Mobility in the 21st Century
Addressing Mobility, Postural and Bio-Mechanical Issues caused by Prolonged Sitting & Rising Obesity through the use of Resistance Training’
- By Simon Griffin
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Mobility
Mobility is the combination of range of motion in every joint structure and the healthy flexibility of your soft tissue (muscles, tendons and fascia).
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Posture
Posture is how you hold your body.
There are two types:
Dynamic posture is how you hold yourself when you are moving, like when you are walking, running, or bending over to pick up something.
Static posture is how you hold yourself when you are not moving, like when you are sitting, standing, or sleeping.
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Bio-Mechanics
Bio-Mechanics is the study of the mechanical movements of the body. Within the context of both the gym, and day to day life, bio-mechanics analyses whether the correct muscles and joints are performing any given motion both correctly and efficiently.
Sitting
How much time do we spend sitting?
24 Hours - 5 Days per week
11:00pm - 7:00am - Sleeping > 8 hours - Sleep
7:00am - 8:00am - Breakfast etc > 1 hour - Activity
8:00am - 9:00am - Commuting > 1 hour - Sitting
9:00am - 5:00pm - Work > 8 hours - Sitting
5:00pm - 6:00pm - Commuting > 1 hour - Sitting
6:00pm - 7:00pm - Rest/Dinner > 1 hour - Sitting
7:00pm - 8:00pm - Walk/Gym/Cycle/Yoga etc > 1 hour - Activity
8:00pm - 10:00 - Television/Reading/Relaxing > 2 hours - Sitting
10:00pm - 11:00pm - _____________ > 1 hour - Activity
Sitting is considered a physiological stress as it is not a ‘natural bio-mechanical movement or non-movement’.
However, the body is resourceful and will adapt according to lines of physiological stress.
When we have repetitive movement or non-movements such as sitting, this adaptation causes muscles and other soft tissues to remodel to become stronger in the direction of stress.
This typically causes in an imbalance of strength to weakness in joints, resulting the loss of both joint mobility and joint stability, alongside pain in one of these 3 areas of the body:
Declining activity levels will commonly cause pain in these 3 areas
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Lower Back Pain
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Knee Pain
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Shoulder/Neck Pain
Declining activity levels will directly affect the mobility of these 3 joints
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Hip Immobility
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Thoracic Spine Immobility
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Gleno-humeral Immobility
Declining activity levels will directly affect the stability of these 3 joints
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Knee Instability
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Lumbar Instability
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Scapula Instability
Obesity Levels
Globally, obesity levels are rising.
Increased obesity has been directly linked to:
Type 2 diabetes
High blood pressure
Stroke
Cancer
Sleep apnea
Osteoarthritis
Fatty liver disease/Galbladder disease/Kidney disease/Coronary heart disease
Pregnancy problems
Depression/Anxiety
alongside Immobility, Postural and Bio-Mechanical Issues
Obesity & Activity Levels in Ireland
According to the HSE, 37% of Irish people have a healthy body weight.
While, 37% of Irish people are overweight,
And between 23-25% or 1 in 4 Irish adults are considered obese.
31% of men aged 15-24 are overweight or obese, compared to 27% of women of this age category.
32% of the population are considered to be sufficiently active to meet the national guidelines
40% of men are sufficiently active to meet the national guidelines compared to 24% of women.
Walking Gait & Obesity
Walking Gait is the pattern that you walk in.
Gait Analysis - An analysis of each component of the three phases of ambulation (heel strike, mid stance, toe-off).
The Gait Cycle
The sequences for walking that occur may be summarised as follows:
Registration and activation of the gait command within the central nervous system.
Transmission of the gait systems to the peripheral nervous system.
Contraction of muscles.
Generation of several forces.
Regulation of joint forces and moments across synovial joints and skeletal segments.
Generation of ground reaction forces.
Stance & Swing Phase
The normal forward step consists of two phases: stance phase; swing phase,
The Stance phase occupies 60% of the gait cycle, during which one leg and foot are bearing most or all of the bodyweight
The Swing phase occupies only 40% of it, during which the foot is not touching the walking surface and the bodyweight is borne by the other leg and foot.
In a complete two-step cycle both feet are in contact with the floor at the same time for about 25 per cent of the time. This part of the cycle is called the double-support phase.
Gait cycle phases: the stance phase and the swing phase and involves a combination of open and close chain activities.
Walking Gait & Obesity
P.K. Lai & K.L. Leung et. al analysed to what extent obesity had an impact on walking gait.
Group A - Obese
Group B - Healthy
The obese group walked slower and had a shorter stride length. They also spent more time on stance phase and double support in walking. Greater hip adduction was shown in the obese group during terminal stance and pre-swing. The maximum knee adduction angles of the obese group in both stance and swing phases were significantly higher. The ankle eversion angle of the obese group was significantly higher from mid stance to pre-swing. There were reduction of peak ankle plantar flexor moment, and increase of ankle inversion moment.
Obesity, Immobility and Health Related Quality of Life (HRQoL)
Forhan & Gill have highlighted the direct correlation between rising obesity levels and decreasing mobility levels, and have also examined how higher levels of obesity, coupled with lower levels of mobility leads to a poor ‘health related quality of life’ (HRQoL).
Can immobility impede weightloss or mobility developments?
Forhan & Gill argued that ‘
patients with obesity are routinely advised by their health care provider to become more physically active for the purpose of losing weight and reducing cardiovascular and metabolic risk.
Although such advice is well intended to promote health and wellness, changes to physical activity levels and the associated benefits are illusive unless issues related to functional mobility are addressed.
If a patient with obesity is not able to move around at an intensity and frequency required to lose weight or prevent weight gain they are at greater risk of experiencing mobility issues.
Those patients with impaired mobility will continue to experience restrictions in activities at home, work, school and in the community thereby having a negative impact on their health related quality of life (HRQoL).
So, short answer: YES
Motor Unit Recruitment & Full Range of Motion
Dr John Rusin argues that loading the body’s joints through their full range of motion (RoM) produces the most optimal muscular reaction within the body.
This hypothesis can be analysed through the use of an Electromyography Assessment (EMG), which calculates the Motor Unit Recruitment (MUR) (the muscle mass utilised during any given motion).
François Billaut of the Victoria University, Australia subsequently tested and confirmed this hypothesis which proved that both high intensity exercises, utilising the body’s full range of motions through each respective joint, produced the largest muscular reaction in the body.
Taking Rusin & Billaut’s work into account, in conjunction with Brad Schoenfeld’s research which highlighted that “intensity (i.e. load)… is arguably the most important exercise variable for stimulating muscle growth’’, we can confirm that it is far more difficult for someone with mobility issues to successfully manage excess body fat, maintain joint integrity and adequate muscle mass standards.
So, practically, how does immobility or bio-mechanical issues impede weight-loss?
When we look at any given compound exercise in the gym, we are looking for a full range of motion to recruit/utilise as many muscles as possible to perform the given exercise.
If a client, or trainee cannot access the full range of motion while maintaining correct joint alignment, then the muscles involved cannot be utilised, or fatigued sufficiently or safely to bring about sufficient muscular reaction to cause weight-loss.
The depth of a clients squat is a prime example of a mobility issue that can arise during training. The higher the squat, the less muscles recruited surrounding the hip capsule, thereby lessening the muscular impact of the exercise, in this case, a squat.
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12 inch box plus gray plate
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12 inch box plus green plate
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12 inch box plus yellow plate
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12 inch box plus blue plate
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12 inch box plus blue & gray plate
Barbell Back Squat
Full Range of Motion (RoM)
Barbell Back Box Squat
Partial Range of Motion (RoM)
Kubo et. al (2019) examined the muscular impact of different squat depth by examining two different categories of athletes.
This study compared the effect of squatting with either full depth (140 degrees of knee flexion) or half depth (90 degrees of knee flexion) on muscle volume of the quadriceps, hamstrings, gluteus maximus, and hip adductors.
17 untrained subjects were randomly assigned to the full-squat or half-squat group, and squatted 2 times per week for 10 weeks. Subjects performed 3 sets each session at 80-90% of their 1RM. Training load was progressed by 5kg once subjects could perform 3 sets of 8 reps.
The researchers found that the full-squat group experienced significantly greater increases in muscle volume of the glutes and adductors compared to the half-squat group.
As stated previously, this increase in prolonged exposure to sitting alongside rising obesity levels commonly results in pain in the following 3 areas of the body.
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Lower Back Pain
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Knee Pain
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Shoulder/Neck Pain
Solely treating the source of pain will only get you so far in eradicating your pain, and will likely be a temporary solution.
It’s of course more complicated to look at the body as a whole and see what other joints may be the root of the problem, but it’s also necessary for long-term pain alleviation and functionality.
Mike Boyle & Gray Cook’s Joint by Joint Approach argues that wherever pain is located in the body, the answer to the problem is usually found in either the joint above or below the area of pain.
Each Joint’s Primary Need through the lens of Mobility & Stability
Gleno-humeral– Mobility
Scapula – Stability
Thoracic Spine–Mobility
Lumbar Spine – Stability
Hip – Mobility (multi-planar)
Knee – Stability
Ankle –Mobility (sagittal)
Mike Boyle & Gray Cook’s Joint by Joint Approach
According to Cook and Boyle and their Joint by Joint Approach, the answer to:
Lower back pain is often found below the lumbar, in the hip, which is typically insufficiently mobile, thereby demanding the typically stable lumbar joint to develop mobility that is was not designed for.
Shoulder pain can usually be traced back to an insufficiently mobile thoracic spine, which in turn causes pain in the shoulders due to their need to forgo their stability in place of mobility.
Knee pain typically is a combination of a lack of both ankle mobility and stability, alongside hip immobility. The stress of an unstable and immobile ankle, coupled with an immobile hip causes the knees to lose their necessary bio-mechanical stability, thereby causing pain.
Each of these issues are becoming more common in the 21st century due to an over exposure to sitting and a reducing activity levels of the population.
So, how to address these issues?
Firstly, when addressing these issues it is important to keep in mind the hierarchical nature of differing training disciplines when training for general health and fitness, alongside optimum mobility, posture and bio-mechanics.
Some forms of training are more beneficial for the general population than others.
However, by creating an objective, scientific and physiological lens to analyse the benefit of different disciplines of training, we can confirm that resistance/weight training is of most benefit to the general population for Mobility, Posture and Bio-Mechanics.
Why Resistance Training to address Mobility, Postural or Bio-Mechanical Issues?
Because intelligently programmed resistance training, which values each joints Range of Motion (ROM) above all else, results in free
mobility,
postural and
bio-mechanical developments,
unlike many other popular forms of physical training such as:
Yoga/Pilates
Cycling
Running
Aerobics
Martial Arts
The Hierarchical Lens of Physical Training gives 1 point to each different discipline of training if the training provides the participant with the following physiological result:
Joint Mobility - 1 Point
Joint Stability - 1 Point
Muscle Mass - 1 Point
Cardiovascular Health - 1 Point
Pain Prevention/Management/Alleviation - 1 Point
Mental Health Benefits - 1 Point
Benefits of Different Forms of Exercise
Strength training and dynamic movements are superior to static stretching for improving mobility, posture and bio-mechanics according to numerous scientific studies:
In 2005, Hess et al. subjected a group of octogenarians to a resistance training program at 80% of 1RM, three times per week; after 10 weeks of training, participants improved their performance on the TUG test (Mobility Test) by 15.7%.
Fiatarone et al. demonstrated that resistance training raised functional mobility even in people over 90 years old.
In 2006, Holviala etal. proved that both muscle power and strength are important determinants of mobility, and that resistance training is a powerful tool to induce specific neuromuscular adaptations that translate into improved mobility in healthy older adults.
Greek researchers looked at a group of men who trained with loads at 40, 60, or 80% of their 1RM or one-rep max. The results showed that higher intensities were linked with greater improvements in mobility/flexibility. That is, the men who trained at 80% of their 1RM were the ones who saw the greatest improvements.
Deadlifts Vs Sun Salutations
Take deadlifting, correctly performed, as an example:
With each rep you’ll stretch your hamstrings, loaded with your additional weight of the bar or dumbbells, to its full range of motion.
Not only will you perform this hinge many more times in a weightlifting session than a yoga or stretching session, but it will be much heavier and more beneficial than simply hinging and touching your ever elusive toes.
With deadlifting you will build muscle, burn calories, improve posture, strengthen your bones and joints and reduce your risk of injury by a staggering amount and your toes will come ever closer to you when you do choose to drop in for a quick yoga session.
So the question arises, why salute the sun if you can just deadlift twice a month. It seems that in this instance, deadlifting can improve the length of your hamstring, but yoga doesn’t seem to help your deadlift?
Resistance Training and the Female Body
Borges-Silva et al., analysed whether or not heavy-resistance training could improved mobility in older women.
His group study involved 3 groups.
Group A: Weight Training (Traditional Resistance Training: TRT)
Group B: Strength and Conditioning (Circuit Resistance Training: CRT)
Group C: Control Group (CG)
His study found that Group A and B experienced significant improvements in functional mobility as a direct result of heavy resistance training, while naturally the Control Group did not.
Osteoporosis & Weight Training
According to the HSE, women who weight train from the age of 16 have an 83% reduction in the risk of Osteoporosis.
Additionally, according to both the HSE & Get Active Ireland, 1 in 2 women and 1 in 5 men over the age of 50 will break bones from Osteoporosis.
As we can see from the above data, osteoporosis is overtly a female issue.
But, why is osteoporosis a female issue?
Why are more women affected by bone loss than men?
Women tend to have smaller bones than men.
Women go through the menopause, and some women can lose up to 30% of the overall bone in their body during this process.
If a female’s period started later than age 15, they are at a higher risk for bone loss as their sex hormones were not regular.
If a female has or had PMT (Premenstrual tension) their hormones are not regular, so they are at higher risk of bone loss.
If a girl/woman loses their periods NOT due to pregnancy. Eating disorders and/or over-exercising are a common cause of this and places the person at high risk to develop bone loss.
If a woman has endometriosis, their sex hormones are not regular, and they are at a higher risk of developing osteoporosis.
If a woman is on the contraceptive Depo Provera, this has been proven to cause bone loss.
If a woman has a hysterectomy, she is at a much higher risk of bone loss.
7 Primary Movements of the Human Body
Push: (Vertical/Horizontal)
Pull: (Vertical/Horizontal)
Squat
Hinge
Lunge
Rotation
Walking Gait
Optimal Standards of Strength to ensure efficient Mobility, Posture & BioMechanics
Male Standards
Vertical Pull: Bodyweight x 5 repetitions
Horizontal Push: Bodyweight x 1 rep
Squat: Bodyweight x 1 rep
Hinge: Bodyweight + 50% of Bodyweight x 1 rep
Female Standards
Vertical Pull: Bodyweight x 1 repetitions
Horizontal Push: 50-70% of Bodyweight x 1 rep
Squat: 75%-100% of Bodyweight x 1 rep
Hinge: Bodyweight + 25% of Bodyweight x 1 rep
Tools within a Gym:
Tools in a Gym
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Barbell
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Dumbbell
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Kettlebell
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Gym Cables
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Plate Loaded Machines (Fixed Pivot)
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Other
60 Minutes - 3 Days per week
Start of Training Session
00:00 minutes - 00:10 minutes - Preparation
00:10 minutes - 00:15 minutes - Stage 1 - Warm Up
00:15 minutes - 00:30 minutes - Stage 2 - Strength - Compound Exercises - 70-80% of 1RM
00:30 minutes - 00:45 minutes - Stage 3 - Hypertrophy/Cardio - 50-70% of 1RM
00:45 minutes - 00:55 minutes - Stage 4 - Non-Compound Exercises 50% of 1RM
00:55 minutes - 00:60 minutes - Stage 5 - Cool Down/Return to Work
End of Training Session
60 Minute Training Session
Stage 1: Warming Up
What is the purpose of Warming Up?
The purpose of warming up before physical activity is to prepare physically for your chosen activity. Therefore the warm up should be specific to the activity. This means warming up the specific areas of the body that are about to be utilised.
Warming up increases your heart rate and therefore your blood flow. This enables more oxygen to reach your muscles, which in turn causes them to perform better.
Warming up efficiently and gradually charges the Central Nervous System at a steady rate, thereby decreases the short term cortisol-release caused by resistance training within the body, which in turn increases the positive hormonal effects of weight training in the long run.
Stage 2: Strength
Strength - Compound Exercises - 70-80% of 1RM
Different Phases of Strength Training
Choosing the compound exercise(s): Push (Horizontal/Vertical) / Pull (Horizontal/Vertical) / Squat / Hinge
Warm Up Sets
Working Sets
Technique Sets: Technique sets are usually compound exercises performed at a sub maximal load, usually 30-40% of a 1RM.
They are used to provide the opportunity to address technical faults and issues that would go unaddressed in working sets with maximal loads.
Strength Training is ideally performed in physiological isolation, ie. with minimal additional physiological stresses on the body other than the load of the chosen exercise.
In Terms of Mobility:
We’ve already highlighted the Greek researchers who examined groups of men who trained with loads at 40, 60, or 80% of their 1RM or one-rep max. The results showed that higher intensities were linked with greater improvements in mobility/flexibility. That is, the men who trained at 80% of their 1RM were the ones who saw the greatest improvements in their mobility.
For more information on this topic, please see my article, Mobility, a free gain of intelligent weight training, an elusive dream in yoga
In terms of Muscle Growth/Hypertrophy:
According to a research review by Brad Schoenfeld (2010) called The Mechanisms of Muscle Hypertrophy and their Applications to Resistance Training, “Intensity (i.e. load) has been shown to have a significant impact on muscle hypertrophy and is arguably the most important exercise variable for stimulating muscle growth.”
For more information on this topic, please see my article, ‘It’s time to put down the kettlebells from TK Maxx’.
Stage 3: Hypertrophy & Cardiovascular Health - 50-70% of 1RM
Choosing the compound exercises to be performed as a Superset (back to back): /Tri-set (back to back to back): / Circuit (typically 4 or more exercises performed in rotation).
Push (Horizontal/Vertical) Pull (Horizontal/Vertical) / Squat / Hinge
The use of supersets, tri-sets and circuits increases the positive impact of weight training on cardiovascular health (work capacity) by performing exercises with a shortened rest period after each set.
Stage 4 - Non-Compound Exercises 50% of 1RM
Stage 4 provides an opportunity to address secondary movement patterns, alongside muscles groups that are not sufficiently addressed within stage 2 and 3 of training.
Ideally the chosen exercises will both create positive muscular damage, but also reinforce and protect the bodies joints to better prevent bio-mechanical issues or injuries in the future.
Additionally, they can be performed at speed to increase both work capacity and cardiovascular health.
Stage 5 - Cool Down
Is there a need to stretch at the end of training?
No. Your joints have already gone through their full range of motion in each chosen exercise during your training.
For more on this please see my article, For the love of God, stop stretching!
This is an opportunity to address cortisol levels in the body and to slow the Central Nervous System (CNS).
Diaphragmatic Breathing is typically the best cool down following the aforementioned training.
So, how to translate this information and an aim towards Optimal Standards of Strength & Mobility into the Gym and your own training?
Vertical Pull: Pull Up
Male Standards: Bodyweight x 5 reps
Female Standards: Bodyweight x 1 rep
Vertical Pull: Pronated Lat Pulldown
Male Standards: Bodyweight x 5 reps
Female Standards: Bodyweight x 1 rep
Horizontal Push: Barbell Bench Press
Male Standard: Bodyweight x 1 rep
Female Standard: 50% of Bodyweight x 1 rep
Horizontal Push: Dumbbell Bench Press
Male Standard: Bodyweight x 1 rep
Female Standard: 50% of Bodyweight x 1 rep
Squat: Barbell Back Squat
Full Range of Motion (ROM) necessary
Male Standard: Bodyweight x 1 rep
Female Standard: 75%-100% of Bodyweight x 1 rep
Squat:
Goblet Squat/Barbell Front Squat
Full Range of Motion (ROM) necessary
Male Standard: 75-100% of Bodyweight x 1 rep
Female Standard: 50%-75% of Bodyweight x 1 rep
Hinge: Barbell Deadlift
Male Standard:
Bodyweight + 50% of Bodyweight x 1 rep
Female Standard:
Bodyweight + 25% of Bodyweight x 1 rep
Hinge: Kettlebell Deadlift
Male Standard:
Bodyweight + 50% of Bodyweight x 1 rep
Female Standard:
Bodyweight + 25% of Bodyweight x 1 rep
How is your head?
According to an article published in 2018 in the Irish Journal of Medical Science which examined the correlation between mental health and physical exercise, (involving 7539 participants), those who met the basic physical exercise levels routinely typically scored higher on the Energy and Vitality Index (EVI) and the Mental Health Index-5 (MHI-5), compared with those who did not met daily phsyical exercise standards.
This confirms what we already know:
Exercise benefits not only your physical health, but your mental wellbeing also.
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