It hurts because you said it did

So I’ve been talking about injuries and pain a bit recently. The thing with pain is it’s actually an incredibly complex subject. There are many factors that influence it, not just the mechanics of any injury but also beliefs and mind-set.

I was once told that if a patient is told that something hurts it will hurt.  So, if I tell you your elbow has a problem and is potentially painful it might not hurt now but if I perhaps say “hmm that’s Interesting, I would expect that issue to give you pain in your elbow” I can almost guarantee soon after you will start to notice pain in your elbow……………..have you got a pain in your elbow yet?

The thing is there may not be anything wrong with your elbow but as soon as you focus on a perceived problem, the brain tells you there is a problem and that a problem means pain-simple version is you just told yourself you were in pain so you are now in pain.

What is pain?

Pain is your brains response to a perceived threat. If you break your leg, you experience pain to encourage you to rest it until it heals. Unfortunately these signals can sometimes get scrambled and this is what causes chronic pain.

We kind of need to press the reboot button (or switch it off and back on again like a pc) but it’s not really that simple with the brain.

Just because the brain is experiencing a threat that is not really there does not mean that the pain is actually imagined, it is to the person experiencing it very real. However we can help to “reboot” by dealing with the psychological and emotional factors surrounding pain.

Firstly I think knowledge is power, as is the language we ourselves and rather importantly the professionals treating us use. (I’m not going down that rant….) This refers back to the catastrophizing blog last week; in that if you believe that your joints and/or muscles are weak, damaged and vulnerable then you will protect them, and worry about them. Again back to the idea that if we believe we are in pain then we are indeed in pain. If we can just have a rational, logical chat with ourselves about what is happening it can help to switch off the alarm bells.

If you get a sharp twinge in your back, perhaps getting up off a chair I imagine the commentary goes like this.

“Oh s!*t that hurts, I’ve damaged something, I’ve slipped a disc, if I move any more I could be paralysed…..”

Now of course there are incredibly, rare and extreme circumstances that this may be the case, however you really aren’t that special. What should actually be the commentary is.

“Ouch, that was a twinge in the nervous system, well I’m still standing and functioning so I should just carry on moving gently and progressively and the pain disappear in a minute”

This can of course be a problem when there has previously been a problem area. I see this lot with back pain. If someone has been told they have “a slipped disc” or a “degenerating spine” they are envisaging their spine as weak, fragile and degrading like a rock face. Every creak or twinge tells their brain that a little more damage has been done. No wonder they struggle to get out of pain and on with their lives!

However if they were educated properly about the strength of the spine (it’s way more stable than we give it credit for), what a “slipped disc” actually is and the fact that all of our spines are degenerating along with the rest of our bodies and it is the equivalent of telling people with wrinkly faces they have “degenerative face disease”-completely normal part of the ageing process that yes is quicker in some than others but you cannot fix “degenerative face disease” by keeping it still and the same goes for your spine.

So, let me know if there are any pain issues you are dealing with that you would like a little reflection on and I will see what I can do.

 

Stop Catastrophising It

As I work with people who generally want help with their body movement in some way I here lots of different ailments, issues and injuries day in day out.

I’ve had scoliosis, osteoporosis, arthritis, new hips, spondylothesis, recovering dislocated shoulders, post knee surgery, ankle surgery and so much back surgery that I am almost blasé’ to it. I train people with lifelong disabilities and am obsessed with following Instagram accounts of people pushing though barriers that would stop lesser mortals and they go on to achieve what may have been considered the impossible. I also find the Paralympics way more inspirational than the Olympics. The lady riding Dressage with no legs……………..I’ve literally got no excuse wonky hips or not at least I’ve got some!

Now as I said I see these things every day so it’s kind of my normal, but what concerns me is that many of these people have been given such negative advice and phrases for their Dr’s and Surgeons etc. So much to the point they can often be scared to move!

The smallest twinge can have some people convinced they are seconds away from full body paralysis! The “my Dr said my disc was right on my spinal cord” you know it’s always pretty close right as its job is to protect it? It takes a serious whack to damage your spinal cord not just a bit of gardening. The “Surgeon said I would always have back pain, he can’t fix me” The surgeon forgot to finish the sentence which should have been “You have got to fix you because surgery won’t do it on its own and whether you have pain or not is again down to you and not a surgeons words”.

“I was told to be careful with my new hip, knee……” It’s actually an upgrade you know! So long as you do correct rehab to mobilise scar tissue and strengthen muscles following surgery it will work just as well if not better than your old one! Trust me I’ve seen it many times.

There are also those that have an onset of back pain and drag themselves to A&E only to feel very dismissed when they just get sent home with some painkillers-“no X-Ray or MRI!”  They have not don’t you a disservice they just know that unless you have had an actual accident there is no reason to suspect a potentially fatal issue with your back and you would be better off with a referral to a movement specialist.

There is also this huge phobia people have of clicking and grinding noises. I often have people say “there is definitely something wrong with my knees they click when I bend them”. I don’t remember ever reading that bodies shouldn’t click-apart from the old wives tale about it causing arthritis which is completely untrue. Clicking, grinding etc. is just air and tendons and ligaments moving about. Anyone that knows me knows I click all the time and you know when I do it the most…………………..after yoga i.e. when I’m at my most bendy!

The thing is I don’t ever remember anyone ever telling me life would be easy and completely pain free?

Unfortunately a lot of the language around pain and posture and injury issues can sound quite scary and therefore be taken completely out of context. There are also just not the resources in the NHS to do thorough and proper rehab and we get left to our own devices.

For some people they have a “bring it on, this won’t stop me” mentality and I find these people (myself included) no matter what will always continue to exercise and either accept that sometimes stuff will hurt or in fact pain will diminish it just takes hard work and a commitment to your body.

You see I read a lot of research about rehab, and pain science and no matter what the injury, ailment, issue or operation the most successful treatment is always the same………………………….exercise!

To me this makes perfect sense for many reasons.

If the issue is due to a joint problem then strengthening the muscles around it will help to support it and therefore minimise any damage and therefore reduce pain.

If the issue is post-surgery then muscle wastage due to immobility needs to be dealt with and again strengthening the muscles surrounding any problem areas can only be a positive step towards supporting it.

Scar tissue following surgery needs to regain its elasticity as the continual shortening has the potential to actually cause more restrictions around the area.

If muscles are generally weak due to postural problems etc. then strengthening obviously helps them to deal with whatever life throws at them much better.

Alongside all that, exercise has been proven to boost your mood as well as improving your general health and helping to minimise risk of heart disease, diabetes and some cancers.

Now I’m not going to lie and say you will do some exercise and immediately after you will feel amazing, anything new to your body may well still be uncomfortable at first-but you were already uncomfortable doing nothing and getting progressively worse with no option but to up your pain killers………………….what if I told you after the initial uncomfortable stage of starting exercise you may actually start to feel better and those pain killers will start to be less necessary??? That sounds like a better long term solution doesn’t it?

So, whatever body injury, ailment, and pain you are dealing with do not accept it as a reason to sit around, sulk and moan about it whilst doing nothing. If you are doing that stay away from me I’m not tolerant! If you want to do something about it then start now, start small accept there may be set backs but pick yourself up and try again, and if you want some help give me a call-whingers and catastrophisers need not apply!

But Everyone Will Stare

This week I was a speaker at an event that featured a Sports Psychologist. She discussed some things that stop people doing the things they want to do.

I see this a lot with my clients. In particular with having had home based clients for several years I have seen people that struggle to exercise because they are scared what other people will think if they see them. That’s everything from not wanting to go to the gym, running outside or even joining a group class. I get it, if you are feeling out of shape or if exercise is new to you then it can be pretty scary to step outside your comfort zone.

If you have never been to the gym, you imagine a place of ripped gym freaks all staring at out of shape no idea what you’re doing you.  Well for most gyms I’ve visited that is simply not the case. In fact people will not even notice you are there! Those ripped gym freaks are too busy looking at themselves in the mirror, and the other regular folk probably feel as self-conscious as you so they certainly aren’t judging you.

If you think you can’t exercise outside because people will stare just ask yourself how many times you have driven passed someone out for a run and mocked or belittled them for it??? Probably never ……………..or you are just not a nice person and you should probably address that. So if that’s what you want to do as part of your healthy lifestyle get out there and do it, and then be hugely disappointed by the lack of hecklers!

That group exercise class, in your head is full of super models with Olympic gymnast strength and flexibility. Have you ever been to a class like that? I’ve been to plenty of classes in my time and I can honestly say not one of them has been like that. They have just been filled with various different kinds of regular people, some like you, and yes some will be super fit but not the entire class-and the super fit ones……they don’t care what you are doing they are too focused on what they are doing. Everyone else is just trying to survive the event like you!

So, I hope you can see that the only person being negative about you exercising is you. Having a rational talk with yourself and looking at what is actually happening in the situation rather than what your emotional, self-conscious head tells you is happening is a good way to break down your own barriers. If not……..well my studio is pretty private so only you and I need know what goes on in there!

You’ve got to fix you

Over the past few weeks I’ve had several people in the studio wanting me to help them with their pain issues. Now it’s all very well coming to see me for an hour and either having a massage or going through some stretching and mobility work; of course you may well leave feeling better (or at least I hope you do!) but that was just one hour out of your week, what about the other 167 hours?

Ok, some of that will be spent sleeping.

  • Is your mattress supportive?
  • Do you have a good pillow set up?

Then you may spend 40 + hours at work.

  • What are your work habits like?
  • Do you sit or stand for long periods in the same position?
  • Do you wear shoes that are unsupportive or most commonly the same shoes every day?

What about when you are at home? How are you spending your time there?

You see the point I am making is that those people that I see that want my help, I can give them exercises or suggestions of how to help themselves with their problems but often they don’t follow through.

It will come as no surprise that the common reason for not following through is being too busy.

  • Too busy to spend 20 minutes per day doing a little physio
  • Too busy to adjust their seating position throughout their day
  • Too busy to think about how they could change their daily habits to minimise their pain.

Too busy to get themselves out of pain?

I have often rather abruptly told these people that I am sure they will find time to think about fitting these things in when the pain has taken over and they are no longer able to go to work and go about their daily activities-hey I mean it sincerely that I need them to see what they have actually just said.

“I am too busy to help myself stay out of pain and prevent it getting worse” Or “I am too busy to prioritise the health and function of my own body”

You ask someone with a disability whether they think they could find 20-30 mins of time per day to work on their body and it would make them fully mobile guess what they would say? (And yes I asked a real person with a disability)

If you are having any issues with pain then of course get some professional help (if you want straight talking no nonsense then you can call me!) but of course be prepared that any therapist or Dr can only do so much the rest is down to you.

Priority Sleep

I’ve been reading a book about understanding your own and other people’s personality types in order to give them the right tools to help them stick with good habits.

It begins by talking about prioritising basic needs and top of the list of and often the most neglected is sleep.

Sleep is an absolute must for not just making you feel better the next day but for actual survival-sleep deprivation is not used as a form of torture for nothing you know!

“Sleep is that golden chain that ties health and our bodies together.” Thomas Dekker

Basically sleep is when our bodies repairs and restores muscles, organs and cells and brain power. Lack of sleep can cause aches and pains, headaches, inability to concentrate and over time begin to affect the function of your organs etc. as they have not time to adequately regenerate.

Yet, it can often be an incredibly undervalued aspect of our health and wellbeing; in fact the ability to survive on very little sleep has become a badge of honour. Often in the pursuit of weight loss and fitness we forego sleep without realising how this can be a form of self-sabotage. Think crazy early starts to get your workout in, only to be knackered for the rest of the day and not being bothered to cook when you get home so you order a pizza………………..

The key to a successful balance is to understand how your own personality and preference works in order to find a routine that works for you.

If you are naturally an early riser then exercising in the morning may well be for you, but that does mean you need to be extra vigilant about getting to bed early in order to get in 7-8 hours of sleep.

If you are more of a night owl then exercising in the evening will probably work better for you and you can enjoy that extra hour in bed in the morning.

The same applies to eating habits. If you are up early and can eat a hearty breakfast it makes sense to eat a big meal that may well need preparing at this time of day, and then later in the day something prepared ahead or easy to prepare so that you have more time to get that early night in.

Then of course it is the reverse for the late nighter. Breakfast may be quick, light and on the go and then the evening meal may require more cooking and longer to digest before going to bed.

So if you are continuing your pursuit of weight loss, fitness and overall health and well ness put sleep at the top of the list, and then slot your other good habits around it as the will power to stick to them and make them a permanent lifestyle change will be a whole lot easier if your brain is awake enough to make the decisions.

Staying Level

I often get asked by people why certain muscles get tight, restricted or underused and the answer is simply “life”. That is our everyday actions and habits that we do over and over again usually in the same way each time.

Think about what some of those actions might be. You brush your teeth with your right hand, drink your coffee with your right hand, you carry your bag on your right shoulder and then perhaps you have one of those curved desks that makes you sit to the right?

Then you perhaps drive your car hunched over the steering wheel, you sit at a desk hunched over the keyboard and then you clean the bathroom hunched over……………….

Do you see what’s happening here? You repeat the same action with the same muscles time and time again, even though the activities themselves maybe different the way in which you use your body is not.

Obviously for different people these repetitive actions will be different but they are essentially the same-repetitive actions.

This can then present itself in numerous ways in your body.

· Restriction can occur in the overused side due to tension
· Restriction can be present in the underused side –which prevents it from performing correctly at all
· Soreness in the over used side –because well tired and over used.
· Soreness in the underused side, often due it being weak and therefore struggling with any load/work at all

There lots of other weird and wonderful ways that overuse can present itself in the body (the human continues to delight, surprise and baffle me!) but these are the most common issues I see.

Depending on the severity of the imbalance depends on how much treatment in terms of physical therapy, rehabilitation exercise etc. is required but a really simple way to help yourself with this is to change up the way you do things.

So, let’s try over the next week or so to do things with your opposite hand! Try brushing your teeth with your non dominant hand.

1% at a time

When we set goals or start new things they can often seem insurmountable.

Say you want to lose weight and improve your diet, you could completely overhaul everything overnight but in reality that is going to be incredible difficult and science has proven many times not sustainable.

 

If you live off cakes, biscuits and takeaway to suddenly switch to salad and fruit is going to be very very hard!.

 

However this doesn’t mean you will never be able to do these things, it just means you are going to have to make some changes and put in some hard work to help to get you there.

 

If you could change just one thing on week one say, drinking more water then that’s a great start. Yes the rest of your diet may be terrible but you have taken a positive step. Then on week two you change another habit, perhaps make your breakfast a healthier option and so on the cycle continues until over the course of the next few months your diet is unrecognisable from when you started out-but you didn’t make life difficult for yourself by trying to do everything at once-you kind of sneaked a healthy diet onto yourself.

 

Just aim to improve 1% at a time and those 1%’s will soon add up to make 100%, or I guess in a real diet and nutrition sense I should say 80% as chocolate, alcohol, take aways (or all of the above….) whatever your “vice” is still fine in moderation it just doesn’t make up the highest percentage of your diet.

Fancy Fats

Ok, so last Macro Nutrient this week it is Fats.

Fats have definitely had plenty of bad press over the years, and it is not warranted. We shouldn’t avoid eating fats at all, they are vital for a healthy body it’s just about eating the right kind of fats.

Fats are broken down into 3 categories.

Saturated Fat

Monosaturated Fat

Polyunsaturated Fat. (Further broken down into Omega 3 and Omega 6).

Fat of all 3 types are important to our overall health.

  • It provides the most energy-this does mean it has the most calories but………moderation.
  • It aids manufacture and balance of hormones
  • Builds and repairs organ cells, the brain and nervous system
  • Transport Vitamins namely Fat the soluble Vitamins ADE & K
  • It provides the aforementioned Omega 3 and 6 Fatty Acids that the body cannot make itself.

Most of the bad rap for fats has been aimed at Saturated Fats. However this is slightly unfair and where common sense should apply. In reality people will quite often consume Saturated Fat alongside high sugar intake and refined carbohydrates –think takeaway and doughnuts….

Suddenly Eggs and Steak are getting the blame for health issues such as high cholesterol associated with a high level if saturated fat. In fact foods such as red meat and eggs contain as much and often more monosaturated fats than saturated fats-so get back to your Eggs people.

As with any part of the diet the devil is in the dose and all 3 kinds of Fats should be consumed but none should be over consumed. If you are eating fresh, whole unprocessed foods as 80% of your diet you probably don’t have anything to worry about with regards to your fat intake.

However if you have been brain washed into following a low fat diet and find yourself constantly starving or lacking energy and struggling to concentrate perhaps you need to readdress the balance.

Healthy Fat Sources include.

  • Oily Fish such as Salmon, Mackerel. Try and eat at least one portion a week.
  • Nuts & Seeds
  • Eggs-particularly the yolks
  • Avocado
  • Olives
  • Meat
  • Dairy
  • Coconut-Coconut Oil has become popular to cook with and add to smoothies and porridge as an easy way to add healthy fat to your diet.

Your homework this week then is to have a look at your Fat intake. If you don’t already try adding one healthy fat portion to your diet every day next week maybe just an egg, some fish or a handful of nuts and see that brain power rocket!

 

 

Protein Pick & Mix

Thanks to everyone that responded to last week about the new carb sources they had been experimenting with-Lentils and Cous Cous has now entered the menu!

This week I want to look at Protein. Most people think of Protein as just those shakes that gym freaks drink and as meat. However there are loads more foods that contain Protein that we should try and include in our diets to keep it varied.

Protein is vital for repair of the body, not just repair from injury or after heavy exercise but also the day to day constant regeneration of organ tissue, muscles, tendons and ligaments; and every other part of your body down to hair, skin and nails.

To be honest I find most people don’t eat enough protein, particularly vegetarians and vegans. A general guide is around 1.5-2g per kg of bodyweight.

So,

Protein is found in

  • Meat
  • Dairy
  • Eggs
  • Fish/Seafood
  • Meat alternatives and Soya products
  • Legumes – beans, peanuts (this includes peanut butter-yay!)
  • Lentils
  • Seeds

To make sure you are eating enough aim to have a serving at every meal. Maybe if you switched to porridge at breakfast you would be adding milk (plant based milks have a little less but Soy is your best option of you are Vegan/Vegetarian).

Or perhaps you could have eggs for breakfast? I pre boil mine in advance and just peel them and eat them in the morning.

If you do  rush out the door without eating why not make a protein shake (you can buy any brand it doesn’t have to be over priced with “magic” properties) and add some milk, a banana or other fruit, a spoonful of peanut butter and maybe even some cacao powder. That’s plenty of Protein in one hit.

Lunch and Dinner time the options are many and varied; add Meat or Fish/Seafood to salads and veg, make a bean or lentil chilli, casserole etc. You could also sprinkle salads or meat/fish with seeds to boost the protein content further.

For snacks try

  • Cottage Cheese
  • Yoghurt
  • Nuts and seeds
  • hummus and crudites
  • peanut butter-try spreading it on an apple
  • edamame beans
  • Beef jerky
  • Boiled eggs
  • Protein bars and shakes

Carb Creativity

Ok hands up, who’s potentially shaped like an Easter egg right now? Yes my hand is up and I’m hoping you can’t see the Crème Egg sat next to me as I write this…..

I thought we would have a look at trying to shake up our eating habits. Not just in an eat more broccoli and no pizza kind of way but more in a try new things way.

So I’m going to start with trying new Carbohydrates. You see Crabs get a bad reputation, and not really deserved. The problem is we are just really good at over eating Carbs, it’s not their fault they are so tasty and comforting.

To prove this I want you to read a pasta packet and weight out the recommended serving (usually around 75g) and just see how different that is compared to how much you usually eat. Clue-it’s usually a big difference!

We also get stuck on the same things. When we think of Carbs we think Bread, Pasta, Potatoes and Pastry.

In fact there are lots of other options!

  • Vegetables, not just potatoes but also any other veg such as Carrots, Beetroot, Cabbage..
  • Fruit
  • Grains-Wheat, Oats, Rice, Quinoa etc.
  • Beans/Legumes-Chickpeas, Black Beans, Cannellini Beans, Lentils

Why not try challenging yourself to mix up your carbs a bit.

  • Have Oats instead of toast at breakfast
  • Eat coloured fruit and/or vegetables at every meal. So berries in those oats, broccoli, carrots, peppers etc. in your lunch and dinner.
  • Try a grain and/or bean you have never eaten before. Maybe try Teff or Freekah (you can get them in the supermarket I promise) with a lunch salad or make a Chilli with some different kinds of beans added.

I’d love to hear how you get on with your experiments!