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LINKS FROM VIDEO

Vid on dealing with fat comments
Vid on HAES® and Bariatric Surgery
Vid on psychology of injury rehab
Vid on positive relationship with exercise
APA Choose Physio site: www.choose.physio

SHOW NOTES

• Viewer question on motivation to do physiotherapy exercises. [2:18]
• How to find your personal ‘why’. [3:39]
• Viewing physio exercises as a ‘performance enhancer’. [5:55]
• Viewing physio exercises as ‘prehab’. [6:42]
• Doing ‘relaxed rehab’. [7:26]
• On the combining physio with a workout. [10:12]
• On being perfectionistic with your physio exercises. [11:52]
• On when to see your physiotherapist. [13:40]
• About the Australian Physiotherapy Association find a physio service. [14:29]
• How to complement your physio support. [15:15]
• How often should I see my physio? [16:11]
• Parting thoughts (becoming a physio’s dream!) [16:45]

TRANSCRIPT

Good day, everyone. It’s Glenn Mackintosh, your exercise psychologist. Today we’re answering a great question on turning those sometimes annoying physiotherapy exercises into regular habits. Hey, guys. Welcome to Thursday Therapy. I hope you’re doing well. We’re doing really well. I just got back from Sydney. I was doing some workshops with some high-performing professionals from KordaMentha which was really interesting. A bit different for me but that was really cool.

Also, just finished the last of our Australian Psychological Society workshops, teaching psychologists about eating, movement, weight, and body image. If you’re in Australia, we’ve never been more prepared to help you out with that stuff. I’m really excited to answer this question today. We’ve had some pretty heavy questions. We were talking a while back about how to deal with fat comments. We’ve been talking about Health At Every Size and bariatric surgery.

I thought we’d just lighten it up and answer a question that really applies to almost all of us at some point. Peggy asks, “I don’t do my physiotherapy exercises at home. I know I should, but it’s like I can’t be bothered. Any tips to get me on the road to complicity?” Peggy, I love this question, because so many of us we just leave the physio’s office and completely forget our exercises. I’ve got a special interest in helping people become really good with their physio exercises, because when they do the benefits are often really, really surprising. Of course, we do them for a reason, because they’re important.

Now, we all know that they’re good for us, but I think I’m a really good person to help you learn how to make them regular habits, because I have a background in sport and exercise psychology where I’ve spent a lot of time working with athletes, helping them rehab from injuries. I applied these ideas to myself as well, and I am a total physio’s dream.

I joined a new gym a few months ago, and one of the PTs said to me just recently, “Glenn, you are the most compliant person with your physio exercises,” because I do them before the gym, she said, “How do you do it?” Now I get to share that with all of you guys. I’m going to give you my five best tips on how to make these just healthy habits that you do every week.

When I was helping athletes rehab from injuries, the thing that I really noticed was that people who stuck with their physio the most and got the best results they had a really powerful why, a strong meaning as to why they were doing their physio exercises. Now, there are a million reasons why you should, but my challenge is I want you to really come up with one that really resonates with you, so you’ve got your own why.

Let me give you a few really good why’s as food for thought. The first reason is just so you can move. Now, I know this is really simple, but it’s the one that gets me to do my physio exercises most of the time. I’ve had some shoulder issues, and I know that there’s not going to be that many life situations that are going to require me to move my arm up in this direction really quickly, but just knowing that I can’t do that very well it kind of irks me, and that motivates me to do my exercises.

It’s not only about moving though, it’s about moving with ease. My physio, Tom Barton, when we’re going through our physio exercises, I sort of said to him, “I’m doing this and I feel like I can move a lot easier.” He said, “Yeah, Glenn, when you do this, you feel 10 years younger, and you do.” People put that on just getting older or they put that on their weight, but Tom’s helped me. I’ve been the same weight the whole time, and Tom’s helped some of my really big clients be able to move a lot easier.

It’s also about being able to move with comfort. We’ve talked about before that your relationship with physical activity is so important. If you want to do some planned movement, some walking, some gym work, a dance class, then your relationship with that type of exercise is so important. I think sometimes the pain and the discomfort associated with movement are hidden barriers to really developing a positive relationship with movement.

If you do your physiotherapy exercises, you’ll be able to move more comfortably, there’ll be less pain associated with it, and you’ll just want to do it lots more. Physiotherapy exercises also help you perform better. You can see them as performance enhancement.

Say, for example, me when I go to the gym, I’ve recently gone back to the gym, and when I do my exercises I kind of have felt like a bit of a broken old man. I’ve got some injuries. I don’t have the range that I used to have. I’ve found that by spending about 15 minutes or so doing my physio exercises I can go through the whole range of motion, no pain, and I’m getting stronger. It’s actually a performance enhancement tool.

I do the same when I do my martial arts training. I find that if I spend 15 to 20 minutes triggering and stretching out my hips before I train, when I kick I can get the full range of motion, and it feels a lot better for me. One of the most powerful reasons to do physio exercises is so you can keep moving. I remember having a chat about my injuries with a guy at one of the gyms where I train, and this guy he’s 60 years old. He probably looks to me like he’s about 45, and he’s just been exercising all his life.

He introduced me to this idea of not rehab, but doing your physio exercises as prehab, so even if you don’t feel the effects of the latest injury that you’ve had, it’s not sore anymore, you’ve got your full range of motion, it feels strong, you still keep working on those muscle imbalances just to protect you from further injury, which I think is a wonderful idea.

When you get to actually doing your physical exercises, you might like to do what I call relaxed rehab. Now, this is where you do your rehab exercises while you’re also doing something else. It’s kind of like you’re doing that other thing, and just doing your physio in the background. This can be really good if there’s some discomfort or sometimes some pain associated with those exercises, because the disassociation, the focusing on something else will help relieve the symptoms of that pain, because your pain is actually psychologically gated.

Let me give you a few examples of relaxed rehab. A great one is to do it while you’re watching TV, so I remember when I first dislocated my shoulder, the World Series cricket was on, and so that was pretty much the full length of my shoulder rehab. I would just sit there doing my exercises, watching a bit of the cricket, checking the score, getting back to my exercises. It just became a bit of a routine that whenever the cricket was on I’d do my physio exercises. You can do that with a TV series or something else you like.

My advice would be don’t choose something that is not interesting to you at all, because that way you won’t be drawn to that, and then do your physio while you’re doing that, but also don’t choose something that requires all of your attention because then you won’t pay enough attention to your physio exercises. You want something that you can just tick along nicely in the background while you’re doing your exercise.

You can also listen to music, listen to an audiobook, listen to a podcast, so you’re just killing two birds with one stone. This is a really cool exercise if you deep down feel like your physio is a waste of time. Even if you have that belief, you consciously know that it’s not but you feel like it is, well, you can at least do it while you’re doing something that you perceive as valuable.

The reality is that you can combine so many activities with your physiotherapy exercises. You can do it while you’re getting some sun. You could do it while you’re reading a book. You can even put your body in certain postures while you sleep. I’d encourage you to go to your physio and say, “Hey, here’s an activity that I want to pair with my physical rehab,” and they’ll be able to work something out with you.

The really cool thing, without getting too psychologisty about it is that these cues then become condition stimulus for creating habits. You’ll go to watch that series on TV, and you’ll automatically go for your spiky ball, or you’ll put that podcast on and you’ll automatically pick up your dumbbell and start doing your exercise. That’s when it becomes a habit, and that’s where the real magic happens.

An activity to combine with your physio exercises that I really love is your physical movement sessions. For example, I’ve already told you that I like to do some rehab before my workouts, and that’s very self-reinforcing because sometimes I think when you do physio exercises it’s hard for you to notice the benefit. If you can do some of your exercises and then notice, “Wow, I feel a bit stronger. My range of motion is better. I don’t have pain. It’s more comfortable. I can do more,” then it becomes immediately self-reinforcing.

It’s not like I’ll do these boring exercises and then I’ll get the benefits some time in the next three to six months. It’s immediate. If I do this now, I’m going to feel better while I’m doing my workout. You can also do it in the middle of a workout, which is a really cool thing to do. For example, when I had to get shoulder surgery on this shoulder, the physio said to me, “Look, Glenn, you can’t really do any intense exercise, but you can do these little exercises.”

They would take me up to about an hour to do, but just doing an hour of physio exercises is a little bit boring. What I decided to do is do the only other thing that I could and I would walk along the river. I had these five or six points along the river where I’d do a couple of minutes of physio exercises outside, and break it up that way.

I also know people that like to do it at the end of a workout, and they say that that can help reduce their muscle soreness and help them get back to the next training session a bit better, which is really cool too. The other thing is, as always with our work, let’s leave the perfectionist at home and go with what works. Don’t think about what you should do, think about what you can do and what’s going to work and fit in with your lifestyle and go from there.

I’ve had a client that I was working with just yesterday, and she had the conversation with her physio where she’s got some hand rehab exercises, for her hand and her wrist. It takes two hours a day. That’s obviously a pretty significant injury. She had the chat with her physio and said, “I want an express hand exercises routine, one that I can do in 30 minutes a day and if I can do 30 minutes a day that’s a whole lot better than trying to do two hours a day, falling short, and not done any at all.”

The other thing is don’t be perfectionistic with your ability to do the exercises. The physio knows that they’re new to you and doesn’t expect you to be perfect, and you shouldn’t expect to be perfect either. If you’re a bit concerned if you’re doing it right or not doing it right, see if you can contact the physio between sessions. If you can’t, keep on doing them the way that you think they should be done. Because what happens then is you’ll come back into the physio session, and because you’ve been practising  even if you’re getting it a little bit wrong, you’ll be consistent. When you’re consistent, that makes you more coachable.

It’s like Babe Ruth’s batting coach said, he said, “I can coach anyone as long as they’re consistent.” If someone’s consistently swinging low or consistently swinging high, then I can coach them. If you’re all over the shop because you haven’t been practising , it’s very hard for your physio to guide you into what to do more of, less of, or differently.

The last thing that I want you to think about is getting the support you need. You don’t need to go it alone. It’s not just all in your head. It’s not just up to you to motivate yourself. Humans, we’re social creatures and we do better with the support of other people. The first point of call for your support is the physiotherapist. Physiotherapists are the most trained in this area, and you can see your physiotherapist for your body the same way you would see your psychologist for your mind.

If you think of your body as like a car, you can see your physio when it breaks down. You can see your physio for regular servicing, which is good to do as you get older, and you can see your physio for performance enhancement if you want to supercharge your car. The Australian Physiotherapy Association is the peak body for physios and their clients in Australia. I’m going to give you a link to their find a physio service.

If you just click on this link and go to find a physio. This service is very similar to the Australian Psychological Society find a psychologist service. I just checked it out for myself this morning, and I found there were 18 physios within a K of me. I think about four or five of them I knew of, and the rest were around and I just had no idea. I’m sure that’s a great place. If you’re looking for a good physio that will work with you and one that you get along with, because you have to have a good relationship, you’ll be able to search around and find a great one for you.

You can definitely complement your physio with a whole range of things, so massage is a great thing. There’s a whole lot of research to show that massage is very beneficial, and a lot of massage therapists actually will work hand-in-hand with a physio, which I think is the best outcome. Same with personal trainers, so at Weight Management Psychology we don’t have physios. We have a couple of physios including Tom, that I just mentioned before, that he talks with our PTs, so the PT can help work with our clients together.

There’s yoga. Even I was in Sydney recently, and I saw a stretch station, so somewhere where you can just go and stretch. There are all sorts of things, but just to make sure you’re not doing anything that undermines your physio work, make sure that you’re talking or, even better, they’re talking with your physio.

The thing to do with your professional support in this area is to see them often. Most of the work, most of the change, most of the transformation happens between your sessions, and so seeing someone regularly just helps keep you mindful. Even though it might cost a little more and take a little bit more time in the short term, it’ll keep you doing your exercises, and that’ll get you way better results in the long term. Find a way to get it done. Get it like you like it, and get all of the support you need.

Guys, thank you for being with me for another Thursday Therapy. I’m sure if you look back through this, you will find a few ideas that’ll really help you become a little bit like me, one of those weirdos that somehow actually does pretty much all of their physiotherapy exercises. If you like this video, let us know. We’d love to hear your comments on what’s useful for you. Definitely share this one. We all know somebody at different times who really struggles to do their physio exercises, but if they did them that would really help.

You may also want to share this with your physio, or with any physio friends you have. I’m sure if they share it with their clients it would ease this challenge for everyone, which would be pretty cool.