February 9, 2025 • 49 mins
Adam shared his personal and professional journey, from working in a takeaway to becoming a physiotherapist, and his experiences with dyslexia, social belonging, and imposter syndrome. He discussed his transition from traditional medical practices to starting his own business, Working And Pain Solutions, which focuses on helping people with chronic pain reintegrate into the workforce. The conversation also touches on the importance of community building, honesty, and social belonging in our profession as a whole.
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(00:00):
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(00:25):
Hello and welcome to You Matter.Hello and welcome to this next
episode of You Matter, where I'mtalking to Adam Sue, a
physiotherapist with his own clinic called Down to You based
in Sheffield, a clinic from which he runs a programme called
(00:46):
Work and Pain Solutions. And we're going to talk in
detail about this programme during the podcast episode.
But Adam also shares a lot abouthis personal history as a young
man in physiotherapy and the thehighs and lows of that journey,
which I think a lot of people will probably understand and
(01:07):
resonate with and some of you will be quite surprised by.
So I think his journey into how he came to offer that programme
is as interesting as a discussion about the programme
itself. Adam is somebody who I hope will
become much more well known in our profession.
I think what he's doing aligns really well with how a lot of us
(01:30):
are thinking our profession should go.
So have a listen, see what you think.
As ever, let me know what chimeswith you, what you find
interesting, what you'd like to take away from what you hear.
And I will be back at the end totalk about that a little bit
more. So hello and welcome to this
(01:51):
next episode of You Matter podcast, where my guest today is
physiotherapist Adam SU. Hello, Adam.
Thanks ever so much for coming on the podcast.
Hello, Joe, Thank you for havingme.
Happy New Year. Happy new Year.
So Adam runs his own company. If you're watching this on
YouTube, if you're watching the video, you'll see both on Adam's
(02:14):
top and behind him, he's got D2Uand his company is called Down
to You, which when you hear about the way Adam works, I
think you'll realise that name is perfect and speaks volumes
about Adam's approach. The reason I've invited Adam on
is because I came across Adam onLinkedIn when he shared a video
(02:36):
of a program he runs, and this program is called Work and Pain
Solutions. I'm going to try and share the
video in the show notes because it really, for me, illustrated
it's very clearly what Adam's about and what he's trying to
do. We'll talk about that programme
more when we get into the episode.
But what I want to do first is hand over to you, Adam, and just
(02:57):
ask if you would go back over your career history for us just
so that we can see what led you to this really interesting point
that you're at now. Would that be OK?
Yeah, that's fine. And everybody has their own
journey and I'm really excited to share my own.
Yeah. So I'm a first generation born
Chinese in in the UK. My mum and dad came from Hong
(03:19):
Kong and China. So not from an academic
background at all. Not really much support from
them in terms of like where to go in terms of like life choices
and stuff like that. And so at 17 years old, when
you're going through school and then you go up, decide what you
want to do for the rest of your life.
I had a bit of pain in my back at that time, actually.
(03:40):
That's what started this whole journey, I suppose, when I think
back and reflect on my left side.
And I spoke about this on another podcast where, yeah, I
was just waking up pretty regularly with pain.
My mom actually did take me to aprivate physiotherapist, gave me
some really basic stretches, which were helpful.
And obviously I've advanced in those moments since on self
(04:01):
exploration. So from 17 decided to do
physiotherapy and applied for the five university courses on
UCAS and did it. And I got interviews and I got
probably have 3 or 4 interviews.And every interview, obviously I
actually had feedback of saying I wasn't empathetic enough
because my work experience on myCV showed no caring experience.
(04:24):
So going back to my background, I was working in a take away
with my parents and from a very young age actually, which is
probably not allowed nowadays. So like from like 12 years old,
I was working in a take away, even at university on the
weekends, I would come back and work with them.
So that really affected my social sort of connections and
social belonging really, which again might influence the way I
(04:47):
approach things now. So from there, obviously it got
rejected and again, no advice from my parents or teachers
about, I think it's called clearing.
So, you know, if you've got the grades and which I didn't care
and you could bring up the university, see if there's
anybody else that didn't obviously make the cut and get
(05:08):
on the course. But I, I didn't know about that.
And I took a undergraduate in sports science and Physiology
and that was a three-year degreeat Leeds and really enjoyed the
course really difficult. And I did put a lot of ownership
for myself in terms of being very driven to be academic or
try to be academic. But I really struggle with
(05:28):
words. I'm, I'm potentially dyslexic,
but I've not gone through the diagnosis or anything like that.
I just obviously live with it and manage it.
So for me, I read read censuses many times before I really
understand the the context of what it's saying.
Yeah. And then from there, through the
degree, I had a little bit of a panic attack actually.
(05:49):
I'd broken down and I knew that I put a lot of pressure on
myself. I needed a 21 to be able to get
into the master's accelerated physiotherapy degree, which I
managed to get on to. And again, that personal story
is really helped me develop the way I am in terms of how I
empathise with clients. And again, through having that,
(06:10):
there's three rejections throughinterviews in that first thing
saying that I'm not empathetic enough really probably still
sort of drives me a little bit in terms of my, my, my clinical
practice, going to the master's and obviously through every
physio degree we have clinical placements.
And yeah, it's time to explore in terms of what you like and,
(06:31):
and see what you want to specialize in.
And again, just from not being very, again, it's, it's a really
weird situation. So as myself, and I'm probably
still figuring it out in terms of social belonging in the, in
the UK and going into a Western culture, NHSI did find it very
difficult. And it didn't help when my first
(06:53):
placement, I had my friend who is from the Zimbabwe and I'm
sure he won't mind me saying, I won't say his name like, but he
was a very confident American guy and he was outspoken.
And I heard one of your recent podcasts and he had a similar
experience, but he was very outspoken, very confident and he
got struck off that first placement and that really
(07:17):
impacted ours. We, we were four guys, our 12
cohort physios and it really impacted our well, mine and his
confidence for sure. We were the two sort of, I
guess, minor, minor ethnicities and and yeah, so that that made
me really work in the air of caution when I was in the NHS,
didn't want to take a step wrong.
(07:38):
Something like imposter syndromecoming from like a Chinese
background take away. Now I'm in hospital trying to
help somebody like that's just that was a huge, huge shock.
And I remember every day going to like a placement and I would
listen to songs which were like quite emotional slash
inspirational. And I would actually sometimes
have tears driving into the, theplacement because I was
(08:01):
wondering like, how am I going to be spoken to today, how I'm
going to be treated and so forth.
So from that, you know, from that experience, I did manage to
pass and, and one of my, one of my MSK placements, I didn't do
very well. And then I had another
opportunity to do another MSK course and I was able to succeed
(08:22):
and do really well with it. And that really give me that
confidence to go into MSK and and private world after that
because I did make that conscious decision not to
probably participate in on the NHS.
I graduated in 2012 and that's where there was a bit of a dip
and recession or job shortage for physios in the NHS there.
So we found it really difficult to get a job in the NHS anyway.
(08:45):
But again, I think I feel like things happen for a reason.
And then from there I went into occupational health and that
really opened my eyes in terms of developing my clinical
practice. It was an organization that
supplied, you know, interventions and occupational
health for long term sickness. So people that have been off
(09:06):
work for a long period of time. And that's where I was first
introduced to functional restoration programs or
principles. And it was more about what can
somebody do instead of what, youknow, what's the pain doing?
So, you know, they, they taught us about how do we get somebody
better functionally and as a byproduct, they're paying my
(09:27):
reduce or actually getting back to an active life and they're
pain reduced as a byproduct. So that really opened my eyes.
And I guess I also want to talk about manifestation.
When I was on my journey to physiotherapy, I did want to
work for the police and, and be the lead physio there and
(09:48):
through the occupational health they had the police as a
contract and I was, I became thelead physio there.
And then within two years I established a really good
relationship with them and the manager there really enjoyed the
way I worked and talked to the officers because they are a bit
of a different kind of bunch. And I was in the police name for
(10:08):
nine years all together and was really able to hone in my
interpersonal skills, my clinical skills in terms of
having that much time. So I had like an hour or so with
clients to talk about the mental, the social, the
emotional, as well as the physical contributions to why
somebody was off work for a longperiod of time.
(10:31):
And so after 3-4 years of doing that on a one to one in a clinic
base, I start to recognise patterns and trends of like what
people were suffering with. And, and now I call it in this
whole bucket of tension basically.
And so tension, yes. So like what is adding to that
tension? What's contributing to them
(10:53):
having that persistent pain? And and you know, we talk about
the bio psychosocial approach. So from doing that and
understanding that there are specific things that adding to a
police officer's life or police staff's life, I started to
develop like a well-being talk. So I was approached by the
obviously all corporate organisations love the health
(11:15):
and well-being arm. And so I jumped on that and said
that, you know, I could present something in terms of physical
interventions. And I started to see like how
the corporate world sometimes reacted.
It's like last minute. We've got a bit of understand
that's going just pay for some interventions and off the shelf
stuff, which wasn't tailored to to police.
(11:35):
And and so when I, when I did the talks, you know, we're,
we're, they're, they're in the mandatory CPT everybody's
crossing their arms. Like, what's this guy going to
teach me about what, you know, what's he know about police?
And obviously me just saying like I work with you guys on the
ground and this is data that I've developed through working
with you guys and having a, yes,the theory side and trying to
(11:56):
encourage behaviour change was really, really hard.
But you know, I had to do the practical side, which they
loved. And feeling the the benefits
from the interventions I give now and all of them always going
from arms crossed and then laughing and, and really
enjoying the course. And then, yeah, getting lovely
feedback from them. And then obviously they did a
(12:17):
review through the HR saying what's the referrals looking
like for occupational health? And again, at the beginning of
that career, I set out a personal goal, I suppose, to
make my job redundant. And this is where the down to
you physiotherapy and health andwell beings come from is that if
I can teach the officer not to come back to me and that they
can deal with flare ups, conflicts, confrontations and
(12:40):
they don't need to come see me, then that's that's what I would
like to do. So if we do the well-being
sessions, after 3-4 years of delivering through the whole
district, they found that the referral rates to the
occupational health for mesc andschool issues were very low.
And then after that report they found out they needed nine
councillors and half a physio for the whole force.
(13:02):
And I was like wow, that's crazy.
And again, a bit short sighted from them.
They said we don't want you to do the well-being stuff anymore.
We just want you to be a physio and do the 1:00 to 1:00 and.
Be the half physio. Yes, exactly.
Or just be the traditional physio that you know that in the
textbook and that's what they wanted.
And I said no, I'm not going to do that and it's time for me to
(13:25):
grow and carry on. Then I had a choice between
going into a, you know, new field and doing MSK out
outpatient service or into FCP. And, and I thought in terms of
my skill set, I think the FCP would be a better role for me to
learn about outside the box. So what else can influence pain
(13:45):
and what what else can influencepeople's symptoms?
And it was such a good learning curve.
And as you know, you know, physio is alone working and in
that police role, I was, you know, alone working there and,
and this FCP role, there was 200physios in the network, really,
really huge network of physios. I thought great, you know, this
(14:07):
is going to be amazing. I'm going to be able to bounce
off people's knowledge and feel part of something once, you
know, social belonging going back to that situation.
And I did, you know, they had the football team and we played
fibre side. I thought this is it.
I found the career for me now for, for a long term, but but
during that time, obviously there's like COVID time.
(14:29):
So, you know, a lot of it was remote and that's where we were
turning to, you know, but for me, I didn't have enough time to
help clients in my way to make me feel fulfilled.
So for example, you know, you have clients and you refer on,
you know, that they they need some more input from someone
else or more investigations. But what I found myself doing
(14:52):
was looking for community services.
So if I had an elderly gentleman, female or whatever,
and I think, right, OK, this is in need for surgery, would
further injections help his pain?
You know, and surgery would not always be something that would
be warranted for somebody at this age.
And I thought movement, social connection is going to be such a
(15:16):
better outcome than going for some more medical support.
So I would always look for like local classes, chair aerobics,
community centres that do like walking groups, coffee and chat,
whatever it is. And I refer to, I found myself
referring to those services morethan the traditional, unless
obviously there's some sinister stuff potential that we refer
(15:37):
on. And then through there, I, you
know, I found approximately 70% of the clients were chronic
pain. So, you know, in the definition
of chronic pain is people havingpain for three months or more
and it's starting to affect their life.
And 70% of the clients will comein.
And I just saw this conveyor belt situation in the GP where
they'll come into the GP medication and then after they
(15:59):
go and they'll be all right for a bit, they will flare up and
they'll come back again looking for some more answers.
And it's again the medical room.So I started to get into this
frustrated situation and, and I thought I've always had this
niggle to start my own thing. I always had my own thing on the
(16:20):
side, to be honest. I've got the side so.
But I'm going to put some more time and dedication into what I
want to do. So I started knocking on some
doors and just saying like, no, this is my background.
I've helped people with long term sickness go back into work.
And then I approached the council and the programme
manager there said, look, we areopen to innovative services and
(16:46):
what are you going to offer? They said there's going to be
some opportunities in the futureand put your bid in.
So I wrote a bid and and told them what that could offer and
the contract manager said that was the best tender.
They they, they're like. Really.
Yes, for the first time I was like, do you write tenders on
the town? I was like, no, I don't.
That was my first one, he said. I loved it and it's really,
(17:08):
really effective and beneficial.And that was in 20/20/21.
I would say at the end of I've got the contract in 2022 and
because I had secured some sort of financial sort of income, I
was able to take that leap of faith and leave employed world.
At that time I had a fire. What did I have?
(17:30):
I had a 5 year old and a three-year old.
So a big financial jump from having security to then
obviously to the unknown. And.
Then from there, and I've grown the organization and I've tried
to stay in my niche of working with the unemployed and
(17:55):
economically inactive who have physical help as a pain barrier
or health barrier to get back into the economic market.
And yeah, it's just growing fromstrength to strength.
And you know, I've always there's, there's sometimes some
downtime and obviously with chronic pain patients, they can
be very complex and very frustrating that for a clinician
(18:18):
sometimes. And then, you know, not making
that behavioural change, even though presented with all the
information and the time and space to, to, to think out loud.
I've always tried to keep in mind lane in terms of like this
is where I want to focus on rather than dabbing, dabbing
(18:39):
back into the occupational health or, you know, the
corporate organisations, even though that's probably where
most of the financial security may come from.
And that's led to the growth of the work in pain solutions.
And the reason why I call it that is because the pain program
in the, in the world at the minute, NHS people go there and
(19:01):
once people go, oh, it's a pain program and down to you, they
go, well, what's the difference between the pain program in the
NHS and the pain program and down to you, you know, and since
COVID, you know, from what I hear from my clients is that the
pain program is about how do we manage your pain?
So using medication and the medical route, as we talked
about before, whereas mine is more conservative, focusing on
(19:27):
function and cans, changing the mindset, the coaching aspect,
which you which you are heavily involved with and getting to
know the person and then taking him through this journey.
And that's where I get most of my fulfilment now.
So yes, just following my passion and that's why that's
what's LED us to today. And I know that's a really long
winded journey of my career, butI feel like that that that was
(19:50):
all kind of relevant to shaping my drive and my why, I suppose.
Absolutely. Yeah.
No, I just let you speak becauseit was 100% relevant and what
you've just said then shaping your why.
I hadn't heard the early story before of the the social
(20:12):
belonging side of it and that story about in your early career
and hearing that makes so much sense as to why you're so why
you're so drawn to what you do now, but also why you're so good
at it. Just that that point actually
about in that placement where the other guy was struck off and
(20:34):
the other young male physios made you feel really nervous.
You mentioned it's probably Tom Jacobs you were referencing.
You had a similar experience. And there's another podcast
episode with Alistair Beverley who shares the same story.
Again, all three of you come across now as very sort of
(20:57):
measured calm, all three of you actually quite softly spoken men
who've all had this early experience of being told you're,
I don't know, too much or not empathic.
It's kind of mind boggling and interesting that it's happened
to so many of you. It's definitely something for
another episode. But yeah, it's kind of shocking
(21:20):
me that that's coming through asthe same story with the similar
demographic actually so many times.
I don't know if you want to say any more about it, but but for
me, I'm sort of mentally loggingthat as something to, you know,
perhaps investigate a little bitmore.
Yeah, and again, it's really hard to not come across like,
(21:40):
you know, attacking anybody elseand stuff like that.
But you know, from my our perspective, you know, it was
like obviously the the profession is still quite female
dominated. And I feel like when we were,
you know, mentored by those female educators, it can be
quite hard in terms of the powerdynamics.
(22:01):
That's just for evolution probably.
And, you know, putting us in ourplace or we we, we as men did
not like that or for it to structure, I suppose from a
female potentially. So it could be our own
responsibility. But the nature of the beast too,
the way, you know, I always liketo self reflect on how that's
(22:23):
developed me as a clinician, howthat made me grow rather than
seen as a negative experience. And that's what's happened to my
friend. And you know, I'm now 13 years,
you know, postgrad clinical experience, my friend.
And we all did a 10 year mark and nine year, 10 year mark.
(22:43):
We all had this conversation going.
Is this it now for the rest of our lives?
And most of us, I did hit our, you know, our, our highest point
in our career in terms of like promotions and so forth.
So he got to abandon a A and, and he was like, is this it?
And obviously he was down South and then he had this young
family. So he decided to, you know,
(23:05):
actually leave the profession for now and become a private
teacher. And then, then he, he, he, he
reflected at one point where his, when he was going through
his teaching training, that a teacher was watching him and he
felt really intimidated again. And he had to do some self
reflection. And we still have really deep
conversations about this. And I love that about him.
And, and we, we have formed thiskind of brotherhood, I suppose
(23:28):
through this kind of adversity to go through these kind of
imposter syndrome slash just notfeeling worthy.
And and so again, I don't know whether that's me proving to
myself by becoming good at my business and being good with
clients and having good outcomes.
Well, I mean, certainly with thethree of you that I've met and
(23:52):
you know, Tom and Alistair have got to know quite well and
starting to get to know you. Another common thread with all
of you is your absolute dedication to the area that
you've chosen to work in and a determination to make sure that
it works for the people that you're delivering to.
I mean, your programme especially in that regard.
Let's let's make sure we do talkabout your programme because I
(24:14):
really want people to understandwhat it is you've designed.
It's a six week programme, isn'tit Adam?
And you work with a health coachas well.
Just talk us a little bit through what a client would go
through or a participant would go through on your programme.
So the new, the typical participant journey is like
they've had, they've developed apain through an injury at work
(24:36):
potentially or injury outside ofwork.
And then they've gone through the obviously the medical route
and sort out advice and treatment and, you know, and
decent treatment and advice in terms of the pathways that's
offered through the NHS, throughthe medical model.
So you know, medication initially rest and go for a
(24:57):
physio and rehab and a bit of strength and conditioning.
And then when it becomes chronicy.
So from prebombs onwards, usually the pattern is right, we
need to give some psychological support.
So then they might go to IAPT, which is, you know, improving
access to psychological therapies when they might do
some talking therapy and talkingabout how, how maybe the nervous
(25:18):
system is impacting the the painor the hypersensitive of the
nervous system is continuing their persistent pain.
And then maybe I've gone to a pain program and then took given
injections, talked about pacing,talked about nervous system.
And a lot of them that come to see me, obviously the ones that
failed that that failed in termsof getting good outcomes,
(25:42):
usually say that the pain is in their brain.
Somebody said to them, the pain is in the brain.
I'm making up the pain. And it's obviously not the
message that the client, the clinician is saying, but that's
what they've taken on. And that's really important that
their interpretation of the messaging and a lot of this, the
messaging that they always come to me about is an Acebo effect.
(26:02):
So like, you know, with the bestintent, rest don't lift, change
a job, all that kind of advice through the make up
professionals because that's going to help you back then lead
to them having limiting beliefs about the back.
They cannot bend, they cannot lift.
And through that fear of movement and the development of
(26:25):
and postural guarding rigidness that's creating to that bucket
attention I mentioned about before from the physical point
of view and the psychological point of view.
So what I recognise is that through their treatment, through
the the previous treatment, theywould always be targeted for one
thing. So from a physical point of view
(26:47):
or from a psychological point ofview and nobody really combined
or blend the two together. And so that's what down to you
work and pain solutions about and we use work as a health
outcome, whereas in the NHS we may not use that as an outcome
because that could be the employability services or the
(27:08):
government's agenda. You know that's so when you say.
Use it as an outcome. Do you mean the fact that they
are working or not working, or the amount they're able to work?
Yeah, if they were ready as well.
So like I feel confident to return to work now.
So, you know, we can do that. And these guys have been off
work for sometimes 20 years, 30 years.
For them to magically go back towork after six weeks, that's
(27:30):
going to be a huge miracle. And I'm not saying it's not
happened, it has happened. But you know, just having that
confidence to return to work andhaving that mindset change to
say that actually, I, I could probably do some part time work
or even some voluntary work now is a huge outcome for us.
And again, going back to my experience in the GP, you know,
sending the elderly to the community centres and just
(27:52):
making that behaviour change andshowing up and doing one Class A
week is, is like music to my ears, to be honest.
So it's just understanding that from a coaching aspect as well,
you know, from your, your, your world is how do we make these
guys know the theory, but then put it into practice in their
lives? And so again, through my own
(28:13):
personal experience of having chronic pain in my back, you
know, it's never stopped me frombeing active, you know, playing
football. And, you know, last year I got
to a nice level of CrossFit, managed to get to a really high
license event in the UK. I mean, we placed nine as a
team, which was brilliant. And, and, and, and that's what I
(28:35):
want to show my clients to is that yes, you have pain, but
does that mean stop? Does that mean you have to
protect? Does that mean you're going to
damage yourself by doing that? So once they've been referred to
me through a work coach or through the NHS or whoever,
which organization that they're dealing with, I will take them
through a 1:00 to 1:00. And it's quite an intensive hour
(28:57):
and a half. We take 1/2 an hour initial
triage where we take down some help information.
And in that hour and a half, we go through the health history,
go through obviously the basic physiotherapy assessment and
treatment to see what their range of motions like, and then
do treatment. And the treatment will involve a
lot of self efficacy. So self empowerment like this is
what I'm doing to you. How do you replicate that
(29:19):
treatment to yourself? And that is the most important
thing about this is the locus ofcontrol.
And there's lots of research outthere and a lot of surgeons out
there now as well speaking aboutthis locus of control.
And when somebody has a flare up, do they have control to
bring it down? And before their strategies were
as rest heat medication, going to see somebody for some self
(29:43):
relief if they could afford it. But all that is passive
treatment. So what is the active stuff
we're doing? All right.
And then and patients will feel the pain spots and hopefully it
will melt away once we've done the release.
And that is encouraged for them to do for the rest of their
lives. Once they've done the release,
(30:03):
they don't go through a very hard physical conditioning.
So as you've seen through the videos, the one that you're
probably referring to doesn't necessarily show the, the
strength that people go through.And, but obviously on my
Instagram and stuff, you'll see a lot of the, the, the, the
stuff we do. So we go ahead.
With you, Adam, the people that haven't seen that.
(30:24):
So this this all takes place in a a gym, doesn't it?
It takes place in a CrossFit gym.
So that's my passion. And again, I love to talk to you
about environment and how that keeps my motivation.
And my drive is about where you surround yourself, who you
surround yourself with too. And so yeah, it's based in
across the gym, very functional gym.
(30:45):
You know, it's not too scary. It's just an open space.
And we do functional movements. And after, you know, playing
with it, we have developed, you know, a little programme, a
structured programme like when we will do deadlift, heavy
deadlifts, we'll do squats, we'll do shoulder and chest
press. So it doesn't matter what area
of your body, body area is a pain.
We will target that through the through the strength issue.
(31:10):
And so, yeah, so then when we wedon't set any glass ceilings, we
just go, let's go and do this deadlift.
We're going to find your one RepMax and let's see where you're
at. And they do it and they do it.
And then they go and I say at the end, I say, how much do you
think you lifted? And they'll be like 20-30 kilos.
And then they've done hundred 110 kilos and they go, wow, I
(31:31):
think I had that strength in me.And giving them more, giving
them them more capacity then allows them to have that
confidence when work legally, you know, you're only meant to
lift 25 kilograms at work. If you if they've done 100 kilos
with me or 80 kilos, let's say, and I say less at work, you've
got 25 kilos to lift. What what's their confidence
going to be like? It's going to be through the
(31:52):
roof. So yeah, I've just basically
joined the dots and, and, and just done a bit of hand holding.
I understand about coaching thatpeople need to get the answers
within themselves, but through the police experience as well,
some people just so institutionalised, they just
need that instruction and guidance and through doing it
(32:14):
they gain that real life experience and the difference
and the wisdom between knowing and actually doing.
Yes. And it sounds like you you're
adopting that side of coaching, which is the sort of the really
supportive mirror that believes in their potential.
(32:36):
You know, to have someone it it's hard to maintain that
belief, isn't it? You can, you can instill it in
someone and send them away. And there will be a point where
that belief waivers. And I think to have, you know,
that repeated contact and you'vecalled it hand holding, you
know, in those early stages, just have someone alongside who
always believes in you and will keep reinforcing that message.
(32:58):
That sounds to me like a huge part of what you're doing.
Yeah, yeah, that's, yeah, that'strue.
And and like I said before, likewith social belonging and
chronic pain, we it's coincided with social isolation, anxiety,
depression, reduced self efficacy and belief and esteem.
(33:19):
So having somebody just say to you, it's going to be OK is, is
where I'm working at the moment for sure.
And even myself, you know, I went through some business
venturing yesterday and I, you know, showed them my accounts
and he was like, wow, you're OK,you don't need me, you're fine.
And I'm like, no, I need somebody please help me.
(33:40):
But actually, you know, instantly that self belief at
every level is super important. And these guys are at the lowest
and low, you know, that little bit of belief just helps them
break out of that pit and that hole that they're in.
You're right, those words, you're OK.
And I totally identify with the financial one.
My, I've got an IFA that's knownme since I was 19.
(34:02):
And he knows that the best thinghe can say to me is Joe, it's
not as bad as you think. It's fine.
But yeah, you're OK is such a strong message.
And you know, we, we think people are OK, don't we?
And it, it doesn't often take much to scratch the surface and
realise that everybody and whatever sphere they're working
(34:22):
in, even the most supremely confident looking people still
need a, a version of you're OK at some point.
So Adam, if people are listeningto this and well, I hope people
are listening to this and realising that this is such a
modern way of working. This ticks every single box of
(34:44):
the way we are being told healthcare should go, even by
politicians. You know, it's a weird alignment
for once about what we think should be happening and what
they're saying. And I'd say that pointedly.
But you know, it fits with person centred care, it
prevents, it fits with preventative care, very specific
lifestyle, functional exercise. I love your, your social
(35:07):
belonging element. If people are listening,
thinking, gosh, that's how I want to be working.
Let's focus on your tender. So you, you said you were given
the feedback that that was the best tender that had ever been
put to the council. What do you think it was about
that tender that was so good? Or did you get any feedback
about why it was so good? Again, going back to my previous
(35:30):
life experience, you know, in mymaster's degree, again with my,
the reason why I brought up my dyslexia is that when I was
given a task or coursework, I would start from day one and a
lot of my clients would do it last minute and be in the
library and doing the Red Bull and doing the 48 hour stints and
stuff. But I would prepare from the
very early on, I would read lotsof research papers and I would
(35:52):
read it over and over and over again.
And I'll put it into a file. And then I think that's
relevant, that's relevant, that's relevant.
And then through doing that repetitively, I actually got
caught up on plagiarism. And yeah, so the head of the
faculty called me in and said, look, this is really, really
bad, blah, blah, blah, blah, blah.
And and you're not going to be able to pass the course and
(36:15):
broke down again, Broke down again, had a panic attack,
brought my very close friend in with me on the the chat.
And he said, look, you can submit again, but your maximum
score is going to be the pass rate, right?
Did it hugely affected my confidence?
The one thing that she said to me and I still it still sticks
for me now is that if you being academically smart or being good
(36:39):
on paper doesn't mean you're going to be a good practitioner.
So that really stopped for me and I and that that's why my
last placement where I did do really well, really helped me
grow my confidence to go, OK, I'm going to be OK.
And so I took on a recent modulespecialised in chronic pain and
(37:02):
I got a distinction on it. And that was a huge, big
confidence boost. Again, with what I'm doing and
putting the agenda, my mindset of how to make this new wave of
physiotherapy, new wave of treating people in, in, in, on
the ground, how does it work? And from having having that
(37:24):
passion, having that understanding, using those
outcome measures, using my knowledge and how to write a
thesis and dissertation, I just applied that to tendering
process. And that was it that, you know,
and then with the research backed, you know, this research
says this, this, this says this,put it onto the paper.
(37:45):
And they went, yeah, it all makes sense.
So, so yeah, that that's what where it came from.
So again, a long winded answer. Just going through, you know,
adversity in terms of my writingskills, then a decent thing.
And then to just point into practice, put on paper and see
what happens. And even now when I'm writing
attendance, I'm going, is this good or not?
And I just got to believe in myself, I suppose.
(38:07):
Yeah, it sounds like you're sortof answering the objections from
the start, you know, through that research and being really
thorough about it. Probably your, well, a bit like
when the first question you answered on this podcast, I, I
could have needed to ask you 6 questions to get that amount of
information. But you know, your, your
thoroughness in the way you answered it speaks volumes about
(38:29):
how you approach things. So let's go back and have a
quick well, I want to have a conversation with two of your
previous selves. So the first one is your 12 year
old self that started working in.
Was it your parents? Chinese restaurant, did you say?
Yeah, Chinese take away, yeah. So if we went back and spoke to
(38:51):
that version of you and asked him what he thought about what
you're doing today, what would he say?
That's so powerful and that's sogood.
Nobody's ever asked me that question before, and that's
probably what I mean. You'll be more coaching and
yeah. And to be fair, I've done some
self reflection and even when I was, I go back to let's do the
12 year old first. I think he would be proud of
(39:14):
where I am. I'm, you know, from being an
Asian background, they always want you to become a doctor or
sort of medical profession. I have two siblings I'm in, I'm
in the middle child and both my siblings not really academic.
And I did have to fight really hard to, to sit down and read
and literally we shared a room and bought the take away as
(39:37):
well. So it's really hard when they're
playing games or fighting. I'll be there trying to work
hard. My mum recognised this and she
put a lock on the door and gave me a room to myself.
So yeah, being in this medical professional, helping people,
making people change their lives, I think he would be,
yeah. Super inspirational and one
something that was really, really nice.
(39:57):
Recently I went to a 40th birthday and his sister who's
slightly older has a son. And said that you're his role
model. And I was like, wow, that's so
nice. And he's Chinese BBC as well.
And so we call him British born Chinese.
And so we, we. Yeah.
So that's lovely to have that feedback.
And it's, yeah, that's what I think the 12 year old would
(40:19):
think. Amazing.
Gosh, I want them to make a filmabout Adam Seuss.
And so the other version of you,I want to talk to you, is the
young physio student on that placement.
Wow, yes, me and my friend, we reflect on that so many times
and we still do. And, and yeah, it still, it
(40:44):
probably still shapes sort of shapes and pushes me and drives
me, drags me or drives me, probably drags me in terms of
like proving myself to my claims, proving myself to my
professional peers that I'm, I'm, I'm doing OK.
And but yeah, I reflect back to that guy.
Like, look, I've built this, I've gone through all these
(41:06):
experiences and yeah, you're going to be OK.
But you have to go through that pain to be able to be where you
are now. And I think that's what I would
say to that guy clearly. Yeah.
And I hope and I'm sure that version of you would be hugely
reassured by hearing this story now.
And doesn't that tie in so well with the people you're working
(41:26):
with? And I don't know if you do get
them to reflect back when they've got to the end of the
program or when they're at that point where they have that
capacity and that belief that they can work.
But you know, to me, it ties in so well with the the path that
you're taking your clients through now from that place of
feeling. Can I do this?
(41:48):
Society or circumstances have dealt me some blows that have
really affected my confidence. But look where I am now.
There just seem to be so many helpful parallels and having
this conversation with you todayjust illustrates to me so
clearly why you have done so brilliantly in this this area.
And you say you're keeping in your lane.
(42:11):
Gosh, absolutely does sound likeit is your lane, Adam.
Thank you. And that's the that's The thing
is that I if I hear peers, you know, trying to venture out and
I say, I don't know, want to do like a food market and I do it,
do it, Yeah. And I'll always, he is now, you
(42:31):
know, struggling to grow their business or go on ventures.
But I'll be the one that always black behind him and pushing
them. I don't know where that comes
from either. But I have a friend, a very old
school friend when I was 7 year old and his brother, we still
play football together and we played on New Year's Eve and we
always get together like Lebanonsides, dad's teams now we're
(42:53):
really unfair, but he would say,oh, it's Adam Sue, fitter,
stronger, faster. I knew it was a produce face
that, you know, I don't know where that's come from.
And again, lovely to explore that.
Why, why where that's come from in terms of that.
But on my patients journeys, like for example, one recent one
through, you know, just coachingand through my company
(43:15):
expanding, I was able to give him a a life coach, I suppose,
or a vocational coach. And he's gone into a different
career and like he's gone into sports retail.
And that's something you found interesting.
We explored printing T-shirts and going self-employed because
because you don't have to be stuck in that islet place.
(43:35):
And then the people that are thepeople I'm working with to feel
like I'm clean. That's all I am.
I know you've got so much more skills.
You've got so much other things,life experience and and what
else would you like to explore? And it's about helping with
those individuals because there's so much resources out
there and so much more opportunities out there now.
(43:56):
Yeah, I love that, Adam. I love the way you're working.
Obviously, you know, with my experience of coaching, it feeds
very much into the way that I really like working with
clients. But it's so great to hear how
you're applying it and this thisarea that's that's so needed.
There's a couple of problems with your sound in that last
(44:18):
section, and your video was freezing.
Oh, no, you're back with me now.It's fine.
We didn't lose you at all. And I hope people listening got
the gist of what you were saying.
I I certainly did, which is why I didn't stop it.
But you're back with us now, so that's great.
Adam, is there any final word you would like to give to
people? I feel like you've just given a
really strong message, like if there's something you want to go
for, then go for it. Is there anything you'd like to
(44:41):
add just at the end of this episode?
So I think the last thing is there's so much information out
there now with social media, there's other physios bashing
other physios and therapists bashing other therapists.
And I feel like through your ownclinical experience, through
your own patient interactions, take some value of, you know, if
(45:03):
you're getting patient through manual therapy, you know, if
you're getting patient outcomes through giving strength and
conditioning, and then believe in themselves that way.
Do it, you know, and, and, but have an open mind and, and
continue practising the way you are and don't feel like it's a
black and white situation. There's so much nuance.
(45:25):
Life is nuance. And that's what I love about
life, isn't that we, we do even through adversity and that it's
very important. And I feel like I'm still
working on that. And so if you still have that,
like I did, that niggle, that itch to start your own thing,
then just start off slowly, stepby step and seek help and
understand your niche and your passion and go from there.
(45:49):
Brilliant. There were a couple of glitches
there, so I'm just going to summarise for people in case
they lost it. But basically Adam was saying
take feedback from your own situation with clients, you
know, see what's happening on the ground, Take confidence from
that, build on that, give yourself, use your own feedback
as much as other people's. And and then finally, what Adam
was saying there, you know, if you hit on something you want to
(46:11):
do, then then go for it. Amazing.
Thank you, Adam. I think the Internet is probably
telling us we should draw the this episode to a close.
But I'm so grateful for this conversation.
And I am really looking forward to seeing where things go for
you. And I would love to have some of
these additional conversations that we've we've hit upon today
(46:33):
to explore some of those things more deeply.
Thank you so much, Adam. Thank you, Joe.
Thank you for everybody listening.
So what an interesting discussion with an interesting
young physio trying to do something very innovative.
It feels like Adam's broken through in a really heartfelt
(46:56):
way some of the bureaucracy and the practical challenges of
putting on programmes like his Work and Pain Solutions
programme. And what came across really
strongly for me was this, this idea of social belonging that
Adam talks about so much, both in the context of his own life
(47:17):
and how social belonging has been a challenge.
And how that manifests with the people that he is supporting to
get back to work, have been out of work, really affects your
sense of social belonging. How social belonging may have
been the thing that actually contributed to the, the
(47:38):
situation they find themselves in before they get support from
Adam. That, that isn't a phrase that
I've heard a lot before, but it,it sounds like it's really
important in this area of occupational health, functional
restoration. So let me know anything that you
took away from that episode, anything that you enjoyed,
anything that you found interesting.
(48:00):
I, I apologise, I normally ask at the end of the episode how
people can get hold of my, my guests and I didn't do that.
So I'm going to put Adam's contact details in the show
notes. So if you are a therapist, a
(48:21):
clinician, a parent, a friend, acolleague, a son and daughter
who is giving two people in all aspects of your life all day
everyday, then do remember that you're OK.
Like Adam was saying, you're OK,you're doing OK, you are OK.
(48:45):
And I'm sure that's the message that you're delivering to lots
of the people who depend on you for support.
So reflect it back on yourself. You are OK and you do matter.
(49:08):
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rehabmypatient.com/physio Matters now.
(00:25):
Hello and welcome to You Matter.Hello and welcome to this next
episode of You Matter, where I'mtalking to Adam Sue, a
physiotherapist with his own clinic called Down to You based
in Sheffield, a clinic from which he runs a programme called
(00:46):
Work and Pain Solutions. And we're going to talk in
detail about this programme during the podcast episode.
But Adam also shares a lot abouthis personal history as a young
man in physiotherapy and the thehighs and lows of that journey,
which I think a lot of people will probably understand and
(01:07):
resonate with and some of you will be quite surprised by.
So I think his journey into how he came to offer that programme
is as interesting as a discussion about the programme
itself. Adam is somebody who I hope will
become much more well known in our profession.
I think what he's doing aligns really well with how a lot of us
(01:30):
are thinking our profession should go.
So have a listen, see what you think.
As ever, let me know what chimeswith you, what you find
interesting, what you'd like to take away from what you hear.
And I will be back at the end totalk about that a little bit
more. So hello and welcome to this
(01:51):
next episode of You Matter podcast, where my guest today is
physiotherapist Adam SU. Hello, Adam.
Thanks ever so much for coming on the podcast.
Hello, Joe, Thank you for havingme.
Happy New Year. Happy new Year.
So Adam runs his own company. If you're watching this on
YouTube, if you're watching the video, you'll see both on Adam's
(02:14):
top and behind him, he's got D2Uand his company is called Down
to You, which when you hear about the way Adam works, I
think you'll realise that name is perfect and speaks volumes
about Adam's approach. The reason I've invited Adam on
is because I came across Adam onLinkedIn when he shared a video
(02:36):
of a program he runs, and this program is called Work and Pain
Solutions. I'm going to try and share the
video in the show notes because it really, for me, illustrated
it's very clearly what Adam's about and what he's trying to
do. We'll talk about that programme
more when we get into the episode.
But what I want to do first is hand over to you, Adam, and just
(02:57):
ask if you would go back over your career history for us just
so that we can see what led you to this really interesting point
that you're at now. Would that be OK?
Yeah, that's fine. And everybody has their own
journey and I'm really excited to share my own.
Yeah. So I'm a first generation born
Chinese in in the UK. My mum and dad came from Hong
(03:19):
Kong and China. So not from an academic
background at all. Not really much support from
them in terms of like where to go in terms of like life choices
and stuff like that. And so at 17 years old, when
you're going through school and then you go up, decide what you
want to do for the rest of your life.
I had a bit of pain in my back at that time, actually.
(03:40):
That's what started this whole journey, I suppose, when I think
back and reflect on my left side.
And I spoke about this on another podcast where, yeah, I
was just waking up pretty regularly with pain.
My mom actually did take me to aprivate physiotherapist, gave me
some really basic stretches, which were helpful.
And obviously I've advanced in those moments since on self
(04:01):
exploration. So from 17 decided to do
physiotherapy and applied for the five university courses on
UCAS and did it. And I got interviews and I got
probably have 3 or 4 interviews.And every interview, obviously I
actually had feedback of saying I wasn't empathetic enough
because my work experience on myCV showed no caring experience.
(04:24):
So going back to my background, I was working in a take away
with my parents and from a very young age actually, which is
probably not allowed nowadays. So like from like 12 years old,
I was working in a take away, even at university on the
weekends, I would come back and work with them.
So that really affected my social sort of connections and
social belonging really, which again might influence the way I
(04:47):
approach things now. So from there, obviously it got
rejected and again, no advice from my parents or teachers
about, I think it's called clearing.
So, you know, if you've got the grades and which I didn't care
and you could bring up the university, see if there's
anybody else that didn't obviously make the cut and get
(05:08):
on the course. But I, I didn't know about that.
And I took a undergraduate in sports science and Physiology
and that was a three-year degreeat Leeds and really enjoyed the
course really difficult. And I did put a lot of ownership
for myself in terms of being very driven to be academic or
try to be academic. But I really struggle with
(05:28):
words. I'm, I'm potentially dyslexic,
but I've not gone through the diagnosis or anything like that.
I just obviously live with it and manage it.
So for me, I read read censuses many times before I really
understand the the context of what it's saying.
Yeah. And then from there, through the
degree, I had a little bit of a panic attack actually.
(05:49):
I'd broken down and I knew that I put a lot of pressure on
myself. I needed a 21 to be able to get
into the master's accelerated physiotherapy degree, which I
managed to get on to. And again, that personal story
is really helped me develop the way I am in terms of how I
empathise with clients. And again, through having that,
(06:10):
there's three rejections throughinterviews in that first thing
saying that I'm not empathetic enough really probably still
sort of drives me a little bit in terms of my, my, my clinical
practice, going to the master's and obviously through every
physio degree we have clinical placements.
And yeah, it's time to explore in terms of what you like and,
(06:31):
and see what you want to specialize in.
And again, just from not being very, again, it's, it's a really
weird situation. So as myself, and I'm probably
still figuring it out in terms of social belonging in the, in
the UK and going into a Western culture, NHSI did find it very
difficult. And it didn't help when my first
(06:53):
placement, I had my friend who is from the Zimbabwe and I'm
sure he won't mind me saying, I won't say his name like, but he
was a very confident American guy and he was outspoken.
And I heard one of your recent podcasts and he had a similar
experience, but he was very outspoken, very confident and he
got struck off that first placement and that really
(07:17):
impacted ours. We, we were four guys, our 12
cohort physios and it really impacted our well, mine and his
confidence for sure. We were the two sort of, I
guess, minor, minor ethnicities and and yeah, so that that made
me really work in the air of caution when I was in the NHS,
didn't want to take a step wrong.
(07:38):
Something like imposter syndromecoming from like a Chinese
background take away. Now I'm in hospital trying to
help somebody like that's just that was a huge, huge shock.
And I remember every day going to like a placement and I would
listen to songs which were like quite emotional slash
inspirational. And I would actually sometimes
have tears driving into the, theplacement because I was
(08:01):
wondering like, how am I going to be spoken to today, how I'm
going to be treated and so forth.
So from that, you know, from that experience, I did manage to
pass and, and one of my, one of my MSK placements, I didn't do
very well. And then I had another
opportunity to do another MSK course and I was able to succeed
(08:22):
and do really well with it. And that really give me that
confidence to go into MSK and and private world after that
because I did make that conscious decision not to
probably participate in on the NHS.
I graduated in 2012 and that's where there was a bit of a dip
and recession or job shortage for physios in the NHS there.
So we found it really difficult to get a job in the NHS anyway.
(08:45):
But again, I think I feel like things happen for a reason.
And then from there I went into occupational health and that
really opened my eyes in terms of developing my clinical
practice. It was an organization that
supplied, you know, interventions and occupational
health for long term sickness. So people that have been off
(09:06):
work for a long period of time. And that's where I was first
introduced to functional restoration programs or
principles. And it was more about what can
somebody do instead of what, youknow, what's the pain doing?
So, you know, they, they taught us about how do we get somebody
better functionally and as a byproduct, they're paying my
(09:27):
reduce or actually getting back to an active life and they're
pain reduced as a byproduct. So that really opened my eyes.
And I guess I also want to talk about manifestation.
When I was on my journey to physiotherapy, I did want to
work for the police and, and be the lead physio there and
(09:48):
through the occupational health they had the police as a
contract and I was, I became thelead physio there.
And then within two years I established a really good
relationship with them and the manager there really enjoyed the
way I worked and talked to the officers because they are a bit
of a different kind of bunch. And I was in the police name for
(10:08):
nine years all together and was really able to hone in my
interpersonal skills, my clinical skills in terms of
having that much time. So I had like an hour or so with
clients to talk about the mental, the social, the
emotional, as well as the physical contributions to why
somebody was off work for a longperiod of time.
(10:31):
And so after 3-4 years of doing that on a one to one in a clinic
base, I start to recognise patterns and trends of like what
people were suffering with. And, and now I call it in this
whole bucket of tension basically.
And so tension, yes. So like what is adding to that
tension? What's contributing to them
(10:53):
having that persistent pain? And and you know, we talk about
the bio psychosocial approach. So from doing that and
understanding that there are specific things that adding to a
police officer's life or police staff's life, I started to
develop like a well-being talk. So I was approached by the
obviously all corporate organisations love the health
(11:15):
and well-being arm. And so I jumped on that and said
that, you know, I could present something in terms of physical
interventions. And I started to see like how
the corporate world sometimes reacted.
It's like last minute. We've got a bit of understand
that's going just pay for some interventions and off the shelf
stuff, which wasn't tailored to to police.
(11:35):
And and so when I, when I did the talks, you know, we're,
we're, they're, they're in the mandatory CPT everybody's
crossing their arms. Like, what's this guy going to
teach me about what, you know, what's he know about police?
And obviously me just saying like I work with you guys on the
ground and this is data that I've developed through working
with you guys and having a, yes,the theory side and trying to
(11:56):
encourage behaviour change was really, really hard.
But you know, I had to do the practical side, which they
loved. And feeling the the benefits
from the interventions I give now and all of them always going
from arms crossed and then laughing and, and really
enjoying the course. And then, yeah, getting lovely
feedback from them. And then obviously they did a
(12:17):
review through the HR saying what's the referrals looking
like for occupational health? And again, at the beginning of
that career, I set out a personal goal, I suppose, to
make my job redundant. And this is where the down to
you physiotherapy and health andwell beings come from is that if
I can teach the officer not to come back to me and that they
can deal with flare ups, conflicts, confrontations and
(12:40):
they don't need to come see me, then that's that's what I would
like to do. So if we do the well-being
sessions, after 3-4 years of delivering through the whole
district, they found that the referral rates to the
occupational health for mesc andschool issues were very low.
And then after that report they found out they needed nine
councillors and half a physio for the whole force.
(13:02):
And I was like wow, that's crazy.
And again, a bit short sighted from them.
They said we don't want you to do the well-being stuff anymore.
We just want you to be a physio and do the 1:00 to 1:00 and.
Be the half physio. Yes, exactly.
Or just be the traditional physio that you know that in the
textbook and that's what they wanted.
And I said no, I'm not going to do that and it's time for me to
(13:25):
grow and carry on. Then I had a choice between
going into a, you know, new field and doing MSK out
outpatient service or into FCP. And, and I thought in terms of
my skill set, I think the FCP would be a better role for me to
learn about outside the box. So what else can influence pain
(13:45):
and what what else can influencepeople's symptoms?
And it was such a good learning curve.
And as you know, you know, physio is alone working and in
that police role, I was, you know, alone working there and,
and this FCP role, there was 200physios in the network, really,
really huge network of physios. I thought great, you know, this
(14:07):
is going to be amazing. I'm going to be able to bounce
off people's knowledge and feel part of something once, you
know, social belonging going back to that situation.
And I did, you know, they had the football team and we played
fibre side. I thought this is it.
I found the career for me now for, for a long term, but but
during that time, obviously there's like COVID time.
(14:29):
So, you know, a lot of it was remote and that's where we were
turning to, you know, but for me, I didn't have enough time to
help clients in my way to make me feel fulfilled.
So for example, you know, you have clients and you refer on,
you know, that they they need some more input from someone
else or more investigations. But what I found myself doing
(14:52):
was looking for community services.
So if I had an elderly gentleman, female or whatever,
and I think, right, OK, this is in need for surgery, would
further injections help his pain?
You know, and surgery would not always be something that would
be warranted for somebody at this age.
And I thought movement, social connection is going to be such a
(15:16):
better outcome than going for some more medical support.
So I would always look for like local classes, chair aerobics,
community centres that do like walking groups, coffee and chat,
whatever it is. And I refer to, I found myself
referring to those services morethan the traditional, unless
obviously there's some sinister stuff potential that we refer
(15:37):
on. And then through there, I, you
know, I found approximately 70% of the clients were chronic
pain. So, you know, in the definition
of chronic pain is people havingpain for three months or more
and it's starting to affect their life.
And 70% of the clients will comein.
And I just saw this conveyor belt situation in the GP where
they'll come into the GP medication and then after they
(15:59):
go and they'll be all right for a bit, they will flare up and
they'll come back again looking for some more answers.
And it's again the medical room.So I started to get into this
frustrated situation and, and I thought I've always had this
niggle to start my own thing. I always had my own thing on the
(16:20):
side, to be honest. I've got the side so.
But I'm going to put some more time and dedication into what I
want to do. So I started knocking on some
doors and just saying like, no, this is my background.
I've helped people with long term sickness go back into work.
And then I approached the council and the programme
manager there said, look, we areopen to innovative services and
(16:46):
what are you going to offer? They said there's going to be
some opportunities in the futureand put your bid in.
So I wrote a bid and and told them what that could offer and
the contract manager said that was the best tender.
They they, they're like. Really.
Yes, for the first time I was like, do you write tenders on
the town? I was like, no, I don't.
That was my first one, he said. I loved it and it's really,
(17:08):
really effective and beneficial.And that was in 20/20/21.
I would say at the end of I've got the contract in 2022 and
because I had secured some sort of financial sort of income, I
was able to take that leap of faith and leave employed world.
At that time I had a fire. What did I have?
(17:30):
I had a 5 year old and a three-year old.
So a big financial jump from having security to then
obviously to the unknown. And.
Then from there, and I've grown the organization and I've tried
to stay in my niche of working with the unemployed and
(17:55):
economically inactive who have physical help as a pain barrier
or health barrier to get back into the economic market.
And yeah, it's just growing fromstrength to strength.
And you know, I've always there's, there's sometimes some
downtime and obviously with chronic pain patients, they can
be very complex and very frustrating that for a clinician
(18:18):
sometimes. And then, you know, not making
that behavioural change, even though presented with all the
information and the time and space to, to, to think out loud.
I've always tried to keep in mind lane in terms of like this
is where I want to focus on rather than dabbing, dabbing
(18:39):
back into the occupational health or, you know, the
corporate organisations, even though that's probably where
most of the financial security may come from.
And that's led to the growth of the work in pain solutions.
And the reason why I call it that is because the pain program
in the, in the world at the minute, NHS people go there and
(19:01):
once people go, oh, it's a pain program and down to you, they
go, well, what's the difference between the pain program in the
NHS and the pain program and down to you, you know, and since
COVID, you know, from what I hear from my clients is that the
pain program is about how do we manage your pain?
So using medication and the medical route, as we talked
about before, whereas mine is more conservative, focusing on
(19:27):
function and cans, changing the mindset, the coaching aspect,
which you which you are heavily involved with and getting to
know the person and then taking him through this journey.
And that's where I get most of my fulfilment now.
So yes, just following my passion and that's why that's
what's LED us to today. And I know that's a really long
winded journey of my career, butI feel like that that that was
(19:50):
all kind of relevant to shaping my drive and my why, I suppose.
Absolutely. Yeah.
No, I just let you speak becauseit was 100% relevant and what
you've just said then shaping your why.
I hadn't heard the early story before of the the social
(20:12):
belonging side of it and that story about in your early career
and hearing that makes so much sense as to why you're so why
you're so drawn to what you do now, but also why you're so good
at it. Just that that point actually
about in that placement where the other guy was struck off and
(20:34):
the other young male physios made you feel really nervous.
You mentioned it's probably Tom Jacobs you were referencing.
You had a similar experience. And there's another podcast
episode with Alistair Beverley who shares the same story.
Again, all three of you come across now as very sort of
(20:57):
measured calm, all three of you actually quite softly spoken men
who've all had this early experience of being told you're,
I don't know, too much or not empathic.
It's kind of mind boggling and interesting that it's happened
to so many of you. It's definitely something for
another episode. But yeah, it's kind of shocking
(21:20):
me that that's coming through asthe same story with the similar
demographic actually so many times.
I don't know if you want to say any more about it, but but for
me, I'm sort of mentally loggingthat as something to, you know,
perhaps investigate a little bitmore.
Yeah, and again, it's really hard to not come across like,
(21:40):
you know, attacking anybody elseand stuff like that.
But you know, from my our perspective, you know, it was
like obviously the the profession is still quite female
dominated. And I feel like when we were,
you know, mentored by those female educators, it can be
quite hard in terms of the powerdynamics.
(22:01):
That's just for evolution probably.
And, you know, putting us in ourplace or we we, we as men did
not like that or for it to structure, I suppose from a
female potentially. So it could be our own
responsibility. But the nature of the beast too,
the way, you know, I always liketo self reflect on how that's
(22:23):
developed me as a clinician, howthat made me grow rather than
seen as a negative experience. And that's what's happened to my
friend. And you know, I'm now 13 years,
you know, postgrad clinical experience, my friend.
And we all did a 10 year mark and nine year, 10 year mark.
(22:43):
We all had this conversation going.
Is this it now for the rest of our lives?
And most of us, I did hit our, you know, our, our highest point
in our career in terms of like promotions and so forth.
So he got to abandon a A and, and he was like, is this it?
And obviously he was down South and then he had this young
family. So he decided to, you know,
(23:05):
actually leave the profession for now and become a private
teacher. And then, then he, he, he, he
reflected at one point where his, when he was going through
his teaching training, that a teacher was watching him and he
felt really intimidated again. And he had to do some self
reflection. And we still have really deep
conversations about this. And I love that about him.
And, and we, we have formed thiskind of brotherhood, I suppose
(23:28):
through this kind of adversity to go through these kind of
imposter syndrome slash just notfeeling worthy.
And and so again, I don't know whether that's me proving to
myself by becoming good at my business and being good with
clients and having good outcomes.
Well, I mean, certainly with thethree of you that I've met and
(23:52):
you know, Tom and Alistair have got to know quite well and
starting to get to know you. Another common thread with all
of you is your absolute dedication to the area that
you've chosen to work in and a determination to make sure that
it works for the people that you're delivering to.
I mean, your programme especially in that regard.
Let's let's make sure we do talkabout your programme because I
(24:14):
really want people to understandwhat it is you've designed.
It's a six week programme, isn'tit Adam?
And you work with a health coachas well.
Just talk us a little bit through what a client would go
through or a participant would go through on your programme.
So the new, the typical participant journey is like
they've had, they've developed apain through an injury at work
(24:36):
potentially or injury outside ofwork.
And then they've gone through the obviously the medical route
and sort out advice and treatment and, you know, and
decent treatment and advice in terms of the pathways that's
offered through the NHS, throughthe medical model.
So you know, medication initially rest and go for a
(24:57):
physio and rehab and a bit of strength and conditioning.
And then when it becomes chronicy.
So from prebombs onwards, usually the pattern is right, we
need to give some psychological support.
So then they might go to IAPT, which is, you know, improving
access to psychological therapies when they might do
some talking therapy and talkingabout how, how maybe the nervous
(25:18):
system is impacting the the painor the hypersensitive of the
nervous system is continuing their persistent pain.
And then maybe I've gone to a pain program and then took given
injections, talked about pacing,talked about nervous system.
And a lot of them that come to see me, obviously the ones that
failed that that failed in termsof getting good outcomes,
(25:42):
usually say that the pain is in their brain.
Somebody said to them, the pain is in the brain.
I'm making up the pain. And it's obviously not the
message that the client, the clinician is saying, but that's
what they've taken on. And that's really important that
their interpretation of the messaging and a lot of this, the
messaging that they always come to me about is an Acebo effect.
(26:02):
So like, you know, with the bestintent, rest don't lift, change
a job, all that kind of advice through the make up
professionals because that's going to help you back then lead
to them having limiting beliefs about the back.
They cannot bend, they cannot lift.
And through that fear of movement and the development of
(26:25):
and postural guarding rigidness that's creating to that bucket
attention I mentioned about before from the physical point
of view and the psychological point of view.
So what I recognise is that through their treatment, through
the the previous treatment, theywould always be targeted for one
thing. So from a physical point of view
(26:47):
or from a psychological point ofview and nobody really combined
or blend the two together. And so that's what down to you
work and pain solutions about and we use work as a health
outcome, whereas in the NHS we may not use that as an outcome
because that could be the employability services or the
(27:08):
government's agenda. You know that's so when you say.
Use it as an outcome. Do you mean the fact that they
are working or not working, or the amount they're able to work?
Yeah, if they were ready as well.
So like I feel confident to return to work now.
So, you know, we can do that. And these guys have been off
work for sometimes 20 years, 30 years.
For them to magically go back towork after six weeks, that's
(27:30):
going to be a huge miracle. And I'm not saying it's not
happened, it has happened. But you know, just having that
confidence to return to work andhaving that mindset change to
say that actually, I, I could probably do some part time work
or even some voluntary work now is a huge outcome for us.
And again, going back to my experience in the GP, you know,
sending the elderly to the community centres and just
(27:52):
making that behaviour change andshowing up and doing one Class A
week is, is like music to my ears, to be honest.
So it's just understanding that from a coaching aspect as well,
you know, from your, your, your world is how do we make these
guys know the theory, but then put it into practice in their
lives? And so again, through my own
(28:13):
personal experience of having chronic pain in my back, you
know, it's never stopped me frombeing active, you know, playing
football. And, you know, last year I got
to a nice level of CrossFit, managed to get to a really high
license event in the UK. I mean, we placed nine as a
team, which was brilliant. And, and, and, and that's what I
(28:35):
want to show my clients to is that yes, you have pain, but
does that mean stop? Does that mean you have to
protect? Does that mean you're going to
damage yourself by doing that? So once they've been referred to
me through a work coach or through the NHS or whoever,
which organization that they're dealing with, I will take them
through a 1:00 to 1:00. And it's quite an intensive hour
(28:57):
and a half. We take 1/2 an hour initial
triage where we take down some help information.
And in that hour and a half, we go through the health history,
go through obviously the basic physiotherapy assessment and
treatment to see what their range of motions like, and then
do treatment. And the treatment will involve a
lot of self efficacy. So self empowerment like this is
what I'm doing to you. How do you replicate that
(29:19):
treatment to yourself? And that is the most important
thing about this is the locus ofcontrol.
And there's lots of research outthere and a lot of surgeons out
there now as well speaking aboutthis locus of control.
And when somebody has a flare up, do they have control to
bring it down? And before their strategies were
as rest heat medication, going to see somebody for some self
(29:43):
relief if they could afford it. But all that is passive
treatment. So what is the active stuff
we're doing? All right.
And then and patients will feel the pain spots and hopefully it
will melt away once we've done the release.
And that is encouraged for them to do for the rest of their
lives. Once they've done the release,
(30:03):
they don't go through a very hard physical conditioning.
So as you've seen through the videos, the one that you're
probably referring to doesn't necessarily show the, the
strength that people go through.And, but obviously on my
Instagram and stuff, you'll see a lot of the, the, the, the
stuff we do. So we go ahead.
With you, Adam, the people that haven't seen that.
(30:24):
So this this all takes place in a a gym, doesn't it?
It takes place in a CrossFit gym.
So that's my passion. And again, I love to talk to you
about environment and how that keeps my motivation.
And my drive is about where you surround yourself, who you
surround yourself with too. And so yeah, it's based in
across the gym, very functional gym.
(30:45):
You know, it's not too scary. It's just an open space.
And we do functional movements. And after, you know, playing
with it, we have developed, you know, a little programme, a
structured programme like when we will do deadlift, heavy
deadlifts, we'll do squats, we'll do shoulder and chest
press. So it doesn't matter what area
of your body, body area is a pain.
We will target that through the through the strength issue.
(31:10):
And so, yeah, so then when we wedon't set any glass ceilings, we
just go, let's go and do this deadlift.
We're going to find your one RepMax and let's see where you're
at. And they do it and they do it.
And then they go and I say at the end, I say, how much do you
think you lifted? And they'll be like 20-30 kilos.
And then they've done hundred 110 kilos and they go, wow, I
(31:31):
think I had that strength in me.And giving them more, giving
them them more capacity then allows them to have that
confidence when work legally, you know, you're only meant to
lift 25 kilograms at work. If you if they've done 100 kilos
with me or 80 kilos, let's say, and I say less at work, you've
got 25 kilos to lift. What what's their confidence
going to be like? It's going to be through the
(31:52):
roof. So yeah, I've just basically
joined the dots and, and, and just done a bit of hand holding.
I understand about coaching thatpeople need to get the answers
within themselves, but through the police experience as well,
some people just so institutionalised, they just
need that instruction and guidance and through doing it
(32:14):
they gain that real life experience and the difference
and the wisdom between knowing and actually doing.
Yes. And it sounds like you you're
adopting that side of coaching, which is the sort of the really
supportive mirror that believes in their potential.
(32:36):
You know, to have someone it it's hard to maintain that
belief, isn't it? You can, you can instill it in
someone and send them away. And there will be a point where
that belief waivers. And I think to have, you know,
that repeated contact and you'vecalled it hand holding, you
know, in those early stages, just have someone alongside who
always believes in you and will keep reinforcing that message.
(32:58):
That sounds to me like a huge part of what you're doing.
Yeah, yeah, that's, yeah, that'strue.
And and like I said before, likewith social belonging and
chronic pain, we it's coincided with social isolation, anxiety,
depression, reduced self efficacy and belief and esteem.
(33:19):
So having somebody just say to you, it's going to be OK is, is
where I'm working at the moment for sure.
And even myself, you know, I went through some business
venturing yesterday and I, you know, showed them my accounts
and he was like, wow, you're OK,you don't need me, you're fine.
And I'm like, no, I need somebody please help me.
(33:40):
But actually, you know, instantly that self belief at
every level is super important. And these guys are at the lowest
and low, you know, that little bit of belief just helps them
break out of that pit and that hole that they're in.
You're right, those words, you're OK.
And I totally identify with the financial one.
My, I've got an IFA that's knownme since I was 19.
(34:02):
And he knows that the best thinghe can say to me is Joe, it's
not as bad as you think. It's fine.
But yeah, you're OK is such a strong message.
And you know, we, we think people are OK, don't we?
And it, it doesn't often take much to scratch the surface and
realise that everybody and whatever sphere they're working
(34:22):
in, even the most supremely confident looking people still
need a, a version of you're OK at some point.
So Adam, if people are listeningto this and well, I hope people
are listening to this and realising that this is such a
modern way of working. This ticks every single box of
(34:44):
the way we are being told healthcare should go, even by
politicians. You know, it's a weird alignment
for once about what we think should be happening and what
they're saying. And I'd say that pointedly.
But you know, it fits with person centred care, it
prevents, it fits with preventative care, very specific
lifestyle, functional exercise. I love your, your social
(35:07):
belonging element. If people are listening,
thinking, gosh, that's how I want to be working.
Let's focus on your tender. So you, you said you were given
the feedback that that was the best tender that had ever been
put to the council. What do you think it was about
that tender that was so good? Or did you get any feedback
about why it was so good? Again, going back to my previous
(35:30):
life experience, you know, in mymaster's degree, again with my,
the reason why I brought up my dyslexia is that when I was
given a task or coursework, I would start from day one and a
lot of my clients would do it last minute and be in the
library and doing the Red Bull and doing the 48 hour stints and
stuff. But I would prepare from the
very early on, I would read lotsof research papers and I would
(35:52):
read it over and over and over again.
And I'll put it into a file. And then I think that's
relevant, that's relevant, that's relevant.
And then through doing that repetitively, I actually got
caught up on plagiarism. And yeah, so the head of the
faculty called me in and said, look, this is really, really
bad, blah, blah, blah, blah, blah.
And and you're not going to be able to pass the course and
(36:15):
broke down again, Broke down again, had a panic attack,
brought my very close friend in with me on the the chat.
And he said, look, you can submit again, but your maximum
score is going to be the pass rate, right?
Did it hugely affected my confidence?
The one thing that she said to me and I still it still sticks
for me now is that if you being academically smart or being good
(36:39):
on paper doesn't mean you're going to be a good practitioner.
So that really stopped for me and I and that that's why my
last placement where I did do really well, really helped me
grow my confidence to go, OK, I'm going to be OK.
And so I took on a recent modulespecialised in chronic pain and
(37:02):
I got a distinction on it. And that was a huge, big
confidence boost. Again, with what I'm doing and
putting the agenda, my mindset of how to make this new wave of
physiotherapy, new wave of treating people in, in, in, on
the ground, how does it work? And from having having that
(37:24):
passion, having that understanding, using those
outcome measures, using my knowledge and how to write a
thesis and dissertation, I just applied that to tendering
process. And that was it that, you know,
and then with the research backed, you know, this research
says this, this, this says this,put it onto the paper.
(37:45):
And they went, yeah, it all makes sense.
So, so yeah, that that's what where it came from.
So again, a long winded answer. Just going through, you know,
adversity in terms of my writingskills, then a decent thing.
And then to just point into practice, put on paper and see
what happens. And even now when I'm writing
attendance, I'm going, is this good or not?
And I just got to believe in myself, I suppose.
(38:07):
Yeah, it sounds like you're sortof answering the objections from
the start, you know, through that research and being really
thorough about it. Probably your, well, a bit like
when the first question you answered on this podcast, I, I
could have needed to ask you 6 questions to get that amount of
information. But you know, your, your
thoroughness in the way you answered it speaks volumes about
(38:29):
how you approach things. So let's go back and have a
quick well, I want to have a conversation with two of your
previous selves. So the first one is your 12 year
old self that started working in.
Was it your parents? Chinese restaurant, did you say?
Yeah, Chinese take away, yeah. So if we went back and spoke to
(38:51):
that version of you and asked him what he thought about what
you're doing today, what would he say?
That's so powerful and that's sogood.
Nobody's ever asked me that question before, and that's
probably what I mean. You'll be more coaching and
yeah. And to be fair, I've done some
self reflection and even when I was, I go back to let's do the
12 year old first. I think he would be proud of
(39:14):
where I am. I'm, you know, from being an
Asian background, they always want you to become a doctor or
sort of medical profession. I have two siblings I'm in, I'm
in the middle child and both my siblings not really academic.
And I did have to fight really hard to, to sit down and read
and literally we shared a room and bought the take away as
(39:37):
well. So it's really hard when they're
playing games or fighting. I'll be there trying to work
hard. My mum recognised this and she
put a lock on the door and gave me a room to myself.
So yeah, being in this medical professional, helping people,
making people change their lives, I think he would be,
yeah. Super inspirational and one
something that was really, really nice.
(39:57):
Recently I went to a 40th birthday and his sister who's
slightly older has a son. And said that you're his role
model. And I was like, wow, that's so
nice. And he's Chinese BBC as well.
And so we call him British born Chinese.
And so we, we. Yeah.
So that's lovely to have that feedback.
And it's, yeah, that's what I think the 12 year old would
(40:19):
think. Amazing.
Gosh, I want them to make a filmabout Adam Seuss.
And so the other version of you,I want to talk to you, is the
young physio student on that placement.
Wow, yes, me and my friend, we reflect on that so many times
and we still do. And, and yeah, it still, it
(40:44):
probably still shapes sort of shapes and pushes me and drives
me, drags me or drives me, probably drags me in terms of
like proving myself to my claims, proving myself to my
professional peers that I'm, I'm, I'm doing OK.
And but yeah, I reflect back to that guy.
Like, look, I've built this, I've gone through all these
(41:06):
experiences and yeah, you're going to be OK.
But you have to go through that pain to be able to be where you
are now. And I think that's what I would
say to that guy clearly. Yeah.
And I hope and I'm sure that version of you would be hugely
reassured by hearing this story now.
And doesn't that tie in so well with the people you're working
(41:26):
with? And I don't know if you do get
them to reflect back when they've got to the end of the
program or when they're at that point where they have that
capacity and that belief that they can work.
But you know, to me, it ties in so well with the the path that
you're taking your clients through now from that place of
feeling. Can I do this?
(41:48):
Society or circumstances have dealt me some blows that have
really affected my confidence. But look where I am now.
There just seem to be so many helpful parallels and having
this conversation with you todayjust illustrates to me so
clearly why you have done so brilliantly in this this area.
And you say you're keeping in your lane.
(42:11):
Gosh, absolutely does sound likeit is your lane, Adam.
Thank you. And that's the that's The thing
is that I if I hear peers, you know, trying to venture out and
I say, I don't know, want to do like a food market and I do it,
do it, Yeah. And I'll always, he is now, you
(42:31):
know, struggling to grow their business or go on ventures.
But I'll be the one that always black behind him and pushing
them. I don't know where that comes
from either. But I have a friend, a very old
school friend when I was 7 year old and his brother, we still
play football together and we played on New Year's Eve and we
always get together like Lebanonsides, dad's teams now we're
(42:53):
really unfair, but he would say,oh, it's Adam Sue, fitter,
stronger, faster. I knew it was a produce face
that, you know, I don't know where that's come from.
And again, lovely to explore that.
Why, why where that's come from in terms of that.
But on my patients journeys, like for example, one recent one
through, you know, just coachingand through my company
(43:15):
expanding, I was able to give him a a life coach, I suppose,
or a vocational coach. And he's gone into a different
career and like he's gone into sports retail.
And that's something you found interesting.
We explored printing T-shirts and going self-employed because
because you don't have to be stuck in that islet place.
(43:35):
And then the people that are thepeople I'm working with to feel
like I'm clean. That's all I am.
I know you've got so much more skills.
You've got so much other things,life experience and and what
else would you like to explore? And it's about helping with
those individuals because there's so much resources out
there and so much more opportunities out there now.
(43:56):
Yeah, I love that, Adam. I love the way you're working.
Obviously, you know, with my experience of coaching, it feeds
very much into the way that I really like working with
clients. But it's so great to hear how
you're applying it and this thisarea that's that's so needed.
There's a couple of problems with your sound in that last
(44:18):
section, and your video was freezing.
Oh, no, you're back with me now.It's fine.
We didn't lose you at all. And I hope people listening got
the gist of what you were saying.
I I certainly did, which is why I didn't stop it.
But you're back with us now, so that's great.
Adam, is there any final word you would like to give to
people? I feel like you've just given a
really strong message, like if there's something you want to go
for, then go for it. Is there anything you'd like to
(44:41):
add just at the end of this episode?
So I think the last thing is there's so much information out
there now with social media, there's other physios bashing
other physios and therapists bashing other therapists.
And I feel like through your ownclinical experience, through
your own patient interactions, take some value of, you know, if
(45:03):
you're getting patient through manual therapy, you know, if
you're getting patient outcomes through giving strength and
conditioning, and then believe in themselves that way.
Do it, you know, and, and, but have an open mind and, and
continue practising the way you are and don't feel like it's a
black and white situation. There's so much nuance.
(45:25):
Life is nuance. And that's what I love about
life, isn't that we, we do even through adversity and that it's
very important. And I feel like I'm still
working on that. And so if you still have that,
like I did, that niggle, that itch to start your own thing,
then just start off slowly, stepby step and seek help and
understand your niche and your passion and go from there.
(45:49):
Brilliant. There were a couple of glitches
there, so I'm just going to summarise for people in case
they lost it. But basically Adam was saying
take feedback from your own situation with clients, you
know, see what's happening on the ground, Take confidence from
that, build on that, give yourself, use your own feedback
as much as other people's. And and then finally, what Adam
was saying there, you know, if you hit on something you want to
(46:11):
do, then then go for it. Amazing.
Thank you, Adam. I think the Internet is probably
telling us we should draw the this episode to a close.
But I'm so grateful for this conversation.
And I am really looking forward to seeing where things go for
you. And I would love to have some of
these additional conversations that we've we've hit upon today
(46:33):
to explore some of those things more deeply.
Thank you so much, Adam. Thank you, Joe.
Thank you for everybody listening.
So what an interesting discussion with an interesting
young physio trying to do something very innovative.
It feels like Adam's broken through in a really heartfelt
(46:56):
way some of the bureaucracy and the practical challenges of
putting on programmes like his Work and Pain Solutions
programme. And what came across really
strongly for me was this, this idea of social belonging that
Adam talks about so much, both in the context of his own life
(47:17):
and how social belonging has been a challenge.
And how that manifests with the people that he is supporting to
get back to work, have been out of work, really affects your
sense of social belonging. How social belonging may have
been the thing that actually contributed to the, the
(47:38):
situation they find themselves in before they get support from
Adam. That, that isn't a phrase that
I've heard a lot before, but it,it sounds like it's really
important in this area of occupational health, functional
restoration. So let me know anything that you
took away from that episode, anything that you enjoyed,
anything that you found interesting.
(48:00):
I, I apologise, I normally ask at the end of the episode how
people can get hold of my, my guests and I didn't do that.
So I'm going to put Adam's contact details in the show
notes. So if you are a therapist, a
(48:21):
clinician, a parent, a friend, acolleague, a son and daughter
who is giving two people in all aspects of your life all day
everyday, then do remember that you're OK.
Like Adam was saying, you're OK,you're doing OK, you are OK.
(48:45):
And I'm sure that's the message that you're delivering to lots
of the people who depend on you for support.
So reflect it back on yourself. You are OK and you do matter.
(49:08):
Do you know your tendonitis fromyour spondylitis?
Below par with PMR? No note about gout.
The Rheumatology Physio website is teeming with content to
engage with downloads, books, courses and more to address any
gaps in your knowledge. Head to Rheumatology dot Physio,
your one stop shop for rheumatology information.
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