Medicine

The Importance of Proper Breathing for Health and Wellness

Posted by

Have you ever felt your breath catch? An awe inspiring view, a new love across the room, a shock from unexpected news? Have you ever felt really short of breath, like there isn’t enough air in the room? Lots of things can make us feel short of breath, some exciting (the new love across the room, the view), some scary (the sound of unknown feet on a dark night, shocking news), exertion and even some diseases.

Therefore a caveat – if you think that your shortness of breath, particularly if linked with a new or persistant cough, could be of pathological origin, go and see your primary medical provider for assessment and treatment.

Breathing is the most fundamental process of life, something we have done since the moment we were born and the last thing we shall do. It is something we never notice until it becomes the only things we can do and is also, uniquely, one of the only autonomic actions that we can control.

Hold your breath. Just stop. No in, no out, just pause. If you are relaxing and have no known underlying issues, you should be able to last 20 – 30 seconds before the desire to breath kicks in. Physiologically, this desire is driven by the change in Carbon Dioxide, not the drop in Oxygen.

The ability to control your breathing, and your response to it, is a wonderful gift, that can help relieve headaches, reduce your perception of stress, control anxiety, increase athletic performance and even change your mood.

And, if your breathing is restricted mechanically, there is research based evidence that manual therapies can also help improve this, increasing your functional effective volume and respiratory mechanics, also helping with the above issues.

At the Clinic, we have spent years working with specialists and carrying out research ourselves on best ways to treat, unlock and improve breathing, from relaxation exercises to breath control systems, and manual therapies to address underlying function issues.

Book today online and talk to us to experience the benefits.

On: Tendons and Ligaments

Posted by

Tendons tether muscle, ligaments link bone.

But both can be damaged, become weakened, or scarred.

So how can we, both as practitioners and people, prevent this, or at least minimise its impact?

Prevention is always better than a cure, and therefore ensuring the tendons (when reading tendons, assume ligaments as well, although there are differences in all sorts of subtle ways) remain strong is vital.

Note – If you are currently taking medications, especially certain antibiotics, check with the pharmacy regarding soft tissue effects. For example, Fluoroquinolone antibiotics have a rare side effect with regards to soft tissue, so if you are prescribed those, it may be sensible to reduce training load during and after the treatment.

Tendons can be trained, like any other tissue, and research indicates that they respond best to cycles of isometric tension, of approx 10 – 30 seconds, with 30 – 50 seconds rest. Initially, it doesn’t even matter what joint position you are in, as long as the tendon is under tension, and pain free. Over time, you can increase the load and the number of cycles you carry out, to ensure continued development.

There is also some evidence that longditudinal supplementation with collagen (preferably from biologically similar connective tissue) is beneficial, especially when consumed with vitamin C.

Once you have a stable, platform, you can work on repairing any scarring or weaknesses in the tissue by using long duration concentric / isometric / eccentric training movements, through the pain free range of motion. For example, a squat under light load, with all three phases taking 10 seconds, although this time is individual.

Finally, there is also some evidence that early, and safe return to loading after injury can help reduce the time to competition, since the stimulus causes the scar tissue to form beneficially, rather than scattered.

TLDR: tendons can be strengthed, healthy tendons can increase your overall performance, isometric exercises are beneficial to tendon health.

On: failure

Posted by

If you try to do too much in one go, you’ll fail.

You’ll fail because change requires effort and energy to sustain and you only have so much of it to go around.

Getting up earlier requires going to be earlier. But you can’t do that if you have commitments that keep you busy.

Cleaning up your diet requires knowledge, planning, effort.

Going to the gym is bullshit. I love gyms, they’re generally my safe place, but they are not the panacea sold by fitness grifters. Gyms are a place of effort, learning, painful self reflection. Go when you are ready for the lesson and can take humility in your kitbag.

Meditation and mindfulness are not solutions, they’re tools. If you can’t accept the dancing monkeys in your head, you’re not going to want to spend any time with them.

And after all that negativity?

Get rid of something. Less is far easier to manage than more.

Stop drinking. Stop smoking. Stop scrolling. If you can’t, accept you might have an addition issue and ask for support.

Walk more, drive less.

Throw out something from your house. It’s almost certainly clutter and there’s a probability someone else could benefit.

Positive deeds are loops. One feeds another. Make space for positive things.

We can offer some of this support.

An exercise review. A safe space to work through basic coaching issues, treatment to give your body space in itself to heal. A motivating kick and gentle reminder that being human takes effort but is worth it.

But make space. Do less, just do less better.

Be kind, be curious.

On: The power of words

Posted by

Words have power. This has been known for a very, very long time.

The words we say to each other, the words we say to ourselves and the words we use to describe the world around us.

By reframing the words we use, we can change the way we view the universe. Even the language we speak with changes the way we interact with the world around us.

The internal monologue we have can change our entire day, or even path of life. So does everyone elses. And of course, these things can be deep and challenging to deal with, so are far beyond the remit of such pages here.

With that in mind, the following are suggestions that can allow us to catch ourselves in simple situations that may then offer benfit to the way we approach certain circumstances.

For example. You injure a knee on a run, which limits your mobility while it heals. If you start telling yourself that you cannot do things because of your knee, then you are creating limitations within your mindset. However, simply by saying that in spite of the knee you can do activities that maintain your fitness, you will optimise recovery, improve your mindset and view the current difficulty in a better light. That is not to say that it is not a difficulty, but the perspective shift of the barrier changes its height.

Or. Change “I can’t” to “how can I?” Shift the view of the problem.

Within a medical setting, we often get patients expressing suffering. Suffering is subjective, valid and to be believed. However, as a professional, you can help reframe the situation by the use of your language patterns to check in with what they are experiencing. From suffering to experiencing does not and should not invalidate their personal reality, but may help explore what it means at that point.

Again, within a medical or caring setting, empowerment is important. If we help someone, we can often disempower them and either create passisivity or an unbalanced dynamic. So instead of helping, consider or ask how you can support them. If they have limited abilities for any reason, then this can help set the correct tone for them to communicate their needs, rather than having your “help” thrust upon them.

If you have repetitive and perhaps tedious tasks to help those around us, from small children and work colleagues to aging relatives, and find yourself saying that you’ve got to, reframe it to get to. I’ve got to take the kids to football – I get to watch them learn new skills. I’ve got to see my grandfather this afternoon – I get to spend time with my grandfather. And so forth.

And sometimes, if you don’t know what to say, say nothing. Supportive silence is much underrated and certainly underused. Slow down, check in with yourself and say nothing.

In spite – because of

Can’t – how can

Suffering – experiencing

Got to – get to

Silence.

Onwards.

On: Testing and Imaging

Posted by

Just because you can, doesn’t mean you should.

As a clinician, there are a huge range of tests and investigations available. Blood tests, scans, investigations, the list of what you can order goes on and on.

Some of them are quite invasive and unpleasant for the patient to go through. Others can expose them to small doses of radation. And all of them have a cost.

How do you choose which to use? The first step is to listen to the person and understand their clinical history. From that, and in conjuction with an appropriate and consented examination, one develops differential diagnoses. And only then, do we start to consider tests to confirm or exclude the diagnosis.

And of course, we have to consider, or at least should take into account, what we will do with the result of the test.

Blood tests can give an idea of the current status of many organs, but if you are complaining of UTI symptoms, i don’t need bloods, I just want a non invasive dip and will treat according to that. However, if I believe that you are anaemic and want to understand why, then a blood test may help, and guide the treatment. And if I believe there is something complex, where it shouldn’t be, then I will want to image it, whilst referring you to the most appropriate speciality.

This is especially true for complex and expensive imaging routines, such as MRI or CT. If you have simple musculoskeletal back pain, and no indication for surgery, then an MRI is not going to change matters. If your clinical history indicates a complex presentation that may require intervention then an MRI or CT is an effective next step. For context, a CT is Computed Tomography, essentially a three dimentional thin slice x-ray model, which is good for seeing hard structures. MRI is Magnetic Resonance Imaging, and best suited to soft tissues and organs.

However, far too many professionals request tests as a holding pattern, so that they feel they are doing something, and are reassuring both the patient and themselves that they are being proactive. This is not a judgement on clinical practice, simply an observed trap that we all fall in to and should be aware of.

So, as a patient, or patient advocate, take the time to check with the person what the test is for and why they think it will help. This will give them the opportunity to educate you, explain their thinking and hopefully answer any questions you may have.

From knowledge comes understanding. From understanding comes courage.

On: Galen

Posted by

The history of medicine is littered with men, and women, who even today, have an impact on the way we treat and are treated when we are ill.

One of these, and one of my favourite, was Galen. A Greek physician who practiced in the 1st Century CE Roman Empire, he studied extensively before moving to Rome and eventually becoming physician to the Emperors, and Gladiators. This gave him significant insight into many areas, and although we now know that many of his thoughts on illess and physiology are incorrect, a great deal of his work is still relevant.

Two of his tenets, which I believe still stand, and we still use are:

The body is a complex interconnect system, which has the capacity to heal itself. This is very similar to the osteopathic principles.

Use physical therapies first, then drugs, then surgery.

This last principle is still undervalued by both patient and practitioner, as it is not an easy fix, and given today’s current phamacopea, it is too easy to reach into the cabinet and take a pill rather than look for an underlying cause.

I would advocate to choose to be different. Seek the cause, make a change and overall health will improve.

Resilience and capacity

Posted by

In the end you have to have something that I give to give the disease as a price of recovery.

Not sure where I heard that but it makes sense.

The more fitness, the more muscle you have to give a serious illness, the more likely you are to come out the other side.

Professor Oliver (geriatrics) noted that he could guess someone’s probability of a safe discharge from the quality of their handshake. Firm, strong, reassuring. Weak, flaccid, concerning. A handshake conveys vitality, determination, strength, even psychological state.

Put the work in now so your future self can live to fight another day.

On: Simple

Posted by

Simple is not easy.

Its simple to do the right thing in any situation, but most of the time it is neither easy to discern, nor to act on.

The discernment is the first and possibly most challenging step. This requires much reflection and patience.

Once you have identified the overall goal, it is easier to understand the steps to progressing.

To simplify, and once you have removed the obviously superfluous, you can also:

  • Delegate
  • Habituate
  • Automate

If there is something that you do daily, can you automate it? Is there a way of making technology support you, so you don’t need to worry about it?

If you can afford it and have no love for it, or no skill for it, can you delegate it?

If you have to do it yourself, can you make it a habit so that it is an unconsious process?

Looking at 2 common goals, weight loss and fitness.

Very broad brush and one reason why most people fail is that there is no end point, and therefore no positive feedback or marker of success.

Rather than weight loss, focus on improving a marker for health thats pertinent to your, whether that is HbA1c (a long term marker of blood sugar), cholesterol, blood pressure and so forth. The changes you will make to improve those will often have a positive side effect of improving your weight as well. Or, improve your height to waist ratio, which will have the same outcome.

How? Simplify – remove the things from your cupboards that you know tempt you, or ask people to reduce your access to them. Delegate: See input from a qualified professional who can provide both motivation and expert guidance towards your goal, not just an internet celebrity. Automate: Set up reminders,

With fitness, choose an event you wish to complete. Then tell people about it. By putting a public commitment up, you will have more drive to do the work necessary to succeed. And you will improve your fitness almost as a side effect.

Fluid

Posted by

We are 60 -70% fluid. It flows in our blood vessels, squeezes round the lymphatic system, cushions our joints, sits between our cells and keeps us moving.

Yet we rarely use fluid movements when we move. We rarely think about it when we stretch, exercise or train. We almost never consider the effect of movement on the fluid flow, how we pump that precious ocean around us.

And most of the time that’s fine, the body will manage itself ok, it has done for years.

But maybe, being present and considering fluid might add an extra dimension.

When stretching, imagine the tissue being squeezed like a sponge, and allow a fluid pump to take place. When mobilising joints, hold that synovial fluid in your mind and feel it cushion, protect and lubricate. Give time in each position for the fluid to flow, in or out.

And be fluid in your movement.

On: Bowls

Posted by

Imagine, if you will, 3 bowls. These bowls are inside you, one stacked above the other.

The first is your pelvis. Already described as a bowl, it supports and holds all above it.

The second is your diaphragm. Separating the organs in your chest from the organs in your abdomen, it forms the top of the abdominal cylinder and should move gently as you breathe.

The third is in your upper chest, at the top of your lungs and about the same level as your collarbones.

This being a conceptual experiment, fill them with water. Then, think about the way you are standing or sitting. Are those bowls going to overflow? Is the water going to run out of the front, the back, even the sides?

Stand easily if you can, weight distributed in the centre of your feet. Soften your knees and ankles.

Then, come up to the pelvic bowl. Tilt it forwards and backwards, until you find the centre, neutral position.

For the diaphragm, you can feel if it is forward or backward and correct.

Ditto the shoulders. Allow them to open, don’t force, allow. A subtle external rotation and lengthening of the clavicle.

Once reflected and considered individually, check in again with all three.

This is probably one of the quickest ways of achieving optimal posture smoothly, balance the bowls, check how they move when you breathe and then, get on with the business in hand.

Of course, if you need help balancing the bowls, can’t find a neutral position or are struggling to fix it in any other way, please book in, we are happy to help.