Transcript

Bart Van Buchem (00:00)
Hello and welcome to the Pain Podcast, Le Pup, presented by Le Pup Scientifique. And ⁓ we're here again. My name is Bart van Buurhem. I'm a Pain Specialist Physiotherapist and with me is founder of Le Pup Scientifique, Timmy Beams. Well, I'm looking...

Tim Beames (00:17)
Hello, hello, good start

there Bart, like it's just so smooth.

Bart Van Buchem (00:23)
⁓ I'm so sorry. We're just discussing, we had a hard 24 hours, headwinds and challenges along the way, families and so on. So like, like anyone's. So I'm looking particularly forward to this episode because we're going to discuss beyond exercise. And we're just here to...

Tim Beames (00:24)
Yeah.

Bart Van Buchem (00:47)
To see if there we can find some common frustration with prescribed exercises, reframing movement away from rigid prescriptions toward lived embodied experiences. That's a mouthful. That's how can we motivate being meaningful in exercise because it's something prescription in my view is like giving the right dose and meaningfulness and making sure there's a shift in behavior or the shift in

possibilities instead of a protocol. So that will be probably a nice title, something like for this podcast, which we always come up after the recordings, which one we did.

Tim Beames (01:29)
instead of protocolized

movement. Yeah, yeah, totally. Well, yeah, like, and then, I have, yeah, we were talking before, weren't we? And it is frustrating in some ways because in essence, this isn't that everybody's doing something wrong, but.

Bart Van Buchem (01:32)
Yeah, probably.

Tim Beames (01:46)
But in order for us to optimize the, you we know and everybody knows as well, don't they? Like, your patients don't come to you and go, ⁓ I didn't know that movement was good for me. Like, there's a known quantity, isn't it? Like, eating the right food and getting good sleep, people know these things, but they don't always engage in it. And then when, you know, a common thing that I hear is...

Bart Van Buchem (02:02)
Absolutely.

Tim Beames (02:13)
that people, even the word exercise, it's almost like that disengages someone from that process as well. ⁓ God, you know, sort of. Yeah.

Bart Van Buchem (02:21)
Is like the back to school thing. Yeah. For some people.

So let me run through the, for the, for like, you can expect this session. we're going to into the, that's the problem with prescribed exercises, the power of meaningful movement. We thinking of, let's see if prescription could create possibilities instead of protocolized ⁓ movement prescriptions. We're going to talk about play curiosity.

And ⁓ in the end, we're gonna summarize, is it as good as we can and see what we can come up with. But this is going to be a ⁓ conversation between Tim and myself from our clinical experience and ⁓ everything that we've learned through our LePub community, which is a whole range of amazing people who have contributed.

to help us be more comfortable and confident in treating pain, which is a challenge every day. And it's big fun. And, but we also need a little bit of a heads up from each other. So this is, this episode will dive into the prescription and exercises that we give people when they go home. So ⁓ probably that that's a good starting point. So, so what, what do you think? you, you basically said to him that

Even the word exercise or prescription to some degree could also have this negative effect on how people interpret it and maybe somehow puts them off. And that's exactly the opposite where you want.

Tim Beames (04:08)
Yeah,

well exactly, movement at one point isn't the same as movement at another point or exercise. So if someone is in pain, the association of doing movement that may typically have caused pain, why would I want to engage in something like that? So yeah, there needs to be some sort of known awareness around what you're trying to do.

Yeah there's challenges basically aren't there and I mean the challenges I think are beyond just the ability to be able to perform I mean in the correct way which also I would say that deliberately because our backgrounds both as physios I'm sure a lot of our education was about you know performing something correctly.

And I think that loses people, first of all, in some respects, but it also loses ultimately what we're trying to do with activity and movement, which is create more opportunities and possibilities to engage in life in the future. ⁓ And that means being able to do things in a variety of different ways, in a variety of different situations, at different times with different people, with and without... ⁓

maybe aids, et cetera, to facilitate that process. I think, and often an assumption comes back that I hear, I mean, is just a reflection of me, is that exercise almost like it's associated with gym and people will even say to me, I'm not a gym goer, I don't like that. You're not one of these physios who gives people gym exercises. And obviously there will be people out there who thrive with that as well.

Bart Van Buchem (05:56)
Hmm.

Yeah, yeah, people. So give me 10 exercises. I can perform every day to solve whatever I need to solve, which is an interesting. So, so let's try to separate these two groups. So people who thrive with exercise, probably you would be very helpful for them to, to receive this prescription, maybe even into detail, like into the depth of the detail, feel like, maybe that's not so helpful. in my experience, sometimes for people with who

need or require, or they think they require these type of exercises, I would probably provocatively deliberately do not give them this prescription as they would expect just to basically, no, not to tease them, but instead of over relying on exercises, sitting with the idea of, well, probably it's something yet this exercise is going to fix me. All right.

Tim Beames (06:42)
Thanks.

Bart Van Buchem (07:00)
But in most of the times it's about changing behavior, changing routines, changing things, or getting insights or gaining insights in how things are actually evolving, or probably you have to act earlier on instead of waiting for the exercise. there are so many reasons for even whether you want to use the word exercise or using it as a, as a thing. So I think that that's probably a good starting point. So if it wouldn't be exercise.

you would expect your patient would probably not that one wouldn't go down well because that they would say like no I'm not I'm not a gym type of person I'm not a yogi I'm not a into Pilates so how would how would you go about that what's your strategy

Tim Beames (07:47)
Yeah,

well we've used a couple of the words already and and let's you know, obviously people listening to this podcast They know we're talking about people in pain I'm looking for the ability to engage in some sort of activity you're getting your body Working for you engaging in something That has some sort of meaning behind it or value behind it. Otherwise, why are we doing it? but but but

We don't always know what that might look like until we try it as well. So there's a sort of exploration phase for many people. And it might be, it might include going to a gym. I wouldn't discount that because I have people where they'll be doing a sort of more rigid structured workout with set routines. But for many of the people that I'm seeing where pain is, you know, a significant constraint or barrier and challenge, then for me, it's about looking

Bart Van Buchem (08:22)
Bye.

Tim Beames (08:45)
for different opportunities to be able to move in a variety of different ways, multiple times in a day as well. instead of it being once a day or once every two days or whatever that might be, I'm looking to see how can we create many different opportunities through a day.

And I think repetition is helpful on one level, but the sort of reframing of an association and perhaps the association is something simply like when I move, I'm in pain. And what we're really trying to do is we're trying to create an opportunity that when I move, I might not be in pain or it might be a different type of pain or it's a sort of pain that I'm okay moving with or so that's...

That's a big part of what I'm initially trying to do when I'm exploring movement with my patients.

Bart Van Buchem (09:40)
Yeah. So is that like creating relevance as well as part of the, the, the exploration phase.

Tim Beames (09:45)
I think.

think it's creating relevance, it's creating ⁓ some autonomy and empowering someone to be able to explore and be okay exploring ⁓ and that that can be a part of it and not just can be but is an important part of it as well. So yeah, and I suppose this comes back to...

I mean, we've set our stores out of saying rigid prescription, but we might still be prescribing, you know, we're saying it's important that you move. It's important that you find ways of engaging in activity, but it doesn't have to be the same every single time. So, yeah, that's that. And the reframing of that, think, is an important thing, which goes alongside knowledge and understanding and what have you in your body and the experience as well.

Bart Van Buchem (10:38)
So there's also this notion of co-creation. Sometimes you just have to tell what to do otherwise. Or yeah, otherwise it will be co-creation. Where do you think co-creation would fit in? Is that also this exploration phase or do you feel like this is more the phase where you start to prescribe like you? All right, let's go try this for the next two weeks. This is...

This is your challenge, if you like.

Tim Beames (11:08)
Yeah, yeah, yeah, totally. Yeah, I mean, I think that's an important...

in like initiator even because you're saying how possible is it you know do you think you've got time have you got time in your life you know how are we going to fit this into your life and there's a bunch of different questions and what might movement right you know what would you be happiest to doing as well so yeah there's a whole bunch of of really powerful ⁓ questions that can help that dynamic as well so ⁓ yeah i would say that's initially an important part the other thing i was

going to say on that point is that we don't know what the right amount is often with pain. So it is a bit of exploration.

There are frameworks on that. Yeah. So I think something that I often use with people is a traffic light scenario. So we'll have green, know, everything feels fine. Okay, you're good to go.

Orange might have a bit of soreness, a of pain, but you're okay with that. And I'll spend time going through sort of cost benefit analysis as well with people and talking about the sort of sweet zone that we want to work in. And a red would be a, you know, no go, you know, if you get into this point, then stop, ⁓ give yourself a little bit of time away from that.

Bart Van Buchem (12:27)
Hmm.

Yeah, that's where you mentioned

finding the sweet zone, which is quite critical or is a is a concept on its own, Finding is because it's not too, so there is a too little, there's a too much and there is a sweet zone. And my experience, if you use this concept, the sweet zone for people in pain is very tight. That's very hard to find the sweet zone could be challenging. What else just just to add?

Tim Beames (12:43)
Yeah,

Thanks.

Exactly.

Yeah. Yeah.

Bart Van Buchem (13:04)
Just to get in some neuroscience here and understanding of, example, things like wind up or how hyperalgesia science or improvement in pain, how it evolves by repetition, for example. what would be quite nice way? you put out the traffic lights. So what would be red? It would be by repetition, the pain increases. Period. Right. So that could be your red thing if you learn.

Tim Beames (13:31)
increases

maybe builds afterwards as well sometimes. Yeah.

Bart Van Buchem (13:33)
And even builds. Yeah. Yeah. Yeah. But if it

eases or it flat plateaus, it might be orange if you like. And green will be, you don't feel it's not even there or it's there, but it's okay. Or it doesn't, or it is even eases, right? It makes it, it's getting better whilst you're doing it more often. So, but there is this case where you like self-treatment type when people like poking themselves and sometimes it, it

It has this very ⁓ short term relief, after that it, it, it, it, or it flares up massively. So that could be a reason for say, probably not the greatest thing to do at that stage, but, I think co-creation also, you have to include this create, well, this, this self, and the self help type of understanding when you can maintain, or you have to.

pause, you probably just have to quit or stop doing it.

Tim Beames (14:35)
Yeah, you're actually right. I wanted to jump in here because there are situations where there might be a delayed effect as well. And if you're only looking at that time point, you know, when I'm doing exercise, how does it feel? You lose that information, you lose that data as such. So the ability to be a little bit explorative, but with some...

Bart Van Buchem (14:52)
Hmm.

Tim Beames (15:01)
you know, you're being sort of carefully, you know, respectfully explorative. You find these things out. And I'm thinking about a conversation I just had actually with a lady with CRPS where it's looking like there is a sort of delay effect. ⁓

Bart Van Buchem (15:21)
Hmm.

Tim Beames (15:22)
And it's so difficult because pain is such a massive feature for her, but it's so difficult to make sense of it until we've run a few careful experiments, if you want. So to find out what the right dose is, what the right type of activity engaging is, et cetera, to begin with, it does require a little bit of careful exploration.

Bart Van Buchem (15:49)
So we're sort of moving into the effect of exercise, but you won't hear people, did too little, saying, nine out of 10, 99 out of 100, there were people say I did too much, it's way too much. So that's a bit of a, that's an interesting one because it's because they did exactly the same routine as they did the day before. But after all,

Tim Beames (16:01)
Thank

Bart Van Buchem (16:17)
It was too much. Any thoughts on that? That situation, which is because it's very common in my, in my experience.

Tim Beames (16:25)
Yeah,

I think so. Yeah, yeah, yeah. And again, we just had that conversation beforehand and I've just been on a call with someone where we're saying, she said, I just don't know what more I can do. And I was like, could you just stop doing stuff? You know, could you give yourself a bit of time off doing things? So yeah, you do often hear that, don't you? You do hear and people, it's not for want of trying. People are trying, they're working hard, but it's almost like they're working too hard.

Bart Van Buchem (16:55)
you

Tim Beames (16:56)
Just coming away from that is important. And that I suppose brings us, you know, we're going to have a whole bunch of different sort of offshoots of conversation here because exercise or activity, I don't think it should be a standalone.

Bart Van Buchem (16:59)
Yeah.

Tim Beames (17:13)
prescribed thing to them because we should consider the setting up and the coming away from the cooling down or the calming down ⁓ including inactivity or rest that might go alongside it. So even pauses. So, you know, if you want to create hypertrophy in muscles, then you need to have a gap to allow that sort of process to materialize, don't you?

Bart Van Buchem (17:39)
Yeah, yeah.

Well, that's that sort of, you just said that there is this not just it's not just about the exercise, not about the volume or the the reps itself, but it's also creating. And I think if I'm correct me if I'm wrong, but you were just saying that you also have to create a space or a context that actually can be helpful. So just even before setting before

performing the exercise or whatever the prescription will be, you have to get into the, let's say the right mindset or the mind, the right feeling or context in general, just to sort of maybe even sort of getting, making sure you're not overacting or missing things that probably are also related to the effect.

in after all. So, so what my experience, some people say I did exactly the same, but the context or the conditions were very different. Not the saying you have to, you have to create this, this, this condition is always the same, but it's on the, on the other end. blaming the exercise. So I shouldn't do this anymore because it made my pain worse. And I think it's quite important to sort of trying to catch some of these contextual factors that may have.

created or influenced the reason why people are so off. This is a bad exercise. ⁓ Because it made my back hurt more, rather than say, well, probably I was a bit tired. I didn't take well, I was a bit distracted, or I was a bit like, frightened at some point and didn't have that before.

Tim Beames (19:22)
who's rushing to get it done and finished, because I know I've got to

do it in my day and I was running out of time and stuff like that.

Bart Van Buchem (19:29)
Exactly. Yeah. Yeah.

Yeah. So, ⁓ it, that sweet zone training, if you like that, that's quite a sophisticated training is that you would consider as part of how much time would you, would you use or take to, to prescribe and, ⁓ explore these exercises before even prescribing it.

Tim Beames (19:52)
That's a great question and that's what I would be doing to begin with. So I wouldn't aim to be giving people too many, you know, we want to exercises, too many things to do. But understanding why you're doing it and... ⁓

Bart Van Buchem (20:05)
Hmm.

Tim Beames (20:10)
Thinking about the effects and having some ability to be able to modify and control and be ⁓ in charge, have agency of what you're doing, I think is key, the beginning part for me.

Bart Van Buchem (20:27)
So, so, and to make it meaningful. We touched on things like playful, habitual movements that were lost and also co-creation in that regard. So, so yeah, great. No, that's good.

Tim Beames (20:45)
Yeah, so there's a couple of, sorry, I'm jumping in again, feel

like I want to do, yeah, there's so much here that we can talk about. there's, there's, there's what there's fitting into your day, there's finding time and the evidence looks like we need to do things quite a lot. So how do we find time and pairing it, you know, stacking it, whatever you want to call it, with other activities or other things that you do in a day is important.

Bart Van Buchem (21:03)
Hmm.

Tim Beames (21:13)
knowing that when I get up in the morning, I do my exercise or when I go and boil the kettle for a cup of tea, this is when I do this activity, is one thing. But then, as you were saying about mind state, but doing it with perhaps curiosity, if you can, taking away the natural judgment that some of us have over what we should feel like or how we should move or how well...

you know, this is going or something. So curiosity can mean a lot of different things as well. And exploration, I think, fits curiosity. And then we've got other sort of avenues of perhaps an emotional state that we might be able to manifest as well. So how and what you do and how you explain it can create some really rich...

experiences that are more playful, more joyful, more exciting as well and you know that setting up and you know these can include pairing things with music or doing it with someone else or having some sort of visualised

⁓ process or maybe trying to do your, mean thinking about stuff that I would do, would be pretend to be a tiger or a gorilla or you know bring in something that is kind of sort of to begin with quite silly and a little bit playful and but it can create some joyful experiences as well with that.

Bart Van Buchem (22:51)
Yeah. So, when I'm, what I hear you saying is that the introduction is it's, it's exploration from both sides. So you suggest and you can go beyond reps and sets, obviously by adding contextual factors and trying. So, so when people, and I think that, because I agree because exercise probably wouldn't be a one-off, right? So it's not the exercise that you would stick with the whole time.

So you that requires some reflection. So, so people will get back to the next session and they reflect. So what I'm, what I sort of picked up more recently, so how, how to discuss this type of, so instead of saying, did you do the exercises? That's probably a no go to say that. did you do them? So rather than basically asking for

Yeah, your own curiosity. So how do you experience it? Is there anything you want to How would you think this reflection of exercises, you could shape that or introducing it once people have probably tried things or not, and they maybe not have done it.

Tim Beames (24:09)
Yeah, mean, yeah, totally. I in the short term, finding a way of taking agency of self and body back and being the one who's in charge of your movement and lessening the sort of protective nature that might be wrapped around that for you. But ultimately, if we're sort of stretching into the future.

Bart Van Buchem (24:29)
Yeah.

Tim Beames (24:35)
we recognise that movement is a really powerful part of wellbeing in humans. So how do we create the possibilities long into the future that movement and exercise might be a part of that person's life and therefore sustained wellbeing as well for them. So yeah, I think we can think about things on different ⁓ temporal levels, can't we? ⁓

Bart Van Buchem (25:03)
Yeah. Well, it's there's a scenario when people say I didn't do the exercise because I didn't have the time or didn't felt comfortable doing it. I did it once and then I forgot about it. It somewhat tells you that you probably have to explore more and better.

Tim Beames (25:15)
Exactly.

I think, and you know what, and this is something that I'd obviously say when I'm teaching as well, is I used to think that was the patient's fault. And I think I was educated to think that's their fault. know, they are, they've been bad for not doing their exercise. But actually what I realise now is ⁓ it's more likely to be on me.

Bart Van Buchem (25:34)
Hmm.

Tim Beames (25:43)
and us from a co-creation point of view of going, we just didn't plump on the right thing. We haven't found the thing that ticks for you. So, okay, so what was it about that? Do you feel like we should continue with it? How about we try and find something else? What might that look like? How are we gonna? And there are constraints, aren't there, of being able to engage in certain things in our life. So if you are a single parent with two kids, both at school age and you're...

you know, both working and providing, where do you have time to be able to bring that into your life? so it is about working with what's possible in you and in your life.

Bart Van Buchem (26:28)
Yeah. And there's also this expectation part when, when an exercise is how likely is it that the exercise will decrease the pain or is it, does it, is it even the goal? I can't remember. Well, there are some pain management tools like breathing kind of type stride strategies could potentially ease pain in a way, or using distraction.

But most exercises are not usually not really aiming to do so, right? They have different reasons for doing it. But in, in, let's say the paining patient is probably seeking for pain reduction in some way. And then the exercise is obviously not going to provide that necessarily. So on expectations is very, it's very important to see what is it doing? Why, why is this?

exercise and what is actually the success group? Well, let's say what's the factor for success in this, this exercise or how do you measure your success rating? I did this exercise for the whole week, 10 times a day. My pain is still there, which obviously sinks.

Tim Beames (27:40)
Yeah, yeah. Anyway, probably

not looking on the right timeframe, are we?

Bart Van Buchem (27:46)
Not really, I guess. Yeah. But another, and the other other ends. people say, I did this exercise and actually my pain moved or let's say, let's reduce by 50%. I'm not sure whether it would be the exercise that has decreased. We don't know, but you could.

Tim Beames (28:02)
sometimes do you care? know if that's what if they're going to engage in that in the future awesome.

Bart Van Buchem (28:09)
Yeah, absolutely. But there's also a risk of people when the pain flares up and a stick with the exercise and they realize that are bullshit exercise. But it may be part of the puzzle at some point. So I always see I'm tend to sort of start very, very small with what I would I would I kind of like and you probably can relate to that team then you have to you have to have an embodied experience.

We're in the clinic in the the consultation that you can exercise the exercise, or you can explore the exercise together instead of putting it on like a piece of paper and sending people out and just just figure it out and see how it goes. That's a way of doing it. But I'm that that's probably not very specific. I think when it's specific, you probably have to you have to figure out what what it is and how it feels and what the objective or the goal

might be and then people can take this experience so they can relate refer to the experience they've had in the clinic and then it's I think it's more likely that it will succeed instead of sending people away with a set of like videos and ⁓ beautiful drawn stuff you probably just have to go through the sequence and doing it yeah step by step for some at least

Tim Beames (29:37)
Yeah, and it might include some of that. Some people want a ⁓ detailed plan of this is what I'm going to do, this is how much I'm going to do it, and you can...

Bart Van Buchem (29:40)
Yeah.

Tim Beames (29:51)
figure that out and hopefully not plump for the old three times ten lots of something but come up with something a bit more novel and interesting that's going to allow them to remember it. I often plump for weird numbers like seven and a half, try seven and a half of these or two and a third of those or something like that and just a way of just making it sort of a bit more meaningful and easier to remember.

Bart Van Buchem (30:11)
That's great.

Tim Beames (30:17)
But even if you have the sort of, you're prescribing some numbers and an amount in a day in a particular exercise, but give them the freedom to explore and experiment with that as well and to try it with or without music on or with or without someone around them or as a sort of mental exercise before they lead into that exercise or whatever, and reflect as well on how that went.

Bart Van Buchem (30:45)
Yeah, yeah. Well, the interesting bit, but ⁓ I really liked your two and a half or two and a three quarters.

Tim Beames (30:53)
you can nick it if you want, yeah, I'm sure I've stolen it from someone some day.

Bart Van Buchem (30:55)
Yeah, it's, it is great. using,

yeah, just, just throw out a number that's just your number. Right. So I think it could, and it is just, just crosses my mind. it's predictability. So if on rep number six, it always starts. Well, you can do three and see what happens. And then you can then 10 and next. And if you just roll the dice, that's your number. That's the today's thing. And

Tim Beames (31:00)
Yeah.

He's like...

Bart Van Buchem (31:22)
I really like to, create this unpredictability or at least creating something novel and maybe some reward in, in, in it, which just makes it really interesting to sort of prevent the prediction. ⁓ and from a, let's say predicting process type of thinking, probably say, well, an exercise never should be the same. It should always challenge you in some way, do something different. And I think.

different or even two and a two and a quarter probably will be an away of putting that up and challenge the average. Yeah.

Tim Beames (32:02)
Exactly.

Exactly, yeah and we're sort of we're dropping into sort of topics we haven't expressly said it but graded exposure and environmental enrichment and things like this and

Bart Van Buchem (32:16)
Hmm.

Tim Beames (32:16)
There

are movement abundance and variability, there are whole areas that we could jump into, but the practical putting it into place is recognising that there might be a bit of stigma associated with asking someone to move or exercise and not dismissing that, but working with it and then opening up some awareness and understanding of what pain might mean to them and hopefully reducing fear to the point where they're

happy to engage in some activity but making that activity a bit more novel, interesting, so they can be curious, they are in control of it, they can try and explore and they're also not too judgmental on how well that went but curious and open to you know what that means and figuring out where dosing might be for them at a particular time.

Bart Van Buchem (33:11)
Exactly. Yeah.

Tim Beames (33:12)
And the dose at that time isn't the dose that they should stick to. So things change over time as well, don't they? So there's some more complexity later on once we've found the ability to engage in meaningful, valued movement and exercise in someone's day and.

Bart Van Buchem (33:20)
Yeah.

Yeah, yeah. So this variability and value probably comes with an exercise should represent real life to some extent. So if it's too modeled, and protocolized is probably not how live works. But protocolized could be helpful for some people. I think that's that's a good summary, like a recap, what we've done. ⁓ If that's all right, and trying. ⁓ Yeah, no shit. That I did have some takeaways from this.

I think movement, especially when movement is exercise and prescribed exercises are, should be meaningful. ⁓ could be some people would be helpful to co-create, ⁓ has to be an elevated experience, ⁓ exploring and, ⁓ finding ways to find the sweet zone. And that can be like a whole process on its own. It's very unlikely that it will happen.

in one session. So that's something as a, as a part. I think when you exercise with people thinking of in the back of your mind, so we are constantly exploring, then your therapeutic approach and people in pain could be very exciting because you never know where you're to end up. But you have this ongoing curiosity that will elicit the next step. And therefore like the

A protocol, you can use a protocol for like a small, a short time, amount of time. But in the end, you probably have to, you have to move on because reality is requiring more emergent properties than a linear, linear thinking. ⁓ Probably for you guys listening. ⁓

We, we think about that. If you're, if you, if you use a focus on, on sessions with, with exercise, you probably just focus on the variability, the value, in the movement exercise prescription, be more creative. Just allow yourself to, challenge yourself and people, ⁓ for patients that, that they have to also be in an, an active part of this thing called.

exercise prescription. So tell people that what you love, what you like to do, set your boundaries, but also allow yourself to explore and explore these possibilities. So in a nutshell, I'm not sure if I touched all the things we've done, but we discussed too much ⁓ just to summarize it in a short thing. I think hopefully this will be very helpful for you just to

Get your head around exercise prescription and to broaden up and get yourself in a creative mode and ⁓ improve there and feel more comfortable with prescribed in this way. Yeah. Any add ons?

Tim Beames (36:33)
Yeah, yeah.

Let us know how it goes as well. We'd love to hear how people go with this sort of knowledge as well. You might be doing it already and have some wonderful ideas and suggestions to share with others.

Bart Van Buchem (36:48)
Absolutely. We're looking forward to hear from you. All right. Thank you for listening. ⁓ Don't forget to have a look at their website. I think while we release this ⁓ session, will be sessions to Tim you have you got hopefully I got your you got my back here. Who's the next episode on the clinical discussions or so did clinical confidence theory.

Tim Beames (37:15)
In clinical confidence, we've got

a couple more with Bernhard. Next up, Irene Vicky. We're looking at radiculopathy in nerve root lesions.

understanding the sort of clinical picture, diagnosing it, using bedside tests, how confident you can be in the results that you get, the sort of clinical toolkit that you might use and how we go about empowering patients to engage in rehab process. That's the next things that are coming up. Yeah.

Bart Van Buchem (37:45)
Wow, well, looking forward to that. Right. Thank you for listening. Have a great day and catch you later.

Tim Beames (37:47)
you

See ya.