1 00:00:00,040 --> 00:00:02,760 Hey, I'm hyper mobile and if you're listening to this, I'm 2 00:00:02,760 --> 00:00:06,480 guessing that you might be too. Hi, my name is Alex and I'm your 3 00:00:06,480 --> 00:00:08,680 hyper mobile host. And today we are talking all 4 00:00:08,680 --> 00:00:11,360 about hyper mobility and the workplace. 5 00:00:11,680 --> 00:00:15,120 Now in my work as a UK registered osteopath, this is 6 00:00:15,120 --> 00:00:18,120 something which comes up a lot in my management of patients. 7 00:00:18,480 --> 00:00:21,520 A lot of my patients have to be able to work or they are able to 8 00:00:21,520 --> 00:00:23,120 work and they're continuing to do that right now. 9 00:00:23,640 --> 00:00:27,480 And because work takes up so much of someone's time, it's 10 00:00:27,480 --> 00:00:29,600 something that I consider to be high yield. 11 00:00:29,600 --> 00:00:31,880 So this means when I look at my patient, I'm thinking okay like 12 00:00:32,280 --> 00:00:34,480 what are they doing when they're not in their appointment with 13 00:00:34,480 --> 00:00:39,680 me, What do I need to help their body be able to do perhaps or 14 00:00:39,680 --> 00:00:42,560 how might they be injuring themselves knowingly or 15 00:00:42,560 --> 00:00:44,760 unknowingly when they're not in the clinic room? 16 00:00:45,360 --> 00:00:48,520 So work is a very important thing in my management of 17 00:00:48,520 --> 00:00:52,660 patients, and something which comes up very often is the idea 18 00:00:52,660 --> 00:00:56,220 of ergonomics. So I'm sure you have all heard 19 00:00:56,220 --> 00:01:01,020 of the term ergonomics. It comes from ergo, ergo meaning 20 00:01:01,020 --> 00:01:04,620 work and nomics meaning science of and it's the science of how 21 00:01:04,660 --> 00:01:07,140 humans relate to their workplace. 22 00:01:07,300 --> 00:01:08,820 And there are different types of ergonomics. 23 00:01:08,820 --> 00:01:11,260 There's physical ergonomics, how your body relates to your 24 00:01:11,260 --> 00:01:12,940 workplace. There's organizational 25 00:01:12,940 --> 00:01:15,100 ergonomics. I believe there's psychological 26 00:01:15,100 --> 00:01:17,260 ergonomics as well. There are all of these different 27 00:01:17,260 --> 00:01:20,560 types of ways that a human can relate to their workplace, but 28 00:01:20,560 --> 00:01:23,200 for the purposes of today's episode, we're just going to be 29 00:01:23,200 --> 00:01:28,160 focusing on physical ergonomics. Now, ergonomics has had kind of 30 00:01:28,160 --> 00:01:31,800 a renaissance in the the last 150 or so years. 31 00:01:31,800 --> 00:01:36,360 It wasn't really a thing until the late 1800s, but it first 32 00:01:36,360 --> 00:01:40,560 appeared actually in the 5th century BCE when someone named 33 00:01:40,680 --> 00:01:41,920 Hippocrates. He's pretty famous. 34 00:01:41,920 --> 00:01:45,800 You might have heard of him. He described A surgeon's office 35 00:01:45,800 --> 00:01:48,410 setup. So they had surgeons back in 36 00:01:48,410 --> 00:01:50,610 ancient Greece because they had a lot of things back then. 37 00:01:50,850 --> 00:01:53,370 And he said, you know, the surgeon needs to have these 38 00:01:53,370 --> 00:01:56,170 tools and in this position and organized this way so they can 39 00:01:56,170 --> 00:01:59,010 do their work most effectively. And that's kind of a good 40 00:01:59,010 --> 00:02:01,370 summary of ergonomics. It's like we need to have this 41 00:02:01,370 --> 00:02:04,850 stuff set up like this to help with the work outcome. 42 00:02:05,130 --> 00:02:10,410 However, there's a deep conflict at the heart of ergonomics. 43 00:02:10,650 --> 00:02:16,130 And this conflict started to appear when ergonomics, after 44 00:02:16,570 --> 00:02:20,500 centuries have been not really a thing, came back into the public 45 00:02:20,500 --> 00:02:22,420 consciousness. So it was actually. 46 00:02:23,180 --> 00:02:26,060 So it was actually someone named Frederick Taylor in the 19th 47 00:02:26,060 --> 00:02:29,980 century who who made famous the idea of the scientific 48 00:02:29,980 --> 00:02:33,500 management method. And the idea of the scientific 49 00:02:33,500 --> 00:02:36,500 management method came from Taylor's studies of people who 50 00:02:36,500 --> 00:02:39,180 shoveled coal. So he was looking at these these 51 00:02:39,180 --> 00:02:42,820 workers and saying, how can we get them to be more efficient at 52 00:02:42,820 --> 00:02:45,460 their work? His main concern was the work 53 00:02:45,940 --> 00:02:49,510 output, the end result. So he said if we get a longer 54 00:02:49,510 --> 00:02:52,230 shovel handle does that help? If we make the size of the 55 00:02:52,230 --> 00:02:55,910 shovel smaller, does that help if we I don't make the shovel 56 00:02:55,910 --> 00:02:58,070 like sharper or something? He was looking at how he could 57 00:02:58,070 --> 00:03:02,230 try to optimize that workers tool to improve their work 58 00:03:02,350 --> 00:03:06,000 outcome without any regard for the the worker by the way, other 59 00:03:06,120 --> 00:03:08,200 than how fast they were able to do that task. 60 00:03:08,360 --> 00:03:12,640 He was then followed by two Russian researchers, 2 61 00:03:12,680 --> 00:03:18,200 Vladimir's of Vladimir Bektorev and Vladimir Mia Sisychev. 62 00:03:18,200 --> 00:03:21,800 I think I got that kind of right and their aim. 63 00:03:22,080 --> 00:03:25,520 Unlike Taylor who only cared very clearly about the 64 00:03:25,560 --> 00:03:28,710 efficiency of the work being done, their aim was to have 65 00:03:28,710 --> 00:03:32,350 efficiency coupled with a minimum of health hazards, 66 00:03:32,670 --> 00:03:36,150 absence of fatigue and a guarantee of the sound health 67 00:03:36,150 --> 00:03:38,710 and all round personal development of the working 68 00:03:38,870 --> 00:03:40,990 people. So these two researchers, they 69 00:03:40,990 --> 00:03:44,870 basically rejected Taylor's proposal to turn man into a 70 00:03:44,870 --> 00:03:48,590 machine. And unfortunately, based on what 71 00:03:48,590 --> 00:03:51,110 I hear from my patients and some of my own experience in 72 00:03:51,110 --> 00:03:55,260 different workplaces, I think that probably most businesses 73 00:03:55,260 --> 00:03:57,660 today, they have kind of sided more with Taylor. 74 00:03:57,660 --> 00:04:00,660 I think there's a lot of prioritizing of the work 75 00:04:00,900 --> 00:04:04,180 outcomes instead of, you know, really truly caring about the 76 00:04:04,180 --> 00:04:06,380 health of the employee. However, obviously every company 77 00:04:06,380 --> 00:04:07,980 is different. There's a lot of variability in 78 00:04:07,980 --> 00:04:09,980 this field. Some people have companies they 79 00:04:09,980 --> 00:04:12,460 absolutely praise and other people have companies that they 80 00:04:12,460 --> 00:04:14,460 do the opposite of in that regard. 81 00:04:14,580 --> 00:04:18,920 So when it comes to ergonomics itself, the way that it most 82 00:04:18,920 --> 00:04:21,519 often comes up in in my work is patients will tell me, you know, 83 00:04:21,519 --> 00:04:24,880 oh, I've I've had an ergonomics checkup, I've had the, I have 84 00:04:24,880 --> 00:04:28,240 the special chair and I have this like special mouse that I'm 85 00:04:28,240 --> 00:04:29,440 supposed to use. And all these things, they're 86 00:04:29,440 --> 00:04:32,320 not really helping. And the reason I think that's 87 00:04:32,320 --> 00:04:35,240 the case is because a lot of the science which ergonomics is 88 00:04:35,240 --> 00:04:39,520 based off, if not all of the science, is based on people with 89 00:04:39,520 --> 00:04:42,800 normal connective tissue or it's not taking into account people 90 00:04:42,800 --> 00:04:44,360 with hypermobile connective tissue. 91 00:04:44,800 --> 00:04:49,650 So we have information on interventions, which we have 92 00:04:49,850 --> 00:04:52,810 evidence helps, helps people in general, helps people with 93 00:04:52,970 --> 00:04:55,770 normal connective tissue because that is the average person. 94 00:04:56,090 --> 00:04:59,130 But if we have a hypermobile person, they may not and are 95 00:04:59,130 --> 00:05:01,410 often not helped by those interventions. 96 00:05:01,570 --> 00:05:04,050 So that lumbar support cushion doesn't help. 97 00:05:04,250 --> 00:05:09,090 That I don't know that standing desk doesn't help at all, makes 98 00:05:09,090 --> 00:05:11,950 things worse sitting upright with that perfect posture after 99 00:05:11,950 --> 00:05:13,710 being taught how to do it, that injures them. 100 00:05:13,870 --> 00:05:17,270 So hyper mobile people are in a bit of a bind because even when 101 00:05:17,270 --> 00:05:19,950 they reach out to their workplace and they say like, hey 102 00:05:20,430 --> 00:05:22,470 I, you know, I'm feeling really uncomfortable work, I'm 103 00:05:22,470 --> 00:05:24,390 struggling with neck pain or back pain or whatever, can you 104 00:05:24,390 --> 00:05:26,990 help me? Their work, the, the offers that 105 00:05:26,990 --> 00:05:29,350 are being proposed by the workplace are often not suitable 106 00:05:29,350 --> 00:05:32,190 for these individuals. Today I'm going to share how I 107 00:05:32,190 --> 00:05:36,550 support patients in managing life as an employee, you know, 108 00:05:36,550 --> 00:05:39,390 and trying to get through that just work essentially. 109 00:05:40,460 --> 00:05:42,540 But before I get into that, there's kind of a choice that 110 00:05:42,740 --> 00:05:45,460 everyone has to make. And that choice is, do you feel 111 00:05:45,460 --> 00:05:48,100 confident talking to your workplace about accommodations? 112 00:05:48,100 --> 00:05:51,460 Or are you someone who wishes perhaps to just try and improve 113 00:05:51,460 --> 00:05:54,300 things as much as possible and in a way that's discreet and 114 00:05:54,300 --> 00:05:57,460 that keeps your, you know, all your health issues private to 115 00:05:57,460 --> 00:06:00,020 you? And again, that choice is really 116 00:06:00,060 --> 00:06:02,580 personal. I encourage everyone to think 117 00:06:02,580 --> 00:06:05,740 about their workplace and some of the expectations and some of 118 00:06:05,740 --> 00:06:08,460 the stigma perhaps, and how that might affect them. 119 00:06:09,450 --> 00:06:11,970 In a perfect world we would all be able to talk to all of our 120 00:06:11,970 --> 00:06:15,130 workplaces about our needs and support interventions, but 121 00:06:15,130 --> 00:06:18,450 that's not the reality. So as always, as I like to say 122 00:06:18,450 --> 00:06:21,290 on here you do you think about what you want to do before you 123 00:06:21,290 --> 00:06:23,130 do it. And ideally, of course, do it 124 00:06:23,130 --> 00:06:25,330 with a qualified healthcare provider. 125 00:06:25,610 --> 00:06:28,850 Because as always, this episode is not in any way shape or form 126 00:06:28,850 --> 00:06:31,690 medical advice. It is for informational purposes 127 00:06:31,690 --> 00:06:35,050 only. OK, So when it comes to hyper 128 00:06:35,050 --> 00:06:38,690 mobility in the workplace, the single biggest source of harm in 129 00:06:38,690 --> 00:06:41,970 my opinion is the the setting situation. 130 00:06:41,970 --> 00:06:45,490 So a lot of people are told or are pressured to do this. 131 00:06:45,490 --> 00:06:47,930 They're they're pressured to sit in a normal upright seated 132 00:06:47,930 --> 00:06:50,210 position. So feet on the floor, you know, 133 00:06:50,410 --> 00:06:54,290 knees at 90 degrees, hips at 90 degrees, back, straight elbows 134 00:06:54,290 --> 00:06:56,690 supported that type of typing position. 135 00:06:57,130 --> 00:06:59,530 And we're talking here of course about workers in sedentary desk 136 00:06:59,530 --> 00:07:01,050 based jobs. I'll talk about work that 137 00:07:01,050 --> 00:07:03,130 requires long periods of standing in a little bit. 138 00:07:03,170 --> 00:07:06,930 OK. But that position injures hyper 139 00:07:06,930 --> 00:07:10,050 mobile people, their connective tissue and again, that's the 140 00:07:10,050 --> 00:07:11,690 stuff. Think of it like the glue in 141 00:07:11,690 --> 00:07:13,170 your body that holds everything together. 142 00:07:13,170 --> 00:07:16,210 It's not as sturdy and the amount of energy and effort 143 00:07:16,210 --> 00:07:18,570 required to maintain that upright position often doesn't 144 00:07:18,570 --> 00:07:21,370 work for them. So what I recommend people do is 145 00:07:21,370 --> 00:07:24,730 try and change positions as much as they possibly can. 146 00:07:25,250 --> 00:07:27,690 So every 20 minutes or every half hour, literally just 147 00:07:27,690 --> 00:07:30,890 cycling through positions and saying, OK, I'm going to sit in 148 00:07:30,890 --> 00:07:33,090 that upright posture and then I'm going to cross one leg, 149 00:07:33,090 --> 00:07:35,570 cross the other, Maybe I'm going to stand at my desk for a bit, 150 00:07:35,810 --> 00:07:37,970 maybe I'm going to sit in a different chair. 151 00:07:38,130 --> 00:07:42,610 Cycling through I find is the best way to help people avoid 152 00:07:42,610 --> 00:07:44,730 injury. And the analogy that I use for 153 00:07:44,730 --> 00:07:47,770 this is imagine if you had a pancake in a hot pan and you 154 00:07:47,970 --> 00:07:50,970 were trying to avoid burning it. If you couldn't take it out of 155 00:07:50,970 --> 00:07:53,330 the pan, what you would do is just keep flipping it. 156 00:07:53,730 --> 00:07:56,370 So that's what we're doing here. We're trying to avoid having 157 00:07:56,370 --> 00:07:59,770 that person have essentially what would be classified almost 158 00:07:59,770 --> 00:08:01,450 as like a repetitive strain injury. 159 00:08:01,450 --> 00:08:04,530 They're spending too much time, whatever too much might be in 160 00:08:04,530 --> 00:08:06,010 that one position and being hurt. 161 00:08:06,130 --> 00:08:08,770 So what I encourage patients to do is just be changing 162 00:08:08,930 --> 00:08:11,570 constantly. Now this becomes a bit of a 163 00:08:11,570 --> 00:08:13,530 problem, of course, in open plan offices. 164 00:08:13,530 --> 00:08:16,450 So I've have had patients who work in high profile kind of 165 00:08:16,450 --> 00:08:20,210 professional careers and they tell me, look, I can't be 166 00:08:20,210 --> 00:08:22,490 sitting weirdly at my desk because I'll get judged for 167 00:08:22,490 --> 00:08:24,090 that. And in that case, of course we 168 00:08:24,090 --> 00:08:25,570 have to take a different strategy. 169 00:08:25,850 --> 00:08:28,890 But if you can change position, if you have a chair that allows 170 00:08:28,890 --> 00:08:32,450 you to do so, I used to, I used to do that to my chair. 171 00:08:32,450 --> 00:08:34,090 For example, I take the armrest off. 172 00:08:34,090 --> 00:08:36,730 Back when I was working in a more desk base job, I would 173 00:08:36,730 --> 00:08:39,650 change the height of the chair up and down all the time just to 174 00:08:39,650 --> 00:08:41,610 try and like vary the position I was in. 175 00:08:41,970 --> 00:08:45,450 If you can change the position you're sitting in, that will 176 00:08:45,450 --> 00:08:48,800 help and I will also try to remember to link in the show 177 00:08:48,800 --> 00:08:52,160 notes some research about why sitting upright isn't as good 178 00:08:52,280 --> 00:08:53,840 for you as you might think it is. 179 00:08:55,080 --> 00:08:57,560 I think it's this like yet another way we kind of punish 180 00:08:57,560 --> 00:09:00,320 ourselves by not being good enough is saying, oh if only I 181 00:09:00,320 --> 00:09:03,440 was more perfect, if only I could just sit in that perfectly 182 00:09:03,440 --> 00:09:05,400 upright position, then I wouldn't have pain. 183 00:09:05,400 --> 00:09:09,840 And it's it's a really seductive and compelling idea even from 184 00:09:09,840 --> 00:09:12,640 from a business perspective. If if we think of Healthcare is 185 00:09:12,640 --> 00:09:14,800 a business, because a lot of it is in many ways. 186 00:09:15,550 --> 00:09:17,790 If we think of the idea of like telling the patient, oh you're 187 00:09:17,790 --> 00:09:20,270 not good enough. If if you're if you work harder, 188 00:09:20,270 --> 00:09:23,270 if you sit upright better, then you won't be in pain. 189 00:09:23,270 --> 00:09:27,270 It's a way that we shift blame to the patient and say it's your 190 00:09:27,270 --> 00:09:30,390 fault. So I have a lot of thoughts on 191 00:09:30,390 --> 00:09:33,510 posture. But in summary, just just change 192 00:09:33,510 --> 00:09:35,870 positions. If you can do it somehow some 193 00:09:35,870 --> 00:09:37,150 way. Change position, different 194 00:09:37,150 --> 00:09:39,950 chair, different positions, standing, sitting, do as much as 195 00:09:39,950 --> 00:09:43,150 you can there. Now of course you can also 196 00:09:43,350 --> 00:09:47,350 certainly find ways to affect the way that your feet relate to 197 00:09:47,350 --> 00:09:49,150 the ground. Some people find stools helpful, 198 00:09:49,310 --> 00:09:51,510 Some people like to have their legs dangling a bit. 199 00:09:51,510 --> 00:09:54,950 I have patients who hate when I have the treatment table so low 200 00:09:54,950 --> 00:09:56,350 that their feet are touching the floor. 201 00:09:56,550 --> 00:10:00,830 So be aware that again, what you are told is perfect, might not, 202 00:10:01,070 --> 00:10:03,470 and in fact probably isn't going to be perfect for you. 203 00:10:03,870 --> 00:10:07,950 Additionally, some patients find it helpful to find time to have 204 00:10:07,950 --> 00:10:10,030 positions of what I call true rest. 205 00:10:10,420 --> 00:10:12,780 So again, hypermobile people, their tissues are loaded 206 00:10:12,780 --> 00:10:15,620 differently in different postures than a person with 207 00:10:15,620 --> 00:10:17,980 normal connective tissue has their tissues loaded. 208 00:10:18,340 --> 00:10:21,700 And a big issue I see at workplaces is neck pain, chronic 209 00:10:21,820 --> 00:10:24,340 neck pain. And my patients will describe it 210 00:10:24,340 --> 00:10:27,260 as like it feels almost like their arms are like just ripping 211 00:10:27,260 --> 00:10:29,060 the tissue between their neck and their shoulder. 212 00:10:29,300 --> 00:10:32,580 It's a really intense pain. It often goes into a headache 213 00:10:32,580 --> 00:10:34,860 and I like to use this like, hand gesture. 214 00:10:34,860 --> 00:10:36,220 I'll do this in clinic. I say like, is your headache 215 00:10:36,220 --> 00:10:38,550 like this? And it kind of, it's like a claw 216 00:10:38,710 --> 00:10:39,950 coming out of the inside of your head. 217 00:10:39,950 --> 00:10:42,430 So it's affecting your eyes, your teeth, your neck. 218 00:10:42,670 --> 00:10:46,350 And that happens because of the nerves and their relationship to 219 00:10:46,350 --> 00:10:49,990 the neck and the shoulder. But anyways, finding a way to 220 00:10:49,990 --> 00:10:53,150 have what's called true rest is very beneficial and it just 221 00:10:53,150 --> 00:10:54,790 means unloading those structures. 222 00:10:55,230 --> 00:10:58,510 So instead of having the arms hanging down too far, 223 00:10:58,510 --> 00:11:01,470 unsupported, and even if they're supported for a normal person, 224 00:11:01,470 --> 00:11:03,830 remember they might not be supported for a hyper mobile 225 00:11:03,830 --> 00:11:06,070 body. What I recommend patients do is 226 00:11:06,070 --> 00:11:09,150 that they get cushions and try and elevate their armrest so 227 00:11:09,150 --> 00:11:10,830 they're up almost like this, like I'm showing it. 228 00:11:10,830 --> 00:11:13,110 If you're watching the video version, hi, you can see me 229 00:11:13,110 --> 00:11:15,450 here. But having those arms really 230 00:11:15,450 --> 00:11:19,130 elevated takes tension off the neural tissue that runs between 231 00:11:19,130 --> 00:11:21,770 the shoulder and the neck. Additionally, it depends on your 232 00:11:21,770 --> 00:11:24,730 workplace, but some patients find it helpful to roll a towel, 233 00:11:24,970 --> 00:11:27,810 wrap that around their neck, and use it just to lift through the 234 00:11:27,810 --> 00:11:30,730 side of their neck. And again, that's just, that's 235 00:11:30,730 --> 00:11:35,760 giving that person's body a way just to be truly at rest. 236 00:11:36,320 --> 00:11:39,040 Because if you're a hyper mobile person listening to this, you're 237 00:11:39,040 --> 00:11:41,880 going to know that getting injured from sitting or lying 238 00:11:41,880 --> 00:11:44,800 down or all these things that are supposed to be restful is 239 00:11:44,800 --> 00:11:48,040 normal for hyper mobile people. So we have to be very strategic 240 00:11:48,040 --> 00:11:50,520 there. Additionally, a lot of people 241 00:11:50,520 --> 00:11:55,880 find it helpful to think differently in terms of mice. 242 00:11:56,390 --> 00:11:59,390 So obviously a lot of work like setups require people to have a 243 00:11:59,390 --> 00:12:01,670 mouse. And the common recommendation 244 00:12:01,670 --> 00:12:04,070 when the mouse results or contributes potentially to 245 00:12:04,070 --> 00:12:06,870 something like a carpal tunnel syndrome or wrist pain is to 246 00:12:06,870 --> 00:12:09,270 give the person this. Like I call it a Penguin mouse. 247 00:12:09,270 --> 00:12:11,390 I don't know what it's called, it's like an upright joystick 248 00:12:11,390 --> 00:12:14,310 mouse thingy. Anyways, what I find works 249 00:12:14,310 --> 00:12:17,550 better and what I use with my patients is actually an 250 00:12:17,550 --> 00:12:20,590 animation tablet. So you can get tablets, I don't 251 00:12:20,590 --> 00:12:23,150 mean like iPad style tablet, I mean an animation tablet. 252 00:12:23,150 --> 00:12:25,500 It's a very different thing. But you can get these tablets 253 00:12:25,500 --> 00:12:28,260 from a company like Wacom, for example, and they don't have to 254 00:12:28,260 --> 00:12:30,740 be expensive, Like don't get the expensive one unless if you're 255 00:12:30,740 --> 00:12:33,740 an animator, okay. But you literally have like a 256 00:12:33,740 --> 00:12:37,860 little pen, a little stylus, and you just tap on it depending on 257 00:12:37,860 --> 00:12:41,060 where you want the cursor to go. And they are incredibly 258 00:12:41,060 --> 00:12:43,980 lightweight. And because they don't require 259 00:12:43,980 --> 00:12:46,460 the same pressure as writing, it's not painful in the way that 260 00:12:46,460 --> 00:12:49,460 writing is for some people. And it's an intervention which I 261 00:12:49,460 --> 00:12:51,940 think can make a big difference and certainly it's an option 262 00:12:51,940 --> 00:12:54,630 worth having. So I've had patients with very 263 00:12:54,630 --> 00:12:57,110 complex wrist injuries who ended up ultimately using a 264 00:12:57,110 --> 00:13:00,550 combination of that like joystick Penguin, mouse thing 265 00:13:00,910 --> 00:13:04,430 and the animation tablet and they found that really 266 00:13:04,430 --> 00:13:06,670 effective. So again, if you see a theme 267 00:13:06,670 --> 00:13:11,950 here, it's thinking outside the box as well-being aware that you 268 00:13:11,950 --> 00:13:14,310 might be more sensitive to temperature changes because a 269 00:13:14,310 --> 00:13:16,790 lot of hyper mobile people have issues with with something 270 00:13:16,790 --> 00:13:19,550 called thermal regulation. So making sure that you have a 271 00:13:19,550 --> 00:13:22,310 blanket at your desk or that you have layers that you can take 272 00:13:22,310 --> 00:13:25,350 off perhaps. But being aware that you are 273 00:13:25,350 --> 00:13:29,630 going to want a very narrow temperature range and that it's 274 00:13:29,630 --> 00:13:32,390 unlikely that your office is going to be able to get that 275 00:13:32,390 --> 00:13:35,430 perfect for you potentially and just having a strategy in place 276 00:13:35,430 --> 00:13:37,870 to deal with that can make a big difference. 277 00:13:38,030 --> 00:13:40,190 Now of course you have to think of the human themselves and then 278 00:13:40,590 --> 00:13:42,830 I don't know if this counts as ergonomics because ergonomics is 279 00:13:42,830 --> 00:13:44,510 the person relating to the environment. 280 00:13:44,590 --> 00:13:46,550 But when it comes just to getting through the work day, 281 00:13:47,000 --> 00:13:49,320 it's very important to think of things like hydration. 282 00:13:49,720 --> 00:13:53,200 So a lot of people find having a little bit of salt with their 283 00:13:53,200 --> 00:13:55,560 water beneficial. Again, there will be some 284 00:13:55,560 --> 00:13:58,520 patients that this is not safe for, so speak with your medical 285 00:13:58,520 --> 00:14:00,880 doctor before making any changes please. 286 00:14:01,160 --> 00:14:04,000 But if you're someone like me who grew up during the low salt, 287 00:14:04,000 --> 00:14:09,320 low fat era, hi, it can be helpful to try adding in a 288 00:14:09,320 --> 00:14:11,000 little bit of salt with your water. 289 00:14:11,000 --> 00:14:13,880 So maybe having some cucumber slices with salt sprinkled on 290 00:14:13,880 --> 00:14:17,520 them, or a few salt and vinegar crisps or just something to get 291 00:14:17,520 --> 00:14:19,240 your salt intake up a little bit. 292 00:14:19,520 --> 00:14:22,520 Put salt on your food if you want, or have an electrolyte 293 00:14:23,280 --> 00:14:25,240 tablet or such such it or whatever. 294 00:14:25,600 --> 00:14:29,600 The reason that this works is because, as my grade 11 biology 295 00:14:29,600 --> 00:14:32,480 teacher like to always say, water follows salt. 296 00:14:32,760 --> 00:14:35,400 So when you drink water, in order for it to be absorbed 297 00:14:35,400 --> 00:14:38,000 through your kidneys, you need to have enough salt in your body 298 00:14:38,000 --> 00:14:40,040 to make that chemical process happen. 299 00:14:40,360 --> 00:14:43,280 So water follows salt. And if you're someone and you 300 00:14:43,280 --> 00:14:46,320 feel like you're just drinking like liters of water and then 301 00:14:46,320 --> 00:14:47,760 you're going to the bathroom and it's clear. 302 00:14:47,760 --> 00:14:49,560 And that that was me growing up, by the way. 303 00:14:49,760 --> 00:14:52,800 Think of upping your salt intake because it might make a big 304 00:14:53,040 --> 00:14:55,440 difference. And when it comes to upping salt 305 00:14:55,440 --> 00:14:58,120 intake and we'll do a whole episode on this one day because 306 00:14:58,200 --> 00:15:01,480 I have a lot of thoughts on it, but I like to think of dynamic 307 00:15:01,480 --> 00:15:04,320 dosing. So for me, I have like a base 308 00:15:04,320 --> 00:15:07,320 level of salt that I'm making sure I get every day as a 309 00:15:07,320 --> 00:15:11,070 supplement, but if it's hot I'll take a bit extra and if I've 310 00:15:11,070 --> 00:15:13,230 worked out that day, I'll take a bit extra. 311 00:15:13,510 --> 00:15:16,630 So I have, I'm able to adjust my dose depending on what I've 312 00:15:16,630 --> 00:15:19,910 asked my body to do that day, which makes a lot of sense as 313 00:15:19,910 --> 00:15:23,310 well thinking in terms of nutritional intake. 314 00:15:23,590 --> 00:15:26,150 So I was literally just talking about this with a patient last 315 00:15:26,150 --> 00:15:29,130 night and they were saying that they felt like they're a little 316 00:15:29,130 --> 00:15:32,530 bit differently, that they're a little bit sensitive when it 317 00:15:32,530 --> 00:15:35,170 comes to caloric intake. And if they go too long without 318 00:15:35,170 --> 00:15:37,410 eating, they feel like they start to crash and they think 319 00:15:37,410 --> 00:15:39,290 that they have maybe like a a blood sugar issue. 320 00:15:39,290 --> 00:15:40,650 But everything's come back normal. 321 00:15:41,090 --> 00:15:45,730 And one thing that I find seems to help a lot of hypermobile 322 00:15:45,730 --> 00:15:50,290 individuals is just trying to really regulate what you're 323 00:15:50,290 --> 00:15:52,170 taking in and when. So making sure that you're 324 00:15:52,210 --> 00:15:55,610 eating at regular intervals and maybe even having smaller meals 325 00:15:55,610 --> 00:15:57,930 more often. That is something that research 326 00:15:57,930 --> 00:16:01,490 does seem to suggest improves quality of life for hyper mobile 327 00:16:01,490 --> 00:16:05,530 people, partly due to potential digestion issues and so on. 328 00:16:05,770 --> 00:16:08,690 But making sure that you're eating off, that you're getting 329 00:16:08,690 --> 00:16:12,570 enough calories in is key. And in all honesty, the single 330 00:16:12,570 --> 00:16:15,490 biggest issue I see in my patients are people who are not 331 00:16:15,490 --> 00:16:18,770 getting enough calories in or they're waking up, they're 332 00:16:18,770 --> 00:16:21,610 feeling a bit poorly and then they're not eating until late at 333 00:16:21,610 --> 00:16:23,930 night where they're having a big meal and they're having that 334 00:16:23,930 --> 00:16:25,890 kind of irregularity in caloric intake. 335 00:16:26,050 --> 00:16:29,010 So trying to find a snack that you can just like have 336 00:16:29,010 --> 00:16:31,450 throughout the day that's healthy and that's kind to your 337 00:16:31,450 --> 00:16:35,210 body might be yet another way that you can make a difference. 338 00:16:35,450 --> 00:16:37,970 And of course, again, this isn't going to be a groundbreaking 339 00:16:37,970 --> 00:16:40,730 tip, but blue light blocking glasses, hyper mob people often 340 00:16:40,730 --> 00:16:42,450 have eye issues. They're sometimes a little bit 341 00:16:42,450 --> 00:16:45,050 sensitive. So having blue light blocking 342 00:16:45,050 --> 00:16:46,730 glasses can make a big difference. 343 00:16:47,010 --> 00:16:49,210 If you've never tried them, I recommend you try them. 344 00:16:49,210 --> 00:16:53,020 They're not that expensive. You can get a pair online and I 345 00:16:53,020 --> 00:16:55,340 swear by them and a lot of my patients were by them, so 346 00:16:55,340 --> 00:17:00,020 definitely give those a try. Now I hope that I've given you 347 00:17:00,060 --> 00:17:04,380 at least a a few ideas in terms of things you can do at the the 348 00:17:04,380 --> 00:17:07,300 workplace if you're a sedentary worker that are pretty discreet. 349 00:17:07,500 --> 00:17:10,420 I'm now going to talk briefly about workers who have to stand 350 00:17:10,619 --> 00:17:14,020 because I once waitressed for about 3 weeks and it was very, 351 00:17:14,020 --> 00:17:17,300 very hard. So standing up for long periods 352 00:17:17,300 --> 00:17:20,020 of time is really challenging for hyper mobile people. 353 00:17:20,359 --> 00:17:21,920 And long doesn't mean like 8 hours. 354 00:17:22,119 --> 00:17:25,359 Like long for me means like half an hour or an hour. 355 00:17:26,359 --> 00:17:28,240 And this is for a variety of reasons. 356 00:17:28,359 --> 00:17:31,880 So a lot of hyper mobile people have issues with blood pressure 357 00:17:31,880 --> 00:17:34,480 regulation. And what I mean by this is that 358 00:17:34,480 --> 00:17:37,640 when they go from sitting or lying down to standing, their 359 00:17:37,640 --> 00:17:40,920 body struggles to accommodate that change in posture to 360 00:17:40,920 --> 00:17:44,550 regulate their blood pressure. And some people will have a form 361 00:17:44,550 --> 00:17:47,590 of orthostatic intolerance that's classified as POTS, 362 00:17:47,670 --> 00:17:49,670 postural orthostatic tachycardia syndrome. 363 00:17:49,790 --> 00:17:52,190 It's a very specific thing with a specific set of diagnostic 364 00:17:52,190 --> 00:17:54,070 criteria. But other people will have 365 00:17:54,070 --> 00:17:57,070 orthostatic hypotension, which seems to be a lot more common. 366 00:17:57,070 --> 00:18:01,110 Based on my clinical work and this type of sensitivity to 367 00:18:01,270 --> 00:18:07,810 blood pressure dysregulation is common in the hypermobile world, 368 00:18:08,090 --> 00:18:10,610 I would say that the majority of my patients seem to have a 369 00:18:10,810 --> 00:18:12,650 slightly abnormal blood pressure. 370 00:18:12,650 --> 00:18:15,650 And I think a big problem again that hypermobile people run into 371 00:18:15,970 --> 00:18:18,490 is that we privilege low blood pressures. 372 00:18:18,770 --> 00:18:21,690 Growing up, I was someone who always had 90 / 60 blood 373 00:18:21,690 --> 00:18:23,610 pressure. I felt cold all the time. 374 00:18:23,610 --> 00:18:25,890 I felt I had it. I didn't feel great, but every 375 00:18:25,890 --> 00:18:29,010 time I saw my family doctor, they were like, wow, your blood 376 00:18:29,010 --> 00:18:31,610 pressure is so low. You must be in such good health. 377 00:18:31,990 --> 00:18:36,710 No, low blood pressure does not make you feel good and 90 / 60 378 00:18:36,710 --> 00:18:39,190 is really the cutoff they use. So again, a lot of people are at 379 00:18:39,190 --> 00:18:42,470 that kind of cutoff line when you stand for long periods of 380 00:18:42,470 --> 00:18:43,910 time. If you're someone who's hyper 381 00:18:43,910 --> 00:18:46,990 mobile and if it affects your cardiovascular system, which 382 00:18:46,990 --> 00:18:49,110 again it doesn't affect everyone in the same way. 383 00:18:49,110 --> 00:18:52,310 So please speak with your qualified and trusted healthcare 384 00:18:52,310 --> 00:18:54,510 provider. But we run into issues with 385 00:18:54,510 --> 00:18:56,430 things, for example, like blood pooling. 386 00:18:56,810 --> 00:18:59,490 So feeling like your legs are really, really heavy, Feeling 387 00:18:59,490 --> 00:19:01,970 like they're swollen even if they aren't visibly swollen or 388 00:19:01,970 --> 00:19:05,010 feeling like they're in pain is common for a lot of hyper mobile 389 00:19:05,010 --> 00:19:07,410 people. And the way to relieve this is 390 00:19:07,410 --> 00:19:09,890 to lie down or to be able to sit at least. 391 00:19:09,890 --> 00:19:13,170 But if you're doing a job like serving at a restaurant, that's 392 00:19:13,170 --> 00:19:16,850 not an option for you. So in that situation, my advice 393 00:19:16,850 --> 00:19:20,450 is if it's possible. Honestly, I found working in 394 00:19:20,450 --> 00:19:23,730 retail so much easier. If you can find a nice boss who 395 00:19:23,730 --> 00:19:26,650 will let you sit down if you work in the restaurant industry, 396 00:19:26,650 --> 00:19:29,530 like speaking with your boss and seeing if you can perch on a bar 397 00:19:29,530 --> 00:19:32,410 stool if there's time in between that type of work. 398 00:19:33,130 --> 00:19:35,770 I was out for dinner the other night and the server took a seat 399 00:19:35,770 --> 00:19:39,090 to take our orders and I I don't mind that I'm the type of 400 00:19:39,090 --> 00:19:41,090 customer. Like I told her, I said I'm so 401 00:19:41,090 --> 00:19:43,810 happy you're taking a seat because I know how uncomfortable 402 00:19:43,810 --> 00:19:46,050 my feet were when I was working as a server. 403 00:19:46,330 --> 00:19:49,490 So sit as long as you like. I know she had work to do, but I 404 00:19:49,490 --> 00:19:51,890 was happy to have her sitting down to take our order. 405 00:19:52,370 --> 00:19:55,530 So my hope is that the industry itself will change over time. 406 00:19:55,530 --> 00:19:59,490 However, I'm very aware that working in restaurants is hugely 407 00:19:59,490 --> 00:20:01,490 high pressure and that there are certain demands and that people 408 00:20:01,490 --> 00:20:03,770 have to stand. So you have to stand. 409 00:20:03,810 --> 00:20:07,490 Here's how you do it. Tip #1 compression socks can 410 00:20:07,490 --> 00:20:10,330 make a big difference. I held off on wearing them for a 411 00:20:10,330 --> 00:20:12,250 long time. They're not the cutest, they're 412 00:20:12,250 --> 00:20:16,170 not the most comfortable, but they really make a difference. 413 00:20:16,170 --> 00:20:18,770 So if you're someone who's standing for long periods of 414 00:20:18,770 --> 00:20:21,050 time, I strongly recommend that you get a pair. 415 00:20:21,620 --> 00:20:24,020 There are all different types. I think the best entry point is 416 00:20:24,020 --> 00:20:27,940 looking at like a sports pair. So I bought a pair from a 417 00:20:28,380 --> 00:20:31,420 company that make them for cyclists and I found those who 418 00:20:31,580 --> 00:20:33,620 work really well for me. I wear them at clinic if you 419 00:20:33,620 --> 00:20:35,260 might see me in them if you see me at clinic. 420 00:20:36,260 --> 00:20:39,980 Additionally thinking of the type of surface you're standing 421 00:20:39,980 --> 00:20:41,860 on. So a lot of hyper mobile people 422 00:20:41,900 --> 00:20:46,140 end up being prescribed hard orthotics and although like the 423 00:20:46,300 --> 00:20:49,500 concept in theory is correct, the execution is deeply 424 00:20:49,500 --> 00:20:51,920 problematic. I cannot tell you how many 425 00:20:51,920 --> 00:20:56,440 people I've had to tell to throw out £500 orthotics and it makes 426 00:20:56,440 --> 00:20:58,480 me very sad to have to do that because I know they've spent 427 00:20:58,480 --> 00:21:00,600 money on them from some other healthcare provider. 428 00:21:00,880 --> 00:21:03,960 But they end up injuring patients and they injure hyper 429 00:21:03,960 --> 00:21:08,560 mobile people because the hard orthotic literally presses into 430 00:21:08,560 --> 00:21:12,440 and compresses the bottom of the foot and what it seems like 431 00:21:12,440 --> 00:21:15,200 hyper mobile people really benefit from in in addition to 432 00:21:15,200 --> 00:21:18,160 some mild support. Not not a big correction, but 433 00:21:18,160 --> 00:21:22,160 like a mild correction, they benefit from a soft standing on 434 00:21:22,160 --> 00:21:25,080 a soft surface, like a soft kind of springy surface. 435 00:21:25,360 --> 00:21:27,640 So I think that we need to perhaps think more carefully 436 00:21:27,640 --> 00:21:29,840 when it comes to orthotics in the materials that were being 437 00:21:29,840 --> 00:21:32,800 that we're using to make them or the maybe putting an insole on 438 00:21:32,800 --> 00:21:35,840 top, maybe something that's like a memory foam or something. 439 00:21:36,240 --> 00:21:38,920 But it's, I compare it to someone punching the bottom of 440 00:21:38,920 --> 00:21:40,640 your foot. It's why a lot of hypermobile 441 00:21:40,640 --> 00:21:43,560 people can't wear Birkenstocks, because the hard bottom of the 442 00:21:43,560 --> 00:21:46,050 shoe injures the bottom of their foot. 443 00:21:46,330 --> 00:21:48,970 So thinking of what you're wearing when you stand, if 444 00:21:48,970 --> 00:21:51,090 you're someone who's in a job where you have to stand, can 445 00:21:51,090 --> 00:21:54,770 help as well, trying to walk as much as possible. 446 00:21:54,770 --> 00:21:57,850 So the thing I hear over and over again when I make content 447 00:21:57,850 --> 00:22:01,370 about standing on my social media accounts is I can walk for 448 00:22:01,370 --> 00:22:03,690 hours, but I can't stand for more than 20 minutes. 449 00:22:03,690 --> 00:22:07,530 And I'm like, yes, I understand you and I think that's because 450 00:22:07,530 --> 00:22:10,780 when you're walking your calf pump mechanism, so that's 451 00:22:11,220 --> 00:22:13,780 basically a structure in the back of the calf which helps 452 00:22:13,780 --> 00:22:17,620 with the return of blood and lymphatic fluid from your leg 453 00:22:17,620 --> 00:22:20,780 and your feet up all the way back to your your heart and your 454 00:22:20,780 --> 00:22:24,060 head. But that mechanism works through 455 00:22:24,060 --> 00:22:27,540 dorsiflexion and that's a term that describes the movement if 456 00:22:27,540 --> 00:22:29,980 you're walking of your knee going over your toes. 457 00:22:29,980 --> 00:22:32,300 So it's like if you're sitting down, it's if you point your 458 00:22:32,300 --> 00:22:37,520 toes up toward your head, and if you're walking, you're making 459 00:22:37,520 --> 00:22:40,120 sure that that fluid is getting kind of pushed back up. 460 00:22:40,400 --> 00:22:42,520 But when you're standing, it's just pulling. 461 00:22:42,840 --> 00:22:45,840 So if you can find ways to kind of put a walk in or be that 462 00:22:45,840 --> 00:22:48,080 person to say like, hey, I'll I'll do that walk or whatever, 463 00:22:48,440 --> 00:22:51,800 that might help as well. Now finally, I do want to say 464 00:22:51,800 --> 00:22:54,360 there is a place for mobility aids and braces and there are 465 00:22:54,360 --> 00:22:57,480 people who need them and there are a lot of people who need 466 00:22:57,480 --> 00:23:00,280 them, who are unable to access them or who feel embarrassed or 467 00:23:00,280 --> 00:23:02,420 stigmatized. And firstly, I want to tell 468 00:23:02,420 --> 00:23:04,500 you're not alone. I have so many patients who feel 469 00:23:04,500 --> 00:23:08,420 very selfconscious, especially because often in hyper mobile 470 00:23:08,420 --> 00:23:11,620 people they will need them one day and not need them the next 471 00:23:11,620 --> 00:23:15,660 because it can be in some instances A dynamic disability 472 00:23:15,660 --> 00:23:18,220 and an invisible disability. So firstly, if you feel 473 00:23:18,220 --> 00:23:21,900 selfconscious, you're not alone. And I, there are a lot of great 474 00:23:21,900 --> 00:23:24,620 disability advocates and other creators out there who can speak 475 00:23:24,620 --> 00:23:28,150 better on this than I can. But we my hope is that in the 476 00:23:28,150 --> 00:23:31,230 future we'll have a world where people are supported and just 477 00:23:31,230 --> 00:23:33,230 doing what they need to do for their bodies, because there's 478 00:23:33,230 --> 00:23:36,630 nothing wrong with that. But in terms of mobility aids, 479 00:23:36,630 --> 00:23:39,830 of course, talking to Rickley's being like I might need this and 480 00:23:39,830 --> 00:23:42,550 having a healthcare provider even maybe support you in that. 481 00:23:42,550 --> 00:23:46,110 So I wrote a letter for a patient recently and I was 482 00:23:46,110 --> 00:23:47,870 worried. I was a bit strong in town, but 483 00:23:47,870 --> 00:23:50,110 I said this patient needs this and This is why. 484 00:23:50,110 --> 00:23:51,390 And they need this, this and this. 485 00:23:51,510 --> 00:23:54,550 And some days they need this and other days they won't need this. 486 00:23:54,550 --> 00:23:57,700 And this is how it is. And I sent it to the patient and 487 00:23:57,700 --> 00:24:00,020 because I I wanted her opinion on the letter before I finalized 488 00:24:00,020 --> 00:24:01,620 it. And she was like, no that like 489 00:24:01,620 --> 00:24:03,580 that. All that all seems correct based 490 00:24:03,580 --> 00:24:05,940 on, that's all correct based on my experience. 491 00:24:06,580 --> 00:24:07,820 Thank you for mentioning all that. 492 00:24:08,660 --> 00:24:11,140 And then she submitted the letter to the department that 493 00:24:11,140 --> 00:24:14,340 she was submitting it to. And apparently they found the 494 00:24:14,340 --> 00:24:16,020 clarity in my letter really helpful. 495 00:24:16,020 --> 00:24:18,810 So if you're clinician listening to this, don't be shy to be 496 00:24:18,810 --> 00:24:23,370 clear in letters when it comes to patients disability needs and 497 00:24:23,370 --> 00:24:26,250 making sure that you're explaining to that workplace or 498 00:24:26,250 --> 00:24:29,570 that school or whatever. This is exactly how things are. 499 00:24:29,570 --> 00:24:31,530 And this is exactly what this person needs. 500 00:24:31,530 --> 00:24:35,810 And this is exactly how you can support them because a lot of HR 501 00:24:35,810 --> 00:24:38,610 departments, they don't even know when HEDS or HSDR. 502 00:24:38,610 --> 00:24:42,520 So giving that clear support can really help people in accessing 503 00:24:42,520 --> 00:24:45,520 what they need as well. We can think in terms of things 504 00:24:45,520 --> 00:24:47,040 that I call like minimal bracing. 505 00:24:47,040 --> 00:24:48,760 So there's a device called the body braid. 506 00:24:48,760 --> 00:24:50,960 I have no financial relationship with them. 507 00:24:51,480 --> 00:24:53,360 I bought one with my own money. I think it's pretty good. 508 00:24:53,720 --> 00:24:56,840 But there are little braces and supports that people wear that 509 00:24:56,840 --> 00:25:00,360 can sometimes help just support their tissue in terms of how 510 00:25:00,360 --> 00:25:02,360 they're having to position their body at work. 511 00:25:02,760 --> 00:25:04,880 And that's something which I do think people should certainly 512 00:25:04,880 --> 00:25:06,680 look into. And we'll have to talk more 513 00:25:06,680 --> 00:25:09,720 about that next time. Thank you so much for joining me 514 00:25:09,720 --> 00:25:11,960 for today's episode. I hope that you've learned 515 00:25:11,960 --> 00:25:13,520 something new. I hope that you've learned 516 00:25:13,520 --> 00:25:15,320 something interesting. And hey, maybe you've learned 517 00:25:15,320 --> 00:25:17,560 something that you're going to try out at your workplace or 518 00:25:17,720 --> 00:25:20,530 your school or whatever. If you have any questions, 519 00:25:20,530 --> 00:25:24,010 please do feel free to write in. And I look forward to seeing you 520 00:25:24,050 --> 00:25:28,650 all or having you join me next time, whether that be listening 521 00:25:28,650 --> 00:25:32,690 to me maybe through one of your apps or watching me on YouTube 522 00:25:32,690 --> 00:25:34,450 because we now have video. Take care. 523 00:25:34,570 --> 00:25:34,890 Bye.