Top Picture shows a bottleneck point of the London to Brighton cycle ride in support of the British Heart Foundation.
Thoughts and Observations of Physical Health
It is well known that having good physical health is an important part of being healthy (see the government's guidelines on recommended levels of activity (1)) and there is a wide variety and abundance of recommended exercises and classes in this day and age, including on-line advice that can be followed in the comfort of our homes. We are spoilt for choice but how do we sort the wood for the trees? You don't have to run marathons to be physically healthy but, like a balanced diet, good physical health needs a balance of factors.
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Children and animals are very good at showing how physical movement is natural and free.
I am a chartered physiotherapist with over 20 years experience and due to a lot of moves (including abroad) I have lived and worked in a wide range of places and met a broad spectrum of people. I am also a hydrotherapist, Pilates instructor and have a degree in psychology.
This web page is something I have put together from my experiences in my work and life to try and outline what I feel are the basic components that are needed for good physical health as well as some general observations about physical activity. It must be stressed I have not academically referenced any of my musings in this website and I am not giving any specific exercises or training instructions. There are many places people can go to for research papers into physical activity and specific exercise advice, including the government's guidelines, and if anyone at any point wants to begin physical activity but have concerns I advise them to seek advice from a suitably qualified professional (2). I am writing my ideas as a result of my experiences of being up close and personal with a range of different people with varying attitudes towards their health and I have written this light hearted piece in order to try and have a voice (however small) because of the emotional strain I sometimes find myself under when working with people. I am so blessed in my job (most of the time) and meet some wonderful people whom I am privileged to help and whose humour, courage and positive attitudes both amaze and delight me, but there is many a time I know other people I am helping could do more for themselves and have a better quality of life if they did actually do more and this both frustrates and saddens me because, in my opinion, the human body is amazing and staying as healthy as possible should be seen as a treasured reciprocal duty of care to ourselves; if we look after our health where possible then our bodies allow us to lead quality lives.
Although many healthy activities are free, occasionally specialist places and equipment are needed to have fun. Health, activity and fun go together. Keeping active helps keep us healthy and being healthy means we can take part in fun, healthy activities more easily. Plus the more fun the healthy activity the more we are likely to want to do it and will keep doing it which helps our health....
Few of us can claim to have perfect, healthy lives. There are many uncontrollable internal and external factors that can affect a person’s health, some of these include medical conditions (mental and physical), life events such as economic pressures, accidents and grief and even the behaviour of others e.g. abuse can affect a person’s health, but what is important is to try to remain as healthy as possible within one’s own limitations. In my role as a hydrotherapist I get to work regularly with clients who struggle with a range of disabilities but even they can participate in physical activities in the pool, sometimes in a more passive role where I do a lot of the work but they are still gaining benefits for their health with the physical movement. It is from working with these clients that I feel even more passionately about how some people take for granted such basic things that others struggle with. We are all aware about the usual arguments about the cost of poor health on the NHS and the economy but I see at first hand the negative impact poor health can have on individual lives; there is many a time I wish I had the proverbial magic wand to make someone’s life better when I see their struggles. It is so true the axiom that we don’t always appreciate what we have until we lose it and when it comes to physical health, even in tight economic times, unlike buying food, there need be no financial cost to staying physically healthy.
Sadly it’s true that if we don’t use it we lose it, for example regular use of stairs. For those that can still manage stairs, they are good for keeping leg muscles regularly exercised. In my professional experience I notice those without stairs at home often take longer to recover from hip replacements than those with stairs.
There are reams of academic studies and advice about motivation for following healthy behaviour and from my own observations of the people I have met and worked with, I am aware there is a vast range of attitudes and behaviour regarding looking after one’s body. It is also an accepted fact, and something I have witnessed with my patients, that the mind and physical body are closely linked, for example it is known that physical activity can help lift a person’s mood while, conversely, emotional stress can have an adverse affect on physical health. Ironically as well, while physical activity is good for us and can lift mood it can also be understood that motivation to participate in an activity can be a struggle if one is not in the correct emotional frame of mind. It is because of this awareness that one has to be in the right frame of mind to participate in physical movement that I like to encourage good body health in a generic way rather than proffer prescribed exercises (unless I am treating someone for a specific problem in clinic). Using a generic ethos rather than rigid prescription means people can choose activities that suit their psyche generally and/or how they are feeling at a certain time. They may not feel up to facing the gym one day, or even leaving the house, but they can still do something however basic it may seem.
The fantastic four.
I like to compare my views on physical health to a healthy diet. It has been known for years that a healthy diet needs a mixture of fruit, vegetables and proteins etc. Whether someone is a fit, teenage rugby player or an elderly, retired seamstress, their diet should have the same basic healthy components. We don’t need specialist recipes all the time, it is just keeping an eye on ensuring our diet includes these factors; as a friend once told me, simply adding a tomato to a ham sandwich is a help to our health. It’s the same with physical health. There is a myriad of exercise videos, books and articles on exercise but it is having an awareness of the basics that is important and trying to keep these elements in our day to day lives.
From my professional work I have identified four basic cardinal factors that I feel the body needs to help it stay healthy. I have developed this list of four because I find it is often one or more of these factors that patients have issues with when I am assessing them in clinic.
My four basic cardinal components for a healthy body are:
STRUCTURE
FLEXIBILITY
STABILITY
ACTIVITY
In the dietician’s world the balanced diet can be illustrated by areas on a plate. Conceptual illustration of physical health considerations is not so easy. Over time I have gradually found myself using animals as a light hearted way to elucidate the components of physical health I feel are important. In the natural world there is a beautiful relationship between structure and function and, with this in mind, I believe animals provide wonderful examples as to how these two are related e.g. size and power are sacrificed for speed in something like the cheetah compared to a lion, and the turtle has limited mobility on land but glides effortlessly in water(3). This phenomenon can be seen in the human world. One just has to look at the range of shapes and sizes of elite athletes. Although both at peak fitness, a long-distance runner is a different body shape to a sprinter as the former needs endurance ability and the latter needs power.
We all have our own interests and backgrounds and different ways of learning things, so my choice of using animals and the actual animals I have chosen to highlight physical factors may not suit everyone but I find animal imagery is a quick, lighthearted way to highlight the factors I feel are important and if they go some way to enhancing people’s understanding of how to stay healthy then great.
STRUCTURE is represented by a giraffe. They are famous for their unique long necks and elegant, upright postures.
FLEXIBILITY is represented by a stretching cat. Cats are masters of flexibility.
Rhinos represent STABILITY. Although rhinos can be dangerous in the wrong situation, I love the firm, solid physique of them.
ACTIVITY can be illustrated by a bee in recognition of the phrase ‘busy as a bee’.
These pictures were kindly drawn for the purpose of this site by a close relative as there were rude comments about the pictures I usually use in clinic. It was commented on that my clinic bee picture was a bit too cartoony although this one here is fairly fierce looking. I hope it doesn’t put people off being active; I want to encourage people to be active not scare them with giant insects!
STRUCTURE
Structure includes good posture. Many people don't realise about the importance of good posture as it is not a 'moving' activity however, like a badly built old fashioned tent will result in uneven strains on the canvas and guy ropes, poor posture can cause abnormal strains on joints and soft tissues.
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Posture is important in the animal kingdom in the way that it can be used to communicate e.g. the crouched, submissive posture. In humans we often associate low mood with a stooped posture and a happy mood with standing tall. Although it can be seen therefore that our posture may alter naturally depending on our mood, we can correct poor posture consciously. By keeping a conscious eye on our posture we can ensure that, if even we have had a difficult few days/weeks, we have some control over the chances of a chronic poor posture developing
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In the health care setting, correct posture is a key element of positioning people in beds and wheelchairs.
FLEXIBILITY
Having healthy flexibility is not about being very bendy, it is about not allowing oneself to become stiff in the joints and muscles. This is important for many reasons but two reasons include hydration and defective movement.
Just like an unwatered plant becomes dry and brittle, joints of the body need to keep moving to keep them lubricated and healthy.
Lack of flexibility in the body puts a strain on movement elsewhere in the body just like a snag in a rope can cause the rope to strain or break elsewhere.
STABILITY
This is the hardest concept to define as it covers everything from balance to core strength exercises and sadly this is also one of the concepts that can actually cause problems if done at too high a level too soon as, if the body doesn’t have good core strength/balance, then it can compensate elsewhere causing problems. Using the tent analogy again, not only may a badly built tent not be able to withstand strong winds but if the canvas of the tent is not properly stretched out and secured, then more strain will put on the guy ropes which are not designed to give broad, strong support. Examples in the body include how, in the spine, ineffective working trunk stabilising muscles can result in problems with the spine and incorrect support around the pelvis can cause problems in places like the spine, hips and knees. Stability is not just about when people are keeping still in one position. Good stability is needed with movement as poor stability results in utilising the incorrect muscles which are not designed for the function they are being asked to do. If you try and ride a bike with badly fitted wheels then the bike will wobble and/or the tyre can rub against the brake pads thereby slowing the movement and wearing down the tyre. None of these are good for smooth, efficient movement and increase the risk of problems.
Stability doesn’t just focus on the stabilising muscles of the body but on the nervous system control of these muscles. Correctly done lower level stability exercises are important to start with so the body's nervous system gets into the habit of firing the correct muscles in the correct pattern and timing to provide maximal support with least effort.
Basic balance exercises help stability. Sadly, in this day and age of prolonged sitting at desks and in cars, we are not challenging our stabilising muscles regularly so they may not able to fire properly when needed.
ACTIVITY
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It is well known that keeping physically active is important for general health. It help keeps things like the lungs and heart working efficiently as well as strong bones, muscles and the nervous system etc. Activity helps emotion by firing up happy hormones such as endorphins and being healthier generally keeps the bugs away. Another example of how activity helps a body system is the digestive system. Not a pleasant topic but no less important; at the far end of the digestive system, regular movement helps regular movement! Gone are the days when people were allowed long convalescences lying around in bed, us physios are notorious now for getting people up and moving!
Not the be-all and end-all.
The above factors are basic foundations to consider. They are not a definitive solution. Just like with a healthy diet one has to consider other things like not rushing meals and when to eat, there are other factors linked in with these four cardinal physical elements such as correct breathing and a person’s emotional background, but I feel these four factors are good starting points and they actually have symbiotic relationships with things like breathing and emotional state. With regards breathing for example, a hunched posture can lead to restricted lung capacity and tightening of chest and neck muscles so if posture is improved then breathing ability is less at risk. Likewise, people with breathing issues can tense up so, when helping people with breathing issues, there is an encouragement to get them to relax and adopt better supported body positions. With regards emotional health, as already discussed, activity can help boost feel good hormones but if someone is really not up to energetic exercise even resting in a good posture can be something positive for their body because, as also already mentioned, low mood can make us tense up or stoop.
My four cardinal factors also don’t specifically mention things like cardiovascular activity or weight training either (current government guidelines recommend two muscle strengthening activities a week) as I see these coming mainly under the activity sector but whatever we do the four factors have an entwined relationship with each other. Participating in weight training is more effective if done in the correct posture with good core stability but one has to be careful that one doesn’t over train muscles at the expense of their flexibility. It must also be realised that although keeping flexible is good to maintain healthy joints and movement, hypermobile joints are not good so stability is needed to counter balance this.
The four factors are not mutually exclusive e.g. prolonged poor structure can lead to both tighter and stretched structures and, conversely, poor structure can be the direct result of tight or hyper flexible structures.
These four components are important whatever a person’s age, ability, activity or level of activity etc. They can be important at low and high levels of activity, indoors or out. Even good posture has to be considered during higher level activity. I have already mentioned weight training needing good posture but things like good horse riding requires good posture whatever the level and I believe parachutists are taught the correct postures for landing!.
Very basic level of an activity
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More advanced levels!
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The Fantastic Four are the Facts,
it's Attitude towards them that Counts.
The four factors above are important but knowing them is one thing, it is the acting on that knowledge that is key.
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Physiotherapy is not just about hands on passive treatment, there is also an educational element about how the patients can help themselves. How much time in clinic is spent on passive treatment compared to self-help education is very variable as it depends on the problem the patient is presenting with but I feel it is important to educate patients not just for the immediate problem they are presenting with but also how best to maintain their physical health in the future as well to prevent re-occurrence of the problem, if possible. Educating patients means a lot to me because, as I have also said, I have witnessed the massive impact poor physical health can have on peoples lives and looking after our health need not be difficult. What is often the hardest part of working with patients is targeting the attitude of the patient in order to get them to understand and participate in healthy physical behaviour. As already stated there is a mass of academic research into motivation and how to get people to do something and/or continue doing something. Research into motivation is valuable in a wide range of areas including the health world to encourage people to follow healthy behaviour. Although I have an interest and background in psychology I am not an expert in motivation so the following are not researched. Just like my fantastic four elements, the following are observations from my experience in work and life.
Consistency is the key. Keep plodding away.
Think tortoise not hare.
Looking after the body is not a competition like the tortoise against the hare and I'm not saying we need to be slow plodders like the tortoise but the attitude towards keeping physically healthy should be like the steadfastness of the tortoise. Similar to following a daily healthy diet it is important to try to be persistent in our physical healthy behaviour. We can all have good days and bad days with our diets (Christmas can be a challenge) and it is the same with physical health. Looking after the body is like weeding the garden. Gardens don’t always need weeding exactly the same way every week; some weeks more weeding is needed and some weeks less is needed. It is the same with the body, some weeks one needs, wants or is able to be more active, other weeks one maybe isn’t as motivated or is unable to do as much physical activity. What is important this that one stays on top of their weeding/physical health. Once a garden becomes overrun with weeds it take more effort and time to control the weeds.
These pictures are not only to illustrate gardening which is a physical activity in itself but they are also visual aids to reinforce the analogy that regular physical activity is like weeding. Regularly done and the garden’s maintenance is easier; left for a while and more effort is needed to bring it back under control.
Can you pat your head and rub your tummy at the same time?
Being healthy is not always about getting constantly faster, stronger, toned etc. Being healthy is also about exercising the nervous system as this is what controls the body’s movements. Regular exercise helps keep the nervous system working efficiently and a regularly challenged nervous system helps us have better physical health e.g. to help reduce our chance of falling when walking on uneven ground (the nervous system controls our body's reaction to any changes in situation by engaging the correct muscles quickly help prevent falling). Often in clinic one of the first things I have to get patients to do is to understand how to feel and control certain movements of their body and stop incorrect movements that their body has adopted. When one first learns a new activity, like learning to drive the car, one has to think consciously first before the nervous system gets the hang of what’s expected of it and takes over unconsciously. An under challenged nervous system is less efficient, gets lazy and into bad habits.
To sail a boat effectively one needs to learn to manage a range of different forces acting on the boat by changing positions and tensions of structures on the boat. It is the same with the body. A body moves more efficiently with the correct tensions and correctly positioned structures but the beauty of the body is that our nervous system will do this for us naturally, provided with we look after it and keep challenging it.
Be proud/stand tall (If you can keep smiling at the same time it makes people wonder what you've been up to!).
There is no such thing as the perfect body. We are all different shapes and sizes and some people are naturally more flexible and/or stronger etc than others. What’s important is respecting the structure and function of the body whatever our abilities. Some of us may not be as naturally athletic as someone else but we all have the same muscles and bones doing the same job, one of which is to support our bodies against gravity. A good posture ensures good alignment of the body's structures and therefore efficient movement at the joints and as the stabilising muscles of the body prefer a good posture, a good posture therefore provides a good position for stabilising muscles to work effectively. Every time we check our postures we are engaging the nervous system and, like with most activities, the more it is done the more natural it becomes as the nervous system adapts.
Historically, good posture was considered important for many years although possibly not for health reasons. Ironically, although the wearing of corsets could be tortuous, they helped support the spine which is the job of our own natural stabilising muscles.
The four pictures either side of the girl with the book on her head (an old fashioned technique for practising good posture) are all of relatives on both sides of her family over 100 years (4), three of them in situations (soldiering and dancing) that encourage good posture. Poignantly, while preparing this website, I re-read Albert's last letter from the trenches in which he wishes his young son will "grow upright and honest and leave drink alone" showing that being 'upright' was considered a positive attribute over 100 years ago!
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'T ain't what you do....
We all have different interests so what we choose to do for our physical health shouldn't matter provided we are getting a healthy benefit from it. What's important is that we actually undertake the activity and are motivated to do it. Work with your own motivational methods. If a fancy electronic tracker measuring device thingamygig suits you to motivate you then great but they are not necessary if you don’t want to feel pressured into measuring everything in minute detail. In days gone past when people were more active, for example they walked to work or the bus stop, they just did it and weren’t obsessed with how fast they walked and didn’t constantly try to do better. They just got on with it. Some days they moved faster than others but they still did it. It is still the same. There are some days we feel better than others so one mustn’t feel disillusioned if one has a bad day or few days. Doing something is better than nothing when we are able. I personally have no speed, strength or stamina. Not only was I always last in primary school sports day races but I grew up with very fit, athletically gifted friends and family members (national schools competition, national sports team and top military level) so I am painfully aware of what it feels like to be last and feel athletically challenged. Over time and from witnessing what some of my patients have to cope with, I have learned to be grateful for what I can do and that it doesn’t matter how far or fast I move when I do activities now but what is important is that I am doing something, I am enjoying it and my health is benefitting.
Bell ringing is an activity that has been around for years, long before the invention of gyms and lycra.
The motivational markers here are supporting the community, working as a team and trying not to get out of time as the whole village will hear the mistakes!
Another consideration I was once told on a student placement is the ‘foot out of the door’ syndrome. It is easier to put a foot out of the door to start your first step if it is something you want to do. You don't have to do an activity just because it is the current trend or your friends are doing it if it's really not your thing. Do something you want to do.
Trying out different activities is not only good for our health but you may find the perfect activity for you that you enjoy and want to do regularly.
Patience is a virtue.
Another modern phenomenon is the concept of ‘instant’. We can upgrade our phones, cars and computers instantly. People can also have quick changes to their physical appearances with plastic surgery. Unfortunately having a healthy body is not instant. As the weeding analogy suggests it is something that has to be worked at gradually. There is no quick fix but learning to adopt a steady, maintainable level. Work at your own pace and the rewards will come
About 15 years years ago I heard about a good motivational book ‘One small step can change your life’ (Maurer R, 2004) in which he quotes the classic phrase “A journey of a thousand miles must begin with the first step” (Lao Tzu). I firmly believe in this. Just like the weeding scenario, healthy living needs to be regular and even if small steps is all we can cope with at the beginning then that is better than not even trying. Another of my favourite quotes that a friend told me a few years ago is “All experts were beginners once”. We all have to start somewhere and over time improvements will occur.
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The word journey is used to describe many things, be it the journey in life or one simple short journey to the shops. We can also describe healthy living as a journey.
I like these pictures as not only does it show walking which is an activity in itself but it can be used to illustrate several things about our healthy, activity journey. We have to start with a simple step, we can go at our own pace, we can go with others and our activity journeys will have twists and turns (some changes in direction are imposed on us and for some we have a choice).
Age, size or ability doesn’t matter when it comes to physical health, we can all do something in our own individual situations.
Use it or lose it vs respect it and protect it.
The phrase use it or lose it is very true with the body and fitness but while I have full support for anyone who use this as their mantra, another mantra to consider may be 'respect it and protect it'.
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Our bodies are amazingly, complex, clever phenomena and it must be remembered that they are never still. I don't just mean the constant breathing and beating heart we can see and feel but all over the body there are the invisible homeostasis processes occuring to ensure our bodies maintain optimum internal conditions. The body is constantly monitoring and responding to changing situations e.g. the increased heart rate during exercise, a change in urine output depending on how hydrated we are and the immediate kick starting of the healing process in response to injury. With open wounds the healing process is not just about preventing blood loss but it is also a protection process as potentially dangerous foreign material is identified, targeted and removed. This protection process is done by our immune system and it, along with all the other body systems, is designed and programmed for the body's survival. If our own bodies are constantly working hard to survive the least we can do is respect them and do our own bit to help and safeguard the invaluable service our bodies do for us.
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Unfortunately because all this happens invisibly we don't always appreciate how much our bodies are doing for us until things goes wrong. I once met one of the senior London olympic athletic marshals who pointed out that he worked really hard during the olympics but the millions of people watching would only notice his role when something went wrong!
We don't always appreciate just how hard our bodies are working to allow us to do what we enjoy
Despite working hard the body doesn't always succeed in its natural endeavours. Chronic pathologies can occur and even the ageing process, a natural phenomenon, is revealed by an awareness that our bodies aren't as efficient as they used to be. Just because it may feel like we are beginning to 'lose it' that doesn't mean we have to give up. If anything we have to respect and protect our bodies even more as, despite pathologies and/or age, our bodies are still working to survive and in these circumstances keeping healthy is often about trying to halt a decline or the speed of decline in abilities where possible.
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A lot of what I am writing here is not just as a result of my education and training but also in tribute to my patients and clients who are constantly teaching me whether it's in clinic, in my classes or in the pool. I love learning from my clients and patients and hearing their own anecdotes about what they notice about their bodies. People in my classes often report they didn't realise how stiff they had become over the years when they first start and how they notice a positive difference when they begin to learn more about their bodies and what they can and can't do and what helps them. At the hydro pool there are clients who have a range of chronic conditions who attend hydro regularly and have been doing so for many years as it is a great means of helping them fight the affects of their chronic conditions. The general consensus at the pool is the six week closure of the pool in the Summer has a negative impact on their physical health.
Athletic careers have a time limit because the natural ageing process means speed and strength etc do reduce with age, but just because our bodies' abilities reduce due to age and/or pathologies, that doesn't mean so too should our support of our bodies. If anything our support is more necessary to slow the rate of decline if possible.
Hydrotherapy is one of my passions. The water provides an excellent medium for people to be physically active whatever their restrictions may be on land.
To exercise or not to exercise, that is the question.
Sometimes I don’t even like using the words ‘exercise’ because for some people this conjures up the image of pain and/or hard work and/or boring repetitions which may not produce the best motivational attitude towards physical activity. Another reason why I use animals to illustrate things is because you don’t see animals counting repetitions; they naturally move and keep active without the need for any measuring devices, although dogs do seem to know when it's time for their next walk! Staying healthy is about moving and utilizing our muscles and bones. Those of you with pets will appreciate how pets change position regularly, will have a good stretch when their body feels they need it and value being free to move around and explore their surroundings.
Although cats are lucky they don’t have to spend hours stuck in offices or cars, we can learn from their attitude that, although they are experts at lounging and appearing to remain still for long periods, they can be very active and demonstrate amazing versatility in their movements.
As for dogs, they just love being out and together is more fun!
But it hurts....
I also dislike the comment ‘no pain, no gain’. Pain is such a broad subject. We talk a lot about pain in the physio world including the phenomenon that there can be good pain and bad pain and there is also discomfort as opposed to pain. With regards pain and activity there is the observation that one can get post exercise soreness which some people like to feel but it comes down to personal choice of activity. Although some people aren’t happy unless they have really pushed themselves during exercise, there are other people who are put off trying things because they are scared that exercise has to be painful as the saying suggests. It must also be acknowledged that it is not just a person’s emotional fear of pain that may stop them doing an activity. If an activity is felt to be physically painful then the body may tense up thereby affecting natural movement and could cause further pain and problems. How hard one pushes oneself and cause pain is a very personal choice and dependent on circumstances but, for general health, movement should be enjoyable and does not need to be painful and cause tension or stress.
Actvity should be fun.
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Having fun with friends makes activities more enjoyable.
The devil is in the detail.
During an assessment in clinic, as well as the background checks about what the problem is and the patient's past medical history and medication, physios also ask about people’s work and hobbies. I find this bit fascinating because it tells me so much about people in such a simple way. These questions can help identify what may be causing the problem they are presenting with if there isn't a clear reason such as a recent injury or operation. A patient's problems may be related to their job for example, in particular recent changes to their working environment (change of job, location) or it may be related to an increase in stress (work or personal) which is either making them too busy to relax or creating additional physical tensions. The questions also reveal just how active people already are and whether this is also a possible cause for their problems, for example there may be someone who is doing lots of weight training or running but not considering their flexibility or stability or they may be very busy with lots of static hobbies like knitting, sewing or crosswords and are not keeping an eye on their posture or getting up and moving enough. Treatment in the health care setting is not always about providing treatment for a problem but finding a cause and also addressing this if possible. Identifying a possible cause is a joint process between the therapist and the patient. The therapist cannot be with the patient all the time and witness what they are doing with their lives but they can get the patient to start thinking for themselves e.g. how are they sitting at work, are they constantly active and participating in high level activities or are they doing a lot of sedentary jobs. Interestingly, although it is common knowledge that a largely sedentary lifestyle is unhealthy, sometimes it is the very active people who have physical problems because they may be carrying a lot of tension (can be both physical and emotional) and they don't know how to relax soft tissues and in some cases they don't even realise how much tension they are carrying.
Even just lying down in a good posture for a few minutes can be good for our health. Firstly a good position ensures a good posture check but a supported body relaxes muscles that have to work hard to hold us up against gravity. There is also the additional bonus of focusing the mind to release tight areas of tension that may be present in the body and/or focus on breathing.
Anyone can join the party however late they arrive.
We can all do something whatever our situation but what I do find difficult is when someone has gone so far down the line of a chronic problem because they either haven’t tried or not realised their physical health is not as good as it could be. I find these situations upsetting because it is either too late to reverse a situation or the effort to get them back is much harder. An example is if someone is overweight and unable to mobilise on an arthritic joint. Arthritis is painful whether someone is overweight or not but an overweight person is putting more strain on an already damaged joint. In a condition like arthritis it is important not to be overweight because of the additional strain on the joint but for an overweight person it is not easy to lose the weight because dieting takes time and they cannot easily use activity to lose weight because of the strain and pain in the joint. Despite the strain and pain it is important an overweight person with arthritis keeps moving because they need to keep their muscles as strong as possible to support their damaged joints and this is especially true in something like arthritis because pain switches muscles off and without the muscular support of the joints the joints became even more vulnerable and under more strain..... It would just be so much nicer if people don’t reach this point in the first place (and I didn’t have to feel so awful for them in clinic knowing what an uphill battle they face).
Cycling puts less strain on the joints than a weight bearing activity like running.
Keep dancing in the rain, don't wait for the storms to pass.
You don't have to wait until the perfect situation, time or place before looking after your physical health. Unless you have a limiting underlying pathology or recent injury, you have complete control over your body and what you can do with it. Even with an underlying pathology or injury you have still some control over how you manage your body within the limitations of your pathology or injury.
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I do understand that sometimes the limitations to physical activity are not just physical illnesses or injuries. Some people lead incredibly busy and stressful lives but it is important not to push physical health to one side until things are better. Every little helps when and where possible. Suggestions like standing on one leg while brushing teeth (safety first though please) or getting off the bus a stop early to walk more are regular but sensible suggestions.
Dancing is fun activity for the right person but even if you can’t do it formally in a class for whatever reason such as time or money you can still dance around the house. (Pointy hat and frilly skirt not essential).
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Ants in our pants.
Although good posture is one of my key components, it must be stressed that we are not designed to stay in one position for too long. We are designed to move. Animals constantly move. It is suggested having small 20 minute alarms on computers to remind people to get up and move regularly.
Your body wants and needs to move. It is important to keep our legs strong and not sit around all day.
Prior preparation potentially prevents post problems.
Although as chartered physiotherapists most of our work is helping people with physical problems, our areas of work are vast including working with people in advance of them having issues such as pre-surgery preparation. When it comes to something like surgery the healthier one is before the surgery usually the better the outcome and with elective surgery it can be easier to prepare oneself to be in an optimum position before the event. Unfortunately real life isn't like this all the time. We never know when we may need urgent surgery, have an accident or start showing signs of another pathology. Just like many children have a natural ability to bounce back after injury or illness, it is clear to see in clinic that the healthier the person, the better their recovery is likely to be after an incident such as an accident, injury or surgery.
Don't wait for something to go wrong before you acknowledge the value of good health.
The healthier you are before something happens, the better the recovery.
There can't be rainbows without rain (but you have influence over the rain).
This quote about rainbows and rain touches on a couple of observations of mine. I chose this quote because although it is similar to 'every cloud has silver lining' I prefer the rainbows one because it is the aspect of the 'rain' that I think is key because, in my mind, the rain is referring to effort i.e. you can't have good health without a bit of effort. As I have said I am not an expert psychologist with training into motivation but I have tried, throughout this page, to make comments about keeping physically active in positive, fun, non-threatening ways because, at the end of the day, being physically healthy is important and a life long thing, not a quick fix and if healthy physical activity can be seen in a positive light then hopefully it will motivate people. Despite all my attempts at positive, encouraging comments though, the aspect of 'effort' must be considered and I would be wrong if I didn't address the need for effort in relation to being healthy, even though to some people the thought of having to make an effort may be a bit of a de-motivating factor.
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One observation I want to make about the concept of effort and physical health is that, in some ways, encouraging people to become energetic is actually the opposite to what is happening in the rest of the world and that is the rapidly changing technology inventions with the aim to make things easier and simpler. There are many things that can be controlled now by the touch of a button and in some cases, simply by voice. Unfortunately this isn't possible with healthy activity because physical health cannot be achieved at the touch of a button, although some people would argue that technological advances are about reducing stress in our busy lives and freeing up time to take part in physically healthy activities. I do not want to go into arguments about this because again there is masses of research into health and technology and the arguments between how, on one hand, some aspects of technology can help health, while, on the other, elements of technology are causing poor health such as increased sedentary lives (this includes cars which we have become more reliant on). I just wanted to raise the issue of technology because, on a personal level in clinic, I have a job where I have to try and explain to people that, unlike their phone that many arrive in clinic carrying, they cannot upgrade their bodies and the problems I am trying to help them with need a little bit of time and effort to address, in particular the body's natural healing process doesn't happen instantly. For some people the concept of having to be patient and put in a bit of effort to achieve something as opposed to touching a few buttons and getting instant results is an alien and unwelcome concept.
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The other observation I want to make about effort is a more positive one, and that is we have control over the effort. Although I have regularly commented that children are great for demonstrating natural activity, when they are at school this activity is channelled into P.E. which is fine when they are small but, as children grow, their interests in activity change and for many school P.E. becomes an unwelcome part of the school day. Ironically P.E. has has actually been part of the school curriculum for many years even before there was a concern children were becoming less active with the increased use of cars and technology. As I have said I have not academically referenced this webpage and I do know some great PE teachers so I may be wrong but, despite an increase in options at schools, I believe P.E. is still not a favourite of the majority of children which is a shame as a negative experience of physical activity in a young age does not bode well for health in adulthood. Children and P.E. is again another vastly researched area with topics studied including things like children being forced to do activities that they don't enjoy and the concept of teenagers' changing bodies and insecurities about their bodies. From my own perspective I sometimes wonder about the fact that because P.E. is such a visual activity, children can see clearly how they compare to others. In academic subjects, although children have a rough idea of where they stand in the class, I am not aware that academic marks are made public so children can't compare their exact results and position in the class which is what happens in P.E. where a child can see exactly where they stand come in something like a running race. I know of a nervous child who participated in Bikeability at school recently but they felt humiliated in front of the class because of their anxieties and was further upset by the instructor's lack of understanding. This child is now reluctant to try cycling on roads which is a shame because of the impact it is having on the child's confidence and opportunities with physical activities.
Whatever the reasons for people not enjoying P.E. at school, I am really keen for people to understand that when they are adults, unlike at school, they have choice and control over what physical activities they do (unless they join something like the military) and this includes controlling things like, when and where they do their chosen activity, who they do it with, how often and for long to do it for etc and no one is judging them (unless that's what they want). What's important is their health at the end of the day.
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In summary. We can't have rainbows (healthy lives) without rain (physical effort, not apps) but we can control the rain (we have choice)!
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Although the belief is that modern technology has made us less active, there are many people who argue that technology can aid physical activity and health.
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I always think it looks like these dancers are dancing on an old typewriter keyboard; I'm not sure this is what combining technology with physical activity means!
When we're at school we have little choice about the physical activity we have to do. Although running is a good physical activity it is something that not many people enjoy and they may have memories of being made to do it at school and it feeling like torture!
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Away from school we can do what we want, when we want and even if you use technology to help you it must be remembered that, at the end of the day, being healthy means a bit of physical effort is needed as has been the case for centuries. Technology has changed but bodies haven't; people were healthy before there was so much technology around. These two pictures were taken over 80 years apart.
Physical activity should be enjoyed not endured!
The negative idea that healthy behaviour is something that has to be endured and not enjoyed emotionally and/or physically is often portrayed in the media in things like comedy programmes where, for example, replacing someone's steak and chips by a lettuce leaf is seen as humorous and attending health farms or starting a new healthy exercise class where the person struggles with the exercise and/or feels foolish with their attempts and what they look like to others is the joke. Conversely the 'fit' person is often seen as boring and overly serious. Unfortunately these stereotypical images are played out in society with derogatory comments about cyclists as lycra louts. This is yet another topic that probably has a multitude of studies into it but, for the purpose of this webpage, I just want to get across the importance of healthy, physical activity in people's lives. I don't care what people do for physical activity or what they look like when they do it but that they feel motivated to do something in a safe way that benefits their health.
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One of the reasons I have used mainly pictures of animals and children throughout this web page is because I don't want to get involved in specifics of image and what adults should and shouldn't look like while doing activities. Children and animals usually keep active naturally without any self conscious hang ups about their bodies and what people around them are thinking about them. I knew a dance teacher who noticed her adult pupils would over-think steps because they didn't want to get them wrong while the children in her classes would just get on with things and didn't care about mistakes.
I believe we should take inspiration from children and animals that physical movement is a natural pleasure to be enjoyed and not be so focused on the negative aspects.
Whether it's chasing bubbles in a tutu or learning to play tennis with friends, children don't really care what they look like, how many bubbles they catch or tennis balls they hit, they just enjoy the experience.
Do it now, you may enjoy it so much you can do it again tomorrow!
I make no apologies for the amount and choice of mantras I have used on this webpage (some common, some adapted and some made up). Many people have their own mantras to help them in certain circumstances and if they work then great. This is one of my favourite sayings and sums up a lot of what I have been trying to encourage about physical health and activity i.e. finding something you enjoy means you are more likely to keep doing it which is important and just as important is don't wait to start (if you haven't already started). The added bonus when it comes to physical health is that by keeping physically active by doing something we enjoy means we should stay healthy for longer which means we can keep doing the enjoyable activity for even longer!
These two pictures show such simple physical pleasures. Looking after our physical health helps us stay healthier for longer so we can enjoy our physical health and therefore simple pleasures for longer.
You can lead a horse to water ....
This site does not have all the answers to physical health. This site was purely written as an interest piece by someone who has a regular role to support and encourage others with their physical health with the aim, hopefully, to get people to think about what they are doing, should be doing and why. I also wrote the article because I find myself sounding like a parrot sometimes, repeating the same advice over and over again during the day so, if by writing this, it helps me not to have to keep repeating myself in clinic then even better. At the end of the day however the choice to look after one's health is a very personal one and despite my chattering in clinic and class, this web page and the thousands of other sites, as well as official guidelines commenting about the importance of having a healthy lifestyle, except for a few severely disabled people the only person who can really initiate and control physical movement is the individual.
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Like getting the horse to drink, the actual getting moving has to come from you.
Thank you for taking the time to read this webpage, I hope it has give you some ideas. You only have one body. Please be kind and look after it; you are the best person for the job.
Anna
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And Finally....
Although I am passionate about these...
Good Posture
Flexibiity
Stability
Activity
It’s the giving it a go that counts!
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1. UK Chief Medical Officers’ Physical Activity Guidelines. 7 Sept 2019
2. It is recommended that advice from a suitable professional is sought first before beginning exercise, in particular the GP if you have any health concerns.
With regards chartered physiotherapists in the UK, you can see one either on the NHS or privately (self pay or insurance). A referral from a medical practitioner is needed to see an NHS physiotherapist. You don't need a referral to see a private physiotherapist if you are paying privately but some insurance companies will insist on a referral. All chartered physiotherapists working in the UK are registered by the HCPC (Health and Care Professions Council). A Chartered physiotherapists' role is to help people with their physical problems. In the private sector, because appointments can be made without a referral, chartered physiotherapists can see patients for appointments even just for advice but any advice is only given after a proper assessment is conducted first just like any treatment is only conducted after a thorough assessment.
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3. Turtles are my inspiration for my hydrotherapy work. One of my roles is to support good physical health and hydrotherapy provides a medium in which people who struggle to be active on land on land can move freely in water and in some cases move independently away from wheelchairs.
4. The black and white pictures show relatives of some of the children shown on this web page. A great grandmother was a Tiller girl and the pictures of the soldiers show a grandfather on one side of the family and a great-great grandfather (Albert Ford) on the other side of the family who was killed in the trenches. Albert’s last letter home can be found on Sky News, Heartbreaking letters from WW1.
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FURTHER INFORMATION:
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CSP (Chartered society of Physiotherapy). The CSP has lots of advice on healthy activity.
Versus Arthritis (Charity for Arthritis formed in 2018 from a merger of Arthritis Care and Arthritis Research UK). Lots of advice about
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Maurer R (2004) One Small Step Can Change your Life, Workman, New York
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