Latest / The Uplift- with Luke Pollock / #32 - Essay 1 - The Importance of Open Problems
Transcript
- Luke Pollock: Hello and welcome back to the Uplift Podcast. I'm your host, Luke, and I'm back with another solo episode today. Today we're going to be talking about rehab specifically. And also a lot of what I've talked about will relate to life outside of rehab. It will relate to sport, it will relate to business, it will relate to self-development and how we can approach it in a better, more rounded, well rounded way. the following essay I'm about to read you is something that I have curator over the last week. I've been writing this every morning, just taking like half an hour or an hour out of my morning to write down some topics on the th on some thoughts on a topic that I have been mulling over in the back of my head. So I used to write for some context. I used to write back a few years ago. It's probably the first thing I did on social media. I made a Twitter account when a thing called money Twitter was very real and people were posting on Twitter and you could pretty much have a full-time income off like 10k followers. So that's where I first started out writing some very embarrassing purly written tweets on there. that was three years ago. And then I moved over to Instagram, was like, okay, I'm gonna actually dedicate now my my physio career to Instagram, try and build a business out of that. But I really haven't found a way to incorporate my love of writing and reading into the physio business. And podcasts has been a really good way for me to do that. But I've also found this week again that I can write well and I can enjoy writing. It really helps me distill my thoughts. So I'm just trialing it this week, trying not to put too much pressure on it, but just gonna try and see if I can like do a an essay a week on whatever I've been thinking about that week, really, or the the previous week. And then hopefully that will help shape some of the solo podcast episodes as well. And then they will come together nicely. So this week we're talking about solving more open problems and I will get into what that means, but ultimately I'd like to start by saying that we're all seeking some sort of control. Whether that's control over our job or your situation, maybe it's your relationship, control over even what you eat for dinner. And then ultimately you want control over your sport and your livelihood. And I think that's very obvious and clear when you're when you don't have control. It drives you mad when we lose control, or even the feeling of losing control drives us mad. But the reality is that we can't control many different things in our life. And one of those things is obviously injury and sport. And I think that is why getting injured can be positive because it reminds you that you are human, that there's lots of things we can't control. But despite that, we try and take control back into our own hands. Research shows that an ACL rupture happens in 600 milliseconds, so less than a second, which would suggest it's pretty out of our control. But Like I mentioned, instead of accepting the lack of control, we fight it. We try and fit this type of thing into our understanding, whether it's you are injured or you're sick. And we try and understand him and and deal with him in different ways. And consistently athletes that I have coached post injury will start scheming about what they could have done better to avoid the injury, why their body broke down in the way it did. They will accept it in a way that feels natural to them by talking to others, maybe by downloading PDFs, by Doom scrolling on Instagram to hear more people that have dealt with it. And that is kind of what we do as physios as well. We just give the the client back some control and this is a really helpful thing to do. So I will instantly start using my clients' language, their terms. I will discuss a potential plan with them. And this, often without knowing, is how I'm giving control back to them. I'm letting them see that I understand their situation and hoping that they now understand their situation a bit more clearly. And it's incredibly effective when we understand that for physios. If you're physio listening or you're an athlete, if you understand that the feeling of having a lack of control is horrible often and we are clutching at straws often to try and get it back. And if you're feeling very frustrated or angry at your situation, it might be because you feel like you don't have control over it. However, there is a flip side to this. There is also a problem with feeling in control. And this is me being completely transparent, I've now treated a lot of different knees and a lot of different ACL injuries specifically. And the more I treat, the less sense it makes to me. You could have the best surgeon in the country, you could be in the best professional rehab environment and you will still struggle with parts of the rehab. So someone in a professional team with a really good surgeon might not get their extension back for four or five, six weeks. And then someone else who just took the first surgeon they've seen They've done some exercises that they saw on Instagram, but they've regained their extension two days post op. There are simply like too many variables to predict and control for us to know this is exactly the step by step process. We feel that it's our job to cover all bases, but ultimately it's not. Our job is to give our athletes a sense of ownership over their situation, to hand them a torch, hand the injured person a torch and say, There's a lot of darkness around you, both mentally and physically, what you're about to go through. Here's a torch, here's start shining your light and start walking into the darkness and going one step at a time. 'Cause we can see the full picture, right? We can see the nine months, but they can't see that. They see one day at a time with a pain. So we're handing them the tools, the torch at the in in this analogy, to take one step at a time. one of the rehabs that really sticks out to me in this is Neymar's rehab. Okay. Neymar, a professional footballer, everyone will say his rehab was completely botched, which I partly agree with, but It's interesting how someone with access to so much money, so much resource can still have such a poor outcome post operation. So, like I said, there's just so many variables to control. And sometimes as a physio, we beat ourselves up, or as the athlete, we beat ourselves up and we're thinking there's too much to control here and I'm not I'm not on top of things the way I want to be. So yeah, the more athletes I treat, the more I feel their outcomes according to timelines are actually outside of my control. We can't predict how the body will respond to trauma until the trauma is applied. We can't predict how the mind will respond to the inaction of long periods of rest. So instead of discovery, instead of trying a different approach, we go back to what we know and what is widely prescribed and accepted, which is the safe approach. But often what I've find is the harder we squeeze as physios and athletes, like do more reps, do more of the same, more of the same, more of the same. The more we try and grip control back. the more the exact thing we want will start to drift from us. So like Will this week, who who was really struggling with his extension, had been smashing his exercises. And it wasn't until I actually said, like, let's relax your upper body. Let's just focus on what we're doing and slow it right down. Try a slightly different approach. that we started to see some progress. So sometimes the harder we squeeze, the more we try and grip onto something, the the faster it'll run from us. Like I said though, seeking control in this environment is completely normal and it's actually really helpful. But I wanna ask you, the listener now. I'm I'm in your ear right now and I wanna ask you, is it is there a different way? Is it the best option? And the reason I asked this is because what we're trying to go back to in this rehab specific scenario is an uncontrolled environment. So we're trying to fit our rehab into a very controlled, meticulous thought through plan when we are ultimately preparing to go back into an environment which is not controlled when it's completely chaotic and we can't actually predict what that player will go through on the pitch. And this is where I want to introduce the open problem. So playing sport is an open problem, meaning a problem that is assigned to you, which there are multiple different ways which you can tackle it. When the solutions are not a yes or no, I would say that's a closed problem. The open problems introduce more uncertainty. So if you think about like a breakdown in rugby, there are over a hundred breakdowns in a rugby game. And no two breakdowns will happen exactly in the same way. So no two players will enter the ruck the same way. More than often it's different two players each time. They might enter from different angles. One might be a jackaler over the ball. Someone might just be clearing through the ruck. Every ruck will happen slightly differently and they'll have to use different physical attributes to overcome that one specific scenario. on the pitch, which happens, like I said, over a hundred times a game. So as a player, if you're doing well, you might be involved in 20 plus breakdowns in a game. So you're completing what is supposed to be a a simple closed problem, either yes or no, did were you successful at the breakdown? But the nuance to that is actually you're completing that task physically in so many, many different ways. So preparing for a breakdown in rehab, In a linear fashion, and you must do this this way, and quite a rigid, rigid fashion, doesn't actually make that much sense because we're preparing an athlete to solve the problem as if it's a closed problem, as if it's a did you do the breakdown well? Did it did you feel pain when you cleared that breakdown? When actually on the pitch, it's a completely different question that are being asked of you. It's an open problem. We're distilling the variables into a way which feels comfortable. We're seeking control as a physio and as the athlete. Now, rehab has come on leaps and bounds. We're seeing the importance of people like Al Murdoch and David Gray who are introducing coordination and speed very early into the rehab. And they've sho shown that this is a massive cornerstone of rehab. And people before them as well have helped lead the path. But these guys are the guys who I've learned a lot from and who come to mind. But I believe that the next step, which most athletes are missing out on now, is exposure to more open problems. So, how can we neurologically stimulate that athlete in the early stage to prepare them for the neurological and physical stress which is to come in the game? Now a term that's previously been coined and I've used a lot is game speed or return to play rehab, but let's focus on game speed. So game speed suggests that you need to be ready for game intensity to solve the problems which are going to be thrown at you during that game. But how about we flip that on its head and we consider that you need to also be able to solve the problems in isolation. Which have many variables and many solutions, and you need to explore those variables and the solutions before you then add speed to it. So a good quote from Elon is, I mistakenly spent a lot of time accelerating processes that I later realized should have been deleted. Speeding up something that shouldn't exist is absurd. If you're digging your grave, don't dig it faster. Stop digging. So if you're teaching really bad habits and poor habits and rehab. And you're giving them yes or no responses to exercises or activities, then don't just chuck them into a game sp a game environment and think, it's game speed and think they'll solve the problems. They haven't been able to you haven't given them the problems to solve in a more controlled environment. So they won't be able to solve them when we add speed to it, and it's a lot more dangerous. If they're gonna dig their grave, don't make them dig it faster. Stop digging. So how do we get an athlete prepped and ready then? To ensure they're confident and familiar with soap and solving open problems and they're comfortable doing this repeatedly and at speed. So how do we get them in that feeling of I've seen this picture before and I can do it repeatedly And I can do it with speed and many different variables around me. Admittedly, this is difficult, and it's something that I'm trying to explore more. I think what we could do is introduce these types of problems a lot earlier in the rehab process. If we ask the right questions early in the rehab, it will give time for athletes to create stronger neural pathways and be more familiar with the type of problems they have to solve on the pitch. Neurons that fire together, wire together. This can start as early as like week two or three of the rehab process when we're asking athletes, can you actually learn to play a new instrument? Can you start a new hobby? Can you make a presentation on this? Where we're giving them multiple different solutions to this problem. So we're asking them to learn an instrument and it's up to them how they do that. That's a that's a very niche example. To the problem. I would also say, can you can you watch this game footage and tell me what you would have done differently there? Or get them to look at footage of them playing and say, Would you change anything? You can do this while they're doing their rehab as well. Open up scenario questions. So you're you're in the 65th minute of a game and you see this breakdown unfold. How would you enter it? Or what would you do here? Let them picture themselves there. And we're actually just trying to prepare the brain for what's going to happen later on in the rehab. So when they go back into this game speed scenario, it's not the first time they've thought or seen this picture in their brain. They've seen it multiple times and they can they don't have to think as much. When we think, things start to fall apart in our bodies. We don't want athletes to think, we want them to do, we want them to play. That is game speed. Playing without thinking. The minute they have to stop and think is the minute something bad happens. Something the the injury risk will skyrocket them. So get creative and do it early. Like I say, the later we it's so get creative and do it early. It's commonly thought that the earlier we introduce game specific scenarios, the higher the injury risk is. But perhaps the opposite is true. Perhaps the later we leave this stuff, the higher the risk of re injury. As a player, the feeling of adrenaline and fear pumping through my veins when I first step onto the pitch after being out during a block of rehab, it it quickly settles when I settle into the game. Playing the game is just solving different problems. However, the issue with this is after an injury, it can feel like we're starting from scratch. It can feel like we're solving these problems for the first time all over again. Consider studying for an exam. Would you best prepare for the essay, the written part of the exam? By answering yes and no questions. Ultimately, you could, this is a good option. You would have to go back and connect the dots, however. So answered yes to this question and no to this question. That might give me the the bit of this paragraph to write. Ultimately, we could prepare for this final part of the exam, the essay part, a lot better if we were given shorter essays to write in the preparation for the main event. when writing the main essay it would feel like we're taking a small step then in instead of a large leap and have to go back and join all these dots. So write essays, don't tick boxes. This will allow you to hit the ground running when you return. your physio and your rehab practitioner love control. Admittedly, I love feeling in control, which is understandable, but they cannot control what happens when you go back onto that pitch. Only the player will be able to solve the problems that are thrown at them on the pitch. The premise from this essay was built around my experience with rehab personally. I'm yet to explore this topic more deeply in practice, and it's something that I'm discovering with my athletes. but I've enjoyed dabbling with th these ideas whilst rehabbing. Inattentional blindness is the idea that we are solely focused on the task at hand and we're often missing the main thing that's in front of us. In rehab we can be so obsessed with the process and feeling in control and achieving milestones that we can forget that we're treating a person who has to go back to a pitch where they have to solve real problems at real game speed. The person is the one who will be returning to the pitch. We need to do a better job. at preparing them adequately. Thanks so much for listening. I really hope you enjoy this style of podcast. I know there's quite a lot in there and I know it can feel a little bit clunky and heavy to think through, but these are the the types of topics that I really enjoy thinking through and the type of one percenters that I want to give my athletes to hopefully get them on the pitch fitter, faster and feeling better than ever. That is the goal. And I think rehab is improving. I think it's still purr and I think we're still here we still have loads of room for growth, which is exciting. I will catch you next week on the podcast every Wednesday. Thanks for listening.