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Did you know that muscle strength and life expectancy are linked?

When the Ruiz study came out in 2008 it got me really excited.

For years I found that adjusting people made them stronger and also made them healthier, now there was good evidence that stronger people lived longer.

AND, being weak increases your chance of morbidity and mortality. ( ie disease and death)
This has been verified in over 60 studies (reference link)

These studies firmly establish the link between muscle weakness, increased chance of diseases like heart disease, diabetes, cancer and early death.

Some measure handgrip strength, others use the large axial and limb muscles but all reach basically the same conclusion. The stronger you are, the longer you live and the less disability you suffer. This effect is independent of age, fitness, exercise and BMI (body weight).

At SpineLab we can make patients stronger instantly, without exercise: that’s the power of the adjustment.

So rather than treating you for the pain in your neck or back your plan of care is aimed at building a stronger, healthier you and keeping your whole family all that way.

So Stay Strong



Dr Carl


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Swallow, E. B., Reyes, D., Hopkinson, N. S., Man, W. D.-C., Porcher, R., Cetti, E. J., … Polkey, M. I. (2007). Quadriceps strength predicts mortality in patients with moderate to severe chronic obstructive pulmonary disease. Thorax62(2), 115–120. http://doi.org/10.1136/thx.2006.062026

Ali, N. A., O’Brien, J. M., Hoffmann, S. P., Phillips, G., Garland, A., Finley, J. C. W., … Marsh, C. B. (2008). Acquired weakness, handgrip strength, and mortality in critically III patients. American Journal of Respiratory and Critical Care Medicine178(3), 261–268. http://doi.org/10.1164/rccm.200712-1829OC

Ruiz, J. R., Sui, X., Lobelo, F., Morrow, J. R., Jackson, A. W., Sjostrom, M., & Blair, S. N. (2008). Association between muscular strength and mortality in men: prospective cohort study. Bmj337(jul01 2), a439–a439. http://doi.org/10.1136/bmj.a439

Ruiz, J. R., Castro-Pinero, J., Artero, E. G., Ortega, F. B., Sjostrom, M., Suni, J., & Castillo, M. J. (2009). Predictive validity of health-related fitness in youth: a systematic review. British Journal of Sports Medicine43(12), 909–923.http://doi.org/10.1136/bjsm.2008.056499

Ruiz, J. R., Sui, X., Lobelo, F., Lee, D. C., Morrow, J. R., Jackson, A. W., … Blair, S. N. (2009). Muscular strength and adiposity as predictors of adulthood cancer mortality in men. Cancer Epidemiology Biomarkers and Prevention18(5), 1468–1476. http://doi.org/10.1158/1055-9965.EPI-08-1075

Xue, Q. L., Beamer, B. A., Chaves, P. H. M., Guralnik, J. M., & Fried, L. P. (2010). Heterogeneity in rate of decline in grip, hip, and knee strength and the risk of all-cause mortality: The women’s health and aging study II. Journal of the American Geriatrics Society58(11), 2076–2084. http://doi.org/10.1111/j.1532-5415.2010.03154.x

Phillips, A. C., Der, G., & Carroll, D. (2010). Self-reported health, self-reported fitness, and all-cause mortality: Prospective cohort study. British Journal of Health Psychology15(2), 337–346. http://doi.org/10.1348/135910709X466180

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Han, S. S., Kim, K. W., Kim, K.-I., Na, K. Y., Chae, D.-W., Kim, S., & Chin, H. J. (2010). Lean Mass Index: A Better Predictor of Mortality than Body Mass Index in Elderly Asians. Journal of the American Geriatrics Society58(2), 312–317. http://doi.org/10.1111/j.1532-5415.2009.02672.x

Artero, E. G., Lee, D., Ruiz, J. R., Sui, X., Ortega, F. B., Church, T. S., … Blair, S. N. (2011). A Prospective Study of Muscular Strength and All-Cause Mortality in Men With Hypertension. Journal of the American College of Cardiology57(18), 1831–1837. http://doi.org/10.1016/j.jacc.2010.12.025

Sundermann, S., Dademasch, A., Rastan, A., Praetorius, J., Rodriguez, H., Walther, T., … Falk, V. (2011). One-year follow-up of patients undergoing elective cardiac surgery assessed with the Comprehensive Assessment of Frailty test and its simplified form. Interactive CardioVascular and Thoracic Surgery13(2), 119–123. http://doi.org/10.1510/icvts.2010.251884

Norman, K., Stobäus, N., Gonzalez, M. C., Schulzke, J. D., & Pirlich, M. (2011). Hand grip strength: Outcome predictor and marker of nutritional status. Clinical Nutritionhttp://doi.org/10.1016/j.clnu.2010.09.010

Artero, E. G., Lee, D., Lavie, C. J., España-Romero, V., Sui, X., Church, T. S., & Blair, S. N. (2012). Effects of Muscular Strength on Cardiovascular Risk Factors and Prognosis. Journal of Cardiopulmonary Rehabilitation and Prevention32(6), 351–358. http://doi.org/10.1097/HCR.0b013e3182642688

Masunari, N., Fujiwara, S., Kasagi, F., Takahashi, I., Yamada, M., & Nakamura, T. (2012). Height loss starting in middle age predicts increased mortality in the elderly. Journal of Bone and Mineral Research27(1), 138–145. http://doi.org/10.1002/jbmr.513

Garc??a-Pe??a, C., Garc??a-Fabela, L. C., Guti??rrez-Robledo, L. M., Garc??a-Gonz??lez, J. J., Arango-Lopera, V. E., & P??rez-Zepeda, M. U. (2013). Handgrip Strength Predicts Functional Decline at Discharge in Hospitalized Male Elderly: A Hospital Cohort Study. PLoS ONE8(7). http://doi.org/10.1371/journal.pone.0069849

Schaap, L. A., Koster, A., & Visser, M. (2013). Adiposity, muscle mass, and muscle strength in relation to functional decline in older persons. Epidemiologic Reviews35(1), 51–65. http://doi.org/10.1093/epirev/mxs006

Cheung, C. L., Nguyen, U. S. D. T., Au, E., Tan, K. C. B., & Kung, A. W. C. (2013). Association of handgrip strength with chronic diseases and multimorbidity: A cross-sectional study. Age35(3), 929–941. http://doi.org/10.1007/s11357-012-9385-y

Puhan, M. A., Siebeling, L., Zoller, M., Muggensturm, P., & Riet, G. Ter. (2013). Simple functional performance tests and mortality in COPD. European Respiratory Journal42(4), 956–963. http://doi.org/10.1183/09031936.00131612

Isaia, G., Greppi, F., Pastorino, A., Bersano, E. M., Rrodhe, S., Ricauda, N. A., … Zanocchi, M. (2013). Predictive effects of muscle strength after hospitalization in old patients. Aging Clinical and Experimental Research25(6), 633–636. http://doi.org/10.1007/s40520-013-0162-2

Savino, E., Martini, E., Lauretani, F., Pioli, G., Zagatti, A. M., Frondini, C., … Volpato, S. (2013). Handgrip strength predicts persistent walking recovery after hip fracture surgery. American Journal of Medicine126(12). http://doi.org/10.1016/j.amjmed.2013.04.017

Chuang, S. Y., Chang, H. Y., Lee, M. S., Chia-Yu Chen, R., & Pan, W. H. (2014). Skeletal muscle mass and risk of death in an elderly population. Nutrition, Metabolism and Cardiovascular Diseases24(7), 784–791. http://doi.org/10.1016/j.numecd.2013.11.010

de Brito, L. B. B., Ricardo, D. R., de Araújo, D. S. M. S., Ramos, P. S., Myers, J., & de Araújo, C. G. S. (2014). Ability to sit and rise from the floor as a predictor of all-cause mortality. European Journal of Preventive Cardiology21(7), 892–898. http://doi.org/10.1177/2047487312471759

Hermans, G., Van Mechelen, H., Clerckx, B., Vanhullebusch, T., Mesotten, D., Wilmer, A., … Van Den Berghe, G. (2014). Acute outcomes and 1-year mortality of intensive care unit-acquired weakness: A cohort study and propensity-matched analysis. American Journal of Respiratory and Critical Care Medicine190(4), 410–420. http://doi.org/10.1164/rccm.201312-2257OC

Matos, C. M., Silva, L. F., Santana, L. D., Santos, L. S., Protásio, B. M., Rocha, M. T., … Lopes, A. A. (2014). Handgrip strength at baseline and mortality risk in a cohort of women and men on hemodialysis: A 4-year study. Journal of Renal Nutrition24(3), 157–162. http://doi.org/10.1053/j.jrn.2013.12.005

Timpka, S., Petersson, I. F., Zhou, C., & Englund, M. (2014). Muscle strength in adolescent men and risk of cardiovascular disease events and mortality in middle age: a prospective cohort study. BMC Medicine12(1), 62. http://doi.org/10.1186/1741-7015-12-62

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Srikanthan, P., & Karlamangla, A. S. (2014). Muscle mass index as a predictor of longevity in older adults. American Journal of Medicine127(6), 547–553. http://doi.org/10.1016/j.amjmed.2014.02.007

Legrand, D., Vaes, B., Matheï, C., Adriaensen, W., Van Pottelbergh, G., & Degryse, J. M. (2014). Muscle strength and physical performance as predictors of mortality, hospitalization, and disability in the oldest old. Journal of the American Geriatrics Society62(6), 1030–1038. http://doi.org/10.1111/jgs.12840

Donoghue, O. A., Savva, G. M., Cronin, H., Kenny, R. A., & Horgan, N. F. (2014). Using timed up and go and usual gait speed to predict incident disability in daily activities among community-dwelling adults aged 65 and older. Archives of Physical Medicine and Rehabilitation95(10), 1954–1961. http://doi.org/10.1016/j.apmr.2014.06.008

Bohannon, R. W., & Magasi, S. (2015). Identification of dynapenia in older adults through the use of grip strength t-scores. Muscle and Nerve51(1), 102–105. http://doi.org/10.1002/mus.24264

Dodds, R., & Sayer, A. A. (2015). Sarcopenia and frailty: new challenges for clinical practice. Clinical Medicine15(Suppl_6), s88–s91. http://doi.org/10.7861/clinmedicine.15-6-s88

Sayer, A. A., & Kirkwood, T. B. L. (2015). Grip strength and mortality: A biomarker of ageing? The Lancet386(9990), 226–227. http://doi.org/10.1016/S0140-6736(14)62349-7

Guadalupe-Grau, A., Carnicero, J. A., Gómez-Cabello, A., Avila, G. G., Humanes, S., Alegre, L. M., … García-García, F. J. (2015). Association of regional muscle strength with mortality and hospitalisation in older people. Age and Ageing44(5), 790–795. http://doi.org/10.1093/ageing/afv080

Rijk, J. M., Roos, P. R., Deckx, L., van den Akker, M., & Buntinx, F. (2015). Prognostic value of handgrip strength in people aged 60 years and older: A systematic review and meta-analysis. Geriatrics & Gerontology International, n/a-n/a. http://doi.org/10.1111/ggi.12508

Costa, T. M. da R. L., Costa, F. M., Moreira, C. A., Rabelo, L. M., Boguszewski, C. L., & Borba, V. Z. C. (2015). Sarcopenia in COPD: relationship with COPD severity and prognosis. Jornal Brasileiro de Pneumologia41(5), 415–421. http://doi.org/10.1590/S1806-37132015000000040

Leong, D. P., Teo, K. K., Rangarajan, S., Lopez-Jaramillo, P., Avezum, A., Orlandini, A., … Yusuf, S. (2015). Prognostic value of grip strength: Findings from the Prospective Urban Rural Epidemiology (PURE) study. The Lancet386(9990), 266–273. http://doi.org/10.1016/S0140-6736(14)62000-6

Martien, S., Delecluse, C., Boen, F., Seghers, J., Pelssers, J., Van Hoecke, A. S., & Van Roie, E. (2015). Is knee extension strength a better predictor of functional performance than handgrip strength among older adults in three different settings? Archives of Gerontology and Geriatrics60(2), 252–258. http://doi.org/10.1016/j.archger.2014.11.010

Volaklis, K. A., Halle, M., & Meisinger, C. (2015). Muscular strength as a strong predictor of mortality: A narrative review. European Journal of Internal Medicinehttp://doi.org/10.1016/j.ejim.2015.04.013

Martín-Ponce, E., Hernández-Betancor, I., González-Reimers, E., Hernández-Luis, R., Martínez-Riera, A., & Santolaria, F. (2015). Prognostic value of physical function tests: hand grip strength and six-minute walking test in elderly hospitalized patients. Scientific Reports4(1), 7530. http://doi.org/10.1038/srep07530

Lino, V. T. S., Rodrigues, N. C. P., O’Dwyer, G., Andrade, M. K. D. N., Mattos, I. E., & Portela, M. C. (2016). Handgrip strength and factors associated in poor elderly assisted at a primary care unit in Rio de Janeiro, Brazil. PLoS ONE11(11). http://doi.org/10.1371/journal.pone.0166373

Kraschnewski, J. L., Sciamanna, C. N., Poger, J. M., Rovniak, L. S., Lehman, E. B., Cooper, A. B., … Ciccolo, J. T. (2016). Is strength training associated with mortality benefits? A 15 year cohort study of US older adults. Preventive Medicine87, 121–127. http://doi.org/10.1016/j.ypmed.2016.02.038

Ding, L., & Yang, F. (2016). Muscle weakness is related to slip-initiated falls among community-dwelling older adults. Journal of Biomechanics49(2), 238–243. http://doi.org/10.1016/j.jbiomech.2015.12.009

McLeod, M., Breen, L., Hamilton, D. L., & Philp, A. (2016). Live strong and prosper: the importance of skeletal muscle strength for healthy ageing. Biogerontology17(3), 497–510. http://doi.org/10.1007/s10522-015-9631-7

Fragala, M. S., Alley, D. E., Shardell, M. D., Harris, T. B., McLean, R. R., Kiel, D. P., … Kenny, A. M. (2016). Comparison of Handgrip and Leg Extension Strength in Predicting Slow Gait Speed in Older Adults. Journal of the American Geriatrics Society64(1), 144–150. http://doi.org/10.1111/jgs.13871

Strand, B. H., Cooper, R., Bergland, A., Jørgensen, L., Schirmer, H., Skirbekk, V., & Emaus, N. (2016). The association of grip strength from midlife onwards with all-cause and cause-specific mortality over 17 years of follow-up in the Tromsø Study. Journal of Epidemiology and Community Health70(12), 1214–1221. http://doi.org/10.1136/jech-2015-206776

Rossi, A. P., Fantin, F., Caliari, C., Zoico, E., Mazzali, G., Zanardo, M., … Zamboni, M. (2016). Dynapenic abdominal obesity as predictor of mortality and disability worsening in older adults: A 10-year prospective study. Clinical Nutrition35(1), 199–204. http://doi.org/10.1016/j.clnu.2015.02.005

Leong, D. P., Teo, K. K., Rangarajan, S., Kutty, V. R., Lanas, F., Hui, C., … Yusuf, S. (2016). Reference ranges of handgrip strength from 125,462 healthy adults in 21 countries: a prospective urban rural epidemiologic (PURE) study. Journal of Cachexia, Sarcopenia and Muscle7(5), 535–546. http://doi.org/10.1002/jcsm.12112

Gaikwad, N. R., Gupta, S. J., Samarth, A. R., & Sankalecha, T. H. (2016). Handgrip dynamometry: A surrogate marker of malnutrition to predict the prognosis in alcoholic liver disease. Annals of Gastroenterology29(4), 509–514. http://doi.org/10.20524/aog.2016.0049

Celis-Morales, C. A., Lyall, D. M., Anderson, J., Iliodromiti, S., Fan, Y., Ntuk, U. E., … Gill, J. M. R. (2017). The association between physical activity and risk of mortality is modulated by grip strength and cardiorespiratory fitness: Evidence from 498 135 UK-Biobank participants. European Heart Journal38(2), 116–122. http://doi.org/10.1093/eurheartj/ehw249

Menant, J. C., Weber, F., Lo, J., Sturnieks, D. L., Close, J. C., Sachdev, P. S., … Lord, S. R. (2017). Strength measures are better than muscle mass measures in predicting health-related outcomes in older people: time to abandon the term sarcopenia? Osteoporosis International28(1), 59–70. http://doi.org/10.1007/s00198-016-3691-7

Celis-Morales CA, Welsh P, Lyall DM et al(2018) Associations of grip strength with cardiovascular, respiratory, and cancer outcomes and all cause mortality: prospective cohort study of half a million UK Biobank participants https://www.ncbi.nlm.nih.gov/pubmed/29739772