Latest / The STA Clinician Podcast / Ep.305 'Sports Medicine and the Pelvic Floor - Science to Practice' with guest Gráinne Donnelly

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Ep.305 'Sports Medicine and the Pelvic Floor - Science to Practice' with guest Gráinne Donnelly · The STA Clinician Podcast

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You're listening to the STA Clinician Podcast, connecting clinicians across healthcare.
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I'm your host, Matt Phillips, and as always, this episode is being streamed
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live on YouTube and Facebook.
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So very shortly in this episode, I'll be bringing up my special guest,
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Guarnier Donnelly, pelvic health physiotherapist, doctoral researcher,
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and most recently editor of the scientific textbook, Sports Medicine and the
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Pelvic Floor, Science to Practice.
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Guarnier is going to be talking to me about that bestselling book,
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as well as her upcoming presentation at this year's therapy show at November,
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in the Birmingham NEC, as always.
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And the presentation she'll be giving there, which is entitled Return to Sport
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After Pregnancy, A Sports Medicine Lens.
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Before that, just a quick thank you to last week's special guest,
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Anna Maria Matsieri, who is currently doing her PhD at the Centre for Pain and
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Active Inference Research at Health Sciences University, HSU for short,
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as well, of course, as many of you know, being director of the ST School.
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In that episode, Anna Maria gave us a fascinating look.
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I mean, it's totally what I'm into, but a great look, introduction into the
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world of predictive processing and active inference, and also psychedelic research,
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which is the topic of one of Anna Maria's presentations at the Issues Therapy Show.
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Available, as always, on all popular podcast apps. And if you want to watch
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it live, then you can go to YouTube, Sports Therapy Association YouTube channel, or Facebook page.
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Right then, let's crack on with tonight's episode. If you joined us live,
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feel free to ask questions.
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And thank you in advance for joining us live. If you do, if you listen to the
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podcast and you like the idea of joining live, that's all you've got to do is
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8 o'clock UK time, go along to YouTube or Facebook and we'll be here every Tuesday pretty much.
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Okay, tonight's episode, sports medicine and the pelvic floor,
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science to practice with my special guest, Guania Donnelly of Absolute Physio.
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Hello, Matt. It's a pleasure to be back again. Well, it's been a while.
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I mean, it's been four years, I suppose. I should say sorry,
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but then I did try calling. You just didn't return my calls,
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but you're here. It's all good.
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I'm really proud of me. You know what I do? I give myself a little pat on the
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back when I see your name and I've actually copy and pasted it with the accents.
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Because that is your name, isn't it? It's necessary, isn't it?
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Do you notice it? Very few people get my name right.
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So no, I do notice when it's right. And so, yes, well done.
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No, thank you. I'm only saying it out loud because I'm not to really congratulate
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myself. I think it's important. If people have got an accent in their name,
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then use the accent. That's the name, isn't it? It's like, there you go.
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So there you go. That's my jump off the moral high horse now for people.
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Use the accents in people's names.
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Right. Now, great to see you. It has been somehow four years since you were
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last on with physio mum, Emma Brockwell.
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And that was back in February 2022 somehow, which probably gives you an idea
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of where the hell have my four years gone.
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Gosh, that's been, when I think back, like, oh my goodness, what was I even doing at that stage?
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I'm trying to think back of what I would have been working at and doing on those
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things. So that's, yeah, I didn't think it was that long.
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That's hilarious. I know, I had to check it as well. I was thinking,
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surely it can't be, but it has been. But then when I was looking at,
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you know, what we could talk about tonight, Right. You've got,
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you've done quite a lot in the last four years, I would say.
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Been pretty busy. You're juggling quite a lot on that plate.
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And I'm looking forward to later on hearing how you juggle that.
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But I mentioned in the introduction, you've got your clinical practice,
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still editorial roles, doctoral research, and then the book we're going to talk about.
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Actually, let's do it now. How do you manage it? And you've also got a few kids
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as well, haven't you? Not to mention.
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I have four kids. So yes, my number one job role is being a mom.
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And then everything else comes secondary to that but so I do get asked this a lot Matt actually
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and I'm there I like to be really transparent and I actually like when this
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question comes up because I can I feel like people can see stuff on social media
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and it can paint a false narrative or a false expectation of what people are achieving or doing,
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so every time I take on another role or another task something else has to give
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or reduce and that's the reality of it we only have a certain amount of hours in a day,
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and so what I have done is as I got more into research my clinical practice
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hours have reduced so I still am doing clinic practice I will always be a clinician
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I like being a clinical researcher,
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But I'm currently only doing one day a week of clinical practice.
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So just, I like to let people know that so they can get some reality into the situation.
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And because it is a juggle for kids. And I was saying to you before we went
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there that I am spending a lot of time as a taxi mom because they're all into
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sports. And anyone out there with kids knows the score.
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There's a lot of run into after school activities.
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I think it's really healthy and it's admirable that you are truthful.
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And I think particularly, I mean, it's interesting, isn't it?
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These days you think, I don't want to draw too much attention to the fact you're
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a mum as opposed to a dad, but there is still, in society, there's a difference,
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isn't there? You know, there's going to be different, for most,
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for a lot of households and things, there's going to be difference in expectations.
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You've got two boys and two girls, haven't you? All into sports.
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So that's interesting. You've got little case studies going on at home,
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seeing their development. I know.
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It's fascinating because they're all so different in personality,
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but they all are very sporty now.
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Good at sports which is great and they enjoy them but then,
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it's very hard to miss a game or anything because the sports teams want them
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there and so that's where we find it hard to juggle because my kids are currently
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in so many sports at the minute that,
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games and trainings often clash and that's a juggle I'm like well you know you
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can't be in two places at once and then you've got the teams kind of trying
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to negotiate as to which one someone will go to but
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and there's a big thing with I'm sure many parents will see this out there if
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you don't want your kids to specialize too young there's a huge risk of overtraining in younger kids,
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which I'm really trying to manage you know I have the knowledge to know that
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we don't want them overtraining but it's very hard to actually control that,
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that's really interesting yeah we've talked about that a lot on the podcast
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and the importance to with a lot of yeah younger,
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younger athletes not to specialize too quickly too soon and the links with yeah,
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possibilities of injury and stuff yeah so interesting right then,
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your website's looking good by the way i love catching up with people for a
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while absolutely also i need to bring it up because it's just a bit of a glow up,
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let me bring it up here look at that,
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i can't remember what the website looked like four years ago but i'm pretty sure it looked like that.
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That's very nice but yeah but it's it's yeah it looks and deservedly so you've
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got so much going on and one of the things that's on there and we're going to
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talk about tonight in particular is yeah the book which you edited.
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When did you start on that project and what made you think, yeah,
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I could take that on, why not?
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Oh yeah, that's a great question. So that project found me, I did not find it.
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So I'm sure a book would always have been something that I would have loved
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or like had a dream goal to do, but I would have thought that it would happen
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later towards the end of my career.
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So I got an email and it actually landed in the junk and it was from
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Ansevier, but I don't know if the same with you happens math but I get a lot
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of like predatory type journals and emails and they're spammy and they usually
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open up with hello Dr Donnelly and I'm not Dr Donnelly yet and so um I usually ignore them so
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I opened it and I was like yeah right kind of like you know good try right so
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I didn't do anything with it and then they sent another email to say if I wanted to get grab,
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meeting an online meeting with them to discuss and I thought hmm so I jumped
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on I was like oh this is legit,
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so then I was excited about it, but also quite overwhelmingly,
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like, oh gosh, not yet. Like, I haven't finished my PhD.
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You know, I'm quite young, you know, relatively young in my career.
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And I was like, that's something that you do later on.
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And it was actually my husband who was like...
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Don't you do that like for the journal like as your full-time job that you do
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as a volunteer I'm like oh yeah I do.
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So it was that that really got me thinking back when actually maybe I could
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do this because the processes the decision making the sticking to timelines
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all of that editorial sort of work is similar so
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that's when I said yes and took a leap of faith now I was petrified but I took the leap of faith,
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and I curated my wish list of contributors and certain topics and so I approached
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these leaders and people I really look up to in the field thinking that they'll
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probably say no because they have their own books to write or whatnot
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and you know what people are so gracious like with their time and
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people said yes and everyone was excited at this opportunity so I was like,
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it was a really enjoyable process overall now there was elements of it that
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were quite tough but it was something I'm really glad I leaned into and jumped
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off the Cliff nearly, because I could have easily ran away and said no.
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It's so nice to hear guests being modest. And I love it because I think every
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guest pretty much I've had in 305 episodes, always at some point kind of mentions,
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oh, I really didn't think I could do that.
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Or just the modesty shows through. And I'm pretty sure there's no studies proving
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this, that having that modesty, having that,
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Socratic humility is necessary to be good in healthcare. I think you've got
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to have it. You've got to kind of like doubt yourself a little bit.
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Otherwise you can be one of these gurus who just stands up and makes videos
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and tells everybody stuff, which is outdated. So it's so nice to see, isn't it?
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I think you have to be your nearly, I think a lot of people are their own largest
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critic, which can be limiting, but you need people around you to nearly give you the push to go.
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But it's it's a good thing to be critical because you kind of catch yourself
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and you want to do the best to put out good evidence-informed information.
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And I think that's where the ethos lies.
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That's good. That's a good segue. Because I was going to say,
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how much of this was there for,
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when we've met up in the past, when we first met, it was all very much,
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probably still is, but it was very much we need to get some evidence out there,
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whether it's kind of like returning to running,
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and looking after female athletes and female athletes aren't little men and
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that sort of stuff, it's always been very much evidence-based.
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Now we're in, when did this come out? How long ago are we talking where you put this together?
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So it published officially in May 2026, the 20th of May 2026.
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So it's only earlier this year, but we were working on it for two years before that.
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So I'm wondering then, like in 2024 compared to like probably 2020 or before
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when we first started talking, how much of it was a chance to push evidence-informed
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text, to clean things up?
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Did that become quite quickly one of the goals like right this is a big opportunity
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now as editor to actually get some quality information out there Absolutely,
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to debunk myths to actually put out,
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there has been an influx and an emergence, we need more but there's been a huge
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influx since we've last spoken on this podcast of actual research investigating actual women.
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So it's been really nice to have this as a vehicle for knowledge translation
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and I think that's why actually some like a lot of those heroes who I reached out to thinking,
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who might not even respond to my email I think a lot of them wanted to get their
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work out there and so this combined curated focused text actually appealed to
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them and like when I looked through it like this textbook,
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you know if I took myself out of this and wasn't the editor of it this is a
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textbook I'd want to buy because like even when I was editing it and I was reading
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chapters from these amazing researchers and expert clinicians,
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like I was like, this is amazing as I was editing it.
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You know, I was like, you know, just learning as I was going. It was so cool.
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I'm conscious that it says £110 on the screen. I don't think I've had an image
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on the screen with a book, £110.
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But who do you think, where does this book fit in for clinicians?
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Like a single clinician working by themselves in a gym somewhere is not going
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to probably fork out for this book. But where does it belong now?
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Well, I would actually say it is an expensive book.
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And first of all, I would like to just make a public service because sometimes
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I meet people in my field who maybe aren't in academia or doing any sort of
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research and they nearly be like, give me a wee wink. Like, you know,
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like, she's landed, right?
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And like, one, I didn't make up that price that was set by the publisher.
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And two, that does not go to me, right? Yeah, that's what I said.
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So it's so funny because I do get the odd wee looks were like,
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you know, and I'm like, oh gosh, no, I wish.
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But I would see this book as an investment and just actually as another kind
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of public service announcement, anyone who,
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is in any way attached, either as a student or in any way to academia,
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all my chapters are in scientific databases.
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So you can access them if you have university scientific database access,
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or you should be able to, if they sign up with Scopus or some of those databases.
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But I see it as an investment that people, I do think that clinicians who are working with women are.
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Especially if they don't have a good understanding of maybe what they need to
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know about the female athlete and maybe they don't know if they need to know
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what this is for you and it's so it's not for our pelvic health clinicians per
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se it's for like the wider sports medicine team
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now ideally big clinics will stock it and have it in their library of sources,
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I'd like to think organizations and big sports teams would have it but yeah
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I've had a lot of thankfully,
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there's been great uptake and I love and same because people often tag me when
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they get it so I'm seeing that people are getting it and clinicians are getting
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it and they're using it and then they're updating either talks that they're
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giving to local organizations or talks they're giving at working in service training and,
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that's the bit where I feel like this this all that work was worth it because
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that's exactly what we want we want to disseminate we want to clarify we want
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to make sure people have a trusted resource that they can take their information
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from and that's not woo-woo
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or n equals one opinion based.
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That's so cool yeah so definitely on a shelf if you're in a multidisciplinary
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clinic then definitely unless you're the actual owner in that which case you
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just go and buy it but if you're part of the team then that'd be great to present to your manager,
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and that to see if they could get it in stock yeah and that's really interesting
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so if you're a student then you should be able to access do you say every single
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chapter within the student library yeah so each chapter is individually indexed now actually if you,
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actually if you sign up and visit if you go to www.sportsmedicineandpillfloor.com
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you can sign up and actually get access to a free chapter,
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as a wee I think it's chapter one actually that I give as a free you'll just
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get sent it afterwards just as a kind of insight into it so that's something
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if you're not sure but I actually think if you Google Google Books I think Google
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actually do a whole big preview of,
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more than I think they should do I think they,
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preview quite a bit of the book so you know there's a wee sneaky tip That's good That's excellent.
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Well, look, I'm on 10%, aren't I? Because we've already had one sale so far
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tonight. I feel like I'm on Shopping Channel.
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Thank you. Charlie King. Let us know what you think of it. I just added the
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book to my basket. Thank you, Charlie.
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What's 10%? No, I'm joking. That's great. It does sound, I mean,
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I don't, I've purposely said the price of it because it shouldn't be an elephant in the room.
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I mean, a book like this is worth it. It's just fitting it into your resources
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and being part of a team. But it's definitely, like you say, I'm interested.
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How's it broken up? Give us a little bit of an idea of how the chapters are
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broken up and maybe a few of the chapters you're really proud of.
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Yeah. So I started off by the pelvic floor is sports medicine.
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So I really wanted to kind of set the scene of why I'm talking about this in
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a sports medicine context and why anyone reading this should want to or need
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to understand it, even if they're not a pelvic health clinician or they don't
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identify as any sort of female clinician.
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Then we go into even things like there's an evolutionary chapter.
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So I like, I'm a bit, one of my hobby research areas is to go to a deep dive
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into evolutionary science.
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So like how the history of how we've evolved as creatures and mammals and humans,
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how that features in today's world.
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And there's a lot of stuff, like even one of the biggest things that we had
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a shit in was we went from four-legged mammals to two-legged.
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And that changed our center of gravity like exponentially. So if you think of
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females in particular, it's going right through to the pelvic floor and loading.
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So I think that's a nice one just to be awareness and scene setting and bringing
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a little bit in about our modern day cultures and society and how that influences.
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Because is that the way we were designed, you know, are we in a world today
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that we were designed to be in?
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And then we go into chapters about like explaining what pelvic floor dysfunction
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is. So we break that down into urinary incontinence and prolapse,
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into GI system and also into pelvic pain.
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And then we talk about management. So screening, management.
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We talk about low capacity testing, which I think is your practical one.
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So what I will say that I'm really proud about in this book is that I kept my
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clinical hat on in many ways because I wanted to ensure that there was highly
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scientific chapters, but I wanted to make sure that they were clinically applied.
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So what do clinicians do with that information?
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Sometimes academic papers can be quite highbrow and it's very hard.
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It's interesting, but like, it's the so what factor. What does that mean for clinical practice?
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So we tried to bring chapters in that kind of were applying it into practice.
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That's really cool. And that's such an important thing. And that's why it's
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so cool because you are staying in clinic. I guess that's one of the reasons because you do...
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Form that bridge journey between sharing some incredible research and theoretical
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stuff but the so what factor,
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if that can come through in a book and that's often obviously the biggest challenge
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isn't it because a lot of it is so what how's this going to change my clinic on monday morning,
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so you focused on that a lot then maybe an example i mean i don't like putting
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it on this box it's such a massive book in case you happen to have one of them
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next year i don't know but it's an example you mean you mean like this one,
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and like it actually is like that's what when people get it they kind of be
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like oh it's actually quite heavy like it is a big big resource.
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It's like i'm trying to think when i was at physio school we did have like we've
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textbooks that probably haunt us forever that we remembered having to carry
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around and probably revise from but it's a big textbook and,
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and like so some of those applied pieces that we have are well in the screening
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chapter we very much take you through like well what do you do like if you're not a
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a pelvic health specialist a female health specialist but somebody's telling
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you that you should really know about,
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like pelvic floor symptoms or be able to screen them in your the athletes you're
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supporting what do you do so we break it down for you we make it really simple
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and not burdensome so like the pfd sentinel is a um,
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i suppose patient reporter outcome measure screening tool that was published
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in bgsm a couple of years ago but it's really five questions and like they give
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you the words to articulate you know do you experience leakage of urine you
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know it gives you it or you give it to the athlete and they can tick,
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if you feel clumsy asking those questions but it just means that if you identify something
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nobody's expecting you to be the person to manage that if that's not your area
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but it's being able to screen it and go do you know what there's actually help
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available for that or like screen them to send them to resources because we
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highlight different resources in the book
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or you might actually be interested in different chapters and actually start
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to give some basic public health type
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information and advice that could actually make a difference to a patient. Yeah.
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But other things we do are like, so you might screen someone and they don't
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say anything, or you might have a patient or an athlete who's coming back from,
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either a surgery or maybe a pregnancy.
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And we talk about how you can test low capacity of the pelvic floor.
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So like we talk about two approaches, either there's two current trains of thought
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because there's no set validated way to do this shit.
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So we talk about either load until you leak or load until one rep in reserve.
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And what that means is that it's not just about leaking, but we use that as the framework.
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But if, say, someone was doing double unders and they leak on the double under,
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you know, load until you leak, would say, give them sets of eight.
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And, you know, that's kind of their starting baseline. Whereas some more,
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I pretend to like to work in one rep and reserve, whereas I'll load someone to seven repetitions.
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And then you're hoping that those repetitions over time increase as you do stuff
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like focused pelvic floor training but also just exposure to impact training
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should over time if it's at the right level
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train their pelvic floor also as well because for those first seven reps their
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pelvic floor is working instinctively reflexively
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without thinking and so it's just giving people a bit of insights and stuff
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that they can do so that they don't feel that,
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they have to be a specialist in this area. They can use their foundational sports
21:05
science understanding and just apply it to this area, which is also a muscle
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group, which also has load capacity considerations like other areas of the body.
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And so you're starting to hone in on knowledge that you actually have yourself.
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Sounds fascinating. Yeah. I mean, I'm sure there's something in there for everybody,
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but I'm also interested, what's the reception been like from traditional sports
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medicine practitioners? Have you had anybody kind of questioning it and going,
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oh, are you sure about that?
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Not that I've heard of yet. So we've got one actually. I've just recently handed
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over my tenure as Editor-in-Chief of the Journal of Pelvic Obstetric and Gynaecological Physio.
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And I've been reviewing my last journal that will go to print comes out any week now.
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But I didn't know, but my journal committee actually sourced independent reviews of the book,
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put it out and so one of them is a sports therapist
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in somewhere in Europe and it's actually really interesting to read the different
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they got a pelvic health physio and they got a sports therapist to review it
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and it's just interesting to see what bits they pulled from what really landed
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with them but they were really interesting I've had a lot of people message me
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on social media talking about like it's just nice to have a trusted resource
22:19
and to go through and it's not that every chapter,
22:21
will resonate the full the full
22:25
I suppose narrative every chapter might be too in-depth for some topics for
22:28
some people so what you might home into you might home into chapters more than
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I'll home into it so it all depends on the way we work what really,
22:37
what we're interested in but also what really applies to our own scope of practice
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and you'll dip in and out of things and take different tidbits from different chapters.
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And so it's not a book that I think people will read front to back.
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It's one that you will dip into chapters as you have a question or,
22:53
you know, you want to find out something about this certain topic.
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And I guess as your career progresses and you get more experience and you see
23:01
more patients and stuff, then you'll be referring back to chapters which will
23:04
start making more sense.
23:06
Absolutely. Sounds very healthy. Now, I'm just wondering, because I mean.
23:09
I wonder how much within your practice and your area of speciality,
23:13
there are traditional academics or clinicians who.
23:20
You're challenging some of the things they've based their life on and are still
23:22
doing and whether they feel like it's a bit of a, you know, a challenge to them
23:27
and their identity and maybe they're.
23:30
DVDs and stuff. Not DVDs, they're too old. They're online kind of programs and
23:34
things which are out there and they're making money out of. Would you ever see
23:37
that or is it something that just doesn't, you don't come across?
23:40
So it's funny because I think because this book in particular is that kind of
23:44
missing sports medicine, the pelvic floor, because people are working in sports
23:47
medicine, anyone who works in sports medicine usually wants to keep people active.
23:50
They usually want to keep them
23:51
in sport and they want to support them and push people to their limits.
23:55
So it's been really useful bringing pelvic health into that because I think that,
24:00
actually it's been sort of like an elephant in this space for so many years where,
24:06
sports medicine clinicians maybe don't know enough about it but they knew it's
24:09
a thing and maybe it's the thing that they felt limited their athletes or you know
24:14
they didn't want to maybe cause further harm so maybe they weren't sure how
24:17
to progress on whereas now we're suddenly being like no we've actually got science
24:20
like the more we you know strengthen conditioning is good,
24:23
building up people's load capacity is good,
24:26
our bodies are more resilient than we think and I think that's being embraced,
24:30
are there people who I would say some of the challenge we will have will be,
24:35
getting people to look at this book in the first place because they might think
24:39
oh well like the pill floor is not really my area like I'm not going there or
24:42
I don't need to go there and ask questions I got there and I hope with time
24:46
that this book debunks how
24:48
really just in the same way as we might screen for red flags or other things
24:52
that we might not manage and we might not have within our scope of practice
24:55
but we it's important that were able to pick up on them.
24:57
The pedal floor should be like that because particularly if you're someone who
25:01
works in a role where you get to spend time with the athlete.
25:06
You might be the only person that they ever disclose or, you know,
25:09
even hint at a sign or symptom of health floor dysfunction.
25:13
And a lot of athletes actually normalize these symptoms or, you know,
25:16
think they're just par for the course.
25:18
And you could be the one person who goes, do you know what? That's actually
25:20
really common to experience these symptoms as a female athlete.
25:23
But like, you absolutely don't have to put up with it the same way as you don't
25:26
put up with a calf strain or a hamstring niggle or, you know,
25:29
any other element or symptom.
25:32
It's really nice to be able to kind of be that person who goes,
25:35
look it, I can send you to resources or go look this up or you know what I mean.
25:39
So go listen to this podcast that Matt Phillips did one time on this topic.
25:45
That's great. I think that, I mean, that's good to hear. I just wanted to check.
25:48
I think it answers what Ceci was asking here as well, which I'll just read out for podcast listeners.
25:53
How hard has it been pushing female health issues forward in sports medicine?
25:58
Is there more enlightenment or are we still in the dark ages? Thank you.
26:02
I feel like I've been interested in this topic for as long as you've known me
26:06
and Matt like so like when we first spoke about stuff several years ago it would
26:10
have been about returning to running postpartum and that's how I got into research
26:13
was because as a clinician I was like
26:16
how do we not have like a clinical guideline for me as a physio for it to guide
26:21
me through how to guide my patient when we have like guidelines post.
26:26
Keyhole knee surgery and guidelines post you know an ankle sprain or anything
26:30
so I just couldn't understand this and so that's how I got into looking to see
26:34
what research is out there finding out that there was very little nothing was really known about this
26:40
and then the more I looked at it I was like how has sports medicine
26:44
why does it deal with everywhere from head to toe but it seems to just absolutely
26:47
skip past the pelvic floor part it's nearly siloed it off and that made no sense to me And then.
26:54
When research started to emerge, like we've had really nice researchers from
26:58
even Australia, like Jodie Dakik and her PhD found that like.
27:02
You know, almost one in two women withdraw from sport because of symptoms of
27:06
pelvic floor dysfunction. So that's huge. That's like a public health priority.
27:09
Women are just dropping out, disappearing, and maybe creating a different excuse.
27:13
Childcare, it could be any excuse, you know what I mean?
27:16
But actually it could be that they're leaking or they're feeling heaviness or
27:19
pressure every time they go to try and do that sport. So they just withdraw.
27:23
So then I feel like I've been banging this drum for several years and engaging
27:28
in research and trying to do stuff and it's only really been since this you
27:33
nearly when I got reached out for this book and I think
27:36
I did a paper with Dr Izzy Moore who you know as well and I first of all I did
27:40
a presentation at a sports medicine conference in Austin Texas and I'll always remember it because,
27:47
it was the first conference I attended after COVID and I was actually quite
27:50
nervous traveling because the world had shut down and we forgot how to travel
27:53
and suddenly I was going into the big world again but it was a really low it was a large conference
27:58
all full of sports medicine doctors there wasn't really many other professionals there,
28:02
but I did a talk on sports medicine and pelvic floor basically and it was really
28:06
well received and from then I got asked to do a clinical commentary,
28:11
in one of the American journals and it got paper of the year and it was after
28:15
that that I think that then it probably got an Elsevier's radar and they contacted
28:19
so So I feel like it was a long time coming, but then when it came.
28:26
It was worth the hustle.
28:27
That's good. That's been great following it. And you mentioned like people like
28:31
Izzy Moore, who I remember chatting with. It does feel like when I first started
28:35
chatting to people, maybe on One Chat Live podcast. And what year was it?
28:38
I was just thinking, what year was it you had the paper with Tom and Emma?
28:43
2019. I was going to say 2019 was One Chat Live conference and Izzy spoke at
28:47
that. So 2019, I'm looking back to that and thinking the names were far and fewer between.
28:52
If you looked at, for example episodes of physio matters podcast you know for
28:57
a while i'm not picking on you jack here by the way but there was just far more
29:01
guys going on but i'm i don't know whether i'm,
29:04
whether it's just my little bubble but it does seem these days people could
29:07
chuck out 10 names of women who are involved in research and are on the shows
29:11
or on the panels and stuff you know so,
29:14
are things getting better or is it just me surrounding myself do you think things
29:19
are definitely improving like,
29:23
Even the fact that Elsevier, as a big, well-known publisher,
29:27
wanted to do a book focused on this topic, I think, and the fact that it's done
29:32
well. So that's the other thing. It's a very vulnerable thing to edit a book.
29:37
Anybody who's in that position wants to do the best job they can.
29:40
They want to curate something that people are interested in that's going to
29:43
help readers and it's going to land well and not be like, huh?
29:47
And so once you hit publish, like as in you send it and you're not going to
29:51
see it again in any draft form, there's a very vulnerable period while you wait
29:55
for that book to come out.
29:56
And what was even worse was that I thought I would get like an advanced copy
30:01
and be able to like look at this and get my head around it and process it in the flesh.
30:04
But actually people who had ordered it started getting it before me and were
30:07
tagging me and I hadn't got my copy yet. So I was very, oh my goodness,
30:11
there was a couple of things I wanted to check that were fixed,
30:13
like that were caught that I had picked up in the last proofs.
30:17
So I got it eventually and do you know what it's been really really well received
30:21
it's still sitting at number one in life sciences in Elsevier which I'm chapped
30:26
about so really happy with that but,
30:30
I do think things are changing do things need to change more absolutely but
30:34
they're already talking about a second edition so this is hopefully going to be.
30:37
A text that keeps going and just gets updated every so often and so,
30:42
who knows like if we the big thing is if we could get it into undergrad courses
30:46
and things like if it can be on syllabuses so that the first time people learn
30:50
about a pelvic floor isn't when
30:52
you know their partner has a baby or something you know because that's currently
30:55
our very reactive model whereas really we know that we need to be educating
31:01
adolescents about pelvic floor they need to be aware of it what its role is because a lot of young,
31:06
teenage girls are actually leaking in sport because the low demands of their
31:10
sport are just higher than what their pelvic floor can tolerate,
31:14
and of course when we think in a biopsychosocial lens we now know that things
31:18
like relative energy deficiency in sport
31:20
actually can be something that exacerbates or exposed symptoms of stress urinary
31:24
incontinence in sport because your body's in survival mode it's going to take
31:28
energy away from non-necessary systems and that has
31:31
an effect on the continence mechanism too so it's crazy and that's why this
31:35
book includes anecdotes about all those sorts of things so that you as
31:39
a therapist, no matter what background you come from, that you can understand
31:44
some of the many things you come across in athlete support already and start to join the dots.
31:50
Very cool. It does sound, yeah, we should rightfully feel optimistic.
31:54
And I think also, like looking back, people like yourself and Emma and Izzy,
31:59
and a list of whole other names of female academics and clinical researchers,
32:04
I suppose, I don't know whether you're aware of this, but do you feel that maybe
32:07
you've inspired other female researchers?
32:10
Clinicians or researchers to kind of like say yes to go yeah I can do this do
32:14
you get that impression sometimes I don't make you feel like you're the old grandmother now
32:18
of research that's actually something that I'm really proud of like when I go
32:21
to conferences I actually get a lot of people coming up to be going because
32:25
I still have the clinician hat,
32:27
I think there's a relatability in that and and because I'm actually really honest
32:31
when people ask me about like I never went thinking that I was going to be,
32:36
a researcher research by me and the fact that I got frustrated as a clinician
32:40
and asked the question and linked in with Tom and then we brought Emma on board
32:44
but we did like that kind of informal scoping review it was more like a white paper.
32:49
But because it there was nothing out there it got legs it got traction it went
32:53
international and then researchers started coming to me to say could you we'll
32:56
do some research in female related stuff but we need someone to inform this
32:59
and we don't have the clinical background
33:01
so I joined as a clinician expert and then over time they were like oh you're
33:06
interested in research and then people started to shaped me up into actually
33:10
doing some of the research.
33:11
So it's been a really nice journey, but there's something very relatable in
33:15
it with the fact that I didn't come out of uni and be like, I want to be a researcher.
33:19
And I just had all these extra knowledge and skills that just,
33:22
I just could apply to straight away. It was something that was very much developed and learned over time.
33:27
And so actually at a conference that I was at recently, I had quite a few people
33:30
come up and say they were interested in getting into research and they were
33:33
just kind of asking like, you know, advice and tips about how to do it.
33:36
And it's that sort of inspiration or that sort of, when I start to realize that
33:42
people can see themselves doing this, I'm like, oh my goodness, like that makes my day.
33:48
And the other area is from doing the journal, Ed-in-Chief, I would pride POGP
33:54
Journal as being a really nice.
33:57
Entry journal, because we're not as scary as some journals where you get your
34:02
sort of F off desk rejection.
34:04
We, even when we do, we're very, very high standards and things.
34:08
But when we do reject, we often give quite a lot of feedback and invite a rewrite
34:15
and brand new resubmission rather that, you know what I mean?
34:18
So we try to teach people the process of academic writing.
34:22
And therefore, I think we've been a very friendly journal.
34:25
And from that, people then start to believe that they can do this because they
34:28
start to see that they're developing the knowledge and skills and insights of
34:31
what this academic world expects and the hoops you have to jump through and
34:35
the processes you just have to learn through experience.
34:38
That's cool. That's great. I'm glad you're getting that feedback and living
34:41
off it because it's well deserved.
34:43
And it's so fascinating because you're setting out to.
34:47
Kind of champion the lived experience of female athletes and empower them and
34:52
get them to not kind of bow down to the taboos and the patriarchy and the male
34:57
coaches not asking them questions and ignoring their kind of,
35:00
you're changing the whole epistemology of it all.
35:03
But in doing so, you're also encouraging researchers to step forward and go, I can do this.
35:08
It's just seems like a snowball of happiness. I'm sure it's not like that all
35:12
the way around and there's still problems, but the knock-on effect of it,
35:16
it seems to be wonderful across research, across the athletes themselves,
35:19
across parents. So it's good. It's very cool.
35:22
We've got some questions here from people. Thank you for the questions,
35:25
people. Keep them coming in. Charlie King, STT, is asking, are these exercises
35:30
adaptable for non-athletic populations? Cool question.
35:33
Yeah, I would actually say the principle in this book. So while we call it Sports
35:37
Medicine, the pelvic floor, and it's very female athlete focused,
35:40
within the book and within different chapters, we're very transparent to kind
35:44
of, I suppose when we think about the athlete, we're thinking about recreational to elite.
35:48
Like we're thinking across the spectrum of people's activities.
35:52
So like the normal day-to-day mom looking to get back to just normal physical
35:56
activity is a recreational athlete in my mind.
36:00
So yes, the principles, the knowledge, the advice, the information is absolutely applicable.
36:05
And then it's just adapted to the level of activity that they're doing. That's cool.
36:09
And Charlie's followed up to put into context on working with women post hysterectomy
36:13
and women with weakness following pregnancy and medical issues.
36:17
Absolutely. So then from, it's still the sports medicine lens to that,
36:20
because again, you know, thinking of women post hysterectomy.
36:25
And thinking of women as we start to even, you know, go across our lifespan
36:30
and different transitions and aging, we want to make sure more people are engaging
36:34
in sports, exercise, particularly strength and conditioning. So to me,
36:38
across the lifespan and across all levels of activity, we need to have a better
36:42
understanding of sports medicine because they need to benefit from what we traditionally
36:46
would have thought just athletes did.
36:48
You know, when we go back, we go back 20 years, women weren't that,
36:52
you know, informed about doing strength and conditioning and nearly didn't want to have that.
36:56
You know, there was nearly all these myths about them. They didn't want to be
36:59
too bulky, you know, and there was a big misconception about what strength and
37:02
conditioning was, what the benefits of it are and we know more now and we even
37:06
know even when we think of oncology populations we need to get people,
37:11
during and after cancer treatments doing strength training and again for their
37:15
bone health for the muscle mass so again all of these populations are athletes
37:20
they're just athletes within whatever population bracket they're in at a given time in their life,
37:25
cool yeah very healthy answer thanks for the questions there so therapy show
37:31
let's move on to that first time yes time.
37:35
Have you been to the NEC have you presented at the NEC before for any other
37:38
conference I have I think CSP conference is there and something else I've been
37:42
there before so I've been it's a big lovely big conference very nice I'm,
37:46
very excited to have you along there and you're delivering on day one which
37:49
is November the 25th 3.30pm in Theatre B for people with your pens and paper
37:54
and your programmes ready return to sport after pregnancy a sports medicine lens program,
38:01
You had, obviously, when they approached you and said, go on,
38:04
yeah, we need you on the show.
38:07
Did you have a few different titles in mind? Or was this something you thought,
38:10
no, this is where I go along. This is the bread and butter that people need to hear about.
38:14
I think I did say I'd do something like sports medicine, the pet floor,
38:17
and I was going to talk more broadly.
38:19
And they asked for the, after pregnancy, I don't know whether it's been a request
38:24
at different shows or they just know it's a hot topic.
38:26
But to lend to the previous question, there is my focus or there's my application
38:31
of the knowledge and information that we have went through and put out in this
38:35
book will be going into this presentation.
38:38
Again, no matter what level someone is, because again, we have the rise of the
38:42
mother athlete having babies, but we also have day-to-day moms having babies all the time.
38:46
So I will be talking about the principles of like
38:51
all the different, I suppose, physical, physiological, psychological changes
38:54
and challenges that occur with that perinatal transition and how we,
38:58
no matter what part of sports medicine team we come from, how we can best support
39:03
them and how we can, I suppose,
39:06
give them the best opportunity of getting back to their level or maybe better than their level.
39:11
So it's how to grade them back in the best way possible and what sort of things
39:14
we need to look out for along the way.
39:17
Sounds cool. And I imagine that even in the, I think it's 30 minutes or something,
39:21
just so tricky, but I imagine for people who come along, there's going to be
39:25
a few little surprises in terms of updating evidence or just tweaking what they've
39:29
been doing until now, particularly in actors' field. do you?
39:32
Yeah and there's a lot like we've been lucky because as the research comes out
39:37
in this field we're getting less restrictive I would say or we're getting more
39:41
empowered as to how we can,
39:44
progress people push people have less restrictions and cautions and less fear-mongering
39:48
because I do feel and I feel like I have even been someone who's been part of
39:52
it like a lot of the stuff we have done in that perinatal population,
39:57
has we were doing it with the best of intentions but we've probably maybe over
40:01
pathologized some things and we've caused fear in some things and that messaging
40:05
can be hard to change like after the research is already changing
40:09
but the social media messaging is still in the older messages
40:13
so it's trying to get people skilled up or understanding where the current state
40:18
of science is now so that we can all kind of support women with the best more uniform message.
40:23
Fantastic. So yeah, that's 3.30 p.m. people are in Theater B on day one, which is the Wednesday.
40:32
Yeah, I totally recommend that.
40:34
And as it goes, it seems, I'm not sure if it's coincidence or on purpose,
40:38
but there's a lot of women's health, amazing women's health stuff going on on
40:42
day one for people who are like suffering from pharma thinking I can only go on day one.
40:47
Don't worry, you've got it. You're going to walk out of there just absolutely so,
40:51
educated with regards to Women's Health, because we've also got friends of yours
40:55
like Siobhan O'Donovan is going to be there on day one at 4.15 in Theatre B
41:00
as well with Beyond the Bra, Why Therapists Need to Know About Breast Weight Management,
41:05
the booby physio Siobhan. Very special.
41:08
Would you agree? Oh, I would absolutely agree. I hope she wears her onesie anatomy
41:13
suit. Oh, definitely the viral one. Yeah, without a doubt.
41:17
Yeah, it's great. And Siobhan's going to be on the show having a little chat
41:19
about that. If you don't know Siobhan, the booby physio, it's just so,
41:23
this is where you just realize everything you say is going to be a pun like
41:26
uplifting and because i'm just thinking of what siobhan would say,
41:28
but yeah you need to see siobhan their puppies and you need to listen to everything
41:32
she says and it's just a great get the information out there forget about these
41:36
ridiculous taboos and do something about it really hands-on there we go is another
41:40
pun i can't get away from it but yeah,
41:42
that's gonna be great on day one 415 and we've also got as well another guest
41:46
has been on the show before michelle lyons there seems to be a theme here of
41:49
people where they're traveling from and great information.
41:51
I don't know whether what's going on there. Something in the water over here,
41:54
guys. I'm not going to lie to you.
41:57
I don't know what that's all about. I'm not quite sure. But we seem to have
42:00
a lot of people flying over across a little channel of water to bring excellence to the show.
42:04
But yeah, Michelle Lyons and who people have been to therapy show will know
42:08
well, basically for just bringing the conference nearly to a standstill with
42:12
bottlenecks everywhere in the STA theatre.
42:14
She's going to be that day 1, 245, theatre A, menopause and musculoskeletal
42:18
health, the fundamentals you need to know.
42:21
So cool. I mean, looking at you three guys together, there's,
42:25
yeah, I mean, that's just a reason to go and pay your ticket price just to go and see those three.
42:30
And just to reiterate, I don't know whether you'll be able to do this,
42:32
but there is more, they're really facilitating speaker Q&A afterwards.
42:37
So for speakers who have got time, rather than staying in the theater and getting
42:40
someone like Mike James hushing everyone out, you can actually go to special
42:43
little booths where people can queue up and then ask questions and that.
42:47
Because I know a lot of speakers kind of really like that. They like to be able
42:49
to give people time afterwards.
42:52
Yeah, absolutely. I would be more than happy to do that. I think they actually
42:55
had said something about a book club.
42:58
I'll have some of my books with me too if people want to flick through.
43:01
Because they had said that there was elements, or I don't know what they call
43:04
it, but there was something to do with Q&A and also something to do with books.
43:07
Oh, wonderful. Oh, there we go. So yeah, take your book along there and get
43:11
it signed. Fantastic. Double the value overnight.
43:14
Right. And I believe you're such a busy person. You're not going to be around for day two, are you?
43:19
I'm not. I'm teaching a course that weekend, so I'm popping home because I have
43:23
to be back to run my kids to some sports and get their uniforms washed.
43:29
But this is, for many people, I think, particularly in the sports medicine field,
43:34
I don't know, this just seems to be conference season.
43:36
And myself and Michelle are actually heading to Denmark on Thursday for a conference
43:41
and so we seem to be just playing hopping everywhere at the minute and trying
43:45
to fit everything in so no unfortunately not there for day two but I will have
43:49
so such FOMO because you know I've been looking at it and there's obviously
43:52
talks that I'm like oh I'd love to go and see that,
43:54
but I'm so glad that so many of the women's health ones are on the day one because
43:58
I will definitely be captioning them.
44:00
That's very kind of you too. Obviously, you're talking about my talk on day
44:03
two. I am. I am. Obviously, at 10.30am.
44:06
I have to put this in there because no one else is going to talk about it on
44:08
their podcast. I'd love to say that. That's a really good topic.
44:11
Yeah, well, obviously, I'm biased. But yeah, so day two, in case you listen
44:14
to the podcast, changing the room, not the person, neurodiversity and MSK clinical practice.
44:18
That'll be in the clinical skills lab.
44:20
And if neurodiversity and neurodivergence is an area of interest to you,
44:25
either for yourself as a therapist or looking after patients who come in,
44:28
And bearing in mind that depending on sources, probably 20% of the people in
44:32
the world think a little bit differently and get categorized into those kind
44:35
of labels, then it's something to look out for.
44:37
Then also on day one, I'll be hosting the panel debate, Beyond Awareness,
44:41
Neuroaffirmative Practice and MSK Care.
44:45
And it's cool. I mean, thanks as well to Therapy Show because women's health,
44:49
neurodivergence, we've got all sorts of things happening there, which
44:54
thanks to the various boards who Therapy Show listen to with regards to information,
44:59
what topics, I think it's a pretty inclusive,
45:03
kind of library of things going on over the two days.
45:06
You should find something for everybody. If there's not, then mention it and
45:09
we'll make sure the next year is in there.
45:10
But yeah, something for everyone. Looking forward to it.
45:13
That's really important. But see, the neurodivergent stuff is really interesting
45:18
to me. And I don't actually, Izzy Moore, who we mentioned earlier,
45:21
I was a part of a piece of work with her.
45:24
We're looking to get more inclusive guidelines to better support neurodivergent
45:28
athletes, because actually sports is something that is really, really good.
45:35
I think the routine the structure the kind of adherence to it but it you know
45:39
certain sports really attract people who think differently in certain ways but
45:43
we need to be able to support them do you know what I mean like we need,
45:46
to understand communicate support so I think that there's a lot of work in this
45:49
area so I'm really fascinated your stuff I must be I will be looking it up,
45:53
well no you're fantastic is in terms of women's health and we were mentioning
45:56
off air in terms of women's health it's so important as well because you I was
46:00
very proud of you mentioning that,
46:02
for women now we're realizing that it's not the case of like oh men are typically
46:07
more autistic than women it's just women,
46:09
for ages and decades were kind of more used to masking and being quiet in society
46:14
anyway because they had to be that way and so because of the patriarchal system
46:18
and that they went undiagnosed,
46:20
so they were and also you know again male therapists or male psychologists choosing male children
46:27
to do their research on and then guess what only finding that male children
46:30
had autism so it's kind of like very parallel and to the whole women's health thing as well,
46:36
but yeah cool so that'll be happening if you're interested in that right time is ticking away so.
46:41
Basically between the best-selling textbook doctoral research clinical practice
46:44
major conference appearances anything else plan for the year.
46:49
I have a couple more conferences. I'm going to the World Congress of Sports
46:52
Therapy or Physicotherapy as well in Bern in Switzerland.
46:55
But I'm just looking forward to then, I need to get, I need to home in and this has put my hands up.
47:01
I need to really get knuckling down into my own doctorate research studies because
47:05
like when you're doing all this, a lot of the work that I need to do at the
47:07
minute, I need to immerse myself in it. So like this chopping and changing with
47:11
my week is not very good for the productivity of that.
47:15
And so I need to pull up my sleeves and knuckle down.
47:18
And that's on, I think I mentioned in the advert, that's on compression garments,
47:21
no support postpartum return to running.
47:24
Yes. So compression garments as an adjunct propelled floor function.
47:27
So again, another clinical interest of mine, one which I possibly thought was
47:32
more perceptual in how they might have effect.
47:37
But I've challenged my own biases with my research, which is always how amazing
47:41
is research when it actually gets you thinking differently.
47:44
Because we try to park our biases as researchers, but of course,
47:47
as a clinician, you have an idea of what you think might happen or doesn't happen.
47:52
So I've been really interested to open my own eyes and understanding about the
47:58
role of these as adjuncts.
48:00
And just like we have adjunctive products in other areas of rehab,
48:04
we need to understand what adjunctive products there are for female pelvic health,
48:08
and create a menu of options for people.
48:10
Wow, that's very exciting. And where are you in the process of that?
48:13
Not to make you realize how much you've got left, but what?
48:17
Oh, I'm a part-time student, which again was my crazy world.
48:20
So I'm doing a part-time and I'm three years into that.
48:24
I think I could have another three years, but I don't want to spend another
48:27
three years on it. Um, but I'm hoping to finish in 2029. Um,
48:31
So not, well, that is three years actually. That is three years.
48:36
No, that is three years. So I have another five years that I could have because
48:38
I can finish in 2031, but I'm not going on that far.
48:42
If you're ever talking, 2029, please arrange a call with me again and ask me
48:46
have I finished my PhD. And if I haven't, have an intervention with me.
48:50
That would be episode 2029. We're looking at about episode 726.
48:55
Excellent. No, I'll put it in the diary.
48:57
I know you're busy. Well, yeah, we tend to get together every four years.
49:00
That's pretty good timing.
49:02
How exciting right then so well thank you so much for giving up your time i
49:06
can't believe an hour's already gone by but yeah so and so looking forward to
49:09
seeing you i don't think we've met in person before have we,
49:13
no but i feel like i know you just because we've come across paths so many times
49:16
so yeah it'll be very interesting yeah it'll be so lovely to see you in person
49:20
even that feels like i have known in person
49:22
i don't think i've yet to meet emma either in person nearly happened and i think
49:25
she couldn't oh no yes she had she came to spoke in the sta theater once of course she did
49:29
she was so nervous bless her yeah she did come to the STA theatre
49:32
no but it'd be so nice to see we were talking a bit off air of different speakers
49:37
seeing each other the first time after maybe years of confirming and talking
49:41
and maybe co-authoring papers it's one of the best things I think about Therapy
49:45
Show especially in this digital age we live in it's so nice to get people together
49:47
actually because I've never met Tom in person have you not really?
49:51
No no no and again another person who I think we are actually speaking at a
49:54
conference in France somewhere next year so I'll get to meet him there but like
49:58
we haven't met in person.
50:00
And sometimes when I meet people in person, like you know them,
50:03
you're really familiar with them. But then I'm like, oh, wow,
50:05
you're so tall. Because like, I don't get that from, you know,
50:07
we're all on height here on screen. And then you're like, oh,
50:10
did not know you were so tall.
50:12
Yeah. Get used to that when we meet each other. Yeah. Okay. Get a ladder.
50:16
Yeah. We get some good photos. Fantastic. No, thank you so much for giving your time.
50:20
It's really exciting to catch up with you and to hear everything you do.
50:22
And just, again, I don't say it to all the guests, but so thank you so much
50:26
for all the work you've done across the like, maybe six years I've been following
50:30
you and everything you've been doing.
50:31
So yeah, you're a credit to the industry and the people you look after.
50:35
So thank you so much. Amazing.
50:37
I appreciate it. And if people want to follow you on social media,
50:39
then you're on Instagram which is I'll put it in the show notes because you're
50:43
never going to remember it but it's Gronje Donnelly underscore absolute physio
50:46
there you go people but I'll make sure it all goes in the show notes
50:48
and on LinkedIn on Facebook is there one main one which you tend to put things
50:52
on or do you just put them across the,
50:54
Instagram and LinkedIn and then it gets copied across autobiography to Facebook
50:59
but it's really Instagram and LinkedIn that I would update the most that's great
51:03
so there you go people if you want to follow it and make sure they get and obviously
51:06
the website which has got details and the book and everything we'll put links to that.
51:10
So there we go right thanks everyone who joined us as well lest i forget and
51:14
thanks for some great questions thanks um charlie and cecily and gary benson founder the sta,
51:21
i'm not six foot six anyway i'm getting old i'm six foot five me and gary is
51:24
a sight to behold okay and and his son jake because we're all like six five
51:28
six six so whenever we grab ann marie or something who's i think last measurement
51:32
is about three foot four we stand next to her and And it's just fantastic.
51:35
It's like we've adopted somebody from Italy, a little child from an orphanage. It's wonderful.
51:41
Yeah, we love that photo for you. Thanks, Gary. Yeah, can't wait to get with
51:44
you and not Jake this year. Anyway, yes, therapy show.
51:47
But yeah, thanks everyone who joined us live. We really appreciate it.
51:50
Thanks everyone who listens to the podcast. If you have listened to the podcast,
51:52
if you enjoyed this, if you found Groni O'Donnelly's information of use.
51:56
Use it, but don't keep it yourself. Share it by basically sharing the podcast,
52:00
leave a rating and review, especially Apple Podcasts, because that's like,
52:04
you know, gets out there really high in Google searches and stuff.
52:07
So just share it and leave a rating and get the good quality information of
52:11
our guests out there for everybody else. That's the only reason we do it.
52:14
And we're going to be back next week once again. And we're going to have,
52:19
oh, Joe, the amazing Joe Turner, founder of mehab.co.uk, is going to be on the
52:23
show, who's also speaking fantastically at Therapy Show.
52:27
Clinical Conversations That Work. If you don't know Joe Turner and mehab.co.uk,
52:31
have a little look for next week.
52:33
It's all about you. It's all about clinicians who spend their lives looking
52:36
after other people and forgetting about looking after yourselves.
52:39
Hence her podcast, You Matter.
52:42
And you know what? If you look after yourself, then you'll be able to look after others even more.
52:46
So it'll be a really cool show catching up with the amazing Joe Turner. That'll be next week.
52:50
If you want to join us live, bring your questions, that'll be Tuesday at o'clock
52:53
UK time. October the 27th.
52:56
Until then, thanks for a final time to Gwania Donnelly.
53:00
Thank you very much for having me. It's an honour. Absolute pleasure.
53:03
And yeah, thanks everyone else. Until then, take care of yourselves and more
53:06
importantly, take care of each other. We will see you very soon.