On: technology, tests and treatment.

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Listen to the patients history, they will tell you the diagnosis.

Possibly not entirely, as patients sometimes miss detail or forget timelines.

However, subsequent to a thorough history and examination, all other tests should be used to confirm or deny your hypothesis, including imaging and blood tests.

The problem comes when we, as practitioners or medical professionals, get distracted by new technology or training. This means we look at what we can do, not what we should do.

Ethically, one should do the least for the most benefit. So just because I can order a blood test doesn’t mean I should, if it won’t change my subsequent decision tree. And just because I’ve bought a shiny machine, the information it produces won’t necessarily fundamentally alter the treatment plan.

As for treatment itself, the gold standard therapeutic ladder must always be applied. Physical intervention, then medication, then surgical intervention.

Knowing how to apply this, when to step up and down, the precise tool and most importantly when to stop, is what we spend years training for and why the patient needs to select their practitioner with care and recommendation.

Only then will they find the person that understands and diagnoses their presentation, educates and treats it effectively and most importantly demonstrates how to prevent its recurrence.

Whoever you, as a patient, go to, don’t be taken in by the technology and treatment modalities, look behind the curtain, look at outcomes and be driven by the outcome.

If you think we can help, please do call, we have over 20 years of experience, in both NHS and private practice, to help you work with your presentation.

On: Movement

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Note: if you’re a seasoned gym goer, this isn’t going to be for you.

Leggings and trainers on, new t shirt, new attitude.

Old body.

A common problem. You’ve got your new motivation, goals set and defined, but after a couple of days, you’re sore, stiff and tired.

Your body hasn’t had time to learn.

If you haven’t moved and exercised vigorously for a while, then time is needed for your soft tissue to change, to adapt, and begin to grow.

And, if you’re a little older, then you need show your body some love to clear the worst of the scar tissue and old injuries first.

From zero, walk. From walking, move weights, from weights and walking to increased cardiovascular load (running, cycling, swimming, rowing etc) and more frequent / intense weights.

Your overall goal should be 3 -4 sessions a week of decent cardio, with an elevated Heart and Breathing rate, and 2 sessions of Resistance Work. If you do CrossFit in a good box, or circuit training classes, you can get this in one session, but anything is good.

If you find injuries that need addressing, niggles that need support, or want a more individual plan based on your body, experience and goals, then contact us, or a professional near you.

Move, you evolved to.

On: Eat to Move

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Flip the script.

Don’t think what is a good or bad food. Other than chewing asbestos or drinking brake fluid, most things we consume are not intrinsically bad for us.

Your body doesn’t see a burger with added cheese and a plate of chips as unhealthy, it sees it as a huge stack of macro and micronutrients. (Macronutients – Fat, Carbohydrates, Proteins. Micronutrients – vitamins, minerals, other compounds). Neither does it see an avocado and salmon salad as healthy. Again, it rapidly reduces it to things it needs and things it doesn’t.

The difference is that the burger probably contains more things that the body doesn’t need, whilst the salad probably contains more that it does.

And herein lies the crux of the matter. If you consume too much of anything, there are detrimental effects. And if you consume too little, ditto. Both lead to poor health, in different ways.

In a modern western society, for the majority of us, we are fortunate that a lack of macronutrients is not an issue. The quality of those macronutrients become a matter for debate and education, but not one for here. So, we mostly suffer from an excess, with the consequential effects of excess weight, poor health and reduced healthspan.

So flip the script. Concentrate less on what you eat, whether it is a “good or bad” food. Eat to move.

If you want to lose weight, eat a little less and move a little more.

If you want to gain weight, eat a little more and move to stimulate the body.

Simple in principle, challenging in practice.

If in doubt, or if you want a more detailed discussion, please do contact us or another qualified professional.

Make a start, the journey ends at the end, but is worth it every day.

New year, old you.

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My new calendar is shiny and beautiful, from a science communication group called Kurzgesagt. (a fabulous YouTube channel). But it is just a graphical representation of another year, and a tool to help me track and organise my time.

Therefore, the concept “new year, new you” is fundamentally pointless, since all you have done is turn a page. Subsequently expecting old habits, entrenched patterns and routines to change overnight will lead to probable failure, disappointment and for some, loss of internal esteem (“I have failed at this task therefore I am a failure”). Expecting to lose weight, exercise more, eat better, drink less, learn a language and read a book a week, all at the same time, is likely to prove impossible, especially when turning off the TV and getting to bed on time is a challenge.

I propose we drop this charade. Rather than starting afresh on a specific day, especially one often immediately following a period of excess, we would perhaps benefit from spending time first reflecting on what we want the outcomes to be, then look at what will lead to those, then pick a specific single goal and work towards that.

To help with this, I will be doing a sequence of posts covering simple tools and techniques that may help you first assess your goals, then progress towards achieving them.

Of course, none of this is specific medical or theraputic advice, it is all general, and if you feel that you need professional support, then please seek it, either via your GP, or the appropriate trained expert.

New Year, New Choice, New Chance.

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A new year dawns, and we awake to new opportunities and choices.

A new day dawns and we awake to new opportunities and choices.

We get to choose, all the time.

Don’t wait for a calendar to tell you that now you can change, start today.

Don’t try and add a new thing to your life, cut something out.

Leave space for the universe to gift you.

Less TV, more learning. Less procrastination, more momentum. Less commitments, more breathing space.

Hodie Est Tempus Felix.

These are the good days.

On: Breathing

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We all do it, 16 times a minute, it’s been written about on here before. But how much attention do you pay to it, as a messenger of your current internal state?

Start by putting your hands on your abdomen, and sniffing. You should feel your diaphragm move. If you have difficulty initiating belly breathing, this is a great technique to find it.

Breathe 10 slow breaths, in through the nose, controlled and slow out through the mouth. Focus on your diaphragm moving smoothly.

If you use this to do a quick body scan, you may find all sorts of areas of tension and holding that you were otherwise oblivious to. You can then note these to work on later, when you have mobility and movement practice.

As you become more adept, you will also notice when your breathing shifts, a cue to your internal stress levels, and a hint that your body is shifting gears for some reason. If you can pause, reflect and assess, it may help you focus on a message your body has been trying to tell you.

If you really want a challenge, pause your normal training for a week, and just focus on breath and mobility work. You may notice a significant improvement in your training when you return, not just from the rest and recovery you have allowed yourself, but in the way you are able to access other underlying systems.

Of course, if you find any areas of restriction or concern, see your general medical practitioner and come to us for further support, education and intervention.

Breathe. Live. Move.

On: The basics

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As practitioners of any form, the more experienced we get, the more tempting it is to forget the basics, and yet, most problems can be resolved with techniques we learned when we were first studying.

Hopefully, we can apply them with more finesse, and refined judgement, but generally, the basics remain true.

  • Structure and function are reciprocal and related
  • We are the product of our environment
  • The body has the capacity to heal itself, given the correct inputs
  • The body wants to maintain a stable state
  • Movement is a hierarchy

If we, as practitioners, reflect and apply these to every patient we see, we can know whether to treat or refer, where to focus our attentions, and if the person is following the recovery path that we would expect, given what we know.

And then, we will have an outcome that, if not what the client expects, is more likely to be what they need at that point.

On: The path to mastery

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First there is apprenticeship. A period of learning the basics, preferably from a master. Often boring, often hard work, apparently pointless if you don’t understand the process.

Eventually, you move on, the masters think that you have learned enough to be safe, to go and independently continue to develop your skills. This is the journeyman phase, and can last many more years.

Eventually, you may achieve mastery of your chosen craft and are a craftsman. This doesn’t mean you can stop learning, merely that you are at an expert level.

However, within this is the fact that there are levels even in the mastery and many do not make it beyond journeyman.

You can see this is almost any domain, from programming to medicine, artist to bricklayer. There are a multitude of journeymen who can do a good job, competent, safe, knowledgeable. These people will provide the backbone, the core of work. They should be working toward mastery, honing, polishing, reflecting.

But you will know when you meet a true craftsman. There is the extra moment, the way they handle themselves and their tools, the way they can see a problem and frame a solution.

Aim to be a craftsman in all you do, and aim to work with as many craftsmen as you can. Find the best and mirror, watch not just what they do but what they don’t do. How they hold their hands, and how they hold their body. Listen to your own body and see if it is allowing you to do the job as efficiently. If you’re studying a more cerebral skill, such as programming or an art, look at the surrounding inputs, their environment and their basic toolset.

And then realise that that final element is a gift, one that they have succeeded in realising. But realise also that few find that final boundary, any hard work is rewarded.

Work hard, explore the boundaries and maximise your skills.

Optimise the body, upgrade the mind.

On: Rehabilitation / Prehabilitation

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The best way to recover from an injury is to not have an injury.

Other than the sort you simply cannot predict, the majority of injuries are caused by poor preparation or the inability to adapt dynamically to the situation.

Rehabilitation goes through three main stages.

  • Pain management
  • Ranging
  • Loading

First, control the pain. This is both passively and actively. Once the pain is a under control, it is a return of function, within that pain free zone. Optimise the range of motion, or activity that is available without causing excessive complaint. Finally, the loading phase, where we return to activity, initially graded and then competition.

This is, of course, a gross simplification of the tasks at hand, offers no insight into the variety of techniques considered, but is offered as a thought guide for the observer.

As stated at the beginning, the best rehab is prevention, through prehab. Prepare better, prevent problems.

Everybody has a weakness, a compromise point, or an area that appears to be less effective, so train those out to become more capable.

Seek professional input if you are prone to niggles, seek professional input for coaching if required and build steadily. Social media is not your coach, a search engine doesn’t replace a doctor.