Tuesday night Q&A

The STLDW*

*Still Too Long Didn’t Watch

People make the biggest difference to their own health

For hip + knee pain that’s a focus on:

B: Optimise Bodyweight

±2kg can make a BIG difference

A: Activity

1. Avoid Boom + Bust

2. Bike (indoors) when rain stops play

3. Scale back slowly

M: Movement

Avoid deep hip flexion

Strength before hills / uneven ground

And importantly...

“Listen to your hips + knees”

It was an engaged audience, lots of questions...

I loved it. So many people passionate about staying healthy.

3 questions stood out..

Can I still run?

This from someone getting the first niggles of osteoarthritis.

(they'd been told to stop running)

I talked about the clear evidence, which always raises eyebrows..

There’s more consensus on this point than in a lot of healthcare..

‘..as of 2002 sufficient evidence.. there's significant benefit of exercise.. in patients with osteoarthritis.

AND

Mixing it up is best 🏌️‍♀️🚴🏽🏃‍♀️⛷️💃🏻💪🏻

So, as part of your exercise regime, after optimsing bodyweight + building back leg strength, + avoiding boom and bust + scaling up slowly…

YES I believe you can still run.

More than that, if running is your thing, your passion..

You SHOULD still run.

That said, always note the nuance:

Keep to shorter distances,
Run more trails than road, and
Mix in more bike than running, BUT
The answer remains a firm YES.

I get pain on outside of hip?

I couldn’t jump into the audience to examine the problem..

But it sounded like tendonitis on the outside of the hip.

And tendons like load. They need to be conditioned.

The tricky bit is conditioning the gluteals.

Think general strengthening on the bike.

AND specific strengthening for the gluteals:

Lateral straight raise exercises out to the side.
Stood upright with support, leg slow + wide out to the side
Build from 2-4 sets /day of 3-5 repetitions up to 10-15 repetitions.

Once comfortable doing 4 sets x 15

Lie on opposite side lift leg against gravity

Start again with 2-4 sets /day of 3-5 repetitions.

And build slowly to 10-15 reps

Lateral planks, pilates and a mix of exercise can all help.
Tendonitis is tricky to deal with. It needs a long-term plan.
Keep at it, scale up slowly and keep consistency built in.

I’ve got 2x Knee Replacements one is painful, how do I get back to golf?

Here we checked Sit to Stand

The bad side was weak.

I asked about squats + lunges

And suggested a 3- to 6-month break

I advised to replace that higher intensity strengthening for the bike. And again we looped back to the principles.

And to the follow up question 'BUT I want to be playing 18 holes by January..' Another reminder to scale back slowly..

Bike

> Driving range

> Practice ground

> 6 holes buggy

> 9 holes buggy

> 6, 9 then 12 holes trolley flat

> 6, 6 then 12 holes trolley hills

> 15 then 18 holes ⛳️

And importantly ditch the time pressure.

Aim for a summer 12 holes, autumn 18.

If winning, scale back sooner..

Easier to scale up than push too much too soon...

And still be in pain.

The flip side just might be a summer of golf ⛳️

And the tools and principles to keep doing what you love ❤️

Thanks to everyone for their questions on Tuesday, and for a lovely evening. There's a lot of what everyone's dealing with written into those questions.

Good luck to everyone 👊