Episode 1520 - Carrying: a lost, essential skill

Dr. Lindsey Hughey // #ClinicalTuesday // www.ptonice.com

In today's episode of the PT on ICE Daily Show, Extremity Division Leader Lindsey Hughey discusses carrying as a valuable skill unique to humans as hunter-gatherers. She points out that humans, with their opposable thumbs, are well-suited to carry objects for long distances and extended periods. However, Lindsey also notes that this skill is being lost in modern society due to sedentary lifestyles and technological advancements.

Lindsey references Michael Easter's book, "Comfort Crisis," which challenges readers to step outside their comfort zones and recognize the importance of carrying as a skill. She suggests that carrying should be trained and incorporated into various healthcare professions, regardless of the specific patient population being treated.

The episode highlights the benefits of training carries. It mentions that carrying trains aerobic tolerance and grip strength, and it is a primary functional skill for picking up and transporting objects over long distances. Lindsey encourages listeners to consider how incorporating carries into their practice can lead to long-lasting functional changes for their patients, enabling them to carry objects without assistance and without needing frequent breaks.

Additionally, the episode emphasizes that training carries not only benefits specific body parts like the trunk, shoulders, and spine but also the entire system. The act of walking while carrying is described as the "magic" of training carries, as it trains the cardiovascular system, respiratory system, and central nervous system. The episode concludes by stating that not training carries means missing out on a unique opportunity, regardless of the specific issue being treated (upper quarter, spine, or lower quarter).

Take a listen or check out the episode transcription below.

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EPISODE TRANSCRIPTION

00:00 LINDSEY HUGHEY Good morning, PT on Ice Daily Show. How is it going? I am Dr. Lindsay Hughey. I will be your host this morning. We are going to chat all things Cary today. But before I do, I would love to just tell you a little bit about some courses that the Extremity Management Division has coming up. There are a host of opportunities. So just this upcoming weekend, I'll be in Madison right before the CrossFit Games. We're so excited to cheer Kelly on and her team, representing her team this morning. My shirt just came in. We're so pumped for that. But if there are a couple spots, like one or two left, so if you're on the fence, sign up now because those spots will probably go. But moving throughout the summer, we have lots of opportunity. So the next opportunity will be August 12 and 13, Rochester Hills, Michigan. There's lots of spots left in there. That's one of our more empty courses. So sign up for that. Because we're not in Nebraska, the following weekend, the 19th and 20th, is actually almost stacked. I don't think there are any spots left, maybe just a couple. So then your next opportunity would be in September with Mark. And there's lots of opportunities to jump in there in Amarillo, Texas. And that is September 9 and 10. He would love to see you there. And then September 16, 17. So we're moving more into the fall season. Cincinnati, Ohio. Mark has some spots there. Take a look on PT on ICE.com. If you're looking for a little bit later in the year, there are opportunities through the winter to join us. But we're not putting any more courses on the books for this year. So 2023. So opportunities are dwindling. But if you want to learn about met best management in your dosage strategies and about tendinopathy and how to load the upper and lower quarter, we would love to have you join us. All right. Today's topic I mentioned is carrying, right? And if you've been to our extrogyn management course, you know that carry lab is a big fun part of the end of day one. And then if you've been to MMOA, you know, carries are really important there as well. And most of our divisions at some point probably talk about the value of carrying. And a little bit about the background that got me inspired to chat about the value of training carries in our patient. It's really from a book I just recently read by Michael Easter Comfort Crisis. It's really challenged me to think about kind of how the evolution of technology and advancement in our society has really evolved away some of our valuable apex predator skills because we have more sedentary lifestyles and just our job demands and our ability to do that. And so we're losing a skill that's really unique to us as hunter gatherers. And because we have the opposable thumb, we are like the prime species to carry objects for long distances for a long time. And we aren't training ourselves in that way, even though we are the most well suited species to do so. And that book, dive into that if you're interested in it because it really challenged my thinking about everything we do in our world today is pretty comfortable. And the book really challenges you to get outside of your comfort. I'd love us to challenge us as a profession, no matter if you treat pediatrics, older adults, summer and summer. In the middle, treat in acute care, treat in home care, treat in outpatient orthopedics, training fitness athletes that carry is a skill that needs to be trained no matter what whether you're seeing upper or lower quarter, or whether you're seeing someone with a spine condition. Let's not keep losing this skill. Even I want you to think before I kind of dive into the three reasons why I think we don't want to lose training carries and their importance is you can even see it in the objects we do carry right like our book bag. Even I want you to think before I kind of dive into the three reasons why I think we don't want to lose training carries and their importance is you can even see it in the objects we do carry right like our book bags, or if you travel a lot your suitcases we even have roller apparatuses to make carrying easier. In our clinics, we need to make carrying harder. One of the three things and value that carries bring our number one from an extremity management perspective is it trains the shoulder elbow wrist hand, right, to be functional to work in this locked out engaged fashion. We have tons of evidence in the relationship between grip strength and mortality. If you have a weak grip, your mortality is poor. We even see it likened to associations with tons of metabolic diseases, and specifically frailty in our older adults. We need to train grip strength, because of that strength that it gives our grip, but that it trains our shoulder elbow wrist hand as well. But not only does it just train the upper quarter. We are actually training the spine, we are training the spine to hold the line as Mitch Babcock would say, right, because it's not just about locking out and training our shoulder elbow wrist hand in a stacked fashion, but we're actually challenging the trunk for those watching on YouTube or on Instagram I'm kind of, if we do this lateral lean we're not getting the benefit right, it's a stack trunk the whole time right while we load. This helps to be not only train the spine to take on load and asymmetrical load right if we're holding it in one side. But it also can be protective of our spine because we teach our spine how to light up right all of our lumbar stabilizers. And if you were to pick up an object that was pretty heavy right now, you will notice that it actually trains the lower body as well right it demands that the glutes the quads the hamstrings all kick in rather than this lazy like me unlocked position you have to actually stack not only the trunk, but your lower body to hold and carry well. It trains the entire system, the whole system gets the goods when we train carries. But guess what the magic isn't just in training shoulder elbow wrist hand and in training the spine. The magic is in the walk, so we don't just have someone carry and stand there. Right. If we think back to hunter gatherer we would carry over long long distances right to bring that meat back home. We need to train folks to carry and hold an object locked out and move and walk so the magic is actually getting our folks moving with weight. This trains our cardiovascular system. This trains our respiratory system and even our CNS right to take on load and be able to go for long durations. If you aren't draining carries you are missing out on a unique opportunity. It doesn't matter if it's an upper quarter issue a spine issue even a lower quarter issue. You need to be training your carries in your folks that are in your clinic or in the hospital, because this is a primary functional skill to be able to pick up objects and carry them for long distances. It trains aerobic tolerance, it trains grip strength and ability. Let's not let this skill be lost to our species. Let's not let this one evolve out. I want you to think about today how you can use carries in the clinic and kind of reflect on what if we got our humans, our patients carrying more for longer. Think of the healthy long lasting functional changes we could make, but not just functional in the ability to carry their objects without needing help from a family member, right or needing to take multiple respites. But I want you to think about mortality, right. We need clear links to grip strength and mortality. Offensive extremity care across the lifespan, young to old requires carries. I hope you'll consider putting this in your plan of care this week. Thank you for your time to join me on this short and sweet PT on Ice. Take care folks. Happy Tuesday.

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