Motion Forword - Words of a Therapist: Good Habits, Exercise Guidance and Review Reflection
Welcome to Motion Forword - Words of a Therapist! Number 34!
Motion Forword is about discussing the combined benefits of movement with a positive mental attitude. Using my personal/professional experiences, evidence-based research and some of your own experiences.
Bringing some hope, positivity, happiness and maybe usefulness to those, perhaps like yourself, that needs a pick me up.
Something about me… Keep your good habits going
I have been doing a lot of dancing again this month.
Surprise surprise!
With a mixture of bachata, salsa, west coast swing and fusion.
And yet, this month, I have missed the most mid-week dance sessions than I ever have. I missed 3 of the 4 Wednesday night classes and 1 Tuesday night class.
Some West Coast Swing…
I know how much joy, laughter and physical benefit dancing gives me so I don’t want to allow myself to slip into not maintaining this good habit. Because it can be so easy to do…
I often find with my patients (as you may know I ask a lot of questions!) that they have forgotten a long-lost beloved hobbie or had to sacrifice a sport for more time at work or with the children or simply, like me, life happened and they broke out of a habit. (the COVID pandemic lock-down would have certainly curtailed a lot of our good habits)
This week I had a classic example with a women in her late 20s with lower back pain. She seemed to recognise how she needed to do more physical activity when I was asking about exercise/sport, yet proudly stated:
‘You’d never guess but I have a black belt in Taekwondo!’
I was super impressed and naturally encouraged her to find that passion again. Either in Taekwondoor perhaps in another martial art. It may have been a coincidence (amongst other things) but she didn’t have back pain when she did Taekwondo. It’s a coincidence worth exploring…
So I implore you faithful reader… please find that love again. Whatever it may be.
Something for you… How often should I do my exercises?
So let’s talk about a hypothetical around exercise prescription:
Lets take 4 people all with the same problem: lower back pain.
Beatrice, a 75 year old woman who enjoys gardening and playing with her grandchildren.
Rupert, a 71 year old man who bowls, enjoys long hikes and walks and a brandy in evenings.
Grant, a 27 year old man who has a sedentary job and enjoys socialising with friends.
Stephanie, a 32 year old woman who goes to the gym 3-4 times a week, does 5-10km runs weekly and has a physically demanding job.
Let’s say, in this example, I give them all seated ‘chair’ squats to work on their gluteal (butt) muscles. The only difference is how we break up the exercises over the course of each day.
Should I tell them to do all the exercises in one go or over the course of the day?
A question I get asked frequently when it comes to the exercises I prescribe people for their problem.
My answer will change depending on the person in-front of me (bespoke exercise guidance?! Whhhaaattt?!)
For now, to keep it simple, from the hypotheticals above I will recommend to each patient either number 1 or 2:
10 Squats x 3 Sets, once per day
10 Squats x 1 Set, thrive per day
Beatrice has really been suffering with her back for a couple of weeks and struggles to get out of bed. She can demonstrate the squat, she’s tentative at first but gains some confidence and can do it without major discomfort.
I recommend Beatrice does No2.
Rupert has had a niggle in his back over the last few months and finds it annoying but doesn’t really bother him significantly enough to stop him bowling or hiking. He shows off how easy the chair squat is and barely breaks a sweat.
I recommend Rupert does No1.
Grant has issues with his back when hoovering and doing general chores around the home. It’s been occurring for several months to a year and he now wants to do something about it because it's getting worse but he's not sure where to start. He can demonstrate the chair squats but wonders how he’ll fit it into his day.
I recommend Grant does No2.
Stephanie is very active and is not a stranger to squats. Her back seems to not flare up when doing squats at the gym even with weight she is comfortable with but running is more uncomfortable.
I recommend Stephanie does No1 and reduces running.
My rationale behind giving Beatrice and Grant No2 (spread through the day) is to help introduce them to activities they are unfamiliar with, especially with their pain. They can gain some confidence (in themselves and in their backs) before increasing the intensity (moving to No1) and for the convenience of fitting it around baby sitting and/or a busy day.
It’s a ‘lets get the ball rolling’ approach.
My rationale behind giving Rupert and Stephanie No1 (all in one go) is because their pain wasn’t impeding their movement and they were already confident with the squat movement. Their good experience in movement and exercises meant that they need the extra challenge to stimulate enough change beyond what they are used to.
It’s a ‘lets build on your foundations’ approach.
Of course, these examples I have made easy to explain the concept but really there may be additional variations between No1 and No2 depending on the nuances of the individual in question.
For example we might consider the volume that Rupert would do compared to Stephanie. I.e. Rupert might be doing body weight squats whilst Stephanie may be able to add an additional 40kg barbell.
There is no right or wrong in my book. The point being, it gets more bespoke the more you dive into each individual's pain/tolerance, goals, circumstances and exercise experience.
A story… A Review on my Reviews
I have had a flurry of reviews recently on my Google page.
Which I am so grateful and humbled by. Thank you to everyone that has left me reviews past and present.
Here are my most recent ones over the last month…
All of these people have their own unique and interesting stories that led them to me with different reasons for their problems with different solutions and approaches.
Since I started Nathan Bull Osteopathy in 2018 I have seen and helped over 1200. But I have probably helped hundreds more where I have worked in various clinics over my (almost) 10 year Osteopathic career.
And how much I’ve grown in that time!
Going back to my shy-green-beginnings in 2016, I would have never thought I would be sitting here, writing my blog about my business, that has 139 5 star reviews and having seen over 1200 people.
We all deserve a pat on the back for seeing how far we have come and the achievements, big and small, that we have attained in our lives. This includes overcoming hardships, disabling pains and lost hope.
On reflecting on my own achievements, professionally and personally, I am also so proud of all of my patients over the years that, with my support, have conquered their battles with pain.
Thank you.
Thanks for reading.
Until next month…
Motion Forword ⏩⏩
Nathan