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Motion Forward - August 2023 - No2

Welcome to Motion Forword - Words of a Therapist! Issue 2!





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 to highlight the fact.


Bringing some hope, positivity, happiness and maybe usefulness to those, perhaps like yourself, that needs a pick me up.


Something about me


Hasn’t August been lovely(ish)! About time we got some sun.


So…


Following on from July’s Motion Forword, I am delighted to say I am still running! As I write this I have now completed 5 x park runs (Fareham, Jersey, Lee-on-Solent, Crystal Palace and Whiteley), 2 x 10km runs and a 7 mile/11.36km run!




Running was a new discovery for me. Something I loathed then discovered… oh… I kinda like it! But something I have always enjoyed… is dancing. (As does my 1 year old nephew! What a rockstar!)


I have had very little formal training but felt I could always hold a rhythm. I used to break dance at University and did a few months of Strictly-inspired Ballroom/Latin lessons.



As my confidence has grown over the years* I’ve become more and more happy making shapes on a dance floor at weddings, parties and nights out. * Now with little regard for what people might think of me! Don’t you just hate how we don’t do things because of the potential judgement of others?! Waste of time!


In early July, on one particular night out at Revolución de Cuba in Southampton I discovered Salsa and was fortunate enough to be shown the basic salsa step and turn.


Inspired, I started going to adhoc-throw-you-in-the-deep-end-type Salsa classes and have since signed up to a series of classes to better understand the dance. I am only 3 weeks into a 6 week course but I am really enjoying it and it brings me a lot of joy. Not just the dance, but meeting new people of all ages and having fun and laughing whilst doing it.


Patch Adams would be proud.


I would encourage anyone to break loose of their invisible shackles that hold them back (see waste of time comment above!) Do something you love, perhaps even do something you think you hate! You might just prove yourself wrong!



Something for you


Have you ever caught yourself saying ‘It’s ‘coz I’m getting old’? If I had £1 (inflation, what can I say?!) every time I heard this phrase… I’d be able to buy myself a night's stay in the Ritz!


Don’t get me wrong, it is a factor. But that's just it. One factor.


If increasing age was the only factor that caused people problems, then why do people in their teenage and younger years get problems at all? And how come there are people in their 70s, 80s even 90s who can still garden, drive and DIY!? Because there are so many other factors at play…

This amazing graph below is taken from a paper by Cholewicki and comrades in 2019. Each coloured circle represents a factor that influences pain and quality of life. The bigger the circle the more influence that factor was deemed to have.


The quite frankly messy, but life is messy, line system represents the relationship between each factor.


Age is one of the 23 lime circles near the top of the graph that represent ‘individual factors’. You’ve also got family history of pain, genetics and biomechanical impairments in the same group, all with similar influence (similar size).


If you like statistics... In addition to the 23 individual factors we have 31 grey ones (social/work), 17 dark blue ones (contextual), 26 pink (behavioural/lifestyle), 30 yellow (tissue injury or pathology), 20 purple (nociceptive detection/processing), 35 green (biomechanical), 36 light blue (psychological)… a total of 218 factors! Please don’t get overwhelmed by this.


I don’t expect people to start trying to ‘fix’ all 218 factors. But it is to highlight the complexity of how pain (specifically lower back pain in this paper) is influenced and how age is only 1 factor out of many.


Age is actually one of the things we can’t change. Yet people seem to spend way too much energy and time worrying/thinking about the number of times we’ve revolved around the Sun whilst on this planet. We just can’t change it. Unfortunately.


But what is awesome is,... we don’t need to! People of all ages with pain problems can improve. Our bodies have so much capacity for healing and recovery. So take solace in that if we spend more time/energy on factors we can change… we’d be doing ourselves a lot more favours…

What one factor can you change for improved health/reduced pain?


A story


This month, my story is about one of my longest standing patients, Kim. She still continues to entrust me for her care and has even enlisted her wonderful father, Roger, into my care!


We first met when I practised in Cadnam back in 2017, she was 57.


Poor Kim came limping into the clinic with a debilitating calf problem and she recalls the dread of realising she had to walk up the stairs when I came down from my room to greet her.


At the time, Kim was working two jobs at dock security and in a hair salon. On her feet for hours on end and pulling long shifts. I diagnosed her with ‘Complex Regional Pain Syndrome’ or CRPS.


I knew this condition would take months to get right, if at all, and it is perhaps one of the first times I remember in my career where I had to give this hard to hear news.


But Kim trusted me to help her and that I had her best interests at heart. We came up with a plan and put it into action… something had to give and the long nights standing at the dock had to go. A necessary sacrifice to help Kim’s recovery.


Kim was diligent with her exercise plan, cautious but tenacious. Always asking questions to get my blessing and reassurance to get the most out of herself.


One follow-up appointment, perhaps 6 months down the line, as I was reassessing Kim’s walk she recalls me saying ‘You haven’t done your exercises have you?! If you are not going to do what I say Kim, you are wasting my time and your money!’ I honestly don’t remember being so blunt, but it clearly stuck in Kim’s memory as she bucked her ideas up!


Kim recalls the little extras I did whilst we were working together… ‘I remember the first shift I went back to the dock security work and you were worried how I got on so you called me the following day. I never forget that’


It took many months, lots of support and guidance from me and lots of dedication from Kim… but her calf got better and nowadays it doesn’t trouble her at all. She even takes positives from it, knowing she can recover from whatever life throws at her (like bad backs and plantar fasciitis!) because she got through the CRPS.


I was, and still am, very proud of how Kim worked through her horrible problem. I reflect on her story and know that there is always light at the end of the tunnel, no matter how bleak it may seem.





If you know of someone who may be suffering from CRPS please direct them to PAIN UK and/or Burning Nights for support/advice. Or myself, of course, I’d be happy to help.


Thanks for reading, until next month…


Motion Forword


Nathan

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