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Perinatal Anxiety and Depression – Eating and exercising your way back to health

In our previous article, we gave a comprehensive background of perinatal depression and anxiety with a particular focus on postnatal depression (PND), in light of Perinatal Depression and Anxiety Awareness Week from November 12th to 18th. In this update, you will find out why a multidisciplinary approach to PND works, and how best to provide support from a case management perspective.

The food-mood link

The majority of research looking deeper at PND suggests an interplay between hormones, neurotransmitters and environmental factors. When looking at what can be done from a dietary point of view, one study1 identified the following nutrients as important when considering food and mood during this time:

  • Folate, vitamin B6, vitamin B12: for their known role in the biochemical processes around mood regulating hormones such as serotonin, noradrenaline and dopamine
  • Vitamin D: responsible for boosting mood, particularly if sunlight exposure is inadequate
  • Zinc: low zinc status is related to depression in the general population
  • Omega-3 fatty acids: particularly important for postnatal depression; omega-3 levels have been found to be lower in women who develop PND than those who do not

The take home message: enquiring about diet is always valid when dealing with mental health conditions, particularly PND, and provide a quick snapshot regarding the overall state of health of a customer

A well-balanced diet ensures a constant supply of these mood regulating nutrients for not only the mother but the baby, and can simultaneously help to keep other health conditions at bay.

New mothers can feel time-poor and might be focusing on their child’s nutrition rather than their own, but as seen above, neglecting key nutrients results in disrupted mental health in the long term.

The role of exercise

The antidepressant effect of exercise has been established across general and clinical populations, and PND is no exception to this. It is worth mentioning that actual antidepressants have some clinical benefit in one small trial, but there is generally reluctance to take a pharmacological option during pregnancy and breastfeeding.

On the other hand, exercise such as regular walking has minimal side effects and can be empowering for a new mother (i.e: they can self-administer the ‘treatment’). A review2 of exercise in managing PND acknowledges that physical activity improves physical and psychological health in the mother simultaneously, and therefore has a positive flow on effect to her children’s health.

The barriers to engaging in exercise after childbirth must be considered, including changes in body weight and fitness, lack of time, low energy and self-efficacy due to PND. Fortunately, an exercise physiologist can use motivational interviewing techniques to work with customers to overcome recognised barriers and bring awareness to other lifestyle factors which may be conducive to wellbeing.

The take home message: while most people know that exercise is good for them, we cannot underestimate the perceived barriers to being active, particularly in the postnatal period.

In summary – pregnancy is an exciting time for many families, however it is also a vulnerable time for the onset of mental health conditions. With the right care in place, the experience of perinatal depression and anxiety doesn’t need to be isolating or overwhelming

Good food, good movement, good social supports and good psychological input can be engaged in a way that mum, dad and baby will all benefit from.

References:
  1. Leung, B. M., & Kaplan, B. J. (2009). Perinatal depression: prevalence, risks, and the nutrition link—a review of the literature. Journal of the American Dietetic Association, 109(9), 1566-1575.
  2. Daley, A. J., Psychol, C., MacArthur, C., & Winter, H. (2007). The role of exercise in treating postpartum depression: a review of the literature. Journal of Midwifery & Women’s Health52(1), 56-62.

Perinatal Depression and Anxiety

Perinatal Depression and Anxiety Awareness Week

12th – 18th November 2017

By Jennifer Smallridge, Accredited Exercise Physiologist

 

At Specialised Health, our Exercise Physiologists are frequently working with customers with a diagnosed mental illness such as depression, anxiety, PTSD or bipolar disorder. One less frequently encountered condition in the Life Insurance space is Perinatal Depression. In light of it being Perinatal Depression and Anxiety Awareness Week, we wanted to shine a light on this illness and provide some information about the profound effect it can have.

Over 100,000 Australian families are affected by perinatal anxiety and depression each year. PANDA – or Perinatal Anxiety and Depression Australia – exists to promote vital information and support mental health in the antenatal (during pregnancy) and postnatal (after pregnancy) periods.

Due to rapid changes in hormone levels, it is not uncommon for mothers to feel teary and overwhelmed in the three to five days after the birth of her child – up to 80% of women experience the phenomenon known as the ‘baby blues’ immediately after childbirth. The good news is, aided by reassurance and support, these symptoms generally do fade after a few days without treatment.

Signs and symptoms

Postnatal depression (PND) is characterised by a significant period of depression that comes on within the first 12 months of having a baby, and usually strikes within the first few weeks or months. It is most common after a woman’s first pregnancy, and although the severity can vary, symptoms include:

  • Feelings of low self esteem
  • Lack of confidence
  • Feelings of inadequacy and guilt
  • Feeling unable to cope
  • Difficulty sleeping, or sleeping too much

It is important to mention that around 3% of fathers also experience PND, and organisations such as PANDA can assist with both maternal and paternal changes in mental health.

Risk factors

 A large scale review1 of the literature has revealed some recurring risk factors for PND, listed below in order of their impact:

  • Depression and anxiety during pregnancy, which is then exacerbated after pregnancy
  • A personal history of depression
  • Perceived life stress
  • Lack of social support
  • Marital dissatisfaction
  • Low socio-economic status
  • A difficult or traumatic birth experience

 From the mother’s perspective

One study2 which looked into women’s beliefs and attitudes around treatment for PND revealed that the preferred treatment choice for most women was individual psychotherapy sessions. Interestingly, although the value of social support for this population is well established, the women surveyed did not perceive group psychotherapy to be a desired option – this may be as a result of concurrent anxiety or simply having too many scheduled appointments during this important time.

Much of the difficulty in managing PND is related to the stigma associated with asking for help, as it is socially accepted that having a baby is considered to be a joyous and positive life event. This attitude can further isolate a mother who is feeling depressed. A frequent barrier cited by PND sufferers to seeking help was around fear of being labelled a “bad mother”.

What can be done?

Research supports stigma reduction around this serious condition by shining a light on the subject – brochures and posters in waiting rooms, open conversations with obstetricians and GPs with clear referral pathways, routine screening, as well as the sharing of stories through groups, forums and ambassadors in the media.

Remember that the human brain is hard-wired for connection, and so a new mother feeling isolated and overwhelmed by her sadness requires strong social supports to counter this. The quote “it takes a village to raise a child” still rings true, and mothers who are striving to “do it all” may actually end up more susceptible to mental health issues.

If you are currently working with a customer who is suffering from PND, be sure to read our next instalment in the Specialised Health newsletter regarding the most up-to-date research and evidence based recommendations for engaging help for someone with PND.

References:

  1. Norhayati, M. N., Hazlina, N. N., Asrenee, A. R., & Emilin, W. W. (2015). Magnitude and risk factors for postpartum symptoms: a literature review. Journal of affective Disorders175, 34-52.
  2. Goodman, J. H. (2009). Women’s attitudes, preferences, and perceived barriers to treatment for perinatal depression. Birth36(1), 60-69.

What role is exercise playing in breast cancer prevention and survivorship? The science behind the movement

From Specialised Health’s Exercise Physiologist Jennifer Smallridge:

October is Breast Cancer Awareness Month 
Aside from non-melanoma skin cancer, breast cancer is the most common cancer among Australian women – the chances are that you’ve been involved in a case with a breast cancer survivor. Fortunately, 89 out of 100 women1 diagnosed with invasive breast cancer survive five or more years beyond diagnosis, but the impact of the treatment and recovery process often remains.

The relationship between exercise and breast cancer prevention and survivorship have been well researched, but here is a snapshot of the most up-to-date evidence in the field.

1. Exercise boosts mental processing speed.
With or without chemotherapy, many breast cancer survivors report a decline in brain function which affects memory, thinking and concentration. A 2017 study2 from the San Diego School of Medicine found that incorporating 12 weeks of regular exercise showed more than double the improvements in cognitive processing speed than that of the control group.

2. Exercise alters tumour gene expression.
Emerging research3 presented at the San Antonio Breast Cancer Symposium in 2016 have confirmed what has been found in animal studies for years – exercise in humans changes the genetic makeup of tumour cells. Study participants in the exercise intervention showed upregulation in cytokine gene expression (responsible for cell death), and downregulation of RNA transport and DNA replication (responsible for tumour growth).

3. Exercise prevents the risk of cardiovascular disease in this population.
For women with non-metastatic breast cancer, cardiovascular disease is the leading cause of death. 2016 research4 from the Journal of Clinical Oncology has found that regular exercise results in a substantial reduction in the incidence of cardiovascular events, coronary artery disease and heart failure.

4. Exercise is vital during chemotherapy.
Being physically active during chemotherapy for early-stage breast cancer improves fitness, quality of life, chemotherapy completion rate, and disease-free survival5. The dose-response relationship for this important stage of treatment appears to be the more exercise the better, with one trial5 finding that outcomes were optimised with 3 x 60 minute sessions per week. 2016 research5 also highlighted the need for motivation from healthcare professionals at this time, resulting in higher compliance and increased satisfaction around the exercise program.

While ongoing research breakthroughs continue to explain the causes behind these anti-cancer mechanisms, the main thing is that women feel supported and encouraged to remain physically active during and beyond a breast cancer diagnosis.

Exercise is an essential part of managing breast cancer but employing the most effective strategies to encourage patients to move and maintain activity is perhaps the most important step.

Motivational interviewing, wellness coaching and cognitive behavioural therapy are all techniques that skilled professionals are able to employ to help with overcoming the many barriers that women experience to being active and often a joint approach between physical and psychological-based professionals is the best way to get the ball rolling.

If you have a customer with breast cancer who is reporting concerns with fatigue, energy levels, cognition, sleep disturbance or just a general lack of conditioning, consider recommending a physical conditioning program as, like we’ve seen, the results can be amazing!

More info:
McGrath Foundation

Breast Cancer Network Australia

Pink Hope 

Make sure to hit “Like” and follow our Facebook page here to get some more insights into what an Exercise Physiologist is and what we do

AND of course if you’d like to make a referral for Exercise Physiology services go ahead and click here

References:
1. Australian Government. (2017). October, Australia’s Breast Cancer Awareness MonthCancer Australia. Retrieved 23 October 2017, from https://canceraustralia.gov.au/healthy-living/campaigns-events/breast-cancer-awareness-month

2. Galindo, Y. (2017). Brain Powered: Increased Physical Activity Among Breast Cancer Survivors Boosts CognitionUC San Diego News Center. Retrieved 23 October 2017, from http://ucsdnews.ucsd.edu/pressrelease/brain_powered_increased_physical_activity

3. Ligibel, J. A., Irwin, M., Dillon, D., Barry, W., Giobbie-Hurder, A., Frank, E., … & Brown, M. (2017). Abstract S5-05: Impact of pre-operative exercise on breast cancer gene expression.

4. Jones, L. W., Habel, L. A., Weltzien, E., Castillo, A., Gupta, D., Kroenke, C. H., … & Yu, A. (2016). Exercise and risk of cardiovascular events in women with nonmetastatic breast cancer. Journal of Clinical Oncology34(23), 2743-2749.

5. Courneya, K. S., Segal, R. J., Vallerand, J. R., Forbes, C. C., Crawford, J. J., Dolan, L. B., … & McKenzie, D. C. (2016). Motivation for Different Types and Doses of Exercise During Breast Cancer Chemotherapy: a Randomized Controlled Trial. Annals of Behavioral Medicine50(4), 554-563.

How creative thinking and merging technology with rehabilitation can deliver amazing outcomes previously not possible

We recommend clicking settings at the bottom of the video above and turning on subtitles.

A few months ago I penned an article on Linkedin which you can see here titled “The Future for Rehabilitation?”. In it i explained Paul’s situation. Paul was a Cattle Farmer living in outback Victoria who had torn his supraspinatus tendon lifting a fencepost and for whom, at the time of writing the article, we had just commenced his  video-based rehabilitation / strengthening program.

At the end of the article I made the statement “We can’t wait to see how his case unfolds.”

Well here we are at the end of the process and we couldn’t be happier with the result!

Check out the video above to hear all about what unfolded in Paul’s words.

I also alluded in the article to the forward thinking staff at BT Financial whom we were working with and whom had engaged us initially to provide the program for Paul.

Enter the brilliant Occupational Therapist, Liz McClean, who initially suggested using a video-based exercise program and encouraged us to explore providing this for Paul. I asked Liz to provide her perspective of Paul’s case and how it unfolded.

From Liz:

“As an Occupational Therapist, finding solutions to facilitate ongoing recovery progression and independence in activities is the key focus of intervention. This can become significantly more challenging when faced with additional barriers where an individual lives in a remote rural location without access to appropriate rehabilitation. When I first reviewed Paul’s claim, I quickly realised that some creative problem solving would be required. It was clear that Paul needed additional support to increase shoulder strength and activity tolerances, if he had any chance of returning to his farming duties. The idea of providing specialised and client centred exercise physiology via Skype or video linking was considered, and after speaking with Brad Domek, we all realised it could be achieved!

The results were absolutely amazing, and I was thrilled to see Paul making gradual progress with each update from Brad. Prior to this assistance, Paul had been advised he needed to avoid many of his farming duties, and continue with light work only. Does light farming work really exist? Brad did an amazing job with Paul, and was able to ensure the exercise program was specific to Paul’s needs and occupational goals.  At the conclusion of the program, Paul had achieved a significant improvement in shoulder movement and strength. He had been able to return to many of his farming duties, which was an incredible result for Paul.

The success of this program proves that barriers can be overcome. Technology can assist in ensuring that all customers have access to appropriate rehabilitation and skilled clinicians, despite their location around Australia – and every customer deserves the best care to ensure a positive outcome.”

Note: Liz McLean has since moved on from BT Financial and is providing her Occupational Therapy services throughout Sydney with a specific focus on applying her specialist skills in the Life Insurance sector. Liz can be reached on 0409 904 959 or liz@emrecovery.com.au

We think that Paul has such an inspiring story and if you agree we’d love you to share it with your customers / clients / workers who may be facing similar battles to those Paul had to overcome. If they can gain some confidence from seeing others who’ve been down the same road and have come out the other side we feel like it’s worth the share.

We’ll be sharing Paul’s story on our FB page which you can link to here and we’d love you to jump over and share it there too. Again, the more we can inspire others to take action the more we’ll see brilliant outcomes like this coming through.

____________________________________________________________________

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AND of course if you’d like to make a referral for Exercise Physiology services go ahead and click here

Low back pain can affect your life in unexpected ways (luckily, we have some exercises to help)

For better viewing and to not disturb anybody we recommend you turn on subtitles for this video, click on settings at the bottom of the video above.

For obvious reasons, low back pain is tough to deal with. But what many people don’t realize is that, beyond the hurting, low back pain also affects many of your day-to-day movements. This ends up creating a vicious cycle: your back hurts, so you alter some of your day-to-day movements without realizing it. And usually, the way you alter these movements actually ends up exacerbating your back pain even more, thus putting you into a cycle of pain that can be difficult to break free from.

In this week’s video and article, our EP Paul Macgugan will cover some of these problematic day-to-day movements, show how these movements should and shouldn’t look, and go through the top two exercises he uses to put his patients on the path to rehabilitation.

3 unexpected daily movements low back pain affects:

(Be sure to watch the video above to get a demonstration of what all these movements looks like)

1. Walking

Yes, low back pain can change the way you walk! What usually happens is this: when someone has a back injury or general back pain, they end up with very tight hips. This in turn causes their feet to turn out at an irregular angle so they walk with an altered gait and with this comes changes to their natural muscle activation, causing ongoing imbalances and further impact to the lower back.

2. Sitting down and standing up

When people suffer from back issues, a basic action like sitting or standing can make things much worse if they aren’t careful.

Often, when people with low back pain move from a sitting to a standing position, they have the tendency to first lean forward and round their back. Then, they put their all their weight on their toes and fold up in a way that puts a lot of compression (and extra stress) on their lumbar spine. Naturally, this only makes the pain worse.

To avoid this, every time you move to sit or stand, make sure you focus on putting your hips back and down. Keep your weight on your heels and try to keep your spine straight instead of rounded as you go up or down.

3. Squat lifting and picking things up

People with back pain rarely end up getting their squat form right.

When Paul teaches squat lifts (or the same movement you use to pick things up), this is what he tells his patients first: when you move into a squat or lift, focus on putting your hips back and down with your feet turned slightly outward. Done right, you should have a nice, straight back and be putting most of your weight on your heels.

Something else to keep in mind is that your knees shouldn’t go over the balls of your feet. If they do, you risk hurting your knees. One way to know if you are in the right squat position is to see if you can wiggle your toes. This lets you get a smooth, easy lift up from the ground as you move to a standing position.


Two exercises to help you go through these daily movements without making your back worse:

One way to make sure you are doing the day-to-day movements correctly is simply to be aware of what the right and wrong form for each movement looks like. Then, try to correct your form as much as you can. But for someone who has back pain, this is easier said than done!

So, it’s also worth strengthening the muscles used in the motions above so you can do them more comfortably in a way that doesn’t make your back worse. On that note, here are two exercises from our physiology program that’ll help you with this strengthening (be sure to watch the video at the top to see exactly how they’re done):

1. Glute Bridge

The glute bridge begins with you lying down with your back on the floor. Then, keeping your back nice and flat on the ground, lift your hips up off the ground. With the glute bridge, it’s important to make sure you get your pelvis at just the right angle so your back remains on the ground. Also be sure to keep the weight on your heels.

Then, you lift up as high as you can go, hold for two seconds, and ease down slowly. As you come down, once again make sure your back stays flat on the ground the entire way.

2. Single Legged Glute Bridge

The next exercise begins the same as the first with a slight variation. Once you’ve lifted up your hips with your back flat on the ground, keep one knee bent as is and straighten out your second leg. This gives you a little more resistance in your glutes and hamstrings. Plus, it activates the external rotators of your hip.

Back pain is a difficult enough problem to deal with on its own….don’t let yourself make it any worse by doing your day-to-day movements incorrectly! If you help yourself get these movements right with a few strength exercises, you’ll be surprised by the difference you feel not only in your back , but in your normal life.

Sign up to our email list here to get more helpful info about Exercise Physiology delivered straight to your inbox. No spam and no selling!! Just useful info to help you understand more about what Exercise Physiology is and how it can help.

AND, make sure you “Like” our Facebook page here for more insights into how we’re using Exercise Physiology to improve outcomes for all of our customers

A great case study and an exercise you might not have seen for LB pain

Kris Scaife explains one key exercise he used to take a patient from being unable to bend and reach past her knees to doubling her sit to stand speed and being able to lift from the ground again, all at the same time as kick starting her return to work process.

Enter Kris:

The patient we’re discussing today was diagnosed with an L5-S1 disc protrusion and at the time of the initial assessment was very stiff, very pain focused and like most who’ve experienced a significant injury, they were guarding a lot of their movements and had become very deconditioned and weak as a result.

Measures from the initial assessment showed that five repetitions to rise out of the chair during a sit to stand test took her 70 seconds, she wasn’t able to navigate stairs very much at all and she was unable to bend and reach beneath the knees showing a lot of limitations to her movement and functionality.

Where are they now:

At the 8 week mark of treatment we’ve been able to halve the time it takes to perform the 5 repetitions of sitting and stand with this decreasing from 70 seconds down to 34 seconds. She’s back to being able to pick pieces of paper up off the floor, she’s able to walk up and down stairs front on instead of using a two foot, sideways gait and discussions are now starting with her doctor to return back into her work duties.

What did we do?

One of the exercises we’ve used for this patient’s lumbar spine and back pain is the “Frog”.

The main idea of this is to strengthen and activate the lower core to help support the lumbar spine. During the exercise, patient’s are instructed to flatten the lumbar spine, take the curve out of the spine, and then maintain that posture pressing the lower back curve into the ground.

Patients are instructed to let the knees then drop to hip width apart and, keeping the hips stable, lift the feet so that the hips reach the 90deg flexion position with knees bent. This can be progressed further by engaging the upper body and starting to make circles with the arms.

To progress to more of a squatting movement pattern or squat based positioning we need to start with squatting to a bench, stool or chair and aim at something that’s at a comfortable range, not too low as you want them to have the strength to get back up once the hips and glutes are engaged, so working within a small range to start is important.

When initiating the squat movement I instruct patients to focus on moving their pockets back to allow the hips to “hinge” and then stand back up whilst driving through the heels of the feet and squeezing through the glutes to ensure it’s the hips and the pelvic musculature that are driving the movement and not the lower back.

Once this movement has been mastered then you can start to get them away from the bench, stool or chair and incorporate more realistic tasks such as those they’d perform at work or in their day to day home tasks.

Well done Kris Scaife!

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Creative thinking in an exercise physiology program to minimise Yellow Flags

Throughout all exercise physiology programs, whether they’re instantly recognisable or slowly identified over the course of a few sessions, Yellow Flags will impact a rehabilitation program whether you like it or not.

Protection is natural

After experiencing some form of trauma, the body’s natural, in-built, response mechanism is to minimise further damage and protect the body at all costs. Hence why your hand will pull away from a hot plate without you having to consciously make the decision to do it. The body recognises that your conscious thought process takes valuable microseconds and instead of sending the nerve impulses all the way to the brain, the message will only travel to the spinal cord and back out to the working muscles to get that hand off the hot plate as fast as possible, even if the benefit is a few nano-seconds, to save you some unwanted pain.

So if the natural response of our body, when experiencing pain, is to minimise further damage it is therefore natural to limit our movements, wrap ourselves in cotton wool and take care at all costs. However, this can occur to our detriment if this behaviour goes on for too long. Muscles become deconditioned, we lose strength, the body adapts to this newer, poorer way of moving and we then place other structures at risk of damage.

What to do

It takes a skilled clinician to break someone out of this habit and help to form more positive behaviours, which still aim to protect the injured area, but encourage more “ideal” movement patterns and restrengthening rather than avoidance which will ultimately lead the client down the path of recovery.

The video above shows one way in which our EP, Biara Webster, is using some creative thinking and a little bit of fun to minimise protective behaviours and get the body moving again.

Sign up to our email list here to get more helpful info about Exercise Physiology delivered straight to your inbox. No spam and no selling!! Just useful info to help you understand more about what Exercise Physiology is and how it can help.

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The role of EP during chemotherapy and post-cancer fatigue

Meet our Brisbane based Exercise Physiologist, Kris Scaife.

Kris is a lecturer at the University of Queensland where he teaches Exercise Prescription for Metabolic Conditions, Ageing and Cancer and well as being the go-to EP for the Oncologists at Greenslopes Hospital, Kris also provides his Exercise Physiology services to Specialised Health clients throughout the Brisbane metro area.

On the role of exercise during the chemotherapy / radiation therapy phase of cancer treatment, Kris says:

One of the big side effects that you get from cancer treatment is that it makes people feel really, really ill. So one of the things you do obviously when you’re feeling ill is you don’t do much and you become sedentary. And that leads into a cycle of fatigue and deconditioning.

There are alot of studies, research and evidence now that state that trying to stay as active as you healthily can, enables you to stay stronger and healthier during the active treatment phase and enables you to cope and endure quite intensive and quite harsh treatment protocols. So keeping the body in as best condition as possible is very important to allow you to get as much treatment possible and improve the potential outcome.

On conducting exercise programs with clients who are post-chemotherapy and are aiming to increase their resistance to fatigue:

The first question I generally ask is, “how are you feeling today?”. It’s all about the delivery of education, “when you’re feeling like this, this is obviously the amount of exercise you can tolerate.” Clients will often push themselves too hard when they’re feeling good and they’ll do very little when they’re feeling bad and this will then exacerbate the “boom / bust” cycle and it’s really about providing the education around teaching their body to tolerate the intensity and use a graduated approach to increasing their activity levels.

One client I’m seeing at the moment has esophageal cancer and had radiation and chemotherapy through the October-November period, leading into a November surgery. So he spent his time in the lead up to surgery coming into the gym two or three times a week aiming to get as strong and as fit as he could.

He’s been back at work, on reduced capacity now, since about March-April. So that was, three months after being in hospital to being back at work. For him to go from the nature of the surgery undertaken at the end of November to get back to being in the office in March, was a great outcome for him.

To discuss how Specialised Health may be able to help your customers click here

To refer a customer with Cancer to Specialised Health click here

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How to feel 40 at 76. A lesson in strength and resilience.

While this story will be most relevant for the CTP insurers out there, the Rehab Providers that are working in the CTP space and those who are working with a client who’s had an amputation, the lessons learnt in this rehab process can be wide and far reaching.

Our Western Sydney Exercise Physiologist, Sebastian Cruzado, has been working with Farrell Steyn, a 76 year old (yes, in the video above i do say he’s 78… sorry Farrell) gentleman living in the heart of the western suburbs of Sydney, Mt Druitt. Farrell’s happy with us sharing a little bit about his story and for us to show a little bit of vision captured throughout his programme and after being involved with Farrell myself in the earlier days of his strengthening program I wanted to write this article to focus on not so much the amputation itself, the injury that he sustained, the rehab that followed or what we’ve been doing with him but more talk about Farrell himself and the attitude that he’s applied, which has been a constant throughout Farrell’s life.

Born in the 1940’s and growing up in the racially charged environment of South Africa in the 50’s and 60’s, Farrell is someone who should look older than he is. At 76 years old he puts most 40 year olds to shame with his strength and power. After being a self-confessed trouble maker in his teens, Farrell hasn’t touched a drop of alcohol for 40 years and has instead devoted the better part of his life to the Church and helping others find their way.

A builder, concreter, tiler and all-round handyman, Farrell has been physical throughout his whole life. He looks strong, he looks fit and he moves better than most 76 year olds, let alone a 78 year old that’s had an above knee amputation.

As Exercise Physiologists, when we preach to people the benefits of staying strong, fit and functional it can often feel like an insurance policy, something that costs you in the short term in terms of energy and time to prevent against an illness, injury or disease that may never occur. However, testament to a life lived based around physicality and movement, when Farrell experienced this latest significant setback in life, the thing that has helped him through the rehab process is the work he did before the fact. Applying a great attitude to the rehab process the same way as he has lived his life, being strong and active.

Despite multiple bulging discs in his lower back, unrepaired torn rotator cuffs in each shoulder and now an amputated leg, Farrell continues to put others to shame with his abilities.

Continue to remind your clients to stay strong, stay active, stay functional, it will pay off.

To get to know our EP, Sebastian Cruzado better, check out this video here

AND, make sure you “Like” our Facebook page here for more insights into how we’re using Exercise Physiology to improve outcomes for all of our customers

How our EP, Mark Watson, helped this fellow avoid surgery and RTW full time

Meet Mark Watson and one of his very happy clients!! Mark delivers a brief overview of a knee rehabilitation program executed perfectly.
 
Sometimes patients are quick to jump to the option of surgery when it’s recommended by their Doctor as they believe that it’s their only way forward and often they’re unaware of the recovery that follows invasive procedures. In some instances, as was the case here, the need for surgery can be avoided altogether. Always consider if there’s a conservative option that may benefit your clients and make sure that all avenues have been exhausted before going under the knife. The body is designed to heal itself but sometimes it just needs the right guidance and expertise applied.

For another example of a huge outcome achieved by Mark click here

AND, make sure you “Like” our Facebook page here for more insights into how we’re using Exercise Physiology to improve outcomes for all of our customers

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