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Abandon the ‘Quick Fix’ Mentality

Of our limited resources, time is the most precious. It’s unredeemable and we can’t afford to waste it. Consequently, the symptoms of ‘urgency’ sickness are breaking out everywhere as a 21^st century pandemic. Everyone feels time-poor and can recall more than one deadline overdue. Queue-rage and growing impatience with red traffic lights are an embarrassing indictment on society. We are the first generation to get frustrated with the microwave. It seems normal now to be texting, making lunch for the day, watching the morning news, all while you are eating breakfast in the rush before work. Multi-tasking is no longer the envied skill of the superior, but the survival tactic of the many. We want it quicker, bigger, better…and we want it now!

The problem is, you can’t rush health. There are no shortcuts when it comes to wellness. As much as I’d sell more books promising a “quick fix”, the only short you’ll experience is a short coming to the long-term benefit. Forget the “miracle cures” and fab-diets, 5-minute abdominal workouts and those expensive weight-loss products that make outrageous promises. Not to be intentionally provocative or contrarian, but our health and wellness is not something to be gambled with parlour tricks. At best, even if some of these gimmicks and celebrity-endorsed products provide short-term results (although many of them don’t even deliver on this), I can assure you that after years of observation and even some experimentation with many of these approaches, they will leave you disappointed in the end. And without question, you will not be healthier.

If your goal is to enjoy a lifetime of good health and vitality, then you must make a commitment to invest in yourself with longevity. This doesn’t have to take brow-beating hard work or years to enjoy, but it does rely on consistency. With continued efforts it becomes a way of life with progressive ease. Your efforts compound over time, and you build strong momentum that propels your continued success. Riding the steady current of wellness as this book outlines, and making a series of good decisions along the journey, will ensure you enjoy the sustainable rewards of a healthier life far more reliably than that spruiked during late night tele-commercials.

Before I Even Had a Name For It Intuitively, I have always believed ‘quick fixes’ in health were a dangerous oxymoron. After studying the mechanics and physiology of the human body, I further resolved that true healing and optimal health could not be offered through some sleek “drive-through” medical service.

“If your goal is to enjoy a lifetime of good health and vitality, make a commitment to invest in yourself with longevity.”

As a young graduate, I embarked on my profession with the intention to provide clients with optimal life-long physical health through innovative techniques that clients found easy to self-manage, were specifically tailored to their individuality, holistic in nature and affordable for the long-term. Today we call it our Results4Life philosophy, but back then it was just the right thing to do.

My launch of this new thinking in health was humble. I founded our first practice in the single carport of our half-renovated home, which I walled up with thin cladding with the help of a close friend. I bought an inexpensive massage bed and a second-hand ultrasound machine to equip the room. I could only afford a modest $372 for necessary therapeutic creams and gels in my otherwise bare room. I wanted to offer superior healthcare to local clients who I believed were in many ways being dis-serviced by a traditional and ineffective approach. The seed for the Back In Motion Health Group was planted.

My intention was to introduce people to true health and not just assist them in recovering from their immediate injury or pain. My picture for them was much bigger than even the clients captured in these early stages. Everything I did was based on strong scientific evidence and medical research, combined with an intuition that made sense to my clients. I was applying mainstream medical knowledge and the science of human movement in a creative way, despite the cautions of some colleagues that my approaches were unlikely to succeed. I wasn’t deterred from pursuing the promise of a more progressive healthcare solution. Clients needed better clinical outcomes with lasting results. It was time for a new way of thinking.

I committed to treating family, friends and their friends with a determination to achieve leveraged health and wellness. In turn, excited clients passed the word along that they were getting new and better results with what seemed only simple variations to their lifestyle decisions. Consequently I gained more clients. Within five months, I was receiving optimistic referrals from prestigious orthopaedic surgeons and highly respected local medical doctors who were astounded by my clients’ results.

Whatever we were yet to call it, it was working! People were feeling more empowered from day one and physically better within weeks. They were adopting my simple strategies for wellness, and were exceeding physical achievements they had previously given up on. Men and women. Young and old. Sporting and sedentary. Professional and blue collar. The principles of this unique philosophy seemed wholly transferable and consistently effective.

“They were adopting my simple strategies for wellness, and were exceeding physical achievements they had previously given up on.”

Within 8 months the practice outgrew the basic home facilities, and I relocated to larger professional premises. I was now on a mission. By the second year the practice had tripled in size, a team of like-minded physiotherapists had surrounded me and we were determined to scale this new approach to anyone who was in need.

I’m not sharing this history to chronicle my achievements. However, I do want to impress on you that the philosophy that proved so effective and novel in my garage all those years ago is still the same approach that underpins Australia’s largest and fastest growing physiotherapy health group today. Christened in 2006 with the namesake Results4Life, this philosophy I’m describing became a way of thinking and a culture amongst our physiotherapists. Our innovative service has empowered clients to achieve new results in health that previously didn’t seem possible with traditional approaches.

“I realised I couldn’t keep doing what everybody else was doing, if I wanted to achieve a result that nobody else was getting.”

Since launching our small practice I have lived and worked with an inquiring mind, always searching to uncover further secrets about how the body moves. I realised I couldn’t keep doing what everybody else was doing, if I wanted to achieve a result that nobody else was getting. When clients excelled in their recovery and went beyond their once confessed physical limitations I continuously sought answers, explanations and rationale that validated their incredible results. I always attempted to reverse engineer whatever benefits my clients claimed. I immersed myself in the detail for a number of years to unravel the rich woven tapestry of strategy and techniques that were positively changing people’s lives. What felt instinctively right at the beginning of my career soon became something I could prove was working. My discovery was a principled approach that could educate and motivate people to take charge of their own health and wellness on a much greater scale, and allow them to experience for themselves real results for life.

The Two Faces of Healthcare In most healthcare practices, the phone predominantly rings because someone is in pain. The caller may have initially tried to manage their injury or condition themselves to some extent, but without success or at least lasting results. In this instance, the client typically visits the practice for treatment and expects some degree of relief to their focal point of pain.

“What felt instinctively right at the beginning of my career soon became something I could prove was working.”

Under a traditional model of care, the therapist’s assessment, advice and intervention is characterised by wanting to please the client with immediate results. Typically they commence treatment with strategies to minimise the client’s pain, thereby making the client more comfortable in the short term. After a series of approx. 4-8 sessions over 2-3 weeks, normally the client would experience some measurable relief of their symptoms, albeit not total recovery. It is very common that at this point clients either instinctively discontinue treatment and wrongly assume natural recovery will continue shortly afterward or the therapist (unintentionally) misleads the client to believe the same by prematurely discharging them with the invitation to only re-attend if further problems develop.

Notably, because the emphasis of care under the traditional model is to reduce pain, very often the underlying cause of the problem remains largely undetected or unresolved. The results for the client are incomplete recovery with a false hope that any current symptom-relief will last, and injury re-aggravation when they resume normal activities. The actions of the therapist are mistaken to be in the client’s best interests because they are saving them money on “unnecessary” treatment and not imposing lifestyle changes the client may find intrusive or overly assertive. This situation ultimately reflects poorly on the expertise and intervention of the therapist and, worse, robs the client of any value in the time and money they have invested in their recovery to this stage.

Invariably, what follows this traditional model is a cycle of repeated episodes of treatment as the client experiences re-aggravation of their injury or recurring symptoms. On each of these occasions, if the therapist follows a similar approach of symptomatic treatment only, rendering incomplete recovery, the merry-go-round is perpetuated. If continued indefinitely, it is only a matter of time before the client concludes their treatment is ‘not working’, and opts for a second opinion from an alternate practitioner, or simply ‘cuts their losses’ and decides to live with the pain. The unending costs and inconvenience of perpetual treatment, understandably, become unsustainable for most people.

It’s also not uncommon for traditional therapists to typically prescribe appointment schedules based on such things as their perceptions of the client’s pain (see Chapter 2 for the dangers of using pain as a reliable indicator of health and recovery), practitioner availability, client affordability or textbook guidelines of routine treatment for specified injuries. Whist this may appear reasonable on first observation, what lacks in this model is a thorough understanding of, and appreciation for, the multi-factorial causes that underlie the client’s symptoms. Furthermore, often the comprehensive and individualised treatment regimens necessary to not just achieve a symptom-free state, but rather one of full recovery and optimal health in the future, are grossly underestimated. In my opinion this stereotypical approach to injury management is dangerously reactive and superficial at best and without doubt is ineffective in giving clients real value.

To grasp some early differences between our innovative health philosophy, from that of the more traditional approach, I have provided a summary of the variations in Table 3.1. Notice also the two separate client experiences charted in Diagram 3.2, further depicting the obvious contrasts.

3.1 Contrast of Attributes between Results4Life Philosophy and Traditional Health Care

Our alternative approach with Results4Life is pictorially represented as 6 distinct zones. We believe that for someone to truly achieve long term health they need to pass through these key phases: Discovery, Relief, Conditioning, Learning, Lifestyle and Refinement. No single stage is finite with an absolute start and finish, but rather each stage interweaves and dove-tails with the others, representing key areas of focus that characterise the objectives and activities of the therapist and client. As you follow the megatrend, at the top of the chart of Diagram 3.3, you can easily see where the transition occurs from immediate injury management to more holistic health and wellness.

Discovery Phase Results4Life has, at the core of its philosophy, the acceptance that all symptoms have deep-seated causes that must be thoroughly diagnosed and addressed for long term results. Therapists must discover the relevant information, history and intent of the client during this phase. They must identify the many possible underlying anatomical, biomechanical, inflammatory and physiological reasons why symptoms persist. Often during this process a number of related (and even unrelated) health concerns are discovered, which can be dealt with in due course for optimal benefits. This detailed analysis gives the therapist a clear profile of their client’s current health and wellness state, and offers a critical opportunity for them to identify personal goals with the client to avoid any misdirection in the treatment that inevitably follows. With clarity regarding what is causing the pain and other symptoms the therapists using Results4Life can then confidently design an integrated treatment plan or personal roadmap in consultation with the client to address matters in a prioritised order.

Relief Phase This phase is the period during which clients mostly receive their ‘treatment’. Therapists typically take charge at this point in a very directive role to modify any aggravating activities of the client and get on top of the debilitating symptoms quickly. This can include resolving the pain, swelling, stiffness and instability immediately without any fear that they are masking the true pathology underneath and giving the client a false sense of recovery.

Conditioning Phase As pain reduces and the other symptoms of inflammation subside, many clients are tempted to self-discharge or, worse still, their therapist encourages them to stop treatment. This is premature as generally full recovery has not been achieved. During this phase the treatment transitions into full scale rehabilitation including tailored exercise and modified activity and relies on far more active client cooperation. The tissues and injured parts are strengthened and conditioned for a return to full activity, although it can sometimes feel like ‘two steps forward, one step backward’. Careful persistence and gradual change are essential.

Learning Phase As the client nears the end of the Conditioning Phase, they are likely to have made a full recovery. However, unless there is careful education about all of the ‘big picture’ contributing factors that caused the problem in the first place, and empowerment around self-management of these predispositions, the symptoms are prone to recur. The greatest attribute of successful clients in this phase is an open mind and commitment to lifestyle change. This is also the phase that most traditional therapists undervalue and skip when time is against them.

Lifestyle Phase This is the phase during which real change happens. Having benefited from a clear diagnosis (Discovery), effective treatment (Relief), thorough rehabilitation (Conditioning), and clear education about the necessary lifestyle changes required (Learning), a well-managed client moves into the Lifestyle Phase equipped to perform at their best. The therapist has a far less active role in this stage and is more like a coach who helps guide the development of healthy habits and lifestyle patterns.

Refinement Phase For reasons of accountability and progressive assessment, clients otherwise ‘maintaining’ or developing greater wellness, are encouraged to have semi-regular checkups. These can be monthly, quarterly or only twice a year, depending on how self-sufficient the client is in managing their own health journey. The therapist will take these opportunities to modify exercise programs, lifestyle trends and even expectations as the client re-commits to the next stage of lifestyle health ahead of them.

As the client cycles through the Results4Life zones, they are continuously monitored by the therapist for real-time variations that may be required, and prescribed individually tailored interventions to both treat their injury and be empowered in self-health. The therapist will gradually taper the intensity of input as the client moves through each zone and effectively migrates from being a very directive practitioner to the role of a health coach. Pain and movement patterns are monitored throughout the process, along with other key objective signs and symptoms. However, clients are not discharged on any of these indicators alone, but rather on the well-considered overall progress to date in achieving the primary health and wellness goals identified by the client.

On paper, it may initially look like commitment to a Results4Life approach takes longer and therefore will cost more money. The reality is, with proven experience, not only do clients get far better outcomes (and therefore more value), but also they keep their health benefits for longer and therefore minimise onsets of re-aggravation and the need for recurring expensive treatment. From experience, the Results4Life philosophy is a far superior approach to health and wellness and one that underpins the secrets revealed throughout this book.

Going around in Circles More specifically, our Results4Life philosophy is characterised by empowering clients through a partnership that engages them in a specifically tailored health and fitness pathway. Diagram 3.4 represents an example of the types of treatment and services our clients may conceptually journey through from injury management through to wellness, achieving their personal health and fitness objectives along the way. The pathway is intentionally written as the ‘infinity’ symbol to represent that health is intended to be a lifelong continuous journey. However, if you follow the flow of movement as directed by the arrows, a well person will mostly only navigate through the right hand pathway of “Healthy Living”, and rarely need to journey the “Recovery” cycle on the left side.

A typical recovery program may involve any variety of professional interventions including postural assessments, manipulative therapy, remedial soft tissue work and specific group exercise classes to rehabilitate an injured area. As clients successfully graduate to each new milestone of their recovery pathway, the therapist can review their progress, modify the treatments as required and otherwise progress them forwards to higher demands with less reliance on external assistance. As they near full recovery, clients are typically re-assessed against a range of relevant holistic health and fitness measures to determine objective improvement and to discover any other health goals the client is intent on achieving. These conversations and expert appraisals assist the client, when the time is right, to effectively transition into the wellness pathway.

The second loop of our model contains services and interventions that achieve general fitness, strength and conditioning, peak performance and broader sustainable lifestyle changes for effective long term health. The loops allow for client continuity and represent a perpetual journey of ever improving health. Avoid going around in circles with traditional treatments. This philosophy challenges you to think about how you can continuously progress to new higher levels of performance and health.

“The Results4Life philosophy is characterised by empowering clients through a partnership that engages them in a specifically tailored health and fitness pathway.”

Here’s One I Prepared Earlier As an example, a middle aged male may present to my practice with a sprained ankle that resulted from tripping down the gutter. Under the traditional approach to health care, this appears to be a straightforward injury. However, knowing 80% of all ankle injuries are at high risk of recurrent sprains¹ it’s not necessarily the case. Adopting the Results4Life approach, I will take a thorough history and lead the examination to learn, amongst other things, how many times the client has suffered something similar, what position he was specifically in when the recent injury happened, possible past trauma to the knee or lumbar spine, nutrition and weight management habits, balance and agility measures, preferred sports and occupational demands that may inherently pose further risk of injury. With the information I gather I can form a differential diagnosis of the underlying causes for the symptoms and set some realistic stretch goals in collaboration with the client. Only after all this would it be appropriate for me to design him a unique tailored pathway for recovery (Discovery Phase).

The treatment program may initially include cryotherapy (ice) and bandaging to manage the swelling and hands-on manipulation to restore joint movement (Relief Phase). Shortly after this, he would benefit from special exercises to rehabilitate balance and control, Pilates to better stabilise the lower spine, stretches to the pelvic girdle to free his range of lumbar and hip movement and speed work on the track to prepare him eventually for return to sport (Conditioning Phase).

However, in the bigger picture of this client, we may also detect he needs to lose some weight to reduce unnecessary load through the ankles, get better alignment around the lumbar spine and pelvic girdle because of the postural disturbance it’s creating through the legs, and apply orthotics to the feet to better leverage the mechanical principles of his running style. Whilst many of these things may not have immediate effect to reduce the pain or ankle swelling, they all go a long way to preventing a re-aggravation of the condition and to promoting peak performance in later sport and life (Learning Phase).

Encouragement to change some nutritional habits, incorporating regular strength and conditioning classes into the weekly routine, committing to a progressive home exercise program and paying more attention to his posture all help to improve the underlying predisposing biomechanical and other factors that contributed to poor health and injury in the first place (Lifestyle Phase).

It’s fair to say that this approach looks nothing like the traditional mainstream model to treating a sprained ankle. It also gets excitably different results that can be objectively assessed at regular intervals and modified to suit (Refinement Phase).

It is important to note that no two people’s health journey is exactly the same. That would be way too simple and belies the individuality with which we have all been created and approach life. Five clients with ankle sprains will potentially all be offered five very different pathways. Some want more out of their physical opportunities than others. Different ages, gender, employment demands, sporting pursuits and even genetic predisposition will colour and bias the different expectations of varied clients. However, what is very clear is that people can achieve the health and wellness they want when they follow our time-proven philosophy.

“It is important to note that no two people’s health journey is exactly the same. That would be way too simple and belies the individuality with which we all approach life.”

Weed-killer! Remember though that pain is not an acceptable diagnosis. A swollen ankle is not an acceptable diagnosis. Fatigue is not an acceptable diagnosis. These are all symptoms with an underlying cause. The new breed of health-conscious people must be determined to pursue wellness by taking action around causative changes that positively impact their movement.

When I was first married, one of my new found chores was to mow the lawn and tend the garden on weekends. Not surprisingly, due to my neglect, there would be times when I would find the persistent weeds aggressively taking over the garden beds like an invading army. However, rather than getting down on my knees and pulling weeds, like a real man, I actively looked for a shortcut. When my wife wasn’t watching, I quickly learned that with a quick sweep of the mower over the garden beds, I could raze the weeds in no time. Things looked great… for a few days. But whilst I savored the compliments and my wife’s appreciation, the subsequent light rains and sunshine were preparing to blow my cover. Predictably, before long, the weeds re-sprouted and the following weekend I was back where I started. My “quick fix” failed to address the root of the problem (literally). Being a slow learner, it took most of my first year of marriage to realise that this wasn’t worth pursuing. Unless I actually pulled the root of the weed, I was kidding myself that I was actually removing them. The same is true when managing your health. Be relentless in digging deeper to uncover the root of your symptoms, threats and risks – and as a result you will be more effective in keeping the benefits long term.

The Cost of Reactive Therapy When you assess the cost of physiotherapy treatment or medical advice, during times of sickness or injury, you need to include in the algorithm the direct and opportunity costs of time away from work and other activities that are important to you. I am back to valuing our time above all else as the most precious commodity or resource we manage. Lost time through wasted treatment, ineffective programs, gimmick products or simply superficial approaches are all costing you much more than you realise.

My invitation is for you to embrace the tenets of our Results4Life philosophy and merge it into a lifestyle of proactive healthy decisions. This book will show you just how convenient and sensible this is. It might not be what your doctor or neighbours are doing…but that doesn’t make it wrong. You will be able to demonstrate that wellness is more achievable than most of us are led to believe.

All reasonable investors want a return on their time and money. You shouldn’t be any different as you wisely invest into your health. Your return will include the enjoyment of a better quality of life, less time away from family and work, and the promise of new adventures.

I’ve discovered over many years through implementing Results4Life that clients appreciate the empowerment provided through this self-management approach. They realise that taking responsibility for their own healthcare and partnering with (rather than being dictated to by) their practitioner is the smartest way to ensure lifelong wellness. Some of my clients have had to go through the trial-and-error process of testing one “quick fix” after another before truly valuing the importance of a long-term wellness roadmap. Others have spared themselves this inconvenience by accepting the advice at face value. Whatever route you take to arrive at a wellness commitment — a direct line or the winding road — know that you are embarking on a journey that will have positive lifelong consequences.

Health Secrets

1 If you are time-poor then you tend to seek shortcuts to health.

2 Quick fixes don’t last. They waste your time and money.

3 Your wellness goal should be optimal life-long physical health.

4 You need a paradigm shift to adopt the Results4Life philosophy of health. You can’t keep doing what everybody else is doing, if you want to achieve a result that nobody else is getting.

5 Your pathway to true wellness must address the complex, holistic and deep-rooted causes of movement disorders if it’s to be effective. Fortunately this is much easier for you to achieve than most people think.

6 Don’t pull out of the journey too early. Commit to all 6 zones of the pathway including the Discovery, Relief, Conditioning, Learning, Lifestyle and Refinement phases. Find a practitioner who will guide you through this.

7 If you invest into a healthy lifestyle, you will reap a leveraged return of positive lifelong consequences.

Actions for Optimal Health

 Review the health secrets of this chapter.

 Walk around the home and identify all the gimmicks and tricks you have gathered over the years in chasing better health. Stockpile them on the floor. Tablets, exercise machines, DVDs, wrist magnets and whatever else you may find. Don’t feel guilty. Rather, channel the enthusiasm you once had for these things into a committed approach to Results4Life strategies that will work.

 Review Table 3.1 and notice the differences between the traditional mainstream approaches to health care compared with the more effective philosophy of Results4Life. Determine to take the latter path in all new health decisions. Don’t settle for symptomatic treatment or superficial strategies ever again. It’s a waste of your time and money. Share this with your trusted health advisors.

 Calculate how much it would cost you in lost wages at work, medical costs and inflated insurance premiums if a moderate back strain took 4 weeks to recover. Add to this the exponential costs if you suffered re-aggravations on 3 separate subsequent occasions over a 2 year period. Try also to put a price on your frustration and regret. This exercise helps to demonstrate why getting your health right the first time is so crucial.

References

1 Safran MR, Benedetti RS, Bartolozzi AR 3rd, Mandelbaum BR. Lateral ankle sprains: a comprehensive review: part 1: etiology, pathoanatomy, histopathogenesis, and diagnosis. Med Sci Sports Exerc. Jul 1999;31(7 Suppl):S429-37.