ENDURE: October 2012

Pro-Activity Prevention Screenings...

Your "Not So Routine" Medical Care - The Proof Is In The Pudding!

With a large bulk of prevention screenings and assessments happening this time of year, our team has been fielding questions related to our annual Prevention Screenings almost every day.  Most specifically, we find ourselves responding to questions/statements like: “Do I really need to do the screening I just got blood work done at my doctors office” or “I didn’t fast so my results will be all wrong...right?”

Unfortunately, there are times when giving a complete answer (in the midst of a prevention screening event for example) to questions like these proves difficult.  But, in truth, we couldn’t be answering a more important question, the implications are tremendous.

The central theme in many of these questions revolves around the idea that the “Prevention Screening” offered by Pro-Activity and lab tests as part of “Routine Medical Care” one receives at their doctor’s office (i.e. “I just got blood work done at my doctor’s office”) is the same thing.  The fact is...they couldn’t be more different! This is where it can get confusing.

Diving in: It often starts with where our "head is at", i.e. our personal definition about what it means to be “healthy” or “well”!  We hope your definition of wellness is not some version of the “well I’m not sick, therefore I must be healthy” delusion, which we call the coin-flip definition, and rather is one that equates health and wellness as "optimal function and performance", the very peak of our personal potential, which we call the spectrum definition.

So how is it different?

It is important to understand that the Prevention Screening is NOT designed to diagnose disease, which is what “routine medical care” is typically for.  The “Prevention Screening” on the other hand is designed to look at a few of the ELEMENTS that matter most in our goal of maintaining the very highest quality of life.  This means it not only needs to identify the risk factors associated with preventable chronic disease, but also needs to identify key factors closely tied to (and perhaps predictive of) high quality of life and longevity.  This is achieved by blending prevention oriented tests (3-minute step, waist-to-hip ratio, sit & reach and grip strength to name a few) with non-fasting values on blood tests into a single screening tool which makes the vantage very different than what is often delivered as part of routine medical care.

Let’s explore the differences a little further...

Why is having non-fasting blood work important?  To many this seems counterintuitive because consumption of anything will have an effect on your numbers......but as we learn more about what the early indicators of risk are (indicators that can be detected much earlier than the "disease markers" most traditional medical groups are looking for) we know that this information - i.e. how your body is handling/processing the food you consume is critically important.  For example, an inappropriate spike in triglycerides or glucose after eating is more important at the early stages than what your blood values look like fasting.  Without getting too deep into it you can think of fasting values as a view of what your blood looks like AFTER many hours of relative rest (sleeping usually) to battle back the damage and "empty the bucket".  In that sense it's telling you if you have the capability to battle back the damage inflicted on the body each day (by our diet, activity, recovery or lack thereof and other lifestyle factors)......and if you don't?  Well that signifies a problem further down the line than we like to be.....more reaction to damage done than prevention per se.  On the prevention side of the spectrum, we want to know as early as we possibly can if that bucket is likely to overflow - the adjustments are easier to make, more effective and the likelihood of damage being done before we recognize it is much lower.  In essence, we want to know IF damage is being done (at all) rather than if you can successfully battle it back each night and non-fasting blood values allow us to get a much better picture of this process underway.  In addition we find that many people in essence "study" for their fasting tests - becoming more mindful of their diet the week leading up to the test - which can give an artificially low value......we'd much rather see the "real" values and work from there.

How about those other tests that I’ve typically never seen performed at my doctor’s office?

3-minute step test:  This version of an "exercise tolerance test" (distant cousin of a cardiac stress test) is a great way of assessing how fit your heart is which is an independent risk factor for heart and metabolic disease.  For example, your blood test numbers may appear to be “fair”, but if you find yourself struggling with this test it may be an early sign that your cardiovascular system is struggling to keep up.  Having a healthy pump is just as important as what you're pushing through it.....if not addressed, over time poor cardiorespiratory fitness can greatly impact your health.

Waist-to-hip ratio:  This simple test has big implications.  We know carrying excess weight in the form of adipose tissue (body fat) is bad for our health, but where we carry that tissue is even more important.  Visceral body fat, the fat carried around the midsection and belly is metabolically active.  Being metabolic active in this case means it increases our body’s production of cortisol, a stress hormone, that when increased has big impacts on elevating blood pressure, blood sugar and triglycerides just to mention a few.Sit & Reach:  A lot of individuals taking part in the Prevention Screening aren’t really sure why a flexibility test they last performed in the 6th grade has a place in this screening.  The reality is this: having good flexibility of the hips, lower extremities and low back has been shown to reduce the risk of low back pain.  In addition, there is evidence to suggest that maintaining adequate flexibility can reduce the risk of developing osteoarthritis in the long term.  Soft tissue that is short and tight place more stress (compression) on the skeleton and in effect accelerates the degenerative process and if you're tight across the hips, you're likely tight across multiple joints.

Grip Strength:  Ensuring you have adequate grip strength is important for many reasons.  Two of the most important: First, the greater the grip strength you have means less compensation is required by other muscles and joints while performing common tasks.  Have you ever strained your neck while opening that stubborn jelly jar?  A little more grip strength can help reduce that risk by allowing you to recruit ONLY upper extremity muscles rather than invoking all of those "body english" maneuvers.  Furthermore, (believe it or not) studies demonstrate a strong correlation between grip strength and longevity.  Simply put- individuals who have or maintain strong grips typically live longer than their counterparts with weaker grips.  The simple fact of the matter is that a strong grip generally means an individual has more muscle and bone mass...both good predictors of longevity.


So why do we push so many people to participate in a PREVENTION screening each year? Well, we feel that “The proof is in the pudding”... the quality, effectiveness or truth of something is easier to judge by putting it into action!  We believe that if you put the Prevention Screening into action you, like the MANY MANY individuals before you, will find honest and effective information that can truly impact the quality of your life!


Written by Justin Bagley, PT, DPT  who practices in the areas of general orthopedics and neuromuscular rehabilitation, injury/disease prevention, wellness and human performance.