The Active Healthcare Practice

“Studies show…”

Two words that can make almost anything sound convincing.

Add an anatomy diagram, someone explaining it confidently, an incredible before-and-after, or a dramatic video of something apparently being “released” using a special technique requiring a practitioner, an assistant and considerable theatrics.

It’s not an exorcism, FFS. It’s manual therapy.

But looking scientific and being supported by good science aren’t the same thing.

Neither are:

“There’s a study.”
and
“This has been proven.”

And treatment marketing doesn’t always sell you a miracle.

Sometimes it sells you a problem.

Your pelvis is out.
Your posture is damaging you.
Your muscles aren’t firing.
Your fascia is stuck.

Conveniently, there’s usually a treatment to “fix” it.

That doesn’t mean treatment can’t help. I use manual therapy every day.

But:

“That helped my pain”

doesn’t automatically mean:

“Therefore the explanation I was given for WHY it helped must be true.”

That distinction matters.

And misinformation has one enormous advantage: it’s quick.

“Your uneven hips are causing your back pain.”

Ten seconds.

Explaining asymmetry, pain, anatomy, individual variation and what the research actually tells us?

That takes considerably longer.

This post is a perfect example.

Guess which version social media prefers?

The ten-second one.

So when you see PROVEN, STUDIES SHOW or SCIENCE SAYS, don’t automatically dismiss it.

But don’t automatically believe it either.

Stay curious. Ask questions.

Especially when somebody is trying to frighten you — or sell you a miracle.

Maybe massage isn’t about fixing what feels tight.
Maybe it’s about helping your body feel safe enough to soften. 💚

And this isn’t just my opinion.

Our understanding of massage has moved on. Including sports massage.

Good sports massage shouldn’t be a competition to see how much pressure you can tolerate. We don’t need to batter a “tight” muscle into submission, dig an elbow into it until you’re holding your breath, or assume that more painful automatically means more effective.

The research paints a much more interesting picture.

Massage can change pain and soreness, influence how an area feels, improve perceived recovery and, in some circumstances, improve flexibility. But the evidence doesn’t support many of the dramatic mechanical explanations traditionally used to explain why massage “works.”

Your nervous system is part of the conversation too.

So yes, my sports massage can be firm. Very firm when appropriate. But pressure is a tool, not the goal.

I’m not trying to win a fight with your muscles.

I’m trying to give your body useful input so that when you get off the couch, you feel better — not like you’ve just gone ten rounds with me. 😂

Massage doesn’t have to hurt to work.

I originally wrote a version of this post almost a year ago, as part of a series about my journey into therapy.

And judging by how many of you are new around here, most of you probably never saw it. 😂

(If you’re interested in how I ended up doing this for a living, the original My Journey Into Therapy series is still on my grid.)

But I wanted to bring this one back because if you’ve followed me for the crunchy shoulders, dodgy hips, painful knees and occasional rant about something I’ve seen on the internet… you might not actually know what I DO in clinic.

So, hello. 👋 I’m Julia, and I have a pretty big treatment toolbox.

I’m a Sports & Clinical MSK Therapist, massage therapist, acupuncturist and PT, and depending on the person in front of me, treatment might include sports or therapeutic massage, acupuncture, dry needling, osteopathic and chiropractic manipulation techniques, TECAR radiofrequency, ultrasound, TENS or NMES, taping, cupping, exercise and rehabilitation.

But here’s the important bit:

None of those things is the treatment.

They’re tools.

Sometimes massage helps you feel and move better.

Sometimes TECAR helps reduce pain and guarding enough to give us a useful window to get things moving again.

Sometimes I’ll use acupuncture or dry needling. Sometimes manipulation, taping, ultrasound or electrical stimulation has a useful role.

And sometimes the most useful thing I can do is none of those things.

It’s working out what might be contributing to the problem, explaining it in a way that actually makes sense, looking at what your body is currently being asked to cope with, and helping you gradually rebuild its capacity.

Because I don’t have a signature technique that everybody gets.

I don’t sell one treatment as the answer to everything.

And I’m certainly not going to try to make your problem fit whichever piece of equipment happens to be sitting in my clinic.

The tool should fit the person.
The person should never have to fit the tool.

That’s pretty much how The Active Healthcare Practice works. 💚

And on that note… I’m off on holiday. 😂

For ONE WHOLE WEEK.

So please, for the love of God, try not to injure yourselves before 8th October. I won’t be here to sort you out.

I’m off to recharge my batteries, get some sunshine and conduct some extremely important research into the consistency and quality of Aperol Spritz across various Greek Islands🍹🛳️ 🇬🇷

Obviously, I will also spend a completely unreasonable amount of time on my sun lounger watching people walk past, absent-mindedly assessing their gait and being extremely judgy about Crocs, flip-flops and sliders.

Interesting right hip drop…

That left foot’s doing something peculiar…

Those Crocs were a choice…

Are you really going to do all those steps in flip-flops?…

Because apparently you can take the therapist out of the clinic, but you cannot make her mind her own bloody business.

I’ll also be collecting a fresh supply of holiday stories, observations and general nonsense to tell you all when I’m back — because God forbid we should ever have a quiet treatment session.

In the meantime:

No dramatic gardening incidents.
No suddenly deciding to run 10k when you haven’t run since 2019.
And absolutely no “I just thought I’d see how heavy it was” DIY-related catastrophes.

I’m back in clinic on 8th October, but I’m already fully booked until 13th October.

So if you were thinking about booking in during October, I’d get yourself in the diary now rather than waiting until something starts making a funny noise — appointments are disappearing quickly.

The clinic will therefore be closed for a week while I do absolutely nothing useful whatsoever.

Apart from the Aperol research.

REST IS NOT BEST.

There are few things that make my eye twitch quite like this one. 😂

I can spend an appointment explaining what’s going on, what you might need to temporarily modify, what you CAN still do and how we’re going to gradually build you back up.

I can send you away with an entire rehab programme written specifically for you — taking into account your lifestyle, goals, likes, dislikes and what you can realistically fit into your life.

It’s bespoke. It’s part of the treatment you’ve paid me for.

Then you come back and say:

“Well, I’ve rested it…”

And somewhere inside my head I’m screaming:

FOR THE LOVE OF GOD, WHERE DID I WRITE “REST IT” ANYWHERE ON YOUR REHAB PROGRAMME?! 😂

Because for the vast majority of musculoskeletal problems I see, complete rest isn’t rehab.

Flu, pneumonia or systemically unwell? Absolutely. REST.

Surgery or an injury that needs protecting? Follow the restrictions you’ve been given.

But back pain? A disc problem? Tendinopathy? Muscle strain? Joint pain?

We’re usually looking for what you CAN do, not putting your entire body on pause until everything feels perfect again.

And here’s another one:

“I’ll start exercising when it feels better.”

But appropriate exercise is part of how we help it feel better. That’s the point.

We’re using movement and gradually increasing load to rebuild strength, capacity and confidence.

That doesn’t mean ignoring pain or pushing through regardless.

Maybe we reduce the load or range. Change the exercise. Swap running for walking, cycling or strength work. Do five minutes instead of thirty.

Modification is not the same as rest.

And “I can’t do what I normally do” doesn’t automatically mean “I can’t do anything.”

Rehab is about finding what you can tolerate now, then gradually building from there.

And if I’ve given you exercises and they’re hurting, too difficult or don’t seem to be helping?

Tell me.

We change the exercise.
We change the dose.
We change the load.
We change the plan.

We don’t quietly abandon the whole thing and replace it with three weeks of doing bu**er all. 😂

YOUR SPINE- COMPLICATED? YES. DELICATE? NOT A CHANCE.

Your spine is complicated because it has to do complicated things.

It isn’t complicated because it’s fragile.

It’s complicated because it has to be strong, mobile, adaptable and capable of controlling enormous forces — sometimes all at once.

It has bones, discs, joints, capsules, ligaments and layers of muscles, all contributing to movement and load management.

And this is why I really dislike the term “slipped disc.”

Your disc isn’t a loose hockey puck sitting between two precariously balanced bones, waiting for one wrong movement to make it shoot out.

It’s an integral part of an extraordinarily interconnected spinal segment.

Discs can become irritated, degenerate, bulge or herniate — but they don’t simply slip out of place.

And all this complexity explains something else:

Sometimes it’s really bloody difficult to tell you exactly which bit hurts.

Look how many structures there are in a tiny area.

A muscle, ligament, joint or other tissue can be painful without there being one neat finding on an MRI saying:

HERE. THIS IS THE BIT.

And an MRI can show structural changes that aren’t necessarily responsible for your pain.

But here’s the really important part:

One painful or irritated structure doesn’t mean the whole system has failed.

You still have an incredibly strong, interconnected system capable of supporting you and managing load while things settle and you rebuild capacity.

That doesn’t mean ignoring pain or bulldozing through an injury.

It means working with what you CAN do, adapting where necessary and gradually building back up.

Because this incredible system needs to be used.

It bends. Extends. Rotates. Carries load.

Your spine isn’t complicated because it’s fragile.
It’s complicated because of everything it’s designed to do.

Strong. Mobile. Adaptable.

And definitely not a Jenga tower.

YOUR SPINE ISN’T A JENGA TOWER.

One wrong move isn’t going to make the whole thing collapse.

But sometimes we talk about backs as though that’s exactly how they work.

“I bent down and something went.”
“I must have put something out.”
“One of my discs has slipped.”

OMG, MY L4 HAS ‘GONE’. 😱😂

Except your vertebrae aren’t precariously balanced like wooden blocks.

Between them are tough, load-sharing discs firmly attached to the vertebrae above and below. Add facet joints, strong ligaments and layers of muscles — including deep muscles such as multifidus — all helping to support and control movement.

Your spine isn’t a stack.

It’s a living, adaptable support system.

And importantly…

IT’S SUPPOSED TO MOVE.

It bends, extends, side-bends and rotates. It copes with walking, running, jumping, lifting, carrying and twisting.

That’s not something that’s going to fall apart because you bent down slightly wonky to pick up your pants. 😂

Of course backs can hurt. Sometimes A LOT.

But pain doesn’t automatically mean something has moved, slipped, gone “out”, needs putting back into place or has degenerated beyond hope.

And while we’re here…

“Degenerative Disc Disease” is TERRIBLE terminology.

It’s a term we’re increasingly trying to move away from — along with “wear and tear” — because they do wonders for the imagination.

And not in a positive way. 😬

Degenerative changes are a normal part of ageing. They don’t automatically mean they’re causing your pain, your back is wearing out or your discs are toast.

They’re changes. Not an expiry notice.

And yes, I use adjustments when appropriate. But feeling better afterwards doesn’t mean I’ve shoved a wandering vertebra back where it belongs.

Nothing was wandering.

Respect a painful back. Modify things temporarily if needed. Get it assessed if you’re worried or it isn’t settling.

But don’t spend your life frightened that one wrong bend, twist or lift will make your spine collapse.

You are considerably more robust than a Jenga tower. ❤️