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Three easy ways to tell if a client is overweight

Most of us have our private ways of assessing how fat we are. We feel our pants getting snug — or loose, if we’re lucky. We take a glance in the mirror or at our reflection in the shop front window.
Of course, there are more objective ways of answering the question. Plain old weight is a good clue, but it’s a total that includes bones, muscles, organs, hair — not just fat. The tried-and-true way of measuring just fat involves getting weighed while fully submerged in water. The difference between your weight in water and your regular weight is used to calculate body density, and from that, the proportion of the body made up of fat. But few of us are going to subject ourselves to regular dunking.
There are other, easier tests: bioelectric impedance, skin fold testing with calipers, dual-energy X-ray absorptiometry (the same technology used to measure bone density). Gyms and fitness centers are beginning to offer some of these. They’ll satisfy the curious, but they’re neither necessary nor practical for routine use.
That leaves us with three more common options. By now, most people are familiar with the calculation known as body mass index. Waist circumference is a hot topic as it becomes clear that it’s the fat we carry inside our abdomens that’s most metabolically active and harmful. And waist-to-hip ratio is getting a second look because of research showing that the fat under our skin — subcutaneous fat — may have some benefits. Here is a guide of these three measures of our fatness, or adiposity.

Body mass index, or BMI, is computed by taking your weight in kilograms and dividing it by the square of your height in meters. The BMI is easy to calculate, and in most people, it correlates reasonably well with overall body fat. It’s also a good measure of health risk: as a rule, when BMIs go up, so do deaths, particularly from cardiovascular disease. But BMI doesn’t distinguish whether the pounds are from fat or from fat-free tissue like muscle and bone. BMI also doesn’t tell us about the type of fat we’re carrying—a significant shortcoming, as the type of fat that builds up in the abdomen is believed to be particularly unhealthful.
Cutoffs and categories are another problem. People with BMIs of 25 to 29.9 are classified as being overweight and those with BMIs of 30 or over as obese. But risk accrues more gradually than those sharp distinctions might suggest. There’s also a question whether the cutoffs ought to be different for some ethnic groups. Researchers have found, for example, that Asians develop cardiovascular risk factors at lower BMIs than whites, so the overweight category for Asians might start at a BMI of 23 instead of 25.

Waist measurement puts a different spin on obesity: it’s no longer about weight or total body fat, but about the metabolically active fat that collects around the organs in our abdomens. Waist circumference is a better predictor of diabetes than BMI and a good indicator of heart disease risk. Measuring it identifies the sizable group of people who pass muster when it comes to BMI but whose large waists put them at higher risk. Still, waist measurement hasn’t become part of routine medical practice for several reasons. For one thing, there’s some uncertainty about exactly where the waist should be measured, although navel-level is widely accepted. Moreover, the definition of too large a waist may need revision: some studies show that health risks start well before the current cutoffs of 40 inches for men and 35 inches for women. Finally, given all the other information that’s collected on patients—blood pressure, cholesterol levels, BMI—it’s not certain that adding a waist measurement to the mix would affect treatment decisions.

The waist-to-hip ratio (WHR) is a simple calculation: waist circumference divided by hip circumference. A small waist combined with big hips yields a smaller number than a big waist with small hips—and smaller is better when it comes to WHR. For women, the risk for heart disease, stroke, and other health problems starts to climb at a ratio of about 0.85, so that is often set as the cutoff for a “good” ratio. For men, the cutoff seems to be about 0.90. Waist circumference has eclipsed WHR, but the WHR may be ready for a comeback. Research shows that WHR is more strongly associated with heart disease than waist circumference alone.
It would be great if there were a magic bullet for instant weight loss. But, the truth is that watching what you eat, reducing calories, and exercising more is the only tried and true way to change your weight and reduce the health risks associated with abdominal obesity.

Individual muscle action versus combination participation

A single muscle never works in isolation to produce functional movement or secure stability.  Each muscle may have a specific part to play in relation to the action of the group, but the integrated action of many muscles groups is required to produce smooth and co-ordinated functional movement.   Specific strength for a specific muscle group uses a specific exercise and position.  This only focuses on isolated strength and ignores the combined synergy and performance of all the muscles acting across a joint.  We need to be cautiously aware of reasons for isolating muscles in an exercise program. Most gym machines promote isolated training.  Whilst we fully comprehend the benefits of strength training which to name just a few are the addition of contractile tissue proteins, the tension generating capacity of the muscle; tendon and ligament becoming stronger, giving more support to the joint etc, we hypothesize that the benefits of strengthening the whole kinetic chain could far exceed the isolated benefits.  Unfortunately, the specific goal of the isolated training comes from weight lifting theories and is often used solely to shape and build the body parts into a state of “perfection” and “decoration”.  The issue then becomes how the body looks and not how it functions.  Movement Therapy rather chooses to focus on promoting the smooth, coordinated, integrated function of all the muscles so that the kinetic chain can function effectively to achieve the objective of the movement.

People should be moving around all day to remains functional and healthy.  Moving, fuels the systems of the body and keeps them at optimal performance.  Many programs focus on strengthening certain muscle groups.  There is no evidence that if you strengthen a muscle you enhance the working of a body part or the body as a whole.  What is essential is that all muscles must have the correct rhythm and tone to react to required holding or releasing sequences.  Skeletal muscles can work for a long time without fatigue.  This is provided that their contraction alternates regularly with complete relation and consequent replenishment of the oxygen supply to repair the effects of contraction and to remove metabolic waste.  The rhythm of work and rest reduces fatigue to a minimum.  Each movement has its own natural rhythm that varies in individuals.  The natural rhythm varies with age, faster in the young and slower as we get older.

For more information attend one of ICK informative workshops on MOVEMENT THERAPY or visit our website at www.collegeofkinesis.com.

Principles and Concepts:  Assessment

To complete an assessment of a client, a proper and thorough systematic examination is required.    This process involves the use of clinical signs and symptoms, physical testing, knowledge of pathology and mechanisms of injuries. ICK students training involved all aspects and the following is a brief summary of what these students study.
Assessment is a sequential method to ensure that nothing is overlooked.  For this reason, the examiner must come to understand and know the wide variability in what is considered normal.  Assessing a joint for an example, the examiner must look at the joint and injury in the context of how the injury may affect other joints in the kinetic chain.
The assessment sequences starts with a complete Patient/Client history.  So much is learned and understood, by simply listening to patient/client.    The history also enables the examiner to determine the type of person the patient is, any treatment the patient has received, and the behavior of the injury or disease.  During the interview it is important to keep the patient/client focused and discourage irrelevant information.  Our students are taught how to ask closed or direct questions for specific information.  For an example:  the examiner should not say:  “Does this increase your pain?”  It would be better to say: “Does this alter your pain in any way?”

Students learn that part of questioning is to ask the age of the client or patient.  Why?  The simple answer is that many issues in the body are age related.  Let’s take the shoulder joint as an example.  Rotator cuff degeneration usually occurs in patients/clients who are between 40 and 60 years of age.  Primary impingement due to degeneration and weakness is usually seen in patients/clients older than 35, whereas secondary impingement due to instability caused by weakness in the scapular or humeral control muscle is more common in people in their late teens or 20’s especially those involved in overhead activities such as swimmers or pitchers.  Calcium deposits may occur between the ages of 20 – 40.  Chondrosarcomas may be seen in those older than 30 years of age, whereas frozen shoulder is seen in persons between the ages of 45 and 60 years if it results from causes other than trauma.  Frozen shoulder due to trauma can occur at any age but is more common with increased age.  Considering all this, one will be cautious when implanting various component of shoulder strengthening work or will approach shoulder stability work differently. 

ICK offers various workshops on this topic, and professionals are invited to enroll for any of these workshops should they want more hands-on information visit our website at www.collegeofkinesis.com.

Abdominal fat and how it affects your health

“How much should I weigh?” It’s a common question, and an important one. Surprisingly, though, it’s actually the wrong question. For health, the issue is not just how much you weigh, but how much of your fat is located in your abdomen, reports the January 2009 issue of Harvard Men’s Health Watch.

Abdominal fat comes in two different forms. Some of it is located in the fatty tissue just beneath the skin. This subcutaneous fat behaves like the fat elsewhere in the body; it’s no friend to health, but it’s no special threat either. Fat inside the abdomen is another story. This visceral fat, which is located around the internal organs, can damage your health.

Scientists originally thought visceral fat was dangerous because it was linked to elevated stress hormones, which raise blood pressure, blood sugar levels, and cardiac risk. A newer explanation relies on the concept of lipotoxicity. Unlike subcutaneous fat, visceral fat cells release their metabolic products directly into the blood, so free fatty acids from visceral fat accumulate in the liver and other organs. This impairs the body’s regulation of insulin, blood sugar, and cholesterol and leads to heart problems. A third hypothesis starts with the complex role of fat cells. In addition to hoarding excess energy, fat cells produce a large number of proteins that contribute to metabolic abnormalities, inflammation, and heart disease. These three explanations are not mutually exclusive; all may help account for the hazards of visceral fat.
One way to evaluate body fat is to measure height and weight, then calculate body mass index (BMI). This is now the standard way to diagnose obesity. Another simple method uses the ratio of the waist and hip measurements. But many experts are turning to an even simpler technique: waist circumference. Because it involves one measurement instead of two, it’s more accurate and reproducible. And new research suggests that this simple measurement is the best way to tell who is at risk for the serious consequences of obesity.

So, what do you do about abdominal obesity? Harvard Men’s Health Watch suggests that you remember the basics. The only way to reduce visceral fat is to lose weight and the only way to lose weight is to burn up more calories with exercise than you take in from food.

Understanding Rehabilitation:  The healing process

It is very seldom that you will find a person in the movement world without a history of injuries.  Often, an injury forces the person to seek help and to start exercise.  As part of the ICK student’s training we educate our students regarding the healing process.

Rehabilitation programs must be base on the cycle of the healing process.  It is important that the trainer has a sound understanding of the sequence of the various phases of the healing process.  The physiological responses of the tissues to trauma (and treatment) follow a predictable sequence and time frame.  Decisions on how and when to alter and progress a rehabilitation program should be primarily based on recognition of signs and symptoms, as well as on an awareness  of the time frames associated with the various phases of healing.

The SAID Principle states that when an injured structure is subjected to stresses and overloads of varying intensities, it will gradually adapt over time to whatever demands are placed upon it. During the rehabilitation process, the stresses of reconditioning exercises must not be so great as to exacerbate the injury before the injured structure has had a chance to adapt specifically to the increased demands.  Engaging in exercise that is too intense or too prolonged can be detrimental to the progress of rehabilitation.  Indications that the intensity of the exercise being incorporated into the rehabilitation program exceed the limits of the healing process include an increase in the amount of swelling, an increase in pain, a loss or a plateau in strength, a loss or a plateau in range of motion, or an increase in the laxity of the healing ligament.  If an exercise or activity causes any of these signs, the trainer must back off and become less aggressive in the rehabilitation program. 
In most injury situations, early exercise rehabilitation involves sub-maximal exercise performed in short bouts that are repeated several times daily.  Exercise intensity must be commensurate with healing.

ICK offers various workshops on this topic of rehabilitation and healing.  Visit our website at www.collegeofkinesis.com for more details.

HEADACHES

INTRODUCTION

Headaches are considered as one of most common complaints one will hear from people around you. Like any other kind of injury or disease, one wants to know the cause of the condition.  Diagnosing the cause will enable a professional to give the correct treatment which may include reducing the symptoms which cause the headache.  Numerous attempts have been made to classified headaches and with the aim to highlight the cause of the headache.  It is important that one realizes that there are different kinds of headaches.  Proper and thorough assessment by a medical professional will assist anyone to establish the symptoms and causes of a headache.  The following will help you to understand the different kind of headaches and to assist you to be able to explain the headache you are experiencing.  Various treatments and management strategies are available from professionals and you should feel comfortable to discuss your situation with the professional of your choice.

THE DIFFERENT KINDS AND POSSIBLE CAUSES OF HEADACHES

The following table will explain that the possible different types of headaches and potential causes.  It is important to consider the possibility that a combination of the causes might be responsible for a headache.

INTERVIEWS AND ASSESSING OF HEAD ACHES BY A PROFESSIONAL:

It is easy to say, when you have a headache, to take a pill in the hope that the headache will disappear forever.  One has to understand, that if you do not find the cause for the headache, there is always the chance that the headaches will return.  Headaches can be light of nature with no serious consequences, but it is important to know that serious conditions may be present and repeated headache should require proper medical assessment.  An interview during an assessment with a professional may include the following questions and you should be able to answer these in your own words:

After the interview, the professional should be able to exclude certain conditions, symptoms or causes for your headaches.  The following should be checked during assessment and then be excluded as possible causes for the head aches.

Once the above have been excluded,  it is time to have a closer look at the following headaches and causes:

To assist with the process of diagnosing the type or cause of your headache, you should complete the following.  Choose an answer in the left or right column:

Answers in the right column are very typical of cervical conditions and headaches while those on the left are answers to the throbbing progressive headaches.  The possibility is not excluded that features of both types may be present.
Tension headaches differ from the two above in that often these features are lacking and that the grade of headache is very low constant daily headaches. Although, it is possible that tension may contribute to any of the other two headaches.  The above will assist you to give valuable information to the professional who is treating you for your headaches.

BASIC MANAGEMENT OF YOUR HEADACHES
Pharmacological management of headaches is often offered as the only way of dealing with headaches. In some cases, this kind of management is effective.  Sometimes self-management of certain components can help to relieve the symptoms.  The following are guidelines for self-management:

This newsletter was compiled by J Claassen (Kinesiologist) Director: International College of Kinesis.