Monday 18 November 2019

Top 3 Things I Would Have Done Differently Over The Past 10 Years

               This September marked 10 years since the start of my entry into the rehab and fitness fields as a student in the Kinesiology program at the University of Waterloo. Over the past decade I’ve been blessed to graduate from 2 universities (and contribute to the curriculums of both universities & teach at one of them), get my PT license & strength coach certification, write for numerous websites & contribute to books, and meet a lot of great people along the way.
                One would look at it and say “you’ve had a successful career.” While I’m proud of my successes at a young age, especially despite some of the challenges I’ve had, I’d be lying if I said there weren’t some things I would have done differently.
When I look back 10 years to when I started my rehab/fitness journey and think of what went well & what didn't ... there are 3 things that stand out to me as "things I would have done differently."

Side note: A common regret identified by many is not spending enough time with others. I do agree with this partially – but I also believe that (to quote Stan Efferding) “you can be good at anything but you can’t be good at everything.” If you’re trying to achieve a high level of success in an endeavour; be it athletics, school, career, family, relationships; that endeavour(s) will take a greater time & effort commitment than other parts of your life. While I wish I could have spent more time with friends, particularly as a University of Waterloo student, the mature part of me realizes that I may have not gotten to where I am today.

With that in mind here are the 3 things I wish I would have done differently over the past 10 years -

1) (The big one) Done a better job of prioritizing my mental health.

This is easily my biggest regret. I’ve wrote about this in previous articles so I’m not going to beat this point up too much – and I want to write a piece on how I try to manage stresses of working with a predominantly persistent pain population.

I 100% believe that having less anxiety & depression would have likely made me more productive, healthier and likely even more successful than I was both in school and in my licensing exams. Seeing counsellors and psychotherapists was the best thing I’ve done in the last 5 years. It helped me feel & perform better … and I wouldn’t be where I am at today without it.

2) Spent more time learning about psychology & communication

This is more geared towards physio school and my first 2-3 years as a practicing physiotherapist.
So much education is focused on the sexy stuff like exercises, modalities and manual therapy techniques - particularly the latter two. But not enough time is spent on how to communicate with people (both in terms of teaching exercises/concepts and behaviour change), how to build rapport/alliance with people, and how to handle difficult conversations (particularly in healthcare).

I joke around that exercise prescription is the straightforward & easy part for most cases (athletes, people with chronic diseases are more complicated). Aspects like
·         Motivating people for health behaviour change
·         Coaching exercises
·         Teaching people about pain and pacing
·         Managing maladaptive beliefs and behaviours
·         Handling difficult conversations (i.e. dealing with difficult clients, goal setting/managing unrealistic expectations)
…are the hard parts and are often the limiting factors of the clients that I struggle with in my current job where 90% of my clientele have persistent pain and/or post concussive syndrome.

I wish I would have spent more time learning about those things - and I impress that on the students that I educate.

Resources that I recommend are…
·        For coaching exercises: anything by Nick Winkelman – a lot of his stuff can be found at ResearchGate or even just through Google
·         For behaviour change
o   The book Motivational Interviewing in Healthcare
o   BJSM has a good free course on motivational interviewing
·         For pain science education
o   Know Pain by Mike Stewart (a phenomenal course for communication in general)
o   Explain Pain
·         For handling difficult conversations
o   Difficult Conversations: How To Discuss What Matters Most
o   Crucial Conversations: Tips For Talking When Stakes Are High
o   Covalent Careers and Ignite Physio also have great resources on their sites

With Mike Stewart at his Know Pain course earlier this year

3) Hired a damn coach

In high school I tried training myself. My workouts consisted of half ROM bench presses, cheat curls, situps, leg extensions & endless running. While they helped me lose a lot of weight and improve my running & calisthenics performance – they weren’t what I needed to maximize my athleticism either for rugby (which I was training for at the time) or powerlifting. Plus whenever my deadlift got up to 225 I hurt my back and had to restart again. Until taking Stu McGill’s class in 2012 I never really learned how to strength train properly.

Using a 3x5 “Starting Strength” like style of training I made good progress for 8 months and then got hurt with patellofemoral pain and took too long to bust out of the “novice/early intermediate” training phase. Bear in mind this was when we didn’t know much about good PFPS rehab and the pain science information was just in the “infancy” stage of mainstream physiotherapy knowledge. It was also when the strength & conditioning scene really shifted from being influenced by Westside Barbell/multi-ply powerlifting to having programs geared towards raw lifting and general preparation for athletics.

I would have saved a lot of headaches and made a lot more progress earlier on had I have hired a good strength & conditioning coach, even to just sporadically audit my programming, - rather than waste time figuring it out myself.

That said, making years of mistakes did give me a lot of perspective and education which I've been able to apply to others.

Programming resources I recommend for therapists/trainers are
- The Ultimate Back: Enhancing Performance DVD and Ultimate Back Fitness & Performance by Stu McGill
- The 5/3/1 book series by Jim Wendler
- Mash Files by Mash Elite Performance
- Advances in Functional Training 2.0 by Mike Boyle
- 10/20/Life by Brian Carroll – hell even the warm up section is worth the price of the book
- Starting Strength by Mark Rippetoe
- The Juggernaut Method by Chad Wesley Smith
- The Vertical Diet and Peak Performance 3.0 by Stan Efferding

No one is perfect – and I’ve learned a lot from my mistakes that I’ve been able to apply to other professionals and students that I’ve educated. I hope this helps because that’s my article and as always – thanks for reading.

How I've Adapted The McKenzie Method Over The Years

If someone were to ask me “what are the biggest influences on your therapy philosophy” they would be (in no particular order) ·  ...