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Motion Forword - Words of a Therapist - No9

Updated: May 14

Welcome to Motion Forword - Words of a Therapist! Number 9! 





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 - Casa Toro


Some exciting news!I’ve moved! Don't panic, I am still at the White Building in Southampton but after two years living with my best friend I am now living in my own digs! 


It’s a modest 1 bedroom which is leading me to relearn all the joys that come with owning your own home: what Dot & Dab is, that some sofa beds are just too big and council tax (at least I get new bins for free!)  


What a ride. Now a bit closer to Southampton I’ll be able to enjoy shorter commutes, less risk of getting stuck on the M27 and a huge Sainsburys! 


You’ve got to celebrate the small wins. 


Something for you - Stop picking that scap!


A few weeks ago, I was playing hockey in Salisbury. My teammates and I were in a spot of bother as we only had 10 men. There should normally be a 11-a-side but we were let down by someone not showing up. 


A man down. No subs. It was a long morning. 


We did what we could but inevitably we lost. 


I took away two things from that game: 


  1. As a team, we showed great character and camaraderie in difficult circumstances. A true sense of all-for-one and one-for-all.


  1. A big ol’ graze on my knee! (don’t scroll down if you are a little squeamish!) 


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Day 0

 


But as is always my (morbid) curiosity… I wondered how it would heal and how it would feel. Here are the results: 



Day 2



Day 13



Day 17



Day 20




As you can see over the days and weeks, it heals as you would expect. With a scab forming to protect  the new skin healing underneath. 


However…


What I found quite interesting was how the upper part of the scab (hip end) was more painful to touch than the lower part of the scab (knee end). Literally day and night.


But why? It happened at the same time? It looked like it was healing the same?


What I realised is that the upper part of the injury, not the lower part, I would quite repetitively knock into the side of the treatment couch that I use at work. This hurt, but sometimes I didn’t even notice! 


As a consequence, not only did one area of the same injury hurt more (literally a few centimeters apart!) but it also healed slower! It was so specific. 

You can see in the picture of Day 17 how the lower part of the scab has naturally come away sooner revealing freshly healed skin underneath before the upper part comes off later by day 20. 


Side Note: The bit left in the middle is where I accidentally knocked off the scab during hockey training on Day 10 after the injury which obviously needed even more time to heal! 


OK Nathan, this is a bit gross, what’s your point?


If we consider any injury or pain presentation like my scab, it may help us understand why things take longer to heal than expected, can feel worse or not improve at all... 


When we ‘knock’ an injury causing more pain directly or indirectly (e.g. pushing into pain, keep doing repetitive work that strains the area, not resting appropriately, ignoring the pain, not sleeping well, poor nutrition, stress/anxiety/frustrations etc etc etc) we are further delaying its recovery. 


This is why I don’t like the ‘No Pain, No Gain’ philosophy that a lot of people tend to adopt. It doesn’t help in most cases and should be reserved for a performance enhancing training (even then it could be argued to be dubious).


So the take home is… STOP PICKING THAT SCAP! 


Leave it alone. Let the body do its thing and heal. Picking prematurely or knocking (accidentally or on purpose!) whilst it's still healing only makes it more painful and delays recovery.





A story - The Winter Shoulder


It had been 6 months since Maia started suffering with a shoulder problem before she came to see me. She struggled with simple day-to-day tasks like loading the dishwasher, dressing and opening a car door. Sleep was disrupted and the frustrations were starting to set in. 


She had seen multiple therapists for her problem. Two months prior her physio had said that she had a rotator cuff injury that was causing her shoulder pain and limited range of motion. But the exercises she was given were not helping and only seemed to make it worse. 



Maia enjoys walking her dog and her day-to-day work is light at best so to have a rotator cuff injury didn’t seem to fit for me. When I examined Maia I felt that Adhesive Capsulitis (aka Frozen Shoulder) was more likely. 



This diagnosis is not a nice one to give as it can take many months to improve and can be disabling at its worst. 


I wrote to her physio who agreed with my thinking. Corticosteroid injections had already been organised which I explained to Maia could help with her condition but may not provide a long-term solution. 


BUT! They could offer us a window of less pain and more movement to capitalise on to improve the problem. 



We adjusted her exercise regime to take into account my diagnosis, making them easier and less painful to complete. From the first treatment, Maia described how she noted an immediate improvement.



Over the weeks and months, Maia was committed and worked hard at her exercises as I drip fed more and more ideas. She was quite the soldier. She was pleased to see the gradual improvements in her pain but also in her mobility. Like this guy…



By week 14, as winter was setting in, she described her problem as being 99% better. She had gone from practically unable to move her shoulder at all to almost full pain free range of motion in this time. 



Maia still likes to pop in from time-to-time for some treatment and to discuss how her condition is going but everything seems to continue to go from strength to strength. 



Thanks for reading.


Until next month…


Motion Forword ⏩⏩

Nathan





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