In 24 hours I’ll be moving, probably very slowly, along the South Downs, nearing Eastbourne.
I have no idea how long this journey will take: Winchester to Eastbourne along the South Downs Way. There’ll be no records except my own.
Now it’s time for some breakfast before getting the pack on, and walking to the start.
The first rest stop is Cocking, 55k. Meanwhile, Chris my support crew, will be cycling back and forth between the van, me and various points, keeping me well supplied.
That’s all I am thinking about right now. Step by step. One stage and then onto the next.
The weather looks good, so I expect there’ll be plenty of walkers and runners along the way. Less through the night though…
I would never have imagined that a monk would teach me to run.
Over the past three months or so, following my DNF in May, I have been getting it together by following a training programme.
This was a programme put together by record breaking ultrarunner Damian Hall. He bases much of his coaching on the approach by David Roche. David is a great advocate of easy running — you can run as easy as you like.
Easy running makes you quicker. Didn’t you know? I am not going to explain to you how, because David can here.
I can tell you that it works from my own experience.
I was pretty broken after two years of non-stop ultras. The pushing, straining, mile after mile initially worked, but the stress on my body caught up. You can’t keep going at that intensity without something giving. I see these folk in the clinic — the ones who are stuck.
So easy together with consistent and regular movements, stretches, stability and strength with have built me a base. What’s more, it has brought the joy back and the confidence to keep going. Perfect timing too with the SDW 100 miler next Saturday.
Thich Nhat Hanh
A great advocate of mindful walking, Thich Nhat Hanh encourages us to slow down, be in the here and now and cultivate a peaceful way.
I used to try and practice mindful running, but somehow had put this way to the back. Instead, I became over-focused on the feelings in my body and trying to work them out. This was part of the reason for the DNF. It is unsustainable because every little ache and pain becomes amplified.
Together with the easy running, I thought I would listen to Thich as I trotted along. To be able to listen to someone or a podcast whilst running means that your pace is easy — not stressful.
Thich guides many meditations, but the one I was listening to resonated. It also worked in as much as I became calmer and calmer, running relaxed and easy. Perfect!
This is the kind of practice I share with people who come to see me. Most if not all benefit from creating a calmer embodied mind having been dealing with many different challenges at the root of their suffering. Persistent pain in particular and the consequences.
The beauty of the practice is that it is so simple. Whilst it may not be for all runners, if you are someone who wants to master the easy run to become quicker, you may find it helpful.
Here are the words. I will share a recording soon.
Try this if you like.
The practice
Run easy, which means with flow, smoothness and upright, using your body as a guide — no strain. Notice your breathing, but do not try to change it or control it. One way is to place your attention at the end of your nose and become aware of the air flowing in and flowing out.
With your awareness now upon the flow of your breath, silently say to yourself: breathing in, I am aware I am breathing in. Breathing out, I am aware I am breathing out. The shorten to breathing in, breathing out.
This brings your attention to your breath in the here and now. If your mind wanders, simply start again. This is a practice.
Some people enjoy the presence and rhythm that this brings, somehow becoming part of the overall movement of running.
A further mantra that I use to remain present and at ease is: breathing in, I calm my mind. Breathing out, I run easy. Then shortened to calm mind, easy running.
Of course, you can create your own as well. Choose words that give you gentle direction that you can follow.
Notice what happens.
Let me know if you like. I’d love to hear.
Next time, some thoughts on nose breathing — because that is what it is there for.
Happy running!
RS
PS/ If you are up on the South Downs Way next Saturday-Sunday and see me or want to join me for a few miles, let me know. I am running to raise £ for St Wilfrid’s Hospice in Eastbourne and in memory of my dad: https://www.justgiving.com/fundraising/richmond-stace11
I have long thought that there should be a self-care module within physiotherapy training. Here is why.
Physiotherapy is arguably the best job in the world. Once qualified there are so many choices and ways that you can take ownership and forge a way forward.
I believe that there is a universal desire to contribute within the profession: to help people improve their lives and make it a better world. This in itself is healthy and helps build wellness. The latter is where we can make a real difference as we encourage, empower and enable individuals to shape positive futures — because they can.
There’s a but.
All this focus on helping others requires a strong sense of self and an absolute need for self-caring.
If you want to care for others, you must start by caring for yourself
#thepaincoach
There is a good chance that a number of therapists will be great empathisers. They will can can feel similar emotions and even pains described by others. There is a reverberation through their own embodied minds, which in time can cause stress responses and anxiety if not recognised — empathetic distress.
In one sense empathy is a gift that allows connection and understanding. Uncontrolled, this can lead to burnout. The answer to this appears to be cultivating compassion, which is boundless. There is an outlet in compassion that is a desire to help — taking action. When we take action there is a kind of release as we feel a sense of control and destiny with our chosen way of helping the person. (Whether they want our help and the kind of help we offer is another question! This is one of the skills of being a therapist).
A common way to practice compassion is with metta, or the loving kindness meditation. We develop our understanding and acceptance of ourselves, accepting that to take care of ourselves is the first step in caring for others.
Person-first. Always
This sits well with the person-first approach: person before patient. Certainly when it comes to pain, it is the person that feels pain, not the body part. We guide and encourage a person, not a body system or a limb. Zoom out.
The more the focus is on the place that hurts, the worse the outcome for a number of reasons: e.g./ attention and expectation play significant roles in pain perception. The more the focus is upon the person and what they want to achieve in their life, the better the outcome.
Each person has resources, knowledge, strengths and the potential to improve their lives. This is the start point, not a list of problems to solve.
It is the same for the therapist of course. A person with all the above.
Building wellness
How do you build yours each day?
To care for others we need to be well. Daily skills and practices that manage and lift our energy, help us to pay attention, maintain a positive outlook will keep us on a healthy path.
These are habits. Many are the same ones that we encourage the people we work with to create.
When I used to run Pain Coaching sessions for clinicians and therapists, we always start with you: ‘know thyself’. There is nowhere else to start. You have to gain insight into who you are, how you think and what you offer. From there you can build and be the architect of a fantastic career.
There are many ways to build wellness. The more obvious include exercise, moving your body, eating and sleeping well. There are more.
Connecting with people who encourage you, getting out into nature, knowing your purpose, breathing and being present more often.
As a start, I have created an infographic that you can use in your own way (download above).
My hope is that we see universities and colleges increasingly include self-care in the syllabus. Some methods and techniques are now outdated and should move aside, making room for the important practices. In my view, there is none more important that making sure therapists feel supported and that they are developing a strong sense of who they are as healthcare professionals.
Training is a huge investment, both personally and for the state. Surely then, we must ensure that the people undertaking this enormous commitment come first and are cared for by teaching them how they can care for themselves.
University lecturers and leaders, I am here to chat.
Heading off to the Menai Bridge for September upandrun
There is a purpose for my ultrarunning, and it is mainly to share hope.
You may have seen the tagline I was using for the September upandrun: ‘ultrarunning to understand pain and share hope’. Here is why.
Ultrarunning to understand pain
Running for long distances means being on your feet for hours, moving along. On the journey, you discover much about yourself — you find out what is under the hood.
Under normal circumstances, we use our resources to deal with challenges as they arise. Life is full of uncertainty (more than certainty), twists and turns. That is the way.
What we can do is to focus on controlling the controllables. What can we control? Our approach and attitude.
Suffering comes from the way that we think about any given situation. Prior to this, it is merely a situation. This has long been realised by philosophers and others.
Life is a journey — cliche yet true. How do you approach the journey? How do you deal with things when they don’t go your way? The style that you use will determine whether you see it as an opportunity (to learn) or an obstacle?
Ultrarunning is the same. You set out on a journey that will be full of unknowns. When you are trotting along and feel great, it is wonderful. What about when you are in pain, feel sick, are hit with fatigue and hunger and thirst and more? How do you respond? How do you keep going?
Sunrise from the Little Orme
The concept of the pain cave describes the place you can go. It is dark.
But, there is ultimate learning about oneself in the pain cave to the point that many embrace the experience.
Pain is inevitable on an ultra.
You become your own experiment (n=1) as you examine your perceptions and thoughts shaped by the very actions you are making. When you change the way you move, your thinking changes — embodied cognition at work. Thoughts are very much grounded in the state of our body, and the state of our body is determined by the focus of our attention. Expectations also play a significant role — we see the world that we expect to see.
As inevitable pain emerges, the opportunity arises to closely examine the sensations and how they change. Different perspectives and different language all shape the experience. Noticing a shift in running pattern, perhaps leaning forward or the head dropping, one can lift and be taller to notice the change in perspective.
What is the story I am telling myself in these moments? If I alter the words, what happens? I notice how attached I am to that particular narrative and how easy or hard it is to let it go. Bringing my purpose to mind, or a loved one and there can be a sudden transformation of state.
Heavy moments are normal. Body, legs, head suddenly feel like sacks of wet sand — have you ever tried to move one? But you know that this will pass, like all perceptions. Nothing is permanent. This insight alone pulls me back from the mire of thoughts.
Our perceptions and bodily sensations are dynamic — always changing. Life is not static, instead fluid and moving onwards. It is the story that stays the same. The one we have been conditioned to believe is true.
Then you realise that there are infinite stories and possibilities. Freedom.
Ultrarunning teaches you about freedom.
I can examine my own experiences under duress and elucidate my resources my journey continues. The finish line is of course the beginning of the next.
Sharing hope
My message is one of hope.
Both the knowledge of pain and what we can do to guide, support and encourage people to live fulfilling lives has grown enormously.
We have much better answers to the questions (start here):
what is pain?
why do we feel pain?
what is the purpose of pain?
what can we do to improve our lives?
Many of the strategies, practices and techniques to transform and overcome pain are taken from the skills of being well, peak performance and strengths based coaching. Over the past 10 years or so, I have called this Pain Coaching.
There is a simple principle. The more you focus on the pain and try to treat it, the worse the outcome. The more you focus on the person and how they want to shape their life, the better the outcome.
Focus on what you want, not what you don’t want. As soon as you are saying, ‘I don’t want this pain’, we focus right back on the pain.
Instead, re-focus on your picture(s) of success and the steps you can take right now in that direction. This is an approach and an attitude. You will need some help, it will be up and down, but
I first met Adharanand in 2019 when I went on a writing and running retreat in Devon that he was co-hosting with Richard Askwith.
We kept in touch.
A few weeks ago I took the opportunity to whizz down to Dartmoor for a one day running camp: The Way of the Runner. This time it was co-hosted by Adharanand and Barefoot Joe. It was a great day, as I expected.
As we said farewell, getting ready to head home from the car park, we mooted the idea of a conversation.
And here it is. Eau naturale. Anecdotes about and idiosyncrasies of ultrarunning.
Much is said about recovery. This is largely because there is no single way to recover after a run. Each person must find what works for them: the art of recovery.
I’ll share some brief thoughts in the form of top tips, off the back of September’s upandrun along the North Wales Path. But, bear in mind what I have just said about the individual nature of recovery.
1. Recovery stops during an ultra
When I run, I now always opt for normal foods rather than gels and the like. This can include any of the following, depending upon the stage of the run: fruit, pasta, sweets, ginger beer, nuts, seeds, flapjacks, a bagel, samosa, coffee, water.
On the longer runs, rest and recovery stops are important for me. On solos, they are fairly brief, but nonetheless, there is relief in sitting down for a few minutes and having a bite to eat.
This is in keeping with my running philosophy that is just for me: finish line, not finish time. I want to fully experience the journey, enjoying the ride as much as I can. There is no rush for me. I am not interested in times, instead just building my belief that ‘I can’ in life.
2. Immediately at the end of an ultra
I enjoy a pizza and a beer.
The most memorable was ending up in Bath one evening, having run down from Gloucester along The Cotswold Way. It had been a pretty foul day and off the back of a period of serious rain in the UK. You can imagine the state I was in….
They were most welcoming in Pizza Express despite my appearance. I was served quickly. Looking back, this may have been so that I left promptly!
3. Recovery takes a little while
The things you do to recover span a period of time. It is an on-going process until you feel back to normal: homeostasis is the goal.
Choose your fuel and sources of hydration according to your needs. It can be a bit up and down after an ultra.
For instance, I will feel hungry and eat. Then feel a bit queasy. And then hungry again and so on.
Whatever you do to recover then, be complete and see it through. This could of course include all of the elements I discuss.
4. Sleep
This might just be the most important one.
Understanding sleep as arguably the keystone of wellness, creating a good habit is vital for recovery and performance at all levels of participation.
Unfortunately, in the modern era, sleep has taken a back seat. For some reason, a lack of sleep has been championed as some kind of machismo feat: I can work for 23 hours a day….how incredible am I? I can be out all night and then carry on….
But it is not. What that is, is a one way ticket to poor performance and health. And probably a shorter life. There are some brutal facts. But we know that people don’t always like to pay attention to the facts.
Bottom line. Try to get the best quality sleep (7-8 hours) as many nights as you can.
5. A special ingredient
When we pay attention, we can realise that there might just be one ingredient that makes a difference. On that, I have made a recent discovery.
CBD oil and balm.
Having had a good chat with Celine from Wholy Me, I was happy to try the drops and balm as part of my daily routine and recovery.
Acknowledging that it is a case study of one, me, I have been taking the drops each day, and massaging the balm as required into sore bits.
I finished the ultra on Monday evening, having started the previous night at 1030pm. My watch told me that I had been going for 18 and a half hours, covering some 120k.
It was time to recover.
Yesterday I was running again, albeit an easy pace and concentrating on form. I like to do this anyway: a slow run (speaking pace), focusing on being relaxed and tall.
I am fortunate to recover seemingly quickly after an ultra. Perhaps because of my monthly jaunts since May 2019.
But this appeared to be quicker than ever. Was it the CBD routine? One cannot say for sure. Expectations also play a significant role, and I do expect to be moving almost normally by day two.
So, I will continue with the CBD as part of my daily rituals alongside other habits: cold shower in the morning, various supplements, mindful practice, movement, attendance to fuel and hydration, and sleep to name a few.
For it is the small things behind the scenes, accumulating their effects each day that make the difference.
Just in case you are wondering, I do believe that the CBD is making a difference to me.
6. Bonus: motion is lotion
Keep moving.
It is tempting to stay still and rest. But it is movement we need to nourish the muscles, joints, nerves and more.
Easy movements, getting up, changing position, trying to maintain best form, and being regular are all important for recovery.
They are also vital day to day because the way we use our body will shape its form. And it is that form you take into running and other activities.
If you sit for long periods, parts of your body will tighten. You will then try to move those parts vigorously in sports causing adaptation and excess strain. This is one of the major reasons for the gradual onset of pain and sensitivity.
The body also keeps a record of every emotion and experience you have. We must look after ourselves as a whole if we want to perform.
Recent encouragement to get outside and exercise each day means more people are out walking and running. Hopefully we are all thinking about keeping our distance and going out alone or with a family member only. If you have started running or re-started after a hiatus, you may want to think about how you can gradually ease into it.
Amongst the headlines we are seeing a number of positive stories. These are fuel for hope and keep us going towards a better time, which will come. One of the positive messages from the outset has been the encouragement to take exercise — the benefits are well known (examples below).
Joint and muscle health
Better decision making
Clearer thinking
Reduced anxiety
Improved mobility
Fitness
Better sleep
Cardiovascular heath
Protective against a number of conditions
Weight control
Being active takes many forms. Two of the most simple are walking and running. We can do this in the house, in the garden, up an down the stairs and around where we live. We can also choose simple exercises using body weight or household items.
Started or starting running?
If you are starting from scratch, you may be best to begin by walking quickly to allow your body and body systems to adapt. There maybe a few aches and pains, which is a typical response to new or different activity.
Casual runners maybe tempted to increase the frequency or the intensity of runs. I’ve seen quite a few people chugging along, panting, puffing and blowing. The 80/20 training rule is a good one to follow — 80% low intensity when you should be able to speak, and 20% high intensity. If you are unsure about how much to push because of known medical conditions or you do not feel confident with what you want to do, you should always take advise from a professional.
Before heading out, easing the body into action with some simple, low strain movements prepare you. Examples include walking on your toes, lunges, squats, and pelvic movements. On return, recovery can include eating and drinking to rehydrate and refuel, together with easy stretches. Much has been written on recovery, but studies have not revealed any particular methods that are musts beyond taking the time to get back to baseline.
There are a number of apps and online resources that give advice on gradually building up your running. A good place to start your reading is Runner’s World.
Enjoy your running and being active
At a time when we are compelled to create a new routine, figuring in movement and exercise will be of great benefit to the way you feel and deal with the situation. Yet we need to be sensible. Gradually building our activity levels to reduce the risk of injury and allowing our bodies to adapt. One of the most important points is that we need to enjoy what we are doing! This way, we will keep it going and build our level of fitness and wellness.
Next UP for #upandrun is the Snowdonia Maverick ultra
On Saturday I’ll take on my first mountain ultra. 64k of trails around Snowdonia.
The main challenge for me will be heights. I ain’t got a head for them. Running along Beachy Head and around the Isle of Wight we stepped quite close to the cliff edge. I get edgy. I’ve been assured that it is ok, nothing to worry about.
The other consideration are the cut off times along the way and the need to complete by 7pm. We start at 8. That sounds ok, but there is the small detail of the 3000m elevation.
My kit is prepared, lodgings are booked for Friday night and now it is an easy week to build energy. The weather looks agreeable but we still have to carry waterproofs with taped seams, a foil blanket and a head torch (with ‘spare batteries’). Things can change quickly on a mountain. I remember a stroll up Pen y Fan last February that started with light drizzle and a mild breeze. By the time we were at the top, you could only see about five metres beyond your hand.
UPdate
Behind the scenes we are having a shuffle around to build momentum. Jo will be taking the lead for the day to day running of Understand Pain (UP), promoting and managing the UP workshops so we can reach more people, running the social media campaign to share the right messages about pain and connecting with partners who want to support our work.
The UP workshops are monthly at the moment. We are looking at running these every two weeks and then weekly in different locations as a next step alongside an online programme.
If you would like to support our work, you can sponsor an event and a workshop (see here) or you can give a donation (see here).
Today I am heading south to spend time in a unit that is doing great work with children. Statistics suggest that 20% of our children are suffering chronic pain. I see a number of kids who are in this situation with their families. Often they do not know what to do, have no understanding of pain and certainly have no ideas about how to move forward. This is where we can step in and help to make a difference. More on this soon.
…or so it has become the night before an ultra. Spaghetti Bolognese, full fat Coke and ice-cream.
This was supposed to be a simple train ride to Eastbourne. But, somehow I ended up on the wrong part of the train and arrived in Hove. Back to Brighton I went in hope of catching the next train to Eastbourne.
How would I get my spag bog? I’ll pause in Brighton and find an Italian. What a find! Pinocchio’s just off the North Laines was vibrant and smelt good. The waiter said he could deliver my meal pronto and so he did — see above. Then came the massive white chocolate ice-cream studded with white buttons and honeycomb; great!
The night train
Now off to Eastbourne at last. It will be bed by midnight, but I don’t sleep well before a race anyway. I usually wake every hour or so, thinking it is time to get up before realising that it is not, and try to go back to sleep. The pattern repeats.
Essential kit
I travel light. Wearing the shoes, ‘my ride’, I pack the essentials only for running. A vest, bottles, first aid pack, spare socks, a second layer, head torch, belt, headphones, cap, buff, sweat band, credit card, charging pack.
The South Coast Challenge tomorrow will be the third 100k run in three months. You start to know what to expect. Times to push and times to hold back become more apparent. Rest stops are planned more closely, and on this particular course, they appear every 10-15k. This may not sound too far. It’s the terrain that has the impact. Tougher terrain can mean it takes 10 minutes to complete 1k, or longer sometimes.
I learned on Race To The Stones that a little lunch (pasta) worked well, together with a foot inspection and change of socks (sweat = damp socks = blister risk). Slipping into a fresh pair has served me well on both the prior 100s.
Visualisation, breathing and meditation are all part of the routine the night before and on the morning. Creating calm and clarity, rehearsing mantras and tools for the inevitable tough moments means being prepared. It’s not a case of will it hurt, but when. I call these the sticky bits. This is the time to keep the feet moving. Plodding along. The ultra shuffle some call it.
Several days before I always experience some interesting bodily sensations. My right foot always hurts, together with my ankle and often the right leg as a whole. Throbbing, tightness, pulling, and a touch of strain all call out like individual voices, a choir perhaps. It’s a little reminder of past sensitivities and that something vigorous is coming up.
An ultra is like life. There’s a beginning and an end, with a sequence of things happening in between. Things always happen. It’s the response that is key in making it what it is for me. How do I respond automatically due to learning, social conditioning and genetics? And how do I choose to respond to those responses? Again, it’s not a matter of if life will have tougher, challenging moments, but when? I need to be prepared, to use those moments to learn and move on. How can I best deal with it? How can I get back on track quickly?
Next stop Eastbourne. Follow my progress tomorrow if you like: #upandrun on Twitter (@painphysio) and Instagram (@paincoach).
understand pain 