Latest / The STA Clinician Podcast / STA207: 'Is Your Client Ready To Return To Sport?' with special guest Steve Miller

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STA207: 'Is Your Client Ready To Return To Sport?' with special guest Steve Miller · The STA Clinician Podcast

• 0:07
  Music.
• 0:24
  207 my name is matt phillips for radio one chat live.com and
• 0:28
  as always this episode is being recorded live on
• 0:31
  the sports therapy association youtube channel and on
• 0:34
  the sports association facebook page so if you are listening to the
• 0:36
  podcast and thank you very much for engaging with us do please
• 0:39
  leave a review if you like the show if you don't like it then just disappear it's
• 0:42
  fine you don't have to say anything but if you do fancy if you'd like the idea of
• 0:45
  joining us live then i do all we need
• 0:47
  to do is go along to youtube at eight o'clock sports
• 0:51
  therapy association or facebook if you prefer and join
• 0:54
  us live and that gives you the chance to obviously ask questions directly to
• 0:58
  our great guests and also to hang out with other people in the live lounge kind
• 1:04
  of network and when you do ask a question or say hi then i can bring that up
• 1:08
  onto the screen which often you know means you're going to share your logo or
• 1:11
  show your business logo so yeah it's a great opportunity to mix and learn at
• 1:14
  the same time which is a pretty healthy environment if i I say so myself.
• 1:18
  So in this episode coming up shortly entitled, Is Your Client Ready to Return to Sport?
• 1:22
  My special guest joining us is Steve Miller, founder of growphysioacademy.com.
• 1:27
  Steve is a rehabilitation specialist currently with GB Judo,
• 1:31
  which we're going to hear about very shortly.
• 1:33
  And he's already well known amongst
• 1:34
  quite a lot of you STA members for his excellent courses and webinars.
• 1:38
  One of which is actually happening tomorrow at 6.30pm if
• 1:41
  you're listening to this live and it's all about achilles injuries in
• 1:44
  sport stm members are entitled to 15 off so
• 1:47
  if you are joining us live then make sure you head
• 1:49
  to the sta members area after this don't go now
• 1:52
  and look for details you can get a great discount from a wonderful
• 1:55
  educator in our industry and we'll be discussing some of his other courses very
• 1:58
  shortly but before i bring steve miller up i just want to give you a heads up
• 2:03
  for next week's episode on tuesday july the 30th i should bring it up onto the
• 2:09
  main screen for those of you who are joining us in the live lounge.
• 2:14
  What do you reckon about statutory regulation for sports
• 2:17
  therapists that's what we're going to be talking about um it's
• 2:21
  back in the news now some people
• 2:25
  are thinking with a new government then finally we've got
• 2:27
  a chance to all get statutory regulation everything's going to be fantastic
• 2:31
  and amazing it's just what industry needs to thrive we'll be just like physios
• 2:35
  other people are a little bit more skeptical and they think that maybe we are
• 2:38
  chasing a little bit of a pipe dream which either can't happen or there's more
• 2:41
  cons than pros so i'm going to be joined next Next week by Anna-Marie Macieric,
• 2:46
  the director of the ST School.
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  And also by Gary Benson, founder of the STA.
• 2:51
  And we're going to have a big chat
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  about the pros and cons of statutory regulation for sports therapists.
• 2:57
  And also look at the history of what's been attempted and not really achieved up to now.
• 3:04
  But we want to know what you think about it. So basically, if you have got some
• 3:08
  feelings, what do you think is a great idea, a bad idea?
• 3:10
  Maybe if you just don't know much about it then head along to
• 3:13
  social media for the sta which is at uk
• 3:16
  underscore sta on facebook instagram or twitter and leave a comment on the statutory
• 3:21
  regulation post you will find there it's not there at the moment although there
• 3:25
  is one that gary posted recently in the face in the sports association facebook
• 3:29
  feed i will put a few more out there just for people to leave comments because
• 3:34
  we as part of next week's show we want
• 3:36
  to address some of the ideas that people put forward to you the listener because
• 3:40
  there is quite a lot as always a little bit of misinformation and a bit of lack
• 3:46
  of information out there so that's what we're going to address next week do
• 3:49
  join us if you want to listen to the podcast.
• 3:51
  Then we're talking about tuesday july the 30th eight o'clock on youtube it's
• 3:56
  going to be a very interesting fact-filled episode um so we'd love to have you
• 4:00
  there to give us your ideas and give Give Anna Maria and Gary something to comment on and talk about.
• 4:09
  Right, back to tonight's episode. Let's get rid of that for now.
• 4:12
  Is your client ready to return to sport? With my special guest,
• 4:17
  Steve Miller, founder of growphysioacademy.com.
• 4:20
  Let's bring him up.
• 4:21
  Music.
• 4:23
  You're listening to the Sports Therapy Association podcast, putting evidence
• 4:27
  back on soft tissue therapy.
• 4:31
  Hey, Steve. Hey. Very well. Thanks, Matt. Peace off.
• 4:35
  I'm okay. I'm I'm just thinking, I hope people realize that I was being a little
• 4:38
  bit sarcastic and cynical when I said we could be just like physios,
• 4:41
  because it is just something which a lot of sports therapists do kind of feel
• 4:45
  a bit with imposter syndrome and they compare ourselves to physios.
• 4:48
  They don't really get, as we've talked about before, they don't get that MSK
• 4:51
  is only a very small part of what it is to be a physio.
• 4:54
  Did you use some time? Because people are going to email me saying,
• 4:57
  oh, Matt, you can see you've got another physio on the show, have you?
• 4:59
  Thanks, Matt. at and also you know saying at your your website
• 5:02
  grow physio academy i'm going to get some
• 5:05
  emails saying oh not grow sports therapy academy is it so
• 5:08
  what's your deal because you are a sports rehab specialist
• 5:11
  how much of what you do today is thanks to the
• 5:14
  physio training you do i i think we discussed this a
• 5:17
  tiny bit didn't we last time in terms of sort of the backgrounds really
• 5:20
  and i am someone who went into
• 5:23
  physio thinking i was always going to end up in
• 5:26
  a sporty world doing msk and I think
• 5:29
  that was pretty apparent from the off really so I didn't do rotations in a traditional
• 5:35
  NHS style but I did go and work for the NHS and sort of connect health and things
• 5:41
  in primary care for about seven years and I think that exposure to rheumatology,
• 5:48
  neurology, respiratory things,
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  little red flags that come up now and again that aren't MSA related were really
• 5:54
  nice to pick up on I'm working alongside GPs in some of these sort of little
• 5:59
  polyclinics and things is really, really handy.
• 6:03
  Yeah, it definitely taught me a lot, sort of from a holistic perspective during
• 6:07
  just the standard sort of 2000 clinical hours that we used to have to do,
• 6:10
  moving around different specialisms as a student.
• 6:13
  And then, yeah, sort of working in that environment, lots and lots of sort of
• 6:17
  scope and specialists that would come in and talk to us through flagging rheumatology
• 6:21
  issues, neurology things, a little cancer potentials and lumps and bumps and
• 6:26
  things like that, really.
• 6:27
  So it wasn't that we're the specialist in those at all, but certainly sort of
• 6:30
  flagging them, highlight them, and then ship them on to the right person as
• 6:33
  quickly as you possibly can, really.
• 6:35
  Definitely. Red flags. This is something we talk about loads with guests,
• 6:38
  and we love having people from different professions on, because one of the
• 6:42
  things I'm always harping on about is if you're going to do any CPD, anything.
• 6:46
  Wherever you are, do some CPD on the red flags so you can signpost,
• 6:51
  so you can signal out to specialists, whether it's female pelvic health,
• 6:54
  male pelvic health, could be rheumatology that's the things because
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  especially in our industry i think we're going to see
• 7:00
  lots of sports people and we're going to get it we're not
• 7:02
  going to be seeing a lot of kind of like non-sport people and we might kind
• 7:06
  of fall prey to being a little bit slack and not recognizing some of the masqueraders
• 7:09
  so it is so important isn't it to like you say keep up with knowledge and know
• 7:14
  whether somebody's accepting something which could be systemic and not just
• 7:17
  treat everything as an msk problem so about team gb so let's let's talk about that
• 7:22
  briefly because I'm just going to share this photo which I put to you earlier
• 7:26
  on and you said yeah that's fine you can show that I just put this photo for
• 7:28
  people who have joined us live thanks for joining us live people are coming
• 7:31
  into the live lounge for those of you who can't see this photo Steve is going
• 7:35
  to talk you through it now and say what's going on and who's in the photo.
• 7:38
  So this all escalated a little bit quickly but the
• 7:41
  the premise of this really is tomorrow we
• 7:44
  have five of the female athletes that I work
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  with in British Judo who are going to represent Team
• 7:50
  GB the olympic games so they all fly out tomorrow gen
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  your general day-to-day stuff it seems a little bit
• 7:57
  cringy to go and get a photo but i thought you know what it'll be
• 8:00
  quite nice to get a photo so i thought you know what let's stand in front the
• 8:04
  gb judo way sign let's get a little standing photo and then all of a sudden
• 8:08
  out of nowhere the girl in the middle lucy just said come on let's let's pick
• 8:12
  him up so that then escalated to our look at this olympic lift Do you know what I mean?
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  And the Olympic lifting, ollie lifting kind of way that you do in a gym,
• 8:21
  this was their equivalent of an Olympic lift really. So.
• 8:24
  Yeah, I probably should have contracted Cora a little bit better and helped
• 8:27
  her out on her edge. That's good, Ferdinand. He looks happy.
• 8:31
  So these are all qualified and they're off tomorrow?
• 8:34
  Yes. So, yeah, all different weight categories that they're competing in.
• 8:39
  I think they've all got a huge chance of meddling.
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  The graph that these guys put in is unbelievable. I didn't know a huge amount
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  about judokas before moving into this world,
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  but in terms of specimens of athletes in the graph that they put in,
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  they are ridiculous i think
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  every single one could be a gladiator that you'd
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  hear to be honest like as all-around
• 9:02
  athletes running power explosiveness pure
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  strength match strength all these kind of
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  things like they are phenomenal so yes and and
• 9:11
  great role models it's so nice i mean i'm biased because in
• 9:14
  this industry and with guests it's it's we've got
• 9:17
  such a history haven't we have been concentrating on male athletes and all
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  the research on samples with males and that and so
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  we're really trying to push women in
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  sport and obviously strong women and yeah i'm sure those five
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  are good examples of particularly strong women and yeah to
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  big them up a little bit more yeah this is they are our five so
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  we don't actually have any men who've competed and qualified
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  for the games this year sadly i think it's the first time ever in judo history
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  but these girls are yeah on a whole different level on a scary level when you
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  see them i certainly wouldn't want to meet them in a back alley sort of thing
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  but they are yeah greatness great to watch great to watch love it excellent.
• 9:56
  So just briefly, you've got, I'm going to bring up a, let's bring up your webpage next, if that's okay.
• 10:02
  Again, if you're listening to the podcast, you don't see this.
• 10:05
  It's just because people do like joining us live and seeing the visuals.
• 10:07
  And I get feedback saying, oh, Matt, I love it when you bring up the screenshots
• 10:09
  and stuff. So this is for the people who have joined us live.
• 10:12
  Let's put this on full. So what I'm bringing up here is a screenshot of growphysioacademy.com.
• 10:19
  As always, just recommend you totally go along there. Don't be put off by the name.
• 10:23
  I'll have a go at steve later on for calling it grow physio instead of grow whatever
• 10:26
  you put but it's i mean there's if we just
• 10:29
  jump to the courses and have a little look at them steve can
• 10:31
  take us through some of those there there's something there which is obviously
• 10:34
  going to help anybody who's working with athletes achilles practical courses
• 10:39
  we've got we'll take us through what sorts of variations have we got in there
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  steve yeah i've just tried to give all the insights that i don't think that
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  i got at university really in terms of practical applications so So if I started
• 10:52
  off at the bottom, so I started off with the Achilles.
• 10:54
  So as you mentioned, Matt, so tomorrow I'm going to do sort of almost take people
• 10:58
  through the management of tendinopathies and ruptures of an Achilles,
• 11:02
  how you calm them down, how you rebuild them and then reintegrate them back into sport.
• 11:06
  And then really what each course does ideally is goes through the practical
• 11:12
  assessment, the treatments and interventions, hands-on taping,
• 11:16
  modalities, whatever it may be. and then a lot of the sort of rehabilitation.
• 11:20
  And then for probably 90% of the courses, I think it's really nice to see the whole journey.
• 11:25
  So what I've done is put a real case study from one of the areas that I've worked
• 11:30
  in, in sport and private practice, and then almost given that as a bit of an overview.
• 11:35
  So you can sometimes know the theory, but how it all pieces together is sometimes difficult.
• 11:39
  And also just acknowledging that it doesn't always go very well or it might go brilliantly.
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  So if there are things that have gone really well, the reflective bit on why
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  I think they've gone well and maybe some things that could have gone better
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  or what's happened with other athletes because I.
• 11:53
  Sometimes you've just got to have that mileage and go through the journey.
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  And it's really a big privilege for someone to give you the ownership of managing
• 12:01
  their injury back into sport.
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  And I think it has to be met with that same sort of level of preparation.
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  And it's really hard to find enough time to go to the levels that you need to.
• 12:13
  Like working in sport is definitely not a nine to five switch off kind of job.
• 12:17
  You do end up sort of sitting on evenings, sometimes planning rehabilitation
• 12:20
  sessions, pre-hab sessions, and trying to mix things up, depending on what you've
• 12:25
  seen. But it's really worthwhile, really valuable.
• 12:27
  And yeah, I've just tried to get my insights really into that.
• 12:30
  And yeah, there'll be quite a few new courses that are coming up now.
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  The Olympics are sort of hopefully coming out the way. So there's a lot of things
• 12:37
  that are just unfinished.
• 12:38
  Like there's lots of testing protocols, how you actually test and screen individuals.
• 12:42
  What stuff's actually useful because you can drown, can't you,
• 12:45
  in data if you overcook it.
• 12:48
  But yeah, just the really pertinent things that I think are really handy and applicable for people.
• 12:52
  I just had a guy actually just last month contact me from India who said he
• 12:56
  basically smashed through everything in sort of six to eight hours a day, done it as a placement.
• 13:01
  And in a month, he basically completed it and then tapped out.
• 13:05
  And I'm like, that is exactly what I wanted to create almost was a placement
• 13:09
  for people who have time.
• 13:11
  Summer holidays are coming up. Like if you are sitting in it,
• 13:13
  if the weather's been pretty tragic, hasn't it so far?
• 13:16
  So if you have got time then yeah do feel
• 13:19
  free to drop on and smash out as much of it
• 13:22
  as you want amazing and and we should reiterate just in case people have joined
• 13:25
  us and we're talking about judo judo judo there's it's not just for kind of
• 13:29
  martial arts it's it's all sorts of sports you've got footballers runners all
• 13:32
  sorts of injuries and examples up there yeah there's a bit of a mix of my life
• 13:36
  in premiership rugby which again sort of encompasses more running
• 13:41
  sprinting dynamic athletes rather than the
• 13:43
  people who only move around like a 10 by 10 square really
• 13:46
  don't they excellent right so
• 13:50
  yes people go and check out grow physio grow physio
• 13:53
  academy.com and have a little really practical based courses yeah definitely
• 13:58
  something there which i love the idea they are so practical and you can just
• 14:00
  have a look at something which maybe applies to your particular clients and
• 14:03
  just think i really need some help with that back there you got it webinar yeah
• 14:07
  great stuff and also you're going to be thank you you're going to be at therapy
• 14:09
  for the Expo this November, which is gonna be very exciting as well.
• 14:12
  Yeah, so thank you for that. We'll have more details about Fairview Expo coming
• 14:16
  up, revealing all of our speakers after the summer holidays and people have
• 14:20
  got their thinking heads back on.
• 14:21
  After, like you say, this blistering sun, which we've been going through,
• 14:24
  this heat wave in the United Kingdom, the great United Kingdom, so there we go.
• 14:29
  Right, so here we go. Is your client ready to return to sport?
• 14:33
  That's what we're gonna be talking about.
• 14:36
  Let's start maybe. Does the title kind of suggest that some clients,
• 14:40
  in your experience, are being sent back to their sport at an inappropriate time?
• 14:44
  Is it something which can plague success rates for clinicians?
• 14:48
  Yeah, and this is certainly not trying to lambast anyone or kind of say that
• 14:53
  people aren't doing jobs well or anything like that at all.
• 14:56
  But I think a lot of the time what I was getting when I was in private practice
• 15:00
  were a lot of sort of second and third sort of opinions that people were sort of sending through.
• 15:05
  And there was just some really common trends that tended to sort of present
• 15:10
  really of reasons why people were breaking down with injuries.
• 15:13
  Maybe they were still not sort of psychologically ready to return yet.
• 15:17
  They just don't feel like they have reached the levels that they wanted to reach
• 15:21
  during their rehabilitation.
• 15:23
  So I think rehab, I only learned to rehab well by moving into sports.
• 15:29
  My world before this at Connect Health and working in part-time sport just didn't
• 15:34
  give me the access or the time or the eyes on time to actually go through rehab well.
• 15:40
  And a lot of the time, what I had was a room that was like a GP room with a
• 15:45
  few Therabands, maybe a couple of little dumbbells.
• 15:48
  And that was about all I had to work with. And when you think of the forces
• 15:51
  and the demands on some of these individuals, it doesn't come anywhere near
• 15:56
  close to replicate anything that people require.
• 15:59
  And quite a lot of the time I found it quite frustrating because I was sort
• 16:02
  of saying, well, when you get in the gym or what have you got access to outside of here?
• 16:05
  And if people didn't have access to these things, then you couldn't get them to do it.
• 16:10
  And often, even when you get people to squat and they've got a knee or something
• 16:14
  like that, that is not, they're not very confident in, they're always going
• 16:17
  to bias the other side, which again,
• 16:20
  in a gym environment often isn't much of an issue, but if they're reluctant
• 16:23
  to step off that side or cut off that side.
• 16:27
  Again those sorts of things might lead to re-injury it
• 16:29
  might lead to secondary injury it might just be an accumulative of
• 16:33
  nature of tightness building up on one side because
• 16:35
  they're just not using it little stress reactions and bones and
• 16:38
  yeah it's certainly sort of things that
• 16:41
  I think I've just picked up on when I look back at what I was
• 16:44
  doing I was pretty poor at rehab and
• 16:47
  that was one of the big driving reasons why I kind of wanted
• 16:50
  to move into a more sporting environment environment where
• 16:53
  i had more time and when i say time for
• 16:56
  anyone who works in sport pick a sport
• 16:59
  that gives you time i've picked rugby and judo which are
• 17:01
  very injury heavy and often it's a we add
• 17:05
  17 people in rehab during the hour and a half slot that we have for rehab so
• 17:09
  that is not going to give me the quality time one-on-one with people that that
• 17:14
  sometimes you crave so if you're at man city and you've got one athlete to look
• 17:19
  after for the entire week and that's your job it's a very
• 17:22
  different world to sometimes these really, really busy rehab slots.
• 17:26
  And it wasn't that we had 17 injuries, but 17 people who were transitioning
• 17:30
  back into full training, sort of prepping for competition, had little work-ons,
• 17:34
  niggles, et cetera, that they needed to kind of just keep up with.
• 17:37
  But it is a very busy environment. So if there's only you, which is often the
• 17:41
  case, and yeah, 17 athletes was the worst it was in my time in this Olympic cycle.
• 17:47
  You're sort I mean, I've got no hair already, but no doubt it would have all
• 17:50
  fallen out had I had a few strands remaining, to be fair, because it's really tough.
• 17:56
  And you get charged up or I get my sort of positive reinforcement bits and get
• 18:02
  that energy and icky guy, if you like, from actually doing a really good job
• 18:05
  working one-on-one, really kind of helping and supporting and looking at the minutia.
• 18:09
  So it's lovely when people go away on camps and it leaves some of the injured
• 18:12
  three or four who you can really get into the sort of roots of what's going on.
• 18:18
  Do you think i don't know what it's like for you i'm not
• 18:21
  saying this is your success rate or your prevalence of re-injury
• 18:24
  but we've heard kind of time and time again i think it's still
• 18:27
  safe to say that one of the biggest risk factors for being
• 18:30
  injured in the sporting environment is having had that
• 18:33
  injury before do you think how much
• 18:36
  of that in your experience do you think is because the
• 18:40
  rehab that that athlete was given wasn't sufficient to reduce the risk of re-injury
• 18:45
  or is it something we should always expect that however well we rehab a client
• 18:49
  the chances are they're in a sport which is a chaotic environment and they're
• 18:52
  just going to get injured again especially when they're trying to reach the
• 18:54
  levels of excellence such as your clients but is it something we should be doing
• 18:58
  better or is it always going to happen with injury.
• 19:01
  I mean, I don't think anyone can eradicate an injury risk at all.
• 19:05
  But I think what we try and do in rehab is mimic the scenarios,
• 19:08
  prepare someone so that if that sort of force or angle of force that comes in
• 19:14
  for someone like knees are a classic one with lots of MCLs, lots of ACLs in
• 19:18
  judo, just because of the nature of the positions that they put themselves in.
• 19:22
  If you're off balance or someone who's heavy lands on your knee at any time,
• 19:26
  it will probably called an mcl or an acl injury
• 19:29
  but done at speed and power and the velocity that's required
• 19:32
  it just becomes more and more risk and i
• 19:35
  think it marries up the the question marks of like do you
• 19:38
  are you gym strong are you mat strong are you neuromuscularly tuned
• 19:42
  in well enough to it and i think sometimes the
• 19:45
  the little triangle of those things can really
• 19:48
  be if there's a missing component can be be something that
• 19:51
  you need to kind of either dial up in one
• 19:54
  area maybe dial down at different other the times but yeah
• 19:57
  i mean once you've got an injured area it's certainly going
• 20:00
  to be more vulnerable i would say that always the
• 20:04
  best heel seems to be the first heel so if
• 20:06
  you get it right first time nature and
• 20:10
  all the sort of scar tissue and adhesions and whatever else
• 20:12
  that form there tends to be better if it's the first time around
• 20:15
  if you are someone who's just constantly irritating niggling things over and
• 20:21
  over and over again the tissue is going to potentially change all of the sort
• 20:24
  of central sensitization and sort of listening and what's happening around there
• 20:29
  in the sort of central nervous system is also going to likely ramp up more and more.
• 20:34
  And then there's sort of checks and things as well. Once people are back and
• 20:38
  you have rehabilitated them to make sure that it might be that they look amazing
• 20:42
  once they go back and you've kind
• 20:43
  of got them through all their strength markers, all of their mobility,
• 20:46
  dynamic markers, all of their power markers, you've introduced them incrementally
• 20:51
  into all the training components, they've got back into competition.
• 20:55
  And then what normally happens is people forget to do the little work-ons,
• 20:59
  the top-ups that actually got them to that state already.
• 21:02
  So just gradually, what normally happens is people go back into competition.
• 21:07
  They then get into the swing of, all right, I'm doing training,
• 21:11
  I'm doing 100% components.
• 21:13
  And then the stimulus that has almost protected the tissue, they may need to
• 21:18
  kind of bolt on as an extra.
• 21:20
  And I think that's the really challenging bit to be that annoying physio,
• 21:24
  sports therapist, whoever you are, to keep on now and again,
• 21:28
  And set little reminders on your phone every week or every month to kind of
• 21:31
  tune back in with them and say, where are you now?
• 21:35
  And are you managing to do the little extra work ons?
• 21:38
  And are you managing to allocate a time in their diary so that they get that stimulus?
• 21:43
  Because it's very easy if we think about something like an Achilles tendinopathy,
• 21:47
  for example, you maybe have rehabilitated them.
• 21:51
  You've done isometrics. You've maybe done some dynamic isometrics.
• 21:54
  You've got them concentrically, centrically strong.
• 21:57
  You've done that sort of return to impact.
• 21:59
  You've got them running. They're back doing their park run 5Ks and what have
• 22:03
  you. And that's what they do for the next six to eight weeks.
• 22:06
  And then all that happens is they then don't do the high load,
• 22:11
  long sustained sort of stimulus that they might require to keep those strength
• 22:18
  markers really high through that Achilles.
• 22:21
  And they just rely on, well, I'm actually, I'm back now and I don't need to
• 22:23
  do these things. And I think that's a common trend.
• 22:25
  So the rehab might have been done incredibly well, but people think that once
• 22:30
  they're back in full training, they're getting enough of a hit that keeps those markers high.
• 22:35
  So what we've tried to do, and this is something that I've really kind of tried
• 22:39
  to drive and get all the S&C team on board is whenever people come in on a morning,
• 22:44
  we alternate between a specific strength test that
• 22:47
  they do as a marker alongside some of
• 22:49
  of their mobility scores that they'll do so we just end up
• 22:52
  with a world where if something starts to drop
• 22:55
  off we catch it before they get injured and go
• 22:58
  oh i wonder what that strength level was
• 23:01
  like oh had it dropped off had it not and it's
• 23:04
  only something that you do for sort of 30 seconds a minute so it's
• 23:08
  not really something that you kind of really fatiguing anyone
• 23:11
  with but it's really nice to have that little touch point
• 23:13
  of data to wonder whether people are starting
• 23:16
  to drift and it's sometimes a bit of a kick up our backside and a
• 23:20
  bit of a kick up their backside to to get on to some
• 23:23
  of those little drills and they're often surprised oh i
• 23:25
  didn't think that that would have dropped off because i'm doing every minute
• 23:29
  of every session in training or competition excellent
• 23:33
  so there's an awful lot of education there that the
• 23:36
  therapists whether you're physio or sports therapist or
• 23:39
  anything you need to be doing with your clients and accompanying their
• 23:43
  journey staying with them even though when they're attaining to sport and they naturally good
• 23:46
  on them they feel confident they're like yeah i'm great.
• 23:49
  I'm back it's going to be great but actually you're saying that the
• 23:52
  return to sport needs to be treated as still part of rehab
• 23:54
  and they still need to be yeah so i think
• 23:57
  i don't know what the little quote was i had but it was almost like assessing
• 24:01
  if you're not assessing you're guessing but also
• 24:05
  on the back of that it's the monitoring side and giving
• 24:08
  them the skills and the tools so they can recheck things
• 24:11
  and it might just be simple things like they go in the
• 24:14
  gym and they do a leg press calf raise or
• 24:17
  an isometric hold on the weight that they were at and actually compare side
• 24:21
  to side the injured to the non-injured is that starting to drop off or you look
• 24:25
  at the endurance of that muscle how many repetitions can they do calf raises
• 24:30
  to normally like a metronome is what we do but almost just if they count in
• 24:34
  the head that's absolutely fine so three ups three downs.
• 24:38
  But yeah, I think having little checkpoints that you ask them to keep an eye
• 24:41
  on as a bare minimum on a monthly basis would be my advice, really.
• 24:47
  Obviously, if you've got more eyes on and more access to them, the better.
• 24:51
  But yeah, a lot of the time what will happen is you get someone in private practice,
• 24:55
  you rehabilitate them really well, they get back to doing what they're doing,
• 24:58
  and then you sort of see them drift in with something else about three or four
• 25:04
  months later, and they're like, God, this was just getting tight.
• 25:07
  So I was stretching it, mobilizing it, but it's just not disappearing.
• 25:11
  And I think that's a really common thing that you tend to find.
• 25:15
  And that might not be that your rehab's not being done well,
• 25:17
  but they haven't kept on top of the little markers.
• 25:20
  So I think the world that we're moving into is so much more data supported.
• 25:26
  So we actually put numbers onto a lot of things. And I find that that's a big
• 25:30
  motivator for the athletes anyway, so they can see the differences.
• 25:34
  Your sort of classic one of ours, does it feel better?
• 25:37
  Oh yeah it feels better after i've had this or that how can
• 25:40
  you then marry that up with some numbers to to sort of
• 25:42
  support even further really that's something that you find
• 25:45
  matter at all in your world yeah i
• 25:49
  mean i'm very much into being able
• 25:53
  to measure things but it's it's it's it's
• 25:56
  the person in front of you isn't it we're talking a little bit off air if you're
• 25:58
  working with somebody who desperately wants to get
• 26:01
  back to their park run or desperately wants to get back to the mat if you
• 26:04
  ask them does that feel better and all they want to do in their mind is get back to
• 26:07
  their game because it's their identity it's their their friends it's their
• 26:10
  everything about them it's getting back to that mat or racetrack whatever
• 26:13
  it's a pitch they're gonna say yeah yeah that's kind of all
• 26:16
  right isn't it you know it might probably maybe
• 26:19
  that person in front of you or you might get the person in front of you you know
• 26:22
  is the opposite and they're a little bit tentative and they're
• 26:25
  always gonna say oh i'm not quite sure it doesn't feel right or can i really
• 26:28
  do this yet you know you might even get that even though they're big strong
• 26:32
  elite male or female athlete by nature they might or because of previous experience
• 26:36
  or feel a friend or something they might
• 26:39
  have that kind of resistancy and kinesophobia as we kind of call it so.
• 26:43
  I i just love as a therapist whether i'm doing it online or face to face is
• 26:48
  getting to know the athlete in front of you isn't it that's such a huge thing
• 26:51
  i guess that doesn't matter what level they are you work with like a lead to
• 26:55
  the elite or going to the olympics do you still find.
• 26:58
  It's so important that the person in front of you can dictate what sort of rehab
• 27:02
  you give them Yeah, 100%.
• 27:04
  So what our rehab will look like with one ACL might look completely different with another ACL.
• 27:11
  I just think about one of the girls that we have at the moment who basically
• 27:15
  when I joined British Judo, she just had her second ACL repair.
• 27:20
  So she'd done a left and then she did her right.
• 27:24
  And to be honest, the journey she'd been on, she'd gone through her rehab with
• 27:29
  her original ACL, which had had a few little bumps on it on the road in the first place.
• 27:35
  She'd then gone back and done what's called a test fight so
• 27:38
  just before competing one of the other
• 27:41
  athletes basically mimicked the role of a competitor and they fought live almost
• 27:45
  like all the shackles come off everything all guns blazing and basically that
• 27:49
  was when she did her ACL on the other side so she never after a full I think
• 27:54
  it was like a 14 month journey then was about to compete but did her other ACL.
• 28:00
  So then coming into this, I was sort of tasked with, I've managed a lot of ACLs
• 28:06
  in rugby and some in football and sort of other sports and random things like
• 28:11
  skateboarding and all that kind of thing in private practice.
• 28:13
  But to do a judo knee was always going to be a little bit different.
• 28:17
  But actually, I think the approach that I had sort of made it different enough
• 28:23
  from her original journey.
• 28:25
  And that one had been done by a guy who's there at the moment,
• 28:27
  who is probably one of the best rehabbers I think I've ever worked with.
• 28:30
  So he's done absolutely nothing wrong. The knee's unfortunately just been vulnerable,
• 28:35
  put in a position on the other side.
• 28:36
  And that is then exactly what you're sort of saying, sort of feeding into that
• 28:40
  kinesiophobia things at the moment. She's just coming back.
• 28:44
  She's going out to be a partner at the Olympics and she's done so well after
• 28:49
  two and a bit years of non-stop rehab to get to a stage where she is
• 28:54
  now flying with both knees but for
• 28:57
  a long time we were doing exactly what you're saying we
• 29:00
  we sent her for testing because we said you're doing really well but
• 29:04
  she was really had a lot of psychological barriers about
• 29:07
  returning to the mat because she didn't even get there in a competition so obviously
• 29:11
  as soon as it comes back to that stage she won't do any test fights she's competed
• 29:16
  now but missed out that part because that was just a psychological block for
• 29:21
  her and actually yeah a A lot of the scores that we've done with her have been
• 29:24
  the other way around going,
• 29:25
  you are absolutely smashing this.
• 29:28
  Your LSI comparing left to right side are exactly the same.
• 29:32
  And then when we look at that against the other athletes in your weight category
• 29:37
  and right through, you're way above where they are as well.
• 29:40
  So overall, we're trying to feed in a positivity vibe for a long time.
• 29:45
  And then now she's got back to competition. I think everything's sort of fallen into place, but.
• 29:51
  Inevitably, if you're in a little dark gym for a couple of years,
• 29:54
  not seeing the whole reason why you're actually doing this sport, it's really tough.
• 30:00
  And I think as a physio, as a sports therapist, working in this environment,
• 30:07
  this was the first time I've worked with female athletes.
• 30:10
  The more holistic approach that I have to take is so different to anything that I've done previously.
• 30:17
  And actually managing the psychological side the
• 30:20
  mental side flagging that and sending that to the lifestyle or
• 30:24
  the psych team if it's just too much but
• 30:26
  the amount of tears that have actually been on this judo
• 30:30
  outfit this year is is remarkable like no other year
• 30:32
  of my life and that's really demanding i
• 30:36
  think for therapists as well like you're taking on
• 30:38
  stuff that you're just a constant an emotional sponge
• 30:42
  and actually to then keep on delivering a positive
• 30:46
  performance and service to
• 30:49
  everybody else and not get caught in that that's something that i think we don't
• 30:54
  get enough help with as therapists so if anyone is sort of listening to this
• 30:59
  and going wow it's all getting a bit much it's getting on top of me all i hear
• 31:02
  is people moaning about their knees their shoulders there's their apprehensions,
• 31:06
  their stresses, blah, blah, blah.
• 31:08
  It is really demanding on us. So do reach out and get help.
• 31:12
  And just, yeah, talk to people about how tough that is, because that is definitely
• 31:16
  something that I've never been prepped for and actually initially needed a little
• 31:22
  bit of support and help with to kind of deload me in different areas because it was just mounting,
• 31:28
  with all these people just crying on me and blah, blah, blah.
• 31:31
  Yeah. That's a great point. A few weeks back we had, I'm not sure whether you've
• 31:36
  met her or know of her, Jo Turner of meethab.co.uk.
• 31:39
  You know, Jo, yeah, who's exactly all about that? And she's always saying,
• 31:43
  especially in our profession, we really are giving, giving, giving.
• 31:46
  And there's a lot of emotional attachments, like you said, emotional sponges.
• 31:50
  And, yeah, it's really important that you don't burn out and don't give some
• 31:53
  time to yourself and that.
• 31:54
  I mean, it can just ruin you and then for your business and your clients and
• 31:57
  everything. So, yeah, great point.
• 31:59
  And we've got a few questions coming up now, if that's all right with you.
• 32:02
  Gary here. I'll come back to you, Israel, if that's OK. A little bit of a case
• 32:05
  history coming out with Israel.
• 32:06
  Let's go for Gary first of all. found the SDA says one of the potential problems
• 32:09
  in sport is the pressure put on rehab team by coaches to get players playing
• 32:12
  before they complete the rehab continuum have you experienced this
• 32:16
  Steve yeah how much pressure is there on you yeah I think this is something
• 32:21
  that I would recommend everybody once you've assessed something don't rush into
• 32:26
  the coach's room and go I've assessed it this is what it is this is how long
• 32:29
  it's going to take spend a bit of time just stepping back and going,
• 32:33
  right, this is what I think is going on.
• 32:36
  Has there been anybody else who's had a similar injury? What experiences have I had?
• 32:40
  If I haven't had them, chat to people who maybe have experienced this kind of thing.
• 32:45
  If you haven't got that, reach out to people on socials, have a look at protocols that are maybe online.
• 32:51
  There is so much amazing material out there to work out roughly how long this will take.
• 32:56
  And then if it says this is a 12-week injury, I would just say to the coaches
• 33:00
  it's a 12 to 16 week injury because it gives you that little buffer if things don't go quite to plan.
• 33:08
  You've got that little window if you bring them back at 12 weeks
• 33:11
  like all the research and everybody's saying then you're
• 33:14
  doing a fantastic job but i think if
• 33:17
  you are in a position where you go you know what it's 12
• 33:20
  to 16 but all i'm going to do is go
• 33:23
  off a milestone based approach where we're.
• 33:26
  Going to basically build the foundation have the.
• 33:28
  Certain markers along that journey it's really nice to
• 33:31
  have the journey mapped out and it'll probably help you
• 33:34
  to make like a blueprint blueprints and anyone who wants sort of access to
• 33:37
  this kind of thing I'm sort of in the process of putting all
• 33:40
  this together so for something like a grade 2 MCL in
• 33:43
  our world that would probably like a 12 to 14 week injury
• 33:46
  what are they going to do along each week and
• 33:50
  it might be every couple of weeks that you kind of chop it into but you
• 33:53
  want to have a rough plan of how that journey is going to
• 33:56
  look and then you can kind of communicate that with
• 33:59
  the coaches but put the caveat on that actually he
• 34:02
  needs to be hitting them or she needs to be hitting the markers as
• 34:06
  we go and actually i know for make something up
• 34:09
  if you want to and i know that from experience these can be
• 34:12
  very very slow initially so this this phase might
• 34:15
  be a little bit longer but actually hopefully
• 34:18
  that will buy us a little bit of time later on but yeah
• 34:21
  i think probably going off a milestone approach rather
• 34:24
  than a hard and fast they're going to be available on this
• 34:27
  date without fail is probably a a better
• 34:29
  way to go they will always push you and push you and push
• 34:32
  you and then look at the calendar and go right well there's this
• 34:35
  match or this competition that is on this date
• 34:38
  can i put them in for that and i think you've just got to hold
• 34:41
  firm and go you know what with this is a recent injury
• 34:44
  this is how long it's going to take i will update you
• 34:47
  as things go because yeah everybody wants
• 34:50
  their individuals and athletes and all that kind of thing available
• 34:53
  the risk again you can kind of package it.
• 34:56
  As we can potentially get them back quicker that comes.
• 35:00
  With an increased risk potentially that
• 35:03
  they may not have hit the markers if they're not hitting their symmetry.
• 35:06
  Markers their sort of markers compared to other athletes in this environment
• 35:11
  then they may be a bit undercooked or if you get them back quicker we often
• 35:15
  have like a they need to have done for a significant injury over sort of three
• 35:20
  months plus they have to have done four weeks of full training to get back in.
• 35:25
  And that's actually something that the coaches said.
• 35:28
  They're not sharp unless they've done four weeks of that sort of full training.
• 35:33
  So actually, you flip it around the other way and go, right,
• 35:35
  well, if you want four weeks of full training, actually, to get us to that point,
• 35:39
  if we incrementally drip them in, can you see how it's going to take this much longer?
• 35:43
  And if you can pinch a few little weeks or anything somewhere that they're on
• 35:46
  board with, you're on to a bit of a winner, really, because there's going to
• 35:50
  be more healing that takes place. But it's a really good question,
• 35:53
  Gary, and hopefully that answers it in some ways.
• 35:57
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• 37:02
  Having a, being clear, not just with the coaches, but also with the athletes
• 37:06
  themselves of how long this could take.
• 37:08
  That's really tricky, isn't it? Because again, depending on the person in front
• 37:10
  of you, if you know the person can take it and it's like, if you say yes, it can be 18 weeks.
• 37:14
  If they're not going to go, oh my God, and just give up and feel,
• 37:17
  you know, distraught by that, which you could just throw some people off the
• 37:19
  track, then you can give it to other people.
• 37:21
  Like I say, you're going to have to kind of break it to them gently or at different
• 37:24
  moments of time, but ultimately your mind you're going to have to still help
• 37:28
  them realize and also like the thing you said about clear markers which i wanted
• 37:32
  to talk to you about now let's imagine,
• 37:36
  Okay, well, look, hold on. This is a good case where we could use our friend
• 37:39
  Israel here, who's come up with the question here.
• 37:41
  So Israel, he's dislocated his shoulder now a couple of times in MMA.
• 37:47
  I think the second time it was throwing a punch and it came out.
• 37:50
  The second time in seven years.
• 37:52
  Obviously, it's very difficult, well, it's impossible without assessing properly
• 37:55
  and everything and knowing all that case history and all the other things.
• 37:58
  But an idea of Mark, I don't know whether you've had similar experiences in
• 38:02
  judo with arms being dislocated, but give us an idea.
• 38:04
  And this isn't don't start writing this down as well because it's not a
• 38:07
  routine for you but it's just to give you some idea what sort of
• 38:10
  markers would you progress before that person could even go back into training
• 38:15
  we'll talk about training afters and to what extent you could start punching
• 38:18
  for just bags or people but yeah to get to that training again what would they
• 38:22
  need to be demonstrating yeah i mean i think it's really i'm probably someone
• 38:27
  who is maybe a little bit more.
• 38:29
  Gym-based focus early on rather than rushing
• 38:32
  to get them to do sort of seated gripping and
• 38:35
  all this kind of stuff really because I sort of feel like if
• 38:38
  I create a foundation that I know is strong through range.
• 38:41
  In the ranges that they're potentially going to be vulnerable in as
• 38:45
  soon as you start introducing variables and.
• 38:48
  Uncertainty in this sort of chaos buzzword that's.
• 38:51
  Kind of flying around the risk of injury is
• 38:54
  going to ramp up considerably now that's hard because you've
• 38:57
  got got to balance up the right well you don't just want to make someone
• 38:59
  purely gym strong because actually all the neuromuscular control
• 39:03
  and reaction time and responding to
• 39:05
  what your opponent's doing is really really important but at
• 39:08
  the same time if we haven't got that sort of confidence and
• 39:11
  markers and things that we require it's really
• 39:14
  important now we are really lucky at
• 39:17
  the moment because the we are we're based with the university of
• 39:21
  wolverhampton's campus in walsall so we do
• 39:23
  have access to their testing equipment and they
• 39:26
  do have some nice bits of kit like they have force
• 39:29
  plates they have quite a bit of valid stuff but it's
• 39:32
  not always absolutely necessary before we kind
• 39:35
  of had this investment of sort of this one and a half million gourmet
• 39:38
  gym like we were basically using handheld dynamometers we
• 39:41
  were using gym equipment to try and get an idea of
• 39:44
  what the output and things that people had were and and
• 39:47
  to be honest that's what the vast majority of people will have
• 39:50
  in a clinical world is but i would
• 39:53
  say that the bare minimum that you should have is something like
• 39:56
  a handheld dynamometer that's so variable pretty affordable puts
• 40:00
  numbers to things and data in terms of sort of the shoulder scenarios just sorry
• 40:04
  just interrupt one second because i can hear how for example israel's head's
• 40:07
  going and other listeners maybe and what other clients would say is that the
• 40:12
  same as doing yourself the gym and seeing how far down the stack you can go
• 40:16
  can Can you use that as a measurement as well, or is it an advantage to having a third party?
• 40:20
  100%, yeah. So I think it depends what you want to try and achieve.
• 40:23
  But yeah, most gyms, like if you've got access to load, you can actually start
• 40:28
  to stress significant amounts of tissue that starts to replicate some of the
• 40:33
  demands, like I guess with a...
• 40:36
  An Achilles or a knee or something, you're probably looking at like six to 10
• 40:38
  times body weight flying through it during running and things like that.
• 40:41
  Now you're not going to put six to 10 times your own body weight on a bar by
• 40:45
  any stretch, but you do have to go heavy.
• 40:48
  So yeah, if you were looking at sort of just static isometric output,
• 40:52
  for example, or one RM, you're going to probably go pretty high.
• 40:55
  If you're looking at sort of almost comparing one side to the other, depending on the sport,
• 41:00
  like we use reps of six, for example, what
• 41:03
  can the non-injured side do how does that compare to
• 41:06
  the other side if they're if they're six rep
• 41:09
  we find their six rep max for example on one side
• 41:12
  and then almost just mimic that on the other if they're not
• 41:15
  even able to push it or they're only able to get two reps then we know that
• 41:18
  they're a little bit down so yeah lots of lots of stuff that's in the gym if
• 41:22
  we're going to do endurance things i think most classic things like today for
• 41:25
  example we had a a guy who's coming back from a patella dislocation So we just
• 41:31
  went through some of the endurance testing with him, which again requires no kit.
• 41:35
  You're just doing single leg squats to failure, single leg hamstring bridges.
• 41:41
  It's sort of 30 degrees long lever because it's a bit more relevant to judo than fully bent.
• 41:45
  And then calf raises. So they're just body weight specific, but you're just
• 41:49
  looking at the endurance of that muscle.
• 41:51
  So again, there's lots of different ways that you can get ideas.
• 41:54
  For us in the world that we're in, we have to go kind of to the next level from
• 41:59
  there to make sure that they are sort of mimicking some of the demands.
• 42:02
  But yeah, we've had probably three or four.
• 42:06
  Shoulder dislocations slash subluxations that have come out in different ways.
• 42:10
  We've had a posterior, we've actually had the full one, we've had a posterior,
• 42:14
  which is really rare, one of the first ones I've ever seen, an inferior and
• 42:18
  an anterior that's come out, popped back in again, and then we've had one of
• 42:22
  them that was an anterior dislocator that had to go on and have surgery.
• 42:27
  But the other three, we've just managed conservatively. And some of the testing
• 42:31
  things that we would look at.
• 42:32
  I guess we get them looking at just the classic things, really keep it pretty
• 42:36
  simple internal and external peak force sort
• 42:39
  of holds for five seconds in each direction repeat
• 42:42
  it three times look at how quickly they create that force
• 42:45
  can they hold that force before it drops off is
• 42:48
  there a decline over those three so is there a fatigue element
• 42:51
  that's coming in so they might be able to hit it really well on the first one
• 42:54
  the graph looks lovely it sort of goes straight up straight
• 42:57
  across and straight down and then it starts to become
• 43:00
  a little bit bit more juttery and the sort of
• 43:03
  recruitment and the output becomes a little bit more varied so
• 43:06
  they could be little indicators of actually maybe the endurance of that
• 43:09
  isn't very good but we're hitting the peak targets each
• 43:12
  time but actually it's starting to drop off fatigue so we need to
• 43:15
  build the endurance of that a little bit more we
• 43:18
  sorry is there an order to that that you see which
• 43:21
  again depend on the activity but in terms of so it's all about strength based
• 43:25
  on maybe calculating one rep max doing six reps and
• 43:29
  trying to achieve that balancing the two sides is there
• 43:32
  an order in terms of build that and then work on
• 43:34
  endurance or can you kind of periodize them and kind of change
• 43:37
  them over what do you suggest yeah i mean i'm a big believer that sometimes
• 43:41
  what you're doing in rehab should almost be the way that you then test so you're
• 43:45
  almost working on something to improve that test so you've got a direct correlation
• 43:49
  the athlete or the individual you're working with can see that direct correlation
• 43:54
  that oh actually i've been.
• 43:55
  Working on this and then I'm going to get really good at this because my score
• 43:58
  was down and then you test get some
• 44:00
  numbers and they're like here's the reassurance and the sort of positive.
• 44:04
  Input really that everything that you've done and grafted on
• 44:07
  specific to this test is making you better and we've
• 44:10
  deliberately picked a test that starts to mimic the injury positions
• 44:14
  that they may require now in the
• 44:16
  earlier stages you're never if someone's dislocated like
• 44:19
  i'm never going to start to put them in their
• 44:22
  apprehensive position and really ram them as hard as i
• 44:25
  possibly can with a handheld dynamometer so what
• 44:28
  we generally do is sort of get them lying flat arms are
• 44:31
  sort of of upper arm supported in this sort of position and then
• 44:34
  doing it here sort of but then they need to be out here when
• 44:37
  they're sort of in the later stages i'm going to go back
• 44:40
  into competition so i think you can have the same lateral rotation in various
• 44:45
  different areas and medial rotation but gradually what you're doing is starting
• 44:50
  to work through the range and starting to work towards the ranges that maybe
• 44:54
  the injury happened with so we get quite a lot of ours that pop out sort of
• 44:58
  opening up, horizontally abducting.
• 45:00
  They get caught when they're being thrown.
• 45:02
  One of them got caught across their body, which sounds a little bit more like
• 45:07
  Israel's scenario where you're almost punching that way, but you get a lot of
• 45:10
  traction onto the sleeve.
• 45:12
  So again, the inferior dislocator was pretty worried about going into that position.
• 45:19
  But by and large, like he sort of actually mimicked quite a lot of things.
• 45:24
  Bizarrely, we said he sort of set himself a challenge to become,
• 45:27
  get the biggest legs possible because again, ACL injuries, he'd had an ACL injury
• 45:33
  on one side and a meniscal problem on the other side and an LCL on the other side.
• 45:37
  And basically we gave him the challenge of creating massive legs.
• 45:41
  But what he'd done is then picked massive dumbbells off the rack to then do
• 45:45
  some split squats and things with.
• 45:47
  But the traction element from just
• 45:50
  holding dumbbells is pretty massive so
• 45:53
  i was freaking out when he's like i was carrying the 45 kilogram
• 45:56
  dumbbells blah blah blah i was doing all my like pb
• 46:00
  dumbbell squats and all that kind of thing and
• 46:03
  i was freaking out going your shoulder feel all right but i
• 46:06
  think you've gone well it's a leg exercise so it didn't kind of
• 46:09
  yeah it would be absolutely fine but if you're an
• 46:11
  inferior dislocator and then ram 45 kilograms of
• 46:15
  downward would force on that area luckily he'd
• 46:18
  done this fairly late on to be honest because yeah and
• 46:21
  then he'd been doing some chins and hangs and all this kind of thing with absolutely
• 46:26
  no problem and he'd actually been doing it off his own back but yeah he'd obviously
• 46:31
  kind of started to mimic some of these positions in rehab and then taking it
• 46:34
  upon himself much through lots of these so yeah i think
• 46:39
  it's just an incremental thing we use quite a
• 46:43
  few other little tests like push-up maximal push-up challenges we
• 46:47
  do some crossover upper upper limb
• 46:49
  tests where you sort of tap in across between two you're almost in a press wide
• 46:54
  press up position and then tap in between the two lines we do almost like a
• 46:58
  y excursion test as well where you're exploring the different ranges they're
• 47:03
  things again that you can do really early on without jeopardizing or putting that.
• 47:08
  Limb or joint at risk of kind of re-injury and it's just a case of building
• 47:13
  and building and building and not kicking on until they hit those targets so
• 47:17
  it gives them a really good motivator,
• 47:19
  excellent great advice yeah a lot of the
• 47:22
  time initially it's it's often the case of finding what they can't do finding
• 47:27
  something which provokes you don't want to go it depends what stage you are
• 47:32
  you don't go straight to the most painful position and say well that's what
• 47:35
  we're going to keep doing but you want to find maybe find what is paying for
• 47:37
  their move like you say slightly different angles so it's less load or different
• 47:40
  direction of force or something.
• 47:42
  And i like the idea yeah comparing it to the it's great but most of
• 47:45
  us got two arms two legs actually you work a lot with amputees isn't it so
• 47:48
  in that case you haven't really got that luxury have you
• 47:51
  if you're helping somebody you've got amputee in the
• 47:54
  judo team haven't you what do you do in that case when you
• 47:56
  haven't got the the judokas who
• 47:59
  are on the paralympic side they are are visually impaired so we
• 48:02
  actually don't have any amputees at all but yeah
• 48:05
  they're varying there's two different categories that they fall into but
• 48:09
  that's a vision i was watching the other day some amazing um it was actually
• 48:13
  jiu-jitsu but it was we had double amputees so obviously they had the same disadvantage
• 48:17
  but it's just incredible it's all ground game but it's great all right so that
• 48:21
  was that was that question doesn't apply but yeah balance finding out what's
• 48:25
  happening at one side compared to the other and i think it's really important isn't it just,
• 48:29
  just writing things down recording that data i
• 48:32
  mean that's one thing i find with athletes is as human beings
• 48:35
  you know mornings where we wake up feeling great and guess
• 48:39
  what we'll have a great session at the gym normally and we'll have mornings
• 48:41
  where we wake up terrible maybe external influences life getting in the way
• 48:45
  and you have a terrible and it seems like i'm not getting anywhere but if you
• 48:48
  could look in your little book maybe on your ipad where it is these days and
• 48:51
  you can see that you're still heading in the right direction that could be the
• 48:54
  shove you need to still remain remain optimistic and take,
• 48:58
  accept the bad days, you know, with greater salt and get on.
• 49:01
  So that's so important, keeping data. I think, I think.
• 49:05
  In a realistic world, some clients, and again, I imagine Israel wants to do
• 49:09
  this all by himself because it costs.
• 49:10
  We're not going to lie. And that's something I think that therapists need to
• 49:13
  be aware of is that their clients haven't got an endless amount of money.
• 49:17
  But I think it's really important in the early stages and even just once a month,
• 49:20
  depending on income, of having that professional with you, isn't it?
• 49:24
  I mean, setting you the exercise because it's easy just to go on a tangent and
• 49:28
  maybe miss what you're supposed to be doing, start getting it wrong.
• 49:32
  Long you work obviously with individuals who are
• 49:35
  ready to do what's necessary although you do get limited time with
• 49:38
  them what's some of your advice for therapists who are
• 49:41
  listening where they know the client hasn't got that much money but
• 49:44
  they want to kind of persuade them and help them realize that you
• 49:46
  do need me not just because i'm making my living believe me
• 49:49
  i've got enough clients but to help you with my reputation with you
• 49:52
  i need to see you at least what's some of the tips you've got for that it's a
• 49:55
  really good point and i'm very mindful that again even
• 49:59
  at my stage when I was working in private practice I the clinic
• 50:02
  that I worked for charging 72 pounds an hour and
• 50:06
  I thought like I if I was paying 72 pounds an
• 50:09
  hour like which I can't necessarily afford to do regularly I want an absolute
• 50:14
  like gourmet package of care and actually sometimes then you kind of flip the
• 50:19
  old manager used to flip it the other way and kind of go well actually like
• 50:22
  a call-out charge for a plumber is 50 quid already before you even start doing
• 50:26
  anything like Like you're doing a really skilled,
• 50:29
  really sort of niche role, which can have a huge impact in people's lives.
• 50:34
  But you're absolutely right. I think...
• 50:37
  What were some of the ways that I think what I, some of the areas,
• 50:40
  if we go down that way that I used to go down was probably assume that people,
• 50:44
  when they come to private practice or they come and see you,
• 50:46
  they aren't getting some hands-on treatment in the NHS.
• 50:49
  So therefore you have to do hands-on treatment.
• 50:52
  But actually I think as time goes on, people just want a really direct message
• 50:57
  and guidance on what they need to do and have goals and targets that they need to hit and
• 51:03
  actually being empowered to make sure that they are listened to, as you said.
• 51:07
  So I think Mike James talks quite a lot about it being a total waste of time
• 51:12
  if you make this gourmet rehab plan and no one does it.
• 51:16
  If someone's only got time to do two exercises, then give them two exercises
• 51:21
  and just go with what are the two hardest hitting exercises that you can possibly give them.
• 51:27
  Because if you give them five or three, they ain't going to do any of the other ones.
• 51:31
  So So I think just understanding their demands and what they are actually willing to put into this.
• 51:37
  So you feel like you've created a little bit of an alliance with them and you're
• 51:40
  working with them rather than just dictating, well, I've worked with X,
• 51:44
  Y, Z athlete and blah, blah, blah, that this is how they've done it.
• 51:47
  The reality is, is people have full time jobs, probably got kids,
• 51:51
  probably got other stresses or the hobbies, things that they want to do.
• 51:54
  So how are you going to fit that in and where are you going to slot it in?
• 51:57
  And then the other one is kind of the Tom Goom effect, isn't it,
• 52:00
  where you should actually do one of the rehab programs that you've delivered
• 52:03
  to one of your athletes and just kind of realize that it's an hour and a half.
• 52:08
  So how the F are they going to fit an hour and a half into whatever.
• 52:11
  But yeah, I think it's just something that actually kind of talking through
• 52:16
  the journey of this is where we're going to begin.
• 52:18
  If it's something like an ACL, usually it's about 12 months for where we are.
• 52:23
  It might take you 18 months but actually these are some of the markers that
• 52:27
  we'd like to hit these are the common points that we generally test that you
• 52:32
  can depending on how motivated how much.
• 52:36
  Cash they have how much availability they have is something that you
• 52:39
  can't control really but how much are they willing to invest
• 52:42
  into you and the journey is really
• 52:45
  important and i think i used to see it the other way going oh
• 52:48
  my god i'm gonna have to try and ram as much in this person doesn't
• 52:51
  look like they've got much money so actually i'm going to
• 52:54
  tell them to come back in a month rather than just
• 52:57
  saying actually my recommendation would be
• 53:00
  that you come back in two weeks we reassess
• 53:04
  where you are with things hopefully you've smashed everything
• 53:07
  that we've done and we get to kick you on to the next level and
• 53:11
  if you're struggling or you're not really progressing as
• 53:14
  well as we'd hoped then we'll address that well maybe we'll vary things
• 53:17
  i mean some people will message their patients and clients
• 53:20
  and things in between sessions i mean
• 53:23
  i didn't used to just because it was sort of a full clinic and i didn't
• 53:26
  have time but again if you've got little touch points or emails that
• 53:29
  allocate a morning to kind of just drop in and say
• 53:32
  please let me know how you're getting on I know there's clever apps isn't
• 53:35
  there that kind of say when people are
• 53:38
  doing exercises what they've done I think half the time people lie they'll
• 53:41
  be sitting watching Netflix and filling in there and
• 53:44
  I've done 12 reps of this and three sets of that but I'm a bit of a skeptic
• 53:49
  I don't often trust the the athletes it's probably just the the world I work
• 53:52
  in because yeah as you say as I think we've mentioned offline they'll say they're
• 53:56
  fine say they're ready to go on the mat say they've done all this training but
• 53:59
  when you actually sort of test them and get into the kind of.
• 54:04
  Nitty-gritty of it, they're quite a long way off.
• 54:07
  That's true. But again, that's the experience of knowing humans and understanding
• 54:09
  and doing the routine yourself.
• 54:11
  But yes, so important to have markers, like you say, and breaking that.
• 54:14
  What could indeed be months if it's some kind of tendon repair and it could
• 54:19
  be they need those mini goals, don't they?
• 54:21
  Right, I've achieved this. Fantastic. Well done. Let's do the next one.
• 54:24
  And I think speaking from, you know, personally, if you do achieve these mini
• 54:29
  goals, then you'll find that 60, 70 quid from somewhere because you can see your progress.
• 54:34
  Actually realize how you know health especially if it's
• 54:37
  your identity it's your life it's something you really need you'll find money
• 54:40
  to do that and i don't know you'll have three less takeaways or
• 54:43
  something in the next four months and suddenly you've got 100 quick you
• 54:46
  know it's like there's always ways cut back on your lattes every day
• 54:49
  there is ways isn't it but that's up to us and i love that
• 54:52
  i love the way that therapists and this may be listeners out
• 54:55
  there sometimes you probably especially less experienced therapists will
• 54:59
  blame their patients oh i gave them a great program they didn't do
• 55:01
  it you know and then they wonder why they're still hurting and we put
• 55:04
  the blame onto them and really as you
• 55:07
  get a bit older experience you realize they didn't do
• 55:10
  the exercises what did i do wrong why didn't they do
• 55:13
  them you know and i think that's a really important lesson and
• 55:16
  if people aren't doing the exercises and following the routine you
• 55:19
  give them yeah it's fascinating actually because yeah i've just invested
• 55:23
  in a monthly touching with a sports therapist actually who's brilliant down
• 55:27
  here in birmingham because i need the accountability ability on actually making
• 55:32
  sure that my lower back does not seize up to high heaven with all the carrying
• 55:37
  and lifting of little ones and driving into works and all that kind of thing.
• 55:40
  And actually it's been brilliant, but my, this is the classic version of me.
• 55:44
  He gave me one hip flexor stretch to do, which is a really nice one.
• 55:49
  Hadn't seen it done before, really targeted exactly what I was doing.
• 55:52
  I felt fantastic afterwards, but.
• 55:55
  And two weeks went by and I hadn't done that stretch once. And I'm like,
• 55:58
  basically that raise, he gave me one to do.
• 56:01
  And I think it's just madness that, yeah, he gave me one exercise,
• 56:06
  which is probably the absolute creme de la creme response, the thing which helps the most.
• 56:11
  But now the back pain's creeping back. I'm now doing it religiously. Can you go in?
• 56:15
  Because we played football today and my back is now tight as a drum again.
• 56:20
  Why do you think you didn't do it? Why didn't I do it?
• 56:23
  Yeah. yeah honestly just just kind of got in the way and then he kind of went
• 56:27
  right well yeah you're up at six with the little man and then you kind of go
• 56:31
  right let's get his breakfast out the house by,
• 56:33
  sort of quarter past seven drop him off at school at quarter to eight and then
• 56:37
  you pick him up on the other side you're back in and then classic kind of rat
• 56:40
  race but brutally honestly could i have done those things at work 100 like even
• 56:46
  if i was watching someone doing some exercises i would
• 56:49
  have gone why don't i just do it now so that's now what i do and i used
• 56:53
  to find i just just if i'm if i had to do some rehab i would just magically
• 56:56
  decide that i know i know exercise you need to do talk to my client i'll do
• 57:00
  it with you and just make sure that they're doing your rehab program you know
• 57:03
  they'll probably get better as well we all know according to greg layman you
• 57:06
  can do any exercises you'll get better eventually so you can ask yeah give people
• 57:09
  your rehab rotation program it's fine.
• 57:13
  It's uh it's that went very quickly didn't it one minute to nine i wanted
• 57:16
  to touch as well on on mistakes people make in
• 57:19
  thinking i've got the strength i've got the endurance let's go straight back
• 57:22
  to the rugby pitch or something because you mentioned this word chaos
• 57:25
  and that's something which i think a lot of listeners might
• 57:28
  be missing from the rehab program just briefly if it's okay with you
• 57:31
  if you've got the time what are some ways you create or first
• 57:34
  just gives an idea what chaos and neuromuscular preparation is
• 57:37
  and how do you recreate that as part of a rehab program that yeah
• 57:40
  so i mean this is very dependent on what sport you're
• 57:43
  doing and what position you are and where you play and all that
• 57:46
  kind of thing but what i think you try to do in rehab
• 57:49
  is during the latter stages in particular it's great if you've got a theme that
• 57:54
  goes through like if they play ball sports you try and incorporate ball as quick
• 57:58
  as possible if they can't move around very much you still have the skill sort
• 58:02
  of acquisition bits that kicked in but it might be in sitting but But yeah, in the latter stages,
• 58:07
  I think this is brilliant for creativity and keeping you interested in what you're doing.
• 58:11
  And if you don't, normally what you'll do is understand someone's sport and
• 58:15
  what their demands are, but ask the individual.
• 58:18
  Ask the coaches, do a little bit of research behind the scenes,
• 58:22
  maybe watch some YouTube clips on whatever it happens, and then start to think
• 58:25
  about ways to recreate a training environment without as many variables,
• 58:31
  and then sort of gradually incrementally introduce
• 58:34
  people who are maybe going 25 percent 50
• 58:37
  percent 75 percent 100 percent all in intensity
• 58:41
  wise velocity wise so they start to get a gradual feel of getting back into
• 58:46
  it they build confidence they don't get re-injured so give us an idea with judo
• 58:50
  because judo is obviously just one-on-one so you haven't got to watch the whole
• 58:53
  pitch for people suddenly coming in you know across the other side and driving
• 58:57
  into attacking you but when you've got
• 58:59
  a one-on-one judo and you want to take out some of the variables how could you
• 59:02
  regress it so you're still challenging some of that reaction time but not actually going full in.
• 59:07
  Yeah. So, I mean, some of the things that we'll do, we'll do quite a lot of
• 59:09
  shadow work with them. So you'll have two people sort of facing each other.
• 59:13
  They might be holding on to each other, but one sort of the attacker,
• 59:16
  if you like, trying to escape.
• 59:17
  The other one's a defender and they're almost trying to shadow each other wherever
• 59:20
  they go. And that might be forwards, backwards, front, back.
• 59:22
  And then basically gradually just build that into, right, well,
• 59:25
  actually you're starting to add little pulls and rotations onto them as they
• 59:28
  try and sort of almost mirror you.
• 59:31
  And it's all very reactive. so the person is being rehabbed
• 59:34
  it's just reacting according to which way they're pulled rather than safely
• 59:38
  doing 10 repetitions or something yeah yeah exactly
• 59:41
  so they do these sort of bizarre little dances around the mat and
• 59:43
  things as well and they sort of turn in and we've got
• 59:46
  sort of bands to do the almost
• 59:50
  mimic the positions that they go into as they're sort of turning and throw
• 59:53
  in and we get them to throw dummies and things like that but
• 59:56
  yeah it's better if you've got someone with them and they as i say they
• 59:58
  sort of pair up they do these little dances they turn in they might
• 1:00:01
  just lift up somebody for a throw rather than kind of going all
• 1:00:04
  in and then they have something called sort of open randori
• 1:00:07
  and grip fighting which is where it starts the intensity starts
• 1:00:10
  to kind of really ramp up quite a lot but open randori is very much randori
• 1:00:15
  for anyone doesn't know is sort of that just free flying fighting competition
• 1:00:20
  that they have open randori seems to be a little bit more we call it like a
• 1:00:25
  gentleman's agreement so you're basically fighting the other opponent,
• 1:00:28
  but if someone goes to throw,
• 1:00:32
  that opponent allows that person to throw them.
• 1:00:35
  So they don't resist it. They don't kind of lock in and try and prevent that movement.
• 1:00:39
  If they've kind of earned the right to throw, they go with it.
• 1:00:43
  So they're getting a lot of intensity.
• 1:00:45
  You sometimes might get them to do 30 seconds of just literally gripping and
• 1:00:48
  then almost like whistle goes, it's gone live.
• 1:00:51
  And then yeah, whoever sort of gets into a position where they're going to attack and throw. Yeah.
• 1:00:56
  The other person sort of allows them to do that. So they're getting a lot of
• 1:00:59
  stimulus, the feel of the mat, the feel of moving around.
• 1:01:02
  It's competitive, but it's still
• 1:01:04
  got that little out channel that you sort of have an escape route of.
• 1:01:08
  You're not going to really injure yourself as long as you're with someone of that level.
• 1:01:12
  We've got lots of weight categories as well. So, I mean, you could chuck someone
• 1:01:17
  who's a lighter weight with someone who's a little bit heavier to start with, which is quite nice.
• 1:01:22
  In sort of football or rugby worlds I've been, and you can kind of get into
• 1:01:26
  play with the academy for a little bit or sort of pick and choose key people
• 1:01:29
  who you know are maybe not as athletic or as intense.
• 1:01:33
  On that, I would be very careful who you pick. I remember I used to work in rugby.
• 1:01:37
  I remember doing a bit of tackle sort of reintroduction stuff.
• 1:01:40
  So we just had like a five-meter channel really where you had an attacker at
• 1:01:44
  one end, you throw the ball to the attacker and their job was to try and get
• 1:01:47
  past the defender, however they may do.
• 1:01:51
  So they're starting to work on reactivity, acceleration
• 1:01:54
  deceleration reading the game almost like doing little steps
• 1:01:57
  but actually the the rule was
• 1:02:00
  that almost in gladiator style you just almost kind of gauntlet them
• 1:02:03
  hold them and then take them to the ground but god
• 1:02:06
  i remember this scottish international absolutely melting this
• 1:02:10
  guy who came back from a fracture dislocated ankle
• 1:02:13
  and he was just starting to build that up and he literally came flying
• 1:02:17
  in even though he'd been told all i want you to do is do
• 1:02:20
  a really kind of gauntlety version blocking
• 1:02:23
  him more than tackling he literally almost like speared him
• 1:02:26
  into the ground you know you're like come on help
• 1:02:30
  me out here we're trying to build his confidence getting back into
• 1:02:33
  a little bit of this and literally did it again then we
• 1:02:36
  had to abandon it because some of these individuals will only be 100 they have
• 1:02:40
  no filter of anything less than so do be very careful who you picked as your
• 1:02:46
  sort of little training rehab partners and things but But people put bibs and
• 1:02:50
  things on people to try and look after them. I had never found that worked in rugby.
• 1:02:53
  Everyone just got smashed no matter what they were wearing.
• 1:02:56
  But yeah, I think it's just almost try best you possibly can to recreate some of those positions.
• 1:03:02
  If you have to grab someone and just almost get them to mimic a certain movement
• 1:03:06
  and then put it into a sort of a live scenario, would be great.
• 1:03:10
  But yeah, feel free to ask people, what is it that you do in your position?
• 1:03:14
  What are you a little bit apprehensive about? about have you
• 1:03:16
  got certain scenarios that i'm not aware of and
• 1:03:19
  how can we mimic that scenario so you drill that until
• 1:03:23
  you are feeling much more confident yeah so that's interesting this is to a
• 1:03:27
  certain degree the therapist as long as they've got insurance could and who
• 1:03:31
  they're working with but they could work with that person to recreate some of
• 1:03:34
  that reactivity because it's always part of there's often a fear isn't it if
• 1:03:37
  you don't do the sport that your client does you're like Am I going to help you?
• 1:03:41
  But just talk to them and mimic it and force them basically to react in the
• 1:03:46
  same way they would have to on the pitch.
• 1:03:48
  But again, I think this is where, again, at the later stages.
• 1:03:52
  People who are injured and coming back will need to work with you and
• 1:03:56
  it may even be you going to their place of sport
• 1:04:00
  and having a look what's going on and then organize a program
• 1:04:03
  or something according to what you see and that sort of stuff so rather than
• 1:04:06
  again just thinking right they've walked out of my cleaning room now that's
• 1:04:10
  it good luck see you later send me some photos there's so much more isn't there
• 1:04:13
  to do otherwise yeah and it's amazing how open everybody is i mean judo is a
• 1:04:17
  bit unique isn't it but people love teaching you about the sport they love as well which is
• 1:04:22
  really nice so yeah ask questions a really
• 1:04:25
  good point yeah about sort of if if you aren't
• 1:04:28
  sure of how they're going to reintegrate back into a
• 1:04:32
  session at training or something if you were to offer to
• 1:04:35
  go down and watch that or chat to
• 1:04:37
  the coach beforehand about what elements training
• 1:04:40
  looks like it's a really useful educational piece and who
• 1:04:44
  knows what sort of opportunities and things exactly really
• 1:04:47
  and you're probably going to be doing more than a
• 1:04:50
  lot of the other therapists in your region and area just doing that little
• 1:04:53
  bit extra which is great but you're going
• 1:04:56
  to cherry pick your your juicy ones who people you actually like
• 1:04:59
  and care about of course yeah yeah if they deserve it obviously that's
• 1:05:02
  the caveat for this if they deserve it brilliant and then just finally is there's
• 1:05:07
  always going to be variance amongst physios or sports therapists whatever person
• 1:05:12
  you go and see so how do you because i mean for example with israel you know
• 1:05:17
  There's reported to me, and according to him.
• 1:05:20
  There's GPs you've seen who have basically said, never, you can't do chips over
• 1:05:25
  again without really doing more than a 15-minute chat.
• 1:05:28
  Definitely didn't go down to the mat and watch him for a while.
• 1:05:31
  There's been physios as well who have said, no, just stay out of the gym.
• 1:05:34
  And again, they haven't really assessed much.
• 1:05:37
  So there's, how do clients, how do people out there,
• 1:05:42
  Actually, people listen to this at third place. How do they advertise their
• 1:05:45
  services so that people know that they are in the know, that they have done
• 1:05:49
  your courses, that they're going to give what you need, as opposed to some of
• 1:05:53
  the mainstream people who have all the best intentions in the world,
• 1:05:56
  but they just haven't got the education?
• 1:05:58
  How do you advertise that on your website to make people realize, I'm your man, but won't?
• 1:06:02
  Yeah, I mean, I think qualifications are obviously things that you can have
• 1:06:06
  on there, you know, your kind of letters and what you've done,
• 1:06:08
  who you've worked with, what your experiences are all sound quite nice.
• 1:06:12
  I mean, I think on that, like even when I probably learned more sometimes at
• 1:06:16
  sort of lower levels than I did when I went to kind of elite level.
• 1:06:19
  So it's not the prestige that you have to have, but that definitely stands out more on a website.
• 1:06:23
  So if you're not at a top premiership club or you're sort of in a division two,
• 1:06:29
  three kind of territory or even sort of lower levels than that,
• 1:06:32
  then you can still learn absolutely tons. And it's worth putting on there what you've been doing. it.
• 1:06:37
  There are loads of courses and things out there that you can kind of upskill
• 1:06:40
  with and add your certificates on. A little plug for Grow Physio Academy.
• 1:06:43
  Obviously, you can kind of go on there, get your certificates.
• 1:06:45
  Once you complete a course and do the exam,
• 1:06:48
  a little short quiz at the end, then you'll get a certificate that says you've
• 1:06:51
  got your certification in injury reduction strategies or Achilles management
• 1:06:56
  or ACL management, whatever it may be.
• 1:06:59
  I think if you have a particular niche that you really like or different sports
• 1:07:05
  that you've worked with.
• 1:07:06
  It's amazing, particularly with surgeons, if they, like we've got surgeons that
• 1:07:11
  we use in premiership rugby, or there's ones who are used for football.
• 1:07:15
  And as soon as they establish this name of, wow, they've done such and such
• 1:07:20
  as, or they are a specific sport related surgeon.
• 1:07:25
  Personally, I think the surgeries by and large, pretty much the same across the board.
• 1:07:29
  Like There's some who are obviously at the top of their game and have little
• 1:07:33
  slight differences that they do, like they might add a little tenodesis or something
• 1:07:36
  in like that or understand a sport a little bit more.
• 1:07:40
  But how that is totally understood when you're digging around in someone's knee or whatever it is.
• 1:07:46
  I think there's probably some little changes and some little amendments,
• 1:07:50
  but it's amazing how much power that has if you sort of associate yourself with
• 1:07:55
  being a mixed martial art or a rugby or a football relator, or you've got a
• 1:08:00
  niche, like, I don't know, even just sort of saying on my, I only saw one,
• 1:08:04
  but kind of managed probably one of the worst ankles I've ever managed in sport back to GB handball.
• 1:08:09
  And I'd never ever worked with handball people before, but actually I feel so
• 1:08:14
  much more competent, to understanding the game, the demands, the positions.
• 1:08:18
  And I actually went to, took my little boy to watch a couple of the games when
• 1:08:22
  she returned back into sport.
• 1:08:24
  And again, it was sort of lovely to see that end product and her come and celebrate
• 1:08:28
  sort of afterwards and make a big deal out of my little boy.
• 1:08:32
  Do you know what I mean? At the end, which was really nice and sort of,
• 1:08:34
  yeah, sometimes being part of that journey, you just build up such a close relationship
• 1:08:39
  with people that actually it doesn't feel like it's work or extra stuff.
• 1:08:43
  Off it's something you'd like to do and go and support them with so yeah i'd
• 1:08:47
  probably just list the sports and things that you've kind of done what certificates
• 1:08:51
  and things you've maybe done.
• 1:08:53
  That's a good idea make it personal your website so people can
• 1:08:55
  see that you are inactive you're educating yourself and yeah like you said stories
• 1:09:00
  of where you've you've nursed a athlete back to health worked with them and
• 1:09:04
  then photos of the success of stuff it's all very good take stupid photos with
• 1:09:08
  olivia with five yeah yeah judicates what they're called judicates Judokas, they're called.
• 1:09:14
  Judokas, without an N at the end. Yeah, Judokas, yeah. That would be good for your website.
• 1:09:18
  Yeah, it's really important because I think taking photos and almost capturing
• 1:09:23
  that moment, it seems a bit cringe at the time.
• 1:09:25
  But, yeah, I'm just looking down at my little sign, that they all were going
• 1:09:29
  to put on, which one day I'll get framed and probably put in,
• 1:09:33
  like, my little man cave somewhere.
• 1:09:35
  Or really nice things to kind of keep in cherished. Yeah, definitely.
• 1:09:39
  Excellent. Right. I've already kept you for longer than I told you I was going
• 1:09:43
  to. So thank you so much for joining us, Steve. Really, really appreciate it.
• 1:09:45
  Gary Benson here as well. Thank you for sharing your knowledge,
• 1:09:48
  says Gary, and expertise.
• 1:09:49
  Steve, look forward to catching up at Therapy Expo, which is only like end of
• 1:09:52
  November, isn't it? That's scary. That's coming around very quickly.
• 1:09:55
  But yeah, I mean, actually, that's that wasn't a that's a nice segue, actually, people.
• 1:09:59
  You know, if you I would these days align yourself really with Therapy Expo
• 1:10:03
  and make a sing and dance about that,
• 1:10:05
  because the quality of speakers there these days really
• 1:10:08
  are on the large exceptional because now
• 1:10:12
  for the last three years there's been a they've been
• 1:10:15
  asking people like the sta people around ca from
• 1:10:18
  the school and people are in the industry to actually recommend speakers as
• 1:10:21
  opposed to just picking back the hat sort of thing or so it's
• 1:10:24
  a really high level there so anybody who is aligning
• 1:10:27
  themselves with them and talking about who they're seeing they will be getting quality
• 1:10:30
  information so including steve who's
• 1:10:33
  going to be there as well talking about i believe this kind
• 1:10:36
  of topic yeah about return to sport and markers and things but
• 1:10:39
  um yeah fantastic be nice to have some videos to show you now with all the protocols
• 1:10:44
  and things on of what some of these tests are because if you aren't familiar
• 1:10:47
  with them it's quite hard to know exactly and describe so yeah and please bring
• 1:10:53
  questions it's probably the best bit isn't it if you've got scenarios or anything
• 1:10:57
  you want to contact me about then please do fantastic and
• 1:11:00
  thank you everyone who joined us live thank you for the questions everybody who came along
• 1:11:03
  if you listen to the podcast you do fancy joining us live but like i say eight o'clock
• 1:11:06
  on a tuesday normally on either youtube sports therapy association youtube channel
• 1:11:11
  or if you prefer our facebook sports therapy association facebook page speaking
• 1:11:14
  of which next tuesday eight o'clock which is going to be july the 30th depending
• 1:11:18
  when you're listening to this do come along come along live it's going to be
• 1:11:22
  important on one next week live, STA 208.
• 1:11:24
  We'll be talking about statutory regulation for sports therapists,
• 1:11:27
  question mark, with Gary Benson, founder of the STA and also Ana Maria Razzieri
• 1:11:30
  from the ST School, because we're going to be chewing over and talking about the pros and the cons.
• 1:11:35
  And also what we really want to do is address some of the common beliefs and
• 1:11:39
  reasons which are given.
• 1:11:40
  And we may reinforce them, we may challenge them, we may give a little bit of
• 1:11:44
  information, a bit of history, a bit of perspective, which might change your mind.
• 1:11:49
  It might, yeah, it might sway you, which is always is the most exciting thing
• 1:11:52
  about debate isn't it being open to actually changing your mind
• 1:11:55
  adjusting your position so there are going to be some social
• 1:11:58
  media posts about statutory regulation a
• 1:12:01
  little bit about history about the latest things that have been released and
• 1:12:03
  talked about and we want to hear you in the comments about why you think it
• 1:12:07
  would be a good idea if we had statutory regulation why you think it might be
• 1:12:10
  a good idea and so on so do please if you listen to the podcast or you join
• 1:12:14
  us this evening then do try and contribute to those comments so we can use them next week.
• 1:12:19
  Otherwise, you're just going to listen to us be talking, and it'd be far more
• 1:12:21
  interesting if we had your input as well.
• 1:12:24
  That's it. So once again, thanks to Steve Miller of Grow Physio.
• 1:12:28
  And if you want to go to the website, it's growphysioacademy.com.
• 1:12:32
  And if you are interested in the course, people, then there's one tomorrow night
• 1:12:35
  on Achilles tendinopathies with an STA discount, go to the member area.
• 1:12:39
  But there's plenty and plenty of courses on the website there,
• 1:12:42
  which I would recommend you have a little look through and decide what could
• 1:12:45
  work for you and your target audience.
• 1:12:47
  Thanks, everyone. Steve, thanks once again. Thanks so much for having me.
• 1:12:51
  And yeah, congrats on doing an amazing job and thanks for hosting like a very
• 1:12:54
  nice problem like you're on your 207th I know 207 fantastic thanks everyone
• 1:13:00
  take care and hopefully we'll see some of you for the next.
• 1:13:06
  Music.