Latest / The STA Clinician Podcast / Ep230: ‘Developing Female Athletes: Women Are Not Small Men’ with special guest Dr Gemma Parry

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Ep230: ‘Developing Female Athletes: Women Are Not Small Men’ with special guest Dr Gemma Parry · The STA Clinician Podcast

• 0:00
  You're listening to the Sports Therapy Association podcast, putting evidence
• 0:04
  back into soft tissue therapy.
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  Music.
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  And we're live. Thank you, Bill. Welcome to episode 230 of the Sports Therapy
• 0:22
  Association podcast. My name is Matt Phillips, creator of runchatlive.com.
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  And as always, this episode is being recorded live at 8 p.m.
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  On a Tuesday evening on the Sports Therapy Association YouTube channel and the
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  Sports Therapy Association Facebook page.
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  We have arrived at the final part
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  of a fantastic month. A focus on women's health, four amazing episodes.
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  And with us very shortly in this episode, entitled Developing Female Athletes,
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  Women Are Not Small Men, will be special guest, Dr.
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  Gemma Parry, a former specialist and research associate at the University of Bath.
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  I can say Bath because she said Bath. My wife's a wig and so it's Bath.
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  I'm also known as Bath to those of you south of Watford. So really excited about
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  that. It's going to be a combination of three amazing episodes.
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  And before we continue, I really should say thank you very much to last week's
• 1:12
  guest in part three, who was Michelle Lyons from CelebrateMoodlyEbrity.com.
• 1:18
  She gave us a fantastic hour hugely informative about
• 1:21
  pregnancy related back and pelvic girdle pain if
• 1:25
  you haven't listened to that then i recommend you listen to all
• 1:28
  229 episodes but particularly listen to last week's
• 1:31
  and make sure you check out celebratemoobliberty.com for
• 1:34
  details about michelle's courses as well
• 1:36
  as the facebook page and instagram account michelle lions underscore moobliberty
• 1:40
  if you're an sta member bear in mind michelle offers
• 1:43
  generous discounts on all of her women's health courses and she's such an enigmatic
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  beautiful person as well i really recommend you check some of that out if you're
• 1:49
  interested in women's health covers everything you could be interested about
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  so do and if there's something particularly which she will refer you on gladly
• 1:56
  to another specialist that she will do so if you're interested in those codes
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  and make sure as always you check out the sta members area,
• 2:02
  up-and-coming cpd details and codes people
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  are flocking in tonight into the live lounge i must say if you listen to the
• 2:08
  podcast then what you can do is join us live and then you can come and give
• 2:13
  comments and questions on the screen for example cecily says sorry to spoil
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  the party gents why is there was something going on cecily before i got here
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  what's all that about oh i see gary and sir glenn sir glenn murphy were here
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  first through the door first of all that's fine.
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  Sarah jones is here as well says evening all wonderful sarah jones from the st school Paul.
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  Gary Benson is obviously founder of the STA. So if you've got any questions
• 2:35
  about that, then make sure you ask him in the comments whilst he's here.
• 2:39
  Gary says, our regional conference in Paul Dorset has sold out already.
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  There we go. We're already starting the few of missing out now,
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  but we are searching for a larger venue.
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  We also have plans for Exeter and Ludlow TBC.
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  Cliffhanger. Thanks, Gary, for that. Amazing hook.
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  Sarah Jones says, are you a posh Cornish local?
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  There will be little sidelines of communication going on
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  there's another reason to come enjoy this live if you want to on a tuesday eight
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  o'clock fantastic thanks for joining us live people really appreciate
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  it as i also mentioned last week if you are interested in women's health then
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  the wonderful wist women in sports therapy team are delivering a four-part menopause
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  cpd series the first one as i announced last week is on wednesday the 19th at
• 3:23
  seven o'clock with the wonderful sarah packard focusing on perimenopause and menopause,
• 3:26
  identifying how hormones change and symptoms that may present.
• 3:31
  A bit more formal for you because that part one's now totally full,
• 3:34
  I'm afraid, so you won't be able to get that.
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  But all the more reason to make sure that you do follow UK underscore WIST on
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  social media for details, any of the next three parts to avoid disappointment
• 3:45
  like the one I've just hit you with.
• 3:46
  And they're free to STA members, another huge bonus for being an STA member.
• 3:51
  If you're not an STA member for some strange reason, then you can pay £15 if you wish.
• 3:55
  But really, if you become an STA member, I'm pretty sure if I do my calculations
• 3:58
  right, it's going to be cheaper than paying full four.
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  It will be. So there you go. Really looking forward to that.
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  And well done, WISTE, for putting such great stuff together.
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  Right, I have left Dr Gemma Parry for long enough down in the depths of the lobby below.
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  So sit back people and as always if you've joined us live then do take this
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  opportunity, it's a wonderful opportunity to ask our guest questions direct.
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  And that's about it, so here we go. We'll start episode 230,
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  Developing Female Athletes, Women Are Not Small Men, with special guest,
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  performance specialist, Dr Gemma Parry.
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  Hey Gemma, how are you doing? Hi, evening. I'm well, thank you. Thank you for having me.
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  I'm done. My pleasure. I'm sorry that I left you down there for so long,
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  just had a little bit to get through. But it's all good.
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  It's all very interesting stuff. And I'm doubly sorry to leave you down there
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  because I have been hounding you via Facebook, via emails.
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  You're a very busy person, it
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  seems. So I double appreciate you giving up your time to be here tonight.
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  No, it's great. And thanks for everyone for joining us. And it's really nice
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  to speak to people about something I'm hugely passionate about as well.
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  Amazing. And your name, I mean, some people will recognize your
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  name from therapy expo you're one
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  of the many people um who were suggested
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  is coming on the show people really enjoyed which we're going to talk about your
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  presentation from last year a little bit later on and so
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  it's great it's all about collaboration people saying what you like and who
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  you want to see so for people who don't know you i know this is difficult especially
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  with the amount of experience you've got you can spend an hour just talking
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  about the different teams you've looked after at all levels but how did dr jemma
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  Parry become what Dr Gerard Parry is today?
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  I think by complete accident to be honest I always
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  sort of joke to students when I talk to them about the 20 year
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  overnight success so I am
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  dual qualified so I started off in sports and rehabilitation first and
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  then I sort of transitioned into physiotherapy for various
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  reasons of what a lot of people do and then just sort of
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  started on that journey around NHS work and
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  then into sports and academies I spent a lot of time in Olympic sport
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  and Paralympic sport is probably where I spent the
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  last decade really and then sort of moved into
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  teaching and research so I didn't really
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  necessarily have a plan I've just been curious about opportunity and
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  I guess things that have come into my path that have sparked
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  interest um around passions that's kind of
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  what's driven me to get to where I am now and I
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  mean you kind of like to mention I've done a little bit of a yeah
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  kind of Olympics and Paralympic programs and stuff if i just
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  kind of give a listeners an idea i'll just say some sports
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  you've been involved in correct me if i'm wrong and there's probably more to add to
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  the list but you've been involved you were lead physio uh gb short track speed
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  skating 2018 european youth olympic festival in finland winter olympics wheelchair
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  basketball team and you've also been involved in gb boxing football raw ballet soccer schools,
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  huge variety of sports yeah I think I'm what's known as a specialized generalist.
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  Yeah definitely transitioned through but that's what
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  I like and I think it's the variety of experiences that have
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  actually definitely contributed to where I am and
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  what I'm doing in my career it's I know some practitioners like to move into
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  I'm definitely going to work in football my whole life and that's what I want
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  and that's fine but for me I never had one sport or one sort of experience that
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  I particularly wanted to be attached to so it's definitely that generalism that
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  has allowed me to get to this point and that curiosity around lots of different things.
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  And was a lot of that across the various teams with able-bodied athletes and
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  disabled athletes, was a lot of that working with female athletes or was it
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  depending on what you're doing at the time?
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  So interestingly, I've noticed probably a bit of a change in the last 10 years.
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  And I think when I started out, the sort of opportunities that were available
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  to me were predominantly in male-based sports.
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  We've definitely seen a change in the women's sports environment.
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  And I think it's, I read a statistic last year that Deloitte's were estimating
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  that, I think it's the first time that women's sport was going to surpass something
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  like $1 billion in global revenue.
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  So we've definitely seen that explosion for women's sports. So for me early
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  on, I'd say it was male-dominated because those opportunities and the value
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  placed on women maybe wasn't what it is now.
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  And then as I transitioned into Olympic sport definitely started to see a lot
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  more we have a generally tend to have a lot more parity around games and certainly
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  Paris last year was the first Olympics where we had more female athletes presence
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  than we did men so I'd say yeah that's a part of career bit more of an even opportunity,
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  That's really interesting. So I suppose that experience in itself encouraged
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  you to think, oh, why have we
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  got, you know, dominance of why am I supporting so many male teams here?
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  Oh, there's not many female teams. And then you've managed to see that evolve.
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  What about, has it also influenced you with regards to what we're talking about
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  tonight, as in female athletes being treated kind of like small male athletes?
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  Have you seen that happening amongst coaches and things like that?
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  So I think what's really interesting is when I sort of sit and look back on my
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  career and you know I completed my PhD a couple years ago that sort
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  of started a really big reflection point in my life and a lot of people I think
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  when you're an undergrad don't necessarily like research research methods it's
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  all a bit of an area where you wouldn't naturally go into or don't feel passionate
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  about so I think my own journey with research I was tasked with a project when
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  I worked at GB Boxing so one of my main roles there was to provide research
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  information opportunity.
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  And that's when I really started to look about what literature
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  says to what's relevant in practice and I think we
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  always sort of come around these discussions about being
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  evidence-based practitioners but also there's
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  that practice-based evidence that I think has equal and
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  important value but maybe doesn't get the recognition that it deserves
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  and when I think about it and sit about it in that domain that's
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  when I started to become really interested in around well we look
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  at musculoskeletal profiling and our monitoring in a certain way
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  but there is the critical mass of literature is actually
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  done on caucasian male and then we sort of seem to want to take that and actually
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  just transfer it into women and we're expecting sort of the same or similar
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  outcomes and it's actually really not and what i'm sort of hoping the research
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  is going to take the direction of now is starting to move towards we see a lot
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  of research comparing men against women.
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  And children against adults. And actually, what's probably really interesting
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  is starting to look at those questions from the view of, why don't we compare
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  women that get injured with women that don't?
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  So rather than comparing those apples and pears, actually, what are we looking
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  within the populations that we're really interested in supporting?
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  And that's definitely what I saw through the adolescent space and the adolescent
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  sector as well, is everything that we learn in adults, we then just sort of
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  try and distill that down into putting that into what we see in our young people.
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  And again, thinking about the journey that you go through through an adolescent
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  growth spurt, there's lots of different things and changes that happen at that
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  point that can really skew what it is that you're seeing as a practitioner.
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  So then when you're trying to figure out what to do with that and how best to
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  support the people you're working with, you're sometimes not inferring the things
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  that you think that you are.
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  Amazing. I mean, this is going to be a difficult question for you, but maybe it's not.
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  Is there an example of something which has been taken from research done on
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  males, which is, has caused like something ridiculous being or an absence of
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  information for female athletes?
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  Can you think of any examples or areas where we've missed opportunities of helping
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  developing athletes, female athletes?
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  I think you could literally pick anything. Oh, really? Yeah.
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  I think if you go into any special tests that you might want to do, so I don't know,
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  like prelim special tests, knee special tests, ACL tests, MCL tests,
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  the vast majority of those tests, like I said, have been done on white male
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  subjects, but they've also kind of been designed and pioneered by a lot of white
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  male orthopaedic surgeons.
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  So again, if we think about how well we can apply that ourselves as practitioners
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  and also the populations we're working on, that's kind of the stuff that doesn't
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  always translate well through into the research.
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  Again, I think about central systems conditioning, VO2 max, all those sort of
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  things that we're looking at in terms of how that might present in male physiology,
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  we know is really different to female physiology.
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  So I think probably the easy answer to that
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  is look at the research like if you go out there
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  and you're even if you're just googling studies I think
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  there was something between like prior to COVID so again like
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  2014 to 2020 if you looked in the sports-based literature only six percent of
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  studies were done on just female cohorts so again if you're looking out there
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  for the literature it's sort of starting to change now and I think that is being
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  driven by monetization from what we're seeing in women's professional sport.
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  But similarly, a lot of research and innovation and design budgets,
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  I think there's something like 4% of R&I budgets are only recognising women-based
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  research. So we've still got loads of gaps that need to be covered.
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  So, yeah, I think you could just pick anything and find gaps very easily.
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  That's interesting. Very interesting. So, like for example, you said tests.
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  You said some of the tests are ACL and that. What's an example?
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  Is it because the norms which people give are based on, like you say,
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  white Caucasian males and we might get a different result?
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  So can you think of a concrete example or something?
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  Again, I can't see anything that I've seen in the literature recently.
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  But I think if I'm going to pick ACL, which is probably the hot button topic
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  that everybody talks about, and then trying to track and monitor menstrual cycles.
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  And we know that there's different changes in joint laxity at
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  different parts of the month we know that there's different changes in joint
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  laxity for women if they are choosing to follow pregnancy or not so again if
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  we're doing our special tests at those points what how might that interplay
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  with what we're actually seeing so what do we know that is normalized what do
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  we know that isn't normalized and I think we probably don't know I think people
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  are striving to get there,
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  that is sort of definitely sort of lacking and
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  again what I see a lot of is adolescent athletes that
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  I work with and obviously have a very big
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  interest in in that space if you don't understand
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  as a practitioner and not all of us do because it doesn't get covered at initial
• 13:52
  training what is happening to your tissue property around how a bone is developing
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  how a tendon is developing how a ligament is developing the classic example
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  is people diagnose a lot of hip flexor strains in younger children and children
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  in the growth sphere and they're actually apophysial injuries.
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  So again it's that sort of understanding that's probably the
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  most concrete example i've got in adolescence is if
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  you don't understand how your system structures and your body structures
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  are changing and kind of what that normative data is and you
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  just take an adult data set and apply that to your clinical reasoning you're
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  misdiagnosing something as a hip flexor strain when quite clearly it's something
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  that's happening at the growth plate great no great examples yeah i'm glad you
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  brought up the hip flexor because i wonder whether i mean there's there's a
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  i think certain people on Twitter, which respectfully most of us are leaving now,
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  but make some great comments on this, never the hip flexor.
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  And I remember we were talking to Holly Sopper-Doyle about hip dysplasia and she again was like.
• 14:48
  Furious where so many therapists will blame the hip flex and really that they're
• 14:51
  missing so much it's almost like diagnostic overshadowing it's just they're
• 14:54
  missing so much because they're obsessed with this hip flex and that's the root
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  of all problems and you can actually make things worse with regards to somebody
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  who might be suffering from that as well as missing the diagnosis if you're
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  focusing and trying to massage the head out of a hip flexor so.
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  Glad you brought that up fantastic so
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  yes it's a nice episode developing female athletes women are not small men
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  we've already kind of covered a lot of why we
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  use that title for tonight's episode i guess
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  we should really point out that we didn't make that
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  title up no no it's popularized
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  by dr stacy sims but interestingly enough not to put anything
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  against the great dr stacy sims who's an amazing physiologist
• 15:30
  and nutrition scientist and made that kind of she's attributed
• 15:33
  to coining that phrase but i think we have to have a shout out who um
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  i think it was it might be michelle lions who pointed this
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  out there's actually a cardiologist nieka goldberg who wrote
• 15:42
  a book back in 2002 i think which was
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  called women are not small men so really i mean respect to
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  dr stacy sims but in terms of you know where that came from in terms of on paper
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  then a cardiologist should get credit for that although obviously she was talking
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  about the heart and stacy sims has done a huge amount of work in terms of basically
• 16:02
  promoting what we're talking about tonight is she somebody that you admire and has inspired you or.
• 16:07
  Yeah, and I think what's actually really wonderful is seeing the emergence of
• 16:11
  women leading for women in our areas that we're working in.
• 16:16
  And it's really interesting what you brought up there about like an older paper
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  that was written by a cardiologist, because one of my favorite research articles
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  that I've picked up in recent times is actually it's an article from the late 1960s.
• 16:28
  And again, it's to do with the adolescent athlete is it was a paper that was
• 16:32
  written by an anatomist, car design engineer, a road traffic engineer.
• 16:37
  Expert and it was around looking at preventing road traffic accidents in children
• 16:42
  because obviously when cars changed and seatbelts changed they managed to bring
• 16:46
  seatbelts in that reduced.
• 16:48
  Sort of death and road traffic accident related injury and
• 16:50
  illness in adults but it wasn't quite having the same effect
• 16:53
  in children so these people kind of got together they looked
• 16:56
  at different proportions of the body for the child and honestly
• 16:59
  I'll try and send the article through so you can send it on to members it's fantastic when
• 17:02
  you look at the proportions of how a developing body changes
• 17:05
  and actually seatbelt design wasn't optimal
• 17:08
  for children and that was the very first paper that
• 17:11
  sort of cemented in how you could make car travel
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  safe reduce the risk of death and I think when you
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  bring people together from different sort of disciplines to kind of problem
• 17:21
  solve this the outcomes of it were actually amazing but the key thing that I
• 17:26
  took from that was that we've known since the late 60s that the environments
• 17:31
  the systems and the structures that we've designed for our young people and
• 17:34
  maybe that we design for women,
• 17:35
  we know that they need to be a bit different.
• 17:38
  And we've known that since the late 1960s, yet we're still not seeing that in
• 17:43
  our society of how it's playing out.
• 17:44
  So I think what's really interesting is when we think about how we learn and
• 17:47
  how we practice, have we actually really considered the environment and the
• 17:52
  system that we're designing for our patients that we work with?
• 17:55
  Very interesting i'd love to get a link to that i might put in the show notes
• 17:59
  because that's a great example back from the 60s of where something's designed but you're not taking,
• 18:04
  i don't want to say half the population probably is half the population but
• 18:07
  yeah a lot of the population not taking them into consideration even though
• 18:09
  you come up with this amazing idea
• 18:11
  i think we had a similar conversation about who was it with i think it was dr
• 18:15
  fiona higgs who started the women in sports therapy and team but it was about
• 18:19
  the not allowing athletes to use nsets during during sports and stuff and it
• 18:24
  was like yeah wonderful because it attacks the stomach and because it can cause
• 18:28
  intestinal problems but hold on there's a certain population of.
• 18:31
  Runners who depend on nsets to do what they do at
• 18:34
  certain times a month or whatever for whatever reason who need to take them and
• 18:37
  this decision was made i can't remember what the name of the race
• 18:40
  was now it's from in america and there was a massive protest because
• 18:43
  the decision makers were guys surprise surprise and nobody
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  had raised like you say they might have thought
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  they were multidisciplinary but they definitely weren't in the sense that because no one
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  said hold on what about female runners who depend on
• 18:55
  incense when they're doing this race to complete it and it was like a really
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  good example again right it got overturned but it's
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  the fact this decision was made without even considering the female
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  runners in it so yeah and i think what's again is
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  quite funny is we always talk about with with pride about
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  human-centric and patient-centered focus and you
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  know patients needs and considering that and
• 19:15
  what i really admire about people like face like
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  you've mentioned is the way that they champion the importance of context
• 19:21
  and there's probably no right or wrong there's you know there's going to be
• 19:24
  lots of different decisions that you make but penultimately when you are thinking
• 19:28
  about developing a female athlete and that's i guess regardless of the lifespan
• 19:32
  of their career whether they are an adolescent starting out whether they're
• 19:35
  going through to masters like that context is really important because without that.
• 19:40
  You you haven't given this holistic consideration of
• 19:43
  everything that we sort of champion as being very imperative to our profession
• 19:46
  definitely yeah i think it
• 19:49
  was from you i think it might have been therapy expert but i liked i
• 19:52
  do like words anyway but i like the distinction i think it was you actually
• 19:56
  yeah between multidisciplinary team which is a phrase which we use with pride
• 20:00
  and i come from a multidisciplinary clinic and that sort of stuff but then you
• 20:04
  kind of compare that to the word interdisciplinary team could you point out
• 20:08
  for our listeners what the idea of differentiating between those two are.
• 20:12
  Yeah. And again, like sort of people like jive me a little bit about the differences
• 20:16
  and I think they are really different because a multidisciplinary team for me
• 20:20
  just means you've got lots of different disciplines in the same room.
• 20:23
  And what that kind of does is it really...
• 20:26
  You kind of sort of still stay siloed. You're focusing on what you're offering
• 20:30
  and what you're delivering and what you're bringing to the table.
• 20:32
  When you have an interdisciplinary team, it's an acknowledgement of all that
• 20:36
  specialty, but you're working together, again, sort of in that mesh,
• 20:41
  you're working towards the directive and the goal of where you're going.
• 20:45
  So it's sort of cross siloing.
• 20:46
  So I think for me, when people say, oh, you know, I do MDT working, that's brilliant.
• 20:50
  But the secret source really sits in that interdisciplinary space,
• 20:54
  because that's where true kind of collaboration really happens so I think for
• 20:59
  me where I've seen that most recently is,
• 21:01
  the physical literacy the consensus statement which I was
• 21:04
  asked to be a part of so it was Dr Lawrence Fowether from Liverpool John
• 21:08
  Moores and some great work that was all funded sort of through
• 21:11
  Sporting and the Youth Sport Trust around how we
• 21:13
  can start defining physical literacy because there was other statements from
• 21:17
  other nations and other parts of the world but we didn't really have one in the UK
• 21:20
  so they asked me to come in as sort of an expert panel member
• 21:23
  which was brilliant and with my background in movement like it you know I thought
• 21:26
  I was going to be brilliant and really good at it and amazing and until you
• 21:30
  go in and sit around a table with other people who are as equally as knowledgeable
• 21:34
  as you and equally as passionate about the subject matter that you are but sit
• 21:39
  at it from a completely different frame that is sometimes opposing.
• 21:43
  For me that's that was true interdisciplinary working because
• 21:46
  they are going to defend their point and their opinion their point of view
• 21:49
  just as much as you are and for me that was a real
• 21:52
  challenge in terms of how I involve my sort of thinking and thoughts in that
• 21:57
  space so if ever you get a chance to debate a topic with somebody who sits outside
• 22:01
  in a different sector with you like yeah just absolutely do it because I think
• 22:04
  it does really change what you understand when you're working with sort of special populations.
• 22:10
  It's interesting listening to you and realising that this
• 22:13
  is somebody who doesn't frequent social media anymore and how
• 22:16
  healthy your attitude is because debate isn't a word used on
• 22:19
  social media anymore it's just in an ideal world
• 22:21
  it's what you're saying sit down with a professional from a different discipline have
• 22:24
  a great debate and come out of it learning more than
• 22:27
  you went in with not on social media anymore you're not missing anything
• 22:30
  at all it's horrendous in fact i mean like you
• 22:34
  said the difference between multidisciplinary and interdisciplinary i like
• 22:37
  that because it it won't be a necessary distinction
• 22:40
  for many people but for those who are multidisciplinary and think
• 22:43
  that they're having a great patient-centered care but if
• 22:46
  they think about it hold on it's true actually we are just
• 22:49
  giving our input but we're not actually coming together and twisting kind
• 22:52
  of tweaking what we believe in for the better of the patient we're just giving
• 22:55
  our input and then putting into a bag and pulling out something so i think it's
• 22:58
  a useful distinction to make but i mean it goes it's rubbish on social media
• 23:03
  there is a i like the distinction for similar conversation between evidence
• 23:07
  informed and evidence-based i think it's quite useful for people who.
• 23:12
  Believe they're evidence-informed, but they're using it to champion just the research.
• 23:16
  And like you said earlier on, they're not taking into account that evidence-based
• 23:20
  actually involves one of the pillars is patient experience and patient expectations.
• 23:24
  They forget about that bit.
• 23:26
  So if you kind of tweak and go, oh, yes, but evidence-informed kind of means
• 23:29
  that we're not, it's not a base.
• 23:31
  It's not like this is the most important and everything else goes on top.
• 23:34
  It's kind of more of a funnel or something.
• 23:36
  But on Twitter recently or someone on Facebook, it was like,
• 23:38
  oh, it's just semantics.
• 23:39
  We shouldn't waste our time talking about this. not had to
• 23:42
  get involved but yeah it's it's a
• 23:45
  shame it's useful to challenge yourself isn't it the words you use i
• 23:48
  think makes you think and reflect yeah and i think
• 23:50
  like you know we're sort of talking about developing female athletes here
• 23:53
  and what's brilliant is hopefully everyone that's listening
• 23:56
  has got an opportunity to do that because we've sort of already identified there
• 24:00
  are you know people are there's a massive race now to sort of fill those research
• 24:03
  gaps and actually if we are going to do that let's let's do it in a different
• 24:08
  way and with the right constructive challenge and the constructive development
• 24:11
  so women can benefit I think that is something that,
• 24:17
  is really important and it like one of the things I found has been part of the
• 24:21
  consensus statement in the panel was people that were coming in from the teaching
• 24:24
  sector and the education sector.
• 24:27
  Were talking about a positive experience and how it's really important for physical
• 24:31
  literacy to have that positive experience now for me as a clinician who's maybe
• 24:35
  worked with people who have chronic pain or ongoing pain, and for a lot of athletes,
• 24:39
  pain is part of performance,
• 24:42
  it's not necessarily a positive experience. And I found that really challenging.
• 24:47
  Because that hadn't been my reality. And it did cause quite a lot of debate.
• 24:51
  And actually, it ended up with me being like, this isn't a hill that I'm prepared to die on.
• 24:56
  But I'm still not comfortable with this concept of positive experiences.
• 25:00
  And as I've kind of delved into physical literacy and working a lot more with
• 25:04
  young people and working a lot more with teachers,
• 25:07
  actually understanding that when you first touch point with movement,
• 25:10
  and that's whether you go on to be a really sporty kid elite or not,
• 25:12
  you know, just interested in participation,
• 25:15
  actually it is a lot more important so that for me was very much being pushed
• 25:19
  into an area that was very much outside of my comfort zone because it's what
• 25:24
  I hadn't experienced with patients and,
• 25:27
  I think again that that came from ID interdisciplinary challenge I would never
• 25:32
  have had that in multidisciplinary challenge.
• 25:35
  You mentioned the word physical literacy and for regular listeners
• 25:38
  on the show and I'm sure people who joined us live it's a term which people are
• 25:41
  aware of now but for people who are listening to the podcast and
• 25:45
  maybe they haven't come across it or not quite sure what you're implying
• 25:48
  by it what is physical literacy particularly with regards to
• 25:51
  developing female athletes so well
• 25:54
  you can definitely go and check that out because it's on the sporting website we've now
• 25:57
  got a consensus statement which you can see absolutely everyone can
• 26:00
  go and read that for free but i think it's basically it's
• 26:03
  how we think feel move and connect with our
• 26:06
  physical literacy journey and it's how we sort of change that throughout the
• 26:08
  life course so my fascination with movement came from my original training as
• 26:15
  a dancer so that's kind of what I did until my late teens only 20s I was never
• 26:19
  going to come into physio or anything like that and I had to stop because I got an injury.
• 26:25
  What really fascinates me about movement in dance is when you're taught to move,
• 26:30
  there's lots of different sort of solutions and options to get from point A
• 26:33
  to point B or to do sort of things differently.
• 26:37
  And when you are dancing, you would describe movement with like a quality.
• 26:41
  So it might be effortless, it might be laborious, it might look pretty,
• 26:44
  it might be damn right ugly.
• 26:46
  But we would never talk about movement as being good or bad or risky or harmful.
• 26:50
  And then I came into this space of what I do as a practitioner and people would
• 26:56
  be teaching me and telling me like no you can't do that's a risky movement I'm
• 26:59
  like what why is it risky it was gonna give you an ACL injury is it is it though
• 27:03
  is it okay and I think that's there's so much.
• 27:07
  Misconceptions around what our movement is and how we try to over
• 27:10
  coach and look for perfect movement and I think what physical literacy
• 27:13
  does and Margaret Whitehead is amazing as is is Durden Myers so if you want
• 27:17
  to pick up any of their research that sorts of talks about your ability to move
• 27:22
  in different ways through different environments through different mediums throughout
• 27:26
  your life course and it's this concept really about having a really good solid,
• 27:31
  movement bandwidth and the ability to move before you
• 27:34
  then sort of start thinking about load and I think
• 27:37
  when you're developing females what and again with
• 27:40
  professionalization of sort of sports and games now we're
• 27:44
  almost trying to ramp up people's loads before they've
• 27:47
  got that ability and that movement bandwidth is that really good
• 27:50
  wide base of support that sits underneath and I
• 27:53
  think that's the bit that as practitioners we sort of struggle with in terms
• 27:57
  of that challenge we're seeing a lot more younger people are going into specialization
• 28:02
  they're not sticking with multi-sport and diversification which again is having
• 28:06
  sort of massive ramifications on it on that kind of journey really and.
• 28:12
  So for me, physical literacy has been a really nice time, something that I already
• 28:16
  knew and kind of what I was taught about in my time as a dancer to sort of step
• 28:19
  back and think about how I can kind of bring this into practice now.
• 28:22
  Because the other key thing that happens for adolescent athletes when you're
• 28:26
  developing them is that they're going to go through a growth spurt.
• 28:28
  And what happens with that growth spurt is that you see a change in natural movement strategies.
• 28:33
  And you're going to because the skeleton grows and outpaces muscle growth.
• 28:38
  So you then get kind of like discoordination.
• 28:40
  I don't know if people are familiar, but it's a term that we use as like adolescent awkwardness.
• 28:45
  You know, those kids that just look like they're Bambi on ice and they're really
• 28:47
  gangly and they were really brilliant six months ago. And then all of a sudden
• 28:50
  they can't catch a ball and they can't stand them all low.
• 28:52
  So what we tend to see is, well, not all kids, but, you know,
• 28:56
  so you get this sort of temporary progression and regression in what you're
• 28:59
  seeing in motor skill and movement.
• 29:01
  And again, as a practitioner, if you're not expecting that, or the athlete themselves
• 29:05
  isn't expecting that, it can be a really uncertain and really,
• 29:08
  disconcerting time and that's when we start you know to try and do really good
• 29:12
  and really diligent practitioners and we start to try and over correct things
• 29:15
  like dynamic knee valgus and,
• 29:17
  actually like it's just a normal part of growth that you have to work with and really embrace.
• 29:23
  So again if you're trying to take away somebody's natural movement strategy at that point in time,
• 29:28
  it might be well-meaning but there might be a negative kind of
• 29:31
  sort of consequence that sits underneath that and
• 29:35
  there is a bit of a train of thought so like athletic skills model which
• 29:38
  I'm like a really big fan of is the more that
• 29:40
  you can develop somebody's physical literacy and their exposure to
• 29:43
  that before hopefully as you go through
• 29:46
  these like really sort of fast changes and those quick changes
• 29:49
  to your growth spurt you're hopefully going to be more resilient and
• 29:52
  get through to the other side relatively unscathed but again
• 29:56
  what I think is also really helpful with understanding physical literacy and
• 29:59
  adolescence it's it's the life course piece and the lifespan fan
• 30:02
  piece like so many children and young people
• 30:05
  have already dropped out of sport or any kind of physical activity
• 30:08
  by the time they're 13 and 14 and to me like that's just it's unbelievable and
• 30:15
  like what does that mean to people's long-term health never mind their sporting
• 30:19
  health or you know that kind of performance element it is what does it mean
• 30:24
  for future generations and,
• 30:26
  that's the bit I think that is also
• 30:27
  sort of quite scary and it's you know catching upon us really quickly.
• 30:33
  Bambi are nice first of all that's going to be used again very nice that sums
• 30:38
  it up perfectly and it's really interesting hearing you talking about that because
• 30:41
  I imagine quite a few of our listeners and if you're in the Lydell Lounge now
• 30:43
  I'd be interested in your experiences regarding,
• 30:46
  adolescence coming in we're focusing primarily on adolescence now for the rest
• 30:49
  of the show which is such a wide topic and particularly female adolescence but
• 30:52
  yeah the growth spurt is something which I think on courses and things.
• 30:56
  Not all courses, unfortunately, but at least on some courses they're mentioned.
• 30:59
  But I think typically it is, oh, yeah, they're going to have this lack of stability
• 31:03
  and they're going to have this discoordination and you're going to have to improve
• 31:07
  that because otherwise they're going to injure themselves.
• 31:09
  And so that probably rings a few bells for people who are listening.
• 31:12
  But it's interesting for you
• 31:13
  to say that it's not another excuse for us to try and mould these kids.
• 31:19
  They might use the word kids. That's sounding really unprofessional. These young adults.
• 31:23
  No, but they are kids. maybe I should stress kids because they are kids into
• 31:26
  how adults move it's a good example of how we're
• 31:29
  treating them as if they should be when really you're saying it's
• 31:32
  something they should embrace and actually it's probably a stage in
• 31:34
  life where they are supposed to be strengthening and getting
• 31:38
  that increase in variability and reaction
• 31:41
  which they're not going to do if we come along and try stiffening them
• 31:44
  all up so very interesting that should reflect
• 31:47
  make a lot of our listeners reflect I imagine yeah and
• 31:50
  again I think it it takes a bit back to that context piece about
• 31:53
  what we were sort of saying when we open this conversation and
• 31:56
  it's unfortunately it's it's not a thing
• 31:59
  that's covered in depth at initial training really I
• 32:02
  mean I don't know of many courses and I'm more than happy to be corrected
• 32:05
  and actually be really happy to hear if it's coming into main kind of sort of
• 32:09
  syllabus and you know undergraduate training and you know I've been there as
• 32:12
  a lecturer it's really hard when you're trying to work with undergraduates you
• 32:15
  cannot give everybody absolutely everything but I think in the same way that
• 32:18
  maybe we like we said we've not considered women alongside men we've not really considered women,
• 32:23
  children and adolescents or that developing child process alongside adults.
• 32:28
  And when we learn about, again, bone development, tendon development,
• 32:32
  when we're learning at undergrad level or initially, it's really important to
• 32:36
  understand that process of how that looks, again, in a developing child or an
• 32:40
  adolescent or through, and how that is with, you know, sort of like an adult.
• 32:46
  And I think there's really key things around maturity if we don't understand
• 32:49
  that so somebody's maturity status so that's where they are at any given time so pre,
• 32:54
  growth or post growth the timing of
• 32:57
  that so where they sit within their peer groups so are they an early
• 33:00
  maturer are they a late maturer are they on time in relation to
• 33:03
  their peers that could also sort of
• 33:06
  have impacts on what they get exposed to because those early maturers
• 33:09
  that have got those physical kind of qualities everyone wants to capitalize
• 33:12
  on because they're better aligned with performance we tend to see like a lot
• 33:16
  of early maturers within sport and along those pathways because people are trying
• 33:20
  to capitalise on that you know that natural advantage and it's the later maturers
• 33:24
  that maybe sort of get a bit missed out because they are smaller and they can't.
• 33:29
  Cash in on again that sort of physical quality development until
• 33:32
  later on and then again tempo is a big one for me so it's sort of how quickly
• 33:37
  or slowly somebody is going through that growth and what you do with it and
• 33:41
  how you manage with it and how that sort of shows up and presents itself and
• 33:45
  strength training is really important movement quality is really important having a good bandwidth,
• 33:50
  having exposure to the right rest and the right adaptation period
• 33:53
  is all really important but until you understand the context of
• 33:56
  what is happening to that body in front of you you
• 34:00
  don't really know how to manipulate and best use those variables to
• 34:04
  that person's advantage so just getting some really good graphs on the basics
• 34:08
  of what maturity is how you can go about measuring and monitoring it within
• 34:11
  your practice and then how you can apply that to the athlete or the child and
• 34:15
  the person or patient in front of you is really going to help you structure
• 34:19
  and scaffold what you want to do next.
• 34:21
  Brilliant great advice in terms of
• 34:24
  courses out there i mean we've had a few people on the show who've
• 34:27
  been talking about physical literacy i don't know i think it's far from mainstream
• 34:31
  i've had john scriven on the show from jersey who was
• 34:33
  at therapy experts a couple of times physical literacy tim stevenson
• 34:37
  shoulder dynamic shoulders you know tim do you yeah i'm
• 34:40
  big into physical literacy and it's lovely to see the word
• 34:43
  used but i do worry sometimes that once the word becomes popular powers
• 34:47
  that be suddenly chucking into all of their adverts and everything now is t-shirt
• 34:50
  and video and that sort of stuff but Angela Jackson somebody's mentioned
• 34:53
  in here Sarah Jones did Andrew Jackson yeah yeah
• 34:58
  Andrew Jackson's amazing for that sort of thing and definitely
• 35:01
  and it's really interesting so someone's just put in there sorry in general
• 35:05
  in gymnastics they drop skills during great yeah so I've just done like a really
• 35:09
  big piece of work for again teachers in schools again somebody outside of your
• 35:13
  specter sector going to speak to teachers they literally teach movement to kids
• 35:17
  all day long and learn some brilliant stuff from teachers.
• 35:20
  What's really interesting is we do see that natural
• 35:23
  skill drop off in a lot of adolescents as they
• 35:26
  go through the growth spurt and that's partly for some of the reasons I spoke
• 35:29
  about is the skeletal growth is outstripping muscular growth but
• 35:32
  also the neurocentral nervous system
• 35:35
  is changing so it's like a real big time of where
• 35:38
  you get a lot of myelin production so sort of the differences
• 35:41
  between your growth skills and your fine skills and but
• 35:44
  you can get up to I think it's like a 25% change per
• 35:46
  week in terms of neurons that's how fast they're changing so
• 35:50
  in terms of how the skills are dropping that it
• 35:53
  is normal like it's a really normal thing that you see in adolescence but
• 35:56
  if you're a coach or maybe a parent who's really passionate about the kids and
• 36:01
  you're just seeing that at that point in time and for the child themselves if
• 36:05
  they've been really defined by sport and their ability again the physical quality
• 36:09
  that they can develop and then they suddenly don't have it and they're not prepared
• 36:12
  for what's normal and what's coming,
• 36:15
  that's when a lot of children feel demotivated don't want
• 36:18
  to continue get dropped from sport that and
• 36:21
  that's kind of what we see so I think in terms of trying to answer Sarah's question
• 36:26
  there around how good general training is I think just having the conversations
• 36:31
  and making people aware that what you're seeing with that adolescent awkwardness
• 36:35
  is actually really normal and it's temporary and it'll be progressive and regressive.
• 36:39
  They're not the finished article at 12, 13, 14.
• 36:43
  And a lot of the academies, particularly in football now, I think a little bit
• 36:46
  in rugby, have sort of started to go down this route a lot more.
• 36:50
  And again, biobanding, which someone has just brought up in the chat there,
• 36:53
  is that's just another way of grouping people.
• 36:56
  It's very challenging to do in the education systems at schools at the moment
• 37:01
  because people are put into year seven, they're put into year eight,
• 37:03
  they're put into year nine.
• 37:05
  And we know that, for example, in year eight, biologically, you can have a five to six year difference.
• 37:09
  So you could have a pupil or a student or somebody that
• 37:12
  sits in year eight who is biologically 10 but you could also
• 37:15
  have somebody who's biologically 15 and again
• 37:18
  if you're trying to meet the needs of such a diverse and
• 37:20
  a like you know big range of group that is something
• 37:23
  that is quite difficult for teachers to challenge and actually it's
• 37:26
  the same for us in practice if we're not checking measuring and monitoring for
• 37:31
  maturation in young boys and girls again the things that we're inferring about
• 37:37
  where they are like we might have a 12 year old in front of us that is actually
• 37:40
  biologically 15 are we necessarily doing the right things at the right time in the right ways,
• 37:46
  so again yeah just to try and answer sarah's question i think biobanding is
• 37:50
  brilliant and i would love to see and some of the research that i did in my
• 37:54
  own phd started to do this is where rather than classifying people out by chronological
• 37:59
  age actually we look at our special tests again.
• 38:03
  By biobanding status so actually what does
• 38:06
  a need to wall look like in somebody pre-growth spurt to somebody
• 38:08
  that's in the peak of their growth spurt because we know that growth
• 38:11
  happens distal to proximal so feet go first then
• 38:15
  like the leg bones grow arm growth and then you get torso growth last so actually
• 38:19
  in terms of what we're referring in some of our metrics that we would use in
• 38:23
  practice if we again take out of the adult literature is that still going to
• 38:27
  be the same for somebody that's just massively taken off through their peacock velocity probably not,
• 38:32
  Great points. Great questions. Thank you, Sarah, as well, for those.
• 38:36
  I wanted to ask you about, I think you've already touched on it,
• 38:39
  but I think it's important for therapists, and I've heard you mention this before,
• 38:44
  that it's not just all about the physical growth spurt.
• 38:48
  I think you talk about four different domains, is it, or four key domains that
• 38:52
  we should be keeping an eye on as therapists?
• 38:54
  Yeah, and again, this is very much reflected in like Margaret Whitehead's,
• 38:58
  what she spoke about around physical literacy.
• 38:59
  And I think for us as therapists and it's definitely something
• 39:02
  I did earlier on in my career and have got a million things wrong about
• 39:05
  is I'm always very or have
• 39:08
  historically been quite focused in on the physical because that's what
• 39:11
  we're measured on in our KPIs how can we
• 39:14
  improve somebody's joint range how can we improve their strength but that
• 39:16
  that is very much our domains of where we sit in so what
• 39:20
  I have sort of coined recently is a term it's called
• 39:23
  the developing child so we've obviously got the physical arm
• 39:26
  which I won't talk about too much because I think we're all quite comfortable there we've
• 39:29
  got the biological aspects which for me refers
• 39:32
  a lot more to those developments around secondary
• 39:35
  sexual characteristics so for girls
• 39:38
  we start to develop breast tissue and again how we can kind of manage that for
• 39:42
  children and young people that want to be physically active and i know you've
• 39:45
  had some amazing speakers over the last few weeks you sort of spoke about the
• 39:48
  benefits of really good sports bras where i've seen that showing up recently
• 39:52
  for the work i've been doing with kind of teachers and in the education sector
• 39:55
  is actually looking at PE kit.
• 39:57
  And again, having the right kit as an opportunity to optimize success to come
• 40:02
  in and be physically active rather than a barrier.
• 40:04
  So I think back to my days of when I was at school and the girls,
• 40:08
  we had to wear like little game skirts and cycling shorts, whether it was summer or winter.
• 40:12
  And it was horrendous if you had to go outside and nobody wanted to do that.
• 40:14
  And if you're on your period, it was just a nightmare because you thought you were going to leak.
• 40:19
  Now schools are being a lot more inclusive in their kind of
• 40:22
  PE kit that they wear so it's consideration
• 40:25
  of the biological changes that happen throughout puberty
• 40:28
  or throughout the adolescent sort of change there how we
• 40:32
  need to consider that as practitioners as well because you get
• 40:34
  changes in body odour you get facial hair all these kind
• 40:37
  of things that are maybe different to the physical arm
• 40:40
  that we would chase but certainly impact and kind of fit all
• 40:43
  the way through and again that links into
• 40:46
  two of the other pillars so we have our psychosocial pillar so
• 40:49
  when we go through our sort of main teenage growth spirit our
• 40:52
  brain and how we socially interact is changing so I
• 40:56
  don't know if anyone's got teenagers but they tend to be less
• 41:00
  concerned about views of parents and authority figures all of a
• 41:02
  sudden your friends and your friendship group become life and
• 41:05
  everything that they want to say about you or where you fit within that
• 41:08
  social order and that hierarchy is something that developing teenagers
• 41:12
  are very much exploring so again if you think about their
• 41:14
  physical activity journeys their sort of sports related journeys.
• 41:17
  Of where they sit they get an injury or they don't it's
• 41:21
  not just the physical or sort of the psychological impacts of
• 41:25
  that injury it's where they sit within their social circle and.
• 41:28
  Again that is something that I maybe hadn't been aware of historically
• 41:31
  in my career and I very am now so how do we
• 41:34
  keep people involved and engaged with sort of
• 41:37
  that psychosocial development amongst their peers and
• 41:40
  then the final one is obviously the psychology space so
• 41:43
  our brains are actually maturing just
• 41:47
  as much as our nervous system is or as much as our musculoskeletal system
• 41:50
  is and what's fascinating to me is that sort of
• 41:53
  change between the limbic system where young people
• 41:56
  and adolescents that are growing they don't evaluate risk in the same
• 41:58
  way they just can't see it we see a lot more of
• 42:01
  those risky behaviors they don't necessarily consider
• 42:04
  others well at all and it's not bad but it
• 42:07
  presents a really challenging behavior because they're
• 42:10
  very much in the here and now and they just don't have
• 42:13
  that limbic system of reason as we as adults in the space have.
• 42:16
  To sort of lend them out almost to get them through so I
• 42:20
  definitely encourage any practitioners or people that want to
• 42:22
  work with this population and they are fantastic give me
• 42:25
  a group of teenagers any day don't just consider the
• 42:28
  physical think about those biological changes
• 42:31
  that are happening think about how it fits in with their psychosocial elements
• 42:35
  and where their their limitations are in
• 42:38
  their own development around how they view themselves within their
• 42:40
  own systems of friendship and parental authority frequently
• 42:44
  when a parent accompanies them into any kind of treatment session
• 42:47
  they're not going to do what mom and dad says and they they're
• 42:50
  almost don't care and then again sort of
• 42:53
  those psychological developments so you can
• 42:56
  explain to them and be really logical around the risk aspects of.
• 42:59
  What they may or may not be doing they probably aren't capable of taking it.
• 43:03
  On board yet because they haven't developed to that point so it's not anything
• 43:06
  necessarily that you're doing wrong as a practitioner you just have to be a
• 43:09
  bit more inventive with how you kind of land that messaging so yeah think about
• 43:13
  it as the system around a child being kind of all-encompassing rather than just
• 43:17
  that physical sort of quality space.
• 43:20
  And that's all going to take skills, isn't it? I mean, stage one is recognizing
• 43:23
  it, but stage two is being able to do something about it.
• 43:26
  And what you just said there, I was thinking, you're not only going to need
• 43:30
  to consider how you're going to communicate with the young athlete,
• 43:34
  but also with the parents, which can be very challenging, can't it?
• 43:37
  Because so often I think anybody's looked after patients who are kind of like under 16,
• 43:44
  the biggest challenge often is, and maybe when you're looking for what's the
• 43:47
  most contributing factor to this particular injury, often there's an over-enthusiastic
• 43:51
  mum or dad or person who cares for that person behind there.
• 43:54
  And it's, yeah, if you're going to help their recovery, that's going to be one
• 43:57
  of the lowest hanging fruit, isn't it? So a lot of skills.
• 44:01
  Yeah. And I think what's really interesting, and again, it might have changed since I qualified.
• 44:06
  And youth sport I suppose it's a little bit with how
• 44:09
  female sports changed actually female sport when
• 44:12
  you used to work through it maybe you know decade ago it was very much it
• 44:16
  was a transition or a stepping stone to get into like the
• 44:19
  top male sports or the top male teams and I think
• 44:22
  when a lot of people qualify and first start out inevitably with
• 44:25
  how our systems work you start in an academy setting or you
• 44:28
  start with the youngest and you kind of go through that progressive journey
• 44:31
  up and through for your career but it's probably actually a
• 44:34
  time where as a practitioner you are at your most vulnerable because
• 44:37
  you are getting that own pattern recognition of your skills you're trying to
• 44:41
  learn your own sort of footing within the profession and where you're going
• 44:44
  but you're actually working with the most changeable and the most complex sort
• 44:49
  of population group so I think without again that context that support understanding
• 44:53
  and education for yourself as a practitioner,
• 44:56
  it can feel like a really vulnerable space and again I think that's we're going
• 45:00
  to start seeing that play out in the next sort of five years especially around
• 45:04
  our young developing female athletes is the level of support that the support
• 45:08
  staff around them receive to allow them to deliver the best kind of care really
• 45:12
  i'm really interested to see how the industry and the sector tackle them.
• 45:16
  Yeah that's is i don't know i think do you
• 45:19
  look ahead with a certain amount of positivity you've mentioned quite a few
• 45:23
  times how things have improved be it stopping young girls wearing white throughout
• 45:29
  their PE career just things which sound so logical and why the hell did it get
• 45:32
  put there in the first place but are you quite positive you have things happening in a in a good way.
• 45:38
  I think things are improving. I think the key really is, again,
• 45:45
  not necessarily replicating everything that's gone before and actually stopping and pausing and going.
• 45:52
  Right, what are the exact needs of what teenagers and developing children need?
• 45:57
  But what are those differences like for boys and girls?
• 46:00
  And it isn't necessarily just the physical qualities. Like I said,
• 46:03
  it's access to sort of training age, training environments.
• 46:06
  And again, it's understanding the movement skills bit and yes
• 46:09
  movement skills movement patterns are trainable
• 46:13
  during this time but they're also really highly changeable and
• 46:17
  I think what's really interesting is we now live in an era where we're
• 46:20
  so data rich and we're getting so much information all the time that
• 46:23
  you can literally track anything from an iphone or
• 46:26
  an ipad but is that information actually
• 46:29
  murking the waters if we almost got too much
• 46:32
  noise now and I think football is a classic one
• 46:35
  for this is it's got so much data but actually what
• 46:38
  what is the quality behind the numbers and again
• 46:41
  we see this a lot with force related data as you you can have
• 46:44
  you know as much information as you want what is that actually telling you and
• 46:48
  what's the story and what what is the content of what makes up those numbers
• 46:52
  so i think for me it's positive it is changing but i think we need to be a little
• 46:57
  bit carefully cautious with just exactly what it is that we're interpreting and And again,
• 47:02
  because there is now such a race to fill all these research gaps,
• 47:06
  I think it's going to be interesting to see what kind of comes out and, you know.
• 47:10
  Sort of what doesn't, I suppose, more than anything.
• 47:14
  You mentioned earlier on, I want to spend some time on that.
• 47:17
  You mentioned you were, you sat in the physical literacy consensus statement
• 47:21
  as an expert panel member.
• 47:24
  And I think you mentioned the physical literacy toolkit as well,
• 47:27
  which is available. and as a tool for both clients and maybe clinicians themselves.
• 47:33
  Let's bring up a little, for those of you who are in the live lounge and you
• 47:35
  love some visuals, let's bring this up.
• 47:38
  So what we're going to talk about now, I'll put it on full screen,
• 47:40
  but we can still hear you, Gemma, even though it's up there behind.
• 47:42
  Oh, that's a massive big picture of you on that, don't we? Not now.
• 47:45
  I'll take that out. It's really better.
• 47:47
  And what we're trying to get is that there, show the stream.
• 47:52
  There we go. Yeah, so what we're talking about here is something you can download online.
• 47:57
  If you go along to the website, what website is it that they need to go to to
• 48:02
  see this physical literacy toolkit?
• 48:04
  So this is something that's been piloted and sort of pushed through the Youth
• 48:08
  Sport Trust. So this is a free resource.
• 48:10
  I've sat in the sort of special interest group around this. I've worked with,
• 48:13
  again, some fantastic practitioners across physical literacy sector in schools.
• 48:18
  So these are people that work. There's the Chance to Shine programme,
• 48:20
  which is through cricket.
• 48:21
  There's people from swimming and judo who sit a bit more at that sort of grassroots
• 48:25
  community development level. So this has been designed with sort of schools
• 48:31
  and education, that sort of sector and workforce in mind.
• 48:34
  So if you're looking at it as a healthcare professional and going,
• 48:36
  well, that feels a little bit out of my comfort zone. Like, carry on.
• 48:39
  It has been designed for that space, but it definitely has portability into ours.
• 48:44
  So what the Physical Literacy Toolkit does, I don't know if you can scroll down
• 48:47
  from there from the view. I can. I can show.
• 48:50
  I've taken some screenshots, but yeah, it's a PDF or PowerPoint you can download.
• 48:53
  PDF version there's PowerPoint versions again that it's all free for you to
• 48:56
  download and this is something I spoke about at Therapy Expo a little bit and
• 49:00
  one of the tasks there is to actually plot your own journey with physical literacy
• 49:04
  and that is something that I would.
• 49:07
  Really encourage a practitioner to do because it
• 49:10
  will make you sit down and think about your own
• 49:13
  relationships with how you move think feel and connect with
• 49:16
  whether that's sport whether you do that recreationally or professionally or
• 49:19
  have done that recreationally or professionally in the past and what
• 49:22
  that might actually be like for your patient or the
• 49:25
  athlete or the person that you're working with so again you've just
• 49:28
  brought up task one there which is fantastic so that's our movement history
• 49:31
  so again if you want to jump through a little bit more if
• 49:35
  you can yeah so what the toolkit
• 49:37
  does is it gives you different kinds of activities this is just the one
• 49:40
  that we focused in on but it gives you some really good questions to
• 49:43
  ask not only of yourself but of the
• 49:46
  people that you're working with so the first
• 49:49
  one there which is brilliant when have you had a positive relationship sustained
• 49:53
  engagement with physical activity and why was this so I'm
• 49:56
  going to use myself as an example here it wasn't
• 49:59
  until I came into this work so you know I've done 20 years in the industry I've
• 50:02
  worked as a dancer before that I actually realized that maybe I hadn't necessarily
• 50:07
  had a positive relationship with physical activity so for me being physically
• 50:11
  active as you know as a child was doing a little bit of pee at school, kind of hated it.
• 50:16
  It was always the smallest, generally a bit rubbish. Very, very good dancer.
• 50:21
  But I'd thought about dance was more for me as of where I was going to be in terms of a career.
• 50:26
  So I wouldn't necessarily say I had that physically active lifestyle. I then got injured.
• 50:33
  And as I kind of went through my 20s and 30s and retrained, what I did in terms
• 50:37
  of keeping my own self fit and active, and now looking at a point in life where
• 50:42
  I've got to start considering perimenopause and menopause,
• 50:45
  it's taken me until I've got into my 30s to go, I talk about this to a lot of people,
• 50:50
  but actually what am I doing within myself so it's only
• 50:52
  been recently that I've taken up things like proper strengths
• 50:55
  training in the gym yoga swimming and
• 50:59
  actually now I understand that about myself and my journey a bit more
• 51:02
  it definitely changes how I interact with my patients so
• 51:06
  I definitely encourage all practitioners start with yourself
• 51:09
  first and see where you're going with that and the physical literacy
• 51:12
  toolkit can be a way of doing it and there's some nice little graphs
• 51:14
  and stuff again that you can it's all free to download that you can kind
• 51:17
  of plot and explore and look at that journey i've used
• 51:21
  this and the model again it's sort of set a little
• 51:24
  bit in education i've used it with the patients and one
• 51:27
  of the key things that how it's changed my
• 51:30
  thinking and i think i said this at therapy expo is i've sort of stopped asking
• 51:36
  the people that i work with what's the matter with you to what matters to you
• 51:41
  very good and that little subtle change again about embracing it's the context
• 51:45
  piece it's me trying to walk the talk that i've just waxed and reported about for the last hour.
• 51:50
  The think, feel, move and connect part of physical literacy really just helps
• 51:54
  me understand and progress through rehab a little bit more with what I'm aiming
• 51:57
  for and understanding what's gone before that person has arrived at that point with you.
• 52:05
  That's brilliant yeah in fact that was the quote which a few people came to
• 52:08
  me on the day like oh wow I've had to write this down on the napkin or something
• 52:12
  as well and I know some of the people who've joined the Live Lounge.
• 52:16
  Still mention that instead of saying what's the matter with you is what matters with.
• 52:20
  To you is such a great change it's
• 52:24
  literally coaching isn't it as opposed to fixing it's such it's so
• 52:26
  good it's really one of those gems really cool
• 52:30
  yeah so that is a free resource as we've mentioned we'll put
• 52:32
  the link in the show notes but if you're listening to the
• 52:35
  podcast and you want to go there now then just head to www.youthsporttrust.org and
• 52:42
  then you can pull your search on the page or just find the link in the show notes but you'll
• 52:46
  take you through to the physical literacy toolkit and it's either a powerpoint or
• 52:49
  a pdf and it is so cool just for self-reflection like
• 52:52
  jemma said and then once you understand it what
• 52:55
  it's getting at and you have those little coins drop in your
• 52:58
  mind and you can understand how the patient's going to react to it and
• 53:01
  the benefits you can get from having those discussions and reflection and
• 53:04
  and just as a therapist you're listening the whole
• 53:07
  thing we talk about for so many episodes of sitting back putting your
• 53:10
  hand over your mouth just to make sure you don't say anything to try
• 53:12
  and fix them just let them basically tell
• 53:16
  you what what matters to them and how
• 53:18
  you can facilitate and help them it's beautiful really good great great
• 53:21
  free resource which is probably underutilized i'm
• 53:24
  sure well again yes and
• 53:27
  no so i think it's weird we're definitely underusing it within
• 53:30
  health we can definitely make more use of it and i think what's
• 53:33
  really lovely there is you'll also see on the pages there's some like little
• 53:36
  thumbnails of videos where people again from
• 53:38
  like judo chance to shine they talk about how they're implementing
• 53:42
  that within the grassroots space and ngbs within.
• 53:45
  Sorry national governing bodies within sports and i
• 53:47
  think something else that i've seen and again when we think about how we want.
• 53:50
  To develop our female athletes again at whatever point throughout the lifespan.
• 53:53
  There's almost a lot of free flow
• 53:57
  of the literature of what we do in sport what we do in sport needs to
• 54:00
  come over to you and actually like i
• 54:03
  said i've learned a lot more from those guys i've probably.
• 54:06
  Learned more from them and maybe what i've given them so i
• 54:08
  think it's about taking stuff from outside of our sector seeing what they do
• 54:13
  really well in these environments around this and they're throwing the gauntlet
• 54:16
  to us to almost pick it up and see about how we best implement this into health
• 54:20
  and again the people that we work with so yeah really looking forward to seeing
• 54:24
  how this plays out particularly for us in the next few years. Nice, great stuff.
• 54:29
  Well, look, it's 8.58. We've got awfully quiet in the live lounge tonight,
• 54:33
  jotting things down probably on notepads and flicking through.
• 54:36
  But I think there's some great takeaways in this episode.
• 54:39
  I love what you said about the developing child and adolescent space and the
• 54:44
  fact how we're probably all guilty of focusing too much on, like you say, Bambi on ice.
• 54:51
  And we're just trying to fix and correct and thinking this is the root of all
• 54:55
  of their problems. when really we should be looking at the context and the ecosystem
• 54:58
  they live in and see, hold on, maybe this doesn't occur, they're not small people.
• 55:03
  Particularly, I guess, I mean, what you mentioned about the physical,
• 55:07
  biological, psychosocial and psychological is going to affect boys and girls.
• 55:11
  Am I being short-sighted or sexist in thinking that particularly girls with
• 55:16
  the heightened biological changes and the ecosystem they're going to be in?
• 55:21
  I mean, boys have issues as well. obviously i don't want to downplay how i'd
• 55:24
  let some boys have loads of problems going in their head but for girls double
• 55:28
  trouble is it because they got to put up with the boys as well i don't know
• 55:31
  was that just me being a boy what's really interesting there and i'm going to
• 55:34
  sort of push and challenge that a little bit and it's good i'm pleased i'm staying and regretting it.
• 55:39
  And this is what's really good is actually like it straight
• 55:42
  away i think already conversations are
• 55:45
  evolving and it's a myth that i commonly hear a lot you
• 55:48
  know that girls are more mature than the boys and I
• 55:51
  think what I again you're already questioning like is it
• 55:53
  okay for me to say that like is that a thing and I think that's brilliant
• 55:56
  and what we know for girls is they generally
• 55:59
  tend to start the growth spurts earlier than boys so because again we're all
• 56:05
  generally function in society by chronological age and that's how we're grouped
• 56:08
  some of those changes become really pronounced and I think what we do see in
• 56:12
  girls is because they sometimes start this you know earlier is we see that physical
• 56:16
  and biological maturation, but we haven't necessarily...
• 56:21
  You know, caught up with the psychological and the psychosocial maturation,
• 56:24
  that is still very much ongoing.
• 56:26
  Like I said, people are not finished articles and you get regressions and progressions.
• 56:30
  So it doesn't all just go in a linear line.
• 56:32
  You get bits that are progressing, then bits that don't, and then other bits
• 56:35
  are coming in and coming out.
• 56:36
  So these experiences are different for girls and boys.
• 56:40
  Again, have we considered the context and the environments that we are building
• 56:43
  and providing for young people?
• 56:45
  What we tend to see with maturity timing is
• 56:49
  for boys that are early maturers because they get the
• 56:52
  height they get the physical qualities that people want that makes
• 56:54
  them successful and faster and you know sort of all that kind of stuff
• 56:57
  for sport being an early maturer as a boy can be
• 57:00
  really really very positive being a late maturer
• 57:03
  for a boy can be less so and tends to have a
• 57:06
  few more negative connotations when we flip that for
• 57:09
  girls if you are an early maturer as a
• 57:11
  girl so you're a bit taller you've got some of those biological characteristics already
• 57:15
  it can be a bit more of a negative experience because
• 57:19
  of some of those sexual characteristics people you know catcalling people assume
• 57:23
  that that dolls are again just generally more mature and I think there is a
• 57:28
  little bit of a you know danger there around sort of weaponizing competence
• 57:33
  and incompetence which I don't think is okay and I think we do sort of need to change and address.
• 57:39
  But we're not there yet in terms of critical mass of the literature of fully
• 57:43
  understanding what an adolescent process is in the growth spurt.
• 57:47
  And again, in terms of looking at those differences between girls and boys,
• 57:50
  we're starting to make ground and change years.
• 57:53
  And we know that there's differences in terms of body composition at what happens at key times.
• 57:57
  But I think we need more to know
• 58:01
  more. And again, how we cultivate that environment for our young people.
• 58:05
  Definitely very wise. i was just i was just implying
• 58:08
  when it comes to exercise and continuing because
• 58:11
  i've seen with running for example i see
• 58:14
  the dropout and it's so sad and athletics of
• 58:17
  girls once they start going through and this the developing child and and with
• 58:22
  regards just to exercise and confidence and continuing what the skills they've
• 58:28
  got and often they'll perform better you know i used to teach like martial arts
• 58:31
  to kids and the girls would be doing all their cards and everything while the
• 58:34
  guys were still trying to work out what left and right was,
• 58:36
  dribbling on the floor. I'm going, come on, kids, boys, please.
• 58:39
  You know, let's just bond together, try and work this out. Because the girls
• 58:42
  are just amazing because they developed just mentally a little bit earlier on.
• 58:45
  But there's that whole stage when they're 12, 13, and then you see the dropout,
• 58:50
  the numbers go down. It seems such a change, such a shame.
• 58:52
  Whereas the guys, if anything, are getting stronger. Not all of them.
• 58:55
  And I feel for the kids who aren't developing, the boys who aren't developing as quickly.
• 58:58
  But I don't know, maybe it's just my empathy because I just see it and it just seems such a shame.
• 59:03
  And often that could be the end of sport for those females and they could have
• 59:06
  done so much with themselves health-wise and confidence-wise and been role models for others.
• 59:13
  So I'm just aware of that. That's why I thought maybe the effect on exercise
• 59:16
  can be more devastating for 13-year-olds.
• 59:19
  Yeah, and I think, again, we don't definitely know yet, but one of the things
• 59:24
  that I talk about, and again, when I talk to teachers and coaches about this.
• 59:27
  When you go through adolescence and you go through that growth spurt and you're sort
• 59:30
  of getting that bone mineralization and you're you know getting lengthening and
• 59:33
  thickening and that kind of stuff you are actually creating
• 59:37
  the bone and skeletal structure that you
• 59:39
  take forward into your adult life and once you've come through
• 59:42
  that peak growth spurt in terms of how you can maximize that
• 59:46
  there's very little room for maneuver you can
• 59:48
  absolutely maintain it by you know continuing strength training and
• 59:51
  we know for as your previous guests have spoken about over the last
• 59:54
  few weeks you know perimenopause menopause is a really key time for
• 59:57
  women in terms of maintaining that investment but
• 1:00:00
  if the initial investment didn't happen in your teenage years where
• 1:00:04
  does that leave you and i think this is one of the key things
• 1:00:07
  that people don't realize so it's
• 1:00:11
  all very well and good hitting perimenopause and
• 1:00:13
  menopause and looking at you know maintaining that but
• 1:00:17
  what was the original investment you made and i liken it
• 1:00:20
  to like a savings account so parents take out savings accounts.
• 1:00:23
  When kids are little and you know birthday money goes now Christmas
• 1:00:26
  money goes in there and for savings accounts that
• 1:00:29
  hit really good times of really high interest so like
• 1:00:32
  what we've maybe recently seen six or seven percent you can
• 1:00:35
  capitalize on those gains really quickly so by the time you
• 1:00:37
  hit 21 24 30 and you want to take that money out you've
• 1:00:40
  got a bit more to spend in terms of investing in
• 1:00:43
  your bone health your tendon health and your ligament health that
• 1:00:47
  key time of investment is these adolescent years so we're
• 1:00:50
  almost robbing our children and people of those good investment
• 1:00:53
  opportunities now to then continue to
• 1:00:56
  maintain them through that sort of menopause period and
• 1:00:59
  later time and you know aging and you know include men in
• 1:01:02
  that as well it's not just women so I think there probably are going to be greater
• 1:01:07
  disadvantages for our sort of 10 to 18 year olds today because they are going
• 1:01:12
  to become our adults of tomorrow and we don't necessarily know what that's going
• 1:01:16
  to look like yet but if we look at our 30 and 40 year old adults of today,
• 1:01:20
  we know that that story's not great. So, yeah,
• 1:01:24
  Yeah, definitely something in the pipeline that's going to come up and come upon us very fast.
• 1:01:29
  Amazing. Such great food for thought. Thank you so much, Dr.
• 1:01:31
  Gemma Power. It's been amazing chatting with you.
• 1:01:33
  And I think, like I said at the beginning, I think it's really brought everything
• 1:01:36
  we've talked about in the last three episodes around and has made people reflect and think about it.
• 1:01:41
  Even though we're talking predominantly about adolescence and developing child
• 1:01:46
  and that, it still links in so nicely to everything else we've talked about.
• 1:01:49
  So thank you for your time. Really appreciate it.
• 1:01:52
  Very much for having me. thank you everyone who joined us as
• 1:01:54
  well live really appreciate that everyone listened to the podcast if people
• 1:01:59
  want to hear more about you or know what's coming up because you're quite you
• 1:02:03
  do guest appearances and presentations and you go to different places of education
• 1:02:08
  if they want to know about what's coming up or even book you what's the best
• 1:02:11
  way of following you or contacting you.
• 1:02:13
  So as we sort of touched on briefly i've sort of taken a bit of a hiatus from
• 1:02:16
  social media so best ways to contact me is
• 1:02:19
  generally through linkedin that's where i am most active and
• 1:02:22
  there's sort of an email on there that people can contact me through as well but i'm
• 1:02:25
  definitely more a kind of conversational type person or individual
• 1:02:28
  sort of discussions or what's required for your sort of
• 1:02:31
  clinic industry or team rather than being a keyboard warrior
• 1:02:34
  in various parts of social media so i just find
• 1:02:37
  that for me we've said a couple of times
• 1:02:39
  linkedin it won't be forever linkedin will turn into something terrible as
• 1:02:43
  soon as everyone joins up it's next but for the moment i keep
• 1:02:46
  it quiet just people listening to podcasts linkedin is where it's happening in
• 1:02:48
  terms of professional education discussion or networking but
• 1:02:52
  don't tell too many people just the clever ones yeah um
• 1:02:56
  so yeah look up dr jemma parry on linkedin don't fall for going
• 1:02:59
  to the wrong jemma parry there is a although she's a very lovely person i hear
• 1:03:03
  you say a clinical psychologist is she yeah i think there's a clinical psychologist
• 1:03:06
  also the same name in wales so yeah i think she sometimes had questions about
• 1:03:10
  adolescence and i've sometimes had questions about prisoners and crime which
• 1:03:13
  neither of us are experts in that because earlier so yeah,
• 1:03:17
  So you are looking, yeah, for Dr. Gemma Parry, performance specialist.
• 1:03:21
  Make sure it's that person you follow.
• 1:03:22
  Otherwise, you're going to be looking at some interesting, but not necessarily
• 1:03:25
  connected to your scope of practice. My specialty area.
• 1:03:29
  Wonderful. Right. So just before we go then, next week, if you listen to this
• 1:03:34
  live, it's going to be March 2025.
• 1:03:36
  And we're going to start a new four-part focus.
• 1:03:40
  This time it's going to be a focus on working with disabled athletes. and
• 1:03:43
  in part one episode 231 this
• 1:03:46
  will be i'm so thrilled and honored to be joined by
• 1:03:49
  some incredible disabled athletes or athletes with disabilities
• 1:03:52
  just to give you a little bit of an idea they're all coming along to join me
• 1:03:57
  next tuesday at eight o'clock and there are two four five people who are just
• 1:04:02
  amazing along with couple therapists so we've got rich potter and richard dickie
• 1:04:06
  davis who some of you regulars will know and set world records at the end of last year on
• 1:04:10
  limitless expedition conquering conquering the himalayas as the
• 1:04:13
  first ever amputees to achieve the path of full length of the snowman trek
• 1:04:16
  in bhutan which is the toughest trek in the world for able-bodied people
• 1:04:19
  with 11 mountain passes at altitudes of over 5 500
• 1:04:22
  meters such a lovely couple of guys rich dickie
• 1:04:25
  davis was that therapy expo and it just warmed my heart to
• 1:04:28
  see people rubbing his stump it was just amazing and i love
• 1:04:31
  the question we got as well saying you said stump a few times is
• 1:04:33
  that really a word we should be avoiding which was such a great question
• 1:04:36
  because other people were probably thinking it but then
• 1:04:39
  you get the guy with the stump going not at all in fact we need to
• 1:04:42
  normalize this it is a stump what do you want me to call it and it was just
• 1:04:44
  such a great moment where i saw shoulders going down and mouths opening closing
• 1:04:49
  so it's so good but they're gonna be with us as well really open wonderful guys
• 1:04:52
  also samantha may and jim at barns were two amazing uk athletes recently returned
• 1:04:57
  from the evictus games 2025 it was in canada.
• 1:05:00
  Obviously it's not just about the medals particularly with evictus games but they did,
• 1:05:04
  amazingly well team uk this year with about 38 medals and
• 1:05:08
  i think it was the top number of serving and and
• 1:05:11
  vets from the army and air force and navy as well so it was amazing and they
• 1:05:14
  excel particularly rowing swimming for which sam and jemma both won medals so
• 1:05:18
  it's been amazing having them here as well and then also they got dan wills
• 1:05:21
  dan metcalf who i've had some amazing conversations with and occasionally he
• 1:05:25
  is and he was despite the left paralyzed from the waist down after a motorcycle accident in 2014.
• 1:05:30
  He has since achieved three scuba diving world records for his disability category.
• 1:05:36
  Fastest one-mile scuba diving with and without a swimming band and also the
• 1:05:39
  greatest distance scuba diving all in fresh open water.
• 1:05:43
  Amazing people with great personalities and they're going
• 1:05:45
  to share obviously the highs and the lows probably rich
• 1:05:50
  bottle probably make a tear come out of my eye again it felt like shineda connor
• 1:05:53
  when he started talking about certain things but um yeah it's going.
• 1:05:55
  To be such a warm amazing sharing episode and
• 1:05:58
  it's everything for therapists to gain if you understand.
• 1:06:02
  What it's like to work with people who are
• 1:06:05
  disabled and how it can improve you as a therapist and your
• 1:06:08
  awareness of working with the individual then it's good this can be such a
• 1:06:11
  carry on so it's going to be amazing so if you can join us for that we're also
• 1:06:14
  going to be with us our Carla Bickerstaff sports therapist from the STA
• 1:06:17
  and also massage therapist Jenny Lane both of whom
• 1:06:20
  have got loads of experience working with athletes with disabilities at the Invictus Games
• 1:06:23
  Jenny recently returned and she was the Invictus Game
• 1:06:26
  UK team soft tissue therapist so it's going
• 1:06:29
  to be amazing I really hope some of you listen to the podcast 2,000 people
• 1:06:32
  who just shadows just numbers on Podbean I see
• 1:06:35
  every week it'd be lovely if you could actually make time and
• 1:06:38
  join us for that so we can greet these people and ask
• 1:06:41
  them some amazing questions and learn from them so that'll be
• 1:06:44
  eight o'clock as always on either youtube or sports
• 1:06:48
  therapy association facebook page whichever you prefer right sorry
• 1:06:52
  about leaving you there just sitting there thinking does he still need me
• 1:06:55
  here sorry dr joe parry but there's a there's a nice segue as well
• 1:06:58
  because you we said before you've gained so much haven't you been working with paralympians
• 1:07:01
  and and there is such a carryover isn't there for when you
• 1:07:04
  work with able-bodied athletes as well yeah so
• 1:07:07
  i've worked with a couple of power sports and again supported wheelchair basketball
• 1:07:10
  into commonwealth games i think it's when you do work within the power space
• 1:07:14
  it's very much n equals one so in terms of meeting the needs of an athlete with
• 1:07:19
  an impairment on top it's yeah it's definitely fantastic population to work
• 1:07:23
  with so i'm sure it'll be very insightful for your listeners over the next few
• 1:07:26
  weeks yeah i'm really really looking forward to so there we go people.
• 1:07:30
  Amazing month coming up thank you once again just to finish off dr jerry parry
• 1:07:33
  really appreciate you're giving me your time and yeah people make sure you follow
• 1:07:37
  dr jarry and connect on linkedin for upcoming presentations and courses and
• 1:07:41
  things like that so that's it thanks everybody for joining us take care of each
• 1:07:45
  other and hopefully we will see some of you for the next episode bye.
• 1:07:51
  Music.