Lumbar pain, neck pain, sciatica, hip discomfort, tendonitis, osteoarthritis, osteoporosis… Is there an adult in the world who has not had or often has one or more of these musculoskeletal health problems? The figures say it all: 80% of the population has back pain. “Sedentary lifestyle is the new pandemic,” says Catalan physiotherapist and trainer Aleix Gusart. This, in his opinion, explains a huge part of our most common evils.
With a large community of followers on the networks, Gusart (@tufisiotemueve) posts practical content to be able to perform exercises at home suitable for each discomfort. Now he has just published More Movement, Less Suffering (Lunwerg), a practical pain training guide. We took the opportunity to ask him why so many parts of our bodies hurt and what we can do to alleviate it.
“More movement, less suffering,” you say in the title of the book. Is this always like this? Should we always move, even if it hurts?
Yes, there are only some exceptions. If you have suffered a fracture or sprain today, it is better not to support that part. But as soon as you can, it is necessary to move. If these are not severe cases, if your pain is a 2 to 3 on a scale of 1 to 10, continue exercising. If you have stronger pain, you should lower the intensity of the exercise, and do stretching and self-massage to relax the affected structure.
The power of physical therapy to improve health is the subtitle. When should you go to the physiotherapist and when should you stop?
You have to go when there is an injury or pain as such. I have been doing online sessions for some time, because I clearly saw that when the patient improved the most it was with exercise. I focused on creating a training program and explaining to patients how pain works.
If we have back contractures, for example, can physiotherapy massages help? We often enter a loop of massage, contracture, massage, contracture…
If you have a long-lasting contracture, massages will only make it worse. If the physio tells you that you should come back in a month and stop by “once a month for maintenance”… I am totally against that. It is necessary to offer good education to the patient: explain to him that muscles do not get knotted, as has been shown. It takes exercise and pedagogy, and over time it becomes less stressful.
So, what role does massage have in the physiotherapist’s office?
In many situations, massage fits into the treatment of a patient, but not as the only solution. In many cases it is thought that the physio is a masseuse, and this is not the case. It can help, and it is part of a total, but what helps the most is exercise, and there are meta-analyses that prove it. The patient comes for a consultation, you tell him that he should do some exercises, and in 85% of cases, they don’t do it and they don’t improve. If you do not do the exercises, you can temporarily relieve the pain with frequent massages at the physio. If that’s what you want, then go ahead. But it is not the solution to pain.
Education against contractures and pain… in what sense? to avoid pain?
To know how pain works, why it hurts. Maybe it’s because you lack exercise, because you spend a lot of time in the same position, or doing the same movement. Above all, it is necessary to strengthen the muscles with strength exercise.
What are the most common pains?
Lumbar, cervical, hip and shoulder pain. The worst is the lumbar pain, and it is getting worse due to a sedentary lifestyle. The key to eliminating it is movement and not holding postures, as in the case of cervical pain. Also, if you can have a high table and combine sitting and standing, this is the best. We have terrible neck pain due to a sedentary lifestyle, today’s pandemic, and also due to poor posture. A sedentary lifestyle will be like obesity, which causes many deaths and is the main cause of metabolic diseases.
Among the most common conditions or pathologies is osteoporosis. You are a specialist in this disease. You call her “the bone thief.” Because?
It weakens the bones and you don’t realize it, sometimes until a fracture occurs. Luckily there is more and more awareness. Women want to take better care of themselves, and they start strength training earlier. The bone inside is like a sponge. With osteoporosis, it is as if the holes become large inside, which causes the bone to lose density. It starts sooner and earlier, because there are more and more cases of early menopause. With the hormonal decrease, starting at 40, is when the pathology can begin.
What are warning signs?
If you are sedentary and if you increasingly notice that you have less energy or are weaker, be careful. I have patients who realize that if they continue in the same dynamic, after a few years they will not be able to carry their shopping bags up the stairs.
What effects does exercise have to prevent osteoporosis?
The benefits are quickly seen if you are between 35 and 50 years old; If you are 60 or older, it will cost more to improve. The effect is that you will notice more energy. And if you had stiffness and pain, you will see how it disappears. It is a wonder. This can be noticed in a month and a half or two if you do the complete exercise programs.
You treat osteoporosis from different basic pillars. Which are?
The hormonal environment, diet and strength exercise. Exercise increases testosterone. We also give supplements with vitamin D, which plays a fundamental role in the hormonal system. Regarding food, I work with a nutritionist, who teaches what priority foods are. What it is about is eating in a way that is more similar to our ancestors, who did not eat pasta all day. It is necessary to eat eggs, fish, meat, have an optimal dose of quality protein…
They repeat to us, actively and passively, the importance of strength. When you reach a certain age, isn’t it enough to just walk, play a soccer game a week, or take a Pilates class?
All exercises are 100% recommended. It’s fine to do yoga, Pilates, soccer, whatever, but strength training should be mandatory. A couple of times a week already gives benefits, it is necessary to do it and especially for women over 40 years old. It is very important.
Another of the prevalent diseases that physiotherapy treats is osteoarthritis. What are the first symptoms it gives?
It affects both men and women. It causes pain, and generally appears due to bone wear in the joint structures. It can appear after the age of 30. If you have osteoarthritis, but you are moving and exercising, the pain will be much less than if you sit all day, at home, in the car or in front of the TV.
Tendinitis is also common… Why does it appear?
Due to disuse of the area. When you suddenly load it and you are not used to it, the tendons complain. If you haven’t done any sport for five years and suddenly you start doing it, you may develop tendonitis. If you train strength you are much less likely to have tendonitis.
Pain that goes down the leg… What diagnosis could it have?
It can have several causes. It could be sciatica (most likely), but it could also be that osteoarthritis in the hip joint produces pain that radiates to the groin, backwards… You must have a medical diagnosis. I share exercises on the networks for people who do not have the resources to go to the physio, and. Or that when they go to the doctor they are given medication and nothing else, but it doesn’t work for them. I always say that if doing the exercises increases the pain a lot, stop, because with sciatica, for example, since the nerve root is involved, you have to be careful.
One of the topics that has had the greatest success on your networks is good posture. Which is it?
The best posture is the one that lasts the least, because each person is made in a certain way, and there are several factors that influence it. If you sit for eight hours with the same posture, that’s when problems arise. You have to get up for a while, you can walk for a few minutes, go up or down to get a coffee… If you vary your posture, there is no problem.
We have cervical pain, lower back pain, sciatica pain, knee pain… It is normal to take one, two or three anti-inflammatories a week, how do many people do?
No, but it has become normal, especially in the elderly. And no, it is not normal, but as we move less and less: work, computer, work, sofa… We are sedentary. It has become normal to take many anti-inflammatories, but they make you burst inside.
Does all this have to do with chronic inflammation?
Yes, the diet we have and the lack of movement has a lot to do with chronic inflammation. If you ask me which of the two things is more important, healthy eating or strength exercise, I think it is strength exercise, without a doubt. A person who does not eat well but does strength exercise has little inflammation. If you have to prioritize something, it is exercise, you must move.
This article was originally published on RAC1.