Pillar 3 and 4 - Training Consistency and Recovery (Part 3) — Transcript

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1. 0:00So pillar three is training consistency
2. 0:02and I would truly say this is the
3. 0:04strongest predictor of a successful
4. 0:06lower rehab process. Often or not the
5. 0:09people who do not stay consistent during
6. 0:11an 8 to 12 week rehab process are often
7. 0:14not going to be the ones that come back
8. 0:15with a flare up. And it's a shame. So
9. 0:18consistency needs to be really dialed
10. 0:20in. And what I mean by consistency is
11. 0:23when things are consistent with rehab,
12. 0:25you adhere to your program, you adhere
13. 0:28to your nutrition, your sleep, we'll see
14. 0:30a significant reduction in flare risk.
15. 0:33We'll see a reduction in pain, but often
16. 0:35than not, we'll see a reduction in how
17. 0:36often your pain reoccurs. When you look
18. 0:39at the research, supervised and
19. 0:40consistent exercise programs will reduce
20. 0:43that reoccurring low back pain up to
21. 0:45about 40%. So that's why it's really
22. 0:47important. Now it doesn't mean that we
23. 0:49have to have a particular exercise in
24. 0:50our training that's going to be magical.
25. 0:52Not a particular machine or modality or
26. 0:55exercise is not going to help us here.
27. 0:57So what it looks like in practice is
28. 0:58we'll always use some sort of daily or
29. 1:00every other day rehab. And it doesn't
30. 1:02have to be significantly long. It just
31. 1:03needs to be somewhere between 10 and 20
32. 1:04minutes that dials in the work we've
33. 1:07already established from the assessment
34. 1:09that we need to put in. Frequency will
35. 1:11always beat volume here. So we need to
36. 1:12be really really important when it comes
37. 1:14down to building a resilience back. So
38. 1:16showing up every single day, even if
39. 1:18it's short and simple, will keep the
40. 1:19nervous system regulated. It will keep
41. 1:21the body adapted. It will keep the mind
42. 1:23sharp. Consistent progression week on
43. 1:25week is really, really important. And
44. 1:27I've got to be honest, this is what
45. 1:28shifts that mindset. If you can rely on
46. 1:31building a consistent routine, you've
47. 1:33already built a habit. And for me,
48. 1:35habits will build a much better mindset
49. 1:38because motivation dips, but habits
50. 1:40don't. If you break a habit, just make
51. 1:42sure you do not break it again and again
52. 1:45and again because you've just built a
53. 1:46new habit. So habits is a really
54. 1:48important term that I use within a rehab
55. 1:50process and us at move will always make
56. 1:53sure habits are the forefront of that
57. 1:55longterm rehab mindset.
58. 1:58When it comes into pillar four, this is
59. 2:00where habits do allow us to safely adapt
60. 2:03to our training week because there needs
61. 2:04to be recovery in there. So recovery
62. 2:06comes under three important strategies.
63. 2:09your sleep, your nutrition, and how you
64. 2:11manage your stress. Now, recovery will
65. 2:14sit into two separate parts here. How do
66. 2:16you manage your body on a day-to-day,
67. 2:17and how do you manage it when a flare up
68. 2:19occurs? So, recovery comes down to, like
69. 2:21I've said, sleep, stress, and nutrition.
70. 2:23Average 7 to N hours of sleep is a
71. 2:26really, really solid number to achieve.
72. 2:28And if we can keep that consistent,
73. 2:30fant. So, the issue with poor sleep is
74. 2:31that it can reduce your ability to
75. 2:33repair tissues and increase how your
76. 2:35pain sensitivity is heightened. If your
77. 2:38sleep's disrupted, your pain experience
78. 2:40can be worse. Nutrition,
79. 2:42anti-inflammatory, and adequate protein
80. 2:44are two important things to consider
81. 2:46here.
82. 2:47When a flare up occurs, the first thing
83. 2:49we need to prioritize is pain relief.
84. 2:51Paracetamol up to 1 g four times a day
85. 2:54is what's going to allow us to
86. 2:55desensitize that nervous system. In
87. 2:58simple terms, your brain's threat signal
88. 3:01to pain can slowly start coming down. It
89. 3:04doesn't mask anything. It just allows
90. 3:06the system just to calm down a little
91. 3:07bit so we can slowly start moving which
92. 3:10means gentle movement is achievable.
93. 3:13Supine pelvic tilts are my absolute
94. 3:14go-to. Lying on our back using a pelvic
95. 3:17up and a pelvic down cue just allows us
96. 3:20to understand where our limitations are.
97. 3:22An anterior tilt where your back comes
98. 3:24off the floor replicates an
99. 3:26extensionbased movement. A posterior
100. 3:29tilt drill allows us to understand what
101. 3:31flexion is feeling like. If we're having
102. 3:34a flare up that allows us not to touch
103. 3:36our toes or bend or lift our leg above
104. 3:3890 degrees, what we need to focus on is
105. 3:41using a pelvic tilt drill to figure out
106. 3:42our bearings to slowly move the pelvis
107. 3:44within those safe ranges. And I'll
108. 3:46always use breathing with this in
109. 3:48conjunction. Two really simple way to
110. 3:50think about this. In this pelvic tilt
111. 3:51drill, lying on your back, feet flat on
112. 3:53the floor, slow breath in through the
113. 3:55nose as you gently tilt your pelvis away
114. 3:57from the floor. And you're going to hold
115. 3:59this for 4 seconds. You're then going to
116. 4:01slowly exhale through your mouth as your
117. 4:03posterior tilt slowly comes in as well.
118. 4:06And you're going to aim for roughly six
119. 4:08to 15 seconds here. And when you get to
120. 4:10the end, hold for another 3 seconds. If
121. 4:13you can do three reps consistently,
122. 4:16amazing. Your goal is get to 10. The
123. 4:19average is one to three. You'll slowly
124. 4:22struggle to get the breath in and
125. 4:24ultimately you'll fail the rep. That's a
126. 4:27good target for you. If you can get to
127. 4:2910, awesome. And then step three is just
128. 4:32reducing that load. So step count and
129. 4:34training intensity are two areas to
130. 4:36consider here. Step count below 5,000 a
131. 4:38day. And when you're at the gym, just
132. 4:39drop the RP down. If your RP is 8 to 10
133. 4:43on a usual training day, drop it down to
134. 4:456 to 7. RP just means rate perceived
135. 4:47exertion. If you're working to 10 and
136. 4:4910, you work to full fatigue. If you
137. 4:51leave two to three reps in a tank,
138. 4:52you're working at RP 8 to 7. The goal is
139. 4:56just to stay active. We don't want to
140. 4:57aggravate things. We just want to keep
141. 4:59moving because that's going to maintain
142. 5:00confidence and it's going to prevent
143. 5:02deconditioning. And one important thing
144. 5:04I need to mention is red flags. If
145. 5:06someone presents with pain down both
146. 5:08legs or numbness, we need to appreciate
147. 5:11this needs to be referred on. This is
148. 5:14the risk of corder aquina. We'll often
149. 5:17find bladder or bowel changes, numbness
150. 5:20when going to the toilet and wiping or
151. 5:23non- mechanical night pain. So you wake
152. 5:25up with sharp pain because you've not
153. 5:27really moved. That sometimes suggests
154. 5:28that something internally isn't right or
155. 5:31we're seeing over a period of months a
156. 5:34significant amount of unexplained weight
157. 5:35loss. If these are found, you need to go
158. 5:38to A&E immediately.
159. 5:40In the final video, I'm going to go
160. 5:42through pillar five and then go through
161. 5:44the two really important case studies
162. 5:45which will really drive home what the
163. 5:47importance is of these five pillars.