Full disclosure; I’m reading Born to Run by Christopher McDonnall. It’s brilliant and as well as the narrative arc of his involvement with a mysterious Mexican tribe of runners it discusses all things running. I’m particular barefoot running.
I haven’t fully reconciled my thoughts on this but I’ve been applying the principles into my practice for years.
I notice, for example that climbers don’t get plantar fasciitis (PF), even those that run. People who do get PF are often short distance runners of not runners at all. And could afford good footwear.
So all the stretching, ice bottle rolling and wearing quality trainers didn’t affect the outcome. So I started looking further up the kinetic chain.
I found instability in the hip and weakness in the calf. It seemed as though the trainers were turning the foot muscles off. So I changed my approach; ballet, single leg work and lots of toe standing. Works really well.
So why don’t climbers get PF and how does this apply to barefoot running? The foot is inherently strong due to standing on little holds or having to support itself on impact. What was particularly interesting in McDonnall’s book is how he describes the impact force through the foot actually increases with padding.
Am I going to advocate barefoot running? Not yet but watch this space….
This is a nice article from Zoe Williams of the Guardian nicely explaining why massage is still party of a Physio’s skill-set. The evidence says it doesn’t help which is why NHS Physio’s don’t do it which is a shame but understandable; the NHS is mandated to provide evidence based practice. The NHS also collects statistics which informs future treatment strategies for us all.
In private practice we’re able to apply a range of techniques and massage is fundamental. Physiotherapists used to be called Clinical Masseurs before the focus became more functional.
Fit in my 40s: I can’t sleep through a sports massage – but will it fix my neck?
I can attest to the beneficial powers of dogs first hand as anyone who has had to listen to me could tell you. I’ll witter on about how my dog has changed my life. If it was down to me, I’d have Ben with me in the clinic everyday.
But not everyone shares this view so he guards my house from ne’r-do-wells.
However yesterday I had the delight of being visited by the lovely Faye who had brought her owners to me for some treatment.
I don’t think I would be the first heath professional who doesn’t always stick to their own advice. The reasons why vary; ego, laziness, time, the usual. Same reasons why my clients don’t always follow my advice I suspect.
But in this occasion I am. I think I tore a disc 2 months ago; agonising back pain, no referred, no neural. No position comfortable. So I was motivated to do the right thing. I’m adding 500m a week to a short, (almost) pain free run. It’s working, I’m getting better.
I’m also adding some gym and a little bit of climbing. For core strength.
This week – no pain at all.
Instead of going to the gym this week I decided I would chop 4 trees into logs for the stove.
With an axe. Just an axe.
The picture shows ONE of the three piles of wood I made. I reckon about 5 tonnes of wood. I still have a couple of tonnes left but need a chainsaw or hydraulic log splitter.
SO about a thousand ‘wood-chops’ – but actual wood chops. Literally. A thousand squats/lunges/dead-lifts (I had to carry the logs across the garded to chop then back again to stow).
I feel a) knackered, b) physically wasted and c) in pain
So unless you have a garden with some trees in to chop down you need a gym.
And if you do have some trees to chop you are probably gonna need a physio.
Sometimes we massage. Sometimes we crick people’s necks. Sometimes we mess about in the gym.
Yesterday I got to go shopping for trainers and romp around the Harbourside assessing Natali’s gait.
Good fun all round
I thought I’d put up some reasons NOT to visit a physio/chiro/osteo. If these things have happened to you or are happening, it might be worth going to see someone else.
1. They don’t take all your personal details, neither do they ask you to sign consent and a GDPR waiver. For physios these are a legal requirement. For chiros/osteo it is strongly recommended.
2. They ask you to remove more clothes than is necessary. Even discounting it being weird, it’s a bit old school. Most things can be assessed with most clothes on. Sometimes it’s necessary but hopefully you should have built a rapport and some trust.
3. They advise you sign up to a “course” of treatment, paid in advance. Walk away. Simple. Block payment packages should be available to help you save money but that’s different.
4. They don’t explain things well enough for you to understand. We can’t all be excellent communicators but we should be adequate. This is, in my view the most important part of the journey to self-management.
5. They repeat the same treatment. Repeatedly (obvs). Things change. If they haven’t changed then they haven’t done anything. Move on .
6. They don’t follow up. Believe it or not most of us actually care and want you to get better (even if it’s just to massage the ego a little bit). Sending emails with exercise plans and occasional reminders is just our way of saying, “are you better? Have I helped?”
7. They don’t encourage you to self-manage. They are inducing a sort of Stockholm Syndrome. They want you to be dependant on them. Don’t be.
8. This is not strictly the case with everyone but it’s worth considering – they’re not into health, exercise and fitness. I guess this only applies with someone selling themselves as a sports practitioner.
I think that’s it.
It’s not meant as a moan. Most therapists are out there doing good.
And also to point out that misdiagnosis is normal, having a bad day can happen to everyone and you can’t like everyone.
Stick with your therapist for a while and you’ll get the most out of them. They’ll get to know you and understand your issues, don’t move on just because they didn’t fix you in two sessions. If they don’t do the above and are friendly and have a varied skills set, give them the benefit of the doubt
Some back story;
Full disclosure – I didn’t do best practice and as my running mileage increased my gym work went down. But I wasn’t ready for big distances and my back “went”. A&E and many drugs followed.
So I’ve been resting for 4 weeks and now I’m starting again – but sensibly. The back is still problematic (inflamed facet joints for those interested) so need to be careful.
The target is 45 miles in 10 weeks. That seems like an impossible task right now.
Physiotherapy is often just that. It’s about looking beyond the pain. In coaching there are 3 kinds of observation; holistic/analytical/deductive.
– holistic is a general overview
– analytical is looking at a specific thing
– deductive is changing something to affect an outcome
So if someone has tingling in their hand then holistically, this is not normal. If the hand itself looks fine then we change something – we test. Then this tells us where the problem is.
In the example pictured I am using analytical observation to ascertain the whereabouts of a tennis ball.