Environment

On: Heat

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The UK and much of Europe is currently experiencing a heat wave (mid July 2022).

We are, by and large, not used to this although I fear that we may need to adapt, due to climate instability.

For those of us who enjoy activity, being active in the heat is a challenge and can be a medical risk for many.

Because not only do we have to take into consideration the temperature on a thermometer, but we also need to account for the humidity, since this has an impact on the body’s ability to lose heat. It is possible to run marathons in the desert more safely than a humid summers day.

Hydration status, electrolyte balance and other physiological conditions also have a role.

So how do we develop flight rules for exercise in the heat?

Firstly, know your body, and pay attention to it. Getting off the aircraft from a cool region and plunging straight into a desert marathon is asking for trouble. Allowing time to adapt and preferably having mimicked the conditions previously is a much smarter idea.

Secondly, understand your hydration and physiological status. Medically, you should expect a fluid balance of approximately 30ml per kilo per day. This does include the water in vegetables and fruit so is not just liquid water. You will also need to maintain a good electrolyte balance for yourself. If you are a ‘salty sweater’ (your t shirt develops white stains as the sweat evaporates or your lips taste salty) then you will need to replace more of both sodium and potassium in the correct proportions. Most sports electrolyte supplements cover this and advertising aside (we are not sponsored) Succeed caps, SIS electrolyte tabs and High Five electrolyte tabs have always done well during my endurance training career. Others are available and you don’t need the sugary sweetness of most sports drinks for anything under an hour anyway.

The other, under reported element to track during activity is heart rate. In general, if your heart rate is higher than you would expect for a specific workload, then you are possibly dehydrated and certainly accumulating heat stress, with your body finding it hard to stay cool enough. If it is dropping and you are struggling to elevate it to the target ranges then you may be suffering with cardiac fatigue. In either case, back off, drink, reflect and wait for it to settle before making the decision to go or no go. A personal rule is to take off 10 beats from my target heart in non acclimatised heat as a safety margin.

Summary:

  • Heat is a stressor
  • Acclimatise and adapt if possible
  • Hydrate using electrolytes if indicated
  • Monitor heart rate if possible and set yourself safety limits

Onwards and stay cool.

And of course, if you need more detailed input on optimising your training, resolving injuries and improving your health span, contact us.

Note: this article is a generic guide and not specific advice. If you have any health concerns or underlying conditions, seek support from your registered medical professional and care providers.

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: Beyond movement

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There are the eight prescribed movement patterns: flex, extend, rotate, push, pull, squat, lunge, walk.

But beyond that is the ability to do them smoothly and under load.

For example, when out walking, without losing step, run your fingers along the ground. That involves walking, flexing, lunging and an element of rotation.

Now repeat the action raising your hand over head to touch a tree leaf. Again, walking, extending, rotation.

The more complex the move, the more we challenge our neuromuscular system, the less spare capacity we have and greater the risk of subtle injury due to compromise.

Therefore, we should train these elements. Not just the standard gymrat moves, but through play.

Look at an object and play with it. A plate carried overhead. A tree branch that can be climbed on or over, or under. A line on the pavement to walk along, skip over, or walk backwards over.

Look at the environment as a playground, and use it to improve the way you move.

Injury proof yourself through play.

You are what you do.

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They presented with a long history of shoulder and back pain, with occasional headaches, particularly in the evening. No other significant complaints, simply a tight and painful upper back, and shoulders, with a stiff neck.

After taking a thorough history and checking pertinent red flags, I carried out a suitable examination, looking at how they used their body, how it wanted to respond passively and actively.

And the thing was, other than the presenting complaint, there wasn’t much to be found. An anteriorised head posture and slightly kyphotic thoracic spine, but nothing much more than you might expect for a modern lifestyle. They exercised frequently, were not obese and tried to optimise their working posture when at a desk.

I treated what I found, and we addressed a few issues, but I was unhappy with their progress, as the complaint didn’t feel like it was resolving along the curve I expected.

Then it clicked. Whenever I went through to reception to collect them, they were playing with their phone. Head slumped forwards on the chest, looking down at the tiny screen and typing or scrolling away.

The problem is, modern expectations are that we are constantly connected, with rewards and punishments meted out by both the device and other people if we do not respond to its electronic siren call. I am as guilty as the next person, at instinctively checking and wasting hours.

It was this small, but frequent behaviour that was causing, in this case, the shoulder pain. Looking down was loading the back of their neck, the shoulders were coming in to support the arms holding close and everything matched when I mimicked them.

However, other than taking the phone away from them, there wasn’t a direct intervention I could do, so instead we discussed possible mitigation strategies, to reduce the automatic reaction, shorten the time spent interacting and change the posture, things that have been shown to work.

Following the rules of three, I suggested:

  • Switching on greyscale. This, interestingly, makes the device far less stimulating, but still allows you to work effectively. It also helps increase battery life on some devices.
  • Clean up the home screen and put apps that distract in a folder so you don’t see them first
  • Turn off notifications for social media applications

The point was simply to create a brain pause that allowed for a moment more reflection before the action, rather than create a wholesale change that would more likely fail.

Having created this awareness and put in some simple measures, we were both very happy to see that the treatment was then far more effective and the presenting issues resolved.

After they had left, I reflected in how the simple actions we do can have profound impacts and that, as practitioners of every discipline, we need to continue to look at the whole person, not just the complaint.

Beyond 3 basic skills

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Previously, the 3 basic movement skills were raised.

These were:

  1. Getting off the floor from lying on your front
  2. Getting off the floor from lying on your back
  3. Walking at least a mile carrying a load

These use the primal movement patterns and the vast majority of us have been able to do them since the age of 2.

We can therefore advance these and actually start to develop them as a physical practice to improve our health, with very little other equipment.

If you have not exercised for a while, or have pre-existing medical conditions, please do consult your GP or practice nurse for a health check before starting any program.

As a test day, start by going for a brisk walk, sufficient to get you slightly breathless after 10 minutes, then aim for a mile, or 20 minutes. Once in a safe place and once you are warm, get on the ground. First, from your front, get up. Then from your back.

If that was challenging, or you struggled to get up, your first month would be simply practicing until you can do 10 from both front and back.

Once you can do that, you can add some more load.

With nothing more than a couple of bin liners, a reel of strong tape, an old rucksack and a bag of builder’s ballast (sand / gravel mix), you can create all you need for a very effective workout.

Fill a bin liner with a few kilos of the ballast. Tape it into a strong, short sausage shape and place this in another bag for safety. Create a few of these, of differing weights.

Once you have the weights, put sufficient in your rucksack to equal 5-10 kilos then do a 30 minute walk at a brisk pace.

Once back, adjust the load in the rucksack to about 2-5kg and perform 10 front get ups with the bag on. The, taking a sausage across your shoulder, perform 5 with it on the right before doing 5 on the left. As you get stronger, increase both the load in the rucksack for the walk and the getup challenge.

You should find that that provides a decent workout and can act as a gateway to more training techniques.