The Science of Fitness Podcast
Welcome to the Science Of Fitness podcast where we aim to inspire you to live a healthier and more fulfilling life as we share evidence and anecdotes on all things health, fitness, performance, wellness and business.
Hosted by Kieran Maguire, Co-Owner and Director of Science Of Fitness with an Undergraduate degree in Exercise Science and Masters degree in High Performance, the podcast includes guests and friends of SOF from all walks of life sharing their knowledge and stories within their field of expertise.
Join us as we provide listeners with digestible and relatable educational tools and entertaining stories to inspire a healthier and more fulfilling life.
The Science of Fitness Podcast
S2 EP20 Merging a passion for sports with a career in physio w/ Sam Sykes, Head of Rehab at Science of Fitness
Ever wondered what it takes to merge a passion for sports with a career in physiotherapy? Join us as Sam Sykes, our new head of rehab, shares his thrilling journey from the football fields of the UK to the world of sports and musculoskeletal physiotherapy. Discover how his personal experiences with sports injuries fueled his ambition to revolutionize treatment methodologies by prioritizing root causes over symptomatic relief. Our rapid-fire questions with Sam reveal his unique preferences and insights into the field, offering a captivating glance into his professional mindset.
Explore the shifting tides of physiotherapy practice with us, as we navigate the contrasts between working with elite athletes and those in public healthcare systems. Sam and I discuss the transition towards data-driven assessments that are reshaping patient engagement and compliance, thanks to innovative tools like the Vald system. We also highlight the burgeoning role of gym-based rehabilitation, moving beyond traditional hands-on methods to create structured rehab plans that align with patient goals and enhance recovery outcomes. This holistic approach not only redefines patient treatment but also paves the way for future developments, such as integrated degrees for physiotherapists and exercise scientists.
In our discussion, we shed light on the intricate connections between stress, lifestyle, and injury recovery. From the influences of stress on the nervous system to the role of sustainable fitness habits, we underscore the importance of tailoring treatment plans to fit a patient's daily life. Sam shares how maintaining personal fitness routines can enhance physiotherapy practice, drawing from his experiences with marathon and High Rocks training. Together, we emphasize the need for an evolutionary approach in physiotherapy, focusing on sustainable habits and comprehensive care that champions long-term health benefits over quick fixes.
Welcome to the Science of Fitness podcast, where we aim to inspire you to live a healthier and more fulfilling life, as we share evidence and anecdotes on all things relating to health, fitness, performance, business and wellness. Welcome, ladies and gentlemen. Back to the Science of Fitness podcast, and today we have physio extraordinaire and our newest head of rehab, sam Sykes. Sammy, welcome on.
Speaker 2:Thank you, good to be here.
Speaker 1:Mate, pleasure to have you. Uh, before we get into it, uh, we're going to do as we traditionally do start with our um, our quick rapid fire questions, man. So I've got a quick five and what I want is a hard yes, hard no, or gray okay, okay, um. So, to kick things off, should every physio treatment prioritize the root cause over the symptom. Yes Hard, yes, yes hard yes 100% Australian physiotherapy model superior to the UK's physiotherapy model.
Speaker 2:Yes, I'm going to have to say yes, that's controversial. Cool, we'll get a few clicks.
Speaker 1:Ice immediately post-injury Hard yes or hard no, or grey Grey, okay yeah. Might have to unpack that Needling or manual therapy if you were to pick one Needling Needling Interesting, and then exercise trumps hands-on recovery treatment.
Speaker 2:Exercise always yeah, okay, cool, we're going to go into detail.
Speaker 1:Treatment Exercise always. Yeah, okay, cool, we're going to go into detail on each one of those. Yeah. So for anyone that is probably going to click on this on Instagram and then give a comment and tee off, listen to the whole episode before you have a go at us. No, that's fine, let's get into you, matt, your history, your background, obviously from the UK, if you can't tell by the accent. Um, you know, growing up based in the uk. What got you into physiotherapy?
Speaker 2:yeah. So um, obviously played a lot of sport growing up, um, main sport kind of being soccer, football, as 90 of the other lads from the uk yeah, um, but yeah was involved in heaps of sports tennis, athletics and just naturally gravitated more towards football. So naturally, as you do, being an athlete, pick up injuries, rolled ankles, just minor sprains and things like that, and kind of went down the path of physio, always had kind of an interest in the body and it kind of stemmed from there really, um, and then met a couple of physios, um, through placement and things at um on college and then, um, that kind of led me down the path of physio at uni.
Speaker 1:so yeah, yeah, cool so was it sort of I think you finished school, you went straight into physiotherapy or did you have a bit of time? That sort of, because it's always a bit great for someone.
Speaker 2:Biology and PE and obviously with the sport background it just seemed like the natural choice, kind of knew at like 16, 17, I wasn't going to be a pro athlete Again, as most young lads want to be, so I knew that I had to go down a different route. So, yeah, having an interest in the body, it seemed like a natural progression. So after school and then going to college studying um sports science, I then went and did um. I got a job as a therapy assistant, um at a hospital, worked in an orthopedic ward and did that for a year, um, and that's where my interest really grew. Um, I was still kind of a little bit unsure whether it was what I wanted to do, um, and then I just kind of went with it and then at uni it really interest really started to grow.
Speaker 1:so yeah, cool, okay, so then you. You. So you finished sports science as a degree, or did you just?
Speaker 2:transition over. I did sports science as a. It was called a b-tech, so it was a diploma, okay, um, so that was basically it's a little bit of a different schooling system in the uk. So you do your um five years, year seven to year 11, and then, um, you do your gcses, um, and then I'm trying to think what that's equivalent to in australia.
Speaker 1:Um, I'm not 100% sure they sort of have now atar rating. Yeah, because you got o levels and a levels and all sorts of things over there as well.
Speaker 2:Yeah, um, and then, um, you either go and do a levels at college or you do b tech. So, um, I just chose to do a B tech, and then that that was kind of a a path into physio from there.
Speaker 1:So yeah, right, okay, interesting. And then you know, stepped into physio, studied four years over there and that's sort of the degree. And then, um, uh, three years, sorry, three years Okay. And then you sort of had that diploma beforehand. In your experience studying did you sort of want to go down that sport musculoskeletal realm pretty early on and did you have any experience that helped you?
Speaker 2:identify that besides the hospital stuff? Yeah, I think like just exposure through watching sport really, and even if I wasn't't playing, I'd go and watch liverpool, or I used to go and watch a team called blackburn as well um yeah, that's it.
Speaker 2:You know, um, they were just a little bit more local and, um, my next door neighbor supported them as well. So my dad and um there's a group of us that went so, um, yeah, just watching kind of how physios interacted with athletes in that environment. I thought it was pretty cool and I always gravitated towards, obviously, sports. So it just seemed more of the natural route for me and I had to obviously get my experience in a hospital setting and I got a lot of sort of my knowledge through uni, where I picked up all the stuff on anatomy and things and in a hospital setting. And you know, I got a lot of the sort of my knowledge through uni, um, where I picked up all the stuff on anatomy and things. And then, um, that's when I kind of branched out. It was more, actually, when I came to australia that, um, just because of opportunities in the uk, um, a little bit harder to come across, um in in kind of a sporting environment, so I got a lot of my experience in australia really.
Speaker 1:Yeah okay, so you finished physio in the UK. Yeah, jump on a plane and come straight here. Did you do a few years there?
Speaker 2:uh, so I did yeah, so I did uh finish uni, uh moved back home. Um, it was pretty crazy time because it was during COVID. So, yeah, um, I think it was 2020, um, so my last placement actually got cut short, so I only did three weeks. Luckily, I was already over on my hours, um. So, um, I ended up finishing the year, did all my exams and stuff and then got a job um back home, um in the hospital, um as a rotational physio, so, um, did like spinal injuries, stroke orthopedics, all different, um rotations like that, which was pretty, pretty crazy, pretty intense through covid saw a lot, saw a lot of like crazy stuff. Um, but it was good, um, good experience.
Speaker 1:Yeah, I was gonna say, because it's often a lot of um, I guess, opportunities for physios graduating yeah, and it can be quite overwhelming graduating going. I want to work in sport? Yeah, probably not qualified enough, you don't have enough experience. You know, would you recommend that going into that hospital setting?
Speaker 2:because it's just going to be so diverse and so extreme and so when you slip into the gen pop or even just the healthy athletic population, yeah, it's not going to be so overwhelming yeah, I think 100, I think, if you can, any sort of experience that you can get and there's heaps of experienced physios in the I'm talking about the NHS from the UK, you know point of view, but in Australia as well, I'm sure there will be. So if you can learn off those guys and the vast majority of them have probably worked in sport to some degree anyway um, so, um, you're going to learn, you're going to pick up, you know experience and um, then from that there might come opportunities where you know someone, might know someone, and that's your way into sport sort of network. It's going exactly um, so it's all about building relationships and connections and stuff. That's um, as well as learning. But, um, I think that's something that I found from working in the hospitals.
Speaker 1:And it's sort of that people side of where you're working with a population that are probably have very different motivations to an athlete. 100%, you know an athlete, you're just getting an ankle secure so it doesn't keep rolling, you're taping it, you're doing preventative work and you know, just managing pain symptoms versus this is someone's life and yeah, you know they've had a hip replacement and they they want to get walking again. Yeah, the scale of, I guess intensity and importance of importance, for lack of a better term of what it feels like is is is pretty large and yeah, it's probably a really important thing for young physios to get exposure to if they have the opportunity.
Speaker 2:100 because it gives them that perspective. Yeah, I think, like having a goal is really important to not just um the patient, but also the practitioner. So the patient and the practitioner on the same page with where we're going with treatment, and that doesn't change. It's a little bit easier with athletes because we always know the end goal, right to get back on the pitch or on the court or whatever you're doing, whereas you know goals are just as important to you, know your general population and everyday people. It's just that they're framed slightly different and it might look a little bit different as well, but I think the meaning behind it is still as important, yeah, and would you say that's almost a bit of a shortcoming when Gen Pop are treated physio-wise and even considering their training in general health and fitnesses.
Speaker 1:you know everyone says goals but the process and the accountability piece is probably not as intense and therefore the goal is probably not considered as important versus if we took the intensity, both as the practitioners and for the patient or the athlete, or however you want to term them, it's probably going to generate better outcomes and results. I sort of think about the pressures you have on you when you're doing a sporting team. You've got coaches, assistant coaches, you've got organizational CEOs and financial teams going get the athlete on the field and hurry up your motivation. It's like there's a stick behind you, and then the carrot of.
Speaker 1:I want to be a damn good physio that gets good recovery outcomes. So you're motivated to hold the athlete accountable, the athletes motivated because they want to play the sport. So, yeah, you know, everyone's working to the same goal. Versus gen pop, it's like no, that back sore. Yeah, we can manage symptoms.
Speaker 2:Yeah, it's almost a compromise in the industry yeah, 100, and I think the different type of pressure, like in the uk, or I'm just talking from a public sector um, experience, it's more about, you know, shortage of beds in that acute setting or inpatient setting. Get them out, get them out, that's it. Um, and the patient isn't always treated to, you know, the best of um, what they should get, really, um, whereas, yes, with with athletes, there's a different type of pressure, um, and there's, yeah, like coaches and things on your back about time frames and when they're going to be back, especially if they're a big player or yeah, yeah, it's coming up to a big game and things. So it's just managing expectations and I think that comes with time. You learn, yeah, how to manage those types of things.
Speaker 1:But it's yeah, I suppose it's something that you know general physio, not only for the patient but the practitioners, can probably learn from that. Athletic setting is like you know. We want to put pressure on both the practitioner and the patient to do the due diligence to get the recovery outcome they want. And having time pressure it helps. It can be too much. You don't want to rush it. As you said, getting people out when they're probably not ready, which is the compromise in elite sport. You see athletes on the field too early.
Speaker 2:Yeah, it creates. It creates that a little bit of stress, but it's a good thing in the sense that it's going to ensure a little bit continuity through treatment and also that I think objective markers are really important so you can use those not just as a practitioner to monitor progress, but also the patient knows that they're improving and, like, like we said with athletes, a little bit easier but, um, like a patient and their goal, um, and we're marking out stages so that they know where they're up to and how far off that goal they are.
Speaker 1:So have you seen that evolve, you know, even in just the last five years? Yeah, in your experience, the access to really decent objective testing, you know we've obviously got the whole vault system, yeah, in here that we use rigorously. Yeah, you know, before then there's kind of a manual muscle test thing that we could lean on and pretty hard to kind of identify anything objectively for gen pop particularly yeah, I think that manual muscle testing is very like subjective, like how you gauge someone's um knee extension and knee flexion.
Speaker 2:Compared to how I gauge it might be different. So, um, I think that's a little bit skewed in inaccuracy, whereas with the valve stuff, um, I know, you know, I use heaps of it and I know you do as well, um, and it's great for using those objective measures, for I think patients love it as well.
Speaker 2:Right, exactly what I was about to say it incentivizes them 100%, and they're going to be. I think it relates to compliance as well. If they can see those objective measures improving over time, they can see that the rehab plan that's been put together is really working and the buy-in is going to be way higher as well.
Speaker 2:so I think it's a really good tool and um, yeah, and to sort of answer to your question, um, I've seen it be utilized a lot more over the last year or two, especially while I've been in australia. Um, and I think it's a really great tool to have. Yeah, it's um, and it sort of has a bit of a placebo effect as well.
Speaker 1:Yeah, for sure you know where it's like and it sort of has a bit of a placebo effect as well. Yeah, for sure you know where it's like. Oh, you got 10, 15, 20 stronger on that external rotation. On that, you know injury that's on your shoulder, rotated. Yeah, rotating half. Yeah, it's getting better. Oh, cool, it is getting better, you know. So, whether that's, you know, frowned upon or what like, at the end of the day it's a better outcome, it's a better strength outcome, it's a better pain outcome for the patient and that's the result that we want to say. Yeah, very interesting. Um, you know, that's obviously one element from a, a model perspective with physiotherapy. Yeah, um, how else has sort of physio evolved, uh, in the last, let's say, 20 years? Um, just sort of reflecting back on the people you've worked with and their experience and what they used to do versus what they're doing now. What have you seen?
Speaker 2:I think you know I can only really reflect on the last sort of kind of five to 10 years. But what I would say is it's becoming a lot less hands-on and, I think, more gym and I think, um, that's definitely a positive. So I think traditionally, again, more hospital setting um acute outpatients and stuff. It's it's very, um, you do a little bit of hands-on and then you get given an exercise sheet and and you kind of hope that they're better. You see them again in a few weeks and whereas now I think there's a lot more structure to rehab plans. It's like, again, goal relating to goals. So it's like you're here, this is the goal, these are the objective measures, um, and there's a lot more of a clear plan nowadays, um, I think there's more integration between physio and exercise um, like the exercise team, eps, which is great because I can treat and then I can actually see what they're doing on the gym floor, how they're moving, what you guys are doing with them.
Speaker 2:Um, there's not as much of that you know from my experience in the uk because we don't have exercise physiologists um, at least in um private practice or sort of acute settings. They might do in high level sport, but here it's a lot more readily available. Like you go into majority of clinics and there'll be eps and physios or yes and physios, and it means that they can work a lot more closely, more aligned um, and personally I feel like that uh produces better outcomes as well yeah, it's.
Speaker 1:It's very interesting because I was, I guess, having this conversation with someone you know, because, as you, would get peppered with the questions of does ice work? Does manual therapy work? Does needling work? How does it work? How does it like? Some people are really inquisitive, as they should be, and I love it when they are, and then it's does exercise outcomes work? And it's like, well, technically, yes, all of the above do. The evidence shows the effects are from one to 72 hours, you know, from manual therapy to doing your foam rolling and triggering, to um needling and breath work and ice baths and even a workout. And I think that's the really important thing that I say to people is you know, if you do one strength session and then wash your hands of it and don't adhere to it for six, for another six weeks or even just another two weeks, yeah, the effects of that strength session are going to slide away.
Speaker 1:Yeah, you know, and so it's sort of this thing where, um, if you had the access to getting a deep tissue massage every single day, you'd probably feel pretty good. Yeah, have you know? Your tissue would respond really well, you'd have less neural tension, whatever else it might be for all the different mechanisms that cause effect. But I guess what would you say are the benefits of an exercise-based rehab plan outside of that 72-hour effect? You know, if you train your body you get neural stimulus, the muscles feel more mobile, looser, better activation reduce pain symptoms, there's more blood supply. It helps with rehab and that sort of thing. You can get a very similar response when you do some deep tissue work or when you do some kneeling. And you know our approach is probably use a little bit of everything, yeah, but what mechanisms in an exercise? Sense Trump, just a hands-on therapy based, no exercise?
Speaker 2:I think it's more about just promoting movement and keeping people active, um, even if that's in a in a low, low level setting. So let's say, someone's got a really acute discogenic back issue and they're really irritable, um, if we can promote like three, four sessions a week where they're just doing some sort of movement, even if it's just graded, you know, let's say knee rocks, knees to chest, something real basic um, and then you know, once that pain's settled a little bit, then we can start working on mechanics, then we can start initiating a little bit of load um, and it's just about getting that patient less fearful, because essentially we want to try and keep them moving. The hands-on stuff is going to be helpful in the acute setting, but it's not something that we want patients to become too reliant on. So for me, exercise is just about promoting movement, and especially in that acute phase, and trying to get patients to become less fearful, less reliant on you as the practitioner, and, yeah, kind of go down that route.
Speaker 2:So, yeah, in answer to your question, I think there's heaps of metabolic benefits as well and things that I'm not going to delve into too much because the physiology can be pretty complicated and I don't want to overcomplicate it for listeners as well. But it's more in that initial stage just keeping things simple and trying to get people moving.
Speaker 1:Well, I think, inevitably, you're going to need to move, and so you may as well practice it and do it in an environment that's controlled. The risk is low because you're going to need to move, yeah, and so you may as well practice it and do it in an environment that's controlled. Yeah, the risk is low. Yeah, because you're going to need to get in and out of the car. Yeah, when you've got that back issue, you need going to need to roll out of bed, sit and stand up from the toilet, so that stuff's going to be there. You've got to show your brain and it's at a subconscious level, as you said to manage those sort of stress responses and fear responses from a pain perspective. Yeah.
Speaker 2:And then that other side of well, there's going to be other added health benefits as well yeah well, and then you know, if people do want to get back in the gym or they want to return to sport, then we can start. Like I said, we can start to work on those mechanical issues that might have led to that back pain or, um, you know compensatory patterns that people have developed, um, and then we can look at more sort of gym based stuff as well. So it's just gradual progressions over time and it's, and it's.
Speaker 1:I think it's the beautiful thing about physio. Um, you know, from my end as a exercise scientist and strength and conditioning instead of high performance very few people come to me and go hey, I don't want to have back pain. Yeah, what do I need to do now? Yeah because then you go into a preventative mechanism and it's amazing, most people come and go my back's screwed, yeah. What do I do now?
Speaker 1:and I'm like well, I can't really help you, like I'll teach you how to move and we can identify the mechanical deficits. That probably got you here. But you need to go and see the clinicians to address the acute issue. Yeah, and then, once that's done, working with the clinician back and forth and that's sort of how the model works here is, you know, we get to to and fro with each other and manage acute symptoms, identify compensatory patterns and then ultimately have people build a system that is strong and robust and preventative. Yeah, and then we don't have to be reactive as practitioners and yeah, it's.
Speaker 1:You know, it's not 100 up every single time. From when we identify the issue. It's up and down a little bit. A little bit of treatment out we come. Yeah, it makes a big difference having that exercise-based approach because ultimately, that's the solution and the best thing. As you said, reliance and dependence on practitioners. It's the worst thing that someone can have 100%. Your career, your life might take you away from that person. It gives you the deep tissue massage and gives you pain relief. And what are you going to do now?
Speaker 2:absolutely, and that's what, um, I think that's what previous models relied on too much. It was, it was, um, you know, quick fix. It was, um, let's see you again once a week over the next six to eight weeks, um, and hope that we get some sort of improvement. Let's give you these exercises to do, you know, when you can do them at home without any guidance or any supervision. Hopefully you do them okay, exactly, and that's what's so good about this environment, because you're um, the patient is getting a lot more value out of treatment.
Speaker 2:So they're not just coming in for, uh, hands-on, they're coming in for, yeah, a little bit of hands-on to improve pain and try and work on some of those deficits. But then they're getting in the gym, they're getting some sort of movement in straight away. They can come in three to five times a week to access all the facilities and resources. They've got you guys there to look over them, make sure technique's good. They're not compensating um. So there's so many added benefits to having that, um, you know, community and also, um, that that membership approach, where they're getting not just physio, they're getting, um, the exercise approach and they're getting all different things added to that different hands-on and it's integrated.
Speaker 1:Yeah, exactly right, yeah, and it drives that adherence, it drives that confidence, which is ultimately the biggest thing you know is someone to be confident to move their body.
Speaker 2:Yeah, and it's probably the worst thing about an injury is it wrecks your confidence physically and it affects everything else as well, like your sleep, your nutrition, your relationships, all that stuff. So, you know, I think, if your health is good and you're, you're training well, um, you know, likelihood is everything else is going to be looking pretty good as well in terms of sleep and and work and nutrition and things.
Speaker 1:So, um, yeah, yeah absolutely, and it's it's an exciting direction.
Speaker 1:It's funny that um I guess you know physio particularly has has moved there yeah um and it's something I say to sort of all the guys that do the internship as exercise scientists, exercise physiologists is please don't chase the green grass of physio therapy. Like the physios need to depend on high quality practitioners that know what they're doing. Um, because if you can run an integrated approach and I can understand what you mean when there's a, you know, a compensatory pattern at the foot or the knee or the hip and we can work together to identify that and problem solve it, it just makes the customers or the patients experience so much more comforting and outcomes better, which is what's really exciting for people out there. You know they want to move well, they want to feel good, they want to be able to go on that run and play with grandkids and do all those little things.
Speaker 2:Yeah, but you've got to be confident in the way you're moving so that you can do those things without having to worry about them. Um, yeah, I think it's what we said we're talking about before, about the, the root cause of issues. So you know, if, um, if someone's having a knee complaint or they've got any injury, it's looking at the foot mechanics, it's looking at the hip and the back mechanics I know we've talked about this a lot before um, and often it won't be the knee that's actually the issue. It'll be something higher up. Or you know, with the foot or um, how they're loading um into certain ranges of movement or ranges that they're lacking um and that's affecting how the knee's being loaded as well. So, um, yeah, I think that gets missed a lot and it's it's good to look holistically, um, but also look higher up than the problem, look low down the problem and see if how that's moving as well, that joint, you know um treating the symptom or the cause.
Speaker 1:Lean after the cause? Yeah, absolutely, and and I guess that's the evolution, as you mentioned, of the physiotherapy as a practice is we're understanding that a little bit more. Yeah, if you were to cast your mind sort of five years time, ten years time, where do you see physiotherapy going?
Speaker 2:um, I think I'd like to think it continues to go down this path.
Speaker 2:I think that um, physio and snc and ep is merging more, which is great to see um, and it'll be interesting whether it'll be interesting to see whether universities start to bring out some sort of um, combined, combined degree, um, because I think that that would be a really good thing, um to come and I think it that's like, like you know, we talked about that's kind of where physio's heading as well, not just physio, ep as well. So, and I think, although it's great to have different disciplinaries, I think that's where, you know, potential barriers are to strength and conditioning coaches, because they can't treat acute injuries, and that's where the reliance on physios is. And then, you know, physios maybe don't have that knowledge of exercise prescription in the mid to long late stage rehab, yeah, and that's where we're really more reliant on you guys. And even acute phase as well in a lot of cases. So, um, I think if they can make some sort of merged degree, I think that'd be pretty cool that'd be outstanding.
Speaker 1:It's something I've sort of um? I think I've mentioned a few times on the podcast, but it's it's going to turn into the new medicine, not the new medicine. You know, medicine's always going to be a really important place, even within what we're talking about, but the level of understanding practitioners need now yeah, is pretty big yeah you know, I did a three-year undergrad and two years postgraduate masters. Yeah, and when I finished my masters it was the first time I was like, okay, I think I get it oh yeah, in my little area yeah if you could name three, um, different diagnosis for injuries at the ankle, I wouldn't know what they mean.
Speaker 1:Yet I've studied for five years, so you know, to do that comprehensive degree, as you're saying, or whatever it might be.
Speaker 1:I can go do physio, sure, and then have, you know, a finger in all the pies, but I think then what happens is I would lean towards physio because that's where I guess the private health models and the business models are really quite robust and they sit, as opposed to, you know, and that's what we're trying to work on is build a model that integrates it for one and then two, you know, lean on that preventative side and it's, I guess you know, whether we all become more specialized in our own little area and then depend on the other person, vice versa and it's kind of how we work here or having people have a comprehensive understanding. But the best thing for me is to be able to go okay, I can read a report that a um, you know, a surgeon's maybe sent through, chat to you about it and understand, cool, these are the areas that I need to focus on, yeah, but have a good understanding of what's going on. It's going to turn into a seven-year degree.
Speaker 2:it's going to turn into almost a decade of study, but it needs to yeah, and I think there's a lot that you can actually treat through physio, biomechanics, exercise, um prescription, um than what people realize. Um, and often you know people will go to the doctors for a quick fix or, you know, um try and um manage their pain and then, you know, get back to what they're doing as quickly as possible. But, um, I think, yeah, but you know, just through looking at biomechanics and trying to correct how people are moving and how they're loading, how they're loading exactly. So that's that's probably the biggest thing. So if we can, if we can work on that, then that will a lot of the time take away. 90 of issues uh, obviously there's, there's still cases where accidents happen. 100 and you've got to be aware of red flags and and things where, um, medical attention is is probably more indicated. But, yeah, a lot of the time things can be treated through um, through mechanics and loading.
Speaker 2:But the thing I was going to say as well, going back to what you said with um degree and study, like, I think the purpose of the degree is designed to get you a job right, but it's not necessarily going to teach you everything that you need to know. So, um, you know, as a new grad. I think it's important to understand that and it's it's going to be a continuous development over the years, um, and you have to really invest in your learning and yourself to to see that benefit. But it does come with time. So involving yourself with good, like-minded practitioners doing your um, your cpd and and your external stuff is is gonna um, it's going to benefit you long term and I think, like you know, it's only really the last two years when I've come to australia where I've developed that side of like functional anatomy and treating the root cause rather than the symptom. So, um, yeah, it's definitely something that you have to keep working on and it's as you said.
Speaker 1:It's sort of it's probably where it's gonna head yeah because there's the other side of like just the biochemical, metabolic wash up of good exercise programs, as you sort of alluded to. Yeah, you know, we spent a fair bit of time looking at that in my masters and just bouts of interval-based work or long, slow distance sort of stuff, and chemically, what effect that has on the body, the brain, the brain's interpretation of pain and symptom in general. And then suddenly we're into a treatment, rehabilitative, rehabilitative, preventative space. Yeah, by just doing a good bit of aerobic work, as long as then we're not biomechanically loading incorrectly in that aerobic work which is causing then an overload and an injury. And it's that integrated system which is, I think, from a health perspective, really exciting. Yeah, it's a big rock, it's a low-hanging fruit and it's something everybody needs to be on top of is moving regularly and getting really strong and not look at my muscles strong, but I'm loading each joint and each muscle and all the tissue appropriately for what it's for lack of a better term designed to be loaded for.
Speaker 1:What are the misconceptions around physiotherapy? You know a patient typically would walk in and expect what, and then when you give them this, hey, this is going to be a 10 to 12 week process. Yeah, because of the mechanical you know deficits that are actually causing that knee pain. Yeah, I can't just rub your quad. Yeah, it'll have a little effect, you'll feel good and then you'll be fine and then you'll be back to where you are, yeah, and then you'll get upset that the physio charged you this much. Yeah, what other sort of major misconceptions do you see? And then how do you think patients should be approaching injury and rehab with a physio, particularly when you said it's that overloading, poor mechanical sort of process or problem?
Speaker 2:I think, having an understanding that there isn't really a quick fix. So, yes, we can improve your pain and your range in that first session, but in order to get long lasting results and better buy in long term, we're gonna have to be consistent with rehab. We're gonna have to be the likelihood is coming into the gym three times a week to do your rehab, or even do it at home. But you're gonna have to have consistency. There's going to have to be a level of accountability on yourself as well and I think it's important for patients to have that understanding when they come in that you know it isn't always going to be a fast process.
Speaker 2:And if you think about as well, like, let's say, you know a 40-year-old lady with shoulder pain and she is a desk-based worker, so she's sort of sat for long periods and kind of in that kyphotic position and she's done that job for, let's say, 20 years and you know, maybe training load is a little bit lower. She's got kids, you know. Know she's got other responsibilities. Um, there's going to be quite a lot to unpack there in terms of not just like movement mechanics and um where she's loading, but also like um external factors, like stresses and and things like that. So, um yeah, we've got a, we've got to look at it as a big picture and it is going to take a little bit of time sometimes. So I think it's important for the patient to understand that.
Speaker 1:You mentioned sort of external factors, psychological stresses. Psychological stresses In your experience. How much of an influence does say a bout, if you will? Psychological stress um affect pain and symptom of injury? Um, for example, christmas time for some people is actually quite stressful. They've got to do a lot of travel, they've got family coming, they're going to organize a lot of stuff, or maybe someone's getting renos and they're just a little bit more compromised around their home where it's pretty much their safe space to down regulate. What have you sort of seen?
Speaker 2:yeah, I think, um, it's, I think, times of the year definitely a big stress, like, like you say, christmas, um, life events that we, you know we can't really plan for a lot of the time.
Speaker 2:So, um, I think that obviously stress is related to you know, your nervous system.
Speaker 2:So you, if you think of, like again, don't want to go into too much sort of detail, but think of parasympathetic, sympathetic nervous system, so like your rest and digest and your heightened state of you know, arousal, or fight or flight. Sometimes we can be stuck in that fight or flight stage for too long. We can be stuck in that fight or flight stage for too long. And then you know, when people present with acute injuries, um, that state of their nervous system is going to affect how they perceive pain, how they react to treatment, um, how they react to load in the gym. So, um, all those factors are really important to manage, but also, like, like we said, about stress, diet, sleep. That's why, in the initial consult, I like to get a good idea of how people are coping day to day, not just with training and injury, but other stuff as well, because that all plays a role in number one how they're going to react to treatment and also how aggressively we might approach that um the rehab.
Speaker 1:Um, okay, certain people might, might need a little bit more time is there a typical type of injury or sort of pain presentation that that you can probably go.
Speaker 2:Hey, this might be a little bit more stress related, not just mechanical stress and load, but lifestyle type stress um, yeah, I mean I'd have to look at more of the like the evidence base, but I think, like you know, your fibromyalgia and your um, your um, crohn's disease and um, those like sort of inflammatory diseases, um are things that might be a little bit more correlated with stress as well. Um, I think you're sort of acute musculoskeletal issues. There will be an element of stress that's, that's correlated to those, but I'd say it's more your autoimmune or your inflammatory disorders that are probably um more correlated with that, with lifestyles. Yeah, okay, um, yeah, yeah cool, okay, really interesting.
Speaker 1:Um, you know, obviously, exercise is a big part of your um approach. Yeah, with treatment and, as we've discussed the various reasons why, um, let's, you know, lean into a little bit more of your approach to exercise personally. Yeah, um, I guess you, as you said, you've come from a sports background and yeah, um, the biggest thing for me with physios is making sure your physio trains. Yeah, um, given that we're a gym and you know that's what we do, you got to walk the walk, yeah, um, so you know, currently you, you're training for hyrox and doing that sort of work. How did you get into that? And, uh, and I guess, what have you found from it?
Speaker 2:Yeah, so I think I've always been naturally a decent runner. So, as, like, football career came to an end and started to pick up more of the running, I entered my first half marathon in the UK and got a decent time and then moved over to australia fairly um, soon after that, um, and looked at like the next sort of event I could do, so I ended up signing up to um, uh, which one was melbourne? And then I did a gold coast half as well, um, and did pretty decent in both of those. Um, what's decent? I got one. My best time is 1.36. Okay, nice. So, yeah, I was pretty pleased with that, but I want to try and get to 1.30.
Speaker 2:So, still working towards that. So and I did my first marathon in Noosa last year and I got 3.42. So decent time We'll take that.
Speaker 2:A lot of learning lessons from that, from the marathon marathon, yeah, top three um pacing, okay, it was definitely a big one. So, um, going out a little bit too too fast um, as we all do. Um, fueling, I think, was a big learning curve as well. Um, I don't know. I've spoke to a couple of dietitians um who've given me some advice around that and things, and I've struggled with cramping as well. So, um, just magnesium and salts and sodium and things like that, and being a little bit more um diligent and consistent with those um is helpful.
Speaker 2:Um, and then I think, training volume um, in terms of you, the training plan that I stuck to was good, but I think I probably could have done a little bit more mileage and probably a less intense pace. So I think we're going to touch on this. But I think, in terms of training intensity, listening to your body a little bit more, sticking to the plan rather than always trying to go out both of the walls, you know 100% and pushing the needle a bit too much and then that's obviously led on to injuries and stuff.
Speaker 2:But anyway, going back to your question, high Rocks was kind of coming big as I was moving to Australia and the UK. I knew a couple of people doing it and then it's only really started, you know, popping off in Australia the last year, um. But I'd planned on doing one since the start of this year and there was a event in September, august, in Brisbane which I signed on to. A couple of my mates were doing it as well and I did the Gold Coast half in July and I was trying to train for both and again, training stimulus was probably a little bit too high and ended up picking up a stress fracture after the half marathon. So I got a good time but paid the price for it and then I ended up having to pull out of Brisbane. But I was still committed to doing a High Rock. So I did the one in Perth, did singles in Perth, which was awesome, and then obviously signed up to Melbourne next month. Oh cool.
Speaker 1:And so if you would briefly, for those that don't know what High Rocks is, summarize what it is, how would you describe it?
Speaker 2:So easiest way to think of high rocks um, it's basically um eight kilometers of running um, but broken down into 1k increments. In between each run you do a station. So there's also eight stations as well. Um, so you start off with with a 1k run um and then you'll go into a thousand meter skierg um, then another k run and then you'll go into a 1,000-meter ski erg, then another K run, and then it'll go like that for eight different stations. So it's broken up into a variety of different what we call functional movements. So you have sled push in there, you have sled pull. You have the row erg, you've got lunges, wall balls. You have the row row erg, you've got lunges, wall balls. So it's all different, a variety of different movements. But the idea of high rocks, I think, is to really fatigue your legs and get you working on tired legs. Basically, yeah, that's kind of how I'd explain it.
Speaker 1:Cool, because I guess the next one for me is like how important do you think a high rocks type program or competition is for people to train and, I guess, get motivated? For I'm one of the weirdos, I'm a very boring, fit person, if you will, if I can even consider myself that In that, you know, I don't really do any events, I don't really sign it, like I've done a half marathon this year and that was it.
Speaker 1:But in the future I'm like I'll just run 21k, I don't need to sign up for an event so um, but again I also understand that I'm a bit of an outlier and that I'm quite prepared to be do the boring stuff. Yeah, um, you know what sort of value and and I guess, what have you seen from a benefit perspective of not only yourself training for a high rocks type situation, but just for general population to be able to do something like that?
Speaker 2:Yeah, I think just having a general base level of fitness with yourself, probably If you can run 5K in a fairly decent time and you do some sort of strength training, your likelihood is you're going to do okay at high rocks. There's obviously a lot more to it, yeah, yeah. Yeah, you need to be training with more specificity. You need to do the lifts and the moves, the movements, and it's just the intensity really. So it's the volume and the intensity that needs practice. So building your aerobic capacity, getting used to working on fatigue legs but if you're a decent runner, I would say that it'd probably give you a little bit of advantage going into high rocks. It's not the be all and end all. Like I say, you still need to train. The sled push and the sled pull are pretty heavy, so you need to be able to move some weight. But if you've got a good level of base fitness and you're a decent runner, then you're generally going to do pretty well.
Speaker 1:You're going to do okay when do people come short, Like from an injury perspective and even a performance perspective? Where do people fall short in training for a higher ox-like event? What's sort of the most common things you'd see?
Speaker 2:I think um falling short on intensity. I would say so. People might run, they might do zone twos and zone threes and easy runs, but um, they probably will underestimate um the. I know I keep saying intensity but like the, the level of intensity and and the workout put that you're having to do in such a short space of time, um, typically you know the event. I mean, like people that are competing in a very high level are doing it in between 53 minutes and an hour, which is insane. But um, generally, you know one hour to one hour, 30 is considered. You know average times um, obviously close to one hour being a considered. You know average times um obviously close to one hour being a lot. You know pretty, pretty impressive, and then right up there one hour, 30, yeah, more towards average, but um, yeah, I think um go back to the question.
Speaker 2:It's it's making sure that you, the specificity is there, so you're doing the movements that you need to be doing, but then also you're you've got the intensity there. You know interval sessions um, you're doing the movements that you need to be doing, but then also you've got the intensity there. Interval sessions you're working at the pace and speed that you need to be doing on the day, or you desire splits that you wanna be putting out there and then also combining the two, so you're doing intervals into an exercise, back into intervals into another exercise. So you're replicating what you'd be doing on the day so it's not something that someone can just go.
Speaker 1:Oh yeah, I train and I'm going to sign up to this weekend, kind of thing uh, probably not it would advise against yeah, I don't think that's the best idea, um, but yeah, I think there's an element.
Speaker 2:There needs to be an element of slight specificity around training for it.
Speaker 1:Yeah yeah, yeah, and it's sort of um, I I guess it's something that a lot of people kind of make the mistake with, and you know, I see it all the time and it's something that kind of gripes me. Is this no, I could do it, you know, you can just go for it, you'll work it, it'll be fine.
Speaker 2:Yeah.
Speaker 1:And not only do people wash up with a ton of injuries you've had a stress fracture yourself, but worse than that injuries. You've had a stress fracture yourself, but worse than that, um it, it really kind of um it compromises. I guess that that whole adherence, you know thing, which probably is the most important thing, it'll a thing, it'll, it'll trump any one-off hard six-week training program effort. Yeah, it's gradually building a system that can handle you know tons of load.
Speaker 2:I think like the biggest and most important variable is consistency. So and that's for rehab, that's for anything, 100. So if you can maintain some level of consistency and stay injury free, you're on to a winner. And the way that you're going to do that is by adherence. You know, sticking to a training plan, um, you know, not sort of over training and thinking that you need to do. You know more is better, it's, it's um. You know, those days that are zone two easy runs, sticking to your zone two easy run. The days that are more intense high rock session, high rock session and then the days that you need to do your strength training, where you know it's a little bit heavier and more for kind of injury prevention um, doing that as well. So yeah, I think sticking to a plan is really important and you're not always going to get better.
Speaker 1:You know not every training session is going to be better than the last one.
Speaker 2:You're going to be worse for a few weeks sometimes 100 and um, I think that's a normal part of training. You know it goes to motivation as well and discipline. You've got to stay consistent to the plan despite the. You know setbacks and how you feel and things like that sometimes. So, yeah, I think sticking to a plan is really important.
Speaker 1:Yeah, and it's that sort of adage of you know, we always tend to get philosophical with it, but it's almost being boring, it's just being prepared to go. Okay. I always tend to get philosophical with it, but it's almost being boring, it's just being prepared to go. Okay, I'm going to do. The goal is to turn up and do what's prescribed and if I can do that consistently, perpetually.
Speaker 2:Yeah, likely the result's going to come.
Speaker 1:The result? Oh cool, I'll take the result, but that's not the focus. The focus is adherence. Yeah, yeah, which sort? Not the focus. The focus is adherence, yeah, yeah. Um, which sort of brings up? And you know, we put a little poll out and we're going to choose one of the one of the instagram questions we got asked and someone sort of brought up the the david goggins, ned brockman, go hard and I could just keep going. Push through it. Kind of philosophy for the average person and being a therapist that has to deal with people that get injuries a lot, um, what would you say to?
Speaker 2:that, um, I'd say that approach is probably not the best for the majority of people. Um, I think it's like majorly impressive um, and yeah, pretty awesome. I just saw kind of nev brockman's um running around um the uh, I think it was olympic stadium, wasn't?
Speaker 2:it yeah it does something crazy um amount of k's. But, um, I think for the, for the average person, it's about building sustainability and something that they can stick to. So, um, for majority of people it's not realistic to um be working to that intensity every day, especially with work and other stresses that are going on. So it's about building habits that people can stick to and that aren't going to increase risk of injury. So if we ramp up training, load and stimulus, then risk of injury is going to go right up, especially if they're an untrained individual. So we need to keep it fairly low level initially and then gradually build it up. So, um, and accountability again. So it's it's how many days they can commit to um, um, it's, it's finding things that they enjoy as well and they're, you know, those things combined are going to build a plan that's going to be more sustainable for people.
Speaker 1:And there's that sustainability. They might provide inspiration those profiles and personalities, but the inspiration needs to, I guess, generate the motivation to start yeah, and then, if you need to refer back to that, to continue to adhere, not break any records, not do anything too crazy, and be able to look back in 12 months and go, yeah, I didn't miss a week. Yeah, or you know, I only had two inconsistent weeks. Yeah, outside of that, I was pretty great adhering to what I wanted to yeah, that's, that's a real one.
Speaker 2:And then, and you know, um decrease, decreasing, decreasing risk of injury as well, um and uh, if we can go that, that 12 months where someone's been really adherent to a plan and they've not got injured, that's um a big win as well.
Speaker 1:It shows that they've responded really well to training, um, and yeah, fantastic well, I'm sure there's a number of little bits that we can dive into within that, but I think from a generalized message, it's really important for people to understand. You know, both from a rehabilitation perspective it's moving in that direction, mechanically and, yeah, being able to build a system that's preventative, um and and that can handle load and doesn't have as much leakage, so that from a force perspective at least, so that when you do trip and fall or you do roll the ankle it's a minor sprain bit of you know two or three weeks of treatment rather than a full-blown surgery, yeah, and you know a 12 to 16-week rehab sort of process.
Speaker 2:Yeah, and it's like you know, like we see a lot of the time where people will have a sprained ankle. They maybe won't seek treatment, they'll manage it themselves. They get back playing because they've managed to reduce swelling and they've got a little bit of range back, and then three weeks later they'll roll it again and that's where injuries can progress. So I think it's important to get on top of the little things, exactly.
Speaker 1:Yeah, I love it All right. Well, mate, if someone's got that little niggle and they want to book in with you, jump in on the website and getting in touch and being prepared to look at the whole system. I think it's a really important thing for people to understand 100%. Yeah, yeah, too good. I guess that sort of understanding from a depth and breadth is really important and really valuable. And you know your approach to physio.
Speaker 1:It's not just going to be a quick 30-minute get in and get out. You know you're going to challenge people to say, hey, listen, going to be a quick 30 minute get in and get out. You know we're going to. You're going to challenge people to say, hey, listen, if you really want to sort this out. Yeah, approach it with a bit more of a longer view. Yeah, invest the time and the money up front so that you can have a system that is much more independent and strong and more affordable and time effective. Uh, down the track, I think it's the biggest thing for people to understand. It's the evolution of the model physiotherapy wise. So, yeah, so, man, I love it. I love where it's heading, yeah, so thank you very much for your time today, mate. No doubt we'll dive into a bit more detail on some of these little areas that we've touched on, but looking forward to just working with you in the next couple of months and years and having you part of the team, mate, yeah awesome Cheers.
Speaker 1:Thanks for listening to today's episode. Thanks for listening to today's episode. For more regular insights into SOF, be sure to check us out on Instagram or Facebook, or visit our website at scienceoffitnesscomau. Once again, we thank you for tuning in to the Science of Fitness podcast.