Today we chat with EP Alice about all things exercise, self care, and managing “nurses back”!
This has been a requested podcast and here it is!
I learnt so much from Alice about pain management, how exercise helps us all both physically and mentally.
I hope you enjoy and use the information shared by Alice.
Find an Accredited Exercise Physiologist near you.
Exercise & Sports Science Australia (ESSA) is the nation’s leading voice on exercise and sports science. We govern and represent university-qualified professionals who support Australians to reach their health and performance goals. Find out more: essa.org.au
Featuring Accredited Exercise Physiologist, Alice Hyslop from All Sports Indooroopilly, QLD - allsportsphysio.com.au
Contact Alice: alice.hyslop@allsportsphysio.com.au
Sponsored by Nutricia. This episode was created independently by the presenters/speakers and the views expressed herein are those of the presenters/speakers, not of Nutricia. This content is intended for healthcare professionals. Medical professionals should rely on their own skill and assessment of individual patients.
Support the show: https://www.patreon.com/tendernessnurses
See omnystudio.com/listener for privacy information.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:05):
Appochia Production.
Speaker 2 (00:10):
Hi everyone, thank you for tuning back into Tenantus for Nurses.
I suspec Woodbine here this season. I am so excited
to announce that the podcast is being supported by Nutritia,
which is a global leader in medical nutrition. They understand
the needs of nurses in the nutrition space and for
over one hundred and twenty five years have provided products
(00:31):
to support child health. Some of Nutrita's pediatric brands include
Neo Kate Junior for children who have food allergies and
appt to Grow for those fussy eaters. And those of
us who have children know many kids who go through
the phases of definite fussiness. For more information and resources,
visit the nutritiona Pediatrics hub at nutritia dot com dot
(00:54):
au forward slash Pediatrics. I just want to say a
huge thank you to Nutritia. Their desire to support nurses
is truly appreciated, and they are allowing me to continue
this podcast so that we can all grow as nurses.
This season, we have some amazing speakers in the pediatric
space which I cannot wait to share with you all. Hi,
(01:14):
my name's Beck Woodbine, and welcome to Tenderness for nurses.
Speaker 1 (01:17):
I'm grateful for the person that I have the opportunity
to be, so I hit it and parked it for
Nellie four years.
Speaker 3 (01:27):
We always have free will, We always get to choose.
Speaker 1 (01:29):
We are autonomous.
Speaker 2 (01:32):
Hi, everyone, thank you for tuning back into tenderness for nurses.
Speaker 1 (01:36):
Today.
Speaker 4 (01:37):
We have the.
Speaker 2 (01:38):
Fabulous Alice Hislop who was an exose physiologist, and it's
pain Week this week, and I thought it was really
important for us to talk about nurses looking after ourselves
pain because so many nurses have bad backs and uteruses
to their knees, and we could go on and on.
So I am very good friends with Samuel, who I've
(02:01):
met through the dog park and we got chatting and
he said, you know what, I've got the perfect person
for you to chat with. And lo and behold, I
know Alice Heir and my daughter played water polo together.
It's such a small word. Brisbane is like one degree
of separation. But look, thank you so much for coming in.
I know you have a busy schedule, but I am
really interested in hearing about what EPs exercise physiologists can
(02:24):
do and how they can help nurses the general population.
Speaker 1 (02:29):
But let's talk about you first.
Speaker 2 (02:31):
You played high level water polo, and I'm assuming you
played that while you're at UNI. Yeah, And did you
straightway decide you wanted to become an exercise physiologist.
Speaker 4 (02:40):
I think I from high school had kind of always
flagged that kind of I guess science sport industry, as
I would say, I think ninety nine percent of people
want to do I had elite sport in my head.
I was like, that's what I'll do. That was my experience.
So I went and did a dual degree of physiotherapy
(03:01):
and exercise science. So I'm an exercise physiologist and physiotherapist.
And I did do sport for about five years. I
work in private practice muscular scalital physio and I did
really enjoy it.
Speaker 3 (03:12):
It gave me lots and lots of skills, but I don't.
Speaker 1 (03:16):
Do it anymore. And I prefer helping the everyday.
Speaker 4 (03:18):
Person because I think exercise is so powerful, whether it
be building capacity or whether it's harnessing its effect on
our mental health and our regulation and using it as
a positive impact for the everyday person.
Speaker 3 (03:32):
And I think we kind of box.
Speaker 4 (03:35):
Elee athletes up with, oh, we get to use all
these special things for them, But exactly the same concepts
and processes and tech we can use for the everyday
person and really harness the power of exercise.
Speaker 2 (03:47):
Interestingly, as you guys know, I recently had major back
surgery and that's what got me chatting with Samuel as
part of my rehab, the physio and the exercise physiologists
and I spend more time with the exercise the EP
than I do the physio. She oversees everything and my
goal was to get back into pilates. I love that
(04:09):
forty five minutes. It was my headspace time, it was
my me time. I enjoyed that type of exercise. But
I didn't realize the value of an EP until I
actually really needed one. And now that I've used an
excise physiologist, it will be something I will continue to use.
Speaker 1 (04:28):
And it doesn't have to be all the time, doesn't.
Speaker 4 (04:30):
No, absolutely, And I think the first question we get
is like, what is an EP. So an EP is
the short name for exercise physiologist. We've done a four
year UNICORSE and I kind of describe us as experts
in exercise and movements. So we help either people with
chronic disease such as osteoporosis, diabetes, or people with musculoskeletal
(04:52):
injuries and we help rehab them post injury. But I
think what's the most powerful thing is we help prevent
injury and we help promote wellness. So post back surgery,
it's a beautiful way to tap into an EP because
we get to focus on people's function, which really aligns
with them being able to achieve things. So, you know,
getting them to squat and work throughout the day, that's
(05:12):
such a functional thing to do and link it to
your specific needs. But going on, we all should be exercising.
There's physical activity guidelines for Australians and a lot of
us don't meet them. But we can make exercise really purposeful.
So we can make it purposeful for our jobs to
make sure that we function the best and we work
(05:34):
the best.
Speaker 3 (05:34):
We can make it the best for our mental health.
You kind of linked in before.
Speaker 4 (05:37):
That's your headspace. It's really important for our regulation. But
we can also make our programs the most purposeful as well.
So I often start with rehabbing someone from an injury,
but then we end up checking in maybe every three months,
because we know our bodies like change in stimulus, they
like change in programmings, whether that be exercises, sets, reps, whatever,
(05:58):
but I might see someone three or four times a
year once they're on that path.
Speaker 1 (06:02):
Yeah. Can people claim to see an exercise physiologist.
Speaker 4 (06:07):
Absolutely, So there's a few different pathways, so people can
claim under health funds as well, and then pending on requirements,
chat to your GP because they'll know what you fit
in there. But there is something called the Medicare Team
Care Arrangement, So people with a chronic disease lasting longer
or likely to last longer than six months, sometimes people
may be eligible to receive some kind of subsidy for
(06:29):
their exercise physiology.
Speaker 1 (06:31):
That's true Medicare.
Speaker 4 (06:32):
Yeah, so there's lots of different frameworks and rules around them.
That so I was like, chat to GP because they'll
make sure you're correctly eligible for it. But there is
that pathway and the reason whether that's there is because
we know that exercise is so beneficial for long term
not just chronic disease. I think we think about diabetes
and things like that when we talk about chronic disease,
but persistently back pain that we see professional and healthcare
(06:55):
workers all around my own profession included on our feet
every day.
Speaker 3 (06:59):
So It's something we really need to take into consideration.
Speaker 2 (07:03):
When I started nursing, and I started in the hospital sector,
we did ninety percent of the lifting, the turning.
Speaker 1 (07:09):
It was full on. Now.
Speaker 2 (07:10):
I was young and fit, but you know I did
catch a couple of patients when they were falling, and
you know, I sustained some injuries. You would never have
put in an instant report back then. You know, that
sort of thing moved fast forward and having nurse for
over thirty years now, my lower back was a mess
(07:30):
because of the position.
Speaker 1 (07:31):
You know, like a lot of nurs a lot of us.
Speaker 2 (07:33):
You know, I did theater for many years, so huge
amount of twisting, standing all day on concrete, moving patients again,
and then now as a dermatology and cosmetic dermatologynurs practitioner,
the funny little bend I have and the twist I
have is what really impacted my back. I think if
(07:54):
I had realized earlier the value of an exercise physiologist.
I mean, I don't think I would have avoided surgery
because there was so much wrong, but it may have
helped my rehab a little better. If I had been
a little bit more aware of the things that an
exposed physiologists can do, particularly as a nurse because yeah, honestly,
nurses backs were renowned for having horrific.
Speaker 4 (08:15):
But absolutely like nursing is such a physical job, right,
and so if you were going to go and do
a sport, you'd ask the question is my body physically
up to this? What capacity do I have? So the
role that the exercise physiologists play is that we are
able to test your strength, your endurance, your posture, your mobility,
(08:36):
lots of different things to go. Where do your impairments
lie and where do your deficits light? And do you
have the capacity to be able to do your physical
job or what areas should we work to improve? Because
if you think of nursing, like all nursing is going
to be different depending on the role, but what's going
to be consistent is that sustained postures and that bent
over hinge position. Whether you are injecting, whether you are
(08:59):
caring for a patient, you're a labor and delivering nurse,
catching that baby, they're all bent over positions.
Speaker 3 (09:05):
And what we can do is then buy mechanically break
that down.
Speaker 4 (09:09):
So we think of that bent over hinge position, well,
that's really a hinge deadlift position, and so well, what
muscles do we need for that? We need really good
glute max but then we need really good rectors abdominers
to be able to hold us in that position. We
need a bit of hamstring as well, so we can
then test and go, well, actually we need to improve
on that muscle capacity to then help you in those positions.
Speaker 2 (09:30):
So EPs in the hospital say, for example, you know
after I had my kids, the physio came and visitors, Yeah,
can an excise physiologist.
Speaker 1 (09:39):
Work out or are they working out of hospitals now?
Speaker 4 (09:42):
Yes, but it's not common yes, So we are seeing
it happen more and more so, particularly in the private
based hospitals that have that outpatient rehab or particularly there
are some specialists that have kind of their own physios
and epteam that might do that. So we're seeing it
become more common in that private sector, which is really
great because I think particularly for that surgery and post
(10:04):
surgical it's improving on the impairments and that deficits that
we alluded to, whether it be strength or endurance or mobility,
whatever it is, and that's where it's quite powerful. We
don't see it in the public setting, but We have
so many great private practice clinicians out there, and I
think that concept that epi's only work with elite athletes
is just not out there. As I said, my journey
(10:25):
is actually find much more rewarding helping the everyday person
achieve their goal because it's whilst winning medals is great
and that's really lovely, being able to have someone return
to work play with their kids. Yeah, you know, that
is the tick for me. And I'm like, if I
can give someone that, that's really powerful. So you said
you've got kids, Yes, how old are your kids?
Speaker 1 (10:48):
Four and seven? Looking at you, I can see that
you're it's still very active. Is exercise something you do
religiously with your kids?
Speaker 4 (10:56):
Like?
Speaker 1 (10:57):
Or you make it fun? Or how do you integrate
fun and exercise together? Yeah?
Speaker 3 (11:02):
Absolutely.
Speaker 4 (11:04):
I often think about exercise as movement because I think
sometimes we can put a lot of pressure on ourselves
to exercise and I have to exercise, and I have
to get here, and I have to get here, and
life is really busy, and I don't think it's helpful
to make myself feel bad if I don't do it.
So I think about movement and I think about engaging
in movement and exercise with them is really important. So
(11:24):
for them, it's much more let's go for a bike ride.
They're really Charlotte's just started touch football, so we're trying
to teach her how to play touch football, so we're
taking the footyball to the park. I definitely also have
the times too that I quarantine my exercise time from
my kids because I think being able to mentally regulate
and have that time for myself, then I'm a better
(11:46):
person for them as well. So sometimes I will actually
be like, no, shut my door. I'm doing my pilates.
It's one of my favorite forms of exercise as well.
I will actually be like, no, I need twenty minutes,
or Charlotte can ride five k's and a bike because
I want to go for a run for five ks.
Speaker 3 (12:02):
So I've kind of integrated it like that. But I
think that's the biggest thing.
Speaker 4 (12:06):
Like if I'm talking to someone about doing an exercise program,
I'll actually start with barriers to exercise because it's often
not about the perfect program.
Speaker 3 (12:14):
The program needs to be good.
Speaker 4 (12:15):
Don't get me wrong, it can't be a bad program,
but it's not that simple because if it was, we'd
all do the perfect amount of exercise and we'd all
be compliant. So you know, barriers can be anything from time, accessibility, finances, motivation.
Speaker 3 (12:31):
Goal setting.
Speaker 4 (12:32):
So I think that is probably where I start to
people and I say, look, we've identified that you need
to get stronger. I need you to go and think
about how you want that to look. Because what's actually
important is we find something that suits you. I'll tell
you if that doesn't align with your goal, I'll tell
you if that's not realistic. But if we can start
with something that you want to do, great, Because sometimes
(12:54):
people just need movement for back pain. Movement is fine,
and so I'm like, pick any exercise.
Speaker 1 (12:59):
I don't care what you do.
Speaker 4 (13:00):
And then other times I've got a nurse who's bent
over someone for an hour at a time because they're
in theater, and I go, look, we really need to
look at your strengthening and your movement patterning and getting
you some functional fitness. Walking's not going to get you that,
So I need you to rethink about how we're going
to put that in your schedule.
Speaker 2 (13:18):
I find once I start exercise, I can get into
a role. How do you get over that hurdle of
starting exercise?
Speaker 1 (13:27):
Yeah.
Speaker 4 (13:27):
Yeah, again starting with barriers, because if we can make
them as minimal as possible, right, we're making that road
much mother and easier for us to get to. So
I do think starting with there, and I'll have that
conversation people and they kind of look at me a
bit funny, and I go, look, I could give you
a goblet square, I could give you a sit to stand.
I could give you ten different exercises and they'll probably
all be achievable. But if I give you gym exercises
(13:50):
and you hate the gym or you don't have time
to go, then it's not going to work. I guess
the other thing too is really have a think about
your goals with it. You know, post back surgery. It
sounds like for you that was that really big motivational
factor for you. You'd have that big event and that
really affect you, and so you're really motivated to get
back into the gym or back in with the EP
and do that.
Speaker 3 (14:11):
Sometimes I think we think, oh, well.
Speaker 4 (14:12):
We have to go to the gym or we have
to do weights, because that's kind of societal and context
like we think that is good.
Speaker 3 (14:20):
But if we can connect it, what does exercise mean
to us.
Speaker 4 (14:23):
You know, in six months time, when we sit here
and we go, yeah, we've had a really successful outcome,
I'll say that person, what does that look like to you?
And that's not what I think it should look like,
but what does it look like to them? And then
I'll reverse it as well. If we're really struggling to
figure out that goal and that motivational factor, I'll say, well,
you've said you've want to exercise. If in six months
time we haven't been able to sort this out, what
(14:45):
effect will that have? What will happen? And so sometimes
reversing that can happen, but it's really tricky. But start
with something you like more practical, start with friends. Like
I say to people, you don't have to like it
all the time. I'm not someone who's going to get
up at four o'clock in the morning. But for my
kids that sounds awful, but it has to be like
(15:05):
so for me running its podcast, like okay, i've got
a podcast, I want to listen to that or get
me out. I know it's so good for my other stuff.
It's about creating space for me. So it's about letting
my husband know I want to do this today and
so he'll make sure he's home in time so I
can go out and do it.
Speaker 1 (15:22):
Do you think scheduling exercise is really important?
Speaker 3 (15:26):
Absolutely?
Speaker 4 (15:27):
You know you think about appointments, you'd always turn up
to them, and so people go the number of times,
I've just got to do it. They're coming, Oh I
haven't been compliant with my exercises. I haven't done them.
I go, okay, they I just got to do them,
and that's just not going to work. Why didn't it work?
Oh I didn't have time. Okay, well next week. Let's
look at your week. When is it gonna go in
and think about specifics when, how where will you be,
(15:48):
what will you wear? How are you going to get there?
Like literally every little detail can help kind of make
that happen from there. And again, collaborating with the nurse
is really important because I might be the expert in
exercise and movement, but you're the expert in yourself, so
you know what's going to work. So I can't say
I'm gonna wear your shoes because it's not the same.
(16:09):
It's you wearing your shoes, and how do you get
to do it? So it's collaboratively connecting together and finding
that solution, and.
Speaker 2 (16:17):
Where nurses physios exosy older, we are so used to
working collaboratively.
Speaker 1 (16:22):
Yeap, that you're saying that to me is just like mix. Yeah,
complete sense. Absolutely.
Speaker 4 (16:28):
And so if you're starting on your journey, it might
be yeah, let's tap in you go, I'm just not
good at doing it myself. It might be tapping into
an EP, it might be tapping into classes, might be
tapping into friends, and you might start with seeing someone regularly.
And then when you've built that up and you're confident
not just in your ability, but we're also confident in
(16:49):
your ability to squat properly, deadly and move properly. Because
it is a skill and it takes time to learn,
it might be okay, cool, don't see me for a
whole other month, and then that'll turn into two months,
and then every three months you're just seeing me to
review your program and progress it.
Speaker 2 (17:02):
I love that concept. A lot of people think it's
going to be hugely expensive. They've got to see you
all the time. I've got to see you once a
week time and cost prohibitive sometimes unless you're a lad athlete,
of course. So that's really great to know. And you
mentioned before that, I could get you into my clinic
(17:23):
and have a look at how I inject or how
I treat a patient, and you can look then at
how I move. You can measure my strength absolutely and
then put into place some exercises to strengthen me, or
maybe we go through and think about maybe different ways
of injecting or mind you that I'd be pretty hard, yeah,
(17:46):
after you know, twenty years of doing it. But you
can teach an old old nutriths.
Speaker 3 (17:52):
Yeah, absolutely like that ergonomic style.
Speaker 4 (17:55):
Obviously with the permission of the workplace, because if you
came into my clinic, I'd actually probably be like, okay,
can you show me what injecting looks like.
Speaker 1 (18:01):
I mean, we have beds.
Speaker 4 (18:02):
I'd probably be like, okay, I'm your patient lying down
for a tend to inject me, so I could have
a look at that movement. Sometimes I'll be like, okay,
can you get your colleague to video you so we
can have a look and see what's there. Because definitely,
I think that's a really tricky part of being a
healthcare professional, is that you're always looking after someone and
sometimes not many ways around something.
Speaker 1 (18:23):
Ok.
Speaker 4 (18:23):
But then at the same time I might look Okay,
can you see if you just split your legs a
little bit more there, bend a bit more, turn it
into a bit more of a lunch, You're actually going
to put less load on your trunk. So see how
that goes. And you might not do that every time,
but you might just do it a little bit more.
Or I might look at you go and go, hey,
that what you're doing there? Could you sit on a
stool and do that? And you go, oh, yeah, I
(18:44):
don't do that all the time. I'm like, okay, but
that's twenty percent of your time. If we can give
you a break for twenty percent of the time, that's
going to be really powerful.
Speaker 3 (18:52):
So I'm the same in my clinic as well.
Speaker 4 (18:54):
I'm up on my feet moving around all the time,
and you will see me sometimes either pull up the
wheely stool and I'll sit down because I'm watching someone
do it. So sometimes it's a about not changing something
one hundred percent because that seems impossible, and often it is.
But it might be modifying it by ten percent, and
then we can then go, okay, we'll looking at that.
(19:15):
We need to increase glute strength, or I'm wondering about
glute strength. Let's actually use our tech. So I mean
tech isn't just for elite athletes. We have a dynamometer
and we have force plates in our clinic. We use
it in the elderly as well. It's great for measuring
strength and for measuring balance, for measuring functional positions as well.
So we can get people doing isometric squats and mid
(19:36):
thy pools and go, actually, well, how strong are you?
Speaker 3 (19:39):
Are you different left to right? Are you at age
match norms?
Speaker 4 (19:43):
Because when we exercise, oh see, if we're going to
intervene with exercise, we need to actually test intervene and
then retest to see if what we're doing is working.
And coming back to that kind of compliance and motivation,
numbers are a really great thing because if.
Speaker 3 (19:58):
I'm just looking at you, going oh, you look really weak.
Speaker 4 (20:00):
We should probably increase your glutes, You're like, well, I
don't feel weak in my glute, but I can Dino
test you and go, well, actually, compared to h match norms,
you're at ten percent. And then you go all right, yeah,
and that number is a powerful thing. Okay, we're getting
you to twenty percent. Well, actually, then what you're doing
is working great, You're feeling stronger you're and then you
(20:21):
kind of get on that merry go round and that
buying is better as well.
Speaker 1 (20:24):
It's really hard that.
Speaker 2 (20:26):
For example, if you've got chronic pain or osteoporosis and
your risk of breaks and falls, which is as we
all know, particularly in nursing over a certain age, and
you have a fall, the outcome is not good. So
an excise physiologist and physio are also fantastic and for osteoporotic.
Speaker 1 (20:49):
Absolutely, and when you can improve the.
Speaker 2 (20:51):
Outcome of osteoporosis through exercise, that's correct, isn't it.
Speaker 3 (20:55):
Absolutely so.
Speaker 4 (20:56):
In terms of when we look at someone with osteoporosis,
it's always a holistic approach. So someone might be seeing
their endochronologists and they might be considering medications. But from
the exercise perspective, if only we're actually pretty powerful in
what we can do. So we know that the evidence
supports strength based training, it supports balance training, and it
also supports impact training.
Speaker 3 (21:16):
But the really important thing with it.
Speaker 4 (21:17):
Is that it's probably done under supervision and by an
exercise physiologist. And the reason for this is a few things.
The stereotypical person with osteoporosis is female. In their sixties
and they'll come into us and they don't have a
history of lifting, so we need to make sure they're
lifting really safely, but then also effectively so that.
Speaker 1 (21:35):
We're actually getting bone load.
Speaker 4 (21:36):
So it's actually about that individualization, but also the supervision
for safe and effectiveness is where it's really important. From
that astereoporosis, but not so much about the bones itself.
When we talk about osteoporosis, it's also about fracture risk,
you know, and the stronger we are and the better
balance we have, we have less fALS risks, and so
it's less fracture risk, so that's really important as well.
(22:00):
In regards to persistent pain, it's just something that's so
much more common then we realize, and that's probably spoken
about as well. We know that movement is good for
persistent pain and exercise is good for persistent pain, but
that's probably where the evidence ends in terms of saying
everybody to pilates, everybody get in the gym, everybody do this.
(22:23):
So having someone I guess who has experience in persistent pain,
but chatting to you on an individual level and assessing
you individually, not just in terms of the impairments such
as strength and endurance and mobility in range of movement
that we've talked about, but.
Speaker 3 (22:37):
The other factors that affect persistent pain.
Speaker 1 (22:41):
Is really important.
Speaker 4 (22:42):
So that might be movement is great, being outside is
the important factor, or that five to ten minutes to
actually do some mobility work, but it's actually really more
about regulation and breath work.
Speaker 3 (22:55):
I take that role as.
Speaker 4 (22:56):
An EP quite seriously for people with persistent pain because
they'll have people tell them just exercise, but that's really
hard when you're in pain, and so to actually give
them that help and support and collaboratively not just tell
them what to do, but help them find their solution
is really important.
Speaker 2 (23:16):
I had significant horrendous back pain for about twelve months
after I fractured my sacrum. If I had taken the
time to see an excise physiologist would have that helped
to break that pain cycle, because then when I did
have surgery and I ended up in hospital. Yeah, that
was the big problem with managing my pain was that
(23:37):
all the pain receptors had changed and I had that
long term pain. Yeah.
Speaker 1 (23:42):
Can exercise alter that?
Speaker 4 (23:44):
Yeah?
Speaker 1 (23:44):
Absolutely?
Speaker 4 (23:45):
So the big thing with persistent pain that exercise physiologists
can help with is that concept of the pain neuroscience education,
and that can seem really scary as a clinician, but
there's some really great resources out there. But I think
something as simple as if I can get my patients
to understand that pain is not as simple as spraining
an ankle, that ligament giving me pain, that's actually not
(24:06):
how pain works. If we sprain an ankle, we get
a signal on the ligament. That signal gets sent up
our nervous system all the way to our brain, and
then pain is the output. And anywhere along that nervous system,
that signal can be upregulated or downregulated at any point
in time. And so that's why we can have large
amounts of pain with not much damage as well. And
(24:29):
that's also why we can have large amounts of damage.
Think about the footballer on the field that dislocates their
shoulder and is like walking around and they haven't noticed yet,
and then they can have not much pain as well.
Even if just starting with that concept is really important.
And then probably pain neuroscience, I think is something that
quality of the education is really really important. And I
(24:49):
have probably my go to of who I'll refer to
for that because that's really important. But I think understanding
that because what we don't want to happen is you
to then be scared of movement. And being scared of
movement makes complete sense because it hurts. You know, our
bodies naturally programmed to be like, Okay, i've got pain,
I'm going to shy away from what we're doing. But
(25:10):
when we have pain for a long time in twelve
months is definitely that persistent pain category, then we become
scared of movement. So I guess having EP in that
time would have potentially helped us found movement that's safe,
and then we would have had some positive messages around movement.
But then also acting, I guess I say to EPs,
we have a really powerful role to act as a
(25:32):
care navigator. So you don't have to have the answers
to everything. I certainly don't have the answers to everything.
But if I can highlight that someone might need some
pain neuroscience education and then bring up the concept with
them and then send them to the right person.
Speaker 3 (25:46):
That's really powerful.
Speaker 4 (25:47):
If I can flag with someone that they might need
dietetic input and then send them I don't need to
know what that.
Speaker 3 (25:54):
Dietetic input is that's not my role or my scope.
Speaker 4 (25:57):
But I think if we can act as a care
navigator and make sure that people get access to a
multidisciplinary team, that's when we have a really powerful impact
as well.
Speaker 1 (26:08):
So you can refer on to a pain specialist if needed.
Speaker 4 (26:11):
Yeah, So if I'm thinking someone needs pay neuroscience education,
I'm probably actually not going to refer to as pain
specialists like a doctor themselves. But there are a few
clinicians within private practice I know that do pain neuroscience
quite well. And I think the thing is is that
pain your a science education. It's not a physio thing
or an EP thing. It's a clinician thing. So just
(26:33):
knowing who to refer to, I think that's really really powerful.
And I always say to people I actually won't tell them.
I'll ask them or say can I tell you about
pain and what I know about pain?
Speaker 3 (26:42):
And they'll say yes if they agree.
Speaker 4 (26:45):
And I said, but before I start, if I talk
to you and you finish and go, she's just told
me it's all in my head, can you let me
know because that's not the message I want you to get,
So please let me know if that's how you've received
that message because the number of patients I have. Oh yeah,
I did a pain course and they just told me
it's in my head, and I'm like, that's not the message. Absolutely,
(27:06):
our brain is so important in it, which is why
the education is so supportive in evidence for doing it.
But I'll say there's so many things that input persistent pain,
which can be a bit scary, but equally it's kind
of exciting because if that many things impact pain, we
have that many avenues to help you with your pain
as well.
Speaker 1 (27:24):
Yeah, that's a real positive sphere.
Speaker 4 (27:25):
Yeah. Yeah, I'd like to say I came up with it,
but there's actually an EP that is the head of
NOI Pain Group, Brendan Mowat, that said it, So i'll
steal that he spoke at.
Speaker 2 (27:35):
There's a conference that's fantastic that you understand enough to go, okay,
that's outside my scope. This is really pain. Yeah, long
term pain orientated. Yeah, so I'm going to refer you
on because I think that's powerful patently, because I went
to a pain specialist who said I was making it up. Yeah,
(27:56):
I was losing more and more strength and my GP
said I was making up the falls and I'm a
just practitioner like I'm in the space and I was
treated that way. And it was only when I really
sat back and went, Okay, I've got to take control
of this now that I found a new GP and
they told me who to see as a surgeon got
(28:19):
in to see them, did pretests and I can't wait
actually to see the six months because I know how
bad I was when I first went in prior to
surgery to where I am now So powerful, isn't it?
Speaker 1 (28:31):
What I loved about Felicity at facspace.
Speaker 2 (28:35):
She would really listen to me, and there were some
days I was so sore and she would work out
what sort of saw I was. So there's some saw
that just saw from exercise again getting back on that wagon,
and then there's surgery saw.
Speaker 1 (28:51):
So we had to work that out.
Speaker 2 (28:52):
But there were days where she go, let's not do that.
How about we do some stretching instead, and I'll show
you how to do some stretches that.
Speaker 1 (28:59):
I didn't even know how to do it.
Speaker 2 (29:00):
And I've done so much exercise throughout my life, but
they were fantastic and life changing. Like I wake up
now every morning and do my set of exercises no
matter what, and they set me up for the day.
Hopefully next week I'll be allowed to go back to plarties.
But that's been a really good goal. And I mean
I'm a goal setter. I would assume you are too,
(29:22):
But I do think setting goals is so important when.
Speaker 1 (29:25):
You've got pain. And it's easy to say that now
I'm on the other side of it. During it, it
wasn't easy.
Speaker 2 (29:30):
Yeah, if you're nursing and you know you've got constant
back pain, it's really good to see someone and get
some goals.
Speaker 1 (29:36):
Absolutely, And I love that. Seeing numbers is very powerful
to me.
Speaker 4 (29:40):
Absolutely, and you would find that, yeah, And that's like
with the tech again. So like at my clinic we
have four stex and we have a dynamometer, which I
think people think we only use that for our athletes,
and no way use it all the time because again,
if we can have that numbers, it actually makes us
prescribe better programs because we can target specific things. But
(30:01):
that in with people, they go, I'm going to change
that numbers not going to defeat me.
Speaker 3 (30:06):
I'm going to make that better and I am going
to be better.
Speaker 4 (30:09):
And I think like with that goal setting too, we
can have really good impact because we build rapport with
our clients. You know, you see them really quite regularly,
especially if it's post surgery, and go okay, like, what's
your goal and.
Speaker 3 (30:21):
People are out to be pain free? I'm like, okay,
that's not a.
Speaker 4 (30:24):
Goal, but it's not saying that it's going okay, what
does being pain free mean to you? In six months time?
If you're pain free, what would you be doing or
what would that look like? So if you said to me,
I want to get back to pilates, well, what does
that look like to you? What does pilarates mean to you?
If you can't get back to polates, what will your
life look like? Because it might not actually be about
(30:46):
the polarates. It might be about that's your time, that's
your regulation, that's you feeling normal, that's your measure of
normalcy for your life. And so I think that kind
of really thinking about our goals and why they're our
goals is really important to tap into, and we have
that skill as EPs to do that. We're not going
(31:07):
to sit someone down and be like, right, let's think
about it. But in the exercise session where chatting, we're
talking to them because there will be bumps in the
road like, unfortunately, rehab is not linear, and if we
can then come back to it, go yeah, but remember
when you're on that reformer and your glue is burning
and you really want to stop, But how good will
that feel because you're on that reformer and you're doing it,
(31:28):
So we can actually bring it back to that.
Speaker 2 (31:30):
See, my goal was that there were these eighty year
olds that were in the class and they could outdo
me in plarties. Like when I first saw them, I
was like, oh my god, they were phenomenal. These women,
They've been doing it for years. Their agility, their strength,
their balance was amazing, and I thought, well, if I'm
in my eighties and I look as good and sound
(31:50):
as good as these women, you've won me over straight away. Amazing.
Three times a week they go and I would plock
up beside them and I'd put my map down and
it was like, I'm keeping up with YouTube.
Speaker 3 (32:01):
Yeah, and that's it.
Speaker 4 (32:02):
So you go like, it's not just about the pilates
PILARTI obviously what you love doing, it's what I love
doing too, But it's you feeling independence, you're feeling strong,
it's you feeling like you're probably your injuries not stopping
you and not taking over that, and like that's actually
unpacking that and going oh yeah, actually that's what pilates
gives me.
Speaker 2 (32:21):
That's why it matters so much to me. And I
don't want to be a decrepit old person. No and
no disrespect to anyone that needs a wheelchair or needs
a walker, but I don't want that for me if
I can avoid it. So I want to do everything
I can to avoid going down that pathway.
Speaker 4 (32:41):
And strength training and exercise is really powerful for combating
the neuromuscular effects of aging. And you know, look, mobility
aids are great because they can then get people moving
and doing better. But then it's about making sure we're
strong and making sure we're moving. And that would look
different on an eighty year old to will on a
forty year old. But that's why that individualization from that
(33:02):
EP assessing them, what's their capability, what can they be doing?
Speaker 1 (33:06):
Is it safe?
Speaker 3 (33:06):
Is it effective?
Speaker 1 (33:07):
Is really important.
Speaker 2 (33:08):
I've been reading a lot about Alzheimer's and tenture and
how important exercise is preventing that and starting earlier, like
they're saying, you know, try and be active your whole life.
But you know that thirty five to forty five age
group is really important to start getting those good habits
in place, and the impact it actually has on reduction
(33:30):
of dementia is profound and none of us want that.
So I was really quite surprised reading the research that
they're actually doing overseas and here in Australia too around that,
and it's phenomenal the outcome that exercise has. You were
saying earlier on about the Australian's standards around our exercise,
(33:53):
can you explain.
Speaker 4 (33:56):
With us? So we have physical activity guidelines, and I
think it's important to use the word physical activity because
often I will use the word movement because particularly with
like Alzheimer's and that kind of stuff, there's lots of
studies that gone to more details should we be doing
this than this?
Speaker 3 (34:09):
But the movement is important.
Speaker 4 (34:11):
So the physical activity guidelines is that this is from
our eighteen and above. Kids have different ones, and I
think these ones go to sixty five as we get
older adults. Again they're a bit different, but we should
be doing our one hundred and fifty minutes of moderate
intensity exercise or two hundred and ten minutes of low
intensity exercise per week as well as two resistant sessions.
(34:32):
Now that doesn't have to be five thirty minute sessions.
This is physical activity, so it can include going walking
to the bus stop. It can include things like that.
On a more individual level, when people come to me
and want exercise plan, this is generalizing, but they'll go
on to one of two categories. They'll either be really
sedentary but they do exercise three times a week, but
(34:54):
we're not quite hitting those goals. But they might sit
all the time, or they're going but I move all
the time, but they're not doing purposeful exercise. So like
a trade yeah, yeah, or someone who's on their feet
all the or a nurse exactly, but they're not doing
purposeful exercise. I say them, look, let's break it down
into physical activity and exercise. So your physical activity is
how much you're on your feet, Like have you met
(35:15):
your limit today or have you sat on your butt
all day? That's really important. We know that movement is
really good and we don't want to be sedentary. There's
even some exercise coming out they're calling it exercise snacks,
you know, and should we be doing little bits really
frequently as well?
Speaker 3 (35:30):
But then equally we need.
Speaker 4 (35:31):
Exercise, and I say, think of exercise as purposeful movements.
So that's when we go, hey, nurse, you are bent
over in that hinge position. We need you doing some
squatting and deadlifting. We need you doing functional movement training
because that mirror is what you want to do, or
you're picking up your grand kids, or you're picking up
your gorgeous little dog.
Speaker 3 (35:52):
You know you need to be able to have the
strength to do that.
Speaker 4 (35:55):
So I kind of break it down into goals because
they might be smashing those physical activity. They might be
on their feet all the time, which I'd say most
nurses probably fit that. I agree, So it might go, Okay, well,
let's increase some specific resistance training for them. Okay, let's
actually start with some functional movement training. Let's start twice
a week. You know you're going to learn these movement
(36:16):
patters twice a week, and all of a sudden, that
becomes a lot more achievable and way less daunting. Between
go I've got to one hundred and fifty minutes and
two resistance training exercises, and I'm supposed to do this.
Let's start with what's going to be achievable, but purposeful
and meaningful.
Speaker 1 (36:32):
To that patient. Yeah. Yeah, So someone goes to the gym,
they see a trainer.
Speaker 2 (36:37):
Yeah, that's very different to an exos sociologist, isn't it.
Speaker 1 (36:41):
Yeah.
Speaker 4 (36:42):
So the thing with trainers is that we actually they
could have as little as three months training and they
could be eighteen, So they don't have the expertise to
be able to assess appropriately and to clinically prescribe exercises.
So you know, there are definitely trainers out there that
have lots of experience, and I've worked with them before,
(37:04):
but the already the time, the way I think about it,
trainers are good for working with what I would say
is the healthy population. Okay, so not people with specific
musculo scialegal injuries, not people with chronic diseases. That actual
clinical reasoning behind why I've given you a squad is
actually really really important because I've taken information from the
(37:24):
subjective assessment, from the objective assessment and clinically reasoned why
that's going to be important for you. They don't have
those skills, they're not intended. They're there forgetting the healthy
population moving.
Speaker 1 (37:36):
Yeah. Okay.
Speaker 3 (37:37):
The other thing is specific goal.
Speaker 4 (37:38):
So even if you'd say, yeah, I'm generally healthy, you said,
when you started nursing, you could do most things.
Speaker 3 (37:42):
But to have that skill to buy mechanically, breakdown.
Speaker 4 (37:47):
Movement and assess gate assess movement, that's just not skills
their train. The big difference is we spend four years
at university gaining all those skills, building them up. We
spend hundreds and hundreds of hours doing placements, so we
have those skills to be able to do that.
Speaker 3 (38:02):
That's just not their intended purpose.
Speaker 1 (38:05):
So what's the name of your clinic?
Speaker 4 (38:06):
I work for All Sports Indrapilli, and I am very
passionate about working there. I've worked there a long time,
and like I said, my journey started out yep, I
wanted to be the elite athletes. I grew up playing
water Apollo and seeing that side of things. But now
my bread and butter and that person I love to
work with is probably that middle aged female and male
back pain is our bread and butter. We see it
(38:30):
so often, multiple times a day. But I think the
thing is exercise can seem really scary, It seems really complicated.
We don't know where to start, and quite often people
have had negative experiences with it, so especially in gyms. Yeah, yeah, absolutely,
I think being able to provide that positive experience and
(38:51):
to get people to go, oh hey, exercise can be powerful.
That's really what sits with me. We're really lucky in
the clinic we have. We're in a multidisciplinary space. So
we have a huge gym that has squat racks and
we run glasses in it for people who don't want
to go to the gym or need that supervision of EPs.
Speaker 3 (39:09):
We also have pilate space as well.
Speaker 4 (39:12):
We have clinical smaller space for people that that's not
their jam either. We have our tech so we have
our dynamometers, we have our fource decks that we get
to use.
Speaker 3 (39:22):
But in our building as well.
Speaker 4 (39:24):
We also have dietitians, we have hand and up, a
limb therapist, we have the dietrists.
Speaker 3 (39:29):
We have ots to.
Speaker 4 (39:31):
Do scars and swelling management. We have specific pilates clinicians.
We have pediatric physios and pediatric exercise physiologists, and then
we have a bunch of other specialists.
Speaker 3 (39:43):
We have orthopods and people like that through our doorst so.
Speaker 1 (39:46):
You do a lot of rehab as well.
Speaker 4 (39:47):
Then we do a lot of rehab, and I think
that's really powerful. We're all different businesses, but again in
that one roof. Even I've had people come in they go, hey,
how's this scarfeel and they're like, yeah, it actually really
bothers me. I'm like, do you know there's something we
can do about that? Go see these people or they'll
come in with a trigger finger or something. I liking
our hand therapist do the thermoplastic splinting. I might go
(40:09):
see those guys. They'll do something specific for you.
Speaker 1 (40:11):
We lived at the hand therapist in Bay Terrace with Chloe. Yeah,
and in the end, I didn't even bother going to
the doctor Giddon nextray. I just go straight to the
theist and she was amazing.
Speaker 2 (40:21):
They're still there on Bay Terraces at win them and
you know, kudos to those guys. They were fabulous and
got Chloe through numerous fractured fingers and lord knows what.
So I just want to say thank you so much
for coming in today and having a chat with us.
I'm going to put your clinic's details on the show notes.
(40:42):
If someone wants to find an excise physiologist that's close
to them and they can't get to say intrapilli.
Speaker 1 (40:48):
Or absolutely, how do they go about doing that?
Speaker 3 (40:51):
So there's probably like two ways I go about it.
One is through ESA's website.
Speaker 4 (40:55):
They have find an ep so that will be on
there and that's probably a really great way because it
will tell the location. Because absolutely I've spoken about barriers.
It needs to be accessible and easy without absolutely. The
other thing, if there's something more specific, you know, if
you're thinking you want to know more about pain, you're
a science education that kind of stuff, that's a bit
more specialty. I'm always happy for people to reach out,
(41:15):
shoot me an email and I can reach out to
my network and see who's available.
Speaker 1 (41:19):
Oh look, that is fantastic.
Speaker 2 (41:21):
I think the one thing I've taken away from today,
particularly around nurses, and I know most nurses have lower
back pain we just do.
Speaker 1 (41:29):
And shoulder pain. That's another one.
Speaker 2 (41:31):
It's a shocker, is that if you're in a private practice,
you can get an excise physiologist to come to your
clinic and they can come in and assess your movement
around whatever your job is, and then give you exercises
around how to strengthen the areas or maybe to stand
a bit differently, or look at ways around improving how
(41:51):
you work in that environment. You can off the bat
go yourself to see an exercise physiologist. If you have
long term pain, you can go see your GP and
if it's needed or so if you fit the requirements,
you can then maybe get some Medicare assistance. And I
can do from firsthand that the private health funds absolutely
(42:14):
give you money back to seeing an excise physiologist, physioot
hand therapist.
Speaker 1 (42:19):
And you know we spend all this money on private health.
Speaker 2 (42:22):
Use it, absolutely, use it, because honestly, I can tell
you firsthand, I love my exercise physiologist. She's been amazing.
Moving forward, once my rehab's over, I won't be seeing
Felicity anymore, so I think.
Speaker 1 (42:37):
I'll be coming able to interpelling tell us.
Speaker 2 (42:39):
I cannot believe you walked into today and I knew
who you were straight away. Honestly talk about me to
be I just am very grateful for you taking the
time during pain week to come and have a chat
with us. All the details will be on the page, guys.
I'll have S's details, I'll have Alysi's details, I'll have
tens Vanessa's details. I'll have it all there and you
(43:01):
can go in and have a look and just take
the time to check out an EP because honestly, first
ten experience.
Speaker 1 (43:08):
They change your life absolutely.
Speaker 4 (43:10):
And you know, exercises is complicated, but it's powerful, so
don't feel like you need to know everything about exercise.
And that's what we go to use exactly so you know,
and there's no goal or challenge too small or too big.
Speaker 3 (43:23):
We're here to help you. So whatever is useful and
powerful to you, that's what we'll try and do.
Speaker 1 (43:28):
Thank you so so much for coming. I appreciate it
so much. My pleasure
Appochia Production.
Speaker 2 (00:10):
Hi everyone, thank you for tuning back into Tenantus for Nurses.
I suspec Woodbine here this season. I am so excited
to announce that the podcast is being supported by Nutritia,
which is a global leader in medical nutrition. They understand
the needs of nurses in the nutrition space and for
over one hundred and twenty five years have provided products
(00:31):
to support child health. Some of Nutrita's pediatric brands include
Neo Kate Junior for children who have food allergies and
appt to Grow for those fussy eaters. And those of
us who have children know many kids who go through
the phases of definite fussiness. For more information and resources,
visit the nutritiona Pediatrics hub at nutritia dot com dot
(00:54):
au forward slash Pediatrics. I just want to say a
huge thank you to Nutritia. Their desire to support nurses
is truly appreciated, and they are allowing me to continue
this podcast so that we can all grow as nurses.
This season, we have some amazing speakers in the pediatric
space which I cannot wait to share with you all. Hi,
(01:14):
my name's Beck Woodbine, and welcome to Tenderness for nurses.
Speaker 1 (01:17):
I'm grateful for the person that I have the opportunity
to be, so I hit it and parked it for
Nellie four years.
Speaker 3 (01:27):
We always have free will, We always get to choose.
Speaker 1 (01:29):
We are autonomous.
Speaker 2 (01:32):
Hi, everyone, thank you for tuning back into tenderness for nurses.
Speaker 1 (01:36):
Today.
Speaker 4 (01:37):
We have the.
Speaker 2 (01:38):
Fabulous Alice Hislop who was an exose physiologist, and it's
pain Week this week, and I thought it was really
important for us to talk about nurses looking after ourselves
pain because so many nurses have bad backs and uteruses
to their knees, and we could go on and on.
So I am very good friends with Samuel, who I've
(02:01):
met through the dog park and we got chatting and
he said, you know what, I've got the perfect person
for you to chat with. And lo and behold, I
know Alice Heir and my daughter played water polo together.
It's such a small word. Brisbane is like one degree
of separation. But look, thank you so much for coming in.
I know you have a busy schedule, but I am
really interested in hearing about what EPs exercise physiologists can
(02:24):
do and how they can help nurses the general population.
Speaker 1 (02:29):
But let's talk about you first.
Speaker 2 (02:31):
You played high level water polo, and I'm assuming you
played that while you're at UNI. Yeah, And did you
straightway decide you wanted to become an exercise physiologist.
Speaker 4 (02:40):
I think I from high school had kind of always
flagged that kind of I guess science sport industry, as
I would say, I think ninety nine percent of people
want to do I had elite sport in my head.
I was like, that's what I'll do. That was my experience.
So I went and did a dual degree of physiotherapy
(03:01):
and exercise science. So I'm an exercise physiologist and physiotherapist.
And I did do sport for about five years. I
work in private practice muscular scalital physio and I did
really enjoy it.
Speaker 3 (03:12):
It gave me lots and lots of skills, but I don't.
Speaker 1 (03:16):
Do it anymore. And I prefer helping the everyday.
Speaker 4 (03:18):
Person because I think exercise is so powerful, whether it
be building capacity or whether it's harnessing its effect on
our mental health and our regulation and using it as
a positive impact for the everyday person.
Speaker 3 (03:32):
And I think we kind of box.
Speaker 4 (03:35):
Elee athletes up with, oh, we get to use all
these special things for them, But exactly the same concepts
and processes and tech we can use for the everyday
person and really harness the power of exercise.
Speaker 2 (03:47):
Interestingly, as you guys know, I recently had major back
surgery and that's what got me chatting with Samuel as
part of my rehab, the physio and the exercise physiologists
and I spend more time with the exercise the EP
than I do the physio. She oversees everything and my
goal was to get back into pilates. I love that
(04:09):
forty five minutes. It was my headspace time, it was
my me time. I enjoyed that type of exercise. But
I didn't realize the value of an EP until I
actually really needed one. And now that I've used an
excise physiologist, it will be something I will continue to use.
Speaker 1 (04:28):
And it doesn't have to be all the time, doesn't.
Speaker 4 (04:30):
No, absolutely, And I think the first question we get
is like, what is an EP. So an EP is
the short name for exercise physiologist. We've done a four
year UNICORSE and I kind of describe us as experts
in exercise and movements. So we help either people with
chronic disease such as osteoporosis, diabetes, or people with musculoskeletal
(04:52):
injuries and we help rehab them post injury. But I
think what's the most powerful thing is we help prevent
injury and we help promote wellness. So post back surgery,
it's a beautiful way to tap into an EP because
we get to focus on people's function, which really aligns
with them being able to achieve things. So, you know,
getting them to squat and work throughout the day, that's
(05:12):
such a functional thing to do and link it to
your specific needs. But going on, we all should be exercising.
There's physical activity guidelines for Australians and a lot of
us don't meet them. But we can make exercise really purposeful.
So we can make it purposeful for our jobs to
make sure that we function the best and we work
(05:34):
the best.
Speaker 3 (05:34):
We can make it the best for our mental health.
You kind of linked in before.
Speaker 4 (05:37):
That's your headspace. It's really important for our regulation. But
we can also make our programs the most purposeful as well.
So I often start with rehabbing someone from an injury,
but then we end up checking in maybe every three months,
because we know our bodies like change in stimulus, they
like change in programmings, whether that be exercises, sets, reps, whatever,
(05:58):
but I might see someone three or four times a
year once they're on that path.
Speaker 1 (06:02):
Yeah. Can people claim to see an exercise physiologist.
Speaker 4 (06:07):
Absolutely, So there's a few different pathways, so people can
claim under health funds as well, and then pending on requirements,
chat to your GP because they'll know what you fit
in there. But there is something called the Medicare Team
Care Arrangement, So people with a chronic disease lasting longer
or likely to last longer than six months, sometimes people
may be eligible to receive some kind of subsidy for
(06:29):
their exercise physiology.
Speaker 1 (06:31):
That's true Medicare.
Speaker 4 (06:32):
Yeah, so there's lots of different frameworks and rules around them.
That so I was like, chat to GP because they'll
make sure you're correctly eligible for it. But there is
that pathway and the reason whether that's there is because
we know that exercise is so beneficial for long term
not just chronic disease. I think we think about diabetes
and things like that when we talk about chronic disease,
but persistently back pain that we see professional and healthcare
(06:55):
workers all around my own profession included on our feet
every day.
Speaker 3 (06:59):
So It's something we really need to take into consideration.
Speaker 2 (07:03):
When I started nursing, and I started in the hospital sector,
we did ninety percent of the lifting, the turning.
Speaker 1 (07:09):
It was full on. Now.
Speaker 2 (07:10):
I was young and fit, but you know I did
catch a couple of patients when they were falling, and
you know, I sustained some injuries. You would never have
put in an instant report back then. You know, that
sort of thing moved fast forward and having nurse for
over thirty years now, my lower back was a mess
(07:30):
because of the position.
Speaker 1 (07:31):
You know, like a lot of nurs a lot of us.
Speaker 2 (07:33):
You know, I did theater for many years, so huge
amount of twisting, standing all day on concrete, moving patients again,
and then now as a dermatology and cosmetic dermatologynurs practitioner,
the funny little bend I have and the twist I
have is what really impacted my back. I think if
(07:54):
I had realized earlier the value of an exercise physiologist.
I mean, I don't think I would have avoided surgery
because there was so much wrong, but it may have
helped my rehab a little better. If I had been
a little bit more aware of the things that an
exposed physiologists can do, particularly as a nurse because yeah, honestly,
nurses backs were renowned for having horrific.
Speaker 4 (08:15):
But absolutely like nursing is such a physical job, right,
and so if you were going to go and do
a sport, you'd ask the question is my body physically
up to this? What capacity do I have? So the
role that the exercise physiologists play is that we are
able to test your strength, your endurance, your posture, your mobility,
(08:36):
lots of different things to go. Where do your impairments
lie and where do your deficits light? And do you
have the capacity to be able to do your physical
job or what areas should we work to improve? Because
if you think of nursing, like all nursing is going
to be different depending on the role, but what's going
to be consistent is that sustained postures and that bent
over hinge position. Whether you are injecting, whether you are
(08:59):
caring for a patient, you're a labor and delivering nurse,
catching that baby, they're all bent over positions.
Speaker 3 (09:05):
And what we can do is then buy mechanically break
that down.
Speaker 4 (09:09):
So we think of that bent over hinge position, well,
that's really a hinge deadlift position, and so well, what
muscles do we need for that? We need really good
glute max but then we need really good rectors abdominers
to be able to hold us in that position. We
need a bit of hamstring as well, so we can
then test and go, well, actually we need to improve
on that muscle capacity to then help you in those positions.
Speaker 2 (09:30):
So EPs in the hospital say, for example, you know
after I had my kids, the physio came and visitors, Yeah,
can an excise physiologist.
Speaker 1 (09:39):
Work out or are they working out of hospitals now?
Speaker 4 (09:42):
Yes, but it's not common yes, So we are seeing
it happen more and more so, particularly in the private
based hospitals that have that outpatient rehab or particularly there
are some specialists that have kind of their own physios
and epteam that might do that. So we're seeing it
become more common in that private sector, which is really
great because I think particularly for that surgery and post
(10:04):
surgical it's improving on the impairments and that deficits that
we alluded to, whether it be strength or endurance or mobility,
whatever it is, and that's where it's quite powerful. We
don't see it in the public setting, but We have
so many great private practice clinicians out there, and I
think that concept that epi's only work with elite athletes
is just not out there. As I said, my journey
(10:25):
is actually find much more rewarding helping the everyday person
achieve their goal because it's whilst winning medals is great
and that's really lovely, being able to have someone return
to work play with their kids. Yeah, you know, that
is the tick for me. And I'm like, if I
can give someone that, that's really powerful. So you said
you've got kids, Yes, how old are your kids?
Speaker 1 (10:48):
Four and seven? Looking at you, I can see that
you're it's still very active. Is exercise something you do
religiously with your kids?
Speaker 4 (10:56):
Like?
Speaker 1 (10:57):
Or you make it fun? Or how do you integrate
fun and exercise together? Yeah?
Speaker 3 (11:02):
Absolutely.
Speaker 4 (11:04):
I often think about exercise as movement because I think
sometimes we can put a lot of pressure on ourselves
to exercise and I have to exercise, and I have
to get here, and I have to get here, and
life is really busy, and I don't think it's helpful
to make myself feel bad if I don't do it.
So I think about movement and I think about engaging
in movement and exercise with them is really important. So
(11:24):
for them, it's much more let's go for a bike ride.
They're really Charlotte's just started touch football, so we're trying
to teach her how to play touch football, so we're
taking the footyball to the park. I definitely also have
the times too that I quarantine my exercise time from
my kids because I think being able to mentally regulate
and have that time for myself, then I'm a better
(11:46):
person for them as well. So sometimes I will actually
be like, no, shut my door. I'm doing my pilates.
It's one of my favorite forms of exercise as well.
I will actually be like, no, I need twenty minutes,
or Charlotte can ride five k's and a bike because
I want to go for a run for five ks.
Speaker 3 (12:02):
So I've kind of integrated it like that. But I
think that's the biggest thing.
Speaker 4 (12:06):
Like if I'm talking to someone about doing an exercise program,
I'll actually start with barriers to exercise because it's often
not about the perfect program.
Speaker 3 (12:14):
The program needs to be good.
Speaker 4 (12:15):
Don't get me wrong, it can't be a bad program,
but it's not that simple because if it was, we'd
all do the perfect amount of exercise and we'd all
be compliant. So you know, barriers can be anything from time, accessibility, finances, motivation.
Speaker 3 (12:31):
Goal setting.
Speaker 4 (12:32):
So I think that is probably where I start to
people and I say, look, we've identified that you need
to get stronger. I need you to go and think
about how you want that to look. Because what's actually
important is we find something that suits you. I'll tell
you if that doesn't align with your goal, I'll tell
you if that's not realistic. But if we can start
with something that you want to do, great, Because sometimes
(12:54):
people just need movement for back pain. Movement is fine,
and so I'm like, pick any exercise.
Speaker 1 (12:59):
I don't care what you do.
Speaker 4 (13:00):
And then other times I've got a nurse who's bent
over someone for an hour at a time because they're
in theater, and I go, look, we really need to
look at your strengthening and your movement patterning and getting
you some functional fitness. Walking's not going to get you that,
So I need you to rethink about how we're going
to put that in your schedule.
Speaker 2 (13:18):
I find once I start exercise, I can get into
a role. How do you get over that hurdle of
starting exercise?
Speaker 1 (13:27):
Yeah.
Speaker 4 (13:27):
Yeah, again starting with barriers, because if we can make
them as minimal as possible, right, we're making that road
much mother and easier for us to get to. So
I do think starting with there, and I'll have that
conversation people and they kind of look at me a
bit funny, and I go, look, I could give you
a goblet square, I could give you a sit to stand.
I could give you ten different exercises and they'll probably
all be achievable. But if I give you gym exercises
(13:50):
and you hate the gym or you don't have time
to go, then it's not going to work. I guess
the other thing too is really have a think about
your goals with it. You know, post back surgery. It
sounds like for you that was that really big motivational
factor for you. You'd have that big event and that
really affect you, and so you're really motivated to get
back into the gym or back in with the EP
and do that.
Speaker 3 (14:11):
Sometimes I think we think, oh, well.
Speaker 4 (14:12):
We have to go to the gym or we have
to do weights, because that's kind of societal and context
like we think that is good.
Speaker 3 (14:20):
But if we can connect it, what does exercise mean
to us.
Speaker 4 (14:23):
You know, in six months time, when we sit here
and we go, yeah, we've had a really successful outcome,
I'll say that person, what does that look like to you?
And that's not what I think it should look like,
but what does it look like to them? And then
I'll reverse it as well. If we're really struggling to
figure out that goal and that motivational factor, I'll say, well,
you've said you've want to exercise. If in six months
time we haven't been able to sort this out, what
(14:45):
effect will that have? What will happen? And so sometimes
reversing that can happen, but it's really tricky. But start
with something you like more practical, start with friends. Like
I say to people, you don't have to like it
all the time. I'm not someone who's going to get
up at four o'clock in the morning. But for my
kids that sounds awful, but it has to be like
(15:05):
so for me running its podcast, like okay, i've got
a podcast, I want to listen to that or get
me out. I know it's so good for my other stuff.
It's about creating space for me. So it's about letting
my husband know I want to do this today and
so he'll make sure he's home in time so I
can go out and do it.
Speaker 1 (15:22):
Do you think scheduling exercise is really important?
Speaker 3 (15:26):
Absolutely?
Speaker 4 (15:27):
You know you think about appointments, you'd always turn up
to them, and so people go the number of times,
I've just got to do it. They're coming, Oh I
haven't been compliant with my exercises. I haven't done them.
I go, okay, they I just got to do them,
and that's just not going to work. Why didn't it work?
Oh I didn't have time. Okay, well next week. Let's
look at your week. When is it gonna go in
and think about specifics when, how where will you be,
(15:48):
what will you wear? How are you going to get there?
Like literally every little detail can help kind of make
that happen from there. And again, collaborating with the nurse
is really important because I might be the expert in
exercise and movement, but you're the expert in yourself, so
you know what's going to work. So I can't say
I'm gonna wear your shoes because it's not the same.
(16:09):
It's you wearing your shoes, and how do you get
to do it? So it's collaboratively connecting together and finding
that solution, and.
Speaker 2 (16:17):
Where nurses physios exosy older, we are so used to
working collaboratively.
Speaker 1 (16:22):
Yeap, that you're saying that to me is just like mix. Yeah,
complete sense. Absolutely.
Speaker 4 (16:28):
And so if you're starting on your journey, it might
be yeah, let's tap in you go, I'm just not
good at doing it myself. It might be tapping into
an EP, it might be tapping into classes, might be
tapping into friends, and you might start with seeing someone regularly.
And then when you've built that up and you're confident
not just in your ability, but we're also confident in
(16:49):
your ability to squat properly, deadly and move properly. Because
it is a skill and it takes time to learn,
it might be okay, cool, don't see me for a
whole other month, and then that'll turn into two months,
and then every three months you're just seeing me to
review your program and progress it.
Speaker 2 (17:02):
I love that concept. A lot of people think it's
going to be hugely expensive. They've got to see you
all the time. I've got to see you once a
week time and cost prohibitive sometimes unless you're a lad athlete,
of course. So that's really great to know. And you
mentioned before that, I could get you into my clinic
(17:23):
and have a look at how I inject or how
I treat a patient, and you can look then at
how I move. You can measure my strength absolutely and
then put into place some exercises to strengthen me, or
maybe we go through and think about maybe different ways
of injecting or mind you that I'd be pretty hard, yeah,
(17:46):
after you know, twenty years of doing it. But you
can teach an old old nutriths.
Speaker 3 (17:52):
Yeah, absolutely like that ergonomic style.
Speaker 4 (17:55):
Obviously with the permission of the workplace, because if you
came into my clinic, I'd actually probably be like, okay,
can you show me what injecting looks like.
Speaker 1 (18:01):
I mean, we have beds.
Speaker 4 (18:02):
I'd probably be like, okay, I'm your patient lying down
for a tend to inject me, so I could have
a look at that movement. Sometimes I'll be like, okay,
can you get your colleague to video you so we
can have a look and see what's there. Because definitely,
I think that's a really tricky part of being a
healthcare professional, is that you're always looking after someone and
sometimes not many ways around something.
Speaker 1 (18:23):
Ok.
Speaker 4 (18:23):
But then at the same time I might look Okay,
can you see if you just split your legs a
little bit more there, bend a bit more, turn it
into a bit more of a lunch, You're actually going
to put less load on your trunk. So see how
that goes. And you might not do that every time,
but you might just do it a little bit more.
Or I might look at you go and go, hey,
that what you're doing there? Could you sit on a
stool and do that? And you go, oh, yeah, I
(18:44):
don't do that all the time. I'm like, okay, but
that's twenty percent of your time. If we can give
you a break for twenty percent of the time, that's
going to be really powerful.
Speaker 3 (18:52):
So I'm the same in my clinic as well.
Speaker 4 (18:54):
I'm up on my feet moving around all the time,
and you will see me sometimes either pull up the
wheely stool and I'll sit down because I'm watching someone
do it. So sometimes it's a about not changing something
one hundred percent because that seems impossible, and often it is.
But it might be modifying it by ten percent, and
then we can then go, okay, we'll looking at that.
(19:15):
We need to increase glute strength, or I'm wondering about
glute strength. Let's actually use our tech. So I mean
tech isn't just for elite athletes. We have a dynamometer
and we have force plates in our clinic. We use
it in the elderly as well. It's great for measuring
strength and for measuring balance, for measuring functional positions as well.
So we can get people doing isometric squats and mid
(19:36):
thy pools and go, actually, well, how strong are you?
Speaker 3 (19:39):
Are you different left to right? Are you at age
match norms?
Speaker 4 (19:43):
Because when we exercise, oh see, if we're going to
intervene with exercise, we need to actually test intervene and
then retest to see if what we're doing is working.
And coming back to that kind of compliance and motivation,
numbers are a really great thing because if.
Speaker 3 (19:58):
I'm just looking at you, going oh, you look really weak.
Speaker 4 (20:00):
We should probably increase your glutes, You're like, well, I
don't feel weak in my glute, but I can Dino
test you and go, well, actually, compared to h match norms,
you're at ten percent. And then you go all right, yeah,
and that number is a powerful thing. Okay, we're getting
you to twenty percent. Well, actually, then what you're doing
is working great, You're feeling stronger you're and then you
(20:21):
kind of get on that merry go round and that
buying is better as well.
Speaker 1 (20:24):
It's really hard that.
Speaker 2 (20:26):
For example, if you've got chronic pain or osteoporosis and
your risk of breaks and falls, which is as we
all know, particularly in nursing over a certain age, and
you have a fall, the outcome is not good. So
an excise physiologist and physio are also fantastic and for osteoporotic.
Speaker 1 (20:49):
Absolutely, and when you can improve the.
Speaker 2 (20:51):
Outcome of osteoporosis through exercise, that's correct, isn't it.
Speaker 3 (20:55):
Absolutely so.
Speaker 4 (20:56):
In terms of when we look at someone with osteoporosis,
it's always a holistic approach. So someone might be seeing
their endochronologists and they might be considering medications. But from
the exercise perspective, if only we're actually pretty powerful in
what we can do. So we know that the evidence
supports strength based training, it supports balance training, and it
also supports impact training.
Speaker 3 (21:16):
But the really important thing with it.
Speaker 4 (21:17):
Is that it's probably done under supervision and by an
exercise physiologist. And the reason for this is a few things.
The stereotypical person with osteoporosis is female. In their sixties
and they'll come into us and they don't have a
history of lifting, so we need to make sure they're
lifting really safely, but then also effectively so that.
Speaker 1 (21:35):
We're actually getting bone load.
Speaker 4 (21:36):
So it's actually about that individualization, but also the supervision
for safe and effectiveness is where it's really important. From
that astereoporosis, but not so much about the bones itself.
When we talk about osteoporosis, it's also about fracture risk,
you know, and the stronger we are and the better
balance we have, we have less fALS risks, and so
it's less fracture risk, so that's really important as well.
(22:00):
In regards to persistent pain, it's just something that's so
much more common then we realize, and that's probably spoken
about as well. We know that movement is good for
persistent pain and exercise is good for persistent pain, but
that's probably where the evidence ends in terms of saying
everybody to pilates, everybody get in the gym, everybody do this.
(22:23):
So having someone I guess who has experience in persistent pain,
but chatting to you on an individual level and assessing
you individually, not just in terms of the impairments such
as strength and endurance and mobility in range of movement
that we've talked about, but.
Speaker 3 (22:37):
The other factors that affect persistent pain.
Speaker 1 (22:41):
Is really important.
Speaker 4 (22:42):
So that might be movement is great, being outside is
the important factor, or that five to ten minutes to
actually do some mobility work, but it's actually really more
about regulation and breath work.
Speaker 3 (22:55):
I take that role as.
Speaker 4 (22:56):
An EP quite seriously for people with persistent pain because
they'll have people tell them just exercise, but that's really
hard when you're in pain, and so to actually give
them that help and support and collaboratively not just tell
them what to do, but help them find their solution
is really important.
Speaker 2 (23:16):
I had significant horrendous back pain for about twelve months
after I fractured my sacrum. If I had taken the
time to see an excise physiologist would have that helped
to break that pain cycle, because then when I did
have surgery and I ended up in hospital. Yeah, that
was the big problem with managing my pain was that
(23:37):
all the pain receptors had changed and I had that
long term pain. Yeah.
Speaker 1 (23:42):
Can exercise alter that?
Speaker 4 (23:44):
Yeah?
Speaker 1 (23:44):
Absolutely?
Speaker 4 (23:45):
So the big thing with persistent pain that exercise physiologists
can help with is that concept of the pain neuroscience education,
and that can seem really scary as a clinician, but
there's some really great resources out there. But I think
something as simple as if I can get my patients
to understand that pain is not as simple as spraining
an ankle, that ligament giving me pain, that's actually not
(24:06):
how pain works. If we sprain an ankle, we get
a signal on the ligament. That signal gets sent up
our nervous system all the way to our brain, and
then pain is the output. And anywhere along that nervous system,
that signal can be upregulated or downregulated at any point
in time. And so that's why we can have large
amounts of pain with not much damage as well. And
(24:29):
that's also why we can have large amounts of damage.
Think about the footballer on the field that dislocates their
shoulder and is like walking around and they haven't noticed yet,
and then they can have not much pain as well.
Even if just starting with that concept is really important.
And then probably pain neuroscience, I think is something that
quality of the education is really really important. And I
(24:49):
have probably my go to of who I'll refer to
for that because that's really important. But I think understanding
that because what we don't want to happen is you
to then be scared of movement. And being scared of
movement makes complete sense because it hurts. You know, our
bodies naturally programmed to be like, Okay, i've got pain,
I'm going to shy away from what we're doing. But
(25:10):
when we have pain for a long time in twelve
months is definitely that persistent pain category, then we become
scared of movement. So I guess having EP in that
time would have potentially helped us found movement that's safe,
and then we would have had some positive messages around movement.
But then also acting, I guess I say to EPs,
we have a really powerful role to act as a
(25:32):
care navigator. So you don't have to have the answers
to everything. I certainly don't have the answers to everything.
But if I can highlight that someone might need some
pain neuroscience education and then bring up the concept with
them and then send them to the right person.
Speaker 3 (25:46):
That's really powerful.
Speaker 4 (25:47):
If I can flag with someone that they might need
dietetic input and then send them I don't need to
know what that.
Speaker 3 (25:54):
Dietetic input is that's not my role or my scope.
Speaker 4 (25:57):
But I think if we can act as a care
navigator and make sure that people get access to a
multidisciplinary team, that's when we have a really powerful impact
as well.
Speaker 1 (26:08):
So you can refer on to a pain specialist if needed.
Speaker 4 (26:11):
Yeah, So if I'm thinking someone needs pay neuroscience education,
I'm probably actually not going to refer to as pain
specialists like a doctor themselves. But there are a few
clinicians within private practice I know that do pain neuroscience
quite well. And I think the thing is is that
pain your a science education. It's not a physio thing
or an EP thing. It's a clinician thing. So just
(26:33):
knowing who to refer to, I think that's really really powerful.
And I always say to people I actually won't tell them.
I'll ask them or say can I tell you about
pain and what I know about pain?
Speaker 3 (26:42):
And they'll say yes if they agree.
Speaker 4 (26:45):
And I said, but before I start, if I talk
to you and you finish and go, she's just told
me it's all in my head, can you let me
know because that's not the message I want you to get,
So please let me know if that's how you've received
that message because the number of patients I have. Oh yeah,
I did a pain course and they just told me
it's in my head, and I'm like, that's not the message. Absolutely,
(27:06):
our brain is so important in it, which is why
the education is so supportive in evidence for doing it.
But I'll say there's so many things that input persistent pain,
which can be a bit scary, but equally it's kind
of exciting because if that many things impact pain, we
have that many avenues to help you with your pain
as well.
Speaker 1 (27:24):
Yeah, that's a real positive sphere.
Speaker 4 (27:25):
Yeah. Yeah, I'd like to say I came up with it,
but there's actually an EP that is the head of
NOI Pain Group, Brendan Mowat, that said it, So i'll
steal that he spoke at.
Speaker 2 (27:35):
There's a conference that's fantastic that you understand enough to go, okay,
that's outside my scope. This is really pain. Yeah, long
term pain orientated. Yeah, so I'm going to refer you
on because I think that's powerful patently, because I went
to a pain specialist who said I was making it up. Yeah,
(27:56):
I was losing more and more strength and my GP
said I was making up the falls and I'm a
just practitioner like I'm in the space and I was
treated that way. And it was only when I really
sat back and went, Okay, I've got to take control
of this now that I found a new GP and
they told me who to see as a surgeon got
(28:19):
in to see them, did pretests and I can't wait
actually to see the six months because I know how
bad I was when I first went in prior to
surgery to where I am now So powerful, isn't it?
Speaker 1 (28:31):
What I loved about Felicity at facspace.
Speaker 2 (28:35):
She would really listen to me, and there were some
days I was so sore and she would work out
what sort of saw I was. So there's some saw
that just saw from exercise again getting back on that wagon,
and then there's surgery saw.
Speaker 1 (28:51):
So we had to work that out.
Speaker 2 (28:52):
But there were days where she go, let's not do that.
How about we do some stretching instead, and I'll show
you how to do some stretches that.
Speaker 1 (28:59):
I didn't even know how to do it.
Speaker 2 (29:00):
And I've done so much exercise throughout my life, but
they were fantastic and life changing. Like I wake up
now every morning and do my set of exercises no
matter what, and they set me up for the day.
Hopefully next week I'll be allowed to go back to plarties.
But that's been a really good goal. And I mean
I'm a goal setter. I would assume you are too,
(29:22):
But I do think setting goals is so important when.
Speaker 1 (29:25):
You've got pain. And it's easy to say that now
I'm on the other side of it. During it, it
wasn't easy.
Speaker 2 (29:30):
Yeah, if you're nursing and you know you've got constant
back pain, it's really good to see someone and get
some goals.
Speaker 1 (29:36):
Absolutely, And I love that. Seeing numbers is very powerful
to me.
Speaker 4 (29:40):
Absolutely, and you would find that, yeah, And that's like
with the tech again. So like at my clinic we
have four stex and we have a dynamometer, which I
think people think we only use that for our athletes,
and no way use it all the time because again,
if we can have that numbers, it actually makes us
prescribe better programs because we can target specific things. But
(30:01):
that in with people, they go, I'm going to change
that numbers not going to defeat me.
Speaker 3 (30:06):
I'm going to make that better and I am going
to be better.
Speaker 4 (30:09):
And I think like with that goal setting too, we
can have really good impact because we build rapport with
our clients. You know, you see them really quite regularly,
especially if it's post surgery, and go okay, like, what's
your goal and.
Speaker 3 (30:21):
People are out to be pain free? I'm like, okay,
that's not a.
Speaker 4 (30:24):
Goal, but it's not saying that it's going okay, what
does being pain free mean to you? In six months time?
If you're pain free, what would you be doing or
what would that look like? So if you said to me,
I want to get back to pilates, well, what does
that look like to you? What does pilarates mean to you?
If you can't get back to polates, what will your
life look like? Because it might not actually be about
(30:46):
the polarates. It might be about that's your time, that's
your regulation, that's you feeling normal, that's your measure of
normalcy for your life. And so I think that kind
of really thinking about our goals and why they're our
goals is really important to tap into, and we have
that skill as EPs to do that. We're not going
(31:07):
to sit someone down and be like, right, let's think
about it. But in the exercise session where chatting, we're
talking to them because there will be bumps in the
road like, unfortunately, rehab is not linear, and if we
can then come back to it, go yeah, but remember
when you're on that reformer and your glue is burning
and you really want to stop, But how good will
that feel because you're on that reformer and you're doing it,
(31:28):
So we can actually bring it back to that.
Speaker 2 (31:30):
See, my goal was that there were these eighty year
olds that were in the class and they could outdo
me in plarties. Like when I first saw them, I
was like, oh my god, they were phenomenal. These women,
They've been doing it for years. Their agility, their strength,
their balance was amazing, and I thought, well, if I'm
in my eighties and I look as good and sound
(31:50):
as good as these women, you've won me over straight away. Amazing.
Three times a week they go and I would plock
up beside them and I'd put my map down and
it was like, I'm keeping up with YouTube.
Speaker 3 (32:01):
Yeah, and that's it.
Speaker 4 (32:02):
So you go like, it's not just about the pilates
PILARTI obviously what you love doing, it's what I love
doing too, But it's you feeling independence, you're feeling strong,
it's you feeling like you're probably your injuries not stopping
you and not taking over that, and like that's actually
unpacking that and going oh yeah, actually that's what pilates
gives me.
Speaker 2 (32:21):
That's why it matters so much to me. And I
don't want to be a decrepit old person. No and
no disrespect to anyone that needs a wheelchair or needs
a walker, but I don't want that for me if
I can avoid it. So I want to do everything
I can to avoid going down that pathway.
Speaker 4 (32:41):
And strength training and exercise is really powerful for combating
the neuromuscular effects of aging. And you know, look, mobility
aids are great because they can then get people moving
and doing better. But then it's about making sure we're
strong and making sure we're moving. And that would look
different on an eighty year old to will on a
forty year old. But that's why that individualization from that
(33:02):
EP assessing them, what's their capability, what can they be doing?
Speaker 1 (33:06):
Is it safe?
Speaker 3 (33:06):
Is it effective?
Speaker 1 (33:07):
Is really important.
Speaker 2 (33:08):
I've been reading a lot about Alzheimer's and tenture and
how important exercise is preventing that and starting earlier, like
they're saying, you know, try and be active your whole life.
But you know that thirty five to forty five age
group is really important to start getting those good habits
in place, and the impact it actually has on reduction
(33:30):
of dementia is profound and none of us want that.
So I was really quite surprised reading the research that
they're actually doing overseas and here in Australia too around that,
and it's phenomenal the outcome that exercise has. You were
saying earlier on about the Australian's standards around our exercise,
(33:53):
can you explain.
Speaker 4 (33:56):
With us? So we have physical activity guidelines, and I
think it's important to use the word physical activity because
often I will use the word movement because particularly with
like Alzheimer's and that kind of stuff, there's lots of
studies that gone to more details should we be doing
this than this?
Speaker 3 (34:09):
But the movement is important.
Speaker 4 (34:11):
So the physical activity guidelines is that this is from
our eighteen and above. Kids have different ones, and I
think these ones go to sixty five as we get
older adults. Again they're a bit different, but we should
be doing our one hundred and fifty minutes of moderate
intensity exercise or two hundred and ten minutes of low
intensity exercise per week as well as two resistant sessions.
(34:32):
Now that doesn't have to be five thirty minute sessions.
This is physical activity, so it can include going walking
to the bus stop. It can include things like that.
On a more individual level, when people come to me
and want exercise plan, this is generalizing, but they'll go
on to one of two categories. They'll either be really
sedentary but they do exercise three times a week, but
(34:54):
we're not quite hitting those goals. But they might sit
all the time, or they're going but I move all
the time, but they're not doing purposeful exercise. So like
a trade yeah, yeah, or someone who's on their feet
all the or a nurse exactly, but they're not doing
purposeful exercise. I say them, look, let's break it down
into physical activity and exercise. So your physical activity is
how much you're on your feet, Like have you met
(35:15):
your limit today or have you sat on your butt
all day? That's really important. We know that movement is
really good and we don't want to be sedentary. There's
even some exercise coming out they're calling it exercise snacks,
you know, and should we be doing little bits really
frequently as well?
Speaker 3 (35:30):
But then equally we need.
Speaker 4 (35:31):
Exercise, and I say, think of exercise as purposeful movements.
So that's when we go, hey, nurse, you are bent
over in that hinge position. We need you doing some
squatting and deadlifting. We need you doing functional movement training
because that mirror is what you want to do, or
you're picking up your grand kids, or you're picking up
your gorgeous little dog.
Speaker 3 (35:52):
You know you need to be able to have the
strength to do that.
Speaker 4 (35:55):
So I kind of break it down into goals because
they might be smashing those physical activity. They might be
on their feet all the time, which I'd say most
nurses probably fit that. I agree, So it might go, Okay, well,
let's increase some specific resistance training for them. Okay, let's
actually start with some functional movement training. Let's start twice
a week. You know you're going to learn these movement
(36:16):
patters twice a week, and all of a sudden, that
becomes a lot more achievable and way less daunting. Between
go I've got to one hundred and fifty minutes and
two resistance training exercises, and I'm supposed to do this.
Let's start with what's going to be achievable, but purposeful
and meaningful.
Speaker 1 (36:32):
To that patient. Yeah. Yeah, So someone goes to the gym,
they see a trainer.
Speaker 2 (36:37):
Yeah, that's very different to an exos sociologist, isn't it.
Speaker 1 (36:41):
Yeah.
Speaker 4 (36:42):
So the thing with trainers is that we actually they
could have as little as three months training and they
could be eighteen, So they don't have the expertise to
be able to assess appropriately and to clinically prescribe exercises.
So you know, there are definitely trainers out there that
have lots of experience, and I've worked with them before,
(37:04):
but the already the time, the way I think about it,
trainers are good for working with what I would say
is the healthy population. Okay, so not people with specific
musculo scialegal injuries, not people with chronic diseases. That actual
clinical reasoning behind why I've given you a squad is
actually really really important because I've taken information from the
(37:24):
subjective assessment, from the objective assessment and clinically reasoned why
that's going to be important for you. They don't have
those skills, they're not intended. They're there forgetting the healthy
population moving.
Speaker 1 (37:36):
Yeah. Okay.
Speaker 3 (37:37):
The other thing is specific goal.
Speaker 4 (37:38):
So even if you'd say, yeah, I'm generally healthy, you said,
when you started nursing, you could do most things.
Speaker 3 (37:42):
But to have that skill to buy mechanically, breakdown.
Speaker 4 (37:47):
Movement and assess gate assess movement, that's just not skills
their train. The big difference is we spend four years
at university gaining all those skills, building them up. We
spend hundreds and hundreds of hours doing placements, so we
have those skills to be able to do that.
Speaker 3 (38:02):
That's just not their intended purpose.
Speaker 1 (38:05):
So what's the name of your clinic?
Speaker 4 (38:06):
I work for All Sports Indrapilli, and I am very
passionate about working there. I've worked there a long time,
and like I said, my journey started out yep, I
wanted to be the elite athletes. I grew up playing
water Apollo and seeing that side of things. But now
my bread and butter and that person I love to
work with is probably that middle aged female and male
back pain is our bread and butter. We see it
(38:30):
so often, multiple times a day. But I think the
thing is exercise can seem really scary, It seems really complicated.
We don't know where to start, and quite often people
have had negative experiences with it, so especially in gyms. Yeah, yeah, absolutely,
I think being able to provide that positive experience and
(38:51):
to get people to go, oh hey, exercise can be powerful.
That's really what sits with me. We're really lucky in
the clinic we have. We're in a multidisciplinary space. So
we have a huge gym that has squat racks and
we run glasses in it for people who don't want
to go to the gym or need that supervision of EPs.
Speaker 3 (39:09):
We also have pilate space as well.
Speaker 4 (39:12):
We have clinical smaller space for people that that's not
their jam either. We have our tech so we have
our dynamometers, we have our fource decks that we get
to use.
Speaker 3 (39:22):
But in our building as well.
Speaker 4 (39:24):
We also have dietitians, we have hand and up, a
limb therapist, we have the dietrists.
Speaker 3 (39:29):
We have ots to.
Speaker 4 (39:31):
Do scars and swelling management. We have specific pilates clinicians.
We have pediatric physios and pediatric exercise physiologists, and then
we have a bunch of other specialists.
Speaker 3 (39:43):
We have orthopods and people like that through our doorst so.
Speaker 1 (39:46):
You do a lot of rehab as well.
Speaker 4 (39:47):
Then we do a lot of rehab, and I think
that's really powerful. We're all different businesses, but again in
that one roof. Even I've had people come in they go, hey,
how's this scarfeel and they're like, yeah, it actually really
bothers me. I'm like, do you know there's something we
can do about that? Go see these people or they'll
come in with a trigger finger or something. I liking
our hand therapist do the thermoplastic splinting. I might go
(40:09):
see those guys. They'll do something specific for you.
Speaker 1 (40:11):
We lived at the hand therapist in Bay Terrace with Chloe. Yeah,
and in the end, I didn't even bother going to
the doctor Giddon nextray. I just go straight to the
theist and she was amazing.
Speaker 2 (40:21):
They're still there on Bay Terraces at win them and
you know, kudos to those guys. They were fabulous and
got Chloe through numerous fractured fingers and lord knows what.
So I just want to say thank you so much
for coming in today and having a chat with us.
I'm going to put your clinic's details on the show notes.
(40:42):
If someone wants to find an excise physiologist that's close
to them and they can't get to say intrapilli.
Speaker 1 (40:48):
Or absolutely, how do they go about doing that?
Speaker 3 (40:51):
So there's probably like two ways I go about it.
One is through ESA's website.
Speaker 4 (40:55):
They have find an ep so that will be on
there and that's probably a really great way because it
will tell the location. Because absolutely I've spoken about barriers.
It needs to be accessible and easy without absolutely. The
other thing, if there's something more specific, you know, if
you're thinking you want to know more about pain, you're
a science education that kind of stuff, that's a bit
more specialty. I'm always happy for people to reach out,
(41:15):
shoot me an email and I can reach out to
my network and see who's available.
Speaker 1 (41:19):
Oh look, that is fantastic.
Speaker 2 (41:21):
I think the one thing I've taken away from today,
particularly around nurses, and I know most nurses have lower
back pain we just do.
Speaker 1 (41:29):
And shoulder pain. That's another one.
Speaker 2 (41:31):
It's a shocker, is that if you're in a private practice,
you can get an excise physiologist to come to your
clinic and they can come in and assess your movement
around whatever your job is, and then give you exercises
around how to strengthen the areas or maybe to stand
a bit differently, or look at ways around improving how
(41:51):
you work in that environment. You can off the bat
go yourself to see an exercise physiologist. If you have
long term pain, you can go see your GP and
if it's needed or so if you fit the requirements,
you can then maybe get some Medicare assistance. And I
can do from firsthand that the private health funds absolutely
(42:14):
give you money back to seeing an excise physiologist, physioot
hand therapist.
Speaker 1 (42:19):
And you know we spend all this money on private health.
Speaker 2 (42:22):
Use it, absolutely, use it, because honestly, I can tell
you firsthand, I love my exercise physiologist. She's been amazing.
Moving forward, once my rehab's over, I won't be seeing
Felicity anymore, so I think.
Speaker 1 (42:37):
I'll be coming able to interpelling tell us.
Speaker 2 (42:39):
I cannot believe you walked into today and I knew
who you were straight away. Honestly talk about me to
be I just am very grateful for you taking the
time during pain week to come and have a chat
with us. All the details will be on the page, guys.
I'll have S's details, I'll have Alysi's details, I'll have
tens Vanessa's details. I'll have it all there and you
(43:01):
can go in and have a look and just take
the time to check out an EP because honestly, first
ten experience.
Speaker 1 (43:08):
They change your life absolutely.
Speaker 4 (43:10):
And you know, exercises is complicated, but it's powerful, so
don't feel like you need to know everything about exercise.
And that's what we go to use exactly so you know,
and there's no goal or challenge too small or too big.
Speaker 3 (43:23):
We're here to help you. So whatever is useful and
powerful to you, that's what we'll try and do.
Speaker 1 (43:28):
Thank you so so much for coming. I appreciate it
so much. My pleasure
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