I recently completed a free online module by the University of Newcastle called the science of weight loss to be more informed when talking to patients and also to shift my own Covid kilos. One of the myths around dieting is that your metabolism slows down in middle age.

  Actually, we now know that your metabolism stays stable between the ages of 20 and 60, even during major hormonal shifts such as pregnancy and menopause. According to The Guardian, a woman of 50 will burn calories just as effectively as a woman of 20.

  The data comes from a major study by Herman Pontzer, an associate professor of evolutionary anthropology at Duke University. The study looked at more than 6,400 individuals – from eight days to 95 years old – and found that exercise regimes and diet are unlikely to boost your metabolism because the human body is programmed to keep its average daily energy expenditure within a defined range. Your metabolism only starts to slow down in your 60s and continues until death.

  “I think there is a deep evolutionary reason to this,” says Pontzer. “In the industrialised world, burning more energy than you eat would be great, but in the wild, that’s a bad strategy. The reason we’re gaining weight is not only because there’s more food available than we have evolved to expect, but because they’re modern, industrialised foods, designed to be overeaten. So you’ve got this perfect storm for making people obese.”
​
  There are also lifestyle reasons for the middle-age spread. Those in the 40s are more likely to be caregivers of elderly parents and/or young children, as well as be in the middle of their careers and have more work responsibilities. The combination of stress, a sedentary lifestyle, being time-poor and sleep deprived, plus the availability of convenience food products and food delivery apps means we are consuming more calories than we intend.

  I found for me personally keeping a food diary was the most effective way to monitor what I was eating and why. I realised I was snacking more out of boredom, or because other people were snacking, than actual hunger.

​  The Japanese have a word for this: Kuchisabishii - eating because your mouth is lonely. Having to write down what I ate for 4 days kept me accountable, even if no-one was going to read my food diary.

​  One other thing I learnt is there is no one single diet that is best for weight loss. The best diet is the one that you can stick with long term without feeling miserable. If you are aiming to lose weight successfully or want to be more mindful about eating, here are some tips.

• A realistic goal is to only try to lose 5% of your body weight.
• Find out about portion sizes and keep a food diary.
• Use a smaller dinner plate so your plate looks fuller.
• Wait 10 minutes or have a glass of water before going back for seconds.
• Understanding the reasons why you want to lose weight. Is it for physical comfort, to get to a lower clothes size or because of other people’s comments? Change for yourself will be more sustainable than changing to please someone else.
• Exercise may not help you lose weight, but it helps improve how your body does background tasks like reducing inflammation, balancing the levels of stress hormone and decreasing your risks of heart disease and diabetes.

I’ve enjoyed the last couple of months reengaging with physiotherapist and teacher Joanne Elphinston in her ART of movement online course. It has really added to my understanding of how to change painful patterns and teach more efficient ones.

One of the cool things I’ve discovered through her work is our body needs a certain amount of tension in fascia and the tissues for us to stay upright. Otherwise, we might as well all be jellyfish. However, if we contract all our muscles, we stiffen up and are unable to move - this is known as the ‘suit of armour’ strategy. Our bodies go from being able to produce finely calibrated movements to only knowing where they are when there is a lot of tension in the muscles.

Our bodies are constantly sensing where we are in space, but injury, stress and hypermobility can interfere with this feedback mechanism. It is as if we become deaf to quiet sounds and can only hear loud noises. What do you do when you can’t hear? Turn the volume up even more! 

​Helping to restore our body’s proprioception is a clever way to improve our balance and get more out of any exercise that we do.​

There are many methods to do this: An easy one that I’ve done in martial arts (without realising its significance) is body slapping or tapping.

First, let's check out your balance on one leg. Now, start with rubbing your palms together quickly, until there is some heat. Then slap or tap both arms, on the outside and on the inside. You want loud, rhythmic noises. Do the same over your chest and belly, over the underwear line in the groin, any part of the back you can reach and finish patting or slapping down the front and back of your legs. At the end, stamp your feet a couple of times. 

​Now for the shakes. Start with your foot, then the knee, and add the hip. Shake it forward and back, and also side to side. Repeat on the other side and follow the same idea for the wrists, elbows and shoulders. Let's look at your balance again. Has anything changed or does anything else feel different in your body? Let me know!

The Department of Health and Human Services (DHHS) has released the updated personal protective equipment (PPE) guidelines for allied health over the weekend, and we now have confirmation of the changes from ‘mandatory’ wearing of face masks in a clinical setting to ‘recommended’. You can read about the changes on the DHHS website here.

In practice, this means both practitioner and patient should wear face masks if:

• you are considered to be in vulnerable health or immuno-compromised
• you work or have been in contact with frontline COVID wards, quarantine systems or international flight crew

All regular santitisation of the clinic will continue between patients.

A couple of people I know had falls in the last month - myself included - so I’ve been thinking about what we can do to prevent falls and injury at any age.

Sometimes being at risk of falling is a result of a health issue, like poor eyesight, incontinence, change of medication or a neurological condition. Be sure to check in with your GP or myself if you feel like your balance has gotten worse recently. Here are a few commonsense tips for around the home:

• Identify and fix up any trip hazards in your living space.
• Get rid of shoes with poor grip, watch your laces.
• Don’t rush chores, take the time to be careful.
• Plan your path and make sure you will have access to any walking aids (if you use them). For example, don’t leave your stick behind at the other end of the house.

​NSW Falls Prevention have a nifty strength and balance video that anyone can do. All you need is a chair and a stretchy exercise band/theraband. I highly recommend it!

Good fall prevention is also about how we recover after we’ve lost balance. This is a simple one that I like to do for balance and coordination. Imagine you are standing in the middle of a clock-face. In front of you is 12 o’clock, to the left is 9 o’clock, to the right is 6 o’clock and behind you is 3 o’clock.

1. Keeping your weight on your back foot in the middle of the clock-face, tap one foot out at 12, 6 and 9 o’clock. To tap at 6 o’clock, take it across your body.
2. Do the same with eyes closed.
3. Can you do this slowly or can you do it fast with tapping 3 times? You can also get someone to call out any number from 1 to 12, and see how accurately you can respond.
4. Step one foot forward to a number but this time transfer all your weight on the moving foot so that you end up with both feet on 12. Do this with eyes open and eyes closed.
5. Now step out slightly wider than what you have been doing, see if you can still keep your balance. How wide can you go before you lose your balance? Can you regain your balance by moving the other foot or your arms?
6. Step forward and balance on the front foot, almost like a hop.
7. For a height or step challenge, stand on a footstool and step down as you go forward, backward, left and right. Make sure the step is secure before doing this!
8. Go back to any of the easier steps, and as you do it, get someone to give you a little tap/push sideways on the shoulder to simulate being bumped. See if you can recover your balance.

Here are some short videos if you need to visualise!

I read an interesting article about pain recently: Can reframing pain make it go away?
​​Quite possibly - is the short answer. 

When we feel pain, it is the result of a complex interplay of emotional and physical factors. A stubbed toe when you are trying to save a falling baby, versus the same mechanical injury after you've had some bad news over the phone, could feel very different. 

The story we tell ourselves about injury and pain can also make a difference in how we recover. As medical science improves, we expect that we can fix everything with the right pill or treatment and can become despondent when it doesn't happen.

Studies have shown that when people are able to reframe and find meaning in a painful experience (this could be a physical like a toothache or an emotional one like heartbreak), their brains activate the body's natural painkillers and the person then becomes more tolerant to pain. 

Often, the fear of being in pain can be worse than the pain itself. Sometimes, stopping that anticipation loop can help you discover micro-movements in which you are pain-free. With all osteopathic treatment plans, we aim to rebuild your confidence with a gradual return to activity and will support you through the whole process of healing.​

Posted by David Attenborough

WHEN I AM AMONG THE TREES
by Mary Oliver
When I am among the trees,
especially the willows and the honey locust,
equally the beech, the oaks and the pines,
they give off such hints of gladness.
I would almost say that they save me, and daily.
I am so distant from the hope of myself,
in which I have goodness, and discernment,
and never hurry through the world
but walk slowly, and bow often.
Around me the trees stir in their leaves
and call out, “Stay awhile.”
The light flows from their branches.
And they call again, “It’s simple,” they say,
“and you too have come
into the world to do this, to go easy, to be filled
with light, and to shine.”

To me, moving with ease means making a complex thing look easy; having control in a chaotic environment; being able to access dynamic power; moving without fatigue or risk of injury. What does moving with ease mean to you?

We can get stuck in compensatory patterns from old injuries or postural habits, and our brain forgets how to move efficiently. Or perhaps we've only learnt how to run/lift/squat by copying someone else, forgetting that they have different body shapes to us!

 Poor movement - whether repetitive or just the once - can lead to pain and injury. We've all heard of someone who put their their back out putting on socks. While manual treatment can solve the pain problem at the time of injury, it doesn't always prevent recurrence.

I've been exploring the art of movement coaching with the fabulous Joanne Elphinston since the start of 2020 and it has changed the way I give patients exercises and stretches. It has also allowed me to explore my own movement and troubleshoot my dodgy ankle with good success. I've felt incredibly fortunate to have discovered this resource during the Covid-19 pandemic, because the format of movement coaching really suits Telehealth!

It is almost a separate beast from an osteopathic session, because the focus naturally shifts to the patient gaining an awareness of what is happening in their own body rather than for the practitioner to make the correction. While there are now there are plenty of online cardio or strength-based pilates and gym classes, what I am doing in these sessions are giving specific, individualised movements geared towards neuro-muscular integration i.e. how do we teach your brain to find the easiest and least painful way to perform an action?