“We are what we repeatedly do…” said Will Durant in his text The Story of Philosophy; this quote has been incorrectly attributed to Aristotle, but that’s neither here nor there.
I am of course writing this to speak about the power of consistency!
I preach consistency ad nauseam to clients. As it is my belief that consistency is one of the requisite principles for achieving goals. So it is only right that I go into a further explanation of why I believe consistency to be so relevant to goal achievement from a health and wellness standpoint. Hopefully, you will find that the following anecdote and science to provide validity to this opinion.
In the winter of 2010 I personal encountered a bout of low back pain that lasted from winter of 2010 to spring of 2014. I injured myself squatting while training for swimming. I experienced low back pain and radiating leg pain that left me in excruciating pain to the point of depression and fear like I had never experienced. Like anyone, I went to my doctor, got an MRI, and was told I had “degenerative disc disease” and a “herniated disc.”
This scared the daylights out of me. My first thought was, “my season, and possibly my collegiate swimming career, is over.” My second thought was “I am way too young to have disc bulges and a degenerative disease.”
For the next 2 years I rehabbed my back every day and lived in a fluxed state of pain ranging from a 1/10 to a 5/10. I changed my training habits, avoided certain exercises and refused to do certain strokes that I believed to hurt me. Post swimming I continued to experience back and leg pain. I resigned myself to the belief that I would be dealing with this pain for the rest of my life.
It was not until I entered physical therapy school that things began to change for me. I began learning about the body in depths that I never understood before. I learned that a lot of my beliefs about my pain, my symptomology, and my condition were not only misguided, but also scientifically false. I learned about the science of pain mechanisms that I was experiencing, as well as my diagnosed pathology. I learned that the “disease” I had was in fact not a disease at all, but a natural part of development. I also learned that the disc bulge I had likely naturally healed roughly 2-3 months post injury, without any surgical intervention.
But why was I still experiencing pain?
It was not until I sought guidance from a professor, that she helped me identify certain movement patterns and fear avoidance behaviors I had developed. She prescribed 3-5 exercises and recommended that I do them every day. Emphasizing that I needed to view my exercises the same way I viewed oral hygiene: something to do every day that will keep me healthy for life.
I did what she prescribed, and did it religiously every day for months. I slowly (emphasis on the word slowly) saw my radiating pain dissipate. I then got curious to the idea of introducing old weight training exercises back into my routine. This is where my progress accelerated. I added squats into my routine, something I never thought I would even attempt again. Within a matter of months I was pain free. And remain so today. Like anyone, I get aches and pains here and there with the occasional flare up, BUT this time I understand and know that I can control my symptoms.
So what happened?
First, my understanding and beliefs changed. The fear of hurting myself further completely flipped to knowing that my body is strong and resilient, and will respond favorably to load and routine exercise.
Second, the consistency at which I applied these beliefs relative to my exercise habits changed.
The result? I regained control over my life.
You see, the inputs we apply to our nervous system are the constructs that determine the output of the nervous system. Which is to say, if I live in fear of movement and if I dramatically reduce the load my body receives, my brain will respond in turn. Essentially, what comes out of the oven is a byproduct of what you put in it. If the ingredients you place into the oven are not ingredients that respond well to baking, then the finished product will be unsatisfactory. Similarly, if you don’t move, if you don’t progressively load your body, and if you don’t practice good sleep and nutritional habits, your body will respond negatively.
What we know about the nervous system is that it takes time to adapt. In fact it typically takes 4-6 weeks of consistently providing input to the nervous system for any adaptation to occur. For example, if you were to begin doing a bicep curl exercise everyday, you would not realize any physical muscle growth for at least 8 weeks. The only things would occur is the neural pathway from the brain to the body becomes stronger, and the muscle’s ability to endure work would improve.
These principles apply similarly when trying to overcome pain. This is why when I hear clients say “my condition is not improving at all,” but then follow up that statement with “but I’ve only done my exercises 2 times in the past 2 weeks,” I respond with “well of course it’s not getting any better! Your nervous system did not even have the chance to adapt!” This is akin to saying “I wanted to do a marathon, but I couldn’t do it after training 5 times! What gives?”
This example is not used to shame anyone, but to encourage consistency! We know that physiologically speaking, change takes time!
Understanding that, I would never encourage anyone to back squat 200 pounds after acutely spraining their ankle. There is a natural healing process that must occur for one to get better. This is where physical therapists are expertly trained in equipping individuals with knowledge about the body’s anatomy and physiology that will help them navigate injuries.
Often our musculoskeletal injuries are not “healed” by anyone other than ourselves. Healthcare providers can provide amazing interventions and education that can setup our system to heal, but the healing occurs because of our adherence to their advice and guidance.
This brings me back to my original point: we are what we repeatedly do. When we are hurt and have pain mechanisms that change the way we live and think, providing the system with frequent positive input is the gateway to recovery!
Thank you for reading!
Below are some additional resources that reinforce this idea.
Everyone will experience change with exercise:
Churchward-Venne TA, Tieland M, Verdijk LB, Leenders M, Dirks ML, de Groot LC, van Loon LJ.There Are No Nonresponders to Resistance-Type Exercise Training in Older Men and Women.J Am Med Dir Assoc. 2015 May 1;16(5):400-11. doi: 10.1016/j.jamda.2015.01.071. Epub 2015 Feb 21.
Strength helps us live longer:
Ruiz Jonatan R, Sui Xuemei, Lobelo Felipe, MorrowJames R, Jackson Allen W, Sjöström Michael et al. Association between muscular strength and mortality in men: prospective cohort study. BMJ 2008; 337 :a4
Disability associated to weakness:
Janssen I, Heymsfield SB, Ross R. Low Relative Skeletal Muscle Mass (Sarcopenia) in Older Persons Is Associated with Functional Impairment and Physical Disability. J Am Geriatr Soc: 2002 May; 50(5): 889-896.
Neural adaptation secondary to exposure:
Nancy N. et al. Repetitive Stress Pathology: Pathology and Intervention in Musculoskeletal Rehabilitation (Second Edition), 2016. https://doi.org/10.1016/B978-0-323-31072-7.00027-0
The adaptive nervous system:
Nathaniel D. M. Jenkins, Amelia A. Miramonti, Ethan C. Hill, Cory M. Smith, Kristen C. Cochrane-Snyman, Terry J. Housh, Joel T. Cramer. Greater Neural Adaptations following High- vs. Low-Load Resistance Training. Frontiers in Physiology, 2017; 8 DOI: 10.3389/fphys.2017.00331