It’s 2023! It’s January! Time for resolutions and remakes and resets! Right?
NO MATTER your proclamation, whether you promise yourself to eat less meat or eat more meat, save the whales or run 3 miles each day, it don’t mean a thing if…
…you FALL.
I begin with a story. Of course. I recently reconnected with a physical therapist friend of mine and the conversation turned to muscle strength, and age related muscle loss. We talked specifically about quad strength. I had spoken in an earlier post about how strength and balance in the hips, glutes, quads, and hamstrings impacts your knee health. But here’s a follow-up pearl. Ready?
Everyday you are falling! Everyday, gravity is trying to push you on your keister and you are trying to stay upright.
When you walk, gravity tries to push you down. Your core and quads engage to keep you upright. Running? Walking downstairs? With every stride you are challenging you quads with an eccentric force. You are subconsciously engaging your quads to prevent you from falling. You ever trip or stumble, say from missing a step or not seeing that crack in the uprooted sidewalk?
I have.
I can still point out the exact uprooted sidewalk on Beacon St. where I took quite the digger 2 years ago at the end of a run. I descended in slow motion, arms flailing about, trying my best to stay off the unforgiving concrete, hoping that no one was watching. Gravity won and I did an epic face-plant. Pissed me off! No broken bones but my whole body ached for a week. Took a few days until I could bend my left knee. It was then that I knew I had to take a step back and refocus my training on my eccentric quad strength and stability.
More on that in a bit. Back to the whole new year, new you conversation.
January is reset time and every article or blog you see on the internet will champion what you should or should not do. Is this the year to finally embrace RAW milk and say goodbye to OAT milk? Is this the year to finally walk 7500 steps each day and do 30 pushups every morning while listening to motivational podcasts and then having a cold shower? Dry January, or is it Whole 30? Again?
Do any or all of these suggestions represent or hold the ultimate key to happiness and the secret of life? Hmmmmmm.
I have a good friend who shrugs his shoulders at all of this. “Luck overrides all of this,” he says. “Just be lucky.”
Maybe. But I am a big fan of the Stoics as you know, so I say:
Stack the odds in your favor, by focusing on what is in your CONTROL.
PrimalMed’s opinion? The secret of life is…
DON’T FALL !!!
And that my friends, brings us to the PrimalMed SQUAT.
The squat is one of the ESSENTIAL primal movements that I discussed in prior posts. The essential bodyweight movements to master include:
Push, pull, squat and plank. I suppose you could throw in hinge as a 5th. These are the ancestral, primal moves that will provide strength and most importantly, BALANCE, so you don’t fall.
Are your quads weak? If you need to hold on to the side of a chair or table to get up or need to press down on your quads when you get out of bed or off the couch, then it’s time to take action. Can you walk down the stairs or upstairs without grabbing on to the rails? If not, then it is GO TIME! (Of course if you have an underlying physical limitation, then you are exempt from this assessment).
So STAND UP! Look in the mirror. Smile and congratulate yourself on taking action and building your base. Use just bodyweight. Stand with your legs at or slightly wider than shoulder width. It’s time for the AIR SQUAT.
Hands out in front for balance. Abs tightened and engaged. Look straight ahead. Make believe you are going to be sitting on a chair behind you. Heck, you can even do this in front of an actual chair, so if your quads are weak, you can plop your tuchas back on the chair.
This next step is key. Screw you feet into the ground. The PrimalMed moves are done with FOCUS and INTENTION. Take that right foot and “screw it” into the floor clockwise. Take that left foot and “screw it” into the floor counterclockwise. Make sure your feet are turned slightly out, say 10 degrees. If they are turned in too much, you are stressing the knees and crunching your medial meniscus ( I say this sadly, from personal experience. I make every mistake on myself first so you don’t have to! You’re welcome.)
Start with your butt. Move it back like you are sitting slowly down. With control. Go down slowly, say 5 seconds to emphasize the eccentric. The key thing is to keep TENSION in the core and legs for control. TIME UNDER TENSION or TUT is a key principle to make this work.
Look at your knees in the mirror. Make sure they don’t cave in. Don’t bend forward at the knees. You don’t want your knees going over your toes. Keep your heels DOWN and focus on driving your heels into the ground.
You don’t have to go all the way down to thighs parallel. In fact, you shouldn’t. Going down a full 90 degrees to exactly parallel actually increases the compressive and shearing forces on your menisci. Feel the quads engage to prevent you from falling back in to the chair. Modify it if you need by holding on to a table or chair next to you for support. Hold the squat for a count of 5-10 to emphasize the concentric. The longer you hold, the more time under tension. That’s good. Go SLOW with a controlled descent. Don’t be sloppy. Keep everything tight. Here’s a PrimalMed reader gettin’ er dun.
When you rise up from the squat, make believe an invisible string is pulling you up from your chest and armpits with your quads lifting you up. Glutes and hamstrings control you on the way down. Quads lift you up. No ‘Bend and Snap.’ That’s more of a deadlift move. You’ll tweak your back and Jennifer Coolidge would not approve. Rise up and do it for a count of 3. The concentric movement here is less important. Your goal is not to build big muscles, but rather eccentric strength to protect you when you walk, run or fall. Bring your arms back to your side as you rise from the squat. Everything tight.
If needed, add an assist and hold on to a chair. Use just bodyweight. No need to go ‘ass to the grass,’ as the gym bros say. Stay short of parallel. As you progress and if you don’t have wonky knees, you can go lower with the hip crease below the knees or hold some light weights or kettlebells. Keep those knees aligned straight or slightly turned out. Avoid having the knees buckle inward (knee valgus). I repeat this because it bears repeating!
Do 20-30 reps. Slow and controlled. Then do your PrimalMed Pushups.
Lather, rinse, repeat. 3 times.
The natural progression of course, leads to lunges and one-legged balance movements. Look up Pistol Squats online. If you can do those, you win a free PrimalMed T -shirt! To begin with simple balance, and for January, just brush your teeth standing on one leg. Alternate legs if you can 10 seconds each.
The goal? To make sure that when you take that tumble, and, despite our best intentions, WE ALL WILL, then you stay sorta upright, and recover without landing on your outstretched arm (hello distal forearm fracture) or breaking a hip.
Search the internet and you will see thousands of variations of squats, and you too can look like a Sumo wrestler or a dancing Cossack if you wish. The key is stick to your own pain-free limits and abilities and then focus on progression. Static split-squats, Bulgarian split squats and backward lunges are great WHEN you are ready. Holding a weight or kettlebell is great WHEN you are ready. As always, if you have any underlying physical issues, work with a functional physical therapist. They can recommend any modifications to suit your needs.
It’s worth every penny.
TL;DR: The PrimalMed Squat is a tool. Put it in your toolbox. Combine it with the PrimalMed pushup. Make 2023 a fall-free year!
See that happy lady in the first picture? She’s having some fun time with those flamingos and teaching them a thing or two about balance.
Oh…here’s some Radiology…can’t forget about my day job!
See this MRI below? I read this one the other day. That zig-zag line in the subcapital right femoral neck near the hip represents an acute fracture. The other arrow points to arthritis and underlying chronic bone injury. This poor fellow took a tumble. Gravity won. Hello hip replacement.
The only PrimalMed approved fall? Heed the wise words of The King !!!
And Listen to this Steve Martin classic so you don’t forget the concept of TUT or Time under Tension.
2023 is the year to spread the word about Your PrimalMed Prescription. Share this with friends and family and anyone else who is interested in random musings about metabolic health and a functional approach to Nutrition and Wellness. Subscribing is FREE. The little pearls and nuggets you take from each post…priceless!
Dr. Ted, thanks so much for reminding us about falling and helping us to do everything we can to become more in control of our ability to remain standing. I’m always interested in reading this because I have fallen quite a bit, but I’m much more cognizant of how to avoid falling. I actually do squats which means that I sit on a chair arms outstretched and get up and down slowly about 10 times. Maybe that’s not exactly your prescription but it comes close, I think. Ted thanks for all the reminders on how to keep ourselves strong and healthy.
Thanks Nancy! We all fall, but it’s gettin up that counts!!! Enjoyed the PUN! Keep on reading and keep on sharing Your PrimalMed Prescription to friends and family!