Latest / The STA Clinician Podcast / Ep241: 'Menopause Transition: Soft Tissue Implications’ - Reflection with Hannah Tabram

Transcript

Ep241: 'Menopause Transition: Soft Tissue Implications’ - Reflection with Hannah Tabram · The STA Clinician Podcast

0:00
Music.
0:12
How are you doing? Welcome to episode 241 of the Sports Therapy Association podcast.
0:17
My name is Matt Phillips, creator of runchecklive.com. And as always,
0:21
this episode is being recorded live 8pm Tuesday on the Sports Therapy Association YouTube channel.
0:27
In this seventh episode of our reflection series, I will very shortly be chatting
0:32
with sports massage therapist Hannah Tabram, who will be reflecting on episode 87,
0:37
Menopause Transition Soft Tissue Implications, that was recorded as part two
0:42
of a Women's Health special we did back in February 2022 with special guest
0:46
Jenny Barrel of Barrel Education.
0:49
Before that, my thanks as always to last week's reflector,
0:53
Sharia Keousawang, also known as Louis Physio, who reflected on episode 73,
0:59
Evidence-Based Pilates, which was recorded back in October 2021 with special
1:03
guest Raphael Bender of Breathe Education and the Pilates Elephants podcast.
1:08
I'm in a great episode as well. Really nice to hear Sharia commenting on how
1:12
a lot of the concepts that she'd learned in Pilates also were taught on her physiotherapy course.
1:17
And Raphael really woke some stuff up and made her realize that she didn't have
1:21
to throw it all away, but just tweak it a little bit. So it was a really healthy listen.
1:24
For anybody who's feeling a little bit threatened by some of this evidence-informed
1:28
stuff that tends to get shouted out on social media,
1:30
but not here on this podcast we break into you
1:33
gently and help you realize that it's just a little tweak
1:36
but with amazing results for your clients so um people
1:39
who joined us live this evening thank you very much cecily's always first through
1:42
the door i'd love to see cecily kind of one of those big sales things at harry's
1:46
i can imagine it's just arms sprayed wide just bursting through the door to
1:50
get all the deals that's the image i have of you cecily tell me if i'm wrong
1:53
uh nikki mansford is here as well saying evenings as nikki just finishing up
1:57
watching my plans be within two ticks.
1:59
Thank you for sharing, Nikki. That's good. We were concerned about that.
2:03
Great. I think we've got some good case histories tonight, tonight's episode.
2:06
It's going to be very interesting. So if you are affected by any of the.
2:12
Conversations tonight, whether personally or with clients, then do share.
2:16
It'd be really cool to have your input. That's why we do it live.
2:19
And Sir Glenn Murphy's in here as well saying, good evening all.
2:22
Good evening, Sir Glenn. Sarah Jones is in as well saying, this should be a
2:25
good one. Okay, no pressure there, Hannah.
2:27
So great. Love it. Love seeing people come in. Thank you very much.
2:31
Let's clear those messages. If you are listening to the podcast and want to
2:33
join us live, then what happens is if you leave a message or comment,
2:36
I can bring it up on the screen.
2:37
And obviously you can ask our guests questions direct and share your own experiences
2:40
and have just a great networking opportunity. So there we go.
2:44
On the subject of networking and opportunities, that was a great segue, Matt. I liked that.
2:49
I mentioned it last week, but the details and tickets for the STA Southwest
2:55
Conference, a collaboration with the ST School's Hands on Hub,
2:59
are actually going on live tomorrow evening.
3:03
Fingers crossed, he said, clenching his teeth.
3:06
But yeah, they should be going live on the ST School website tomorrow evening, May the 14th.
3:11
And this collaboration is is yeah
3:14
it's going to be great i mean i'm personally involved in it i will be
3:17
emcee across the two days of education and it's kind of advertised as be part
3:22
of the future of healthcare education which i had to twist and murray has kind
3:27
of risked a little bit to put that in there but it really is it really is a
3:31
twist on probably everything you've been used to in a conference with the idea of taking it back to.
3:36
Boot education, the learning cycle. There'll be lots of reflection,
3:40
self-analysis, assimilation of information, practicals and stuff.
3:43
So it's going to be great.
3:44
It's happening in Exmouth, as it is the STA Southwest Conference as well,
3:48
on the 20th and the 21st, which is a Saturday and a Sunday.
3:52
It's a good start, isn't it? Yes, for some of you. It's badly people who prefer
3:55
it midweek, but we decided to do it on a weekend.
3:59
It's a full day Saturday and then half day Sunday, which means you can still
4:02
get back to wherever you've got to do in the second half of Sunday.
4:05
So we've really thought about this together and tried to deliver something which
4:09
is putting you in the centre of it.
4:11
You put your patients in the centre, we put the therapists in the centre for the conference.
4:17
So yeah, really excited. Details will be there on the ST School tomorrow evening.
4:21
If you're not in the south-west of the UK, then don't worry because another
4:24
thing we're doing to try and help with this future of healthcare education is
4:27
we are planning on moving around the country so that you haven't got to travel
4:31
miles to get to this amazing conference. So it'd be lovely to see you.
4:34
And if you can travel, then do come along.
4:36
But there are plans for it to move around and to come to somewhere near you.
4:40
A bit like Noel Edmonds and the Swap Shop, but different in lots of ways as well.
4:45
So right, if you're interested in following, revealing of speakers,
4:49
I'm so excited. Actually, I'm going to reveal a speaker tonight at the end. So there's the hook.
4:53
There's a wonderful segue into one of the speakers that I'm so excited to reveal.
4:57
And we'll do that at the end.
4:59
But yeah, make sure you do follow at UK underscore STA and at the ST School
5:03
on social media and go to thestschool.co.uk.
5:07
And as of tomorrow evening, there'll be a page up there showing not everything,
5:11
but enough to make you have a little think about whether this truly will be
5:15
the conference to go to in September.
5:18
Right. I've left her down there for long enough. So let's get rid of that beautiful artwork.
5:24
And let's bring up Hannah Tabram, who will be reflecting tonight in episode
5:28
241 of the Sports Daily Podcast on menopause transition, soft tissue implications.
5:34
Music.
5:35
You're listening to the Sports Therapy Association podcast, putting evidence
5:40
back into soft tissue therapy.
5:46
Hey Anna, how are you doing? Hello, I'm good thank you, how are you?
5:49
Very well. I've just heard some lovely tweeting in the background,
5:52
you are outside aren't you? I am in my lovely treatment room, yeah.
5:57
It's good to see the treatment room because you were actually on the show back
6:00
in March, last year, February and March.
6:03
Was it that long ago? It was. Yeah, it's just over a year.
6:07
What have you done in that year? Oh, I don't know. Oh, it's not even going to.
6:11
Yeah, you gave us, you and other clinicians gave us a really well-received episode
6:16
about how to set up a sports massage therapy business. It really was really popular.
6:20
The first one was how to set up a sports massage therapy business at your home.
6:23
You introduced us to the conversions and what was involved and you gave loads
6:27
of really helpful tips. And I know people were taking notes.
6:30
I know around the country now there's people,
6:32
there are sheds everywhere little doppelgangers of your friends,
6:38
not parallel to the universe they really do exist probably around the corner
6:41
for you and then you came back for the part three which is mobile event work
6:45
when you share the experience as well so in other words you're a pro and you're
6:48
just ready to rant at length about the menopause.
6:55
For people who don't know you and didn't watch these episodes yeah
6:58
could you give us a little intro into yeah who
7:01
you are what you do what you what involves yeah of
7:03
course so yeah I'm Hannah I'm a sports massage therapist
7:07
or soft tissue therapist I'm never entirely sure which one I want to use I am
7:12
down here in Norfolk in kind of the middle of nowhere normally working from
7:16
a shed in my garden and I have been doing this since late 2021 is when I qualified
7:22
with my level three and then I got my level four just over a year after that.
7:26
So I still feel quite new to it, but not brand spanking new anymore.
7:34
Because of where I live, the population density is quite low.
7:37
So I wouldn't say I specialize really strongly in any particular kind of client.
7:41
I get a bit of everything, but I do have certain issues, client groups,
7:46
I suppose, that really interest me.
7:48
And one of those is women, and especially women going through perimenopause
7:52
who are, you know, menopausal, postmenopausal.
7:55
I see quite a few of those women as well.
7:57
So yeah, it's something that really interests me.
8:00
Fantastic thank you very much i just have
8:03
to say for the podcast because people can't see where you're sitting when you
8:06
say shed i know it's a sudden thing but shed for me
8:09
is like a very small place which looks a bit like a
8:11
big kennel and there's no way there's no
8:14
way what you're sitting in could be compared to kennels beautiful and
8:18
that episode kind of you have to describe us and there's i think
8:20
it's photos and images as well before and after yeah if i
8:23
remember your hubby or something in wellies oh i
8:26
don't think i posted the picture of him using the concrete breaker in his
8:29
crocs it's fine we won't
8:34
bring it up again brilliant so um so i
8:38
guess that's i mean my next question is going to be why out of all the episodes
8:41
we've got did you choose jenny bowles one but i guess
8:43
that's it were you at that time do you
8:46
know what i so i didn't listen to this one when it was first recorded
8:49
i listened to this one it would have been in kind of late summer early
8:52
autumn of that same year so I had been going
8:55
for a few months and because I initially
8:58
when I started my training I joined the FHT and then
9:01
that membership had lapsed I decided to join the Sports Therapy Association
9:04
instead and I was kind of at that point of like okay it's going okay I'm getting
9:11
clients through the door you know things are building up nicely but what do
9:16
I actually want this business to be? Where do I want it to go?
9:20
I think also, and I know this has been talked about on other podcasts and it's
9:24
discussions that, you know, people in the industry have,
9:27
I think you sort of qualify and you're like,
9:30
I'm going to go and I'm going to massage people and I'm going to save them and
9:33
I'm going to make their muscles longer and I'm going to change their joints
9:36
and I'm going to release all the toxins because that's what very often,
9:40
that's what I was told when I did my training course. And of course you believe what people tell you.
9:45
And then you learn a bit more you're like actually I'm not going to lengthen
9:48
muscles and I'm not going to release toxins I'm going to do something but what's
9:52
it going to be and actually am I doing any good
9:55
am I making a difference am I just giving people a nice back rub and making
9:59
them feel better so then I listened
10:00
to this podcast and I found it really validating and really inspiring,
10:05
and in some ways a bit frustrating not because of the information or the podcast or Jenny but because.
10:11
I'll talk about why in a minute, but really inspiration.
10:14
It's like, yes, this is something that's worth doing.
10:16
This is something I'm going to carry on and this is what I now want my business to be.
10:21
That's great. I mean, I'm sure I'm going to edit that and send it to Jenny because
10:25
I'm sure that's everything she wants to do.
10:31
Great. That's amazing. So, yeah, I mean, that's such nice to hear that for listeners,
10:36
I think that, yeah, you went through the same kind of process where you did
10:40
have to tweak and change some of the things you've been taught.
10:42
You do go through some emotions don't you where some people get
10:44
angry straight away some people get sad some people just chuck
10:47
it in and think i can't do this anymore which is tragic it's
10:50
a waste of a wonderful human being who wants to help others so
10:54
that's a great reason okay i'm really glad to hear that episode helped
10:57
with that so maybe for listeners who aren't aware i mean straight away in the
11:02
episode jenny and you've mentioned a couple as well jenny introduced to terminology
11:05
like perimenopause of menopause menotransition of postmenopause yeah maybe for
11:10
the listeners could you give a little breakdown of of how they are different and and the timeline
11:16
yeah sure so perimenopause is when all this starts is when your hormone levels start to fluctuate.
11:23
One of the things i think that i thought because a lot of this was new information
11:27
to me when i heard on the podcast which is what made me so cross because it's
11:32
like i am a woman heading for 40 and no one has told me any of this stuff and
11:36
this is going to happen to me why did no one think did no one think this would
11:39
be happy, this would be good to mention.
11:41
So it's not a smooth kind of downward slope.
11:46
Your hormones kind of go, they go up, they go down, they go crazy.
11:49
Your estrogen levels will fluctuate.
11:51
It's one of the reasons that, for example, if you go to talk about your hormone
11:55
levels and someone says, we'll do a blood test, there's not much point because
11:58
tomorrow, your hormone levels could be totally different. That's only a snapshot in time.
12:03
You go through all that for a period of time that can be years.
12:08
And then menopause is the one day when it has been one year since your last
12:12
period. And that's the day you hit menopause.
12:14
And then every day after that, you're postmenopausal.
12:17
That's kind of it. That's really interesting. And it reminds me,
12:22
yeah, the points made in there.
12:23
So when we think perimenopause, and I'm speaking out for listeners,
12:28
I know not thanks to people like Jenny, but I think people believe that that's
12:32
kind of like the months leading up to menopause or something.
12:34
But you said yourself it could have been happening. Yeah, yeah.
12:38
And it has, there are so many different things that perimenopause affects.
12:42
Again, people, you know, my impression was like, you might get some hot flushes
12:46
and you might not sleep very well.
12:48
There you go. That's perimenopause. It can affect lots of things.
12:53
It can affect, you know, I've got really dry eyes. I have contact lenses in
12:56
and I have to put eye drops in all the time now.
12:58
That can be a perimenopause thing.
13:01
It does affect your sleep. Yes, you will get hot flushes, your temperature regulation.
13:05
You can end up feeling cold.
13:07
You can end up having all sorts of weird and wonderful symptoms.
13:12
I did a really interesting evening in the local village hall,
13:16
the perimenopause specialist nurse, the menopause specialist nurse in the area
13:20
did an evening and we went along.
13:22
And the list of symptoms we all came up with was extensive and alarming.
13:27
And it was also great for me because virtually everyone in there was either
13:30
a client or someone that I knew in the villages.
13:33
I know all of you, half of you have been semi-dressed in my treatment room. Nice to see you all.
13:39
But yes, this is definitely one of my main client groups. Here they all are.
13:43
But yeah and i do and i did and yeah that is what i found so frustrating this lack of information,
13:51
that women have this idea that we all
13:54
or at least in my case nobody ever thought
13:57
it was worth mentioning this nobody ever thought
14:00
it was worth explaining this and you can end up feeling like you're
14:02
going bonkers i'm interested i'm interested in this like i i don't want to pry
14:07
too much into personal life but sisters mum was there opportunities for people
14:13
to say it to you I'll watch out for this or so I my sister's younger than me
14:18
so she's got all this to come.
14:21
My mum I knew a bit about what my mum went through but it wasn't a big conversation we'd had,
14:27
I've talked more about it now actually with women in my family quite often anxiety
14:35
is a big thing that happens.
14:37
I know that my grandma ended up on Valium during her sort of perimenopause transition
14:42
and then had to go cold turkey.
14:44
And that's one of the things that my mum remembered. But I think that,
14:47
again, one of the things that I think Jenny talked about was making this a normal
14:53
conversation for people to have.
14:55
And I think our generation of women, because we have the internet,
14:58
it is a much more normal conversation to have.
15:01
You can go online and you can talk. You can find women all over the world and
15:05
you can talk to them about this and you can do so if you want to.
15:07
You can do so anonymously so you don't have to feel embarrassed.
15:11
Actually people in the past did not have this and i don't know if there was
15:15
a stigma but i think there was
15:16
a bit of a taboo and so yeah it wasn't discussed hugely openly let's say,
15:23
very interesting so for listeners listening now one if you suspect that you
15:29
are having symptoms that could be connected this and you're in your mid to late
15:33
30s one is put it's potentially possible you're not going crazy and two is normal
15:38
that you haven't found out about it or no one's told you about it.
15:41
There's not to be embarrassed because you'll probably find that a lot of your
15:44
friends as well don't know about it.
15:45
I think Jenny says something, which I remember now, she says something along
15:49
the lines of you find out, oh no, you know about menopause when it happens or
15:53
something. You know, you know about menopause when it's there.
15:55
In the lead up to, you've got no idea and then boy, do you know about it when it happens.
15:59
Absolutely. You're just bimbling along, quite happy. You've spent the last 30
16:03
years getting the hang of periods and all of that stuff and then suddenly your
16:05
body goes, hey, no, no, no, no, we're not doing it this way anymore.
16:09
Like, oh my God, I wasn't ready for this.
16:12
So yeah, and I think that often we can have those conversations as therapists
16:18
because we have the chance to build relationships with our clients and to build
16:22
that therapeutic alliance.
16:23
And so I feel quite strongly that it's important that we have at least a basic
16:29
understanding of this, even if we're not title experts, I think that's fair
16:33
enough, but that we recognize it or recognize it on some level.
16:38
I think it's really important that we try and find out what's around in your local area.
16:42
Who's there? Where can we send people to? Where can we send women to if they
16:45
find they're struggling?
16:47
Because we might be the first point of contact someone has. Someone comes to
16:51
you with something like a frozen shoulder.
16:53
Or I think Jenny was talking about
16:55
gluteal tendinopathy that just won't go away. All that kind of thing.
16:59
Perhaps they'll come to us first. And I think that's, it feels like quite a
17:04
responsibility in some ways, but it does feel important to know about this stuff. Thank you.
17:08
It's interesting. So because it's one of those things, isn't it,
17:11
which feels weird to add to your subjective and your initial consultation and stuff.
17:16
But we ask about pregnancy, that's going to be on the list.
17:19
I think most people now will ask about potential saddle soreness and things
17:23
like that or pain when you go to the toilet and stuff like that.
17:25
But it's just another thing which might feel a bit weird to start off.
17:28
But at what stage do you remember when you did start asking people about if
17:35
they knew about symptoms of menopause or maybe history of pregnancies and things? Sure.
17:41
It was right after I listened to this podcast, I went out and rejigged my consultation forms.
17:46
So before every first appointment, I send an online form out,
17:50
which is like, you know, have you had cancer?
17:53
Have you done this? And now there's a section that I ask, do you have a regular menstrual cycle?
17:58
For my female clients, obviously. Are you pregnant?
18:01
Are you in perimenopause? Are you taking hormonal contraceptives? Are you taking HRT?
18:06
Are you postmenopause? And then explain what that is. And so it opens that conversation up, I think.
18:12
And I also think putting that in writing and then sending that over to someone
18:16
gives them time to think about it, as opposed to just confronting someone when
18:19
you've only just met them. So how are your hormones?
18:21
Very good. You know, that can be a bit of an intimidating question.
18:25
And some people, I mean, I would be delighted if someone asked me that.
18:29
I would probably spew out all the information immediately.
18:31
Let me tell you about what's happening to me right now. I'm furious about it.
18:35
But some people will feel more reticent, and that's fair enough.
18:38
It gets people to think about it. And you might not mention it.
18:43
In the end, it might not be relevant, but it might be. And it just gives you
18:47
an idea of what's about to come through the door as well.
18:50
That's such a good bit of advice. That really is. In terms of communication,
18:54
I'm sure a lot of what we talk about in the next 20 minutes will be about communication and that.
18:59
But yeah, sending that pre-questionnaire, which you've got the open-ended questions
19:03
of just yes and really cool to get them out of the way.
19:07
Because otherwise, if you do it when they come in, it just turns into a Q&A
19:11
session of closed questions, isn't it?
19:13
Where they just go, yes, no, yes, no. And you're not going to get your client
19:15
to talk or really unpeel layers sort of stuff.
19:18
So get them out of the way and then give them the open-ended questions when
19:21
they come in. Yeah. Very cool.
19:24
And it can be, it might be several appointments down the line that this becomes relevant.
19:29
So I had a lady who came to see me quite a few times.
19:33
Basically, she had fallen over playing a racket sport and she had,
19:37
I say she fractured her clavicle. I saw the x-ray. She did a proper job on it.
19:41
It was surgically pinned. She was having physiotherapy and she came to massage to help.
19:46
And as we went through our chatting, I was like, you know, after a few appointments,
19:52
I was like, you know, you really did do a number of, did anyone sort of talk
19:55
to you about bone density and that kind of thing?
19:58
So, well, they said it definitely wasn't osteoporosis. Okay.
20:01
You know, you said you're postmenopausal. When did you hit menopause? Well, I was 42.
20:07
That's quite young. And I was like, okay. And then later on,
20:10
we were talking about her mum having experienced osteoporosis and having suffered with that.
20:15
And because I had all those bits of information, it's like, I'd probably go
20:19
back and have another chat with your GP about that and see if they'll refer you for a DEXA scan.
20:23
You know, I would probably go back and have that chat, I think.
20:27
And she went back and she had the scan and we're waiting for the results.
20:31
But because you've got all that information, it gives you what you need to talk
20:36
to that client and help them come to the decision.
20:39
And empower them to go back and say, well, actually, just you saying,
20:42
oh, no, it's definitely not that and not explaining why. I'm not very happy with that.
20:45
Actually, I'd really like you to explain your reasoning if that's okay.
20:49
Because we don't screen for osteoporosis. I think we should personally.
20:53
But I'm only a massage therapist, so what do I know? But, you know, we don't.
21:00
And really, waiting until someone's broken something is a bit late.
21:04
So, yeah. It's lovely hearing you because, and we say this so much,
21:09
as a massage therapist who is straight away getting that therapeutic alliance,
21:14
you're about to put your hands on them, they're taking their clothes off.
21:16
There's a trust there and a confidence.
21:19
So when you do, if you give them open-ended questions, they're more likely to
21:23
come out of these things and adopt a state of mind where they're actually going
21:26
to go to the GP instead of just going, yeah, yeah, I'll do it.
21:28
I'm not going to do it at all. so we do have
21:32
a wonderful opportunity to play such an important part in the diagnosis and
21:37
earlier diagnosis and prevention of misdiagnosis in this so it's great it's
21:41
really nice hearing you do it does it empower you does it make you feel good
21:44
as a therapist when you know that she's been to see a lot of allied health professionals
21:48
and that and it wasn't really,
21:50
signposted whereas you just a massage therapist you must feel quite good about
21:54
it without blowing out chumpy but it's course fulfilling i mean yeah it is i
21:59
think i think there's something.
22:02
I don't want to generalize too much and say all women experience this,
22:06
but i've certainly experienced having sort
22:09
of women's problems fobbed off and
22:12
dismissed and not really taken very seriously
22:15
and i think that is a
22:18
wider problem than you know just the
22:21
medical profession i think that speaks to our whole society women's pain
22:24
is undervalued it's not always taken seriously so
22:28
actually being the person who gives
22:30
someone hopefully the impetus to say no it is okay for you
22:33
to go and argue about this feels really good
22:36
and it's like I really wish someone had said to me you know what you can go and
22:39
argue about this you don't have to wait 20 years you
22:41
can go and you know complain about it and say no this is not good enough it's
22:46
really nice to be the person that I kind of wish had spoken to me if that makes
22:50
any sense brilliant that's amazing so it's so nice to know that listeners are
22:55
going to hear this from you amazing
22:56
and thank you so much for sharing with this it's so so very much what.
23:01
I think these reflection series can help therapists with you know hearing it
23:05
from other clinicians it's so cool i just wanted to say nikki that was nice
23:08
as well nikki mansfield said gives the client permission to talk about it too
23:11
and might spark their own curiosity about how linked all these things might
23:14
be sparking curiosity in their own health is just how to get behavior changes
23:19
you You know, we tell people all the time,
23:21
listen to your body, listen to your body, listen to your body.
23:24
Sometimes maybe what we need to be saying, these are the questions you should
23:28
be asking your body. Here are some things to listen out for.
23:31
Otherwise, it's a bit amorphous and a bit like, well, what does that actually,
23:34
what does that mean kind of thing? Listen to your body. You can sort of,
23:39
You can sort of help people to draw their own conclusions, I think.
23:44
And I mean, also, we are in a strong position, I think, as therapists,
23:48
as you said, to link things together.
23:50
So one of the questions that we might ask, for example, is, you know, how are you sleeping?
23:54
Which is something that we would probably ask every time when we're doing our subjective.
23:58
If someone is perimenopausal or
24:01
postmenopausal and they say to you well do you know I'm not sleeping very oh
24:04
why is that I have to get up and wee three or four times a night
24:07
that again that can be a menopause thing that
24:10
can be a sign of vulval atrophy or vaginal atrophy that is incredibly common
24:15
and eminently treatable and it can really really affect people's eyes very badly
24:21
it can cause things like recurrent UTIs which when you're a younger woman is
24:26
okay But when you're getting to, you know,
24:28
20, 30 years down the line after
24:30
your menopause, it can make people really ill. It can finish them off.
24:34
So, again, if you can be the first person, say, well, actually,
24:37
you don't have to put up with that. You can go and see your GP.
24:40
Maybe go and have a word with them. You could really be helping someone,
24:44
not just today, but sort of 20, 30 years onwards.
24:47
So that is one of the things that I feel quite firmly about.
24:53
Yeah, but it's great. It's just a lovely process of just questions and many
24:58
questions and they start answering and reflecting and the aspirant can lead
25:02
to, yeah, like you say, in some cases, yeah, very much life-changing situations.
25:08
You mentioned a couple of times. Oh, sorry. There you go. Sorry.
25:10
I just can say we have the luxury of time. We don't have to fit it all into
25:12
10 minutes. That is true.
25:14
And like you say, it might not be straight in that first initial consultation.
25:18
It might be after you've given them some fantastic relaxation and kind of desensitization
25:24
that they're going to open up.
25:25
So that's the power of them the human touch i wanted
25:28
to make sure we fit it in you mentioned a few times like gluteal tendinopathy and
25:31
shoulder issues can you explain to our listeners what the connection is
25:34
with regards to menopause and a
25:37
higher prevalence of tendon issue so
25:41
when you your estrogen levels
25:44
drop during menopause that sends your
25:47
body into kind of an inflammatory state essentially so
25:51
when you then tweak something you're
25:54
already in a state of inflammation and then you're getting more inflammation on
25:57
top and so you know we
26:01
the link between frozen shoulder and menopause is not one
26:03
that I'm fully clear on I have to be honest but I'm not sure how well studied
26:08
that's been but there does seem to be a link there although as I understand
26:12
it we don't know fully what it is but yeah tendon issues because everything's
26:16
already a bit inflamed and then you go and poke it and it gets even more so.
26:21
And that's one of the things that Jenny talked about as well.
26:23
And that's one of the things I talk to clients about, because one of the things
26:28
that means is that things might take longer to clear up than you might hope.
26:32
And, you know, if you have tweaked your knee before.
26:36
And it cleared up in this many weeks, maybe now it's going to take a bit longer.
26:40
If you can introduce that and explain that and say, look, it doesn't mean it's
26:44
going to be like this forever, but it might take a bit longer to get better.
26:48
We might need to progress your exercises more slowly.
26:51
You know, you might need to look at, Jenny talks a lot about anti-inflammatory
26:54
diet, you know, making sure you're doing what you can to get your systemic levels
26:59
of inflammation down, which will then help with that kind of topical localized inflammation as well.
27:05
And i think again just having that information just knowing that it's okay it's
27:10
going to get better it might take longer but it is going to get better and i'm
27:13
not going to be cropped forever
27:15
is really powerful and will really affect someone's mental state
27:18
and of course that affects then how they feel in their body without
27:22
a doubt and of course the whole ecosystem as well
27:24
because we're not just seeing that patient we're seeing also their relatives
27:27
the people that live with the children the husband the partner whether
27:30
it is the pet it's all you're changing very
27:33
much that whole ecosystem which is so it's lovely
27:37
i like to think of it as a really nice responsibility it's
27:40
something we can help with hugely especially and i think even if someone comes
27:46
to see you and they haven't got you know tendinopathy or frozen shoulder or
27:49
something one of the things that tends to happen that age of menopause transition
27:53
of perimenopause is often an age where women are getting pulled in 14 different directions already.
27:59
And then your hormones go crazy. And I think one of the things I'm probably
28:03
paraphrasing a bit here, but one of the things that was said in the podcast
28:06
is actually just having a massage
28:09
and some time to be looked after is very powerful and very worthwhile.
28:13
And I think that's what I found really validating about this.
28:15
It was like, actually, even if all I'm doing is having someone lie on my table
28:19
for an hour and be looked after rather than the person doing the looking after
28:24
that is still valid and valuable and worthwhile.
28:28
And so I can keep doing that and know that I am making a difference even if I'm not I don't know,
28:34
lengthening their quads or whatever that's fine and yeah I think sometimes the
28:40
best thing that we can do is just look after someone for an hour so they don't
28:44
have to look after anyone else.
28:46
Wise words hannah very wise
28:50
words i was gonna rant you have
28:53
to try and get along to the fta conference because it's just i mean this is
28:56
something which we're trying to help people with because massage therapists
28:59
do believe they're at the bottom of the food chain that they're just giving
29:02
someone a massage to feel better but what you've just said encapsulates the
29:05
whole thing about that down regulation of
29:08
the nervous system is something which will help people either talk about
29:11
something if they want to maybe not with you maybe when they get home it
29:14
gives them time to think get clarity relief from pain even
29:17
if it's only temporary it allows those better
29:20
decisions to be made and it's yeah it's
29:23
massively huge it's why the other guests we've had on the show say even
29:27
whether it's surgeons or it could be female health
29:30
physiotherapists it could be male pelvic health physiotherapists they all have
29:35
massage therapists involved in that circle of care because they recognize that
29:39
this down regulation this yeah this touch is can plays such an important part
29:43
not always but a lot of the time because humans basically like a bit of,
29:47
primal grooming they like that contact it's in our nature most of the time yeah absolutely.
29:53
Very cool stuff i'm going to address jackie's comment
29:56
here thanks for sharing jackie i'll read it out loud for people listening
29:59
to the podcast jackie barker says i had a surgical menopause
30:02
age 28 this year
30:05
now 28 years post-menopause i was told i had to acquire a
30:08
dexascan every five years i had one 23 years ago i had a few msk issues and
30:12
have been asking for a dexter scan on and off for the past five years eventually
30:15
i spoke with a different gp who asked when did you have a last dexter scan yeah
30:20
i don't know and it is ridiculous because you know obviously if,
30:28
jackie's having there's going to be a massive cost to jackie you know in terms
30:33
of vulnerability to fractures and the pain that causes, there's also a huge
30:38
cost generally to us as a society.
30:40
If we've got women falling over and fracturing their hips left,
30:43
right and center, this is not good for anyone.
30:46
And, you know, from, I've never had a DEXA scan, but from speaking to my client
30:50
who went and had one, it was not an involved process.
30:54
You know, it didn't take a long time. I think she went, it was set up in a supermarket
30:57
car park somewhere in one of the local towns.
30:59
So it's like, why this is this is something that we
31:02
could be doing why are we not doing this why are
31:05
we not doing this why are we waiting for problems to develop and
31:08
then go oh dear we're going to have to do a hip replacement or oh dear you're
31:11
going to be in hospital for ages or oh you're going to be in rehab or you know
31:15
or maybe you'll never go home again because once you get to you know talking
31:20
about much older people you might not be able to live independently anymore,
31:25
if you break a hip that could be it,
31:28
So why on earth are we not addressing this? Although this is going away from
31:32
massage therapy and back into the world of campaigning. And I don't do that anymore.
31:37
She said. She said. No, it's great. Thank you, Jackie, for sharing that.
31:42
But I think what's interesting for me is when you went to a different GP,
31:46
and that kind of reminds me of what you said, Hannah.
31:49
If women are empowered to actually speak up and go and see someone else,
31:53
if they're not happy with the way they've been treated or something.
31:55
And this reminds me of Alistair Beverley, the learning disability physio.
31:59
He was talking about diagnostic overshadowed, which I'm sure you saw that episode.
32:03
And he was talking about it initially with how people with learning disabilities
32:07
can come with an issue and symptoms, which if they didn't have that learning
32:12
disability, they would be investigated.
32:14
But because they've got Down syndrome or something, then it's kind of,
32:16
they thought, oh, it's just part of that, isn't it? That's why you're acting like that.
32:19
But he was very quick to say this can happen with women. In fact,
32:22
it happens a lot with women.
32:23
They say that he seems just because oh you're going through the you know it's
32:27
a menstruation issue or it's because you hit the menopause and it's it is sadly
32:31
diagnostico-shadowing yeah,
32:33
and i mean it's something the someone in my own family was suffering from certain issues,
32:40
and went to the gp and was told well that's normal it's not normal what she
32:44
was suffering from it's common but that's not the same as normal and she had
32:48
to go and see someone else to get treatment And you just think,
32:51
how many women are being sent away going, well, that's fine.
32:55
Somebody else, I'm really going to start ranting that. It makes me really close.
32:59
It was anyway since 90. I know. That's true. You'd be like, cut her off.
33:02
A friend of a friend went to see her GP who was trying to persuade her to stop HRT.
33:07
And he said, well, we used to go through menopause without any of this HRT stuff.
33:11
Did we? We? Who's this we?
33:15
We? Okay. As my friend said, we used to do amputations without anaesthetic,
33:19
but we have moved on from that point. That's a good point.
33:23
But yeah, it's... But it's interesting.
33:26
I mean, yeah, even with GPs, people think all GPs are going to be trained the
33:30
same amount and they've got the same way of dealing with patients.
33:33
But there's going to be good and bad in every profession. But I think,
33:35
Leah, the important thing is have the power, in this case, if you're a woman
33:41
with symptoms like this and not quite sure that what you've been told is you've
33:44
been treated fairly or listened to.
33:46
If you've ever been listened to, then yeah, go and see someone else.
33:49
Yeah. You know, don't let them say you're just nagging and complaining about
33:52
something you should put up with it because it's, no.
33:55
And don't wait till it gets bad. You don't have to wait until it gets really bad.
33:58
You are allowed to go when it's just irritating. Oh, yes.
34:03
Leslie has been triggered and we haven't released the rant.
34:06
What a lovely iteration, Leslie. Thank you very much. One of my clients called
34:09
me a terrier the other day because I was ranting about this very issue. Yeah.
34:15
It's funny, isn't it? Because the patriarchy who told women,
34:18
oh, stop ranting, stop going off.
34:20
The patriarchy who used the word hysterical, taking it from Latin for the woo,
34:25
they're the same people who are probably saying, oh, just go away.
34:28
There's nothing wrong with you.
34:29
It's ironic. I'm sure we used to manage without this kind of thing, did we?
34:35
Very interesting that is so interesting yeah amazing
34:39
amazing yeah reflection thank you and i think
34:42
i liked how jenny because we've talked
34:45
already how yeah the depletion estrogen and that and more susceptible
34:48
to this and this and this blah blah blah and even towards the
34:51
episode back two or three years ago with jenny i was like
34:54
inside i was thinking oh wow women listening to this are
34:56
just thinking this is the end of the road i might as well just give up now turn the
34:59
light off because it's all downhill from here my body's just giving up but
35:02
I liked the way well first of all you know
35:05
in your experience is that a common feeling amongst women
35:08
is there a danger for them to think I think there's definitely a danger of that
35:12
I think especially when you're in the thick of it and I'm not fully in the thick
35:16
of it yet I am on the nursery slopes and there are still days when I think could
35:20
we just stop this is not fun I remember saying to my mum I feel like all the
35:26
things that give me joy in my life are going to be gradually stripped away.
35:29
I'm not going to be able to run anymore. I'm not going to be able to do this.
35:31
I'm not going to do that. And I know that's not true. In my head,
35:34
I know that's not true, but that is how I felt.
35:37
But I know, I remember you asking Jenny that question.
35:42
Is everyone going to be massively, massively depressed? Is it actually all terrible?
35:47
And my observation is no, there is, the other side is there.
35:52
I think I've just signed up for Jenny's Third Age Woman course.
35:56
I haven't managed to watch any of the videos apart from the introductory ones yet.
36:02
But she describes it as a rite of passage, and I think it is.
36:05
And no one ever said rites of passage were easy.
36:07
But you do go through it, and there is another side.
36:11
And I think there is power in getting through the side and still being there
36:18
and still being willing to use your voice.
36:20
And especially now, when we do talk to each other more,
36:24
when it is so much more of the conversation now, people like Davina McCall and
36:31
other sort of celebrities talking really openly about their experiences and
36:34
really removing some of that taboo, I think the only way is up.
36:38
The other thing that jenny said that i really liked in the introductory thing
36:42
was when you're talking about the statistics so things like stats for osteoporosis
36:47
and all that kind of really scary but they are historic they are reflecting
36:51
the situation you know these.
36:55
Ladies they were going through their menopause transition maybe
36:58
30 years ago without any of the information or
37:01
treatment options or knowledge that we
37:03
have available to us now so in 30 years
37:06
time how different will those statistics look we have the opportunity to make
37:11
to make that change no one was talking about lifting weights 30 odd years ago
37:16
not for women anyway because you didn't want to get bulky it was all about i
37:21
was having this conversation with a client she's like yes you did aerobics in
37:24
your green leotard with the green goddess,
37:26
and it's all about cardio and i find that very reassuring as well that we do have the opportunity.
37:33
You know to a certain extent aging is going to happen but we
37:37
can use the information we have now to do it as well as possible
37:40
that's very cool yeah yeah
37:42
that's it's great and yeah i
37:45
mean it's easy to say isn't it but i think with
37:49
people like yourself helping patients and other listeners
37:52
if you can do that then you can help the person
37:55
find if you might not be straight after you say this
37:58
wonderful thing they might just go yeah right thanks bye but you
38:01
can sow the seed and it is like jenny says it
38:04
is kind of the beginning of a new chapter it's not the end it's
38:07
the beginning of a chapter i think she describes it she says lovely she
38:10
says women over 50 are both powerful powerful terrifying
38:13
and dangerous that was the one yes i
38:17
agree liberation you know
38:20
that's the way to kind of look at it but yeah
38:23
society needs to change everything around you needs to change to understand
38:27
that as well to make it you know I think my observation is you appear to run
38:31
out of flips to give it's a family show yeah I was like do you know what yeah
38:38
that's fine and I think yeah there is power in that.
38:42
Very cool. Okay. Well, that's been a wonderful reflection. Thank you so much, Hannah, for your time.
38:48
Excellent. I can't wait for people to listen to this. If you have been listening
38:52
and you have been affected by it, then do please let us know.
38:55
You can go to YouTube and leave some comments in the YouTube section that they get a life forever.
39:00
They've got a wonderful shelf life and they're appearing in Google as well.
39:02
So use YouTube if you can.
39:03
If people want to get in contact with Jenny, then bowleducation.com.
39:08
Still there very much so. A lot of it's online now. i've had
39:11
some wonderful courses including i saw recently the
39:14
brand new 200 hour therapeutic coaching for women diploma the
39:18
one you mentioned hannah was i think it's third age
39:21
woman so it's all the way through the whole
39:24
menopause extravaganza yeah there's
39:27
an awful one there and it's worth just checking out to stimulate thought and and
39:30
get the same kind of empowerment which hannah had from listening to
39:32
the episode i hope you've got from listening to hannah tonight so do check
39:35
that out viraleducation.com link will be in the show notes
39:38
and then if people well when people have enjoyed
39:42
what you've been saying and if they want to follow you and get
39:44
in contact with you we've got hannah tabham.co.uk website
39:49
and then social media where do you mainly hang
39:51
out these days at the moment mostly on facebook although
39:54
i have to admit most of my updates at the moment are making sure people don't
39:59
go to the wrong place because i've had to move out of my treatment room temporarily
40:02
i love i was just looking i love the comment that um nikki just made about not
40:07
waiting for the other side and finding good things in perimenopause,
40:11
which I think is awesome.
40:13
And yeah, talking to your friends and finding that kind of community, I think is awesome.
40:21
And it's kind of a shared experience in a way. So yeah, I love that.
40:27
Nice one, Nikki. We like it. Sisterhood has been a massive one.
40:30
I'm talking more deeply with my girlfriends than ever before as we share it
40:35
nice very cool so yeah hannatapham.co.uk Facebook just look up Hannah Tappham
40:40
Sports Massage Therapy there is an Instagram page as well just got some stuff
40:44
on there Hannah Tappham Sports Massage yeah I remember to post on there.
40:49
Now we've announced this to the world and you're going to have to put something
40:52
on there okay that's fantastic,
40:54
next tuesday continuing
40:58
this reflection series i'm going to be talking to it's the
41:02
same ballpark it's brilliant i'm so glad that these two i mean you just chosen
41:05
one that interested you next week physiotherapist emily sweet has also been
41:09
on the show before she's going to be reflecting on one that was actually early
41:13
on this year in february which was pregnancy related back and pelvic pain so
41:17
you kind of we're in the same kind of ballpark here which would be nice,
41:20
excuse me which would be nice to continue the conversation i'm sure there'll be lots of parallels.
41:23
That episode 229 was recorded, like I say, in February with a special guest, Michelle Lyons.
41:31
And yeah, Michelle Lyons, spoiler alert now in case you wanted to wait until tomorrow evening,
41:37
but Michelle Lyons is signed up already to be speaking at the Hands On Hub and
41:42
STA conference in September. I'm so excited. I couldn't keep it any longer.
41:46
So yeah, if you're interested in seeing Michelle Lyons once again, oh man,
41:51
last time I saw her at conference, it was just in the aisles it's
41:53
amazing so yeah exmouth september look
41:58
out for the release of details and tickets tomorrow but
42:00
yeah michelle lions is one of our keynote speakers who will be talking in exmouth
42:04
in september at the hands on hub and sda conference so that's great glad i got
42:08
that off my chest now it's like i feel cleansed so so wonderful thank you hannah
42:14
it's been really really great listening to you really really nice really enjoyed
42:17
it and thank you everyone who
42:19
us live thank you for everyone who shared your own personal experiences i
42:21
really appreciate that so jackie barker thanks for sharing and nikki and everyone
42:26
else who is with us in the live lounge i really do appreciate it if you have
42:30
listened to the podcast and you want to join us live then like i say eight o'clock
42:33
on a tuesday on the sports therapy association youtube channel if you're happier
42:37
listening to the podcast then that's fine but do please just leave a rating,
42:41
and a review because that's how we get this kind of word good word out to more
42:47
people The more you leave a rating and a review, then the more it goes up the Google rankings.
42:51
And that's what we're trying to do, put out quality information.
42:54
So do please take time to do that if you'd be so kind.
42:58
Right then. Thank you, everyone. Hope to see some of you on Tuesday.
43:01
Thank you, Hannah Tabra. I really enjoyed it. I'm even looking forward to listening
43:03
back to it. It was wonderful. Thank you so much. Love the chance for a rant.
43:08
Music.