Mental health

Pandemic Lessons Learned - Dealing With Uncertainty

 
man holding questionmark sign over face
 

Pandemic Lessons Learned - Dealing With Uncertainty


Dear all, I hope that you are safe and well and I think it is just about ok to still wish you a very Happy New Year! 

In June I wrote a blog post with the title “Looking after our mental health in challenging times”. At that point it looked like we might be nearing an end to the pandemic or at least there was some movement in the right direction. Six months later we find ourselves in a national lockdown and it is almost a year from when this first started.  

There is no denying it, this has certainly been a challenging time for a lot of people. Work adjustments, parenting challenges, relationship dynamics changing, social life alterations, sport and exercise modifications and so much more has meant we have had to adapt in the most unexpected of ways. When something is also out of our hands and the changes are enforced upon us, it can seem more challenging as the locus of control is external rather than internal.  

For today's blog post I thought it would be useful to discuss some of the lessons learnt and how we can approach the current situation to best manage life around us. Here are 3 main lessons we can learn:

Lesson 1- Control The Controllables

 “ You cannot control what goes on outside. But you can always control what goes on inside.” Wayne Dyer.

 In life we have a choice to make which although can seem reductionist and too binary, it can serve to let us control how we see life events happening. One is to see them as happening TO us and the other is to see them as happening FOR us. The former places us in a path of accepting that the events which occur which are not initially perceived as positive are almost there as a form of punishment. We demonise the event and see only the struggles we have faced and what we have lost. The latter mindset gives us a sense of opportunity and curiosity. No one can control this virus 100%. Our attempts with all the measures in place , vaccines, lockdowns etc serve to maintain, reduce and hopefully bring closer and end to it. But,  the virus is way more powerful than we are and will live it life as it sees fit. 

We can accept the situation as it is and learn to find elements in our life which we can take more control of,  or we can waste time and energy on gathering even more information, reading more news, hypothesising as to what may or may not happen with the virus. What becomes of the latter? There are thousands of people out there whose job it is to do this, the scientists, doctors and researchers who are paid to spend their time doing this. And yet we get drawn into joining them to feel some level of control over the situation when in reality, not even the experts have the answer.

If we spent more time focusing on what we could control we would undoubtedly have less anxiety, less fear, more time for ourselves, more energy to pursue meaningful endeavours which would serve our own personal development and overall health and wellbeing. Sure, we need to know the basics and what big changes have happened, but other than that, could it be that the time spent mulling over the uncontrollable could be better spent controlling our inside world?

 

Lesson 2 - Adaptation Not Abolition

“The key to success is often the ability to adapt.” - Confucius.

When something gets taken away from us or becomes more of a challenge we can approach the situation with 2 points, fixed or growth. The fixed mindset can tell us things like: 

  • Well that's it, I can't do that anymore so I’ll stop completely until this is all over.

  • If I can’t do it like I did before then I’ll just stop it altogether.

  • I’m all or nothing so I’ll wait until I can give it my all again.

  • It’s pointless just doing a little, the benefits won’t be enough.

 

I have heard similar principles being said over that least few months. People who, for example used the gym regularly, altogether stop as it’s not accessible. Or people who have less time now to dedicate to their rehab stop. It is our job as clinicians to help you find ways where you can adapt and not abolish all the things you used to do. There has to be a level of acceptance of the status quo and a willingness to adapt in spite of it. Having the above mindset allows you to have ready made excuses as to why you can’t continue doing at least some of the things you did. A growth mindset has the following dialogue:  

  • Ok. This has happened, what is possible for me instead?

  • I can’t do that anymore, but what could I do?

  • Even a small step is bigger than no step at all.

  • The skills I learn now could improve my old skill when I get back to doing that.

 

Let’s take playing tennis as an example, which has at times not been possible. If you were to take all the components of playing tennis down, what could you still work on and perhaps even improve? Perhaps you know that your footwork isn't the best at times. Buy a speed and agility ladder and work on that for a few months, that would no end help your game! Perhaps you've had that niggly shoulder whilst serving that you can't shake. Spend some time working on the strength and stability of that shoulder to allow you better performance when you're back.

 If you dig a little deeper into things, the space and time we have been given can serve as a powerful vehicle to allow you to upskill. It sounds so basic but I often say to patients “Ok, so you can't spend an hour in the gym anymore, can you spend 15 minutes doing a HIIT class?” They often respond with “Well what will that do?”. “ More than doing 0 minutes will” I say. In times such as these, sometimes we have to appreciate that maintaining and ticking over is just fine and that is way more conducive to just stopping.

  

Lesson 3 - Finite vs Infinite 

The infinite is in the finite of every moment.” - Zen proverb.

Life can be divided into things which are finite and infinite. Films, sports, a working day, a song, a train journey, a holiday, all these things have a start and an endpoint. It’s easy to conceptualise this and place ourselves in that time frame. What you notice about these things is that they are just that, they are things or events. What isn’t finite in life is our emotions, our development, our intellect, our wisdom, our growth and our experiences of life. It’s very easy to approach this pandemic and more specifically the virus itself as a finite thing. Whilst at some point, yes, Covid-19 will cease to exist, there will not be an end to viruses as a whole for now, or at least perhaps ever, in the life existence as we know it.

 I feel that at the moment so many people are placing such emphasis on dates, numbers, restriction changes to this that they approach it with an end in mind. Like other things in life, if we lead with expectation over appreciation of agreements then this can set us up for disappointment. If our expectations are met (let's say the news aligns with what we hoped for), we gain a momentary sense of relief and some level of freedom may come with it. But what next? Do we then start to set higher expectations? What if they aren't met? What if there is a u-turn like there has been so many times? Do we then continually just ride this rollercoaster of emotions ranging from elation to stress and worry? What actually changes?

 Something which can help in these situations is to actually place yourself way ahead in the future, several years even. Think about a conversation you might be having with someone who either lived through this or perhaps didn't, a niece or nephew or a grandchild.  Hopefully that conversation could go along the lines of “Remember that time when everything was really weird and we had to wear masks and everything was shut, how strange was that? But here we are, still living life.”

 This, like many things, will be a memory in years to come. It will have its place in history like other events. Check in with what is present to you and how the moments you have during this time are approached with a sense of openness and optimism. Ask yourself this one power question to keep present and focused: “How can I approach today different or better than I did yesterday and how will that keep me focused on the infinite approach to feeling and experiencing a different appreciation for the now?”

Thank you for taking the time to read this.

Alex. 

Alex is a physiotherapist with Physio Remedies and also a Life Coach. He works with people to gain greater awareness in any aspect of their life they may be struggling with by allowing them to explore what might be possible with more clarity in their goals and ambitions. Ultimately he aims to provide opportunities to people to lead a more fulfilled and extraordinary life by unlocking their fullest potential. You can get in touch with him at alex@alexmanoscoaching.com and follow him on Instagram at @alexmanoscoaching.

8 Tips To Master Your Mindset Through Injury

 
head and mind jig saw puzzle illustration
 

8 Tips To Master Your Mindset Through Injury


I hope you are all safe and well and are hopefully coming out of this period in a good place. Although this time has been challenging for many, it certainly has given us some space to reflect on many things which hopefully will serve you well moving forward. 

Today I wanted to talk about how to manage your mindset through an injury. This is such a crucial part of overcoming an injury, and in fact, can be the difference in the time of recovery and also the success of the recovery. Injuries are difficult to deal with as they stop you doing the things you love doing or even more practically can stop you from being able to manage normal daily activities. There is a huge three way connection between the mind, the brain and the body. As an analogy I like to think of it like this. Imagine an oil refinery, the petrol and a car. The oil refinery is the mind, the petrol is the brain and the car is the body. 

Processing     →     Fuel     →     Performance

Oil refinery     →     Petrol     →     Car

Mind     →     Brain     →     Body

Ultimately what we fuel our body with, physically, mentally, emotionally, spiritually, will determine the performance of the car. I know first hand, both having being injured and also having seen 1000s of injuries, just how a person’s mental attitude can help. When I worked in professional football, what amazed me was the difference in how players coped with similar injuries and how this impacted on their recovery. Although we can’t cheat physiology, healing and anatomy on a grand scale, we can certainly change it by altering our brain physiology which has an impact on our perception of pain and function and can lead to a quicker and more successful return to full health. 

Below are 8 tips for managing the energy that goes into overcoming your injury. No matter how big or small your injury is, there is always a place for improving the overall well being of your mind to help your recovery. 

1. Accept and don’t blame - At times of course, our actions may have been a factor in our injury. If we suddenly did something we were completely unaccustomed to then yes, we could look back and say ‘Oh why did I do that?!’. This is ok, but rather than blame ourselves, we should use it as a lesson for the future. We don’t set out with an intention to injure ourselves! We most often have good intentions, to be healthier, fitter, stronger etc, and this enthusiasm can overlook the fact that our body was perhaps not prepared for that change. Accepting that it has happened and moving on to deal with it as best as possible is key. 

2.  Don’t compare - No two injuries are ever the same and they are certainly not the same in how they present in different people. It is important to stay present to your injury and focus on that and that alone. You can certainly draw on experiences of previous episodes you may have had or people you know who have had similar but use that as a check point rather than a strict comparison. You may judge your progress negatively if you compare it to others who have recovered quickly. Stay in your own reality. 

3. Goal setting - This is a really crucial area and it is up to you and your therapist to come up with short, medium and long term goals. The most important of these are the short term goals as they will keep you present. At the start of your rehab your therapist should know what your ultimate goal is as this differs for everyone. Short term goals however are the key to keeping momentum going. You should establish a set of what we call process goals and then little tests you have to pass before you can move onto the next stage of rehab. This really is more for your therapist to do and then give you the exercises to reach those milestones but it’s really important to understand how these process goals will move you closer to your long term outcome. In the back of your mind, have that long term goal in sight, but each day focus on the tasks right in front of you. This is what will cause the mini shifts day in day out and before you know it you’ll be closer to your dream destination!

4. Clean language - The way we describe our injury and how we visualise what is going on in our body is really important. Unfortunately, it is not just patients who use inappropriate language when describing injuries. Therapists can also fall into habits which aren’t beneficial to an a understanding of the pathology of the problem. There is a lot of fear which can creep into a patient’s mind when they are spoken to in language which serves to, at times, catastrophize the problem. Depending on the injury of course, examples of such words are ‘unstable, broken, inflamed, tight, flared up, out of place’. Now in some instances, it may be appropriate to use some of those terms but a lot of the time it just isn’t scientifically right. The two most common misconceptions I hear are “My ITB is tight’ and “My back is out of place”, both of which aren’t really true! Speak to your therapist to gain a good understanding of what’s going on and use better language yourself in describing it. It can be a real game changer in moving forward with your rehab and altering your mindset. 

5. Visualisation - The power of visualisation is very real. You may have seen the images of F1 drivers mentally practising the circuit prior to getting in the car, tennis players getting into the zone during breaks, dancers working through routines in their heads etc. This constant mental imagery closes the gap between the thought and the action and allows the two to be more whole. This can work in rehab too. There are studies which show that adding visualisation can help the recovery from injuries. Sitting there and visualising healing taking place, picturing a healthy joint, muscle of whatever is injured, and looking positively at the recovery can aid both pain and also function. It is almost like a mini hypnosis which can be so powerful. It may sound odd, but talking to your injury verbally for a few minutes a day can help with recovery. 

6. Breathing - Similar to number 5 this is a really simple technique that we can use. The reason breathing properly and mindfully is so important is the effect it can have on the physiology of our body. Although you won’t notice the immediate effect of, say, breathing for 5 minutes a day on your rehab, over time the change is real. Breathing helps to regulate cortisol levels, the hormone which is released during times of stress. Regardless of where the stress is coming from, cortisol will be elevated in this state. During injury, stress may go up. Exercise has the effect of releasing your happy hormones: endorphins which can counteract the stress hormone. So, if your exercises routine has been disrupted and this balance of hormones has been affected, taking just 5 minutes twice a day to focus on some breathing techniques can really help regulate stress. You can try diaphragmatic breathing, box breathing, alternate nostril breathing - there are many forms of breathing out there. Please make sure that you are in good health, have no associated heart or respiratory conditions, are not pregnant and do not have other health issues that could be a contraindication to doing some of these techniques. 

7. Be adaptable - In some instances we have to accept that an injury may force us to reconsider what we can do going forward. I personally know how this feels.  After having had several ankle injures, I have now accepted that I can’t do the things I did 10 years ago which is ok and I have since found new things to help and also keep my enthusiasm up for exercising despite not being able to do exactly the same things. Re assess your current exercise routine, be open to trying things you haven’t tried before, understand that our bodies do change with age - what may have previously worked for us may not be serving us as well now. I am a big believer in having variety in your exercise, unless of course you have a very, very specific sport or event which requires you to train very specially. For example, it would be counterproductive for a 100m sprinter to suddenly take up lots of yoga as they actually rely on an element of stiffness to produce power over a short space of time. Train your body in different ways to ensure good balance of strength, flexibility, power and fitness. 

8. Make sacrifices - Ultimately it comes down to how important an outcome is to you. Your ultimate goal and your lifestyle have to be aligned if you want to see the best and quickest results. Not only can our brain not comprehend conflicting thoughts, nor too can our body. What do I mean by this? Well, if you want to lead a healthier lifestyle and yet keep telling yourself that you love fast food, your brain will become confused and so too will your actions. Similarly, if your goal is to ski after a knee injury and your physio has set you a programme of going to the gym 3 - 4 times a week, choosing to go out socialising on two of those days instead is not going to produce the results you need. It may sounds common sense but it is often not common practice. Your daily habits will, over time, produce the results you want. It’s that simple. Be prepared to sacrifice some things, perhaps only for a while mind you, to focus on what matters most at the time. 

I hope that these points have been useful in identifying some areas you could work in to optimise your rehab. I am a huge believer in mindset and how it affects the body and paying attention to the above can really help shift you in the right direction. 

If you would like to find out more about any on the above then please feel free to contact me at alex@physioremedies.com.

I wish you well in your rehab and I appreciate you for taking the time to read this article.  

Stay healthy, stay strong!

Best wishes 

Alex. 


Words by Alex Manos.



Looking After our Mental Health In Challenging Times

looking after your mental healthv

Looking After our Mental Health In Challenging Times

Managing purpose and productivity during the coronavirus pandemic

Our mental health has a huge effect on our physical health and it’s important we take notice and care of both, particularly during challenging times such as these. As physiotherapists, we talk a lot about physical health so we asked our specialist physio Alex, who is also a Life Coach and Yoga instructor, to talk about looking after your mental health:

I hope that you are all keeping well and have been safe and healthy during this unusual time. It’s encouraging to see that the green shoots are hopefully appearing and slowly but surely we will be returning to a more normal way of living. It has been a challenging time for everyone no doubt in many ways. Not only has the financial implication taken its toll on many, the major shift in balance of work, life,  family and  social time has made it a challenge to re adjust. 

I wanted to briefly share some of the insights I have had and how I have managed to keep momentum going despite a huge reduction in my day to day work which has given me time and space to explore other things. I do this to see if I can hopefully help guide you into a mindset which focuses on the positive which has come from this. 

I wanted to write about two concepts which have perhaps been a challenge for many to find results in: they are productivity and purpose. So much of our value in terms of productivity and purpose comes from our time spent at work and for many of us who have not been able to continue working in the same way, this dramatic shift could have been met with a lot of resistance and a sense of feeling lost. A lot of our work is based around a problem and then solution type scenario. Whatever line of work we are in there is usually a starting point and an end task to to our duties and with that comes a sense of accomplishment, recognition and validation for our efforts. We gain purpose from being productive in the work we have been given to do, that's completely natural.

So what happens when our external source of productivity gets taken away? How do we generate that internal fuel to drive our feeling of purpose? What happens when our daily focus suddenly shifts and we have a blank canvas as to what we can attend to? 

The brain and mind is a wonderful thing and one of the beautiful contradictions is that when we get the things we often yearn for, we miss, we wish we had more of, we are often not prepared and actually struggle to manage them. It’s the reason why so many lottery winners actually end up losing all their money or run into emotional and social problems because they suddenly step into a new way of life which they themselves have not created, so they actually are unaccustomed to it, it’s alien to them.

So what can we do to manage this so we come through it with purpose, productivity and a sense of value? 

Here are 5 ways we can look at what has happened and happening with a fresh and positive mindset, a mindset which will make us appreciate things. 

  1. Ask yourself this simple question. Prior to the change, what were the things I really wanted more of? Of those things, which ones were in my control to make use of and appreciate. 

  2. What areas in my life needed more attention? Perhaps it was health and fitness, your relationship with a significant other, your relationship with your children, your intellectual life, your emotional and spiritual well being, your career (perhaps a career change), your time spent communicating with family and friends. Looking at those areas, what steps have you taken to elevate them to a new level? Where can you find areas of personal growth to work on? 

  3. What can you be truly grateful for? The simplest way to do this is to start a gratitude journal or practice. A nice way to do this is the ’10 finger gratitude practice’. Each day, sit quietly somewhere for 5 minutes where you know you won’t be distracted (the start to the day is usually best if possible) and open your hands. Close your eyes, visualise and internally repeat 10 things you are grateful for and each time you do, close one finger until you have done 10. Then take your hands openly and place them over your heart and breathe deeply 5 times inhaling the things you have just show gratitude for. Literally fill your body with a sense of appreciation for what you have. 

  4. Understand that rest is a necessary thing. Taking a pause from usual life, if you are fortunate to be able to come out of it unscathed, is a blessing. If, we say live to an average age of 80, 5 months off equates to 0.5 percent of your life. Think about it, 0.5 percent of your life to recharge, re group, re evaluate what matters and spend time doing some of the things you really really want to do.

  5. I personally came from a place of thinking that we are just merely passengers on this planet. As much as we have created some wonderful things we have also done some extremely damaging things to the planet. I take solace in thinking that perhaps the planet needed a break from us to recharge, regroup, find it’s beauty again, breathe and restore some of it’s natural existence so that us humans can live in more peace and harmony with our surroundings and the other creatures and living beings which we share this world with. Think about the dolphins in Venice, the flamingos in Mumbai, the pandas in Hong King zoo mating. Theses amazing pictures and stories which have come out of the earth having some time to itself. 

Another wonderful tool we have at our disposal in this modern era is the availability of free information. At the touch of a button we can watch a TedTalk, a you tube video, listen to a podcast, download free programs, access free exercise routines. So many wonderful ways we can keep exploring self development and personal growth, for FREE! 

When we come from a mindset that things happened for us and not to us we can hopefully begin to accept the challenges and appreciate the new opportunities that may arise in this time. 

  • There is purpose in reading a book 

  • There is purpose in spending uninterrupted play with your children 

  • There is purpose in having the chance to sit as a family to share a meal more often 

  • There is purpose in taking a walk in the woods and saw during the amazing weather we have had

  • There is purpose in listening to podcast

  • There is purpose in watching that Netflix series you have been wanting to 

  • There is purpose in starting to learn a new language 

  • There is purpose in learning to cook 

  • There is purpose in just slowing down

There is purpose all around us. Once you can detach from needing an end result to something, needing that goal crossed off, one can find purpose in the journey and the existence of just being present and appreciating the things right in front of our eyes.

In perhaps one of the greatest movie speeches of all time and a personal favourite of mine, Al Pacino playing Tony D'Amato in the film Any Given Sunday, says ‘That’s what living is, the six inches in front of your face’. It’s a wonderful philosophy as it can keep us grounded and in the moment. 

I hope that you have enjoyed reading this message. This kind of work is a passion of mine and I have been fortunate to learn from some of the very best and I am grateful to have a platform to share and serve people in a way which I too have been served by others. 

Words by Alex Manos.