People are fascinating. We come in all different shapes, sizes, colors, and personalities. Humans are formed based on their ancestors, culture, family, environmental exposure, athletic and recreational activities, as well as habits of daily life. What we do with our day and how we interact with other living and non-living beings helps form our physical presence on this planet.
Astrophysics is also fascinating. I contemplated going the route of a physicist as an undergraduate for some time and still maintain a nerdy intrigue of basically all things science. If you look at the natural occurring elements on the periodic table, every element other than hydrogen has basically been formed via the exploding, imploding, and creation of stars in our cosmos. Hydrogen, the simplest type of atom, was the first to form in our galaxy. Fusions of hydrogen atoms created the first stars in the galaxy. Since our bodies are made up of billions, upon billions of atoms, we are essentially made up of stardust! If you look at the atoms in our body, 99% of our body’s mass is made up of only 6 different kinds of elements: oxygen, carbon, hydrogen, nitrogen, calcium, and phosphorus. So we are all made up of basically six different kinds of atoms, atoms whose origin come from the stars of our universe. Talk about being connected and one with nature! This is getting pretty deep….
Let’s get back to people. We are all made up of the same particles. Our chemistry and physiology all basically works the same. All of us are classified under the same scientific taxonomy, Homo sapiens. So how and why are we so different? I find these questions fascinating and wonder about them frequently throughout the day. Why do some people have freakishly long legs (like myself!) and others long torsos? Why can some people run marathons and never get injured and yet others struggle to run 15 minutes without hurting? Why does each one of us think and perceive the world so differently? If we are all made up of basically 6 different atoms of the same stardust, why are we so different???
For me, that’s what makes life exciting and fun to think about. Each person’s physical and neurological differences need to be accounted for when they come in for physical therapy treatment. While we are all very unique as far as how we are made and how we think, we all have to work against the same laws of physics. Those freakishly long legged people have different challenges with gravity compared to those freakishly long torso people. Long, narrow people have different air flow challenges with respiration compared to wider, shorter people. People with lots of genu valgum (“knock knees”) have different stressors on their feet, knees, hips, and back compared to people with high genu varum or who are “bow-legged.” Those with really flexible joints (“double-jointed” folks) need to address different aspects of their biomechanics than individuals with really stiff joints.
In David Epstein’s book The Sports Gene he discusses a variety of physical traits that benefit an athlete for different sporting events. Epstein notes that the average height of an NBA Basketball player is 6’7”, while only 5% of the American male population is over 6’3”. Of these American men between the ages of 20-40, 17% are NBA players! Most humans have an arm span that is equal to their height. For example, since I am 6’1”, my arm span is roughly 6’1”. NBA players, on the other hand, have an arm span that is significantly longer than their height (good for blocking shots!). For instance, Anthony Davis, the first pick of the 2012 NBA draft is 6’9” and has a 7’5” wingspan.
In his book, Epstein also discusses that much of our body shape is due to where our ancestors evolved. Those who have ancestors that lived primarily around the equator developed long slender bodies with proportionally longer limbs, a body type allowing for more efficient cooling. Conversely, those whose families evolved further from the equator (think Vikings and Eskimos) have a short, stocky build, which is less efficient for cooling, but much better at keeping the body warm. It is no coincidence that the best distance runners have proportionally longer legs and happen to reside near the equator (think Kenya and Ethopia). Michael Phelps, one of the most talked about and gifted athletes of the last generation, is seven inches taller than the world record holder in the mile (Hicham El Guerrouj) yet they both have the same inseam measurement for their pants. El Guerrouj is gifted with long legs and can use those long legs to propel him over ground really stinkin’ fast, whereas Phelps has a lot of torso that keeps him buoyant and efficient in the water.
For more info and great pictures of these incredible athletes:
El Guerrouj: http://www.voice-online.co.uk/article/hicham-el-guerrouj-2004-athens-olympics
Phelps: http://www.scientificamerican.com/article/what-makes-michael-phelps-so-good/
So what does this mean for physical therapy? Sure, we are all made up of the same stardust, but like snowflakes we are all created very differently. When an individual comes in for treatment, we need to consider their body size and shape to create an optimal program. For example, people with long legs (yours truly!) will always be glute-challenged. We also have very long lever arms that need to be controlled by the muscles around our hips. Conversely, although El Guerrouj is tremendously gifted in many ways, both physiologically and biomechanically, he must have strong glutes in order in to keep those long levers he has for legs functioning properly. Another challenge presents itself for individuals with long, narrow, thin torsos. This body type will always be predisposed to over-developing their neck muscles for breathing. They will likely have complaints of tight necks and headaches more than someone with a wider (but not too wide) torso. Imagine trying to breathe through a narrow coffee stirrer straw versus a wide Big-Gulp straw from 7-11. It takes a lot more effort to breathe through that tiny coffee straw! Those with narrow, long torsos are constantly asking their diaphragms to pull air through a narrow straw (their neck and thorax). Since this requires so much work, the muscles in their necks will have a tendency to engage in order to help pull in more air to their upper ribs. This overworks their neck muscles for things they should not be doing all of the time (read more about breathing).
When you come into the clinic we will consider your body structure and how it relates to why you are coming in to see us. Your body’s structure and its battle with gravity and physics will help determine the correct and optimal course of treatment specifically for you. So, if you ever ponder the meaning of our existential connection of common stardust ancestors, allow yourself to appreciate how very unique each and every one of us is!
This post was written by Craig Depperschmidt, DPT, PRC