Viva Lewes Issue #139 April 2018

HEALTH
Dan Nicholls
Myth-busting physio
Dan Nicholls is a man of many medical hats:
he is an advanced practitioner in the NHS, a
visiting lecturer at Brighton University, teaching
human anatomy in the cadaver lab, and he's
worked as a physio for the British Basketball
team, British Swim team and England Athletics
as well as 2012 London Olympics and 2014
Commonwealth Games.
He also finds time to manage Motion Physiotherapy,
a clinic at the Southdown Sports
Centre. But don’t expect to find him there if you
read this before April 16th: he’ll be on Australia’s
Gold Coast, working once again with Team
England at the Commonwealth Games.
Physiotherapy is for everyone, and not just pro
sportspeople, of course, and I’ve asked to meet
Dan in his clinic, shortly before he sets off to
Oz, to bust a few myths around back pain.
“Myth number one,” he asserts: ‘Pain equals
damage’. The level of pain experienced is rarely
proportional to the amount of injury sustained
to the back. Pain is far more complex than
this; the Chartered Society of Physiotherapy
acknowledge pain levels are a reflection of how
threatened each human perceives itself to be.
For example, past experiences, general health
factors, beliefs, sleep, stress and exercise levels
as well as psychological wellbeing, all play important
parts in how much pain each individual
might experience”
“Myth number two: ‘a scan will show me what’s
wrong’. Again, not necessarily true. Scans correlate
poorly with symptoms of low back pain;
additionally, research has shown that people who
don't have low back pain have disc bulges, disc
degeneration, disc protrusions and facet joint
degeneration. These things are down to normal
ageing: wrinkles on the inside. This does not
mean all scans are irrelevant, but the conversation
after a scan is critical, contextualising it
with normal findings in a pain-free population.
To give you an example in a recent survey, of
3,110 over-50s who felt no back pain, 80% were
shown in scans to have disc degeneration, and
36% had disc protrusions.”
“Myth number three: ‘I have a back injury, so I
should avoid exercise, especially weight training’.
Again, not true. Studies have shown positive
benefits of exercise and high load resistance
training. The right sort of training can result in
making your back more robust. Most importantly,
select a form of exercise you enjoy.”
Dan’s work with professional teams is about
preventing injury as well as treating it, but his
clients at Motion Physiotherapy predominantly
come to him with existing injuries. Enough of
the myth busting: what should I do, I ask him,
to make sure I don’t have to visit his clinic again,
this time as a patient? “The answer’s
in the name of the clinic,” he
says. “Keep moving. Here’s
another stat: the average
adult spends 70% of
their waking hours
sitting down. Movement
can be viewed
as medicine, and like
all medication you
need to get the dosage
right. Motion is the
potion.” AL
Dan runs Motion Physiotherapy
(01273 480630)
with his wife Penny; it’s
business as usual
in April for
her.
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