“70 Percent of Disability Could Be Prevented”

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Recently, I was meeting with my orthotist to try to design plan #43 (at least) to deal with my ankle-that-does-not-move-properly.

I asked him how much disability he sees that could have been prevented with early intervention physical therapy. Like, if that person who is post polio or post stroke or who was diagnosed with MS or Charcot Marie Tooth ten years ago had been seen by an expert in watching movement, how much of their currently level of disability could have been avoided?

Without missing a beat, he answered. “70 Percent. Easily 70 percent.”

When I asked a similar question to my Neuro Physical Therapist, she didn’t have a percentage, but she said the neurological population was the most underserved of all chronic conditions. She agreed that a huge percentage of disability was avoidable. I don’t know if these numbers are scientifically accurate, but I wouldn’t be surprised. I routinely see even perfectly healthy people with aches and pains and injuries caused by nothing more than moving wrong for years, with no one there to tell them to do it differently.

Beyond shocking, this is entirely unacceptable. It is the reason I wrote a book and course on Pilates for MS in which I have a ton of exercises I wish I personally had done from the early years of my own MS diagnosis, and the reason I hope fitness teachers and physical therapists (and dare I dream, the medical system) will step up to the challenge and help. Because any preventable disability is too much.

For me personally, I wish someone would have emphasized (screamed) the importance of doing ankle range of motion, stretching, and strengthening exercises. Why? Because your feet are the farthest thing down the nerve pathway from your brain, and the most likely to be affected from poor nerve conduction or neurological weakness. I wish after I had foot drop 12 years ago which “mostly resolved,” that someone would have sent me to a physical therapist who could have assessed improper ankle biomechanics that would turn into an orthopedic problem. I wish I had fitness teachers earlier who knew how to work with MS and tell me what I could work on to prevent things from worsening especially when I didn’t think anything was really wrong.

I’m lucky that I found Pilates when I did. It has kept me strong and flexible and reasonably balanced. But there are still things that went wrong that didn’t have to.

I was diagnosed with MS in 2002. In that time, I’ve never stopped exercising. It’s easier to prevent problems than to fix them after all. Without any exception, the people I know with chronic neurological conditions who are doing well are the people who move regularly. But I know more now, and I would have done some things differently.

There isn’t a handbook for the newly diagnosed that says “Do this, not that.” How are we, as a society, failing people with chronic conditions if in no other way than not making them 100% informed about what can happen? Offering the best tools to help prevent disability? And, what can you, as a fitness professional, do to change that? Quite a lot, I think. Quite a lot.

In health,


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