Back Pain Clinic: 21/10/20 – 2 hours – Session 1
This was the 1st of 6 session. Another student and I met with John Downey who facilitated the session. Also in attendance was an Osteopath who was researching for her PHD. Delegates are referred from the NHS consultants following other treatments either not working or not being viable. A combination of people negative and positive MRI results but all with chronic back pain. The group was very small, only 5 were referred and only 3 arrived.
I really enjoyed with session and felt very familiar in the setting. Initially I wanted to listen and watch John to learn how he was facilitating the group discussions and pitching the information. After the first hour I felt very comfortable to engage more with the group. We then broke out into pairs and worked through some very light mobility and stabilisation work. My father has been a sufferer of chronic back pain for 20 years so I felt I could really empathise with the ladies on the course. I feel very excited for the next session to see what I can learn and how far we improve the situation of the group.
Back Pain Clinic: 22/10/20 – 2 hours – Session 2
Today the session looked at recapping on last week and catchup regarding the steps and exercises and how the participants found them. Exploring the pain cycle and nordic walking benefits and techniques and finally a step test. Only 2 of the ladies returned this week and both were initially a little apprehensive, they commented that they’d experienced pain following the introduction of the exercises. Once we’d discussed what the pain could be attirbuted to and reassured them, they relaxed and become more engaged. They both did well with the step test and nordic walking without too much aggravation.
Both ladies have a good attitude but seem to be unsure what the best things to do are as they’ve been given conflicting information previously. For example, one lady with sciatica was informed that she should not go into extension, which completely contradicts the research by McKenzie, where repeated extension and centralise the pain. I’m keen to get these ladies into the clinic as I believe some rehab will support them in addition to the course content which looks more at an holistic approach considering all biopsychosocial factors. However, I do not want to get ahead of myself out the clinic.
Back Pain Clinic: 04/11/20 – 2 hours – Session 3
This week we again only had 2 participants on the course. We’d been informed that the participant had decided to continue with the process and is seeking surgical intervention instead. This week, Sam led the session as John had childcare issues. Sam had a very different approach and invited Gemma and I get get a lot more involved in the talks and especially the exercise. The ladies seemed a lot more positive too following the previous weeks activity. This week we covered ‘McGill’s Big 3’ core exercises, we also introduced Band exercises & went to the Gym for the first time to introduce cardio machines,
This was an enjoyable session because of the positivity in the room and the level of involvement I had. I feel like the sessions are now starting to have a genuine positive impact on the ladies involved. I was very happy to demonstrate and coach exercises both in the classroom and the gym. I could see the fear washing off of the ladies with every successful, pain free repetition. Offering slight words of encouragement and reassurance seem to make the world of difference the fear avoidance these ladies have previously had.
One You Plymouth: 09/11/2020 – 1.5 hours – Session 1
This was an observation of ‘One You Plymouth’, invited to by Sam following participation in the Back Pain Clinic. This was the 1st of 4 x 2 hour sessions delivered to a group of 6 individuals who have recently been diagnosed with illnesses such as type 2 diabetes or COPD. The session was primarily geared toward around promoting physical activity and healthy eating to a group, who were very openly reluctant to do so. A few delegates said very little but the ones who were forthcoming were extremely honest about their unwillingness to do physical activity.
For the most part, the information provided was to me very basic. Which served as a reminder how little many people know. Also how even basic movement or any movement can seem unrealistic to some people. This was an online group so I was sat with camera and mic off, which as times was difficult as on many occasions I felt I some input to offer but had to remind myself It was just an observation. It would be great maybe share some ideas with Sam for future sessions.
Back Pain Clinic: 11/11/20 – 2 hours – Session 4
John was back week. Again, the ladies seemed to be very upbeat and grateful to be involved and also having such a small group, which meant it was very tailored to their requirements. Following, a catch up we discussed different mods of exercise, including the differences between physical activity and planned, progressive exercise and the benefits of resistance training. We discussed barriers and we can overcome them. Nutrition was covered. We spend much longer in the gym this week and looked at resistance training.
John has a different style than Sam, both are great but he takes the lead a lot more and offers a lot more in depth information. I find myself listening and learning a lot more than talking which has pro’s and con’s. I contribute when it’s appropriate but John has great knowledge and holds the room very well. The ladies again, were in good form and were really excited to get back in the gym. We did an good warm up that involved some challenging movements such as split squats and bilateral farmers walks. We them used Leg Press, Chest Press and Seated Row. All exercises were completed without pain and further built the confidence of the group.
One You Plymouth: 16/11/2020 – 1.5 hours – Session 2
This week saw a few less participants following the first week. The focus of this session was based around nutrition, specifically the governments eat well plate. The eat well plate was introduced in 2007 so I was a little disappointed to see it still being provided as best advice. That said, the team did a good job of explaining that it is slightly outdated and there are other ways of successfully managing your intake of food. Primarily the session was around educating the participants to make better decisions for themselves. Whether the willingness of making these positive changes are there, remains to be seen.
One participant did comment on the frustration of how confusing companies make their labelling and marketing. The sad truth is, these companies aren’t out to support the health of our nation, only to extract it’s money through selling products.
One You Plymouth: 23/11/2020 – 1 hours – Session 3
Once again, there was a reduction in participation numbers. The focus this week was around the importance of sleep and managing stress. The participants were invited to offer their own experiences with quality of sleep and perceived levels of stress. It seemed that poor health and poor sleep go hand in hand for this group. They expressed difficulties sleeping and levels of stress.
The team talked them through good sleep hygiene. Covering screen use before or in bed, food and alcohol before bed, noise and temperature. The group seemed receptive to his advice. I also need to improve in these areas so made quite a few notes on this one.
Back Pain Clinic: 11/11/20 – 2 hours – Session 6
This was the final session with the remaining two participant. It was pretty much entirely a gym based offering consolidation and direction with their new knowledge of training and their own capabilities. Both ladies had done incredibly well and were extremely grateful to all of us for our help. Ultimately we did very little in way of physical therapy. It was all confidence building and education, which sadly had seemed to be lacking in their previous healthcare visits. I shows how important mindset, education and pain management is when it comes to recovering from injury, especially chronic conditions.
One You Plymouth: 16/11/2020 – 1.5 hours – Session 4
This was the final session for the few remaining participants. The focus was consolidation consolidation of what had been covered in previous weeks and agreement and commitment to their SMART goals. With this being entirely online, there was very little accountability and no real follow up. I didn’t feel this group were as engaged or optimistic as the face to face group seen in the back pain clinic. They did seem to retain information provided and definitely gained something some their attendance. But these individuals had such a long way to go to be considered healthy, I wasn’t convinced this programme was enough to get them firmly on the path. For me, it was a reminded that despite hoe demotivated some people may seem in the gym, just being in the gym is a huge step in the right direction.