Editor’s note: The podcast Chasing Life With Dr. Sanjay Gupta explores the medical science behind some of life’s mysteries big and small. You can listen to episodes here.
When people are young, if they are fortunate enough to enjoy good health, they get to move their bodies with carefree abandon — running, jumping, bending, dancing, twisting — in pursuit of whatever activity they are engaged in.
But if they are lucky enough to get older, life intervenes: Free time becomes more limited, and interests, responsibilities, habits and behavior all change. Many people abandon the playground and learn to sit — in a classroom, at the office, in front of the TV, in a car.
Then at some point, many notice they have grown stiffer, and maybe it hurts to do this movement or that one, or they can no longer move in all the ways they want to. And people often attribute the aches and pains to simply getting older — but is the change inevitable?
Quantifying mobility has been, excuse the pun, a moving target. “Every physician on the planet, every physical therapist, every chiropractic physician, all agree about what the body should be able to do. We’ve said, here’s what blood pressure is, and everyone knows that. Here’s what (body) temperature is, and everyone knows that. We started to become very sophisticated about understanding some aspects of our physiology, but not range of motion,” Starrett said.
“What ended up happening is we created this definition of (mobility): Do you have access to your native range of motion? Can you control it? And, when we improve those things, did what matters to you improve?” he asked.
Starrett’s most recent book, coauthored with his wife, Juliet Starrett, is “Built To Move: The 10 Essential Habits To Help You Move Freely and Live Fully.” It addresses mobility: measuring it (with 10 tests) and, equally important, regaining it in small increments that don’t take up all your time.
“How do we simplify the process so it doesn’t feel so overwhelming?” he asked. “I’m not giving a busy working mother another listicle.”
You can listen to the full episode here.
Why should you care about range of motion and mobility when the couch is so comfy and many of your needs and wants are only a mouse click away? Because mobility is associated with longevity, Starrett said.
He noted that falling is a big predictor of injury and decline in people age 65 and older.
“If I don’t have access to balance or range of motion, I can’t solve as many movement problems. And losing your balance is a movement problem,” he said. “Getting up and down and being independent is a movement problem. Being able to rise from a chair while you’re holding your baby or your cat, or holding a cup of coffee and a book is just a movement problem.”
As you get older, your body is more likely to “throw an error,” Starrett said. It’s a matter of use it or lose it.
“If I want to have a joint and tendons that act like joints and tendons my whole life, I better use that joint and I better load those tendons,” he said. “Otherwise, they’re not going to be available to me as readily.”
Muscles and tissues are like obedient dogs, he said. “They always adapt. At no age do you stop healing. At no age do you lose the ability to reclaim range of motion. It’s going to be a little slower than when you were 15 — that’s true. But the bottom line is your body is always going to adapt.”
What can you do to easily retain or regain some of your mobility? Starrett has five tips.
Get your body into different shapes
People mostly move from lying down to sitting in a chair to walking around a bit, Starrett noted. “Modern environments don’t really ask much of the movement language of our bodies. Most people are only using a few words that their bodies could write,” he said.
“The first thing we should be thinking about is, ‘Well, how do I increase my exposure to more movement language?’” he said.
“One of the easiest ways, for example, that we think would foundationally change society is if people sat on the ground in the evening, for 20 or 30 minutes while they were watching TV, while they’re reading a book,” he said. “And that could be leaning up against the couch; it doesn’t have to be in a strict lotus.”
Getting into and out of that cross-legged position will also expose you to different movements, especially in the hips and knees. The practice can also tell you a bit about your ability to move freely and effortlessly.
“Being able to get up and down from a cross-legged position is an excellent predictor of all-cause morbidity and all-cause mortality because … it says a lot about how you are interacting and adapting to your environment,” he said.
And if you need to fidget, fidget — because that will also get your body into additional interesting positions, he said, such as kneeling or squatting.
For more ideas on getting your body into different shapes, you can watch short instructional videos on Starrett’s The Ready State YouTube channel.
Hang from a bar 3 minutes a day
If you’re experiencing aches and pains in your shoulders, neck or back, Starrett has a fix. “I want you to hang for three minutes a day,” he said.
You can hang in many different ways, he said — by grabbing the edge of a sink or a doorframe or, better yet, a pull-up bar — just get your arms above your head and stretch a bit. Even the yoga pose “downward-facing dog” counts as hang time, he added.
“That would fundamentally change your posture, change your neck pain, change your breath, change your shoulders, make it so you’re more durable. I mean, that is a foundational posture,” he said.
“Go to the airport and watch people in the (body) scanner,” he said. “You’ll see why we have that as a test (in the book), because people literally … cannot put their arms over their head anymore.”
Walk more (for a surprising reason)
To keep stiffness at bay and maintain your mobility, Starrett advises everyone to do plenty of walking every day.
“If I could give everyone in my family a pill that reduced all-cause mortality and morbidity by 51% — that’s walking 8,000 steps a day,” he said.
“If you want your bones and tendons and ligaments and perceptive systems to work, you have to physically load them,” he said. “Right now, we’re seeing an epidemic of osteoporosis, osteopenia, sarcopenia — people are losing muscle, losing bone. That’s because this body is an adaptation machine, and if you stress it, it adapts, and if you don’t stress it, it adapts (in an undesirable way).” Walking loads our bones, our connective tissue, our tendons and our musculature.
Additionally, walking helps the body decongest and clear waste, Starrett said.
“Your body makes about 3 to 4 liters of lymphatic fluid every day,” he explained. “And the lymph system is the sewage system of the body: all of the broken-down cellular material, all of the waste, all the proteins that are too big to come in through your capillaries, all go out through your lymphatic system.
“What we need to do is appreciate that that sewage system of the body has been bootstrapped through our muscle system,” he said. “And so, if we want to decongest, move the waste along, then we have to keep moving.”
It also happens that as congested tissues get stiff, they don’t heal as well, he said. By decongesting our tissues, we get improved blood flow, which is also good for the brain.
Play more
Exercise doesn’t need to be all work.
“We started to treat the health of the body as like some onerous task,” said Starrett, noting that play has been lost in our modern lives. “When’s the last time you did a sport or jumped into a dance class?
“One of my favorite tools that I use even for my elite athletes (are videos by) Caleb Marshall, who is The Fitness Marshall,” he said. “We use (his free three-minute dance routines) to warm up, to have fun, to laugh. And what it does is it gets me moving in a novel way. It gets me interacting with my friends. It’s super fun.”
Starrett also carries around a flying disc in his backpack so wherever he and his wife go, they can have spontaneous play during a moment of free time.
“Play could be a continuum,” he said. “Going for a walk with your friends in the evening — I’m going to call it play. Exploring your neighborhood on a hike could be play. Humans are best when we’re playing. And that will solve a lot of movement problems.”
Don’t neglect the basics
For robust physical movement, Starrett advised a balanced diet with enough protein and fruits and vegetables.
Starrett recommended aiming for 800 grams of fruits and vegetables a day. “That could be frozen, that could be fresh, that could be beans, that could be potatoes, that could be fruits and vegetables — not just kale,” he said. “It’s about fiber and micronutrients. I need you to have all the vitamins and minerals on board so that you can have healthy tissues.”
And he recommends at minimum getting 0.7 to 0.8 grams of protein per pound of body weight. “It’s about, ‘Hey, I want to have enough protein on board to be able to build muscle and build bone.’”
And don’t forget sleep.
“You’ve got to sleep,” Starrett said. “There’s not a single study in the world that says you can get by with less than seven hours of sleep. So, we look at seven as our sort of minimum threshold.”
“When I work with people who are in chronic pain, who want to change their body composition, learn a skill, heal an injury, we start with their sleep,” he said.
We hope these five tips help you get started on your mobility journey. Listen to the full episode here. And join us next week on the Chasing Life podcast when we examine the macronutrient that’s having its moment in the sun: protein.