Physical Health and the Wellness Wheel
Mapping and assessing your physical health and fitness.
Posted Sep 05, 2017
This guest blog was authored by Tim Henriques, who is the Director of the National Personal Training Institute - the school for people who wish to become personal trainers. He is the author of two books, NPTI's Fundamentals of Fitness and Personal Training and All About Powerlifting; as well as numerous articles about health and fitness. He is a dad, teacher, lifter, author, trainer, coach, and a Dungeons & Dragons aficionado. You can follow him on Facebook and Twitter.
Mens sana in corpore sano.
(A sound mind in a strong body, or a healthy mind in a healthy body if you prefer).
As suggested by this quote, a fundamental piece of mental health is physical well-being. The goal of this article is twofold: to help you quickly assess your physical well-being and to help you direct your efforts toward improving the specific aspects of physical wellness that you most wish to improve.
First, though, let us be clear about what is meant by “physical well-being”. We can start by locating the construct of physical well-being via the Nested Model of Well-being (depicted below), which provides a general map of the construct of human well-being. The Nested Model specifies the four domains that go into well-being as follows: 1) Subjective; 2) Health and Functioning; 3) Environment, and 4) Values and Ideology. Domain 2, Health and Functioning, is divided into subdomains of (a) the psychological and (b) bio-physiological levels.
This blog offers you a quick map and assessment of the bio-physiological domain in the Nested Model by separating it into three broad aspects: 1) Physical Health; 2) Fitness; and 3) Sporting Ability. To help illustrate this more clearly, let’s examine this as a picture, which is called The Wheel of Wellness.
At the center of every wheel is a hub, in which every other aspect of the wheel revolves around and springs from. The hub of the Wellness Wheel is Physical Health, which refers to the general functioning of one’s biological systems. If one’s physical health is impaired, it will likely leak into mental health as well, especially if the impairment is significant. Conversely, as the quote that started this blog indicated, optimal physical health will contribute to mental health.
Physical Health: Two Quick Kinetic Tests
The textbook definition of health is: the absence of disease; the state of being free from illness or injury. However, I believe since the goal is to optimize physical health, one should not be content to be labeled as simply disease free. Instead, we need to recognize optimal states of functioning. One powerful indicator of physical health is one’s kinetic ability. This refers to how effectively one can move and control one’s body. There are two practical and easily applied litmus tests to gauge one’s physical health via kinetic ability: Walking and Rising from the Ground.
A fundamental difference that separates animals from plants is the animals’ ability to move around in the environment. The fundamental way for humans to move is to walk. The simplest way to test walking ability is to do exactly that, to perform The Walking Test. To do this you walk for one hour unaided (on a treadmill, around a track, or outside on reasonably flat ground) and measure the total distance covered. Most humans top out on walking speed of about 4.5 mph as a sustainable, natural pace. As such 4.5 miles covered in 1 hour will yield a perfect score of 10. The Rockport Walk Test can be substituted for The Walking Test if desired.
The second key physical activity that humans need to be able to perform to function independently in the physical world is represented by The Sitting Rising Test. In this test, an individual finds a comfortable space clear of hazards. They start off standing, and from that position they sit on the floor fully, and then they stand back up. The goal is to use as few contact points, other than your feet, as possible. Every time you use your hand or knee for assistance – on the way down and on the way up – you lose a point. Sitting and Rising using only feet scores a perfect of score. This test has been extensively studied with older populations (Brito et al., 2012) and there is a remarkably strong correlation between longevity and how one scores on this test. For full details on how to score this test, see the video: https://youtu.be/oQIbffQj2xM
The Physical-Kinetic Health Scoring System
If one’s goal is simply to stay physically independent particularly as one ages, to move around normally in the world, and to fight off ailments associated with poor physical health, the goal is to optimize both walking and the Sitting Rising test, which means to score in the low risk (green) in each category. If one can’t do that then, if feasible, additional work in the form of exercise should be added to help move an individual toward that goal. If a person doesn’t know how to do that or where to begin, then they should consult with a personal trainer, preferably a trainer with a degree in the field or one that has completed a 500+ hour program approved by the Department of Education.
Sometimes individuals are not content with simply being able to walk and rising from the ground easily and they want to push their physical abilities. This moves us into the realm of Physical Fitness.
Physical Fitness cannot be adequately tested or described by one single term. Fitness itself is defined as the ability to perform a physical task; as soon as the task is defined certain aspects of fitness become more or less important. Fitness instead is typically subdivided into five classic components: Muscular Strength; Muscle Endurance; Cardiovascular Endurance; Flexibility; and Body Composition.
Muscular Strength represents how strong one’s muscles are. The technical definition is the ability to execute a motor pattern against maximal resistance; with a more common definition being the ability of the muscles to contract one time. Strength is often tested by using a barbell on exercises such as the Squat, Bench Press, or Deadlift. If desired machines can be substituted to test similar movements, such as the Chest Press Machine and Leg Press Machine.
Muscular Endurance is related to strength, but it is not the same thing. Endurance is the ability to repeat something, to perform an action over and over again. As such the technical definition of muscular endurance is the ability to execute a motor pattern multiple times against a submaximal resistance; with a more common definition being the ability of the muscle to contract multiple times. Muscle Endurance is often tested with callisthenic based exercises such as push-ups, sit-ups, dips, pull-ups, and holding a plank.
Cardiovascular Endurance, sometimes referred to as just Cardio or CV for short, represents the ability of the heart and lungs to provide oxygen to the body. Oxygen is king when it comes to cardio. Each step in a marathon or each stroke in swimming isn’t that hard, but the ability to perform that activity over and over again is. Cardio can be tested by the following tests: Rockport Walk Test, Step Test, Fit Test, 1.5 mile run, or a VO2 Max test. Cardio is defined by finding an individual’s VO2 Max, which is a way to quantify one’s cardiovascular ability. The goal on a VO2 max test is to have a high score, anything 40+ is pretty fit, 60+ is excellent, and anything 20 or below is poor.
Flexibility is defined as the range of motion at a joint. A joint is where two bones meet in the body; different joints have different ranges of motion. The elbow joint typically just moves forward and backward, whereas the shoulder joint has the greatest range of motion of any joint and it can move in almost any direction. The most common test for flexibility is the Sit and Reach test, however Wall Test is popular for upper body flexibility and the Overhead Squat Test is popular for total body flexibility.
Body Composition divides all mass in the body into one of two sections: fat mass and fat-free mass (sometimes referred to as Lean Mass). Lean mass includes muscle, bones, hair, skin, nails, organs, etc whereas fat mass is one’s bodyfat. Bodyfat is typically measured using skinfold calipers but other measures are available. For males a bodyfat of higher than 22% is defined as unhealthy (not obese) and for women the standard of 35% or more bodyfat is unhealthy. Some bodyfat is vital to health - the goal is never to have 0% bodyfat for looks, performance, or health. Nutrition has the most powerful impact on body composition.
Looking back on our two kinetic tests for physical health, it should become apparent that multiple components of fitness are represented in each test. Walking best tests cardiovascular fitness, body composition, and muscular endurance. The Sitting Rising Test best measures flexibility, muscular strength, and body composition.
If one’s goal is to not have one’s physical fitness limit them in anyway during their life, then one’s focus should be to optimize the various components of fitness. For the vast majority of people this means they will want to include structured exercise as part of their weekly routine. This includes: strength training, cardiovascular work, and stretching. Each aspect should be performed multiple times per week and the individual will want to eat a variety of healthful foods without taking in excess calories on a regular basis. However, for some this is still not enough. Those individuals wish to test themselves against various physical challenges and as such they will typically engage in sports as a way of comparing one’s physical abilities to another.
One’s sporting ability builds upon the components of fitness but further utilizes various subcomponents of fitness, including: Power, Speed, Explosiveness, Agility, Quickness, Balance, and Skill.
Power is the ability to express a high level of strength at a rapid rate of speed. A shot put, a maximum vertical jump, or lifting heavy weights from the ground to above one’s head (a snatch) are examples of power.
Speed represents how fast one can run, a person’s maximal velocity. The 40 yd and the 100 M dash are the two most common tests for speed.
Explosiveness describes the ability to move a specific limb or part of the body extremely rapidly against light resistance, it is sometimes referred to as speed strength. Throwing a punch or a kick in martial arts represents explosiveness.
Agility is the ability of an individual to slow down (decelerate), change direction (or at least have the option to do so) and then accelerate again. A running back juking out an opponent represents agility. The shuttle run test given in PE classes tests this ability. Tennis, racquetball, and badminton are all sports that require very high levels of agility.
Quickness is the ability to respond and change body position to an unexpected stimulus. For example dodging a punch or avoiding a ball coming at your head is quickness. Agility typically involves changing the position of your whole body, whereas quickness just refers to a small part of the body. Boxing, martial arts, and ping pong require very high levels of quickness.
Balance is the ability to maintain one’s equilibrium in dynamic situations. In other words, to perform various physical tasks without falling. Walking requires a small amount of balance; walking on a balance beam requires more, and performing tricks on a tight rope is the ultimate test of balance.
Skill is the ability of the nervous system and the muscular system to work together efficiently to produce a coordinated movement. Think of your muscles like a car and your brain as the driver of the car; both are very important if you want to win a race. The most important thing to realize about skill is it is not a single universal thing, one is not either skilled or not. It is task specific. A person can be incredibly skilled in one activity and be very unskilled in another. Skill is best improved by practice with a specific intent toward mastery.
As previously stated, the goal of this article is help you direct your efforts and the efforts of others in the most productive fashion. If one simply wishes to be healthy the focus should be on walking and the ability to complete the Sitting Rising Test with ease. If one wishes to be fit, then more energy will be put toward training one or more of the components of fitness. If one wishes to engage in sports, then a large amount of time, energy, and resources will need to be devoted to the various subcomponents that specific sport relies upon.
Keep in mind the wheel works from the inside out. One cannot develop an extremely high level of sporting ability if one can’t walk more than a few yards without stopping or one can’t get off the ground without help. The components of fitness are not, and cannot be, ranked as a hierarchy, instead they are best viewed as spokes in a wheel, each equally important to health and wellness. If one focuses too much effort on a single component or subcomponent, their wheel can become ‘warped’ which in turn can cause more central problems in either fitness or health as time progresses. While it is okay and sometimes necessary to specialize to master certain tasks, one should not ignore the other aspects of health and fitness during that process.
My number one message to you is this: do what you can so that your physical health and fitness do not negatively affect your life. Make fitness and health a priority. You don’t have to spend huge amounts of time on it, but it will need at least weekly attention. As the Earl of Derby so accurately put it: Those who think they have not time for bodily exercise will sooner or later have to find time for illness. A small investment in improving and maintaining your health can yield huge dividends throughout your timeline.
Brito LBB, Ricardo DR, Araujo DSMS, et al. Ability to sit and rise from the floor as a predictor of all-cause mortality. European Journal of Cardiovascular Prevention, 2012; DOI: 10.1177/2047487312471759