Bridging the Gap
Justin Price, MA, explains why we need to address the connections between extra weight and chronic pain.
Justin Price, MA, is a biomechanics specialist, expert in corrective exercise, and creator of The BioMechanics Method® continuing education program. His assessment and exercise techniques are widely used by health and fitness professionals around the world to help people eliminate chronic pain. Price has been consulted for his expertise by Time, Newsweek, the New York Times, The Wall Street Journal, the Los Angeles Times, the Chicago Tribune, Tennis, Men’s Health, Arthritis Today, WebMD and Discovery Health. In addition to working one-on-one with clients in his San Diego facility, he serves as a continuing education provider for ACE, BOSU®, TRX®, PTA Global, PTontheNET, Power Systems® and NSCA.
ACE: In your day-to-day life, how do you see the impact of the obesity epidemic in the lives of your clients, friends and family, or just people you pass on the street?
Justin Price: In my line of work, I see a lot of people in chronic pain: family members and friends, young people, blue and white-collar workers, stay-at-home mothers, professional athletes and fellow fitness professionals. No matter what aches and pains they have, the source of their problem is usually a musculoskeletal imbalance or alignment issue that their bodies must constantly adjust for. When someone is overweight or obese, it makes chronic pain problems worse since the extra weight compounds alignment issues. People who are overweight or obese have to contend with a multitude of health risks, risks that unfortunately increase the likelihood they will experience chronic pain.
ACE: What misconceptions—if any— do you believe fitness professionals have about people who may be struggling with their weight? Why is it important to overcome those misconceptions before helping clients to meet their goals?
Justin Price: I am not an expert on obesity, but I have worked with countless clients who have anxiety surrounding their physical conditions, as many overweight people do. Regardless of the source of the anxiety, it is a fact of nature that humans often sabotage their chances to succeed or change their current condition. Take our profession, for example. I know that many health and fitness professionals experience aches and pains at some time or another. However, because we feel the need to maintain a certain level of fitness, we sometimes train or play sports even though we know that participating in the activity will worsen our pain. This is similar in nature to people who engage in overeating. They are most likely well aware that what they are doing is not helping to improve their current situation. However, engaging in self-sabotaging behaviors like these fills a psychological need.
I think it is essential for health and fitness professionals to remember that people who continue to engage in activities that make their problems worse, whether those are people struggling with their weight or battling to stay fit, are not entirely different than we are from a mental standpoint. Understanding that some actions may be filling a need can help fitness professionals recognize the “why” of a client’s behaviors, which should be addressed in conjunction with physical fitness.
ACE: How does excess weight change the way a person moves? What are some long-term effects associated with those altered movement patterns?
Justin Price: Overweight and obese people typically carry a lot of excess body fat around the midsection. This increased weight at the front of the abdomen can pull on the lower portion of the spine, making the low back overarch (excessive lumbar lordosis). When a person’s low back arches excessively, it can also cause a downward rotation at the front of the pelvis (anterior pelvic tilt). These musculoskeletal adaptations to the lumbar spine and pelvis can lead to low-back, hip and groin pain. Obesity can also cause the rectus abdominis to become overstretched from the constant downward pull of excessive weight in the abdominal region. Consequently, the rib cage can be pulled downward and out of alignment (since the rectus abdominis originates on the front of the rib cage) and eventually lead to a rounded shoulder posture (excessive thoracic kyphosis). This imbalance can cause shoulder and neck pain. Additional weight in the abdominal area also tips the entire body forward, resulting in excessive pressure on the ankles, knees and feet (which must work harder to prevent the person from toppling forward). Extra burden on the feet can lead to overpronation, resulting in foot, ankle and knee pain.
ACE: Why do you feel knowledge of biomechanics and corrective exercise can enable fitness professionals to be more effective in helping those impacted by obesity?
Justin Price: Think of your body like a car. If your car’s wheels are out of alignment and you are the only person in the car, then your wheel alignment issues will likely have minimal impact on your car’s performance because your weight is a tiny percentage of the car’s overall weight. However, if you take a group of friends and everyone’s luggage on a long trip with your wheels out of balance, you increase the likelihood that your car will break down due to the consequences of all that extra weight carried over an extended period of time. This is similar to an overweight or obese person trying to move or exercise. Having an understanding of how to assess an overweight client’s posture, and the knowledge to design appropriate corrective-exercise programs, will enable fitness professionals to help the client improve alignment dramatically prior to and during exercise, making it less painful and more enjoyable.
ACE: What advice would you give to people who may not know where to start when it comes to losing weight and changing the way they live?
Justin Price: When you attempt to change a lifelong habit or develop a new skill, you need to see evidence that your efforts are bringing success. Whenever you implement a plan to begin losing weight, it is important to start slowly and choose simple, achievable actions that make you feel as though you are successful. As your confidence builds, you can add additional steps at your own rate to ensure you continue to feel successful at every stage. This way, the process of losing weight is self-fulfilling and ultimately enables you to reach your weight loss goals.
Similarly, if you are a health and fitness professional helping clients to lose weight, it is imperative that you start them out slowly by working with them to create a plan of simple and easy-to-follow steps they can achieve successfully. Overwhelming clients with unrealistic programs or your extensive knowledge of diet and exercise can unintentionally make them feel incompetent, and it can ultimately sabotage their efforts to reach their goals.