After 17 years as a practising Chartered Physiotherapist, completing an MSc as well as a Diploma in Medical Acupuncture, and having attended many further education courses on Physiotherapy related topics, I found myself earlier this year asking myself ‘what next?’.

Continuing professional development is very important to me both personally and professionally. However it was proving difficult to find courses and educational opportunities in physiotherapy either not already completed or relevant to my area of practice as a musculoskeletal specialist.

I have always had a keen interest in health in a broader sense, not just physical but also in relation to diet and nutrition, exercise as well as other lifestyle factors such as sleep, the role of sunlight, recreation, communication etc. All factors which can also have a profound impact on pain management and physical function which have helped me develop as a physiotherapist over the years.

Following on from my last post where I emphasised the importance of moving frequently, here I’ll be discussing how we can take a few further steps towards improving physical health.

Strengthening

First up is the importance of pushing, pulling or lifting something reasonably heavy which would include our own bodies. This means taking some time out away from our normal day to day activities to do some focussed strengthening exercise.

So what are some of the benefits?

• You’re more likely to burn stored fat which is useful for weight management. That is assuming of course you’re not loading up on lots of sugar and other carbohydrates such as bread, pasta, potatoes etc. The body will burn carbohydrates as an energy source first, and if taken in excess will be stored as fat, not good if you are trying to lose weight.
  
  
• Regular movement helps reduce aches and pains, motion is lotion.
  
  
• Movement enhances brain function, concentration and memory.
  
  
• As well as the function of the heart, lungs and vascular system.
  
  
• Slow, regular movement helps with stress management and promotes longevity.

It was 10 years ago when I remember hobbling down the stairs to collect my next client. I was holding my back upright and rigid, almost afraid to move in fear that I might further strain what I suspected at the time was painfully ‘unstable’ sacroiliac or pelvic joint. I had also been assessed by an experienced clinician who had told me I was ‘misaligned’.

Roll on ten years and I now understand, based on current research and expert opinion that the pelvic joints really don’t move very much, hardly at all in fact. When reflecting on my injury and considering my age, gender and how I injured myself (pulling a suitcase awkwardly form under a bed), it became clear that my strained lower back and pelvis wasn't likely to have been left unstable. But at the time I did not have this knowledge and so felt very threatened by this part of my body. It felt weak and I lacked the confidence to move freely as well as run and exercise in the gym. The pain I felt added to this sense of threat.

I was watching Toby, our 5 year old, bending down to pick up his box of wooden blocks a few days ago. The box was reasonably heavy and a little awkward but this did not seem to deter him. He bent his hips and knees, also allowing his back to flex, then took hold of the box and while holding it close straightened up. He tottered with the box into the living room then reversed the process to put the box down onto the floor.

Why did this simple functional task get me thinking?

In recent years there has been a strong move away from this idea that we should be ‘bracing’ our backs before we bend and lift everyday objects. The notion of contracting your ‘core’ muscles, becoming rigid, not allowing your back to move before doing anything of a physical nature has been strongly challenged and is now considered by low back pain researchers to be very unhelpful. This way of moving, once considered the ideal, is now understood to promote pain, limit function and encourage people not to trust their backs.

Exercise is crucial to good mental and physical health, variety is also important, the body thrives on variety. My body was getting too used to going through the weekly motions. I am familiar with the CrossFit concept and was keen to shake up my exercise routine. So I decided to give it a go.

As a chartered physiotherapist I have treated many injured CrossFitters, I knew the potential risks. I was therefore keen to take it easy and hopefully not pick up an injury myself. Form and technique first, increase load later. When I turned 40, I asked for life advice, a sports doctor friend of mine simply said ‘look after your joints’.

Running is an excellent form of aerobic activity to improve your health status, reduce disease risk, modify body composition(best when combined with a good diet) and improve all around physical fitness. It is also a weight-bearing activity that helps in maintaining bone mass and preventing osteoporosis.

Current guidelines by the American College of Sports Medicine recommend 30 minutes of moderate intensity aerobic activity at least 5 days a week for adults. Brisk walking is an excellent activity to reach this desired level of activity as it is easy to perform, uses the large muscles of the body, both upper and lower, and it does not require any expensive equipment. Running will burn more calories than brisk walking due to the increased intensity of the activity. This is great for energy expenditure but does bring with it an increased risk of injury.

CrossFit has become hugely popular in Ireland over the last number of years. It is a form of training that incorporates resistance training and cardiovascular training and uses compound exercises (exercises that involve more than one joint) to develop greater functional movement.

CrossFit is not just for advanced clients. Participants range from high level athletes to absolute beginners and each workout can be customised to each individual. While high level athletes tend to suffer more overuse injuries, beginners commonly injure their shoulders, back, knees and ankles.

Apparently it is safer to ride to work on your bike, contrary to the beliefs of the Dublin public who feel commuting by bike is inconvenient, not enjoyable due to the wet climate, and is dangerous.

Public initiatives in cities around the world are trying to convince more people to drive less and bike more. This is not an easy task according to a new study in the Journal of Public Policy & Marketing, co-authored by a Marius C. Claudy from UCD. The authors point out that despite the public view about the weather, Dublin actually has a drier climate than many cities in the Netherlands, a country having a strong bicycle-commuter community.

The positive reasons in favour of converting from 4 to 2 wheels include cost-saving, improved physical fitness and health as a result of being more active as well as reducing C02 emissions.

Age-old exercise wisdom has always included stretching as part of the pre and post activity discipline. We've believed that a good stretch will help reduce injury, aid recovery from the stresses of exercise and even improve our performance during the event.

While some exercise specialists still hold these physiological benefits of stretching to be true the efficacy of such effects are being challenged by others.

Earlier this year Lorraine posted an article titled Important Tips For Stretching Properly

Some key points from the article: