,

Could running actually be the BEST way to protect your knees?

,

A recent study with 14,000 participants revealed some fascinating insights:

  • Non-runners had a HIGHER prevalence of knee pain.

  • Running could actually PROTECT your knees by inducing beneficial adaptations through mechanical loading.

But here’s the kicker:

When we try to shield our knees by avoiding movement, we might actually be reinforcing a cycle of pain and fear.

Running, under proper guidance, sends a powerful message to the brain that everything’s OK!

Here are three tips to keep you going strong:

- Maintain a high cadence of 170-180 steps per minute to reduce stress on your knees.

- Invest in well-supported shoes to cushion impact and provide stability.

- Strike a balance between walking and jogging to build endurance while minimizing strain.

, ,

When Biomechanics DOESN'T Matter

, ,

Greg Lehman has been a pioneer in helping us to understand pain and biomechanics and finding out when they matter.

He is a advocate for “Movement Optimism” - an approach that helps you build confidence in your body and avoid the common trap (fueled by well meaning health care professionals) of getting stuck in sometimes irrelevant biomechanical narratives that create fear and entanglement in the body.

I would encourage you to watch at least the first five minutes as he pulls apart the most common things you might hear coming from your health care professionals mouth.

“What I often say is, it’s not the pain science or neuroscience that challenges these biomechanical ideas, it’s the biomechanics itself. And if you know the biomechanics well, you can really see the holes in the common arguments.”

I hope you enjoy this eye opening lecture at the San Diego Pain Summit (click on image below to watch on youtube).

, ,

"Back to the Body": Charting a New Course in Physiotherapy

, ,

In the dynamic field of physiotherapy, a transformative wave is reshaping our traditional approaches to pain and injury.

This evolution, termed "Back to the Body," represents a significant departure from past practices, integrating modern science's revelations with a renewed focus on the body's intricate signals.

As we delve into this shift, it's essential to appreciate the context from which we're moving and the promising direction in which we're headed.

The Traditional Paradigm: A Focus on the Physical

Historically, physiotherapy has been deeply anchored in a biomedical model, concentrating on the body's physical aspects—its joints, muscles, and tissues.

This approach, while foundational, often adopted a reductive lens, aiming to "fix" what was perceived as broken or misaligned.

Diagnoses frequently highlighted deficiencies: a "weak" core, "tight" muscles, or "improper" posture.

While these assessments were made with the best intentions, they inadvertently introduced a nocebo effect, where the negative framing of conditions could exacerbate patients' perceptions of pain and disability, sometimes with minimal relevance to their actual experience of pain.

The Shift Toward Mind and Emotion

The field's expansion to encompass beliefs, emotions, and the broader neurocentric model—largely influenced by the pioneering work of researchers like Lorimer Moseley and David Butler—marked a significant leap.

This phase brought to light the brain's integral role in pain perception, advocating for a more comprehensive understanding that transcends mere physicality.

However, this shift, for all its merits, occasionally led to an overemphasis on the psychological at the expense of the physical.

Patients sometimes felt their pain was being dismissed as purely a construct of the brain, leaving them feeling invalidated and overlooked.

"Back to the Body": A Holistic Reintegration

Today, we stand at the precipice of a new era, inspired by Bud Craig's insights into homeostatic emotions and the complex interplay between mind and body.

"Back to the Body" advocates for a return to a more integrated approach, where pain is recognized as an interoceptive signal—a cue from our body indicating a need for attention and care.

This perspective sees pain not as a mere symptom to be eradicated but as a critical piece of feedback within our body's attempt to maintain balance.

With advancements in technology—such as heart rate variability monitors, blood glucose tracking, and sensors for lactate and inflammatory markers—we're now equipped to decode the body's signals with unprecedented clarity.

This technological leap, combined with principles of load management as outlined by Tim Gabbett, empowers us to identify and respond to the body's cues more effectively, fostering an environment where positive adaptations are more likely.

Empowering Through Understanding

This shift towards an integrated mind-body model is about empowerment and education.

It's about guiding patients to tune into their bodies' messages, recognizing the signals of overload and stress.

It encourages a response to discomfort informed by understanding and mindfulness, rather than fear or the pursuit of immediate fixes.

This approach demystifies the sensations we've labeled as pain, reframing them as part of our body's broader context of response.

Moving Forward

"Back to the Body" heralds a return to physiotherapy's roots, enriched by our journey through the realms of psychology and neuroscience.

It's a call to embrace the body's complexity, leveraging science and technology to deepen our connection with ourselves.

As we chart this new course, we embrace a model of care that is both empowering and educative, one that places the patient's experience at the forefront of the healing process.

In doing so, we not only address pain more effectively but also foster a holistic sense of well-being.

Daniel O’Grady

,

Could Qi Gong help with chronic pain?

,

As a physiotherapist, I'm always on the lookout for holistic approaches to complement traditional pain management techniques.

Qi Gong, an ancient Chinese practice that combines movement, breathing, and meditation, has shown remarkable benefits for individuals experiencing pain.

Here, I'll discuss three key benefits of Qi Gong that can be particularly helpful for those seeking relief from chronic pain conditions such as Fibromyalgia.

1. Enhanced Circulation: The Foundation of Healing

One of the primary principles of Qi Gong is the promotion of Qi, or life energy, throughout the body. This concept, while rooted in traditional Chinese medicine, parallels the Western understanding of the importance of circulation for health and healing.

The Qi Gong Approach to Circulation

Qi Gong exercises are designed to gently stimulate and encourage the flow of blood and lymphatic fluids. This is crucial because good circulation is essential for delivering nutrients to tissues and removing waste products that can contribute to pain and inflammation.

How It Helps with Pain

By enhancing circulation, Qi Gong can help reduce muscle stiffness and promote healing in injured tissues.

For individuals with conditions like arthritis or peripheral neuropathy, improved blood flow can lead to a reduction in pain and a greater range of motion.

2. Breathing: The Rhythm of Relief

Breathing is at the heart of Qi Gong practice.

The slow, deep, and intentional breaths characteristic of Qi Gong can have a profound impact on pain perception.

The Qi Gong Approach to Breathing

Qi Gong breathing techniques emphasize diaphragmatic breathing, which encourages full oxygen exchange and activates the parasympathetic nervous system, often referred to as the "rest and digest" system.

How It Helps with Pain

This type of breathing can help reduce the 'fight or flight' response, which is often heightened in people with chronic pain.

By promoting relaxation and reducing stress, Qi Gong breathing can help alleviate muscle tension and pain.

Additionally, the increased oxygenation of the blood can improve energy levels and facilitate the body's natural healing processes.

3. Regulating the Nervous System: The Path to Balance

Chronic pain is often associated with dys-regulation of the nervous system.

Qi Gong's meditative movements and focused breathing can help restore balance to the nervous system.

The Qi Gong Approach to Nervous System Regulation

Qi Gong practices encourage mindfulness and present-moment awareness, which can help shift the body away from the stress response and towards a state of equilibrium.

How It Helps with Pain

Regular Qi Gong practice can help downregulate the sympathetic nervous system (responsible for the 'fight or flight' response) and upregulate the parasympathetic nervous system, leading to a calming effect on the body.

This shift can be particularly beneficial for people with pain conditions, as it can reduce the sensation of pain, improve sleep quality, and enhance overall well-being.

The Intersection of Qi Gong and Fibromyalgia Management

Understanding Fibromyalgia and Autonomic Dysfunction

Fibromyalgia (FM) is a complex chronic condition characterized by widespread pain, fatigue, and a host of other symptoms that collectively degrade the quality of life.

Recognized in the early 1990s, FM is often seen alongside conditions like chronic fatigue syndrome (CFS) and irritable bowel syndrome (IBS), leading to the concept of central sensitivity syndromes (CSSs).

The underlying mechanisms of FM involve central pain pathway sensitization, stress response system dysregulation, genetic factors, and psychological influences.

The autonomic nervous system (ANS), which regulates vital functions like blood pressure and heart rate, has been implicated in FM due to its dysfunction.

Studies suggest a predominance of sympathetic nervous system (SNS) activity and a reduction in parasympathetic nervous system (PNS) activity in FM, which may contribute to the condition's symptomatology.

For individuals with FM, regular Qi Gong practice has shown consistent improvements in pain, sleep, and mental and physical function, with benefits persisting for months after the practice.

The Research on Qi Gong and FM

Research indicates that the benefits of Qi Gong are related to the amount of practice, with those adhering to a regular routine experiencing more significant improvements.

Systematic reviews and meta-analyses of Qi Gong for FM have been cautious but generally positive, although they often call for more stratification in trials based on the amount of practice.

Qi Gong's Mechanisms of Action

Contemporary theories suggest that Qi Gong may work through neurochemical, neuroendocrine, and neuroplastic changes, as well as through mind-body regulation within a biopsychosocial model.

Specifically, Qi Gong may regulate the ANS, enhancing PNS activity and sympatho-vagal balance.

Qi Gong and Vagal Nerve Activity

The vagus nerve, a crucial component of the PNS, plays a significant role in maintaining homeostasis and regulating pain and inflammation.

Qi Gong is thought to increase PNS activity and thus could potentially benefit the core symptoms of FM by interacting with the dysfunctional system.

Studies on vagal nerve stimulation (VNS) have shown promising results in FM, suggesting that Qi Gong's effects may be partly due to its influence on vagal activity.

Future Directions and Clinical Implications

The potential of Qi Gong to improve parasympathetic activity and autonomic function in FM is an exciting area for future research.

Studies should aim to assess the therapeutic regimens of Qi Gong on symptoms and autonomic parameters, exploring the durability of these effects and their clinical significance.

Conclusion

As a physiotherapist, I find Qi Gong to be a valuable addition to a pain management program.

Its focus on circulation, breathing, and nervous system regulation can provide a multi-faceted approach to pain relief.

For those living with pain, Qi Gong offers a gentle, yet powerful way to take control of their health and find relief.

It's a practice that not only eases the physical aspects of pain but also nourishes the mental and emotional sides, offering a comprehensive path to healing.

Want to try it for yourself?

One of my favourite online Qi Gong instructors is Jeff Chand. He has some simple youtube videos and he teaches in a very relatable and light hearted manner.

Check out the link below:

What’s been your experience with Qi Gong? I’d love to hear from you in the comments below…