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. 

Put more movement in your day

I've just started working with a new patient on movement rehabilitiation who has had ongoing back pain for the best part of 2 years.  He's got structural damage - degeneration in the facet joints of the vertebrae.  He's a desk bound office worker and doesn't get much of a chance to get away from his seat.  He just came back from a weeks holiday where he walked (and danced!) and moved for pretty much the entire day and he reported that he had virtually no back pain and no stiffness - symptoms he has been suffering with daily.  He hasn't started his rehabilitation exercise programme yet.  The only difference that he made was adding in movement to his day.  Since beginning my practice as a remedial soft tissue therapist, the number one complaint I treat is stiff and sore back, neck and shoulders from sitting at a desk all day.  The body does not like sustained positions.  We are designed to move!

So how do you add more movement into your day if you have a desk bound job?  Well, if you're in London I have super treats for you!  

Firstly, if sounds to simple to actually have any affect, but walk your 10,000 steps per day.  I didn't even know my iPhone as calibrating my movements around town until one of my friends introduced me to the Health app that comes with the phone.  When I opened it up I was shocked to see it had been recording my steps for months!  

As you can see I have what I would consider an inverse pattern to most people.  As I move around for my work, my weekday steps are pretty high.  But look at Sunday 10th July - I must have been sleeping the whole day!  Also, I take my phone on my runs and I run 4-5 days per week so that movement would have been added here also. 

So how do you get your steps in without adding a whole 8th day of the week to walk around guilt-free with nothing else to do?

Well I stumbled across this handy little find - TFL have released a Walk the Tube map showing the number of steps between each station in a bid to get more people to walk shorter distances and ease the stress on the tube in rush hour.  

And for those who are time conscious on their commute to work here is the same map detailing the time it takes to walk between stations.

And here is an Evening Standard article on 8 London tube journeys that are quicker by foot!

Another great little find is handy little article on Londonist.com called The London Walkers Tube Map about great London walks you can do at the weekends to get those step figures up!  Click the link above or the image below to get all the info.  

Now, with all that walking, you might have noticed that too much walking can give your discomfort too.  So, make sure you wear comfortable walking shoes on your commute or on your bumble around London.  If you are on a long walk then take a tea and cake break!  If you would like to do some beneficial spinal mobilisations before you set of and after you return then check out my article and FREE ebook here. 

If walking is causing you considerable discomfort, or your pain gets worse the longer you walk then please feel free to contact me at KT@precisionmovement.co.uk and we can have a chat about your situation.  

The 5 benefits of massage treatment (plus FREEBIE!)

Hello!  I'm back.  After a long sabbatical of blogging I've returned to share my insights, new finds and help information to help you all recover from injury effectively and maintain a healthy and enjoyable life through movement and fitness.

As many of your already know I am training to be a soft tissue therapist.  In it's simplest form I can be referred to as a massage therapist but the techniques I am learning also help with soft tissue injury recovery.  Massage is mostly regarded an enjoyable experience that helps you feel more relaxed.  But it has many other important benefits for health, injury recovery and training.  Read onto find out the top 5 benefits of regular massage treatment. 

The flow of fluids  

Massage has a pumping effect on blood circulation which helps transport nutrients for growth, repair and nutrition as well as removing waste products at a cellular level.   Lymph is fluid found in tissues that is not part of blood that holds certain nutrients and also collects waste products from cells.  Unlike the blood, the lymphatic system does not have a pump system.  Lymph is moved through muscle contraction.  However, if you are recovering from injury and unable to contract certain muscles then massage can help push lymph through the body more effectively.  

Body maintenance for regular training

For those of you who train regularly massage is an important maintenance tool for recovery and increased training gains.  When you exercise you create micro-trauma (tears) in muscle fibres.  The body responds by laying down repair tissues (scar tissue) for healing.  This is all perfectly normal.  However, with repeated training sometimes the tissues doesn't get enough time to heal so scar tissue can build up without you noticing until there is a significant impairment in muscle function or pain.  Regular massage therapy can help identify small areas of build up and break them down before they become an issue.  Post-workout massage can increase the rate of healing and recovery which means your body is in the best working condition for your next training session.  

Injury recovery

Massage can be a great contributor to the healing of soft tissue injury.  When muscle fibres are injured the body lays down scar tissue in the first stage of healing.  When the fibres are healed the body clears up the excess scar tissue.  However, sometimes due to a premature return to exercise scar tissue does not fully leave the healed area and then lays down more in response to micro trauma from exercise.  An excessive build up of scar tissue can lead to layers of muscle fibres, which ordinarily glide over each other, sticking together.  This can impair the function of the muscle and surrounding tissues and potentially lead to further injury.  Massage can help break down the scar tissue and adhesions and realign the fibres so the muscle can heal and return to full function.

Localised tissue flexibility

Sometimes rather than a whole muscle, only a portion of the muscle becomes tight.  Stretching the whole muscle cannot reach the portion that really needs to be stretched.  Certain massage techniques can help stretch and release localised tissue and also helps to draw muscle fibres and sheets of muscle fibres and fascia (connective tissue) apart in different directions.  Massage therapists can help identify areas of tightness before they start affecting performance and/or causing discomfort.  

Nervous system

The immediate effects from massage are felt mostly through the nervous system.  The direct affect of massage is that is stimulates nerve receptors in the tissues and reduces tissue tension.  Nerve receptors also respond to touch, warmth and pressure which helps place the body in a parasympathetic state - otherwise known as a state of relaxation, healing and recovery.  It helps decrease blood pressure, mental and emotional tension and encourages digestion.  That is why you feel so good after a massage!  

One stop shop

In fact, massage is beneficial on so many levels that in my opinion it can no longer be seen as a luxury or a treat.  With our busy lifestyles, it is imperative that we stop and take time to relax, heal and recover.  When you book a massage treatment you have no choice but to lie on the couch and be treated.  Even if you don't want to go because you have a million other things you think you should be doing, after your treatment you'll feel like a different person!  For me it's akin to the benefits of meditation or a micro-vacation!

Free massage

As part of my training I am required to log 100 hours of practice treatments.  I hold my free massage clinic on Fridays between 3-7pm in Mayfair.  Treatment is 100% free until I qualify in July.  The only charge is the clinic room hire of £20.  So, if you would like to experience some or all of the benefits of massage email me at KT@precisionmovement.co.uk and we'll get you set up with a date for treatment!  

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.

Does having a strong core relieve low back pain?

Screen Shot 2014-01-05 at 21.32.20

Well the obvious answer is yes having a strong core contributes to the relief of low back pain.  The bigger questions here are what is the definition of 'the core'?  What muscles is the core made up of?  Is it only abdominal work I need to do?  The answer to this question is a resounding NO!  How do I activate 'the core'?  How do I move successfully whilst keeping my core activated?  If you would like to know the answers to these questions then read on.....

What is the core?

Unfortunately it is mostly referred to as the abdominal region and this is a classic example of how a little information can cause more harm.  Think of the anatomy of the core - the centre of your body -  it is a cylinder.  It has an anterior wall, the abdominals, but it also has sides, a back, a base and a lid.

Just like a house if you only re-inforce the front wall you will create imbalance in the house and the un-inforced parts will weaken and crumble.  If you only train the abdominals you will create an imbalance between the front and back of the body.  The abdominals will get stronger and the back muscles will get weaker.  the pull on the bones from the abdominals and the lack of counteraction from the back muscles will cause a more flat back and a posterior rotated pelvis.  For those with disc injuries this is just about the worst thing you can do because the discs are at even greater risk of coming out, irritating the nerve and causing you great discomfort.

The mechanics 

Activating your core is not as simple as contracting a few muscles.  The diaphragm acts as the lid of your core cylinder as well as playing a major role in respiration.  Your breathing is very much involved in optimal core activation.  If you have faulty breathing mechanics and/or the alignment of your ribcage and pelvis is out this affects the role of the diaphragm in core activation.  Ultimately successful and useful core activation is a blend of alignment, good breathing mechanics and the understanding of how to activate ALL the muscles that make up the core.

Gently does it

Activating your core for support is actually very gentle - about 10-15% of a maximal contraction.  If you contract to hard you'll do what is called a brace.  This is not bad and in some cases is necessary such as in ultra heavy lifting but what happens to the cylinder is it becomes rigid and immovable.  The point of activating the core for support is so you can move freely without restriction.  If you are going red or cannot breathe when activating your core you are contracting too hard.

Intra-related - it's complicated

There is no use thinking I'll train all those component parts separately.  In order to provide optimal support for your spine all these muscles need to work together.  You have to train the brain to switch on these muscles like a conductor begins an orchestra together.  If the firing order is out it will sound like a badly rehearsed concerto.

All together now

Once you have the component parts working in harmony then you must teach your body to move with this new core support system working.  At first it will be a conscious effort but over time it will become automatic.  This enables you to move effectively for life, for fitness, for your sport and with the correct support so you can move without pain and minimise the risk of injuring yourself further.  

So now you know that your core is more than just the abdominals I would recommend seeking out a specialist who can teach you correct alignment of the ribcage and pelvis, correct breathing technique and correct core activation to support your spine.  A good indication of a specialist in this field is one that can explain the mechanics and teach you the application simply and effectively.  

If you would like to know more about core activation and how it can help support your back and other joints effectively for movement contact me at KT@precisionmovement.co.uk.

Looking inside the body for the cause of your pain

MRI

Scans help identify whether structural damage is causing or exacerbating pain.  Personally I think knowing is better than not knowing so I would always go for a scan.  But what scan is best for you?  And what are the pros and cons to scans?  Read on to find out more....

What scans do

A scan can show nothing even though you may be experiencing excruciating pain but it can rule out structural damage so you can begin looking at other factors.  If a scan does show evidence of what is causing your pain this can provide a sense of relief.  It also helps the specialists, therapists and rehab practitioners tailor your recovery plan more effectively.  The important thing to remember is that whatever the scan shows, it is just information.  It is the decisions and actions you take from learning this information that will form your recovery plan.   The most common scans used for back pain are x-rays and MRIs. 

X-rays

An x-ray can tell you if there is anything wrong with your bones.  An x-ray will show up breaks, fractures, bony change like arthritis or bone growths called spurs.  What is can be really useful for in terms of potential causes of back pain is showing loss of disc height.  Structural damage to discs and also ageing can cause the discs to reduce in height.  This results in your vertebrae (bones that make up the spine) sitting closer together.  If the cause of reduced disc height is not known it may be better to opt for an MRI to gain a more comprehensive picture of what is going on.  

Pros:  cost effective, reduced wait time for scan if any

Cons:  restricted information, small dose of radiation

MRI scans 

An MRI scan (magnetic resonance imaging) can show you bones, muscles, connective tissue, nerves, discs, arteries and all other structures in the body.  It takes a series of images at very small slice increments and then puts it all together to create a complete picture.  Often with an MRI scan you get several slices to view which enables consultants to 'look through' structures beyond the surface.  It gives you a comprehensive view of everything in the area of pain.

Pros:  more accurate diagnostic tool 

Cons:  Expensive, often wait list on the NHS but  can go private, closed MRI scanners can be claustrophobic to some so ask for an open top one if available.

Getting an MRI quickly

There is often a wait list for an MRI scan on the NHS.  You can get a scan quickly through private medical insurance but if this is not an option there is an alternative solution.  Vista Diagnostics offer MRI scans from £200 with short notice appointments available.  You could potentially get a scan within a day and results within 2 days of your scan.  For more information visit www.vistadiagnostics.co.uk.  This option could eliminate much anxiety and frustration which can make your condition worse.  It could also mean starting treatment earlier so you can get better faster.  

Results

Whatever can you have make sure you understand the results.  The radiologist who interprets the results of your scan will send you and your specialist a letter explaining what has been found.  Once you know if there is any structural damage you can make a more informed decision about how to proceed with treatment.  If nothing is found that is totally ok - there are many people who suffer with back pain who do not have any structural damage.  Often pain is caused by poor posture, your lifestyle habits, your nutrition choices.  Discuss treatment options with your specialist and ask about manual therapy and corrective exercise as well as alternative forms of pain relief like acupuncture.  

Key points 

The key points to take from this are firstly MRI scans are the more comprehensive scan option and secondly, whatever the scan shows it is just information that will help you make a better decision about your recovery plan.  If you have structural damage like a disc prolapse or stenosis it's ok - you are not going to die!  Many many people have structural damage.  The most important thing is to put a multi-disciplinary recovery and management plan in place.  For more information on back pain and injury recovery and rehabilitation please contact me at KT@precisionmovement.co.uk.

My top 5 reads for chronic back pain sufferers

me with my books

I love sharing knowledge!  Which is why I have compiled a list of my top 5 reads for chronic back pain sufferers.  They are all easy to read and most of them have tips and information you can apply immediately.  If you are suffering from chronic back pain and you really want to know what to do about it and how to handle it then read on.... 

1.   Explain Pain by David S Butler and Lorimer Moseley

A comprehensive information packed book that explains how pain comes about and what it means.  Although it's a little pricey I think it is must read for chronic pain sufferers.  

2.  Painful Yarns by Lorimer Moseley

A wonderfully entertaining book that uses the authors personal anecdotes to explain the mechanisms of pain and about taking responsibility for recovery.  

3.  Treat your own back by Robin Mackenzie

This is a good book for anyone with disc prolapse.  It gives easy to understand advice and information and is a great starting point for approaching recovery.

4.  Sitting on the job by Scott L Donkin

This book is a bible of information if you are a desk bound office worker with back pain or any workplace associated injuries such as carpal tunnel or RSI.  

5.  How to eat, move and be Healthy by Paul Chek

I recommend this book to everyone I meet.  It looks at all areas of your health and wellness and is an integral part of healing nad recovery from any pain or injury.  

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.

5 sources of stress that make your pain worse

stress ball

In my

1st newsletter

where I shared the link to

Kelly McGonigal's Ted Talk

on How stress can be your friend I promised I would also share the other 5 unsuspecting sources of stress that may be compromising your health.  Although is true that your conscious perception of stressful situations can transform the outcome, there is little you can do about forms of stress you do not know about.  

Did you know that stress can come from foods, hormone imbalance, electromagnetic sources, too little or too much exercise, and temperature changes?  And did you know that all these sources of stress can contribute to a relapse of your injury, pain or discomfort?

Stress build up throughout the day

I'll use an example of how stress can build up without you even knowing.  You wake up to an alarm after a restless nights sleep. You force off your tiredness with a coffee and rush out the house because you are late.  You leave the house without a coat and it's too late to go back to get one now - you'll be cold all day.  When you get to work the computers are down  The You won't finish that proposal for a client today, you'll lose the contract and your bonus!  You have a makeshift late lunch and more coffee to stay awake.  You decide to shake off your stress by going for a run even though your back hurts and when you get home, you order a take-out and you can't wait to get the kids in bed so you can 'unwind' with a few glasses of wine before you fall asleep on the sofa in front of the TV.  Sound familiar?

Many stressors one response

What if I told you that everything in the above example stresses your body?  Think of your body having a threshold - a tolerance for all the stressful things we put it through.  What if I told you that repeating this over and over would create a build up of stress that might result in a seemingly 'random' injury or illness?  It does.  The body only has one response to stress.  It does not matter if the stressor comes from a food that you are unknowingly intolerant to or over exposure to the sun.  The body's response is to shut down so it can heal.  Repeated abuse of these systems results in tiredness, compromised immunity and suppression of healing and recovery.  This leads to discomfort, pain, injury, illness and disease.

How to combat these sources of stress...

In this blog i'll give an overview of how to combat these unsuspecting sources of stress so you can begin to change your mindset on how to deal with your discomfort, pain, injury and or illness.  As each of these subjects are pretty hefty on their own I'll be sharing information in more depth over the coming weeks.

1.  Nutrition

Eat from the earth.  Refrain from eating any foods that are packaged, processed and tampered with.  Reduce stimulants like coffee to the minimum to prevent stressing out your adrenals.  Be aware of your alcohol intake

2.  Hormonal/Adrenal

Sleep enough and rest properly.  Sleeping and rest are not the same thing!  Sleep 8 an average of 8 hours in a blacked out room in silence.  Maintain balance between work and life.  Acknowledge that you are not superman/woman and that rest is as important as action.

3.  Electromagnetic

Get enough sunlight for vitamin D but not too much - hardly a problem in the English winter months!  Eliminate all electronics from your bedroom and switch off lights at the mains.

4.  Exercise

Definitely exercise but make sure you are not overdoing it.  If you are injured seek professional help to recover effectively.  Strike a balance between healing restorative exercise like tai chi and hatha yoga and more energising forms of exercise like hitting the gym or running.

5.  Make stress your friend

If you haven't watched this video on how to make stress your friend I highly recommend it.  Kelly McGonigal says it better than I ever could.

How to make stress your friend

6.  Thermal 

This seems rather obvious but pay attention to your body temperature. Anything that keeps you too hot, burns you or adversely keeps you too cold is a stressor.  Make sure you are temperate in all situations - at home, work and when you sleep.

Lastly, this is a huge topic and I'll be covering smaller chunks in finer detail as the weeks go on so you can begin to make changes that will result in a healthier, happier pain free life!  If you have questions please email me.  

Information sourced from Paul Chek's How to Eat Move and Be Healthy book, CHEK Institute, USA.