physiotherapy

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.

RS #thepaincoach

My career to date

Since becoming a physiotherapist, I knew I wanted to work in oncology. This decision was shaped by various experiences in my teenage years, including watching my Granny go through ten years of cancer treatment before she died when I was 16. I sometimes think about the sliding doors that led me to the job I’m in now – and how close I was to choosing an entirely different career path. I know somehow my Granny led me into my dream job and I’m grateful every day for it.

Working in oncology is different every day; cancer can affect any part of the body, so for every patient I work with, I may see any combination of cardiovascular, orthopaedic, respiratory, neurological, musculoskeletal and holistic problems. For this reason, I must be flexible, creative and patient-centred, in order to provide my patients with the best possible care.

I am a huge advocate for the NHS, and extremely proud of the work I have done and continue to do within our incredible national treasure. I am currently working full-time in a hospice, while also doing bank shifts in an oncology intensive care unit. It is such rewarding work but, as someone who is made up of both a scientific and creative mind, I found the strict structure of the NHS curbed my visions for better ways of providing care.

The current situation in oncology rehabilitation

Currently, physiotherapy and other allied health professions are hugely under-utilised in oncology. With only 30% of the people needing cancer rehabilitation receiving it, it’s clear we have a long way to go.

Thanks to incredible research and trials, we are seeing better outcomes in cancer; there is now an average ten-year survival rate of around 50 % across all cancer types. The flip side of the coin is that we are seeing more long term side-effects resulting from more advanced cancer treatments. I have met people who are in remission, but have

accepted living with a compromised quality of life because they believed this was the cost of being cancer-free. This is not true!

Physiotherapists and allied health professionals can work with people to manage the side effects of cancer and treatment, allowing them to live fulfilling, active lives. My vision is to use physiotherapy to help as many people as possible to enjoy a meaningful life after cancer. Is this not why we go through the treatment in the first place? We must get more people talking about cancer and rehabilitation.

My vision

In the face of our uncertain future in healthcare, I feel passionate about providing those going through cancer with the highest quality support. When seeing outpatients in the hospital, I found there were patients travelling from outside of London to see a specialised oncology physiotherapist. Since a majority of these people were experiencing fatigue and pain, this felt so backwards to me and I knew there must be a better way to deliver high-quality advice – without the financial, time and physical implications of a hospital round-trip!

I knew the solution was to take my expertise online, to reach as many people as possible, regardless of geographical location and local services. I spent most of 2019 thinking about my idea, unsure of where to begin. Then, on New Year’s Day, while on a flight home from New York, I decided I had to just go for it (I always do my best thinking on planes and trains – anyone else?).

The very next morning, I set up my website and STRONGERTHAN was founded!

What do I offer?

I offer 1:1 online physiotherapy appointments to those living with and beyond cancer., to help them stay strong in body and in mind. I love to work with a diverse range of people of all ages, backgrounds, cultures and abilities. There are countless reasons that someone may seek physiotherapy; from exercise and lifestyle advice, to managing peripheral neuropathy or breathlessness. My role is extremely versatile and I am constantly learning from my patients, about the realities of life with cancer.

Some examples of the people I may meet and work with are:

● A young athlete, recently diagnosed with cancer, who is aiming to complete treatment and return to competing as soon and as safely as possible.

● A busy mother, who wants to improve her shoulder function following a mastectomy, so she can play with her children comfortably again.

● An older person having chemotherapy, who wishes to maintain their strength and manage their fatigue, to continue living independently at home.

● A business-professional, who would like to be able to return to their cycling commute to work, following abdominal surgery and radiotherapy.

● A person receiving palliative care, who wishes to improve their exercise tolerance in order to comfortably attend an important wedding.

● A young person in their 20s, who has poor body image following extensive treatment and wishes to maintain their weight and muscle mass.

The patient is the centre of my work – I wouldn’t have a job without them! I listen very closely to what they have to say and I want to know their story. This is something that can be done very easily by video consultation. Research has found that more people feel comfortable opening up to health-care professionals during video appointments, compared with face-to-face. This is likely due to the security that being in the comfort and privacy of their own homes brings.

I always ask myself: if it were me, ‘would I follow that advice?’. If I felt my health-care professional heard and understood what I had told them and felt excited about my goals with me – I would feel more confident to make adjustments to my lifestyle and change my habits, to better my quality of life.

Investing in physiotherapy, your health and your future is an important decision for anybody. Working with a health-care professional will provide someone with support, encouragement and accountability to ensure they are able to make the changes they need, to live their life the way they want to.

In summary…

With cancer treatments advancing, it is essential that we provide innovative after-care to match. To reach as many people as possible living with and beyond cancer, we must continue to re-think how we provide specialist physiotherapy advice.
I will continue to shout about online physiotherapy, because I strongly believe that having expert rehabilitation a few clicks away, is the path to a brighter future for those

living with and beyond cancer. So, to anyone reading this post now, who thinks you or a loved one might benefit from this support – book your appointment now and thank yourself later!

Hannah Leach