Motion Forword - Words of a Therapist - No 13

Welcome to Motion Forword - Words of a Therapist! Issue 13!

Motion Forword is about discussing the combined benefits of movement with a positive mental attitude. Using my personal/professional experiences, evidence-based research and some of your own experiences. 

Bringing some hope, positivity, happiness and maybe usefulness to those, perhaps like yourself, that needs a pick me up. 

Something about me - Running Season!

When I first started this blog, I was running regularly. I surprised myself against my own biases that I could enjoy running. Through the winter months and during hockey season I couldn’t keep it up. 

But I have started again! This month I have ran 4 x 5kms around my new home of Hedge End. 

Having not just ran since November, I knew the first run would be tough. It took me 29:52 and I had to take a seat after 1km as my back was sore. 7:49 off my personal best. But I knew this would be the case and coming back to my principles of gradual exposure and consistency would get me through. 

My best run since has been 26:02. 3 minutes and 50 seconds faster with less discomfort. But a gradual improvement in my time I was happy with (as you may be able to tell from my face and hair!). We can measure improvement in all sorts of ways. Not just our time/speed. For me, being able to run comfortably without my back pain and feeling the ache in my calves instead is an improvement! Let’s see if I can keep up the running during a, hopefully, sunny August! 

Something for you - Ultra-processed Food

We’ve all heard of processed food. Milk to make cheese and yoghurt, wheat to make bread and pasta, even our meat is processed as it has to be minced, cut and smushed into sausages and kebabs!

But until earlier this year I had never heard of ultra-processed food. 

Ultra-processed food, or UPF, is described by Dr Chris van Tulleken in his book Ultra-processed People as not really being food at all… It is a ‘food-like substance’. Taking something that was food, processed it, altered it, re-engineered it by adding things like emulsifiers, stabilisers and flavourings to make it palatable, tasty and addictive. Not only that, but it prolongs the shelf life, reduces the cost of food by reducing waste and makes it very cheap to buy. 

So what's the bad news? Companies usually have one thing in mind above all else… profit. So for companies that sell UPFs they want us, the consumer, to buy more. Therefore they have purposefully designed their products to be addictive. Usually at the cost of nutritional value. 

This means UPFs are giving us more calories for less, if any, nutritional benefit. Also described as ‘empty calories’. Dr van Tulleken creates a very persuasive argument as how this socioeconomic and cultural shift has lead to a lot of the obesity crisis we see in modern Western societies. He gives a disturbing account of the ‘Nestle ship’ that started targeting markets in Brazil, a country previously with low levels of obesity, heart disease and diabetes, which has been heavily linked to the obesity crisis there.

If you are wondering how to know if something is UPF, it is relatively simple:

Dr van Tulleken’s rule of thumb was if any of the ingredients included in the product are not something you would have in your kitchen cabinet (or perhaps find hard to pronounce!), then it is likely UPF. Things like cellulose, dextrose, maltodextrin, xanthan gum, gellan gum and glucose/fructose corn syrup (this is not an exhaustive list).

Another trick to spotting UPFs is if they require heavy marketing and advertising on TV or on the packaging to promote how ‘good for the body’ it is for you. Cereals are particularly guilty of this with all the vitamins and minerals they’ve had to ‘add back into it’ (a form of ultra-processing) to make it healthy. As Dr van Tulleken put it: ‘you’ll never see adverts on broccoli saying how healthy it is for you, it just is.’

The main take away from his book is that UPF is everywhere. It’s not going anywhere anytime soon. But, if we understand what this ‘food’ is doing to our bodies: making us gain weight, affecting our hormone regulation, making us addicted to it, we can make conscious decisions to start moving away from it or making healthier choices. 

I still enjoy my biscuits, but I’ve stopped having UPF bread and oat milk (yes there is gellan gum in some oat milk brands) and pay more attention to how much of something I am eating. When I pay attention, I realise I can be mindlessly eating UPF when I’m not hungry. It makes me stop and think:

 ‘Do I really want to eat that?’ Often the answer is no. 

FYI: Ultra-processed People by Dr Chris van Tulleken is available on Spotify to listen to!

A Story - Overcoming the Pain Barrier

Harry is a 35 year old husband with two young children. He works long 12 hour shifts of two days on and two nights on. He enjoys keeping active going to the gym 3x a week, boxing and golf when the weather allows. Back in April this year, Harry came to see me because his back was spasming over the last 3-4 months and it was getting in the way of his sports and activities. He described how he was more worried about the consequences of his sports on his back rather than actually enjoying them. 

A week prior to Harry attending he also felt that something ‘went’ and having had a disc herniation in the past, it prompted him to finally see someone. 

Important Note: Often people describe how their back ‘goes’ or ‘went’. I’m not sure we fully understand what we mean by this when we say it (as I’m not even sure we have the vocabulary to describe these feelings) but often it involves a sharp sudden pain, often out of the blue that can make us feel unsteady, weak and cautious of movement. Subsequently it can, but not always, be followed by nagging discomfort and/or ‘weakness’. Despite how it may feel and how we describe it, it is very very unlikely that the spine becomes out of place. As for spinal breaks/fractures and disc herniations (slipped discs) these only occur in ~1% and 5% of back pain cases respectively. 

Fortunately for Harry, after case history taking and examination, there didn’t seem to be any obvious signs or symptoms of breaks or disc herniations. This suggested that his back pain was not the ‘quick-refer-him-to-the-doctors/ A&E’-type but more the ‘this-pain-sucks-but-we-can-get-it-better’-type. 

Initially, we stopped doing ‘hinge’ movements, such as deadlifts, at the gym as this seemed to aggravate his back. I focused on easing any tension in the lower back and glutes and improving quadricep flexibility.

In the weeks following as he tried to reintroduce these movements we discovered that his left hamstring wasn’t as strong as his right which could have been contributing to his more left sided lower back pain. We started him on some hamstring isolation exercises to bring this area back up to speed. 

By early June, Harry had returned to normal gym routines with back squats and single leg Romanian Deadlifts feeling fine with his left hamstring strength feeling almost as good as his right. 

Another month later in July he described some discomfort and pain but not all that much and not stopping him anymore and his hamstrings felt equally strong.

Now all he needs is some decent weather to allow him to enjoy his golf! Thanks Harry, it's been a pleasure. 

Thanks for reading.

Until next month…Motion Forword ⏩⏩

Nathan