Movement Therapy in Practice
Movement Therapy celebrates the idea—put forward by Ida Rolf—that a body’s health should be defined not only by its “chemistry” but also by its “structure.” A body whose soft tissues (muscles, tendons and ligaments) mesh effectively with its bones will be a happy body. Creating a structurally sound body—free from chronic pain—is our main goal. This is accomplished by building strength through the full ranges of motion in the key muscle/bone systems of the body (especially where the spine has to branch out and support the arms and the legs—at the pelvis and at the shoulder blades). Range of motion is key because this allows the different parts of the body to work smoothly together—to flow—eliminating the obstructions that cause pain.
Patients come to realize that their own health depends on how they move. And they discover, usually to their surprise, that the most commonly used forms of exercise—running and weightlifting—can be dangerous because they limit range of motion. This danger arises by shortening key dominant muscles, which creates obstructions, blocks flow, and leads to injuries. Also all the hard pounding of both these exercise systems leads to injuries. These injuries often lead to surgery and then back to chronic pain. (Look at what happened to Tiger Woods, with multiple knee and back surgeries, and finally addiction to pain medications.) So the exercise that was meant to strengthen the body and lead away from pain ends up circling back to pain. Both underuse and overuse of the body can do harm.
Movement Therapy uses those forms of movement that best respect the structure of the body: walking, yoga, tai chi, Qigong, and Pilates. All these forms—especially as a person advances and practices several forms—strengthen flow and balance and range of motion. And each of these forms has a different role to play, depending on a patient’s current limitations and fitness level. We start with brisk walking and the easiest forms of chair yoga and tai chi. Each patient learns to experience flow, to breathe slowly and calmly with the chosen movement, to respect the individual structure of his or her own body, and to move without pain.
But eliminating chronic pain is not our only goal in Movement Therapy. Three key scientific studies (2010 and 2016) stress the importance of physical movement to heart health and to cancer prevention.
The first, in 2010, was released by the American Heart Association (“Strategic Impact Goal Through 2020”) with the title “Defining and Setting National Goals for Cardiovascular Health Promotion and Disease Reduction” (Donald M. Lloyd-Jones, Chair; Circulation, 2010; 121: 586-613). On pages 596-7 and 599 this study stresses that to reach “ideal health status” the patient must “achieve control of all metrics through lifestyle alone” [“without medications”]; “although the achievement of ideal levels of a cardiovascular health factor through medication use is important . . . this is not equivalent (in terms of favorable outcome or risk for events) to having maintained or achieved ideal levels of cardiovascular health factors from childhood to young adulthood to middle age without medications.” Even these cardiologists admit that the way to robust health is not through medications but through lifestyle behaviors centered on food and movement. The “Goal/Metric” for “Ideal Health” in adult “physical activity” (table 3, p. 598) is being met by 45% of the US population, and it involves “150 min/wk moderate intensity or 75 min/wk vigorous intensity.” This has been the accepted standard of necessary exercise for heart health since the large studies of the 1980s: walk briskly for 30 minutes, five times a week. No surprise here, and the science, in multiple studies, backs this up. Movement Therapy uses this as our baseline.
The big surprise in this 2010 heart study comes in the next line of table 3: “Healthy diet score.” Less than 1% (“<0.5”) of US adults and children achieve “Ideal Health” status in the food they eat. This status requires “4-5 components” of “healthy eating”: 1) fruits and vegetables (4.5 cups per day); 2) fish (2 servings per week); 3) “fiber-rich whole grains” (3 1-oz servings per day); 4) sodium (limit); 5) “sugar-sweetened beverages” (limit); 6) “avoidance of trans fat”; 7) “avoidance of processed meats”; 8) “displacement” of these meats and “other highly processed foods” with “unsalted nuts, seeds, legumes, and vegetable sources of protein” (4 servings per week minimum).
There is a long discussion of a “healthy diet” (pp. 595-6, 601), with two key bullet points on why they chose these components: 1) “dietary habits that have the strongest evidence base for likely causal effects on cardiovascular events (ie, not just risk factors), diabetes, and/or obesity”; 2) “an overall recommended dietary pattern based on foods rather than nutrients . . . for better communication . . . and action by practitioners, individuals, and policy makers.”
The reason I have turned away from movement to food here is that a significant portion of the US population (45%) now understands the need for movement (exercise), but only a tiny fragment (less than 1%) eats enough of the foods that make a person healthy. This is precisely why Food & Movement Therapy has a double and conjoined focus: movement and food. Movement Therapy is meant to lead a patient from movement to healthy eating to reducing or eliminating medications (toxic stressors) whenever possible. (We want to build robust health on the same foundation recommended by this ambitious 2010 heart study.) Once a patient starts to move in a healthy way (more than once a week), that patient starts to take her health seriously and to consider changing what she eats. Especially if she is in a program, like ours, with more advanced participants who form a community based on healthy food.
The second scientific report comes from JAMA Cardiology with Stephen Sidney, MD, as the lead author (published online June 29, 2016): “Recent Trends in Cardiovascular Mortality in the United States and Public Health Goals.” In her discussion of this report, Jane Brody, in The New York Times (Aug. 2, 2016), says, “the researchers [“from the Centers for Disease Control and Prevention”] called their findings ‘alarming,’ suggesting that cardiovascular benefits from medical interventions may have reached a saturation point and that further improvements depend largely on changes in society and personal behavior.” In other words, these “improvements” depend on us using food and movement to advance our own health.
This JAMA Cardiology study concludes (p. E5): “anticipated declines in the prevalence of smoking, high cholesterol levels, and hypertension (in males) would be offset by substantial increases in the prevalence of obesity and diabetes. . . . The prevalence of diabetes nearly tripled, from 2.5% in 1990 to 7.2% in 2013. An estimated 29 million US adults have diabetes.” So, even as more Americans start to exercise and to take medications for cholesterol and hypertension, it is not slowing down the death rate from heart disease. Type 2 diabetes is a huge risk factor for heart disease, and it is driven by two main dietary trends: too much refined sugar and too many animal products. All the exercising in the world will not drive away diabetes, but a lifestyle transformation in what you eat will. “The percentage [of Americans] meeting ideal levels for body mass index and glucose decreased from 1999 to 2012; and the percentage meeting the ideal level for diet was near zero” (p. E5; remember the “less than 1%” healthy diet score from the 2010 study!).
The third scientific study “pooled data from 12 prospective US and European cohorts” to discover links between movement and cancer risk: “Association of Leisure-Time Physical Activity With Risk of 26 Types of Cancer in 1.44 Million Adults” (lead author, Steven C. Moore; JAMA Intern Med. 2016; 176(6): 816-825). The main findings were these: 1) it defined the key level of exercise intensity for cancer prevention as the same as our 2010 heart study: “150 minutes of moderate-intensity activity (eg, walking) per week” (p. 817); 2) it stated “an estimated 51% of people in the United States and 31% of people worldwide [were] not attaining recommended physical activity levels” (p. 817); 3) “higher activity levels were associated with younger age, more education, lower BMI, and lower likelihood of being a current smoker” (p. 819); 4) “higher levels of leisure-time physical activity (at the 90th percentile), as compared with lower levels (at the 10th percentile), were associated with lower risk of 13 of 26 types of cancer examined, with risk reductions of 20% or more for 7 of the cancers” (p. 821); 5) “among the overweight and obese, a higher physical activity level is still associated with lower cancer risk” (p. 823); 6) “physical activity’s biological link with cancer has been hypothesized to be mediated through 3 hormonal systems: sex steroids, insulin and insulin-like growth factors, and adipokines” (p. 823); 7) “several nonhormonal mechanisms have been hypothesized to link physical activity to cancer risk, including inflammation, immune function, oxidative stress, and for colon cancer, reduced gastrointestinal transit time” (p. 823).
If prominent scientific thinkers in the fields of heart disease and cancer push us to move (or “exercise”) in order to live longer and better, then it is up to us—the leaders in healthcare innovation—to create a movement system that draws in and encourages patients. A movement system that is safe and gradual—that does not injure the same high percentage of participants as in running and weightlifting. A movement system that also tackles chronic pain (especially of the lower back), unlike running and weightlifting which exacerbate that pain. For, remember, chronic pain is the spark that lit the fuse of the opioid epidemic exploding across our country.
Lastly, a movement or exercise system that does not tackle head on the current toxic food environment in America—that pretends exercise is enough—will never have the kind of impact we need to fight diabetes. When Coca-Cola and others in the food industry spend millions of dollars supporting “exercise” programs in our schools, they are simply using “exercise” as a mask to hide the diseased face of their own product. They say food doesn’t matter. That we can exercise our way out of the current diabetes and obesity epidemics. They are lying, and they know it.
At Food & Movement Therapy we use movement as a way of attracting patients to a community of health-minded movers. But our goal is, bit by bit, to get these patients to strengthen themselves enough to move on to the much harder struggle ahead—to reject the toxic food environment around them and to build their own health with every bite they take of clean, whole foods.
Food & Movement Therapy (famtusa.org): changing the healthcare landscape of America one body at a time.