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Case Analysis: The Weekend Warrior

There are no quick fixes to getting fit. A consistent approach towards fitness is critical to good health, writes Dr Raju K. Parasher

Photo Credit : Sanjay Sakaria

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The weekend warrior is broadly defined as a person who either self-realises or is asked by his physician that he needs to get fit, and/or indulges in weekend fitness pursuits and/or participates in team building offsite activities/retreats which include games.

Fitness, of course, is also the new mantra for the corporate worker — at all levels. Employees work in an environment of high stress, deadlines and unhealthy eating habits —they work hard and play even harder. They are competitive by nature and are constantly in the search of new challenges. They are so involved in this ‘corporate life’ that health is always on a back burner, even though they have access to annual health check-ups and health club memberships. However, they have no time to take advantage of all these benefits — life is on a high — all the climbing, running, hurdles, jumps, and warrior games play out in the workplace and/or in ‘virtual’ space. One fine day, their body gives up and collapses! This leads to emergency doctor visits, tests and specialists pronouncing the verdict: Your health parameters are out of range. YOU NEED TO GET FIT! End of story? NO. The story begins.

Pradeep Carvalho is a typical corporate client trying get fit after hearing the ultimatum on his health. Except he does not know where to start. When his friends advise him to join a gym, he does not think that is hard. After all, he was an athlete in school and had won the inter-college squash championship 10 years back. So, he decides to join a gym and hire a trainer. Herein lies the first problem — a memory of what was 15-20 years back and the ease with which he can get fit again.

Pradeep retains the image of his squash stroke play and fitness when the ligaments, joints and muscles of his body were in a different state of strength and stability. Twenty years later, there is a mismatch between the memory of his squash abilities and the state of his body: his muscles have lost tone, strength, flexibility, and his joints have become stiff. Thus, even the slightest attempt by Pradeep to play at his past performance levels is going to lead to excessive stress/strain and damage to the body tissues due to overstretching, use of excessive force and incoordination.

A second problem is Pradeep’s current lifestyle. Sedentary lifestyle, excessive travel, sleeping on flights and cars weakens muscles and supporting ligaments. Also, like any efficient machine, the body works only when there is a demand. Movement demands of a sedentary lifestyle are limited, thus there is a loss of muscle-fibre, as muscles are not needed to generate power, when sitting for long periods of time — the ligaments on one side get overstretched while the opposite ones shorten, joints that are not required to move, lose their range of motion. Inactivity also leads to circulatory deficits at a microscopic and molecular level — leading to reduced nutrition and the further weakening of tissue. Concurrently, the cardiovascular system also becomes sluggish — as there is no demand on the heart and lung musculature as well.

Problems arising from a sedentary lifestyle can be classified as ‘postural’ and necessitate correction as soon as possible, or else they lead to chronic neck and back problems. Simple solutions such as standing and stretching, simple exercises while sitting to realign the spine and relaxing the muscles, and use of ergonomic furniture, should be instituted early, to counter the effects of ‘bad’ posture. The use of multiple digital screens has made postural correction strategies increasingly imperative.

Pradeep has to realise that there are no quick fixes. Unfortunately, wellness centre managers/counsellors and/or trainers are very successful at selling this impossibility. Be advised that they are selling a very marketable commodity and have to meet their ‘sales numbers’ as well. Ideally, the managers/trainers/counsellors should give the client a realistic picture and timeline. Although, both client and trainer are looking for quick results, one to get fit and the other to enhance their numbers.

It is important to remember that the body needs to be ‘prepared’ to ‘become’ fit. Fitness broadly consists of a cardiovascular component and a physical component.

Grossly cardiovascular fitness refers to the efficiency of heart-lung-cell mechanism, while physical fitness is the efficiency of the neuro-muscular-skeletal systems. Both are intractably linked — each dependent upon the other.

In both cases, it is imperative that a proper assessment be carried out and realistic goals and timelines set. At a macro level, an examination of the physical status (flexibility, strength, etc.) and cardiovascular endurance (distance walked without exertion, BP, HR, etc.) should be carried out after their physician advices a ‘fitness’ programme.

Once long-term and short-term goals are established, they should be started on stretching, a low resistance strength training programme and a low impact cardio programme. Both passive and dynamic stretching exercises should be carried out before and after activity and should involve the whole body. Strength training should be started using body weight (functional training) or elastic bands. The cardio fitness programme could simply be a 20-30 minute walk at a medium pace. If a client suffers from back or neck problems, it is important to modify the programme accordingly.

Clients are advised to exercise at least five times a week — with a break mid-week and at the end of the week. Progression should be done on a weekly basis after reassessment. It is important that exercises be done correctly using proper form. Incorrectly done exercises lead to more damage.

This routine, I imagine, sounds boring to the high energy client who likes control, quick results, and is forever short of time. However, it is imperative that they adhere to the exercise regime as prescribed. Individuals who tend to overdo their exercises initially can cause damage to their tendons and joints.

Competitive games should be avoided in the beginning as inherently players like ‘winning’ at all costs — especially the ‘very’ competitive corporate individual. This can prove detrimental to the overall fitness programme as the likelihood of injury increases exponentially. Taking it easy goes against their personality and does not align with their inherent nature to play hard and win. Even a self-paced game such as golf becomes a ‘battle to be won’. Furthermore, they follow the mantra of ‘more pain more gain’ to the extreme — and are egged on by their trainers.

Injuries, degenerative or otherwise, need to be rested for healing to take place causing further delays to the achievement of their fitness goals. Taking pain killers and anti-inflammatories only masks the effects of injuries — and do not heal them. They also delay the healing process as they continue to play and/or lift weights, thus making the tissues more vulnerable to re-injuries and more difficult to treat. Healing is a natural process and can only be facilitated by the use of external modalities such as those used by physiotherapists. In extreme cases, physicians have used stems cell therapy, platelet rich plasma therapy (PRP), etc.

The challenges of corporate life are a plenty and consequently the corporate worker needs a healthy body and mind to overcome them. Moreover they hate to be sick — it is a sign of weakness and a hurdle in their quest to move up the ladder of success. They are so caught in the life that they generally ignore the warning signs — which they consider as niggles that will ‘go away’. However, they turn out to be indicators of something more serious. A daily dose of painkillers and couple of drinks get them through their 24/7 lifestyle — until the body and mind stops responding! It might be more prudent for the corporate individual who endeavours to become fit to follow the proverbs ‘A stitch in time saves nine’ and ‘slow and steady wins the race’.

A fitness warrior that we have not covered here is the individual who ‘over trains’ and is ‘obsessed’ with his/her training programme. Yes, over training can also lead to injuries. Here the challenge is to get the patient to do less! A report for another time.

Then again, the rampant use of supplements and their benefit in exercise. A huge industry has grown around their use. The biggest myth surrounding the use of supplements is that the body needs more to become stronger and that they benefit the healing process. There is, at best, conflicting evidence in support of this claim by the industry. In fact, a general healthy diet contains enough proteins per kg body weight for most sports people.

There are two additional issues that we need to be cautious about: the extra metabolic load and the long-term effects of high protein diets.

Read Case Study 'Common Sins And Fitness'
Read Case Analysis by Rahul S. Verghese

The writer is Senior Consultant at Physical Therapy Clinic, Delhi and Director/Principal at Amar Jyoti Institute of Physiotherapy. He is a doctorate in Motor Control/Learning from Columbia University, NY, and has 30 years of clinical experience


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