I know, crazy right? I must be mistaken? It has to be some kind of black magic? I’m pain-free because of some other factor? It must be psychosomatic?To be honest, I have heard it all now. What’s important? My wrist is pain-free enabling me to get back to a normal life after 2 years of pain!
Well, if you thought any of the above you wouldn’t have been far from my initial thoughts. However, what is important is my right wrist joint is now pain-free (allowing me to commence at full speed with my Doctorate) whilst gaining improved left foot and shoulder mechanics.
Fifteen months ago I decided to include some basic yoga moves into my weekly exercise routine. I had always struggled with Downward Dog: pain in left shoulder and pain right wrist joint and lack of dorsi flexion of the left ankle. I saw many professional Yoga Coaches with this query, and although my Downward Dog pose looked better, it certainly didn’t feel better as the right wrist pain increased and strapping the wrist became a daily requirement to get through the day.
I sought advice and/or support for the left ankle restrictions and right wrist pain from Consultants, Manual Therapists, Holistic Therapists. After having exhausted all these options I was then requested to complete a battery of medical imaging in light of trying to understand the triggers to these symptoms I had – all of which came back unremarkable i.e. nothing to report.
I was very fortunate to attend a 10 month Clinical Mentoring Programme this year (2016) and to have the greatest pleasure (whilst also being very humbled by the experience!) to work with 26 World Class Manual Therapists integrating skills for the greater good of the patient – no ego’s, no brain-washing, no claims as the panacea of all ills, no cultish behaviour – just Clinical Experiences integrating with Evidence-Based Practice: as a Sports Scientist & Researcher – this is very refreshing! On the final day of the 10months mentoring, I was suddenly under the Clinical microscope of a super knowledgeable, charismatic Physiotherapist called Rachael Corbett.
To go through the detail of what happened next would take (funny enough) 10months of Clinical Mentoring! But what happened next was completely non-linear in its algorithm, with the inability to be able to explain using Newtonian Laws. (However, that will be explored later in my Blogs). Rachael had collected lots of objective and subjective data on my symptoms, whilst building my story with hypothetical deductive reasoning – whilst I did what I do best, I challenged her. Rachael proposed her hypothesis of my symptoms, concluded with a little treatment of my right carpometacarpal joint (thumb joint) and ‘voila’! Right wrist pain – gone (and I put itthroughh all kinds of tests that would have previously brought me to my knees in pain), left ankle doors flexion – improved. Rachael followed this up with discussing corrective exercise prescription (CEP) to retrain my body to optimise it’s biomechanics.
I am a challenging researcher. I was that child who was always asking ‘why’? I am now one of the few adults who is always asking ‘Why’? I have continued with my CEP, progressing as and when needed, and am delighted that my right wrist joint has been pain free for now three months. Upon return back to the UK I have had appointments with another Physiotherapist, Jen Cardew, who has modified my CEP to include corrections whilst completing yoga poses of which I can now achieve downward dog with no limitations nor pain.
But how powerful can a corrective exercise prescription be if every day ‘you keep doing what you’ve always done, you’ll always get what you’ve always gotten’ (Einstein c. 1900). For example when walking my dog everyday for 60minutes plus and I always carry a bottle of water and hold it in my right hand, dog lead and dog on my left side. Gripping the bottle with my right hand generates and compounds the original issue with my right thumb joint which has shown to drive my right wrist pain and non-optimal biomechanics of my left ankle – not advised when walking! So how powerful can a CEP be if you are not considering/advising active daily living activities that reverse all the good work? Pro-longing positive outcomes and definitive change? Demotivating the patient/client as they are not getting better? To be explored later in my Blogs.
So, upon reflection of my active daily living tasks i’ll be modifying the following:1) Consider which hand I’ll hold my water bottle in when I next walk my dog! Or get out the camel back!2) Holding my phone.3) How i hold a book when reading.4) Add CEP post writing.5) Vary the position i place my right hand in when using the touch pad on my MacBook6) Holding knives when chopping vegetables.7) Holding the steering wheel when driving the car etc etc. So how affective can Manual Therapy be (combined with a CEP) if your patient/client spends 1 hour per week (out of 168 hours in the week!) with you being re-aligning and corrected if they go back to all the things that embed the poor motor pattern in the first place? Does including homework of corrective exercises improve their outcomes? Possibly, but then they have to be doing the homework! Now brings the question of do you interview your patient/client and make sure they are committed to fixing themselves… Or are they coming to you to fix them??All these to be explored within my Blogs.