I’m frequently inspired by my friends and clients; when people do things that push them despite everything.
I’m not one to idolise the privileged.
However, I’ve just finished Everest, The First Ascent by Harriet Tuckey. It’s about her father, Griffith Pugh. It’s a critical biography of a deeply flawed genius and a fascinating account of some of the early British Himalayan expeditions.
But what has inspired me the most is the number of things he could rightly lay claim to having invented. As I see it the following were his ideas:
- High altitude oxygen protocols
- Same for hydration
- Down jackets
- Hypothermia treatment
- Running shorts
- Peaked visors that are not hats
- Post fracture rehab
- Modern physiotherapy
It’s a great read. Highly recommended.
I’m back running after a 4 month hiatus due to injury and to keep me focused and motivated I thought I would investigate barefoot running (see previous posts).
I was convinced. My plan to run everyday for 1 month started with 10km – felt good, no problems. Day 2 – 5km, shortened to 4 due to calls pain.
Ooooh. Ow. Very tight calves.
However, back up and running thanks to Louisa Clarke and her magic cups. Feeling good.
The wider role of a Physio could simply be to maintain health and fitness. Whether working in A&E helping clear lungs of blood (yup, that’s a thing we do), repositioning intubated and unconscious patients in intensive care so they can breathe (another thing) to helping people walk again (obvious that one).
Part of our remit must therefore be “lifestyle” factors. We can’t be an expert in everything but we should always be looking for answers; questioning things, asking ourselves if there is anything else we can do and importantly, looking at the evidence.
I used to work alongside a personal trainer who adamantly believed meat was an essential part of diet to the extent where they had meat at every meal; bacon for breakfast, pork chop for lunch, steak for dinner. They passed this onto their children so convinced were they of their belief. Indeed, they even wrote a recipe book for their clients. When I pointed out that the WHO (World Health Organisation) had determined (by looking at the evidence) that red meat was “possibly” carcinogenic my PT colleague said they had interpreted the evidence wrong!
Now, I didn’t argue; beliefs don’t work like that but I did review the evidence and it seemed sufficiently robust for me to become a vegan (I was already a vegetarian).
However, I recently listened to Michael Gregor’s podcast at nutritionfacts.org and discovered not only was the science sufficiently robust but that the word “possibly” was only inserted as a result of pressure from the American FDA (Food & Drugs Administration) due to pressure from the food lobby.
In fact, meat does give you cancer.
In the same way as a mosquito is an infectious disease vector the report describes the food industry as a “chronic disease vector”.
I wonder if my PT colleague is still mainlining meat…..
Here’s my favorite bag of meat swimming with too many sticks.
Barefoot Ted speaks some wisdom as quoted in the book Born to Run by Christopher MacDougall.
He is discussing how people didn’t get plantar fasciitis before the creation of the running trainer and how modern, long distance running tribes also do not suffer.
The foot is perfectly designed to absorb the impact stresses of running on rough hard surfaces and if the skin is thick enough it can survive extremely harsh conditions.
Does this help a modern physio fix PF?
I would say yes.
It’s all about making the foot stronger. Force it to change, adapt, harden and it will take the everyday rigours of life, quite literally, in it’s stride.
How do you treat PF in the typical, elderly population? Supported (obvs) toe stands, step jumps, tip toe walking.
How about dancing? Absolutely.
More is less as far as I’m concerned. And who knows, they might get fitter as well.
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.