The power of being human in healing & recovery

Photo by Anete Lucina via unsplash.com, edited by KT

In the last month of 2016, I was deeply struck by the death of AA Gill, a "journo giant", who died from cancer. It inspired me to write this article about why being human to each other, and to ourselves, can have a profound affect in healing and recovery and at the very least make an individual feel that they matter, especially when facing terminal illness.

AA Gill's last article, published just one day after his death explained his traumatic and frustrating journey of care from the NHS in the last months of his life. I was struck by how beautifully he narrated his situation. He was denied a life lengthening treatment, immunotherapy, because it is too expensive to get on the NHS. He acknowledged the genuine care towards of the people who work within the NHS towards him, mentioning in particular a nurse who was devastated to learn that his chemo was no longer working. He ended his article by saying,  "you don't get that in the private sector" referring to the humanity and empathy of the nurse.

You can read AA Gill's parting gift to the world here:

http://www.thetimes.co.uk/article/more-life-with-your-kids-more-life-with-your-friends-more-life-spent-on-earth-but-only-if-you-pay-d7lwpht3j

Same same but same

The turn of a new year always makes us a bit more philosophical as we look back at what we have achieved and then look forward to what lies ahead for us. I see countless Facebook posts about 2017 being the year of kindness, of solidarity, peace, togetherness, humanity. I myself posted my new years message, urging people "to be the change you want to see".  New year or mid year, we all want the same thing to feel the humanity of others and to feel that we matter. It's what connects us and it has powerful healing properties.

How to be human 

Above all, whether you work with people or have people in your life who are in pain or recovering or not, the way we can help each other in a daily way is just by being human. Being human to me means being kind. It means holding space for someone when they need you; listening to someone in need of being heard; giving of your time, energy and love. It also means holding space for yourself, listening to yourself and allowing yourself to be quiet, giving back to and loving yourself. I believe the body knows how to heal itself otherwise our species would not have survived this long. It needs the right conditions - physically, mentally and emotionally to help it along. 

Humanity heals

This is relevant in our personal lives, in our work life and particularly in medicine and therapy when you seek help for illness and injury. Being human or what the medical profession often call "bedside manner", can have a profound affect on your perception and ability to recover.  It is really important that you choose therapists and medical practitioners you trust, have a good relationship with and who hold space for you without judgement or ego during your healing and recovery. If you feel you need more "human" than what is being offered do not be afraid to walk away and find therapists who better suit your needs. My new guru, the late Louis Gifford, believed that the human part of therapy and medicine is as important as the healing of tissue, because you, your consciousness, is part of that healing. Your synaptic connections, your thoughts, play a part in what messages get sent from the brain to the tissues. Feeling safe and cared for positively impacts your emotional and mental outlook on recovery.  

Human yourself  

And kindness and humanity doesn't always have to come from others. Being human to yourself is just as important. I firmly believe part of the self-management of your own injury or condition is being kind, loving and compassionate to yourself. So go be more human to yourself and others in 2017 and see what impact it has on your healing and recovery, your life and the lives of those around you.

If you are struggling with an ongoing injury, or have suffered with ongoing pain that just won't go away we can help. Please contact KT at KT@precisionmovement.co.uk for a complimentary phone conversation. 

The Precision Movement end of year message

Another 365 days down as we say goodbye to 2016 in just a few weeks time.  In celebration of 2016 I'd like to share with you my Christmas message... 

What an amazing year we have seen in the UK.  No year is ever dull here but 2016 was particularly colourful.  The people voted on Brexit, we got a new Prime Minister a British win at Wimbledon, a British win in the Tour De France, 27 gold medals and 2nd place in the medal table at the Olympics in Rio.  It just goes to show what a nation of talented, motivated, driven people can do when they put their minds to it. 

In the world of Precision Movement we helped numerous people out of pain and back to full movement function.  This year I've had people compete in the London Marathon, Pru100 cycle ride, I had clients return to golf after years of pain and injuries, a client participate in a kayaking adventure week in Scotland, 2 clients competed in the Patrouilles Des Glaciers for the 4th time.  I successfully sent clients on ski holidays, watersports holidays, and I rehabbed a total knee replacement which was super fun!  Others have returned to a life without pain, cycling to work, running at their leisure, playing a game of football with their friends - and this is why I do what I do...

Life is short.  I am a firm believer in designing your life.  Pain and injuries are sometimes a part of an active life - but they shouldn't stop you from getting back on track and getting out there, experiencing and living the life you want to live.  Precision Movement exists for the adventurers, the explorers, the active souls who want to really live a life without restraints, without borders - a life of freedom.  Our clients (that's you) live the type of life that creates stories around the dinner table leaving your grandchildren mesmerised, in awe and inspired to go out a life their own life of freedom and adventure.  Yours is the life that other envy - it's full, its beautiful and if injury or pain ever strikes, we'll get your better so you can go out and do it all over again!

So as we enter 2017 I want to know what you will all go on to do next.  You've got 365 days in 2017... what will you achieve?  What heights will you reach?  What depths will you delve to?  

All in all its been another amazing, inspiring year for me at Precision Movement.  I cannot do my job without the support, the loyalty and the 'fight' that you bring to your movement, rehab and training journeys with me.  Keep talking about Precision Movement and what it has helped you achieve.  Send us the adventurers, the explorers and anyone who just wants their freedom back!  

Wishing you all a safe, healthy, happy and festive holiday season with family and friends.  Take this time to rest and recover and I'll see you all again in 2017 for more adventures!  

Hot chocolate that helps your healing & recovery

As the days and nights get colder it's tempting to reach for warm foods that give your comfort but may not be nutritionally beneficial.  Nutrition is an integral part of recovery from injury and pain as well as supporting a healthy happy lifestyle.  

You really want your food intake to be doing the following:

1.   Reducing inflammation in your gut and in your body overall.  Inflammation stresses your immune system which means healing and recovery are compromised.  You want to promote healing and recovery by reducing inflammation.

2.  Nourishing your body with antioxidants, vitamins and minerals for healing and recovery and for all the vital processes for a healthy, happy functioning body.

3.  Fuelling your adventures or your rehabilitation is that's where you are currently at!  Whatever your life is filled with you want your food intake to support you so you have the energy to enjoy it.

A quick and easy way to fulfil all these criteria and even take with you on your adventures is with this incredible rich hot chocolate drink.  It's loaded with anti-inflammatory foods such as coconut cream and super antioxidant rich cocoa powder containing maca and cacao as well as plenty of vitamin E from the fresh almond milk.  I drink it as a bedtime warmer when I make my hot water bottle at night.

Rich Hot Chococo

Ingredients

* 1 cup fresh pressed almond milk

* tablespoon coconut cream 

* 1-2 tablespoons Of The Earth Superfoods Hot Chocolate powder

* Stevia to taste 

Instructions 

Place the almond milk in a saucepan on the stove and heat gently so as not to burn it.  Place the almond milk and all the ingredients in a blender and whizz up.  Drink with joy and let the nutrients heal you!  

My secret antioxidant loaded winter warmer drink!

I have a secret to tell you... I've been drinking this super amazing antioxidant loaded drink every morning this year.  And it makes me feel super virtuous! So I thought I'd finally share it so you can be virtuous too.  Also it's more of a winter warmer than a spring/summer refresher so it's more apt for October. 

KT's super antioxidant Winter Warmer drink 

juice of 1/2 a lemon 

juice of half a lime  

1/4 teaspoon of Clear Spring matcha green tea powder  

A slither of fresh ginger grated  

2 teaspoons of baobab powder  

manuka honey to taste  

Boil the kettle and place all the ingredients except the honey in a mug. Fill the mug with hot water and stir until all the ingredients are blended nicely. Add making honey to taste.  You're good to go!  I take mine in a KeepCup so I can enjoy on my morning commute :) 

An audio postural meditation for you

I'm always trying to think of ways to recreate the sessions you do in the studio for your to travel with or do at home.  As you know, consistency is the key to getting better faster.  

I have considered doing video clips of exercises but I'd rather not have your attention on a screen when it should be on your body and how exercise feels. So, I've come up with something I think is much much better! I'm going to trial audio recorded training sessions.  

Benefits  

1.  It's the closest recreation of doing a session in the studio with me but without me. 

2. You'll hear my motivating little voice saying all those helpful little analogies and KTisms that get you in the right alignment doing the right movement. 

3. You can take your focus into your body and use a mirror for feedback instead of looking at a screen. 

4. You can put on your headphones anytime, anywhere and inconspicuously do your programme. You'll look like a total pro in the gym! ;)

5.  You'll be more motivated to do that third and final set instead of just doing the bare minimum two.  You know it's the last set that really counts!

First come first served... for the freebies!

I'll be trailing the bespoke recorded training session for free for the first three people to email me.  I think one has already gone now so there are only two free ones left.  Just inbox me at KT@precisionmovement.co.uk and I'll record your latest home programme for you to download and listen to whenever, wherever.  

Going forwards, bespoke recorded sessions will be charged - fee upon request! 

Freebie for all

As as a preview, and due to popular demand, I've recorded a demo above. It's a 10 minute guided postural meditation that you can listen to on your commute to work or on a 10 minute break during your day. You can do it sitting or standing.  Let me know what you think! 

For those of you not working with me at the moment, if you don't understand what the analogies in the recording mean please do feel free to book a postural session with me so I can teach you.  Once you know what all the references are the recording will make much more sense!

If you would like me to send this recording to you directly so you can download it to your phone please ask me in your next session or email me at KT@precisionmovement.co.uk.

Precision movement philosophy phrases to live by

After last weeks blog about checking in with your goals for the last quarter of the year, I thought I'd follow that with some motivational inspiration. Sometimes we get so bogged down with the day to day stuff we forget the big picture reasons for living and enjoying life. So here are the Precision Movement phrases to live by... Everybody say Om! 

1. You are what you absorb 

Sadly just eating the right foods is now not enough if you are not absorbing their goodness! How do you know if you are absorbing the nutrition you eat? Well you should feel good for eating highly nutritious food but most of us don't know what good feels like if we have only what we feel like now to compare it to. So my recommendation would be to get your gut tested and see how functional it is. See our partners page for contact information on Karen Maidment and Hannah Richards who can help with this. 

2. Movement is the foundation of life 

From the movement of blood and transport of nutrients and removal of toxins to getting around town movement is absolutely essential for life. It's also really important to move well, efficiently and effectively to minimise injury and discomfort. I believe movement is as important as breathing, eating and sleeping.  Stagnation leads to injury, depression and indifference.  So move more and move well - if you need some help with this you know where I am. 

3. Your body is a thoroughbred 

We can take our body for granted. We don't think about what it does every day to enable us to live, to see, to hear, to communicate, to move, to breathe, to digest food. Our body is a gift, it is our house and we should take care of it like it's a thoroughbred race horse or a top of the line sports car. You wouldn't put sludge in a sports car so don't put rubbish in your body. You want to nurture your body, feed and water it well, give it sunlight and fresh air, move it regularly and give it a bit of challenge every day to make sure it can withstand the toughness of life. 

4. Study your user manual 

Too many people assume they know how to move well. Here's what happens - we are born, we teach ourselves to move (amazing!), we continue to learn good movement and sports in childhood and hopefully our teen years. Then we go to university and we either continue (super amazing!) or we stop moving. Then we go to work and it's basically all over. I'm generalising here but you get the idea. When we enter the work place we teach our bodies to adapt to the sitting work environment which can give us all kinds of issues. The greatest gift you can give yourself is re-learning good movement either through a sport like martial arts or dance or working with a movement specialist to support you and get you back to your sports. 

5. If you don't use it you lose it

I am a personal testament to this! If I don't exercise regularly I start to lose my strength, my stability my tone and my shape. Many of the people I work with begin to lose their postural endurance and flexibility.  You've got to make an ongoing commitment to yourself to maintain your body. You'll live a longer happier life if your body is agile, functional and well taken care of. It really comes down to loving yourself enough to take care of yourself. 

6. Get in your discomfort zone

Comfort doesn't lead to growth or change. I purposefully placed myself in some very uncomfortable situations this summer to remind myself what it's like for my clients to change movement patterns and posture - it can be frustrating and uncomfortable both physically, mentally and emotionally. So I do know what it's like to start something completely new - I highly recommend it regularly. The joy comes when you master something that you've been struggling with - that's growth, that's change, that's a life worth living and an example worth setting to your children, friends and family around you. 

7. Movement is a constant teacher 

I'm finding more and more as I work with clients watching them learn and connect with their bodies that movement serves as a fantastic teacher. No matter how long you have been training you can always learn some new movement or reconnect with how movement feels in your body. To me, mastering movement is not about just exercising it is about really understanding how your body works and serves you. I highly advocate using movement and sports for challenge and personal growth. I am still humbled by movement - it's always been my greatest teacher. 

8. Mind over matter 

Firstly the brain is the control centre of movement. We don't move unless the brain is motivated towards something. Many things are involved in the motivation of movement. One of the important factors is how you feel about/towards that intention. If you dislike what you are doing your brain gives a different output in contrast to if you do like what you are doing. So, when moving, even if the movement or exercise is something you don't particularly like, train your mind to find the benefit in it and feed that information through the brain and attach it to the exercise. The brain/mind/body will avoid things it doesn't like - so override the dislike factor - reframe it. The saying mind over matter is never more true than it is here! 

9. Be present 

When anyone comes to work with me in the studio yes there are reps and sets and alignment and gains and goals etc. But what I really think they gain is the experience of being present in their body. It might sound a little kooky but going to the studio or the gym and just going through the motions, the reps, the sets, thinking about work or what you'll do afterwards is really not as beneficial as being present with your body for your workout. Movement is an enriching educational experience. It's an outlet, a form of expression, a release of energy or a way of conjuring up energy. But all this good stuff only happens when we are present in our movement. It's like anything really - when you are present you are alive and the experience is banked. When you are somewhere else you're just wasting what you're doing in the present. 

So there you have it - 9 magical philosophical paragraphs to live by.   Now go forth and conquer... :D 

Is this the best hotel gym space in London?

As many of your know Precision Movement has been making extensive additions and changes to our little Mayfair studio space courtesy of Grosvenor House Apartments.  And though she be little she is (mighty) fierce and versatile.  Here are the new changes to the space and how they optimise your workout.

The rig 

This March we had a custom designed BeaverFit rig installed into the ceiling.  This has been the most anticipated change in the studio since we moved in.  The rig will be used for pullup/chin up and brachiation training. Also check out the fat GRIPZ for extra intensity without extra load.  It has proved super popular so far! 

Suspension Training 

The rig also enables us to use TRx, Crosscore180 and Olympic Rings for suspension and aerial training.  Bring on the strength!  The rig is 3.5m long meaning we can have someone working on the Kinesis, someone working on the TRx and someone in the weight area quite comfortably.

The floorspace 

The matted floorspace has been increased by a third meaning more workable space for people to use and more people using the space at the same time.  It also means the floorspace becomes more versatile - we can bring out a barre for a ballet workout or clear the space for kickboxing or a yoga based work-in.  We have had some guests using the space to practice their karate katas and MMA moves.  We have left the space open for just this purpose because no single person's workout is the same and we want to cater to that as much as possible.

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We now have adjustable weights up to 41kg each alongside the original rack of 1-10kg.  We have a few olympic bars and weight plates for more traditional strength training as well as weighted medicine balls and powerbags.  The original Kinesis cable machine is still installed as well.

 The bring out put back system 

We have lots of different equipment that can be used in the space - kettlebells, powerbags, battling ropes, agility equipment, olympic bars, medicine balls.  We bring out what we need into the space for your specific workout and then put it back to open the space up again.  It sounds really obvious but many gyms, particularly hotel and residence gyms are the same space as our little studio but packed full of machines which limits the type of exercise you can do in the space. Training has moved on past machines... there are some uses for machine work but at Precision Movement we are more steered towards challenging your body in different ways. Which is why we think our space is becoming one of the best hotel gyms in London. 

The space is being used more than it ever has been and it's being used in many ways, for all kinds of movement, workouts and sports conditioning.  If you haven't been down to visit yet, then please do. We'd love to have you! 

Do you want to know what KT is really like?

Let's face it, I'm hard to sum up in a tidy little phrase - though many have tried!  So I asked my lovely clients, the recipients of my knowledge and expertise to describe their experiences of working with me. My fabulous web/video/media guys at SquareGlu sprinkled magic dust over it to produce this little movie... 

Thanks to to my lovely clients for taking part - I did tell you I'd get you your five minutes of fame! And thanks to SquareGlu for making such a professional end product.  

Popcorn at the ready.... ;) 

Featured Specialist: Karen Maidment Functional Nutritionist - keeping your insides healthy!

Karen Maidment is co-owner of Pure Body Balance in Gloucestershire.  She is also the author of Meals that Heal and the creator of specialist cooking workshops that teach you how to make meals that really do heal your body.  Karen not only specialises in nutrition but in all the systems of the body and how they work together to optimise a healthier happier lifestyle. Karen works with clients of Precision Movement to optimise their lifestyle and nutrition aspects of health to support the training they do with us.

KT:  What sparked your interest in Nutrition and wellness?

Karen: I have always had a love for cooking and food. From a very young age my sister and I were encouraged to get involved with our parent’s back garden allotment. We would get paid a penny for every caterpillar we removed from Dad’s cabbages! And my mum would pop us on a foot stool so that we could reach the worktop and make little cookies and fairy cakes. I grew up in the countryside where blackberry picking, locally shot pheasant and rabbit and home grown produce were part of the norm.

Later on in life during a dip in enthusiasm for my post graduate career in fashion my now husband and business partner Adrian, encouraged me to follow my heart and begin a distance learning course in Nutrition Coaching. Three years later as I was coming to the end of this first course Adrian was taken seriously ill with Crohns Disease. After 2 years of misdiagnosis he finally ended up having major surgery and so we used both his education with the CHEK Institute and my knowledge in nutrition and lifestyle management to turn his health around.

KT:  For you, what is the foundation of health?

Karen:  Actually to me a healthy mindset is the key. After a decade studying and working in the health industry I have come to realise that as health coaches we tend to be way to hard on ourselves. There is a level of perfectionism that we seem to aim for that is simply unattainable. Yes eating organic food, clean water and seasonal produce are the foundations of my nutritional regime, BUT honestly none of this matters if I don’t like, love and respect myself enough to make those choices daily. Most importantly, it's to treat myself with compassion when I don’t make the most healthful choices. I am only human after all!

KT: What types of people usually seek out your help and why?

Karen:  This has evolved as I have evolved both as a coach and with my own health journey. During my 10 or so years in the industry I have worked through numerous health issues myself, in fact I am still a work in progress. From Adrenal Fatigue to Amenorrhea, IBS to Insomnia. I tend to find that clients with similar health issues to those I am working through seek me out. A few years ago I started my website endibsnaturally.com at that time I was working through major IBS symptoms and so it seemed natural to me to share how I was healing myself with my clients. Now I tend to be working a lot with auto immune disease and adrenal fatigue. Many of my closet family members have various auto immune diseases, such as my husband and after an incredibly successful and busy year in 2014 my adrenal health certainly took a hit!  My clients tell me that they connect with me due to my authenticity and ability to show compassion through my own challenges. It requires a great deal of courage on my part to show what I sometimes feel are my imperfections, but my clients LOVE that. It makes them feel understood and shows them that if I can get well they can too.

KT:  How do you help people achieve better health and wellness?

Karen:  Nutrition and lifestyle coaching fused with practical recipe and cookery support. Ultimately there is no point knowing what you can and can’t eat if you don’t know how to cook and follow a basic recipe.

KT:  What do you specialise in?

Karen:  Many back pain syndromes and injuries are caused by inflammation which creates instability leading to injury. For instance tennis elbow and lumbar spine weakness have show to reduce and resolve themselves once inflammatory foods such as gluten and dairy have been taken out of the diet. I often see reoccurring injuries failing to heal after corrective exercises and hands on therapy due to this inflammatory process. In addition using foods as medicine you can actually facilitate a quicker recovery from pain and injury. Saturated fats for instance are known to improve bone, muscle and tissue structure, as is homemade bone broth which contains high amount of collagen and gelatin. I have seen fantastic results by supplementing with a mixture of bone broth and Great Lakes Gelatin in structural and tissue related injuries.  Anti inflammatory juices containing ingredients such as fresh turmeric and beetroot and calcium rich greens such as kale and spinach are also great nutritional medicinal tools to promote recovery.

KT:  What do you typically eat for breakfast?

Karen:  We follow a Paleo type diet so we often have eggs, salad and some root veggies. I make us a seasonal green juice everyday which nearly always has fresh lemon and ginger, two of my favourite juicing ingredients. I always make sure I have live foods with my cooked protein. Poached wild salmon is a favourite as are the most incredible organic handmade pork and herb sausages from our local farm shop.

KT:  What are the four foods/supplements you cannot live without and why?

Karen:  Food wise I love organic coconut oil and ghee, these are my staple forms of fat. I do not tolerate dairy very well and so ghee gives me all of the great fat soluble vitamins without the casein and lactose. Wild honey, which is my favourite sweetener, it tastes great and contains live enzymes to help you break down carbohydrates whilst offering up antibacterial properties. Homemade broth to keep my digestive system happy and my bones, skin and muscle strong.

With regards to supplements I cannot live without the North American Herbs & Spice range, these are food grade, wild and handpicked. Particularly I love their probiotics (Healthbac), there adrenal and B vitamin booster (PurelyB) and their mineral support (Purelymin). I do not take any supplement every day, rather I listen to what my body needs and take them as and when I feel my body needs a little boost. Bear in mind that most supplements that you buy are synthetic and are actually of very little use to your body.

KT:  With Easter just around the corner, can you recommend a healthier option for a chocolate Easter egg?

Karen:  I am totally in love with Booja Booja chocolates, particularly the champagne ones. They taste insanely good and contain no dairy or gluten, to big no-nos for my health. They are also organic. You could also consider making your own raw chocolates, there is a fab recipe in my cook book Meals That Heal.

Karen's book Meals that Heal is available to purchase HERE 

Details of Karen's next cookery workshops can be found HERE 

To find out more about working with Karen to optimise your nutritional health please contact her at karen@purebodybalance.co.uk or call the centre on 01285 83127.

How corrective exercise differs from regular exercise

KT at Precision Movement

The number one question I get asked is "Are you a physio?" - unfortunately I cannot lay claim to this esteemed profession!  I am not a physio.  The second question is, "So are you a personal trainer then?".  Again I cannot say I am a Personal Trainer either - well not anymore.  I fall somewhere between the two and work under the grandiose title of "Corrective Exercise Specialist".  This line of conversation invariably leads to a discussion about what type of exercise I do and how it differs from gym training.  I will now humbly attempt to explain in an effort to give you a better understanding of the difference....  Wish me luck!

What is corrective exercise?

Corrective exercise is a special type of exercise usually used as part of the rehabilitation process in healing and recovery from chronic pain, injury or surgery, or given to those who suffer from poor posture.  The emphasis really is on optimal alignment, stability, mobilisation and then strength development.

In comparison regular exercise that you might do in the gym or in sports has a different goal - often increased fitness, body shape change, weight loss etc.  As the goals are different the exercises and movement given are bigger and incorporate more muscles.  This helps co-ordination for sports and is also effective for conditioning the body to change shape and increase fitness.  If I were to give these exercises to someone who is in pain and has poor alignment, poor stability, mobility and strength they would not be able to perform them effectively and could potentially hurt themselves further.

It's important to mention here that corrective exercise also forms a foundation for all movement and exercise.  If your foundational principles are good then your risk of injury is much reduced.  When clients come to Precision Movement with fitness goals we still take them through foundational principles to make sure alignment, stability, and mobility is optimal for more complex movements.

The types of exercises

The majority of exercises I do with clients at the beginning of their programmes are floor or swiss ball based.  I ask them to repeat the repetitions many times to elicit postural change and I also ask them to engage in mindful exercise which includes some psychology techniques.  Corrective exercise rarely makes you sweat and definitely doesn't increase your heart or breathing rate.  It is not easy though!  The areas we stretch are usually tight and stiff and the muscles we train are weak to begin with.  When clients adapt and improve, programmes are updated to challenge them further.  

A classic exercise I teach clients is the horsestance series.  It looks very easy but it is actually quite challenging.  Before clients can do this exercise effectively I'll also teach and often reset their breathing mechanics, help them effectively activate their core and how to activate stability through their hands and feet.  When the exercise is performed correctly it is exceptionally effective in training stability and forms a solid foundation for more complex movements that you would do in the gym or in sports.  

Typical exercises you might see in the gym are squats, lunges, pullups and pushups.  These are all neurologically complex movements meaning the brain needs to send a huge amount of information to the muscular system to perform the movement successfully.  You might use a kettlebell swing which is a dynamic form of a deadlift pattern. Running, martial arts and many other sports are also exceptionally challenging to the body and brain. To perform these exercises and sports well you'll need optimal joint stability, understanding of core function, breathing mechanics, optimal joint mobility and to minimise the risk of injury good alignment throughout the body as well as in the movement.

When does corrective exercise become regular exercise?

At Precision Movement we are specialists in change.  Our goal with everyone is to get them to a fully functional movement state for life and whatever sports they participate in.  

We don't want someone lying on the floor doing a mundane exercise forever.  We may ask someone to do this in an early stage of rehabilitation to get certain muscles firing but when they adapt to the exercise we make it more challenging.  All the exercises we give have many many progressions right up to regular exercise that you'll recognise well.  Perhaps the difference in giving regular exercise at Precision Movement is we might make changes or modifications that are specific to an individuals needs eg.  A static lunge might include a band to emphasise the inclusion of the hip stabilisers that have a tendency to be lazy - they might now be strong but the band acts as a reminder for the individual to maintain good knee alignment.

In a way, we use corrective exercise like servicing a machine.  A machine that has been running for a while might need some parts changed, an oil or water change.  Similarly, we'll do a maintenance check and make sure all the stabilisers are firing correctly and alignment and mobility are good.

For more information on corrective exercise for postural alignment, pain relief and management of injuries and degenerative conditions please contact us.

How to be healthier and happier at work

I love my job!

Last month I was invited to speak at the Lansdowne Club in Mayfair about the tragic death of Moritz Erdhart. I posed the question 'does the responsibility of your health and wellness lie with the company or does it lie with the individual?'  In part 2 of this blog I'll be focussing on how you the individual employee can take responsibility for your own health and wellness at work.

The buck stops with you

I truly believe your personal health is your own responsibility.  That is not to say you should automatically know how to attain optimal health - that is what health specialists are for.  But, however many health benefits your company offers you it is your responsibility to use them.  I think we can all attest to feeling sharper, more productive and more amiable when we are well rested, well fed and have a sense of content and happiness about our lives.  

Stop, think

Every time you order a meal you are making a personal choice about how to nourish your body.  Only you can get to the gym, or get to the 5-aside football, office rugby game or pilates class.  Only you can make a decision to sort out your desk related back pain.  And it also your choice (within reason) about when to leave the office at night. 

The LifeRez - It's a state of mind

You can minimise the chances of injury or illness by taking responsibility for your health now and making LIFESTYLE changes that you can maintain for the foreseeable future.  A few blogs ago I wrote about Precision Movement's Life Resolution campaign - making smaller manageable health changes that you can maintain for life. At work your priority is work but health and wellness will make your work more enjoyable.  The liferez system is perfect for implementing health and wellness into you work life.  

The essentials

There are a few small essentials that you can easily incorporate into your work place.  Start with your work station - ask for an ergonomics assessment to ensure you have the best possible posture when you are working.  Drink more water and you can start by adding just one extra glass of water a day.  Make sure you leave the office at lunchtime for fresh air, natural light and movement.  There are many more things you can improve easily and you can find out what they are and how to implement them on Twitter page and Facebook.

The back bone of life

Screen Shot 2014-01-05 at 21.21.53

Last week I was asked to speak at the L Club in on Sloane Street about the importance of the spine for health throughout life.  I thought I would share with you what I shared with the audience of the L Club how your spine develops, what injuries it is most vulnerable to at certain parts during your life and how you can minimise the risk of injury as you age.  If you are tempted to just read what it says under your current age bracket this would be foolish.  Remember what you have done in the past and what you do now will all influence how the spine will respond in later years. Read on to find out more....

0-3 years 

When we are born our spines are curved like a shell.  In the first 2 years up to when we walk we go through huge amounts of development and change in the spine.  We learn how to move it and stabilise it and to sit up, crawl and walk the spine changes alignment.  As we grow our spines take on three curves - cervical, thoracic and lumbar and these curves are responsible for maintaining good posture, keeping our intervertebral discs in place and providing shock absorption.  This is one of the most important developmental stages of our lives and we should never underestimate the value of babies learning to move efficiently and effectively.  The movements and postures that babies learn here serve them for the rest of their lives which means if faulty movements are developed it will affect movement, co-ordination, posture and strength development in later years.

3-21 years

This is the time when we should move and learn sports.  Jumping around and pounding on our bones is the best way to make them dense and strong coupled with a good intake of calcium from leafy greens and vitamin D from the sun as well as good overall nutrition.  Any weight bearing sports are good for bone density development (swimming is a non-weight bearing sport).  Intense learning of sports is not recommended until age 7.  Ideally children should try out lots of different activities.  At age 7 if children show an interest in a particular sport they have enough neural development to learn more intensely.  Children should not lift heavy weights as it can stunt growth.  

21-30 years 

When we get to 21 we have fully grown but we can still increase our bone density.  Bone density is exceptionally important for the prevention of osteoporosis.  Between 30-35 our bones begin ageing and it is no longer possible to increase our bone density - we can only slow the rate of decline.  This is effectively done by weight bearing exercise such as strength training.  The discs between your vertebrae have fluid and a jelly like substance inside which acts as part of the shock absorption I mentioned earlier.  At at 30 our bones cannot get any denser.  From here our bones go through a process of becoming less dense.  

30-45 years 

This is the time when the spine is most vulnerable to disc injuries.  Mostly because of our lifestyles - too much sitting and not enough movement.  Up to age 45 the discs are refilled with fluid each night as part of the recovery process when we sleep.  This is why you are taller in the morning and shorter at night!  One of the reasons why disc injuries happen between 30-45 years is because of years of 'ligamentous creep' the connective tissues in the spine stretching over time to accommodate poor posture.  Ligaments are the strongest structures in our bodies connecting bone to bone and they give our skeleton stability.  Once ligaments are stretched they do not go back to their original length.  Over time, years of time, it makes the spine unstable and then the discs become vulnerable to pressing out on to the nerves.  

45-55 years 

Past 45 the discs begin to dry up and the spine becomes stiffer.  This actually has an advantage as the discs are less prone to pushing out against the nerves because they are less plump.  However, less fluid in the discs means loss of disc height.  Firstly, you lose height which is not so bad.  Secondly, your vertebrae are much closer together so the ligaments become lax and can create instability.  This hinders movement, particularly rotation, and can also lead to bone spurs and stenosis.  

55 onwards 

Depending on what you have done or not done with your body you may experience some pain or injury in your spine as you age - common but not normal issues are osteoporosis, arthritis, spondylitis, ankylosing spondylitis and postural imbalance.  What I always find interesting is that most people as they age will have some sort of disc degeneration but not all suffer with pain from it.  The key here is movement - the more active you are the less likely you are to feel pain.  

The most important point here is what you can do to minimise the risk of injuries and diseases when you are older.  Once you have these issues they can be managed but they are not reversible.

If you want to know more about minimising the risk of spinal complications when you are older or maybe you have a spinal injury that you'd like to know how to manage better then contact me at 

KT@precisionmovement.co.uk

.

How to avoid the 5 common causes of back pain

old lady stretching

One of the number one questions I get asked is how to I avoid back pain?   Nearly all of us will experience back pain at some point in our lives.  But how wonderful would it be to minimise the risk of getting back pain?  Read on to find out how.....

1.  Stress

We all know too much negative stress is bad for us and some of you may know that it affects us physically.  Stress is part of our lives and it helps us achieve success and conjure bravery when we need to step up to the plate.  You have a stress threshold - a line that once crossed begins to compromise your immune system.  It slows your recovery and healing rate so normal repairs that should occur result in tissues getting left and more damaged.  This can be as small as an ulcer or a big as your back pain.  The best source of information I can give to you is about your perception of stress and I cannot say it better than Health Psychologist Kelly McGonigal in her recent TED talk.  It's 8 minutes and a revelation you will not want to miss out on. 

2.  Lack of movement

You are designed to move.  Sustained poor posture is a major cause of back pain and structural damage.  Make sure you move throughout the day.  If you are desk bound, walk around the office, take the stairs for a few flights, leave for a lunch break.  In the recent article "The making of a corporate athlete" by performance psychologists Jim Loehr and Tony Schwartz that was published in the Harvard Business Review it is recommended that every person does at least 2 strength training workouts a week for endurance and to promote mental and emotional recovery.  

3.  Poor posture

Sit, stand and walk tall.  If you are exercising, exercise tall.  Another major contributor to back pain is poor posture.  If you already have back pain then poor posture will make it worse!  You may be blissfully unaware that your posture is bad but if you are currently pain free it is well worth investing the time and effort to work on your posture to minimise the risk of injuries occurring.  In this day and age, with the mountain of information and specialists to help you there is no excuse for poor posture.  Seek help.

4.  Repetitive faulty movement patterns

This is an extension of poor posture but relates more to exercising with poor form.  I have seen so many clients walk through my door who hit the gym 5 days a week but when I assess their movement patterns it is clear they do not have good technique and their movement patterns are contributing to their pain.  If you are working out in the gym and have not had any guidance at all in the past 6 months then ask a professional to look over your technique.  

5.  Poor nutritional intake

Your nutrients for every day micro damage to your body come from food.  Food provides you with the building blocks for repair, to create new cells, to strengthen your muscles, to strengthen your bones and connective tissue.  It is imperative that you take care of your nutrition and nourish your body it is as much a part of minimising the risk of injury as movement is.  

For more information on exercise for the prevention of injury and for back pain and injury recovery please email me at 

KT@precisionmovement.co.uk

Featured Expert: Helen Skehan RSI physiotherapist

manual therapy

Helen Skehan specialises in the treatment of RSI (repetitive strain injuries).  She is the owner of

Physio Solutions

clinic in Islington, a clinic that she built herself over 16 years, houses 9 therapists and also offers massage and ergonomic assessments in the work place.  

KT:  Helen, what is RSI?

HS:  RSI stands for repetitive strain injury.  It is a term given to work related non-specific upper limb injuries and does not always mean the injury has come from repetition or is a strain.  Patients present with a number of symptoms that may not always be the same from person to person.  

KT:  What symptoms are common with RSI?

HS:  I test for many things - often clients present with varied pain in the neck, shoulder and arm, tingling ,numbness, temperature changes, swelling.  I look for specific tightness, muscular imbalance and postural misalignment.  I may also send clients to be tested by a rheumatologist to eliminate other underlying conditions.

KT:  How does RSI develop?

There are many different ways RSI can develop.  It is often a combination of a poor workstation, poor posture, lack of exercise (although not always sometimes I see patients who are real gym bunnies),not taking enough breaks at work, high stress, lots of typing and ignoring initial symptoms.  

KT:  How does stress play a part in the development of RSI? 

I would say stress exacerbates symptoms.  Mechanically, stressed induces increased muscle tension in the neck and shoulders where the nerves exit the spine and pass through the shoulder joint down the arm.    Also, breathing rate increases and during stressful times we tend to adopt a upper chest lead breathing pattern which utilises the accessory respiratory muscles surrounding the neck and shoulders.  The nerves are supposed to glide through neighbouring structures but if the muscles are contracted it can squeeze the nerves causing pain, numbness and tingling.

KT:  What is your opinion on exercise for RSI?  Does it create more strain or can it help?

HS:  I always try to get my patients to engage in some form of stretching, mobilization and exercises.  There is always a role for graded exercise in the recovery of RSI.  It is important to go by a tolerance factor - the patient should not work into areas of pain.  

KT:  What affect does posture have on the development of RSI?

HS:  Sustained postures for long periods in poor alignment are definitely not healthy and can contribute to RSI.   Typically patients that have RSI injuries have a rounded upper back, a forward head carriage and their shoulders are rotated inwards.  It is very common to find neck an shoulder stiffness as well as a lack of mobility in the upper back.  Some patients can suffer from headaches.  Even more distally you find that patients often have hamstring and calf tightness. 

KT:  What impact does modern technology like smart phones and portable laptops and tablets have on the recovery of RSI?

HS:  All these devices encourage a poor posture as you tend to look down at the device you are using.  People tend to overuse their smart phones which stresses the fingers, wrists, hands and forearms.  With tablets and laptops they can be heavy to carry around and we tend to look down when we use them which strains the upper back and neck.  

KT:  What advice can you give to people using smart phones and tablets for work?

HS:  Modern technology is improving all the time.  For smart phones you can use the voice activation system to cut down on your typing time.  Try to avoid using your phone and tablet when you travel on the tube and bus to give your hands and arms a rest.  At work place a tablet on a stand or a removable keyboard.  For laptops and desktop computers invest in an ergonomic mouse or a roller mouse that sits at the front of your keyboard. 

KT:  What are the early symptoms of RSI?

Any hand symptoms that are related to desk work including pain, muscle cramps, tingling, numbness, swelling or feeling of swelling and restricted movement.  Also be aware of any of these symptoms in the shoulder and neck area even repeated small episodes.  We should be able to function without pain.  I would recommend diarising your symptoms and check over a period of time whether the symptoms remain or get worse.  If in 10-14 days the symptoms are still there then seek treatment.  

KT:  What other advice would you give to those suffering with RSI?

HS:  For those with mild symptoms I would advise regular movement that is based on improving postural alignment and mobilising the upper back.  Backstroke can be helpful and calming to some.  Avoid cycling as the posture can encourage symptoms to get worse.  RSI is an injury that develops over time and through the continual use of bad habits.  The most important thing is educating yourself on how to minimise the risk of injury and taking responsibility for your health and wellness at work.  

For more information please visit the website at 

physiosolutions.co.uk

 or to make a booking with Helen please contact her clinic, Physio Solutions, on

0207 713 7780

.  For more information on how exercise can help you recover from RSI injury please contact me at

KT@precisionmovement.co.uk

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3 ways to create a healthy and happy workforce

Happy at Work

When I spoke at the Lansdowne Club in Mayfair last month I asked this question:  

Why companies are responsible for the health and wellness of their employees?  

Would you leave a machine to run your business without applying the proper maintenance check?  Health and wellness in the workplace influences sick days taken, how staff represent your company - do they look tired and overworked? In turn these factors influence productivity, retention of staff and ultimately the success of your company.  So what can companies do? 

1.  Culture of health and wellness

Develop a culture of health and wellness as part of the work place.  Make it part of your company ethos.  If you actively encourage a healthy workplace you will find your staff will continue that.  I truly believe people want to be healthier.  

Ideas

a.  For an in house client meeting order from a healthy organic deli and offer fresh salads and fruit instead of sandwiches, cakes and cookies.

c.  Set up lunch time workshops for staff to learn about a wide variety of subjects that impact their health and wellness.  I talk about posture and alignment and how to minimise the risk of desk related aches and pains.  Often experts in their field will come and speak for free.

d.  Offer an ergonomics assessment to all your staff.  Actively encourage good posture and movement throughout the day by recommending staff leave their desk for lunch.  Have a water cooler that staff can walk over to throughout the day.  

2.  Reward value not volume

If you put in place a rewards system based on being available day and night on the blackberry, working late into the night, setting up competition between your team members on who can stay at the office the longest, employees will do what they need to one keep their careers and two get ahead.  Over time this will not serve you or the employees.  Create a culture of rewarding value not volume of work.  This is a tough one as every company competes for business and has deadlines to fulfill.  However, a job well done which takes a little extra time is much better than a rushed shoddy job.  Giving employees a feeling of pride over their work is also part their of health.

Ideas

Again you can begin with small changes.  What and how you reward will be individual to each company.

3.  Budget

what would be more costly to your business - a budget for health and wellness that retains staff and increases productivity or replacing the same position 3 times in 18 months?  Set aside a budget for health and wellness as part of the maintenance of your company.  Any benefits that you can offer employees particularly ones that take care of their health and wellness are always greatly received and play an important part in staff retention.  

Ideas 

a.  Instead of going out for a big lunch to celebrate the company anniversary do something interactive and fun like a game of dodgeball.

b.  Take a team bonding day with a private walking tour around an art gallery.

c.  For the company Christmas party arrange a healthy cooking workshop that is interactive and ends with a big festive meal.  

You can also consult health experts and consultants about implementing a bespoke structure that will work for your company.  I personally think a cost efficient and relatively easy way is to build health and wellness lectures and workshops into company lunch times or friday afternoons acts as a continual reminder, motivation and inspiration to employees to take care of their health. This is one of the things I do.

The facts are simple - a healthy workforce makes a healthy successful company.  If you are not actively promoting health and wellness in your company you are missing a trick.  Look at what the 46 healthiest companies in America are doing....

http://greatist.com/health/healthiest-companies

The health and wellness of employees is not just the responsibility of the company.  Find out how you as an employee can take responsibility for your health and wellness, whether your company promotes it or not, in Part 2 of this blog.

The Life Resolution - the only one to make - EVER

Happy New Year

Have you set your New Years resolution (NYR)?  No?  Good!  Don't do it.  Seriously do not set a New Years resolution this year.  Here is what is faulty with the NYR...

Faulty goods

Often we set a short term goal that can be achieved within 3 months - to stop smoking, lose weight, go to the gym, stop drinking so much etc.  Some of us achieve it most of us lose interest.  If we do achieve our goal (yay - well done you!) we are prone to slip back into our old ways and vow to ourselves in 9 months we'll try again.  

Why?  Because life is too important.  We are creatures that seek out good times and fun.  We want to participate.  So how do we deal with the conundrum of good times v being good?  

Golden Goods!

Precision Movement challenges you to set a Life Resolution (#liferez). The liferez is a lifestyle change.  It starts with taking a good look at your life and saying what can I change here to be healthier, happier and have optimal wellness and enjoy my fitness?

Instructions

The liferez is exceptionally easy to assemble.  You choose your changes and when, where and how to implement them and the reasons for doing so.  Ideally make one small change each month.  If you feel your change is successfully implemented and fits well with your life then go on and change something else.  

Completely customised

Your liferez is designed by you.  You can choose anything you would like to improve from as little as one less cup of coffee per day to taking your first vacation in 5 years.  We all have different needs, priorities and responsibilities so make changes that serve your life.  If getting to the gym 5 days a week is impossible for you then don't include this in your liferez.  Seek out what would work better for you.  Measure your progress by your own life yard stick.

Second class post and loving it

The liferez is an endurance event - it's your life.  You wouldn't want to sprint through your life akin to same day DPD delivery would you?  You'd want to take your time, sit in the post office for a while and enjoy the view, take a few travels, maybe get lost and redirected before arriving at your destination a la 2nd class Royal Mail.  With the liferez you'll make smaller steady changes that you can work into your life over time.  They'll take a little effort in the beginning but will soon feel routine.  

T&Cs

With the liferez you will value the T&Cs and you get to make up your own.  My T&Cs are based around the 80/20 rule.  80% of the time I am golden and 20% I splash out and throw caution to the wind.  My T&Cs stipulate that after my splash out I return to my golden ways and this keeps my liferez in check.

Guarantee 

The great thing about the liferez is as long as you use it consistently it has a lifetime guarantee.  It will always serve you.  

Want to know more about TheLifeRez?  Follow me on Twitter and use #theliferez or on Facebook. Contact me at KT@precisionmovement.co.uk

How to talk to your GP about your back pain

When you hurt the priority is to make it go away, quickly.  The problem with back pain is it takes a bit of time to settle and usually takes a combined of manual therapy, corrective exercise and optimisation of a few lifestyle factors.  If you are keen to sort out why you’re hurting but are skeptical about how your doctor can help read on for my 5 top tips for speaking to your GP about getting your back pain sorted.  

A GP checks and more often than not rules out urgent, serious and sinister issues and is then the gateway to further treatment options.  Personally, I’ve found that having a plan about what I would like to discuss with my GP before my appointment helps me to get the questions I have answered and also directs the conversation towards what is next in the process.

A whole approach

Back pain often needs a comprehensive approach which may include pain relief, physiotherapy, medical review and possible further investigations. Go in with a mindset of taking a whole approach to getting better.  A whole approach means taking on board all systems of your health and using more than one method to manage your back pain. 

pain medications

You and your GP may agree that you may benefit from taking pain relief. Ask your GP how the pain medication works - I always find if I know how something works I find it works better. Make sure you know the any possible side affects and talk to your doctor about dosage and how long you should take it for. If you are not keen on taking pain medication ask you doctor about alternative forms of pain relief such as acupuncture, heat or massage. Be sure to ask about whether you would benefit from a review with a sports doctor, consultant or physiotherapist.

Be specific

Notice patterns of pain, when the pain occurs, when it gets worse and what makes it get worse.  What makes it get better? Does it ease throughout the day?  All this information helps your GP to make a decision about how best to help you.  

What is the plan

Ask your GP what the plan is and what the next steps are. If you already know how you would like to manage your back pain discuss this with the GP. If a referral is indicated ask who you will be referred to and why.

Imaging

GPs will likely refer to a physiotherapist, sports doctor or consultant for the management of back pain. It is common to start with a course of physiotherapy but sometimes a GP may refer you straight to a consultant or sports doctor. It is at this stage imaging (ultrasound, x-ray, MRi, spect scans) are discussed and potentially ordered. Talk to your GP about whether you need a scan and if not now when it may be an option.  

Please note that a scan can be useful adding more information about your anatomy with respect to your presentation, but it is a snapshot of you when you are still. The body is infinitely more complex.  A scan, if indicated is added to the information about your presentation - it doesn’t supersede it.

What does it mean if you wake up with low back pain?

Low back pain is the 2nd largest reason why people take sick days from work.  80% of the UK population will at one time in their lives experience back pain.   One of the most common symptoms I come across in clinic is patients waking up with pain or stiffness in the back.   Read on to find out why this might happen and how to relieve symptoms.

The spine throughout the day

Over the course of a day we lose height because the discs that sit between the vertebrae (spinal bones) lose fluid through the day. This fluid is replenished overnight as we sleep. as a consequence we are slightly taller in the morning and slightly shorter in the evening. It makes compelling argument for the importance of good sleep quantity and quality. For my top 10 tips on the best sleep ever (my most popular blog post) click here.

You may also wake with back pain from lying in an uncomfortable position for a long time and the muscles may just be feeling stiff and achy.

What happens when you sleep?

Sleep is when your body heals and recovers from the day’s events.  This includes the restoration of fluid in the discs between your vertebrae.  Sometimes discs The expansion of the discs with fluid can sometimes cause pressure on the nerves that run through the spine and this can cause discomfort on waking.

Nerves get on my discs

Nerves are sensitive creatures.  They like space and freedom to do their job.  When a disc expands over night from the intake of fluid it can reduce the space for the nerve and cause you to hurt when you wake up.

  When the body experiences pain especially around the spinal cord where your central nerves run through, the muscles surrounding the area may contract to stabilize the area.  The body knows that the nerves running through the spine are exceptionally important for function and survival and it will do anything to preserve their health.  In this case it means contracting and tightening up the surrounding area.

What can I do?

If you find this is a persistent symptom that is compromising the start of your day because of discomfort or stiffness and it is affecting your function for example dressing or showering you may benefit from a physio review.

Morning Mobilizations

You can also try Precision Movement’s morning mobilizations - gentle movements in a safe unloaded position that help ease the stiffness of the muscles and bring increased blood flow to the area.  You may find them useful as a stating point for management.

Beneficial breathing for back pain & injury recovery

For this weeks blog post, I’d like to touch on a subject that is often overlooked.  What plays a major role in the alignment and stability of your body, is critical for your survival and is also integral to maintaining a sense of calm?

It’s breathing. Your ability to breathe is truly amazing.  It keeps you alive, it’s highly linked to how you feel and what state your body is in, it’s autonomic (you don’t have to tell yourself to breathe) but you can also take conscious control of it.  The control and awareness of your breathing is your own little magic remedy for stress relief.  Do a quick test now and count how many times you breathe in and out per minute.

Rate yourself!

A normal natural breathing rate is 12-16 full breaths (inhale and exhale) per minute.  Obviously, when you are exercising breathing rate increases as a necessity of the need to transport more oxygen to the muscles for work.  If you breathing rate is higher than normal for every day living this may be an indication that you are stressed.  This could be mental, emotional or it could be nutritional or digestive.  Whenever the body is disturbed or under stress it has the same response.  Breathing rate increases with stress.

Discover your Depths

There are a few ways to breathe.  The most common, although not most beneficial is chest breathing.  This is a short sharp shallow breath, which is usually quite fast and is associated with the stress response.  This type breathing contributes to getting more oxygen into the top area of your lungs as muscles in the upper back, shoulders and neck are use to lift the chest during strenuous exercise.  This is not however, a breathing technique that should be used in every day life.

Breathing that causes pain and injury

When someone breathes like this they usually inhale and exhale through their mouth and this can often bring the head position forwards and create mild (and sometimes major) stress on the neck and shoulders.  The body will also respond hormonally, as it thinks it’s under stress so it will secrete a low constant level of cortisol – the stress hormone.

Breathing for healing and recovery

Deep breathing/belly breathing or diaphragmatic breathing is a full breath where by the whole lungs are filled with air, the diaphragm drops down and the organs below it push out against the abdominal wall.  Two thirds of a full breath happen below the chest, then last third of the breath should lift the chest if needed.  This type of breathing takes the body into a state of relaxation and rest.  Often a diaphragmatic breath is inhaled through the nose and exhaled out through the nose or in through the nose and out through the mouth.

Breathing for exercise

A simple effective berthing technique that helps you to relax and destress is to inhale for 6 counts hold your breath for 3 counts then exhale for 6 counts and rest for 3 counts.  It takes a bit of time to slow down the breath so go easy to start.  Practise this for 5 minutes a day and within a week it will seem easy.