Health

On: scheduling

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There are 5 main barriers to exercise and lifestyle change.

  • Enjoyment
  • Access
  • Convenience
  • Affordability
  • Environment

Enjoyment: if you don’t enjoy the activity you aren’t going to be able to sustain it. This is not the same as not enjoying it during, when it’s challenging and perhaps painful, but whether it provides a sustainable level of enjoyment that reinforces its benefits over the discomfort.

Access: if you can’t access the appropriate facilities to support the activity then you aren’t going to participate. For example, if you like swimming but the nearest pool is 15 miles away then you are not going do it. Similarly, if the only gym is in a building with stairs and you are less mobile then you won’t go.

Convenience: you’ve found an activity you enjoy and a place to do it. But the timing is wrong, the only available slots or classes are when you are at work, or putting the kids to bed then you aren’t going to make it work.

Affordability: even if the location is good, it’s an activity you enjoy, and the timings are convenient. Another block is affordability. If you cannot afford it you simply won’t be able to do it.

Environment: you’ve got the activity, you’ve got the access, you’ve got the convenience. You can even afford it. The last one is environment. If it feels wrong, or doesn’t allow you to feel right then you won’t do it. From dark streets in the ending preventing you in feeling confident running, gym bros laughing and filming everything, to a crowded and cluttered family lounge preventing a home workout, the environmental barriers can be quite subtle but significant.

Simply being aware of these potential barriers can help all concerned, from health and exercise professionals to patients and clients, plan and adapt their goals to better serve their outcomes.

On: Bowls

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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.

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: Gravity

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We exist in a gravitational field. You may not appreciate it for the most part but it has influenced your evolution for the past few billion years.

What we don’t tend to do it treat clients or patients in the appropriate gravitational plane. We barely even consider it.

And yet we wonder why we sometimes don’t have the success that we want when resolving issues.

We assess and examine while the patient stands or sits, then lie them down for our convenience.

Instead, why not examine and treat them in the plane that leads to dysfunction. This may lead to insights and interventions apparently disconnected from the presentation but linked and required.

Swimming problems? Standing exam is fine, but clarified in prone, sidelying or supine. Running issues? Listen to the body then treat sitting at the very least. Lower back pain? Get the patient to demonstrate relieving and exacerbating positions and listen, then apply your skill.

Want to create a relaxing outcome, then perhaps removing gravity is a good thing, unloading the heart and helping the lymphatic and venour drainage systems work effectively. But for more active therapies, it may be that following the gravitational field is a good idea.

Using gravity may well offer that differnce that can improve your practice.

Using gravity to change the relationship of the patient can pay dividends.

On: Keep paddling

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Or walking, running, swimming, cycling, dancing, lifting, playing.

Anything that gets you hot and out of breath, 3 to 4 times a week.

As more research is carried out into the causes and underlying mechanisms of post disease processes such as long covid and ME/CFS, a number of the researchers are following paths that lead to dysfunctions in patients mitochondria.

For those who for whom school biology was a while ago, mitochondria are generally considered the power plants of the cells, turning energy you consume into energy your cells can use.

Of course, it’s more complex than that and they tend to have a number of other roles, but essentially the research is showing that problems with these tiny batteries can lead to bigger problems elsewhere.

Whilst treatment modalities are still being developed, and for lots of sufferers recovery is going to be challenging, requiring multidisciplinary support, for the rest of us, we can reduce the risk to ourselves but optimising the efficiency of our mitochondria.

How? Use them.

It has been shown that endurance exercise stresses them in just the right way to make them stronger.

Finding that sweet spot depends on a number of factors including your genetic predisposition, your training history and the epigenetic environment (a catch all phrase for the nutritional, psychological and environmental pressures), but for the 80% rule, anything at low to moderate intensity for long periods of time will have a positive effect.

Prepare for an unknown future.

Get stronger, move further, fuel better.

Of course, if you have any more questions, musculoskeletal restrictions or want more technical input, contact us.

On: Nature

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Take a walk in your head. Out into the countryside. Not the bucolic picture of fields and animals and Sunday afternoon picnics, but the disconnected country. No mobile phone, dark woodlands, no shops or easy takeaways for food and water. Go further. Away from all the signs of humanity. The raw and unfiltered natural world.

Could you thrive there? Could you survive there? The experts will tell you in a temperate environment, you have 3 days without water, three weeks without food although in reality it would almost certainly be faster than that before death caught up and tapped you on the shoulder.

Even people who spend their time in that world, who practice and prepare, would not travel out without caution and care.

Because we are, as humans, pretty rubbish. We are not the apex predator we believe ourselves to be, far too many of us are prey animals with forward facing eyes (apparently the mark of a hunter).

We moved from hunter gathers to agriculture around 12000 years ago. And even before that we worked best in tribes, and carrying tools.

Knowledge weighs nothing, and although you may never need to know how to find and filter water, what plants can be eaten or how to catch and dispatch animals, spending time outside and reconnecting with the real world away from devices and screens, preferably with others is demonstratably good for you in every way. And of course, if you wish to learn those other skills, then find a reputable teacher who can guide you safely. Instagram, as one instructor put it, is not your coach and nature will still win if you fight her.

Even better is to find a tribe to do it with.

Learn to move, to feel earth under your feet and let your eyes settle on a distant horizon.

Your body and brain will thank you.

On: Self, Family, Community

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We are all linked, it is one of the joys and pains of humanity. We are nothing more than mammals that tell stories, and make tools, but far too many of us forget that and think we are above and disconnected from the rest of nature.

Reconnection with what supports and upholds us is vital for all of us, and all of us. No person is an island, or can exist for long as one. Neither should we. As the wheel turns, and peace becomes war, light, dark, the fragile nature of nature is revealed to those who recognise it.

What has this got to do with promoting optimal physical and mental health? Everything.

Unless we take time to listen and reconnect with our body’s requirements, we cannot develop. If we cannot develop, we cannot support ourselves. If we cannot support ourselves, we cannot support our families, our communities and the wider world.

For example, regular mobility work means less risk of injury, which leads to less time off work, or training. Improving your diet means better health and less need for medical support at some point in the future. And, if you are seen to be doing these by others, you might inspire them to try as well, another unintended benefit.

Looking further out, if we can help our family reconnect then we can have a positive influence on them as well.

And so on.

We must reconnect and re-engage with our selves, then our family, then the community, all the time holding onto the natural environment that supports us.

If you feel you need any help working though musculoskeletal issues that could be holding you back from being an asset, please contact us to see how we can work together. And then our skills can be used to help improve you, and the positive changes can roll on.

On: Dosing

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On: Dosing.

The dose is important. If you take too little of a medicine, it is ineffective. If you take too much it will kill you.

The same stands for training, or almost any action. Too little and you will experience no benefit, too much and you will burn out. Of course, this effect tends to be cumulative, and with training, too much may not be immediately obvious.

Which is why finding your baseline, and seeking professional input is vital, particularly when starting out or attempting a specific goal.

Once you’ve set a goal, seek an expert to tune it and succeed.

What cost fitness?

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What cost fitness?

Occasionally, people complain about gym prices, the cost of personal trainers and kit.

Only occasionally though. Because if you understand the value, you wouldn’t complain about the cost. Other than kit. There’s always a new shiny toy to try, and past a certain point, none of which will really improve your performance.

If you’re stronger, you’re less likely to die early, unforeseen events excepting. If you’re fitter, you are more likely to survive a hospital admission (being admitted to hospital is really bad for your health). If you’re healthier, life seems easier, because you have a greater capacity for stress.

Now, fitness is different to wellness. Wellness is a never-ending feast of rubbish, where a huge number of people, both honest and exploitative play. You might benefit from a yoga and meditation session (both are demonstrably good for you), but you don’t need yoni steaming and jade eggs. And you certainly don’t need to spend 300 pounds on any of them.

Fitness is far more measurable and relatable.

At the most basic, you need nothing more than you already have to improve your fitness, other than knowledge.

However, if you know nothing, then the next step is to ask an expert, or at least a professional. This is where gyms, trainers and such come in.

Do not ask the internet, as you have no filter on what is good or bad. As an internet guru, I could tell you to do 5k every other day and 50 burpees for breakfast but if you’ve got a medical condition, or an injury, or the most exercise you take is picking up the remote when you turn off your laptop after working from home all day, then I may actually kill you. Unlikely, but possible.

Instead, find someone you can have a conversation with, who can answer pertinent questions and give you honest answers. You may need to pay for their time but hey, you wouldn’t ask your next door neighbour to help fit a kitchen unless they are already skilled in it.

If you can’t afford that route, then go to the library and read a book. Lots of fitness people have written books and at least they’re relatively validated. And the walk there is a good start.

So, to loop back to the start, pricing. A gym has significant running costs, a personal trainer is not working 40 hours a week and is self employed. In the end, it is a return on investment question “am I getting out what I am paying in?”

As an example, a local CrossFit box charges £75 per month for 3 sessions a week. But for that you are getting equipment, expertise, time, and a quality environment. A local council gym may charge £30 a month, but you won’t be getting the expertise and programming, so you’d better know what you’re doing on your own (hint- that 12 reps/3sets on each machine will rapidly lead to plateau and boredom).

How does this tie in to us? We are professionals. We treat injuries, and have over 20 years of working with people. We coach, and work with trainers who actually care and understand their jobs.

If you want to live longer, healthier and perhaps even happier, come talk to us.

The first step is the hardest, but the most rewarding.

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.