Wednesday, March 24, 2010

Toilets and Range of Motion

Range of Motion (ROM) is an often neglected term or idea in the fitness realm. The most popular cardio machines in health clubs (elliptical, bikes, recumbent bikes, skiers, treadmills, stair steppers) do not address ROM issues. In many cases, they actually build on the problem!!

What does a toilet have to do with Range of Motion?

We just renovated a bathroom in our home. The one-level style of our home caters to older folks, and we wanted to add another feature that might increase this appeal....a taller-than-normal toilet. Old people like these thrones because they are easier to get on and off than a standard one. These bowls are no longer called "handicapped" models, but "comfort height." What troubles me is not how many younger people request these models, but rather why they are needed! Read on.

What is "the ROM issue?"

ROM is the degree to which certain joints bend, stretch, flex, hold, and articulate. Those people with poor ROM have difficulty getting into and out of certain body or joint positions. Those with exceptional ROM easily manipulate their bodies into and out of not only normal positions, but the extremes at which their bodies are capable of. Simply put, we should strive to reach the maximum of ROM in all of our body's joints and movements. But we do a bad job at maintaining this pre-programmed condition. Enter the ROM issue. Or should we say "epidemic."

It is proven fact that our muscles are weakest at the maximums or extremes of ROM. Take climbing stairs for example. A staircase made of 6" tall stairs is easy to climb. The ROM required of our hips, knees, and ankles is nominal. However, stretch each stair riser height to 12". Now we see increases in the ROM required in all of these joints and muscles. It becomes more difficult because our muscles are forced into positions where they aren't as strong. Now stretch that stair riser height to something even taller!

Take the "lunge test"

I just walked around my home with a measuring tape. My bar stools are 30". I was able to get one flat foot on top of the barstool and step up onto it (beware of the ceiling! If I hadn't had tall ceilings, I'd have knocked myself out.) I encourage you to try the same. Find something taller than 12" and sturdy and climb up on it like a stair. No hands! For those of you who are adventurous, find the maximum height you can get a foot up onto. For me at 74" height, the 36" kitchen counter was about 1" too high to plant my foot onto. Getting up onto it would be another challenge!

This diminished strength at maximum ROM is normal to ALL people. It is nature. The problem is that many of us can no longer even get our bodies into the position in the first place, let alone get out of it.

Old people begin to fail at taller stairs, then normal height stairs. This ability decreases until any stairs are impossible.

Problems with "luxurious" cardio machines

In the article Third World Squat by Craig Weller, the author believes all humans should address poor muscular balance and flexibility. He doesn't see these imbalances in those who live in third-world countries for the reasons listed in his article. These indigenous peoples have maintained the natural ROMs programmed into our human design. They have not allowed comfort equipment or safe-to-use cardio machines to adversely affect their bodies' ROM.

So what happens as we grow older? We allow ourselves to adapt to our surroundings: chairs, elevators, Rascal scooters. We lose muscular and joint flexibility. We find comfort in using fitness equipment that keep our joints from these maximums of ROM. Take the above listed cardio machines. They limit our ranges of motion. Why? One reason is that there is a smaller chance of injury in operating in these narrow ROMs...leading to fewer lawsuits against the manufacturers and health club. Another reason is that the human body does not get as sore when kept within comfortable ROMs, and we "feel good" after the workout...which keeps us paying membership dues and buying the equipment. So we use them. Lastly, these machines are open for use to a wider variety of skill level for those with poor flexibility...because beginners have to begin somewhere!

Users of these machines leave the club feeling good. Yet they generally leaving without working on one of the most neglected aspects of fitness: wide Range of Motion.

These machines are not all bad. They serve a purpose. A limited purpose. The problem lies in the belief that these machines are the end-all-be-all. These machines are good for warmups, rehab, and beginners with limited flexibility and ROM. But we should aim to advance beyond them! Into a program that includes ways to optimize our abilities to get into and out of these extreme positions. Ask yourself if YOU condition your body within wide degrees of joint movement or not.


Being flexible is a very positive physical trait. However, muscular flexibility on its own is not enough to claim "wide ROM." Wide ROM factors in strength and balance at those extreme positions. You might falsely believe you have ROM because you have a terrific stretching routine. Don't be fooled. You might be missing something.

Another test

Here is another at-home hands-on segment. Some call this the "box squat test." Find something low to sit on. Maybe it's a 5-gallon bucket, a milk crate, or a cinder block. Maybe it's a stack of Olympic weight plates, two cases of beer, or a stack of phone books. Maybe it's the toilet seat. Sit down. Put your feet bottoms flat on the ground. Yes that means your heels too. Stand up without gaining momentum or rocking to your toes. Can you do it? Keep messing with different heights to find the lowest measurement you can. As our friend Tom G poetically rhymes, "Get your ass to the grass!"

To do this test well, you must have muscular balance. Most deficiencies are in the posterior chain of hamstrings, glutes, and lower back. Not just flexibility. But strength.

The soft couch at the family party

You've all probably been told at some time, "Don't let grandma sit in that chair. She'll never get out!"

Have you ever been to a family party where an older uncle or grandma sits down in that couch with soft cushions? A couple of you had to reach out your hands to pull him or her up? But of course not after he or she gave all the effort possible to get out on their own accord. They shifted momentum. Tried to rock themselves to the edge. They tried to press down on the couch or chair arms (mimicking a dip position). But they had to resort to you and your cousin pulling them onto their feet.

Back to the toilet

Talk about "functional fitness." Wow. Who'd have thought that ROM and practical real-life fitness would have an application in the bathroom? And who'd have thought I'd sink down to actually write about it?

We are catering to this adaption of narrow ROM in our powder rooms when we put in comfort-height toilets. The problem is that it seems as though the people who NEED these items are getting younger and younger. It's a sad state of affairs when middle-aged folks need to rock themselves off the potty.

We will all get old and weak and feeble. Hopefully I get to live that old. But I'm not going down without a fight. I'll continue to bash cardio machines and poor ROM. I'll steadily suggest and make a case for third-world squatting and wide lunges....for those in preschool, the nursing home, and everyone in between. I really truly believe that working within and striving for wide ROM as a young person, and continuing into older years, provides for the highest probability of a high quality of life into old age.

The day might come when I am too old, weak, or injured to get up off the toilet by myself. But it is not today. And if I have a say-so in it, it's not anytime soon either.

Please make a commitment to increasing your ROM. Do something about it today.

MORE: For more on ROM and scaling issues, please read George Demetriou's article here.

1 comment:

J Caruso said...

O.K. Lou ... It's been over 48 hours since your toilet post and no one has commented yet. I guess someone has to take the first "plunge". First of all, thanks for not actually posting a picture of you on the toilet. Second, if you ever get to a point in your life and you do need assistance getting off the toilet, you know you have MANY friends who will be there for you! Lastly, thanks for your insight on ROM. I have an arthritic left knee, and I battle ROM, but I too am not going to go down without a fight!