IronMan 70.3 Dun Laoghaire

This year I was able to be, again, involved in the Dublin Ironman event.  The Dublin Ironman is a half Ironman and the route normally involved entering the Irish sea for the swim at DunLaoghaire. After a 1.9 km swim participants will transition over to the bike section which involves a 90 km cycle up the Wicklow mountains. The last section is a 21.1 km run back towards and around DunLaoghaire finishing close to the starting point of the race. If this is a half Ironman you can imagine how physically exhausting and mentally challenging full events are as well as something as, to be frank crazy as the Kona Ironman race in Hawaii, which is a 3.86 km swim, 180.25 km cycle and 42.2 km run in searing heat and hostile terrain.

Those in the event range from professionals, seasoned veterans, triathlon club members, endurance sport activists and then some of the most normal people who decided this was to be their new obsession for the coming year. Prior to race day I spent the 2 days beforehand dealing with various cases and individuals with issues ranging from simple checks on niggles, strapping, soft tissue work and full on consultations and real down to the wire decisions regarding if a certain person could compete in the race. The two days beforehand were long and tiring but being able to prepare so many people for such an event felt great.

On the race day myself and seven other therapists set ourselves up well before the end of the race was even in site. our first patient of the day had injured themselves in the water which was incredibly choppy on the day. The slow and steady stream of people who had injured themselves during the race and those professionals who had finished the race in an inhuman time suddenly became droves of being being accessed, looking for soft tissue work and even a few being stretch out because the could no longer do it themselves as a result of exhaustion. From 8:00 am in he morning until nearly 5:30 pm we provided care to a large number of the participants.

The Ironman event is such an endurance event that even the therapists are exhausted after it all. The event makes you feel like you can really do any kind of event. For all the people who loved and hated the training process you were hard pressed to find a single participant who wasn’t happy that they choose to compete, maybe only a few disgruntled partners and family members not as enthralled in the sport having to wait an entire day for the event. Yet the comradery expressed in the event and the dedication needed and shown by so many people, you can only appreciate and admire all those who decided to undertake the event.

This was my second year involved with the Ironman, in different roles between both roles and I definitely hope to involved again in the future especially with events such as the first full Ironman event being held in Cork in 2019 and the Hell of the West triathlon which I have been persuaded to train and enter next year.

 

 

 

 

Faculty of Sports & Exercise Medicine Conference 2018

Last week I attended the Faculty of Sports & Exercise Medicine (FSEM) conference at the Royal College of Surgeons Ireland. This year the Conference had a focus point in the return to play post shoulder injury. For those of you that don’t know what FSEM is – it’s an annual gathering of doctors,  surgeons, researchers, physiotherapists, and of course athletic therapists, presenting findings from studies as well as new methods of rehabilitation and surgical interventions to conditions and injuries. We basically come together to discuss the latest developments in the field of physical health. This allows for a body of knowledge, that would normally never be dispersed to be tangible for all.

There was some savage speakers this year. With the likes of Eanna Falvy, the Irish rugby team doctor who spoke about on field management and the occurrence of shoulder injuries in rugby. He interestingly   spoke about how rugby has evolved from its beginnings to something barely comparable to what it once was pre professional era. Body size, strength, play style and aggression have all lead to an increase in injuries especially those in the shoulder where the ideal of aggressive rugby in the breakdown via the poaching of a ball and active clear out has lead to an increase in shoulder injuries. He also spoke of the need to prepare athletes for the season ahead of them as you cannot prepare the athlete mid season, when training load and type are dictated by schedules and physical conditions there and then.

Edel Fanning described the return to play for contact athletes after shoulder stabilisation surgery. She described how the loading of the uninjured side and reductions in strength from one side to another or from internal to external rotators can make it difficult for athletes to return to a position where equilibrium is achieved once more. She also showed how rather than basing rehab plans off pre described time frames and rather base it off objective and measurable improvements from the athlete.

Nick Grantham described a very different int of view coming from a strength and conditioning background but showing how no one field within health and fitness is isolated. He described the strength, power and honestly versatility of an athletes shoulder using downhill biking as an example and showing how specialised a certain activity can make an athlete. He described rehab in a far less rose tinted light than it is often portrayed with the focus being placed on the avilable resoucrces and pjysical attributes being available to each and every specific athlete. We often to much on the on the structures that have become injured rather than the reason why they have become injured sometimes trapping ourselves in a loop of repeated returns and failures of tissues.

Probably my favorite piece of information from the entire conference which states that essentially just following information previously recorded and not catering rehab as an individual experience will not produce outcomes where rehabilitation’s effectiveness is maximised. Essentially, everything is situational and so you cannot paint every injury or condition with the same paint brush. Sean O’ Brien also spoke on his professional career and often as therapists we can forget but the athlete or patients point of view regarding their injury and rehab.

In all i really thought the conference was great and a huge amount of knowledge and opinions were expressed. Not all pieces were directly relatable to every field of expertise but something to better your skills as a practitioner  was present in nearly every talk, workshop or conversation on the day.

Wellfest 2018

So this year I was able to make my way to Wellfest. For anyone who doesn’t know what Wellfest is, it is essentially a two day festival where fitness and health in most of its forms gets a chance to show what its made of and allow people to experience it. Im a little late talking about it as it was nearly 4 months ago now, but I still think it is an event worth talking about and how it reflects Ireland right now. Wellfest has only been running fora couple of years now but has already become an event where thousands of people attend over two days. The event had a large number of successful and big name fitness and health enthusiasts such as Joe Wicks, Davina McCall, Simone de la Rue, Hazel Wallace and other home grown talents such as Movement 101 and Gerry Hussey. These individuals represent all very different aspects to modern health, from yoga, classes, diets, mobility and even psychology. The event represents perfectly how health and fitness has become the fasting growing industry in Ireland. Be it food, clothing, supplements or health related ideals, Wellfest acts as both a showcase to well established and start up health and fitness related businesses. Wellfest is a very unique event in the sense that fitness and its importance is given a very large and obvious spotlight.

Fitness in Ireland is going through its renaissance period where more gyms, clubs and fitness related businesses are springing up constantly. As time has gone on individual gyms within large urban areas have moved away from the old style of old school, super functional gym that may not have been what anyone could be called pretty. The new model of gym are style functional but they have now needed to be become apart of a larger industry where the best are the best for a reason. The model is perfectly shown in Flyfit and Raw gyms where near 356 day memberships, in several places and functional machinery and equipment with a pleasing aesthetic controlled by people normally with a background normally rooted in a far greater understanding of human physiology and anatomy has gained them some of the greatest success in the Irish fitness scene. Other people then such as the Happy Pear who have turned lifestyle into a successful business have shown that the fitness industry is not solely about gyms and sports clubs anymore.

This is then showcased in really only one event altogether in Ireland. You have yoga classes being held beside mindfulness talks, across from cooking tutorials and mobility classes while a HIT class it booming out across the field and various entrepreneurs passionately push their products and visions. You have people who do not share the same points of view and would rarely get a chance to speak with anyone who holds a different opinion literally sharing the space beside one another discussing their points of view and where they hope they take their own ideals in the future. It is definitely a unique event and it still also shows the growing and somewhat childish side of Ireland where we haven’t yet come to terms with the fitness industry and our knowledge of it. You have a fairly young demographic at the event but it does also show how it is continuously changing and trying to encourage a greater mixture of people to feel comfortable in the industry. This could be seen in the people who brought their start ups tho the event and the addition of a kids section for parents at the event.

Welfest does definitely show the best parts of what the health and fitness industry has to over as well as the growth of this industry in Ireland. The main question is how the event will grow, what direction they’ll try and take it and how health and fitness will mature and grow in Ireland after such an intense period of success and growth best described in an event such as Wellfest who has gone from strength to strength.

What does Pain mean to you

What does pain mean to you?

Pain is always a very difficult topic to discuss. So many people describe pain in different ways and pain itself and the idea of what it truly is, how its perceived and what we should do when we experience, especially in terms of injuries or activity, seems to change on a regular basis. For a long time therapists use to chase the pain finding the symptoms of pain, leading to initial short term improvements but never caused the pain to fully leave or the true cause to be chased down and dealt with. We as humans became heavily dependent on getting rid of pain so we could function long enough to compete or just get through the day. this lead to many people suffering in the long term, with tissues being damaged and movement patterns leading to injuries merely being ignored instead of changed.  The international association for the study of pain describe pain as “An unpleasant sensory and emotional experience associated or as a result of actual or potential tissue damage”.

In certain sports they have become dependent on the idea of deal with the pain to allow an individual to compete for a long enough period and then to essentially come off injured. American Football is the worst culprit for this and still continues to chase the symptoms instead of the cause.  Sadly leading to the abuse of NSAIDS, painkillers normally injected into an affected area but the overuse of which can cause tissue degeneration. Other sports have already moved away from such methods but often we find ourselves stuck in a situation where we have an athlete asking to play and willing to push through an injury, coaches balancing their want for player safety and need to produce results and therapists stuck between the want of their patient and the knowledge of what is truly occurring to them and what will occur with further stress.

People often want a quick solution and don’t want the hassle of consistent or prolonged rehab or activity when a quick solution of masking the pain will allow them to do the same. America alone spends $323 billion dollar in 2015 on pain medication with it likely to increase to $450 billion by 2021. Obviously this includes individuals taking pain medication for conditions that cannot be cured through rehabilitation and activity but a huge sum of this money is towards people suffering chronic but curable pain as well acute pain due to musculoskeletal injuries or tension.  Looking then to the entire world the money spent on short term relief of pain is astronomical in comparison to the price of what rehabilitation or increased levels of activity cost in the long run. 

The issue with always masking or reducing pain is that pain is not always a bad thing. Pain normally allows for us to find the cause or the issue or the reason behind injuries. It also allows us to prevent ourselves from returning to a position where our tissues cannot, at that time, deal with the loading asked of them.  Pain is a way for your body to protect itself by trying to force us out of positions or activities that is causing damage or this sensation to be produced. Pain not only causes physical changes but mental as both are interlinked to a level where we often cannot control it. Pain will lead to physical change which will lead to mental changes in the form of a change in movement patterns and the reaction to fear. This is often an unconscious factor but often leads to prolonged changes in the way we function. We can also become over saturated with pain meaning we can become hypersensitive to it or almost numb to its presence, both as bad as the other in functional terms.

Pain can illicit a response from several systems including the motor, endocrine, sympathetic nervous and immune system.  Pain also does not always mean tissue damage in the sense of an injury.  For muscle and tissue to correctly develop it has to be broken down and built up, with the correct loading for more avascular tissues. Pain is also exceedingly selective with pain producing a different  response or level of pain depending on its cause or placement of injury depending on the activities of each person e.g. knee pain in an Olympic weight lifter vs a musician. Our body has specific healing phases with each tissue type having a different time-frame of healing. Masking the pain or introducing exterior stimuli to reduce pain before these stages are complete to an excessive level can cause issues where a premature return to activity occurs several times causing chronic problems.

Our biggest issue stems from a mixture of refusing to spend the time needed on correct rehab to produce long standing results and our lives revolving around excessively sedentary lifestyles. We only need to be active in the correct manor for short periods each day but we find it difficult to entertain the idea of it. Time seems to be the real killer with us normally not having the patience or willingness to give time over to what seems hard to make things easy in the long run, instead doing what is easy and maintaining what is wrong for the long run.

Trying to Set Up a Business

Recently I have been trying to find myself a place to start my work out of. This is always a difficult scenario for anyone hoping to start working for themselves. We spend so long becoming experts in our own fields, while learning this and taking instruction from others, that we often don’t learn more practical skills such as how to do taxes, how to sort our accounts and how to approach setting up a business. Sometimes we become so single minded that we often forget that we aren’t going to simply be able to apply to a single workplace and get that job we want or be able to find the perfect place to set ourselves up with the right number of clients and atmosphere in the area.

Starting a business starts with a lot smaller scale work which I actually find much harder. Setting up various contact pieces such as a website, Facebook page and getting in contact with people, handing out leaflets and business cards. So essentially social aspects and foundations to the business itself. I am not the best when it comes to going in to people and chatting to them about business. Not the actual talking aspect but the part in which you initiate the conversation or send off that first message. This is the same for many people who also find these interactions difficult.

Starting this has really made me far more aware of how much more I still have to learn. Dealing with patients and their injuries is now my normality. Dealing with having to find a space to work out of, put funds together to pay for it, pay for necessary equipment, getting a business card put together and printed, advertising and then keeping track of all that while sorting out insurance and deciding what type of business I should become not so much. These were not things that were going through my head as I walked up a small flight of stairs to receive my degree. I had ideas of having a small holiday and the apply to a couple of clinics and teams and start off from there. That didn’t quite play out the way it did in my head. If you are lucky and skilled enough to find work in an established clinic, you are definitely in a good place and your work probably reflects that you deserve it as well. If you haven’t then its a case of finding out exactly where you stand in this industry and what you do with yourself and that’s a big question.

I had never initially intended to go off and try to set myself up from the beginning. I did not think I needed business cards, a website or anything that would be something for myself. I imagined a few years of working in a fairly safe position, working hard and then maybe going off on my own and after a few years of learning everything I needed be able to set myself up hassle free. I was fairly naive when I see it written in front of me. People told me various different things like “It’ll all happen in time” or “Don’t worry these things sort themselves”, these are not phrases that build confidence. Then someone who is now my business partner and pretty much does all the hard slog to allow me actually do what I want to do simply asked me”Why aren’t you setting up your own space and work for yourself”. It was such a blunt and harmless question but I couldn’t think of an answer that didn’t revolve around “Well people normally work for someone established first and then try and sort themselves out”, except that’s what I thought and I was wrong, as much as that pains my ego.

So here I am attempting to establish myself as a real adult, I mean therapist. With my own space and equipment, with all the social media pieces and contact foundations and I still haven’t really started as many people have already told me, who understand how business really is, that “You never stop, you never finish, you merely keep growing or you fail”. Hearing that actually makes me nervous far more than I ever thought because the idea of failing seems horrible but realistically how would anyone learn if they didn’t fail and try again. Or as my business partner said “If you fail when you’re this small at least not that many people will notice”, which made them laugh and nearly made me hyper ventilate. So here I am panicking over things I shouldn’t and then not even being worried about the actual work itself. I am probably going to end up making everyone a nervous wreck around me until I actually have that very first patient and then after that I’ll be hooked.

Yet if I could give anyone who wants to open up their own clinic or some form of work revolving around health care, look into how businesses actually function, look into social media and how to talk to people and if possible find someone patient enough to help and put up with you because and speaking from experience you will freak out and only afterwards will you wonder why. Im still not really in a position to give advice as I am pretty much as big a noob at all this as there could be but its a case of swallowing all that ego and fear and being ok with a few set backs as long as you keep moving foraward.