Physical Capital
Physical strength, endurance, flexibility and power are all assets that serve us throughout our lives. We can add to them by engaging in health-affirming behaviours like eating nutritious food in appropriate servings, by engaging in regular exercises, by getting enough sleep, and by proactively seeking help from medical practitioners in the event of illnesses or discomfort. We can also subtract from our assets as well by engaging in health-deteriorating behaviours like overeating or eating the wrong kinds of food. We can consume substances like alcohol or tobacco in excess. We can refrain from exercise and even engage in activities that undo our body's ability to move freely, like sitting in sedentary postures throughout the day, and by ignoring the advice of our health practitioners.
Physical capital has important implications in a clinical context. It is the sum of resources that allow us to engage with the world in a manner that we choose. It determines the kind of injuries that people will experience as well as how quickly they will return to normal life. A younger individual with no prior medical history, and who exercises regularly while refraining from behaviours that negatively impact their health will have a faster and less effortful recovery from a simple injury than an older individual who lives a sedentary lifestyle characterised by behaviours that subtract from their health. Additionally, the healthier person will be less likely to experience chronic and strain-related injuries, especially if they are physically fit. People who don't take care of themselves, or who don't engage in health-reinforcing behaviours, are more likely to experience injuries like chronic back pain, headaches, shoulder and arm pain.
So, it seems like the right and appropriate thing to do is to work to improve our physical capital - to be fitter, eat healthier, get enough sleep and take care of ourselves. This is even more important when we consider that the world around us is arranged in a way that may be detrimental to our health, or at least not make us healthier. It would be right to say that the best way to minimise the incidence of chronic injuries such as back pain, shoulder pain and neck pain would be to invest proactively into physical strength and well-being through regular exercise and health-affirming behaviours.
However, physical and health capital are not simply strength, flexibility, cardiovascular endurance and power. All of those things are things that can be measured and quantified. Harder things to assess - but which also contribute to physical capital - are the amount of education someone has regarding health and wellness, and their willingness and ability to leverage that into action.
Mind and Matter
Health education is an essential part of building and maintaining physical and health capital across the lifespan. Education is empowerment, in that it allows a person to make decisions ahead of time in their own best interest and decreases their dependence on a practitioner. Any time dependence is decreased, independence is increased. Clients should come away from clinical sessions with an improved understanding of themselves and their bodies, as well as an understanding of the recovery process. A nuts-and-bolts comprehension is essential in creating a good outcome for the client no matter the reason they come into the clinic. Every practitioner should be a teacher and an outreacher.
The final, but at the same time the most difficult element to manage is a person's willingness and ability to engage in health-affirming habits. Habits are tricky things to fall into and easy things to fall out of, even more so in the intra-COVID-19 society we live in. Even before the Coronavirus Pandemic, barriers to engaging in healthy behaviours included the prohibitive cost of gym memberships and equipment, the time investment needed to yield actionable results from programs, an overload of health-related information from practitioners competing for primacy in an oversaturated and highly overburdened marketplace, and a lack of energy at the end of the day.
Problem Solving
The role of a clinician is threefold: to build the client's physical capital, to leverage the client's physical capital to produce the best outcome for them, and to empower the client to make decisions that will expand and reinforce their physical capital into the future. All of these elements work together; one cannot be dealt with independently because they all form part of the same foundation and implementation. Building physical capital involves prescribing and monitoring programs of exercise, but those programs can't be written without an understanding of the patient's context and the requirements of their life. Leveraging the patient's capital can't happen without access to resources outside the clinic which in turn rely on the patient's being able to make time and spare resources to access them. The ability to make decisions longterm depends on longterm goals. The clinician has to engage in a process of creative problem solving, engaging with all of the elements needed to build independence and culture an attitude of proactivity toward health, as well as decreasing dependence on the clinician.
Physical capital may constitute the sum of resources that allow us to engage with the world in a manner that we choose, but accessing and leveraging that capital is the key to a good outcome. It's a problem that cannot be solved by one party by themselves, but as a result of a collaborative effort. A person's physical capital comes from their body, their mind, their context and their life, and all four of those dimensions need to take part in the process of their recovery. To diminish the importance of one of these elements is to diminish the process in its entirety, and to disadvantage the patient.
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