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Oliver Crossley: Listen to your body before it yells at you
39 Plays29 days ago
Oliver Crossley is an integrative Physiotherapist for complex pain and invisible illness. Oliver is the founder of Yogic Physio, where he blends ancient practices and modern science-backed rehabilitation to provide a holistic service. Oliver is a yoga and meditation teacher who is passionate about bringing these ancient practices into modern pain care.
DISCLAIMER: This podcast is for educational purposes only. The views expressed in this podcast do not constitute medical advice and are general in nature. You should obtain specific advice from a qualified health professional before acting on any of the information within this podcast.
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Transcript
Impact of Stress on Health
00:00:00
Speaker
these stresses chew down on our body budget. And when we don't have money in our body budget to meet these stresses or we're using it to meet these stresses, we don't have it to do the normal repair and restoration that every single human needs. And that's where psychological and physical issues can come up. I've literally driven myself into quite a severe depression from this, not because I was, i mean, there was definitely ways I was framing and thinking that weren't helpful,
00:00:27
Speaker
But I just depleted my physiology. i I emptied my bank account and was in debt and my body was forced to rest yeah as an example of that. Yeah, if you don't rest, you'll be forced to rest one day.
00:00:40
Speaker
You've got to listen to the whispers, otherwise you'll get yelled at.
Meet Oliver Crowsley
00:00:44
Speaker
Today we speak to my mate, Oliver Crowsley. Ollie is the founder of Yogic Physio, where he blends ancient practices and modern science-backed rehabilitation to provide a holistic service to those struggling with complex chronic pain and invisible illness.
00:01:02
Speaker
I hope you enjoy the conversation as much as I did. This podcast is for educational purposes only. The views expressed in this podcast do not constitute medical advice and are general in nature.
00:01:16
Speaker
You should obtain specific advice from a qualified health professional before acting on any of the information within this podcast.
00:01:27
Speaker
Ollie, thanks for coming on. We've been back and forth for a little bit, but I appreciate you taking the time to to speak with us. And yeah, I just want to ask a quick question to help us to learn a little bit about you If we, and I'm not sure you have a Wikipedia page, but if you did, what would what would the first paragraph say about you That's a really good question. Yeah, man, thanks for having me on. It's a pleasure.
00:01:55
Speaker
That struck my brain a bit. I honestly don't know. i I think what I'd hope for it to say one day maybe is that He is someone who's trying to, I guess, bring...
00:02:13
Speaker
contemplative practices, mindfulness practices, yoga. There's too many different ways of describing these things and I haven't really found one that works. Into healthcare and healthcare care into into into that. without Sounding a bit wanky, I don't really like the spirituality word, but bringing spirituality into healthcare and healthcare care into spirituality, um for the particularly in the context of improving pain care.
00:02:35
Speaker
Yeah, awesome. Awesome. And tell us just a little bit about you personally. where you grew up whatever whatever that looks like. Just give us a bit of a snapshot of Ollie, the person, not the professional.
00:02:48
Speaker
Yeah, for sure. aye I've kind of lived everywhere. Like I was born in Sydney. My dad's random jobs just took us all over the place. So we you know went to Western New South Wales and then up to to North Queensland in the late 90s. And yeah, spin of i for better or worse, I think it's actually made me a better physio because otherwise I think I would have been not been forced to learn the social skills and
00:03:20
Speaker
you know, get over my autistic introversion, but we lived out in the outback in Longreach, you know, during the year of the outback, which was cool. ah We've lived in the Northern Territory. I finished high school in Darwin.
00:03:33
Speaker
and And because of that, I was really lucky for my parents to take me all across a lot of North Australia.
A Transformative Experience in India
00:03:39
Speaker
And and so... Every time, you know, I see travel shows or things like that, i'm I'm really grateful that that was a part of my life because I got to see so much and and I guess see so many different types of people and and understand so many different ways of life.
00:03:53
Speaker
And then then at the end of high school, I i was really into economics and and to into sort of the, I don't know,
00:04:05
Speaker
ah A friend wrote me into the UN debating stuff, which was a pretty nerdy thing to do, like model UN society stuff. It was a lot cooler than it sounds. And then I had this idea that I'd go uni and, you know, study economics and almost, you know, work in international development or some form of banking. and and and And that was where my head was at. You know, I was really, really just kind of dialed in on that. But...
00:04:33
Speaker
One thing that really changed, sort of turned my life direction to to a left or to a really odd direction was before I went to Melbourne Uni to start that economics study, I decided to go on a gap year, like, you know, so many little privileged white kids do, and try to go to go to India, of all places. I went to a really cool school in Darwin that didn't have...
00:04:59
Speaker
um It was was just really, it doesn't exist anymore, unfortunately, but it was a private school, but it was heavily subsidised by the government because it had a lot of Indigenous boarding students there from all across Central and Western Australia.
00:05:15
Speaker
So playing AFL was pretty tough there, but we but because of that, they had people from Canada, kids from you know the UK doing like boarding parent gap year programs there and and staying on campus and and living with these kids and Yeah, just doing what you do at boarding school.
00:05:32
Speaker
And so they were like, well, you can do this or these other spots around the world. and And I saw this picture of this lady with a blackboard on the top of this concrete building in India with a bunch of young monks on the ground and with no interest in Buddhism, no interest in any of that, no prior real understanding of any Indian culture, any of that, nothing.
00:05:51
Speaker
Just went, kind I want to do that. And so long story short, I'd saved up some money, worked on some perling boats as a lot of people in Darwin do to get a bit of cash and went over there and so lived in a Tibetan monastery for six months, five months really, um and taught English to a bunch of young like Tibetan and sort of North West Indian young monks and got really exposed to their whole culture, Tibetan Buddhism, the Dharma and meditation and dropped into a few yoga classes and then all of a sudden, know, life direction changed. So ever since then, I guess Buddhism, my meditation practice, has been a big driving part of my life because I came back and and and went went went to Melbourne Uni for a bit but just didn't, sort for lots of different reasons, didn't follow through with that plan and pivoted to physio and many years later, here we are.
Career Path Influences
00:06:51
Speaker
Yeah, awesome. It's funny how sort of experiences and those kind of things can really shift your life trajectory. And and it it sort of explains some stuff for me in terms of your interest in yoga, meditation, mindfulness, those kind of things.
00:07:07
Speaker
and And so why physio though? Like why not say psychology or um another profession? Great question.
00:07:18
Speaker
Sometimes I ask myself that and go, maybe you should have, but... In many ways, I'm glad I did it. ah To be honest, the frame behind me, um if anyone watches the video, is the reason why. so i was I was sort of struggling to keep myself going at Melbourne Uni. ah I was like struggling to fund my uni lifestyle.
00:07:39
Speaker
It wasn't a very glamorous one. I was living in a share house. I just couldn't find work in Melbourne. i was I was loving the course, but I just, for lots of different reasons, really couldn't afford to keep going. And so... ah parents were like it's all right just come back to townsville they were living there at the time they'd moved there after darwin james cook uni's here you can study economics there and i went oh i'm still a bit of a snob than and and like i was like oh but melbourne uni's like one of the better ones for this so let's see what jcu is good at i mean they and they had a you know they're well well renowned for science particularly marine biology but they had had this really good
00:08:15
Speaker
med school and an allied health school and and i saw a physio program and plan number two in in the back of my head, I was always interested in health science and physical stuff. And because of the, I guess the yoga interest that it kicked up underneath all the Buddhism stuff,
00:08:31
Speaker
I went, what if I do that? And I was driving home with mum with all my stuff from Melbourne to Townsville. And she told me, and I knew this already, but my grandma, who I unfortunately never got to met meet, my mum's mum, was a physio.
00:08:43
Speaker
She registered in, I believe, 1945. If I look at that picture there, yep, physio registration board. And she, you know, back when physios then did work in hospitals mostly with, you know, polio patients, lots of traditional rehab, like most people think of physio these days. And I've always had an affinity to her, I guess, a sense that it's where I get a lot of my brain from. And, yeah, there was just this weird calling, I guess, to to follow in our footsteps and and see what happens.
00:09:18
Speaker
So it's in your blood, mate. it's in your blood. there you go There you go. It's a lineage.
Battling Fatigue and Viral Illnesses
00:09:25
Speaker
I'd love you to share some of your struggles with with either pain, I'm not sure if that that is a problem for you or has been, um or ah chronic fatigue, which I know has been a struggle in in some part of your life.
00:09:41
Speaker
Yeah, just share share with us little bit about that journey. Sure. wonder what to pick. Like everyone, I've had injuries, um even nursing one now, but it's coming good in my foot. So...
00:09:55
Speaker
I haven't had so much as a persistent pain journey, but I definitely have had a persistent fatigue journey that's been it's brought up more, I guess, widespread body pains. And now with what people like you and I and in the world know about pain, I see pain and fatigue as very closely linked, which is why i work in this space mostly now. And so funnily enough, it goes back to India.
00:10:22
Speaker
We were living a pretty humble life, you know, bucket showers, washing sheets in the in the in the stream kind of thing. And don't where I got it from or what it even was. Probably a month into my time there, I i got this, what i could what I can only sort of describe as I'm pretty sure it was glandular fever.
00:10:41
Speaker
And I was knocked out for a good week or two, just I couldn't get out of bed. and And obviously sort of had a pretty strong need to because these kids were, you know, I was practically their babysitters. Like I did try and teach them English, but i don't know how good I was. I gave it a red on that. Young kids, I was just a babysitter. So I was calling my auntie, who's an early childhood educator, a lot for help. And she would send me colouring in books and stuff. Yeah.
00:11:08
Speaker
No, I got knocked with this glandular fever and and like long story short, ever since then, there's been quite a few bouts of different viral illnesses leading up to, you know, probably most recently COVID or this recent bout of the influenza that's knocking the world around.
00:11:24
Speaker
and Ross River virus, Barma Forest virus, all these nasty mosquito viruses. And afterwards, now I realise why I was vulnerable to it, but anyone can be.
00:11:36
Speaker
There's just this horrible sense of Like there's tiredness and then there's and then there's sort of of fatigue or or as as you know as chronic fatigue syndrome really known by its cardinal symptom of post-exertional malaise or PEM as it's often shortened too And this experience of PEM, is it's so hard to describe to people who haven't felt it I think most people have felt some sense of it when they get a really bad flu, but it's like it never goes away.
00:12:05
Speaker
And it's ah it's a horrible thing to grapple with. And I think each each viral illness that came along, it just knocked me back more and more. and And COVID was probably the worst one because then, you know, after that, I'm an insanely exercise-focused person, not because I'm special or disciplined or or in any like that, but literally just because it keeps my head clean. um My yoga practice most mornings a week. Now, like you, I'm you know' into riding my bike and stuff.
00:12:35
Speaker
even if I want to on the days, weeks, sometimes months where this hits me, it's a problem that sort of recurs, I'll i'll get knocked back. and And just you, even if you want to push through, you can't.
00:12:48
Speaker
But if you do, it sort of, it whiplashes you back twice as strong. So that's a bit of an all over the shop ADHD version of the story, but multiple sort of viral illnesses are now starting to see and help a lot of people with post viral fatigue, ah which can progress to proper myalgic encephalitis or chronic fatigue syndrome. The naming is controversial itself. Mm-hmm.
00:13:12
Speaker
It's given me a lot of extra empathy and a world, a lens, view into a world of many forgotten and disabled people. 100%.
00:13:24
Speaker
I... i Yeah, the reason asked the question was because I can see the link between fatigue and pain, especially when it comes to persistent pain or chronic pain, the words, again, we use interchangeably.
00:13:42
Speaker
i prefer persistent pain, but most people probably more aware of the word chronic pain, to be honest. But tell us what is the the link between the two and how do you think that, the yeah, they re relate?
Stress and Neuroimmune System
00:13:58
Speaker
Yeah, the the way they relate is the way the and the reason why is part of why I think we can now better explain persistent pain itself. And I'll be talking to the converted here, but it's it's the relationship between the nervous system and the immune system.
00:14:15
Speaker
Now, most people... whether you're a regular person off the street or or even you know medical specialists, we're prone to making sense of things by breaking them down and understanding them in separate little buckets. you know like Like if you put something together, you've got the different parts.
00:14:35
Speaker
the table I'm you know using now. It's got its legs, it's got its top. um And when it comes to body systems, we often think of them as quite separate. But as as we both know, they're so closely connected that they may as well be the same system, the neuroimmune system, I guess.
00:14:51
Speaker
And because... those two are connected. Whenever one has a tantrum, the other gets affected because, and and especially with all the strange things that we're only really beginning to make sense of in a way that I think is coherent, that that makes sense now with how the immune system even functions.
00:15:14
Speaker
We can start to see how the immune system affects the nervous system. And then, of course, because these two are everywhere in the body, everything else, you know, like why are all my muscles aching?
00:15:25
Speaker
Because there's stuff happening between these two systems that connect and even just ah something I saw this week that's a little bit nerdy but I think there's a way of describing it that makes sense because I'm definitely no immunologist There's a particular immune molecule, I guess, marker. One of those strange things that the doctor tries to tell you is on your blood test that's called an interleukin.
00:15:54
Speaker
And it's ah it's a cytokine, which is a thing that gets released when you've got inflammation. So think of it like an inflammatory chemical. and And that has been shown to be linked between It's been released by the brain and I guess linked with a lot of muscle fatigue and functional loss in these populations, in fatigue and and other other illness populations. So really it just comes down to the nervous system and immune system being intimately connected and that as soon as the immune system starts functioning too much, too little or weirdly, yeah it all gets pulled down with it.
00:16:34
Speaker
Yeah. Tell me, how do you how do you manage it? It sounds like it's a bit of an ongoing thing. What are your tools that you use to manage it? Because I think that the tools that you use to manage that will also be very useful to people that are suffering with pain.
00:16:51
Speaker
so Bingo. Bingo, yeah. Because I think when it comes to
00:16:57
Speaker
even just... Yeah, the how do I start with this? the The big problem that everyone experiences when they've had an injury or they've had a ah fatigue illness like this, whether it's short-term or long-term, is that humans are prone to the classic boom-bust cycle.
00:17:15
Speaker
We think that we... You know, we have a day where we feel all right and we do all of the things, either because we have to or we want to. And then the body goes, no, thank you. That was too much. You've extended the budget and I'm going to make you pay back interest tomorrow and you'll be extra sore, or extra tired or both.
00:17:33
Speaker
So how I start and the harder lesson, i always say this to clients, like, I can tell you this honestly because I've made the mistakes more than you have is pacing, which is an annoying word, I think. I still find it annoying when I hear it because it sounds so easy but in practice it's so hard. And pacing is about structuring your what you do according to how much you have and and a body budget ah or spoons is the classic you know metaphor that people use in this community.
00:18:06
Speaker
But a body budget is the one I love to to talk through as and as a sort of a metaphor. How much money you've got in the bank, like in real life, fluctuates day to day, week to week.
00:18:17
Speaker
And, you know, we all want to spend spend money on things we like, buy that new bike, so set of shoes, holiday. you know, we can't have everything we want and that's the problem with our body as well. And so it comes back to sort of finding a baseline, much like a budget, of how much we need to spend, how much we have to do, and to see if we can balance it out.
00:18:36
Speaker
and And that's the the starting point. And then, of course, it gets into lots of different rehab strategies, whether it's building stuff up, which... is more risky in fatigue stuff and and not nor a bit controversial, I might say, in the community.
00:18:53
Speaker
Pain as well, really, in both. But but the thing I'm trying emphasise more is is the is the calm stuff down um yeah category. and that's that There's a lot more there that's unexplored than the you know exercise, classic rehabilitation bucket of things to do.
00:19:11
Speaker
Yeah, one of the one of the reasons I think pacing is challenging is because there's more involved than just physical things, right? So like ah if it was just physical and that's all it responded to was was how far you rode your bike, it would be pretty easy thing to sort of work out. But when you put in the cognitive factors, they the social factors, the psychological factors that all can influence um overall fatigue and how the nervous system's responding,
00:19:44
Speaker
it becomes extremely challenging because you might be pacing yourself well with physical, but there's a lot of cognitive load or there's a lot of stress or there's some other factor. And that's where it just becomes amazing.
00:19:58
Speaker
Man, I feel like there's a, you know, I'm a bit entrepreneurial. I feel like there's something like a tech tool in this space that could could provide a fair bit of help, fair bit of help.
00:20:11
Speaker
Yeah, you're right. I want you to explain, because you've talked to me about this, but I want you to explain allostatic overload or allostasis in general.
Understanding Allostatic Overload
00:20:23
Speaker
try it try Try to do it in a in a friendly, because a lot of people listening will like, well what even is that? um So, yeah, I want you to explain that and how it relates to pain and also fatigue.
00:20:35
Speaker
For sure. I think it comes back to what you just said, that... that it's ah it's It's a bit of woo-woo truism, but mind and body really are two sides of the same coin.
00:20:47
Speaker
And stress is just as much physical as it is psychological and they can influence each other. And I guess... their their effect is on the same systems. You know, when I go out and as I just did before, mow the lawn in the midday Queensland summer heat, that has a drain on a stress on my body and it has to meet that that that stress and adapt in the in the immediate term and then afterwards it has to recover.
00:21:13
Speaker
And similarly, you know, with things we do mentally or emotionally. You know, if we have a a big argument with a friend or a spouse or or a colleague, that we get stressed physically because our nervous system's priming us to a potential threat that that we want to successfully move through and make sure we're safe afterwards.
00:21:34
Speaker
Cognitively, you know, if you've got to do something that's really hard, like the, don't know, your your taxes at the end of the year, a uni assignment, um all kinds of different things that we have to use our head for in a really often difficult way.
00:21:50
Speaker
Allostasis is just a way of saying stability through change if you translate it from, you know, from its Greek ah to English. And it sort of, ah it's a it's an opposite or ah expansion of the classic medical idea of homeostasis, which is just,
00:22:07
Speaker
not classic stability. And where homeostasis matters is that, you know, our our body temperature, everyone knows our body temperature has, you know, one degree range it can be. And if it drops out of that, either too high or too low, you're really ill and and it has to keep it in there.
00:22:24
Speaker
But other things that we, you know, any any of us know, like our heart rate, how often we breathe, how much we breathe in a minute, or our our blood pressure. Every one of us has had our blood pressure checked at least once in our life by the GP, and we see those numbers that make might make no sense, but they go up or they go down.
00:22:43
Speaker
The body's constantly trying to adapt to these stresses. And like you said, they're not just physical, they're multidimensional, usually emotional, psychological, cognitive, physical, even environmental. You know, you can you can be sunburned. You can be too cold. Those those come into it.
00:23:02
Speaker
And where allostatic overload comes in is that we can adapt to these stresses in the short term. you know your Your adrenaline can drop when when you know you get into a car accident and you have to try and make sure you're alert to the to the circumstances.
00:23:18
Speaker
But if you're you know doing night shift week after week after week and that's moderately or even mildly stressful, but it's staying there over the long term and you don't have ways of really calming down or adapting to that. And it's really hard for humans to do that as an example.
00:23:38
Speaker
then our body sort of upregulates all of the ways that it adapts to this stress and that can have negative health consequences. We all know that high blood pressure has has issues um down the line, whether it increases you know risk of cardiovascular issues with our heart, things like strokes can become more common, all these different health markers that that matter.
00:24:04
Speaker
they're often increased for a reason is the, is the sort of wisdom that this idea provides that yes, it might be useful to take a medication that your doctor gives you to bring that blood pressure down, but it may be even more useful to zoom out and go, why is it elevated in the first place?
00:24:22
Speaker
Is it because of dietary stresses or environmental stresses or personal stresses or all three of them? And these stresses chew down on our body budget.
00:24:34
Speaker
And when we don't have money in our body budget to meet these stresses or we're using it to meet these stresses, we don't have it to do the normal repair and restoration that every single human needs. And that's where psychological and physical issues can come up. I've literally driven myself into quite a severe depression from this, not because I was, i mean, there was definitely ways I was framing and thinking that weren't helpful,
00:24:58
Speaker
But I just depleted my my physiology. i I emptied my bank account and was in debt and my body was forced to rest as an example of that. Yeah, if you don't rest, you'll be forced to rest one day.
00:25:11
Speaker
ah think it's... You've got to listen to the whispers, otherwise you'll get yelled at. Yeah, that's a great way to put it. That is a great way to put it. Ultimately, all this is saying to me is that I should take more holidays.
00:25:24
Speaker
Oh, yeah. No, you know, short-term bouts of stress are great as long as there's adequate a time to to rest and recover. And that's a physical thing, that's ah that's a stress, psychological thing and and all of those factors that you mentioned as well. So how does that – because a lot of people think of pain, when they think of pain, they think of the very physical realms and they're thinking of injury, tissue damage.
00:25:51
Speaker
Explain how this all – plays out in someone with pain if you can i know that's a tricky question but yeah big one through the curveball there'll be a couple more mate there'll be a couple more this is the this is where gosh it's it it really is hard for people to make sense of it and i i use i guess maps is is the way i try and make sense of it so pain, you know, it is related to physical stuff.
00:26:23
Speaker
Tissue gets irritated, sensitive, damaged, and, you know, chemicals and things tell our nerves that there's something going on and then our nervous system gives us this experience of pain for reasons we're still understanding.
00:26:36
Speaker
And I guess because the nervous system is the central thing in that and it just so happens to give us thoughts and feelings as well, then they're connected. and it's And I guess what we've got to delineate here is is not not a conscious psychological side of it solely, but that your thoughts and feelings, they're bi-directional in that they can contribute to and enhance the chemical stuff that happens in our body, physiological stuff that happens in our body when we're under stress.
00:27:17
Speaker
And that can be things that make inflammation go up. That can be things that make our immune system go hyperactive or or hypoactive, not as active. And then also these stresses, these extra, and you know, and inflammatory things that happen in our body can also make us more...
00:27:36
Speaker
more prone to thoughts and feelings that are perhaps unpleasant, whether it's, you know, rumination patterns, which is a word that just means that our thinking is very repetitive and all-consuming. If you're ruminating, it's that you're, like, I just think of a cow that they ruminate by chewing on grass, swallow it bring it back up again, keep chewing on it. And you can if you think of grass being your own thoughts, that's ruminating.
00:28:05
Speaker
and So that ruminating can be because your body itself is under a lot of physiological stress. So those two, those things, you know, yes, your your control of that is part of it, but it's a small part is is the thing. And it's not all in your head.
00:28:21
Speaker
It's that your head is connected to your body. And that's all one thing.
Managing Anxiety through Mindfulness
00:28:24
Speaker
I don't know if that explains it very well, but that's the beginning of where I try and start. Yeah, no, no, that that's great. i I love that you say it's not all in your head.
00:28:35
Speaker
And I also love that you say it's not all under our control. But I also look that that going too far just leaves us helpless, right? There's nothing we can do so So yeah, so i love that there is still stuff that we can do. and And we can unpack some of that stuff. Actually, maybe just like some really practical, like what are some stuff you can do to feel less pain or feel less fatigue if you have a persistent pain or a persistent fatigue problem?
00:29:10
Speaker
This is where I bring out my inner woo-woo therapist, psychotherapist self, my alter ego. It's just listening to your body that I really do think, you know, humans have been around a ah really long time as far as we know.
00:29:28
Speaker
And science, as wonderful as it is, Western medicine and our ways of making sense of ourselves and the world as wonderful and helpful as they are, haven't been around for that long. And so I think we've we've got a lot of what we need, not all that we need, inside of us, and we can listen to it.
00:29:48
Speaker
But that's that's a challenging skill for many of us to develop. And often I find, was just saying this to my partner before, that we haven't actually been given the opportunity to learn how to do that.
00:30:00
Speaker
And so we've been forced through societal conditioning, things we needed to do growing up or didn't need to do, whatever the reasons are, for some reason, a lot of people, myself included,
00:30:14
Speaker
have grown up not really being given the chance or not being really incentivised to listen to their body and act in accordance with what it's trying to say to you. And it's not always giving you clear messages. Sometimes you need a push when you feel like not doing it, but most of the time listening to it's a good idea.
00:30:30
Speaker
And so I guess the practical thing is always to start there and to learn to feel into what your body's telling you and start to interpret and practise interpreting what that means.
00:30:41
Speaker
So if I wake up in the morning, and I've had a pretty bad sleep and my muscles are all a little bit achy and I'm feeling a bit irritable, then that's a sign that I've now learnt that my body budget's a bit low and I shouldn't go hell for leather and and spend all of my body dollars on a really intense exercise session to just kick in some endorphins and make myself feel good for a while.
00:31:08
Speaker
Because as I've learned, I'll crash later on that afternoon and I'll probably put myself into a deeper hole, a deeper debt, if you will. yeah and And all of the practices I think that are growing in popularity these days are different ways of getting people from their but unique beliefs, circumstances, skill deficits to come to the point where they can safely listen to their body because it's a pretty challenging experience and and learn to interpret what it's telling you.
00:31:37
Speaker
yeah Yeah, that's a good answer. Good answer. I find those sometimes like people say, I'm just going to, I'm going to be, i'm going to dig a little deeper and I want ah like, say just some practical tools. So if I said to you know, i'm feeling anxious, what would you, what would you tell me to do from a practical tool point of view?
00:32:02
Speaker
this is This is where um I don't want APRA on my ass, excuse the the language. But I'll preface this by saying that the the the boundaries between physio and psychology are getting very blurry and I think that it's okay that they are because scope of practice is important here. But I would say ah that...
00:32:27
Speaker
Me as Ollie and not me as a physiotherapist. That's probably the easiest way to answer this. How about I say it this way, Ollie? How would you do it? How would I it? If you were feeling anxious, what would you do?
00:32:40
Speaker
This morning I was lucky. So this morning I woke up feeling pretty pretty anxious because I've got lots of stuff to do over the next few days and I'm not sure I can do it. And I was just in my head. I was in my little state. And and i'm still I still work through that. So what I did was i i've got I've got a ah meditation practice that I'm getting better at being consistent with, which is my way of of really letting go of meditation
00:33:07
Speaker
grasping patterns and and listening into my body. So first step is is is get comfortable, get a little bit quiet and and feel and scan and listen. And listen without...
00:33:23
Speaker
hyperfixing and and listen without too much judgment or too much interpretation because what I find is is that thoughts aren't that useful most of the time but sensations usually pretty helpful even if you don't don't elaborate on what they mean, if you just feel things and let them move through, which is an uncomfortable thing to do, the thing that that comes out of Buddhism or the Dharma or a lot of these contemplative traditions is that it's impermanent.
00:33:54
Speaker
I've got it tattered on my arm to remind myself when I was 21. then All things, all compounded things are impermanent. And so if I stick with this, it's not going to be around forever, just like everything else in the world.
00:34:05
Speaker
And then when it goes through me, my nervous system, if it it wasn't too intense, knows, has more confidence in meeting that and knowing that I'm still safe. Because and anxiety is is just a ah threat state. like It means that I'm under some perceived or actual threat.
00:34:22
Speaker
But it's not always safe or useful to sit down and listen to it, to get still. Most of the time, most people, and this is where I really, within the scope that i'm and I can practice in, I try and get it very personal because everyone's got different I guess, traumatic experiences or barriers or resistance to listening to their body because there's a lot of noise there and it can be threatening just to pay attention to it first place.
00:34:49
Speaker
So actually getting out and getting physical is one of the best things for for for anxiety, I think, and oh for that mild threat state. Now, getting physical, moving your body, in a non-distracted way.
00:35:02
Speaker
That's something that's like thankfully getting out the mainstream now. I just listened to a book from Steve Magnus called Win the Inside Game. Highly recommend to anyone listening. And he talks about like going out for a walk or a ride or or a roll around doing yoga stuff on the floor, any kind of movement that gives you joy, but doing it in a way where you're not distracting yourself with a podcast as good as this one is or music. Hey, don't say that. No. know, stop for a moment and, and and and you know, feel what it's like. and and it's ah And that can be one of the best ways because then after my sitting practice this morning, I've got on my, you know, my bike's got one of those trainers where I ride to nowhere in the back room at home.
00:35:41
Speaker
And I sat on it for 30 minutes and got off and i felt a little bit better. i could I could at least have a starting point to, you know, meet the challenges of the day for one one of the better ways of saying it.
00:35:53
Speaker
Yeah, great answer. No, I'm glad that I just wanted to like chip down because sometimes people, unfortunately, I've found, you know, what you're explaining is so more so much more accurate than then some of the explanations we see out there, especially what those going around social media, for instance, you know.
00:36:11
Speaker
I've got back pain because I have flat feet or you know, you throw out, you can you can think of a myriad of them. But your explanation is is more nuanced and more accurate, I think, to what the science is saying. But the sad reality is people want simple solutions.
00:36:29
Speaker
not Not many people, we're we're nerds, Ollie, so we kind of like that, ah you know, the complexity of it all and we can sit in that. But really people want simple solutions to this complex problem, which is chronic pain.
00:36:44
Speaker
which is which is chronic fatigue. um And so, yeah, sometimes those practical tips are super helpful for people. And you mentioned two, which one I would put in a nutshell, mindfulness, and the second one is exercise. And I think, phew, you probably hit the ones with the with the most evidence supporting them.
00:37:03
Speaker
Outside of obviously a referral to a psychologist, as well as, you know, sometimes, you know, Yeah, some drugs. Yeah, medication helps.
00:37:14
Speaker
Yeah, Medicaid, that's a better word. Drugs has a little bit of stigma behind it, but you know what I mean. For sure. Yeah. So, no, that that's awesome. Thanks for that. I want to ask you a very – look, pain is complex. We've sort of talked about that to some degree, but give us your best, say, paragraph on why we hurt Us humans, why do we feel pain?
Understanding Pain Perception
00:37:44
Speaker
Gosh, the more I get older and maybe wiser, maybe not, and the more I work as a physio, the harder that question is to answer because there's so many conflicting things. But ultimately, I think you and I are big Lorimer Moseley fans and his brief definition is my favourite. It's because somewhere in the body, maybe multiple places,
00:38:09
Speaker
there's a threat going on. Now that threat might be chemical, you know, it might be inflammation like there is and my foot right now. it might be It might be mechanical, physical, you know, breakdown or or break of something like nearly one of the bones in my foot, but it we stopped it before it did.
00:38:33
Speaker
Or it might be threat or... threat systems coming on all over, you know, whether that's the immune system as we've spoken about, which I think is really where it comes down to. If if we can explain pain, a lot of it comes back to immune system stuff.
00:38:47
Speaker
and And, of course, because nothing happens in the body without our nervous system because it's the only reason like or the main reason we're conscious as far as we know. then all of it has to get filtered through that. So it's the boss. and And whether or not there's stuff happening out in the periphery of the city, the the central, you know, management board, the CEO and his and his team need to need to process it all and spit it out.
00:39:11
Speaker
That's a really bad answer as I'm as i'm listening to myself say it. I actually love it. I actually love it. I think i think it was great. And i and i look, i I can relate to your hesitancy. I know I'm giving you very hard questions.
00:39:26
Speaker
That's all right. But it's more for the listeners. For you to try to, like, you know, summarise it in a very small sentence is extremely challenging. so and And I think it's, you know, when you mentioned about the how hard it is to to sort of explain in simple language. Yeah.
00:39:44
Speaker
If you know the Dunning-Kruger effect, and listen oh my god if you just Google that, it just means, Ollie, that you're not the peak amount stupid, which which unfortunately, this and ah this sounds a bit demeaning. But unfortunately, many people stay at that point, and especially on social media. like you know And and they they're very simple in their understanding of very complex problems.
00:40:08
Speaker
You know, when you set out to study physio, you thought, oh, this is pretty easy. This makes sense. I understand. And then, i don't know, where six, seven years in, you're realizing the complexities of of life. um And so I think that that definitely shows your wisdom, mate. so don't don't beat yourself up too much.
00:40:28
Speaker
Oh, thanks, man. And for listeners, if people are making it sound so well, look, I was going to say, if people are making it sound super simple, it's probably not true.
00:40:40
Speaker
Mind you, I think that some some pretty decent experts in this area have been able to sort of solidify very complex ideas into very simple metaphors and things like that. But in general, it's not as simple as what we what we think, no against especially when it comes to pain.
00:41:00
Speaker
I think it's very individualized too, like on that point is that I respect now with what I know when any professional, and they can be medical or, you know, they could be the plumber coming to help at my house.
00:41:12
Speaker
Yeah. If they're giving me a bit of uncertainty as part of how they're explaining the problem, you know, yeah I think it's this, but we don't really know for sure. I've got to test X, Y, Z. Yeah.
00:41:23
Speaker
that gives me a lot of confidence. But for many people, that can be quite threatening. And so much like medications can react to some people and help others, I think explanations of things need to be adjusted to the person because that's why it's so tough and why why we hesitate, right, to say something on a podcast because it's like, who knows it's what's listening. They could hear this and go, oh, yeah, whatever is full of it. And then the other yeah another person might go, oh, yeah, that's wonderful.
00:41:47
Speaker
Yeah. On that, on that, I... You know, i i have a mate that's starting to be an orthopedic surgeon um and, you know, hang out with some orthopedic surgeons from time to time. And when I say hang out, I usually just shadow them. Not much is said because they're in the zone and they're very busy people.
00:42:07
Speaker
Yes. But I think sometimes we – am nervous about this. Humans are really good at flip-flopping or going to extremes on things.
00:42:18
Speaker
And I think – sometimes we throw the baby out with the bath water and in this case when it comes to pain science with persistent pain i would say that the bath water is the body and physical structures that i think are still important and even in persistent chronic pain where we usually think those things would have mended i still think the body is important I'm a bit nervous about going too far one way or the other.
00:42:50
Speaker
do you... no, you're in the middle. I think you're in the middle. I say this all the time. It's like, you know, we've seen this with what a great example is these bushfires that so commonly happen in Australia for anyone that's an Aussie listening or the horror that we saw in Los Angeles just in recent weeks and months, depending when you listen to this.
00:43:09
Speaker
yeah the We know that weather patterns and big complex stuff in the bigger sphere of things, like with pain, were a big part of why those fires happened. You know, the wind was just mental, that people in helicopters that are highly skilled pilots could barely fly properly and get water in.
00:43:27
Speaker
And yet we also know that on the ground, like in the body, there was so much dry and drought-ridden, you know, foliage that's just waiting to be...
00:43:39
Speaker
but you know incinerated by by a fire that could race through. And so it's, I say it was in the body is that, you know, just because in you know, in a national park or in the bush, it might be really dry and ready to, to,
00:43:52
Speaker
light on fire, you could have a big rainstorm come through and stop that from happening. It's the same thing in the body. it It's just sort of that you need all these factors to come together. hundred percent 100%. And sometimes a surgeon fixing a certain structural problem is enough to toler for it to – and so I never like to rule out any option.
00:44:14
Speaker
and when it comes to this and it just is that's where it's hard as a clinician is to piece apart what what is important what is going to help and obviously informed by a whole body of research it can be quite complex and I actually think it's quite freeing if there are any surgeons listening um I think it is quite freeing from a surge surgical perspective because when when a sir when a When surgery doesn't fix the problem of pain, I think people's immediate reaction is to blame the surgeon. He must have botched it. He must have done a bad job.
00:44:51
Speaker
And I think in most cases, they haven't done a bad job. They've actually nailed it. And the outcome is just variable because there's other contributing factors. And I think it it should be quite freeing for them, even though they do live in a very biomedical situation.
00:45:06
Speaker
model because that's that's that's the area that they practice. And a lot of them are understanding the complexities of of pain. I think so these days.
00:45:16
Speaker
yeah Yeah. They just happen to work with the structures and and and that's important. there's There's a role for that. So, yeah, awesome.
Yoga's Influence on Self-Efficacy
00:45:24
Speaker
Tell us about your yoga background. ah yeah You kind of briefly mentioned mentioneds where the inches interest stemmed from.
00:45:33
Speaker
But tell us about, because I, mate, I am, so you're you'd be on flexibility, you're on this side of the spectrum. And I am so embarrassed as a physio about how inflexible I am.
00:45:47
Speaker
I'm about probably 40 years up in age, up the spectrum from where I probably should be right now. But were you were you good at it?
00:45:58
Speaker
Because like for me, I'm like ah flexibility, that like even stretching back when I was playing basketball, I was like, I'm not a stretching guy. And then when the research came out to support some of that, I was like, yes, I'm never stretching ever.
00:46:13
Speaker
But it was really because I was just rubbish at it and we like to do things we're good at. what was your exactly what was What was your reason for into yoga? That's a good question. I still ask myself that and I'm i'm not completely sure, but i i think I just felt really good.
00:46:32
Speaker
it It definitely was challenging. I definitely wasn't, as much as I do think I might have some generalised hypermobility that's just genetic or innate, that's come, you know, that's that's been...
00:46:45
Speaker
maybe um and uncovered by yoga, by yoga posture practice. Because that's the thing, right? You talked about flexibility and the classic yoga teacher thing when they hear that is to come in and go, it's not all about flexibility. It's about training the mind, being like unifying mind, body and breath and and and all this stuff. And then people go, I just check out the hippies ranting, like whatever.
00:47:06
Speaker
But I guess to answer question, I jumped into a class, I walked out and I felt awesome. yeah And I really struggled to feel at home, like many of us humans do, right, at home and comfortable in my morning.
00:47:19
Speaker
I've done all the sports. My parents took me, bless them, to way too many different things, everything from ice hockey to cricket to soccer. Yeah. I tried and and enjoyed but i never stuck with and and never felt, I don't know, comfortable or or even good at.
00:47:34
Speaker
And something I've learnt recently is that, This weird psychological concept of self-efficacy is really important and a big predictor in people's pain outcomes and everything outcomes, life outcomes.
00:47:47
Speaker
And i self-efficacy is just how how confident are you to do the thing and and think that you'll do well at it or that even if you don't do well, that you'll that it's worth it.
00:47:57
Speaker
And I had bugger all outside of academic stuff. And so yoga for me gave me confidence again and gave me a feeling of homeliness in my body and self-efficacy.
00:48:09
Speaker
And it gave me some excitement, you know, because a lot of yoga is very slow and people think of this like bunch old people stretching. But there's a particular type of yoga that caught my interest and captured my ADHD brain and gave me so much of what I needed and still need, know, from when I started 18, 19 through to at 31. It was it was.
00:48:29
Speaker
it was it was You know, it it had a nice system. It was well-rounded. Like it was, it wasn't just physical. It had breath regulation and breathing training practices integrated into it. It it had a mindfulness and concentrated focus. So it was, it was quite contemplative, I guess, but it was really physically challenging. And there was cool stuff that I could work towards doing over a really long timeframe, over 10 years, you know,
00:48:57
Speaker
to do things that I never thought I would do, would you know, stand up, lean back and touch the floor with my hands and then stand up from that position again. I wouldn't have dreamed that I was physically capable of doing that in high school trying to play AFL in Darwin with my stiff, you know, low back pain that I had then.
00:49:14
Speaker
the yeah So it growed, I guess. I just i got the i caught the bug and and that's where now it's it's helped me help others better because I see that, you know, I love yoga and I think that there's a way to make it accessible and beneficial to everyone because it's not just about flexibility. It's about learning to slow your breath down, synchronise it with movement, improve your attention and ability to read your body signals.
00:49:41
Speaker
But ultimately, any form of physical movement that's enjoyable, meaningful and gives you self-confidence is where it's at. And that you know could be mind dancing or gymnastics.
00:49:54
Speaker
Yeah. <unk> ah That's cool. That's cool. Tell tell me, can you can you stretch your pain away? you know what, sometimes you can, ah sometimes you can't. So it's ah it's a scalpel to me. like it it can It can stuff things up and and create mayhem and you know damage. And I have done that to myself. You can overstretch.
00:50:15
Speaker
But on the other side, there are certain stretches, certain movements in yoga that can be wonderful. And I think it comes back to the fact that we've been talking about the nervous system a lot today and you know, it's all a bit complicated. It creates thoughts and feelings, but we forget that it's a physical structure and that to stretch out our arms or to stretch out our legs is to stretch out our nerves. And sometimes they like that and they need that and it helps them stay healthy. And and I think for me,
00:50:43
Speaker
I've got this thing in my lounge room, which is a wooden calf stretch board, and I stand on it every day and fold forward and and, you know, one leg or the other or both legs and try and touch my shins or the feet or the board.
00:50:55
Speaker
And doing that every day, um i don't know if I've found the cure for back pain, Lockie, but I reckon I have. I reckon if everyone does that, they'll be right because I am. Classic. I was going to please disregard that if you're listening. No, I'm joking. No, I'm only joking.
00:51:14
Speaker
But by my board, it's $200. No, you can get $30 on eBay. It's great. $200, mate. You're not selling it high enough. No.
00:51:25
Speaker
Yeah, no, I want you to say you gave an answer that I think is pretty accurate. You know sometimes it can help with pain. Sometimes it doesn't. What are the variables that makes it sometimes help?
00:51:38
Speaker
know this is a hard question. I'll start there. what are the What are the variables that makes stretching sometimes a helpful thing for people with pain? I think if, and there's some easy tests to do this. I think because a lot of my work now I've been privileged as you have to help people online and COVID shown us that online physio, as weird as that sounds, is useful is as useful and as helpful to people as not. I've learned that you can do a couple of tests, two movements, let's say.
00:52:08
Speaker
These are neurodynamic tests for the people out there who are in the health world. You'll probably know these. But for those who don't know what that means, it's a particular way of moving that stretches, we think, puts nerves more under stress as opposed to all the other things in our body.
00:52:25
Speaker
And, you know, one of them I can show here is just, you know, an ulnar stretch test where you drop your shoulder way down, way from your ear, and you might press your hand away. And see right about at this point where my elbow isn't even fully straightened for those who aren't watching this, I've got a sensation in my fingers that's just like just before numbness.
00:52:44
Speaker
And I think we all know that feeling where you you hit your funny bone, which is your ulna nerve and you get that. oh So, and you can do that for your leg as well, where you slump forward in your chair and stretch your your leg out, your knee out.
00:52:56
Speaker
Just testing that could could tell you how sensitive to stretch your nervous system is. But ultimately, I think it comes down to any other like choice of exercise in pain and and stuff that you would talk to people about every day is that how how irritable are your symptoms?
00:53:13
Speaker
you know How quickly do they fire up? How quickly do they calm down? Because if they don't fire up too quickly and if they calm down pretty pretty quickly, then you're probably going to be okay. But again, the cliche, your body will tell you.
00:53:26
Speaker
There's a point in, I teach yoga once a week Palm Beach here Ritual Yoga and Pilates, and it's a pretty chill class. You know, the oldest bloke could show up and be fine. So you're welcome, Mogi. I'll fit right in. You'll fit right in. No, it's good. It's there for everyone. And I say, you know, there's a point in the stretch where I think,
00:53:49
Speaker
if if you want to explore this, where you go, oh, that's coming on, i can feel that, that's a little bit uncomfortable, and you sit just maybe back from that or just on it and breathe with it. And if you can breathe with it, then it's probably going to be okay.
00:54:02
Speaker
But, of course, if you've got any form of nerve injury or or sciatica or or arm sciatica, you know, radiculopathy, ah just the fancy word for it, then you've got to be careful. You know, it's a lot more risky. But for most people, if you sit on that edge and you don't push it, because so many of us just push through and that's where it goes wrong.
00:54:19
Speaker
We just don't listen to our bodies, which is yeah what I started with in our conversation. Yeah. And I think there's, you know, there's some certain structures that probably... when they're injured or grumpy, they don't particularly like it and it can sort of slow recovery. And then there's other structures that really love it. So, like yeah.
00:54:37
Speaker
And you mentioned one of them, the nerves, off often they they they hate it. Although, you know, Yeah, it's all about, it's it's it's usually not the, it's the dose, the dose, the dose is the most important thing, right? Dose makes the poison or the medicine. yeah Exactly.
00:54:53
Speaker
Exactly. tell Tell us a little bit, and I know you could talk for hours about this, especially because you've just stepped been to a conference, the Ella's yeah conference. Yes. Tell us just briefly around hyperability hypermobility spectrum disorders.
Hypermobility Spectrum Disorders
00:55:09
Speaker
and Just give us a summary on that if you can. For sure. Yeah. This is something that I annoyingly came to, I think, a little bit later than I wanted to, but I'm grateful I'm here because it's still not a well-known thing.
00:55:21
Speaker
And I think it's more important than it sounds because of... all the other types of health issues that are connected with it quite commonly.
00:55:33
Speaker
So hypermobility, hyper, more, too much, a lot, mobility, movement. A lot of people have joints that just move a lot and there are lots of reasons why. Some people it's just nothing in particular you know,
00:55:49
Speaker
genetically faulty or different they just are a little bit more bendy or the way that their skeleton shaped because every single human is different even if you know you'll be different to your parents and your siblings that their body just allows more movement than others and those people do get self they self-select because they tend to do well and enjoy like any of us do with our choice of physical activity or sport sports are activities that that uh that use that to its force, gymnastics, yoga, yoga,
00:56:20
Speaker
Gosh, even like Olympic weightlifting, if you watch the Olympics every four years and you watch those people throw heavy heavy weights overhead, they're the most flexible people on earth sometimes. So hypermobility is a spectrum.
00:56:32
Speaker
And on one side, there's people like me that are a bit bendy and they've got to be a bit wary of it because it might mean that they can, theyre perhaps a little bit more vulnerable to being injured in certain ways.
00:56:42
Speaker
You know, they can overdo it. Like I've nearly dislocated my left shoulder from from overdoing it. Whereas on the other end of the spectrum, it can come to certain genetic disorders that we're thankfully understanding more about, Ehlers-Danlos Syndrome, where...
00:56:58
Speaker
and and and rheumatological illnesses, things that you go and see a rheumatologist for, where for genetics or for some disease reason, the connective tissue in our body, which is everywhere, but usually we think of ligaments and tendons to simplify it, they're not as tough, they're not as rigid as an average human.
00:57:23
Speaker
And so it means when wherever that tissue is, there's more give, there's more mobility. and And, you know, when it comes to musculoskeletal joints movement, that's pretty easy to think through. You go, okay, you you might want to be careful with certain movements where you can go beyond the joints range of normal range of motion.
00:57:45
Speaker
Mm-hmm. Not that it's a no-go because I think that's where some people in the hypermobility space get a bit too dogmatic. and I won't go into a deep dive there, but it is safe to go to end ranges. you know If your elbow bends beyond 180 degrees, it doesn't mean you need to avoid it or be afraid of it. I've seen people handstand on elbows like that for their lifetime.
00:58:03
Speaker
Just go and watch Cirque du Soleil. You can see what I mean. Yeah. but But it does mean that there's a little bit more risk there. But where it comes in, I think where it connects and is more important to understand is that that connective tissue is everywhere else.
00:58:15
Speaker
You know, it wraps around us our our important vital organs. It wraps around our nervous system, our brain and spinal cord. And there can be serious issues that arise that are very correlated to lots of other illnesses or or conditions like neurodivergence, you know, yeah forms of autism, ADHD, OCD, et cetera, dysautonomia, which are ah illnesses around the autonomic nervous system like postural orthotatic sachycardia syndrome,
00:58:52
Speaker
and and other forms of sort of weird inflammation like mast cell activation syndrome where all kinds of strange stuff can happen. That's another conversation. These people are more prone to being to being sick. You know, when they get COVID, they really get COVID. when they they They're the ones that have the allergies usually. And so what I've learned is that that these are the people who are most easily dismissed.
00:59:19
Speaker
These are the people whose test results come back kind of weird or fine, but they still feel really ill. They still keep getting injured. They still keep having issues. And so I think thankfully where we're at, or at least in my little siloed bubble,
00:59:32
Speaker
we're listening to these people, we're learning more and we're getting better research to make sense of what's going on because it is very complicated. But I think listening to these people and giving them ways to feel safe in their body and move again is is empowering them to find more quality of life and health that they might not have had otherwise.
00:59:52
Speaker
Yeah, i've I had someone recently that I think may fall into this this spectrum And umm sort I sort of tossed and turned about it from um from a pain perspective, how whether to go down this rabbit warren. Do you know what I mean? Like sometimes it's like,
01:00:11
Speaker
ah it can it could There can just be too much investigation, too much testing, too much. And I know there's a fine line between that. Don't get me wrong. I think there's a time for it 100%. But for those people that are like, oh, do I really need to scare this person with this this whole concept that they've never even thought of?
01:00:29
Speaker
um Yeah, that's an interesting one. i I was going to ask you advice, but no one else probably would care about that. Yeah. well I think there's a lot of people, you'd be surprised because a lot of these people have, these are the ones that we care about. Like the reason I think you've made this podcast is there are so many people out there that have given up talking to their GP, given up finding a physio, given up talking to anyone.
01:00:53
Speaker
Yeah. Because no one's really listened. No one's offered anything that's actually helpful for their pain. Yeah. Or for these people, for their pain, for their allergies, for their, you know, fatigue and other chronic illness symptoms that just have not been validated or made sense of. And so I think... Yeah.
01:01:13
Speaker
Whilst, yeah, you're right, there can be a real rabbit warren and and I think diagnoses are a double-edged sword. In this population, they they offer um a lot more safety and a lot more, don't know, these people would just go, ah, that feeling of, oh, now it makes sense. It's like for me, I'm very open about this and I talk about it a lot now, but In the last two years, you know, to go back to the fatigue story, I've realised that I have ADHD and likely have ah level one autism according to how the DSM is now, you know, but I won't get started on how we even frame and label and make sense of people with different brains.
01:01:58
Speaker
But it's meant that I now understand that I'm a little bit more sensitive, that the way my nervous system works takes in lots of information, which is a blessing and a curse, and it makes me more easily sensitised to...
01:02:10
Speaker
everything that you know to illnesses and stuff and so with these people sometimes just going hey there's a there there there's a real thing here and yeah you you can explore it yeah and then it sort of gives them the agency and potential hope that that might carry them somewhere yeah i guess my my reasoning sometimes with not going down the rabbit warrant is because it is around treatment options and So yes like in some some scenarios, it's like, oh, well, let's go down that because there's actually good, if we do find out that that's what it is and there's really good research around treatment options for that. And so it's like fantastic.
01:02:46
Speaker
I think validation is important. And so that' it that's an option that I think is is important and and probably a reason to go down that. Around treatment options for the hypermobility spectrum disorders, what what are the treatment options?
01:03:04
Speaker
Gosh, where do we begin? because i i guess the good thing is that... Sorry? Sorry, we're quite early on this, right, in terms of learning and understanding. Yeah, I think relatively, yeah, you're right. i the I think the thing that's good about this is that if you do send people down this rabbit, Warren, there's not the Nasebic or high financial and and quality of life costs that can come at the other side of treatments that we don't really...
01:03:31
Speaker
you know, like or or approve of as much, you know, as as in chronic pain yeah conditions. Yeah. Whereas, you know, they can they can overlap. So I guess the the nasty surgeries that are risky or the spinal cord stimulators, that whole conversation just isn't as prone and then and it more actually comes back to going, oh, my God, my immune system is really sensitive and reactive and if I go and talk to a GP and get things like an H1 or an H2 agonist, all of a sudden my gut pain and and fatigue is halved and that's for for the people out there. Again, I'm not a doctor. I don't recommend taking this and medication but if you talk to a doctor that's aware of this stuff,
01:04:13
Speaker
H1 agonist is your antihistamines and H2 is something like Zantac and as an anti-stomach acid. Those two medications have had some pretty weirdly helpful outcomes for, chip you know, even when you're having something like COVID or these mast cell immune widespread inflammatory reactions that these people can get. So it's,
01:04:34
Speaker
I guess the cool thing is treatment-wise, a lot of it comes down to understanding that there's a lot of triggers that set them off and that they can avoid, you know, that that going out into, you know, places with lots of fragrance, like walking through that section of my department stores can be really triggering.
01:04:52
Speaker
And that's something they may not have never have thought of unless they just go, why I'm always sniffly when I walk through here But then movement-wise, there's so many options. Like I've got a great book here I'm going to pitch. um I haven't met her, but but Zoe McKenzie a fellow physio and she's written this wonderful book, Exercise Well with Autoimmunity, that really just steps back and offers gentle movements for these people where movement itself and exercise might just be really unsafe because everything just makes them hurt or dislocate or get injured.
01:05:22
Speaker
and stepping it back and being given structure as so many people, you know, Jeannie DeBond's another great example, Zebra Club Online. There's so many resources out there, I guess, is is what I've come to learn from the Ill Has Done Lost Society and this wonderful group of people that are out there taking this forward.
01:05:40
Speaker
Yeah, awesome. Awesome. That was super helpful for me. And I ah hope it was helpful for some people listening, especially if they're going, oh, maybe I fit that. Go and have a chat to Ollie or talk to a GP that's well informed around this kind of stuff.
01:05:56
Speaker
I'm sure there's other health professionals, rheumatologists. GPs are the, that some, you wouldn't, unfortunately, rheumatology isn't coming around to this. I hope, yeah you know, within the year or two, a lot of rheumatologists, there are really great ones, but I think they've just got so much to read about because it's probably one of the most difficult medical specialties to be. Yeah, yeah, yeah. That's the thing. There isn't a medical specialist that really covers all the things that people with hypermobility deal with. So, yeah There are specialised GPs and thankfully quite a few in our corner of the world in Australia that I can direct people to.
01:06:31
Speaker
Thanks, mate.
Benefits of Online Physiotherapy
01:06:32
Speaker
Ollie, why should someone choose online physiotherapy or telehealth physiotherapy? because you don't have to get up from the couch at home. Great answer. It's pretty good.
01:06:45
Speaker
For the people I see, it's great because they're like that, right? You know, they've got really, really heavy, nasty fatigue. and And sometimes you just get hit with a flare day where leaving the house expends your energy, body budget, your spoons that you really need to save and use for other things like cooking yourself food or helping your family members or whatever is more meaningful to you.
01:07:09
Speaker
And so I think what it does is it improves access ah where people might not be able to to get access to healthcare. So whether that's, you know, just being able to leave home and drive, getting transport, or whether it's just where you are in the world. I've had the privilege now chatting to people, you know, on on cattle stations in Western New South Wales and Queensland,
01:07:29
Speaker
that get to chat to a physio that knows their particular problem as opposed to, you know, the very good physio that's two hours away in the town that knows a bit of a little bit of everything.
01:07:40
Speaker
So I think it's for me it's about that access and equity and it's just all you need is internet. And I think where you and i really agree on, I think, where where it's coming forward is what physio is or at least what we do that matters is the sense-making, the education, understanding the problem.
01:08:04
Speaker
Because we get to we get the privilege of having the time with people, but doctors and other people don't always ah for lots of reasons. Finances, just time in the day, people... to sit down and explain stuff to people in a way that makes sense for them, that empowers them.
01:08:19
Speaker
And then we also get to offer movement options and and calming down options that I've discussed today that are, I think, where the rubber hits the road. They're the most impactful treatments.
01:08:30
Speaker
And if it comes down to giving what really works as opposed to what people want, that's where it's really helpful. you know never You know, you can still go and see massage therapist in town, as a lot of my clients do, but they can jump on and chat to me from the comfort of their own home, chat to you, and get really specialised advice that suits their context.
01:08:51
Speaker
Yeah, i went and saw a physio just recently and I said to him, And this was in person. And I said, I don't want hands-on therapy. Like I just want to let you know you don't have to do that. and you can end you ready think they could Yeah. and and and And literally because I honoured his ah skill set and his expertise.
01:09:13
Speaker
And I felt like as a physio that sort of knows on the inside what what what's going on, I felt like our time was better spent if he wasn't distracted by that. And and the parallel to a lot of people, that is just like mind-boggling. Yeah, yeah, or blasphemy, depending on exactly depending on who you are. But yeah yeah, I think a lot of people, they think telehealth physio or online physio, and they're like, how does that work? how can And and not and i'm I'm not talking uninformed people, by the way. Like i'm talking GPs and the likes that are very well informed around these things. Well,
01:09:54
Speaker
Unfortunately, and this is no crack at GPs, but they've got to know so much about everything. too much. and it's And it's literally impossible for them to be an expert in every area.
01:10:05
Speaker
Yeah, same as us. They're an expert generalist, though, and have a super important role to play. um And so I just want to make it clear, i'm not undermining that. No, no, no. They can't get around to everything. But I hope, and this is where I think the research can come out and, and you know, industry bodies like our Australian Physio Association that you know, may or may not do the the the work to just tell people about it and say that this works. And I think they've done a reasonably good job at that, but there's still just more work to do
01:10:38
Speaker
And you're right. it's there's ah There's a lot of knowledge there. And I think any time, like I got the best advice ever for acute neck pain and a shoulder dislocation from a physio in Perth because he was just the one I could get onto and talk to.
01:10:54
Speaker
yeah And in one session he gave me all I needed to rehab that shoulder yeah and i rested it. I did what he told me to and within three weeks I was back to doing full range backbends.
01:11:06
Speaker
yeah So it's in yoga. So I think it's some a little bit goes a long way. It's really cost effective. That's probably the last thing we can finish off. You have spend that much money. Totally, totally. This is the final question and it's a bit of a tradition for the podcast is if someone is – in pain or suffering with fatigue and they're feeling down in the dumps, they feel like there is no hope, what would your advice be to them?
01:11:35
Speaker
um faith that your body is able to adapt because even if in the worst of days, no matter how long you've been experiencing, struggling with the symptoms that you have, and I get it, I've been there.
01:11:54
Speaker
There's been months, years knocked out of my life from the stuff that I've experienced and friends and clients who've had even more. Things can turn around and they can turn around in ways that you don't expect. And it may not be the recovery you might expect, but I think there's always a better horizon ahead if you see things from this perspective um and if you and if you you get the help to yeah to to fill up your body budget again, I guess, in the many ways that you can that that matter to you.
01:12:30
Speaker
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