I’ve been training regularly with weights for a quarter-century. My dad gave me a pair of 5kg dumbbells when I was 8 years old. I caught the strength and muscle-bug when I was about 16, thanks to mum bringing home body building magazines from work. I’m now 41. Those who have known me for that long, know that training has in some sense defined ‘me’. I exercise and I go to the gym. I haven’t been active in sports since rupturing by ACL in Jan 96.
I didn’t start using kettlebells until the end of 2013. I saw them being used *properly* by Master RKC Andrew Read as part of a Functional Movement Screen course in Melbourne. The RKC hardstyle techniques couldn’t be more different than what I used to watch (and cringe at) being done in group classes at Fitness First. Prior to Andrew Read, I actively avoided them because I thought they were crap.
I do very occasionally go to the gym and pick up a barbell, but essentially I’ve been training exclusively with kettlebells ala RKC/SFC/Pavel Tsatsouline since December 2013.
Without doubt they have transformed the way I train and the way I practice as a Physiotherapist. During the same period my education and clinical practice dramatically shifted direction too. I steered away from the now outdated and invalid structural pathoanatomical model of blaming structures and my manual therapy background trying to “fix” pain with my hands. Now I focus on movement, function, patient self-efficacy and education. The kettlebell and the Strong First principle has been an integral part of that shift. The expectation in my practice is that everyone does exercise – EXERCISE IS MEDICINE.
As a Physiotherapist in the hospital system, I used to feel like I was getting dumber. It didn’t matter what medical condition or surgery someone had had, my job as the Physiotherapist in an acute setting was to help get them up out of bed and walk. If they were bed-ridden, sitting up and standing was progress. If they could stand up, walking was progress. If they could walk, using stairs was progress. If they could walk 10m, 15m was progress. Exercise is medicine and in an acute hospital setting it is physiologically essential. It’s not too dramatic to suggest that we die without movement. The effects of being bed-ridden and physically inactive can be disastrous. Walking may not sound like much, but it’s fundamental.
In a Private Practice setting, people are past the acute need to be fundamentally upright and just moving. Whether they’ve had surgery, recovering from injury, have a medical condition, are in pain, or generally deconditioned from poor choices regarding physical health, my role is to improve their physical health through exercise; to provide them with the necessary education about their physical health, and the skills to make me redundant. Shifting the locus of control from me to the client, and empowering them with a sense of self-efficacy is the best thing I can do. It’s not my job as a Physiotherapist to “fix” you; that’s your job because what you chose to do with your body is your choice and yours alone.
I still use manual therapy, but very sparingly. In helps in building the therapeutic alliance; to make the most of the all-important non-specific effects of treatment. Sometimes it ticks a box of meeting a client’s expectation if their prior experience has been solely manual therapy. It also gives me the time to educate them about its’ physiological effects. Safe, non-painful, reassuring physical touch from a caring, compassionate professional can have profound physiological effects, even if it does absolutely nothing structurally.
A comfortable treatment environment, lots of close attention, uninterrupted listening that isn’t rushed by a 15 minute consultation time, checking to make sure I’ve heard and understood all of the client’s narrative, setting a clear expectation of what they want to achieve in terms of goals, making it clear how I can help, providing pain educating and reassurance that it’s going to get better, asking the client to take charge of their own recovery, establishing boundaries and setting accountability and responsibility on their part to stick to the plan, and having them feel comfortable enough to ask questions and give me feedback. Phew!
The volume of clinical research indicating that exercise and the graded, progressive and variable loading of tissue produces the best physiological outcome, regardless of condition, is overwhelming.
Expectation violation, graded exposure, conditioned pain modulation, overcoming habituation, maladaptive beliefs and behaviours, physiological deconditioning, anxiety and learned helplessness, exercise induced hypoalgesia, descending cortical inhibition, and building the components of healthy related physical fitness.
A simple round weight with a handle on it helps me to address all of these!
I pick things up and put them down – if you don’t find that funny search Planet Fitness on YouTube
Taking a leaf out of Adam Meakin’s book, I fucking love kettlebells!
Seriously, if you haven’t tried them, do it.