "better" these numbers look. Obviously there is significant variability from person to person as to what an ideal value may look like. However, there are generally better trends to strive for such as lowering blood pressure, better control of blood sugar, etc.


Isn't "Wellness" a Good thing?

In general, yes. I am simply advocating for people to think bigger than this. Wellness, in my mind, can be defined as the lack of injury or disease. This is a great start for many people because it is less intimidating and it allows for people to begin taking responsibility for their own health, rather than rely on providers to "fix" their health. However, when you think of your health in terms of this continuum - this is only half of the battle. Having a certain level of fitness is protective and can be thought of as tangible health "insurance" in that you are able to withstand more physical demand and are able to handle suboptimal conditions without having a resultant injury or disease process begin.

For example, lets take the case of 2 people. Person A has a good baseline of fitness and as a result is in a state of good health. Person B is somewhere between sickness and wellness on the continuum. They have no active injuries, but have been recently diagnosed with diabetes as a result of their lifestyle.

Anyone who has lived for a significant amount of time knows that life throws many things at you that you can't necessarily prepare for. The beginning of the COVID-19 pandemic is a great example of this. Many people were subject to a more sedentary lifestyle than they were previously used to during this time. Whether people didn't feel comfortable going to the gym, their gyms were closed, or they had no idea how to exercise at home - people were not as active as would be recommended.

Now lets apply this situation to our example people, person A and person B. In the case of the COVID-19 pandemic, both are subject to a period of relative inactivity - let's say 6 weeks for the sake of the example. Both people begin to decondition and functionally decline as a result of inactivity (if you don't use it, you lose it). At the end of the 6 weeks, person A is much less fit and ends up closer to the "wellness" portion of the continuum. Due to their protective level of fitness, they were able to overcome this unforeseen circumstance with little detriment to their health. Person B at the end of the 6 weeks makes the same "jump" toward the left side of the continuum that person A did. However, because of the relatively low level of fitness that they started with - person B is significantly closer to being considered in a state of "sickness". Person B had diabetes previously, so after this unforeseen circumstance, they now have a worse control over this condition. They are now dealing with complications from uncontrolled diabetes including peripheral neuropathy (painful tingling and numbness in the feet and hands) and diabetic retinopathy (vision issues).

This is why the idea of having "insurance" to our health is important. Even in this fictitious example, how we care for our bodies makes a big difference and we need to be taking charge when it comes to our personal health.

If you need guidance on what this might look like for you, contact us today using the information at the bottom of the page. I would be happy to discus this further! Population health is definitely a passion of mine.

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Medical Disclaimer: All information on this website is intended for informational and educational purposes only. The authors and partners are not responsible for any harm or injury incurred. It is important to seek professional guidance about your condition or injury. No guarantees have been made or implied regarding specific results of the services described.

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