Saturday, 13 February 2021

Why I am staying at home....

I thought I would write this post as there has been much confusion in my line of work caused by the mention of 'other medical or health services' in the following government guidance:


 You Must Stay At Home, except where noted below

Exception 4: medical need
(7) Exception 4 is that it is reasonably necessary for Persons to leave or be outside Their home—
(a) to seek medical assistance, including to take any medical tests, be vaccinated or access any of the services referred to in paragraph 17 of the Schedule;

Paragraph 17: dental services, opticians, audiology services, chiropody, chiropractors, osteopaths and other medical or health services, including services which incorporate personal care services and treatments required by those with disabilities and services relating to mental health


However, although important for mental and physical health and rehabilitation, massage therapy is not counted as one of the health services and is not defined as medical. It is not included in the list of allied health professions considered as essential. More to the point the guidance explicitly lists massage therapists as one of the close contact services that must close (see below). My association therefore decided that the 'other medical and health services' is not applicable to us. A treatment from me involves being close to each other for over fifteen minutes and I feel the associated risk cannot be justified whilst infection rates are so high. I so want to work, but I agree with the statement below from my Professional Association and will stay at home until given the green light to return to my treatment room. 

Meanwhile I am still available if anyone wants advice over aches and pains, or just a listening ear. Do take care of yourself, I look forward to when we can meet again.

 Dear ISRM Members,

We are aware that this evening certain Professional Associations and the CNHC have changed their advice regarding level 4 & 5 therapists working during this national lockdown.
The ISRM’s position is that nothing has changed since we delivered our latest guidance on 4th January, and as such our members should not provide face to face appointments at this time.
As a Professional Association we exist to represent the best interests of our members for their studies and their businesses. We also have a public duty to take account of the health of our members, their clients and the community at large. We take this duty extremely seriously.
In order to provide our members with as much background to our decision as possible, we will share the below, which shows how legislation and Government guidance interact;
Legislation (Remaining the same as November)
You Must Stay At Home, except where noted below
Exception 4: medical need
(7) Exception 4 is that it is reasonably necessary for Persons to leave or be outside Their home—
(a) to seek medical assistance, including to take any medical tests, be vaccinated or access any of the services referred to in paragraph 17 of the Schedule;
Paragraph 17: dental services, opticians, audiology services, chiropody, chiropractors, osteopaths and other medical or health services, including services which incorporate personal care services and treatments required by those with disabilities and services relating to mental health,
Guidance (updated 6th January)
Close Contact Service Must Close
This includes hairdressers, barbers, beauticians, tattooists, sports and massage therapists, dress fitters, tailors and fashion designers
Relationship between Legislation & Guidance (Directly quoted from the Government)
To find out exactly what the rules are during the coronavirus pandemic, you need to look at both legislation and government guidance. Legislation sets out legal obligations and restrictions that are enforceable by law. If you do not abide by the legislation you are breaking the law. Guidance and advice is likely to be based on legislation (in which case it will be legally binding) and it might offer the best or most appropriate way to adhere to the law.
The law is what you must do; the guidance might be a mixture of what you must do and what you should do.
Some Figures For Consideration
When we restarted work in July, the incidence of covid in the UK was less than 1 in 1000
The November lockdown came in because infection rates were in the region of 1 in 100
As of January 6th, in England the incidence is 1 in 50 with hot spots of 1 in 30
In addition we know that the latest strain is 50% - 70% more infectious, which was not the case in November. Our hospitals have more covid patients than at any time during the entire pandemic (30,000 as of 6th Jan). Life saving treatments are being stopped. We are at Covid-19 Alert Level 5, indicating that the NHS may be overrun within the next 21 days without significant changes. We were at Covid Alert Level 3 when we restarted in July.
We are in Lockdown and the very clear message is;
STAY HOME, PROTECT THE NHS, SAVE LIVES
During normal times, we hope that you select the Professional Association that you want to represent you because you agree with the ethos of the association, what it stands for and how it works to progress the industry. Now in these extraordinary times, tough decisions must be made, our ethos, our duties to our members and what we stand for in the future of Soft Tissue Therapy means we are very confident to make these tough decisions and stand by them.
Thank you once again for your support, we will get through this together
The ISRM Team

Thursday, 4 February 2021

How is your First Aid?

 

Image by Claudia Schwarz @purlzlbaum

I will be updating my Emergency First Aid at Work certificate in a couple of weeks time with the St John's Ambulance. I have to renew my certificate every three years by doing a course in person but in between I sometimes do online courses to keep my awareness of basic first aid topped up. These don't take long to do and could help you to make a real difference to someone in need of help. Here is a link you may like to use to one that is available for free during the pandemic:

https://www.strongrootstraining.com/first-aid-awareness-at-home?fbclid=IwAR2lsOm4p9jqNOWhPtls5nFK0KQpLjIpRS3v_8HBVyI3eST7Dz2cPuWHnWI

The Red Cross also have online information:

https://www.redcross.org.uk/first-aid##

Earlier in the pandemic I did another one with SJA  which presented me with scenarios and I had to select the appropriate actions (suspected heart attack; heavy bleeding; unconscious person; choking). It was excellent and did identify some areas where I needed to brush up my knowledge.

https://www.sja.org.uk/course-information/free-refresher-course/?utm_source=Communigator&utm_medium=email&utm_campaign=COVID110221&utm_content=

Even though I have been doing first aid courses for over twenty years now (usually emergency first aid but I have done the three day more thorough course as well) as with everything if you don't use it regularly it is difficult to remember everything. I am very glad that I have not often been in situations that require me to use my first aid skills but this lack of practice makes it even more important that I keep refreshing my knowledge.

Do also keep an eye out for where you can access a defibrillator near your work or home, you can look them up on this site: https://www.heartsafe.org.uk/aed-locations

Monday, 18 January 2021

Walking not slipping...

 


It's been pretty slippy out there recently; when it hasn't been icy, it's been muddy, and sometimes it's been slushy mud over ice. All a bit of a challenge to our balance! At this time it's very important to look after yourself and not end up injured so you may be using studs or other footwear to improve your grip, but there are also movement strategies to remember:

  • Relax! Let your body stay relaxed so it can monitor what is happening underfoot and make minute adjustments to help you adapt and balance. Your nervous system will be working with your musculoskeletal system far faster than you can consciously control!
  • Remember to breathe; as well as being generally a good idea this will help you keep relaxed.
  • if you slip but recover your balance before you fall that is amazing - your body is looking after you!
  • Look at my blog post on vertical hip release; this movement strategy will help your body absorb and respond to the challenges posed by slippy conditions.
  • Look at my blog post 'Hunting in the Forest' which is about keeping your centre of gravity over your feet as you walk; again this will help with keeping your balance and feeling secure as you move forward.
You can find the two blog posts on the 'exercises' page of my website, scroll down to the bullet points where you can find the links to the posts.

I sometimes find myself nervous about going out in icy or frosty conditions as we live on a steep hill, but if I use these strategies plus maybe some grips that I can pull over my trainers then I find I cope just fine - and feel so much better for getting outside! Obviously I am not you so do use your own judgement to keep safe out there - especially when there is black ice.


Friday, 8 January 2021

Retraining the brain around persistent pain.

There has been a great deal of research into pain in recent years; it is now much better understood that perception of pain, as in how much pain we feel, is mediated by the brain rather than the tissues. Many of you will have seen a short talk on pain, 'Why Things Hurt' by Professor Lorimer Moseley made back in 2011. Here is a recording of a more recent lecture by him that as well as explaining what is going on when we feel pain also explores (from 48 minutes in) how we can manage our pain and retrain our pain response.  


One of the things that I really like about how he talks about pain is that he emphasises that many of his patients with chronic, persistent pain are some of the bravest people you could meet. He understands that persistent pain can get us down, that we can begin to worry that people don't believe us or that they think we are 'weak', or we may begin to be frightened of what is happening with our body to create all this pain. This is why he is so keen to educate about pain and as well as watching the video I recommend having a look at the two websites linked to below. 

In summary:
Pain is there to protect us, but it can become oversensitised and turn from a useful tool to something that is controlling and restricting us.
It is influenced by context and meaning - past history/associations; our mood, fears, thoughts and health; our beliefs, knowledge, culture, social circle and so on (listed in the video).
Inflammation elevates the pain response.
Perception of pain can be dampened down by:
- understanding what is happening, and being shown understanding.
- having patience and persistence as retraining something that has developed to protect us will take time.
- having someone to support and coach you through the process.

He also emphasises that movement and activity is good especially once a safe baseline has been established to build from; not moving (where chronic pain often takes us) is not good. We need to retrain the brain that movement is safe - something that many movement therapies such as JEMS embrace.
My own journey with chronic pain turned a corner when I discovered two different yoga teachers, teaching very different types of yoga, who provided a safe context for me to explore - gently, over many weeks so that my brain could listen to my body and recalibrate - movement that I had learnt to avoid, and to learn that movement was not only safe but felt helpful and liberating.

Useful links and resources:
- These two sites are mentioned by Lorimer Moseley and have been created to provide help for people experiencing chronic pain:

- This is a link to a pamphlet on persistent pain, produced by the Tasmanian health system. It is very simply but thoroughly explained.

Tuesday, 5 January 2021

Beginning 2021 with a lockdown



As expected, we are in another lockdown and I have had to postpone in person appointments until the infection level allows them to resume. 'Sports and massage therapists' are listed by the government guidance as one of the close contact services that must close. 

The following paragraph is from the legislation and lists some of the exemptions. Some have suggested that Level 5 Soft Tissue Therapists could be meant by 'other medical or health services' but I believe this to be a misinterpretation. Soft Tissue Therapists are not at present officially recognised as a medical or health service and are not included in the Allied Health Professions.

'Paragraph 17: dental services, opticians, audiology services, chiropody, chiropractors, osteopaths and other medical or health services, including services which incorporate personal care services and treatments required by those with disabilities and services relating to mental health,'

I am still here for you; many people have found 30 minute zoom sessions helpful for exploring exercises and breathing, and to generally off load about anything on their mind - I am here to listen! If you would like a zoom session or a phone call you can contact me by email or phone to arrange. I am at present not charging for these sessions - they are my way of offering some support at this time

Wishing you all the best as we continue to go through this difficult time. All of us will be experiencing challenges, do make use of the help out there including from charities such as Mind that have helpful advice on their website on coping strategies. Martin Lewis' website 'Money Saving Expert' has lots of helpful advice on financial aspects of the crisis from universal credit to help for the self employed and small companies.

Take care,

Kate

Wednesday, 30 December 2020

Nearing the end of 2020...

 


Here we are, nearly at the end of 2020 - a year which has been so different to what we expected this time last year. I hope you and your family and friends are well, and that 2021 what will be an easier, kinder year.

I was reading an article by Joanne Elphinston earlier today where she discussed the words resonating with her: resilience but also adaptability, tempered by kindness and patience for ourselves as well as others. There will have been times where we had to weather the storm the best we could and other times when we had the energy to take a breath and look around us for how we can adapt to this unfamiliar situation we find ourselves in. This chronic state of affairs is stressful and exhausting even as it becomes familiar, and so we should be patient and kind with ourselves as well as others - but also recognise that there will be days where it's hard for us or those around us to be patient or kind. 

At present the 919 Clinic is closed for the Christmas holiday; I hope to reopen on Tuesday 5th January but if we move into Tier 4 in Sheffield I will have to remain closed until further notice. Those of you who have been in for recent treatments will have experienced my new couch cover, made from medical grade, phthalate-free fabric that I can clean after each treatment. I think it looks very smart and it has reduced my washing load whilst maintaining hygiene standards.



As we approach New Year's Eve I wish you all the best for the future; take care, hope to see you in 2021.

Monday, 30 November 2020

Letting that back relax... (video)

We often hold tension in our backs without being aware of it; this exercise explores tuning in to relax the back whilst engaging the arms and legs in gentle movement. It is a simple exercise that transfers to how we walk, stand, run....

As you explore the exercise, notice how your body feels against the ground and how your body is absorbing and reacting to the movement. Begin with gentle pressure as you press your legs and arms down into the ground or your feet against the wall and observe what happens with your back. Allow yourself to become as relaxed as possible and notice how the sensation of pressing down travels through your body.

Click on the link below to watch the video:

https://vimeo.com/485557631/