How Health Care Reform and Fitness - A look back in time

I've been watching the health care debates on CSPAN over the past few weeks. This is certainly a monumental task that will have serious consequences no matter which direction it takes. Whether it is Clinton's plan, Dole's plan, Mitchell's plan or one of at least a half dozen others that are on the table, some type of health care reform is coming, and those changes are going to affect your workouts. Does that sound strange?

As the saying goes, truth is usually stranger than fiction. Whatever happens with health care, people are always going to have a tendency to train improperly, and haphazard, risky, illogical training techniques invariably lead to injury. As it stands today, you might treat that injury yourself at first, but if it doesn't respond as you'd like it to, then you're going to see a physician. Some injuries are simple and can be diagnosed clinically during an examination.

If the physician is progressive, he or she may prescribe a combination of treatments to resolve the problem. Well, that's the way things are now. There are two main reasons why health care reform may keep this scenario from playing out as described: 1) If the injury isn't simple and requires further tests, such as CAT scans (high-resolution X- rays), MRIs (soft tissue imaging), bone scans, arthrograms (joint evaluations) or electro diagnostic tests (nerve tests), the regulations established by the upcoming reform may deny you access to these tests.

This isn't some dark, imaginary setting of the future. It's happening already. Many physicians have had their hands tied by insurance companies and HMOs because these wonderful diagnostic tests are deemed too costly, so what will happen when we see reform that's aimed at cutting back expenses? In some cases the tests are allowed only in critical situations or if surgery is absolutely indicated.

2) Many insurance companies have already determined that almost any form of therapy is relatively unnecessary, so they now offer policies to individuals and groups that cost considerably less but don't cover physical therapy. Consequently, when policy holders need physical therapy for an injury, they find out that they're not covered or that they're limited to 12 sessions regardless of the severity the injury or post surgery complications. There is a well-known list of diagnosis priorities that was created in Oregon and that gives most musculoskeletal injuries a very low priority.

The continuation of this train of thought, which is sure to come, will make it difficult for most athletes to get adequate treatment for muscle, tendon and ligament injuries, including most disk injuries, known as protrusions, or herniations, and associated nerve root irritations. How does all this apply to you? The simple answer is that if you're not careful when you try a new exercise or modification, you may hurt yourself and never be able to recover sufficiently from it due to limitations placed on your health care. An accurate diagnosis may not be available to you, and if it is, you may not have coverage for proper treatment.

If you're an average citizen, you may have difficulty paying for treatment out of your own pocket. My point is this: For five years I've been writing this column to show readers how to avoid injury and how to analyze training techniques, methods and styles from a clinical and scientific point of view. I have attacked and heavily criticized certain exercises, but it's not a question of like or dislike. It's a question of keeping you, the trainee, from being exposed to biomechanical points of risk. Use the information presented here to enhance your training and prevent injuries. We must all keep in mind the thing we most don't like to think about.

Human beings are finite, limited, and we don't have an infinite ability to train, recover and train again. With all due respect to professional bodybuilders, the majority of people who read this column have full-time jobs and families-including the stress of raising children and paying for schools and health care. Thus, they don't have the luxury of full-time training with well-planned and spaced meals, naps and sleep periods and less distraction.

Those of you who lift weights under these circumstances should expect to do it for your health and for the sake of training itself. Most of you can recall when you were bitten by the iron bug. A great deal of time has passed since that day. Many of you-or people you know-trained very hard using what you thought was good technique. A lot of people cut back or dropped out after it became obvious that they couldn't keep up the pace once they had the responsibilities of a career and a family, when there simply wasn't enough time in the day.

You can and should train, but don't worry about using the latest title winner's workout. It probably isn't for you. Keep your program simple. Remember the columns that featured John Brenner, who used only four exercises, or powerlifting champion David Shaw, who held five world records while training just four hours a week. Drop the exercises that I've suggested, including upright rows, front raises, leg raises, knee-ups and twists, just to name a few.

Use a progressive, or periodization, training plan. It's time to take responsibility for what you do in the gym. You must seek out as much information as possible before you expose yourself to injury. We health care providers may not be able to give your injuries the same level of care in the future, and as any iron enthusiast knows, an injury that keeps you from training is a significant disruption in your life.

So try to prevent the injury first. You no longer have the luxury of trying someone's wild training scheme with no thought to the injurious consequences.