Ep.216: 'The Patient No-One Told You How To Treat' with special guest Alistair Beverley

Music. And we're live. Welcome, people, to the Sports Therapy Association podcast, episode 216.

My name is Matt Phillips, creator of runchatlive.com. And as always, this episode has been recorded live on the Sports Therapy Association YouTube channel and Facebook page. In this episode, entitled The Patient No One Told You How to Treat, my special guest is going to be Alistair Beverley, director of ldphysio.com, promoting and improving healthcare services for those with learning and lifelong physical disabilities.

Alistair is going to be presenting in the STA Theatre at Therapy Expo this year at 2.25pm on day one, which is November the 27th, discussing the skills we as soft therapists can take from learning how best to support patients with a learning disability, something most of us are certainly not taught in our training, despite there being around 1.5 million people in the UK with a learning disability.

If you have joined just for the live recording then as always feel free to place questions and shared experiences in the comments we've had a few technical issues the last couple of weeks so if the sound goes or anything just put something in the comments so that i know but hopefully it will be smooth sailing now with my new sponsored by vodafone 500 megabytes broadband connection if you are listening to podcasts and if you have any questions you're welcome to find the recording

on sports therapy association youtube channel and enter your question in the comments there we do keep an eye on it we try and keep the conversations going. But for now, without further ado, I shall clear the fog out of my throat and I shall bring up Alistair Beverley, director of ldphysio.com.

Hey Alistair, how you doing? Good evening Matt, very well, thanks. Yourself? I'm okay, well you're still here. It's better than the last few weeks, cameras haven't gone yet, so far it's just heaven. We've got people joining us live, for example Cecily Hislop is through the door.

If you do decide to join us live, podcast listeners then what I can do is bring your messages up on the screen so you can share your beautiful face or your logo so there's a little bit of networking as well Cecily Hislop says evening all good to have you back Matt thank you Cecily I love you very much too and Sir Glenn Murphy which as you all know I love just saying that's the caliber of listener we have here Sir Glenn Murphy MBE is here as well evening Sir Glenn

and thanks very much for joining us again, And as always, people, if you are new and you're watching from afar, you are welcome to ask questions. Martina. I love calling him Martina because that's what it looks like when it first comes up. But actually, it's not Martina at all. It's Alistair Beverley. I believe there's a story that Alistair is going to talk later, which involves no clothes in a banister. But we'll talk about that later.

So Martin is here. I'm so excited to heckle Alistair that I even showered before this. So fantastic. The mood had me set. Alistair, anything you want to say to Martin?

For those of you who don't know contextually martin is like my little brother so that that's kind of the relationship thing that we have going on where i'm the mature and experienced one and martin is just annoying oh really is that the relationship it is when he comes to you with problems he has pretty much pretty much yeah just to contextualize our interaction for everybody, there we go fantastic right so thank you for joining us everybody who's live

and like i say if you do want to join us live then and listen to the podcast and just head along to the sports Therapy Association YouTube channel or Facebook at eight o'clock normally on Tuesday. Right Alistair good to see you how are you? I'm very well thank you I'm very well I'm not so much enjoying the darker nights all of a sudden but it's you know it is what it is.

This is true I could get a whole conversation about that I've tried going to gym and do running on a treadmill in the evenings but it's just too hot and too many people so I'm gonna have to go and take up running outside in the dark again which I'm not a big fan of but the reflective gear and the head torch back out.

Exactly have you seen that yes it's fun it looks great but it's just you can't really switch off and relax but anyway we digress what is weird is a whole year or practically a few days short has passed since we did this which seems ridiculous where has that where have those 300 days gone you were a guest with us back in november last year it was the day after halloween if i remember rightly episode 172 which was entitled keeping your hair on what you weren't taught about communication,

which was the presentation you gave at Therapy Expo last year in the STA Theatre as well. You're back again at Therapy Expo this year for people with their pens and papers ready. It's going to be 2.25pm on day one, November 27th.

So there you go, have your lunch and then go to the STA Theatre, bring your lunch with you if you want to get there early and listen to the presentation by Alistair, which is going to be The Patient No One Told You How to Treat, which we're going to delve into and i'm really keen to hear about but i guess the most important thing is hopefully there's some people listening who don't know about you so i wondered whether i know it's so difficult especially for a man of your age as you've mentioned

compared to martin easy for martin but a man who's got experience and wit and and that sort of thing and and wisdom yeah give us a summary of how you and why you became the ld physiologist so yeah thanks for reminding me what time i'm on i've just written those things down actually as well there you go so yeah so i'm a specialist a specialist physiotherapist i operate in the private sector ex-NHS physiotherapist i've also worked for charities and volunteered at three

world games for special olympics great britain essentially i ended up falling into learning disabilities primarily because at the time when i graduated in 2010 there were no jobs, there are around 100 applicants for every physio post and a third of my cohort actually didn't even go into the profession they left the profession entirely so I happened to find the only job that was available I think I was the only person in our cohort of 120 to get a job before we graduated.

It was it was crazy times back then and I ended up just getting the only job that was available which happens to be community learning disabilities now what I see with hindsight is that I had an older brother who had learning disabilities and so almost my entire upbringing the previous 22 23 years had been leading up to that point of me getting a job as a specialist learning disability physio and then I was working in NHS for probably about three years across my career now I went private to give

myself more freedom to give myself more flexibility and to give myself more voice that i'm able to say the things that need to be said i think not everything is rosy when it comes to healthcare for people with learning and intellectual disabilities in fact things are quite dire and we all as healthcare professionals need to take a role in being better at supporting these kind of patients and that's why i am here but speaking to you at the sports therapist association

because sports therapists soft tissue therapists massage therapists all have a role to play and at the very least being aware of these issues and able to advocate for people with these needs because as you mentioned there are 1.5 million of them in the UK and apparently there's a study done that looked at people who have a personal connection to somebody with a learning disability and find that there are 13 million people

in the UK who have a personal connection to somebody with a learning disability so there's a lot of power there and we just need to know how to harness it in order to affect change and this is my little way to go one step better than. One clinician at a time to try and make some change that's such a valuable point. Because you talk about the people who are living with a disability of some form.

But yeah, obviously, it's the families and the people who are living with them whose lives are affected as well. Particularly if there's, like you say, there's treatment which lacks in many departments. It was actually 2022 when I met you at Therapy Expo for the first time with a presentation entitled Diagnostic Overshadowing, When the Correct Diagnosis Can Kill.

Maybe can you define diagnostic overshadowing because it's something which i hadn't come across the word in i come across the phenomenon but not those words and i think it's quite an important word to know about it makes you start thinking and realizing what the situation is yeah i think so probably diagnostic overshadowing is one of the most important parts that i teach about but not many people have come across it diagnostic overshadowing is when

you put down the clinical presentation of somebody to the fact that they have a particular characteristic now in the case of my personal and professional interest that is a learning disability so somebody turns up in your clinic and they are displaying i don't know hand buy-in or new behaviors or certain things.

Or certain clinical criteria that you would normally attribute to something and investigate but because they have a learning disability that overrides your thought processes and you sort of go well of course they're going to do that they've got a learning disability that's what these kind of people do and therefore you don't investigate the the pathology in the same way that you would do and this isn't just a phenomenon that linked to

learning disabilities it's something that i believe exists hugely in the care of elderly people i think it's hugely prevalent in mental health services and i think probably the biggest sector of our population is women and we look at women's health and the health of females in the population and all the times women are almost gas lit into you know it's all in your head in your pain there was another study done the other day that

came out and i can't remember the name of it and they were looking at studying women in pain and and how over the years women have been told well you know it's a menstrual cycle thing or it's menopausal or just you what you know you just cast these things off to the diagnostic criteria that over overarching a cloud everything else that you would see but if you took that aspect away and just looked at the clinical presentation you would treat things differently and

diagnostics are shown is when you don't do that and you miss serious pathology or you miss pathology that's treatable and that leads in our case for people with learning and intellectual disabilities to nearly half to about 44% in the latest figures but last year was half of deaths of people with learning disabilities were found to be from preventable healthcare conditions.

That's so shocking. Such a shocking statistic. And this is again, I mean, there's gonna be plenty of times when I say this during the program, but people you really should follow.

If that's blown your mind, which hopefully it has, if you understood it, then follow Alistair on social media. And there'll be in the notes, obviously links to it. But I would recommend that you follow either on Instagram, or even on TikTok, if whatever you tend to look at most, without going into why you're on TikTok. But if that's your feed and that comes up, then follow Alistair Beverley on that. It's always underscore the LD physio underscore. That's where you can find him.

Because, I mean, you drop, I mean, it's an emotive topic anyway, but you drop some serious truth bombs that should make people feel a bit guilty for not knowing. But then that's not the answer, is it? There's reasons. Why? Where do you place the guilt? Why isn't this more common information? Why does everyone know what a Kardashian twin is doing, and yet they don't know the sort of things which you're putting out there?

Yeah, I mean, it's a tricky thing, and it's something I've tried to delve into. And I think we have a societal issue in how we look at and – I'm just seeing that comment. You've been trolled successfully there. Well, good, Martin. I misread it, actually. So never mind. And I think we've got a societal issue with where we place value in society.

And unfortunately, there's been a big thing in the past sort of, I don't know, 10, 15 years of looking at you are valuable if you can contribute to society.

If you are somebody who is financially contributing to the economy and therefore you're, People with disabilities are seen as freeload, as scrounged, as in that narrative, you know, from, you know, without going too much into politics of, you know, trying to reduce social care costs and people are freeloading on the economy and they're scrounging off you and I and getting benefits and all this malarkey that's led to actually people being not valued. Because they don't contribute in those ways.

And the challenge there is that because we don't see them as valuable, we don't even take the time to educate people about these things.

It's seen as niche and being seen as niche creates a self-fulfilling prophecy where three percent of the population right now are being almost ignored within healthcare training so when we look at it my posts aren't to make any individual feel bad they are to highlight the scale of tasks now the things that i'm saying aren't new they're publicly available information and if somebody won't put on a conference feedback this is all stuff i could just google and i was like yes.

Yes yes you could but you don't yeah and that's why i need to say it i'm happy to be the mouthpiece i'm happy to be the person who takes the stick i'm happy to be the person who maybe riles people up because that's what's needed we need to be emotive with the thing that we're saying because the old way of going oh people learning disabilities are great and people are differently abled isn't working we need to tell you that half of people are dying they could still be alive,

i need to tell you the story about how my brother died let's tell you the story about how this blind girl went in for cataract surgery and then starved to death and inpatient and the hustle and tell you about that as a routine elective cataract surgery these things need to come out because if they don't the old ways of saying how things need to change aren't aren't working so we need something new and i might be getting it wrong i might not

be that catalyst for change but i'm going to try no i think you do a great job but this is why i implore people should need to start following you so they start making this a common day conversation because it will Some of the things which Alistair shares, you will comment on it with somebody else because you feel the need to share it with somebody else because you'll be so blown away with some of the stats and things.

You'll feel you're obliged to share. And that's how quality information gets out there. So, yes. I'll say at this point, yeah, it's well worth having a look at Alistair's website. I'm going to put a little screenshot up here for people who like the visuals, because a lot of people you join us like us, you like those visuals, don't you? So go to theldphysio.com.

You'll see a whole host of information there. But in particular, as I've pointed out in the last couple of episodes where Alistair has joined us, you will see a blog which is all about Alistair growing up with his older brother, John. And it's an incredible mixture of humor and honesty and tragedy and anger.

But it's something which you should all, I mean, I rarely say that everybody should do anything, but I really do believe that everybody should read this just take it away with them whoever you are whatever you may be suffering or not suffering from it's just eye-opening and written so wonderfully so go along to theldphysio.com and have a look at that if you haven't already because i don't want to sound like over the top but it will change your life some things you read just go

wow that's made me into a different person and and you'll go to sleep and your brain will process it and you'll wake up a better person for it so go and have a look at that um if you can please right i'm not entirely sure why matt but the most liked blog post on it the most read one is the time that john set me on fire i'm not entirely sure whether to take that as a positive thing or maybe people looking for instructions but this is just this this

you write in such a human way and like you mentioned there's there's saving you from bullies there's i mean john suffered from down syndrome wasn't it i mean something else i want to point out as well is just to clarify because a lot of people understandably won't understand the difficulty between a learning difficulty, a mental health issue, or a learning disability. And I think it's quite important too. So how would you separate them? How would you define them?

So it's not helped by the international nature of social media, but I shall define it as we do in the UK, which is where I practice primarily. And so much as a learning difficulty is something which makes learning harder, but is not deficient to warrant the term disability. So it isn't, its effects aren't as wide reaching. As to affect it to the level that you're classed as disabled.

So things like dyslexia, dyspraxia, dyscalculia, all are disabling in of themselves, but having dyslexia doesn't mean that you don't need support. Sorry, having dyslexia doesn't mean that you need help with having a wash and brushing your teeth before you go to bed. Having dyscalculia doesn't mean that you're unable to drive a car. And again, that's not to say that all people with learning disabilities are unable to do those things.

In fact and also people with learning disabilities may also have dyslexia dyscalculia but if you just have an adhd dyslexia dyscalculia those will be classed as learning difficulties within the uk definition a learning disability is something where there is a developmental issue that affects how the brain functions on a physiological level so people with down syndrome an extra copy of either chromosome number 21 or you can have a copy of trisomy 17 as well which is called

mosaics down syndrome which is much rarer form but manifests slightly different and also i've trying to vocation but that's i'm getting a bit specific here there is something physical that's happened whether that's cerebral palsy whether there's some genetically inherited or genetic.

Mutation like the word mutation disorder and again disorder difficult language is difficult it's hard to use when talking about disability but so why people suffer from things and people actually live with things rather than suffer from i just said that i'm glad you brought that up because as i said it i just swallowed a little bit of babysit because i said he suffered from down syndrome that's exactly the sort of thing but at least i'm thinking it no no that's fair that's fair.

You know and this isn't a woke conversation is it yeah but it's good isn't it to question the words you use i think it's really important because the words we use do i know one thing for example which you can't stand to the extent that it does make me smile is where this impression we've got of some people with learning disabilities because they're quieter and by themselves we think and maybe they're smiling and we stereotype thinking oh they're such angels they're such nice people

oh angels and i think you said on the website it boils my blood but yeah that's that tell me this because that's something which i think people will will relate to and actually think yeah i do think that i pass somebody down syndrome i look and think oh at least they're happy they're so affectionate you know and that annoys you doesn't it because what's the issue with that it does because i think you know i don't know if we see these things to make ourselves feel better you

know is it about seeing someone with a disability and then thinking oh well at least happening therefore that makes up for all the injustice that they're experiencing and that somehow makes us feel better like people with down syndrome get pissed off people with down syndrome get annoyed people with down syndrome are dicks my older brother was a dick sometimes, and i've not used this hashtag a lot but i think the hashtag right to be a dick

is one that i tried to so i nearly tried to to start off about disabled people and there are people with learning disabilities who are our souls there are people with physical disabilities who are our souls. I could be an arsehole. Martin Christensen frequently is an arsehole. We've got, you know, sorry, I'll park on back for the swear words here.

But it's a very emotive thing because people with learning disabilities are just people and they will have moments of being dicks and they will have moments of being nice people. And then they'll have moments when they're happy. They'll have moments when they're sad. Nobody exists in a permanent state of being. And that's just the same. And that's what I want to see. What I'm trying to get to with all this, with all the blog posts about John, with all the real, is about normalizing disability.

And about seeing somebody with a disability and just going, okay, let's engage and have that confidence to talk to the person rather than going, oh, there's a thing, or oh, let's stare, or oh, isn't that a cute thing? It just becomes normal. And when we can normalize things, we start to treat people as normal. And when we look at that equality and equity of service, then we're able to give people the services that they require. We give staff the training.

And actually then when we normalize it, we start to recognize there's benefits to other patients too and that's another reason i'd suggest to go on my website or you know if we do any future courses to come on them is is because right now half of my caseload doesn't even have a learning disability but half of my caseload have come to me because they value the skills that i have as a specialist working in this area that i can apply to the patients that i work with and i've had patients who've

had horrific experiences with mainstream or various healthcare services and they come to me because they value this approach that I have and that approach has come from working with people with learning disabilities what I'm trying to look at and what my thought last year was about was about trying to take skills that I've learned or that exist within my area of practice and look at how we can translate those into mainstream services.

So that's another reason for people to come and listen, because, you know, there is stuff that you can get from there that will make you a better clinician with non-run, disabled and disabled patients. Definitely. Great. Yeah, great advice. And again, we'll move on to the actual talk in a second, but I think the way I see it and the way you make me think is whilst we are having these stereotypes of people with a learning disability, then we're not realizing that they're people as well.

And that's one of the problems that could cause diagnostic overshadowing because we're not thinking oh yeah this person could actually feel lonely or pissed off as well or they could be suffering from mental health problems aside in fact i think these it shows doesn't it them studies that people who have got learning disabilities are more likely to have mental health problems because of the way they're treated in that so the last thing they'd be coming through

a circus door is us to think it's not accepted they're a person and they've got the right to be pissed off or be dick or whatever and be angry so yeah yeah no it is the case yeah you mentioned you know people with learning disabilities three times more likely to have experienced mental health issues and another another thing not to get too macabre right a lot of the work that i do is helping support autistic people as well who also have learning disabilities and for the

first time last year they studied 2022 data on so there's a thing called the leader project which exists to try and study the deaths of people with learning disabilities and how we that's how we know that you know 44% of deaths last year were preventable sorry 44% of deaths in 2022 because that they they do a it's a year like were from preventable healthcare conditions that's how we knew through COVID people with Down syndrome were eight times more likely to die from Down syndrome.

They also did it they also included for the first time people with and without sorry autistic people with and without learning disabilities I'm thinking of mental health issues the number one killer of autistic people in the UK was suicide. Mm-hmm. Now, that says a lot about the state of support of mental health services for autistic people when that is the number one killer. Pretty horrific.

Would autism be, I've seen autism described as an example of a learning disability rather than because it does affect, but then there's different levels of autism. Yeah, the understanding of autism is an involving area of practice. And the best people to hear from are autistic people themselves. There's some great people. Joanna Grace, she runs a company called The Sensory Project that looks at supporting people with profound and multiple disabilities.

But she herself is autistic and she speaks really, really well and has written a book about being autistic. There's another author, and it was a former academic called Pete Warmbie, who's fantastic. He's on Instagram as well. You can find him. And he gives a great perspective of what it is like to live as an autistic person. And so my work and my view on autism is essentially synthesized from what they've said, but also with the patient people I work with, plus academic reading.

So it's interesting. And autism is not in of itself a learning disability. Autism exists on a spectrum. And it's quite funny because you often hear the phrase, well, we're all on the spectrum, aren't we? And with the increase in exposure of the phrase neurodivergence and social media making everybody think that they are neurodivergent or ADHD or something, And, you know, there's so many posts like, oh, do you ever blink?

That's such an autistic thing to do. They're just rubbish posts that are just clickbait. What I would say, and I think the reason that people fall foul of this notion of we're all on the spectrum is because a lot of the things that autistic people experience are things that are relatable to most of us. So autism is a different way of perceiving the world and social interactions is the best way to describe it.

But it's characterised quite commonly, but not exclusively, in a desire for justice, so just general justice, whether that's the rules or law or just unwritten rules. Sometimes a difficulty in experiencing social situations, or a difference in experiencing social situations is probably the best phrase. An ability to hyper-focus on particular tasks. And some people describe that as their autistic superpower, is that I can just hyper-focus and shud everything else off.

Autistic people also experience more higher rates of the difficulty with processing sensory information from the world around them however the majority of autistic people go through their lives and you probably wouldn't know that they're autistic primarily because a lot of them masks due to social anxiety and risk of being ostracized from peer groups but a lot of people have relationships houses families jobs and don't have any sort of you know learning impairment whatsoever they

just have that difference in social communication and understanding those rules I was going on to the point of why I think we're all people think we're all on the spectrum and those differences that people autistic people experience we can all relate to I can relate to a want for justice in the world or on social media I can sometimes find social situations difficult or tiring the difference is that it's about the response that we have to these situations is if I see injustice.

I find it hard and it does, you know, sometimes upsets me. But if I have something else that I need to do, I can move on from that. And I can almost park those emotions for the period of time that I need to move on from and get on with my day. A lot of autistic people may see those things and again, not exclusively, but a lot of people will really find those things almost incredibly deflating, incredibly tiring, super fatiguing. Some people will struggle to leave the house.

I can go to the doctors and the dentist and i might not like to go to the dentist but i can do it as part of my day and i might whinge about it but i don't need them to go to bed for the next two days because it's taking so much out of me to engage with that so i think that's the notion that we can also roll on the spectrum and actually there is a there is a distinction between an autistic person and an autistic person there's a long a long-winded answer

covering lots of different things there around autism and it's microcosm and i may have done some and if there's any autistic or neurodive people listening they may be screaming at their monitors or headphones right now i appreciate i'm not an autistic person so as i said before the best people to listen to are the people i mentioned before amazing no great stuff and i'll make sure the links to those people you've

mentioned go in the show notes so that people can look them up so thank you for that.

So there's such a i mean all of this is a reason in itself to come and see you talk about whatever you like at therapy expo but this year you've chosen a title i love the the titles you choose i don't know how long you think about them where they just come to you but this year just repeat people have joined us a little bit late not kind of picking on anyone imi tester for being late, still better here than not here. Good to see you, Amy. Thanks for joining us.

Then, yeah, we're talking about Therapy Expo this year. Alistair Beverley is going to be with us at 2.25 p.m. on day one, which is November the 27th, a Wednesday in the STA theatre with a presentation called The Patient No One Told You How to Treat. We've kind of talked about the message behind that title and it holds a very stark truth and very sad truth.

But what are you hoping that people gain from coming to it essentially because it's 25 minutes which is always a challenge i appreciate very difficult to write something to last 25 minutes and get your message out there but what are you hoping people walk away with that's not a slander on the fact that i ran short last year with my talk was it if you want a quick talk alistair will be good in five.

It's it's you know so the talk is is essentially because it's a reflection of the fact that we as healthcare practitioners and you know my star therapists and people that exist in the health and wellness industry we don't get exposure to people with learning disabilities i know because universities are recruiting me to deliver content on learning disabilities and i'm like if that's the bottom of the barrel you know then no there's clearly nobody else talking about

it because if you're coming to me you know got by so when we don't get exposure and actually there have been studies done on healthcare professionals and how much training or support they get around supporting people with learning and intellectual disabilities and it is minuscule it may be an hour at best in a whole three to five year curriculum and so what I'd like is people to come away number one with the confidence that if you see somebody in the

clinic or in life or in a healthcare situation that you are better able to, be confident, do the things that need to be done in order to make that person have a positive experience. What I'd like you to also take is, as we mentioned before, is some skills from that or some tips and tidbits from that that you can then use to apply that will be the benefit of all patients that you support. And so essentially, you know, we want to improve confidence, we want to improve understanding.

And we also want to start a conversation because, you know, that's why I'm here talking today is because you know we need to talk about these things because if we don't talk about them some people and some of our training doesn't even acknowledge that they exist and it creates that self-fulfilling prophecy that this is a niche area when actually people with disabilities should have the same or do have the same rights to access mainstream services as anybody else does and people with disabilities

that lend disabilities partake in sport they get sports injuries and they require rehab from those and they will be coming to sta members for that rehabilitation or physiotherapists.

And therefore we need you guys to be prepared to be able to support them and genuinely that starts right from the scratch of how do i introduce myself to a person with a learning disability because i've had situations i take students on clinical placement as part of my training as i mentioned before i also teach badly and i've had students where the situation will talk about a session or talk about a patient that's upcoming we will make all the plans

of the subjective of the objective we'll get in front of the patient and the student will have a sat beside him the student will go what do i say now and i'm like say hello introduce yourself you know try try try and create some sort of connection but because we've never come across people with disabilities we just don't know how to interact we don't know if it's a special way there's so much you know tiptoeing around should i say this shouldn't

i say this and i'm like more better if you said something.

Than if you just sit there and do nothing so so confidence i think will be the key thing it's a great word and it's and it's so cool to hear because especially with our audience who are a lot of hands-on therapists and i think, alongside hands-on there is a desire to help there's a certain altruism maybe an empathy because you're willing to I always kind of say you're willing sometimes to rub a very hairy back with oil between your fingers and that's not something everyone

wants to do especially not getting paid that much but there is I think with a lot of manual therapists a natural kind of empathy I mean it doesn't mean you can't learn better techniques and learn motivation interviewing and stuff but but that doesn't mean you're still human and you're kind of limited to a certain extent by your life experiences so yeah if someone comes in who you've not exposed to before then yeah you are just going to go white as a sheet or start stumbling or thinking what do i

do now treat them as a person just because they can't communicate with in the same way doesn't mean they're not going to hear you in the same way or so yeah amazing and you're definitely the person to do it i'm just going to remind people in the who are listening live if you have had any experience working with somebody with a learning disability obviously it's going to be different they're all individuals there's no kind of one classic tale

but it'd be interesting to hear if any of you had any experiences what was it like the first time did you were you prepared is anything that helped you or you wish you'd done afterwards just to keep the conversation going in there.

Obviously we've got some comments here martin i can't bring up all your heckling but we'll have a little pause here to bring something up martin says martin christensen says everything ali does ends up lasting shorter than he wants some will say it's still worth it again we'll have the story about Alistair carrying somebody up nude upstairs to put that yeah we'll talk about that later on at the end of the show thanks Martin for reminding us about that incident speaking of short yes Martin

I think I think back to the point around the the session and I think you know in terms of how to communicate with people that's something that I focus quite heavily on and one I've got two physio students right now third year physio students from the University of Nottingham but it's really interesting reading their reflection because there's a lot of stuff that we do every day that we don't necessarily consider, and there was a great reflection that talked about how.

How the student had learned to reduce the power imbalance that exists between therapist and patient, and how making themselves more human and being receptive to the person's communication style and adapting themselves had improved the engagement of that person so much so that this person who hadn't been out of their house for a therapy session in six months is now planning to come to clinic for next week's therapy session so you know you know

we can talk about we will talk about some of these skills and actually having students right now is really informing the talk that i'm writing because it's making me consciously aware of things that we just do because we just do them and to make them more salient points for for you guys when we come to therapy expo fantastic yeah i've been following the journey of these two people what was their history where did they come from and how

did they end up with you but it certainly wasn't a bakery i can tell you that you have to watch the wheels on bread and tug of war and stuff like that but No, no, no. The theory there is that students is a positive correlation between students who produce baked goods, home-baked goods, and students who get high marks. Now, it can't be for legal reasons, proven causative, but they're just a strong positive correlation. So we're out there to help students try and get the best marks they can.

So, you know, we just suggest that people bring baked goods. Today, our university students, University of Nottingham, third year, one, Anna, is the England under 20, is lacrosse captain. European champions Clang we'll drop that in there and then there's Joe who is, his third year and he is an avid, Brazilian Jiu Jitsu fighter and recent volleyball volleyball enthusiast as of last weekend but considerably weaker than Anna though it seems yeah.

It's strange isn't it Jiu Jitsu is fine when you're on the floor wearing your gi but standing up seems to be a little bit of a letdown well it's quite funny I use a boxing or hook and jab pad work a lot with the people I work with because everyone has a seemingly desire to punch me in the face. So pads are usually quite a good defense mechanism. And they were doing, they got the pads on the first time. And Anna actually in her first year at uni did a charity boxing match.

So she did like the training sessions and she started striking the pads and we were all just a bit like, oh, what have we got here? We just all took a step back. So they're two students who hadn't got any experience with learning disability. I'd actually been in to their unit to do lectures last year. I was in for two days teaching. And actually when I taught, I took three people I work with, or the university paid three people I work with to come in and give their own story as part of the day.

We did half a day with those guys telling their experience with healthcare services. And with the idea then that the students also get exposure in interacting with a person with a learning disability because we said it's not something that people do. And that was kind of the only experience that they got of disability and learning disabilities. They are currently halfway through week three of a five-week placement.

And certainly they're doing all right baked goods wise it's it's 50 50 you know learning how things go and so the idea is hopefully that i mean it's great that the the university of nottingham is sending people to you because i guess that means they've got an interest they want these students to come back and then feed it to the rest of the year and then maybe they'll get changed the syllabus which is always a very slow process isn't it but yeah this is a very

important step to doing that yeah like i say uh people if you do want to follow some of these stories and they're very much well worth following than instagram reels or tiktok let's bring up i should also mention i've got like hair standing up on the back of my back which is normally when anna maria is cursing me even though she's not in here so i should mention as well that you're going to be in the hands on hub as well on the second day so if people are only coming along to the thursday

as opposed to wednesday then you can still catch alice doing the hands on hub by the st school who will be there at 12 10 p.m with a presentation silent struggles the impact of sensory processing on clinical practice now obviously there's going to be a crossover what we talked about but what's that presentation and what are some of the aims of that and what people will walk away with i think for people looking first this is i should say that i'm not bald i've been victim to some sort of dropping

on here i do have a full head of hair i think yeah martin was in charge of yeah. Twice my picture has been shown on this podcast and twice it's been absolutely horrific so thank you for that so yeah sensory processing is our brain's ability to interpret sensory data from the world around us. And there are many ways in which that can influence somebody's experience of everyday living. We all have situations when we are better or worse at dealing with sensory data.

If you are, for example, the classic thing of being in a car or on public transport, and you're trying to find a new address, sometimes it's dark, you might be tired. And the classic thing is you turn the radio off to see better and find the address.

That is us unconsciously filtering out superfluous sensory information or if you have that situation where the music's just too loud all of a sudden you know if it's music you're not in control of that music's too loud and and it's really and that aggravates us to quite a level where that becomes all you can hear about it's like somebody says don't think about your own breathing and now everyone's thinking about their own breathing breathe in breathe out please continue that so we we have

the ability the majority of us who don't struggle with sensitive processing issues to filter out superfluous information but there are people for whom for various reasons their brain struggles to filter out what is important and what is sent superfluous like for right now people listening maybe in a car maybe at home their dog might be asleep there someone might be snoring i might hear my computer whirring like it's going to take off.

But I can filter all that information out because my brain knows that that's low level information that doesn't need to be presented to me right now and it says I need to focus on Matt's voice and so I can do that. But for people with sensory processing difficulties, their brain cannot do that. So I talk, well, let's explore about what happens or what can happen when the brain struggles with those issues and how it can impact what we can do in clinical

practice. But more importantly, what we can do to help people who may struggle with those things. Fantastic. So, again, it will be very empowering and giving people confidence in the tools to make a difference. So great. So something a little bit of Alistair on both days on the Wednesday and the Thursday.

Day right it's 8 42 which means it must be violet time for people who for people who are following, you on reels or on tiktok let's just bring these up to give people a little visual as well so yeah on instagram instagram posts but also the reels it's just the way you film it's just amazing it's such it's so effective i'm not joking it's true and also on instagram so on TikTok as well which is a wonderful platform for you and people will be pleased to know not a dancing site

but it's just such great it's just if you have to describe how should TikTok be used to put quality information education out there then you are it so what we're going to talk about now is a star in fact the star is on one two three four five the sixth post in there called Violet who you came across now before we bring up a video of Violet um can you in your own words give us a little back story to how you and violet got to know each other i was hoodwinked,

i really was it i still claim that do you yeah yeah. I happened to be working working late one day it was a tuesday actually in end of may and i came home late my wife and daughter were at home and i came through the door and my wife was like good evening darling dinner's on the table now you know and and it was the way you know normally She would have said, you know, I've cooked dinner. You know, it's on there if you want it. And my daughter was like, hello, father. Oh, God.

And I was like, what's going on? And then my wife, Liz, I just call her my name, Liz, had shown me a video of this puppy that had been found locally and was being looked after by some volunteers who support a veterinary centre where she'd been taken into. Of a puppy, a disabled puppy, whose front paw didn't work in the way that they should, asking if they can rehome it.

Now there was lots of excitement and it's not uncommon for me to get a video of a dog thrust upon me and need to be homing upon any part point of the day thanks to social media usually thankfully they're in like adelaide or las vegas or something and it's like okay obviously this one turned out to be at the vet's it was a mile and a half from my house they got like a thousand likes on instagram so i was like quite quite confident in going okay do you know what if you want to you know

put an inquiry in and she said great i already have and i was like oh and all of a sudden we've got this this started to get serious and she said oh well do you know what we could really support it and we but we've got two labradors right now so we were two dog household they're labradors so they're not the smallest dogs in the world and then she said then the message came back saying yeah i know nobody nobody's nobody's inquired nobody's inquired about taking her in can you

help so then i was like oh oh wait this is quite quickly becoming real and then i started to think okay you know there's a discussion you know can we help the dog i don't know what breed she is you know we don't know anything about her breeding or upbringing vet bills all these sorts of things it was a real sort of running through my head we don't know what you know her parents were like what was the temperament usually it's nice to meet the parents of the dog so

that you can understand a bit more about the dog and where it's come from and this dog just been dumped in a box under a hedge beside a flower bed for two. Nights and when they found it it had not a lot of fur and no bark left or yap. I think it had been dumped quite quite young and so I said look okay in the end what we'll do is we can take it in.

I'm a human physio but i think you know doing a bit of reading around we can we can maybe help it and see if we can you know keep it for a while see if we can offer it some rehab support work alongside the vets and you know see how we go so then then they were like let's go and see it let's go and see it and i said no no we're not going to take you because if i take you two to the vets we'll adopt that dog and every other animal that's

at the vets i said let me go down because i need to genuinely see whether or not we think we can help this dog from a rehab perspective.

So a quick hasty google on dog anatomy helped me to identify like you've got no soleus we all know that yeah we're talking about the wrists it looks like she's it's her elbows a problem with that it's the dog wrists with the problem i was like okay i went down to the vet and and then in the car park of the vets did a little video just sort of freaking out just going so to me like oh god what what am i doing telling the story and then of course i met her and she she poddles up and what somebody

described on social media as the cutest commando call ever i can't unsee that now, and that was it yeah she was she was clearly clearly coming home right should we stick the video i think that's a good introduction i think now we've we've said some words and now i've looked now people who have joined us live um get your get your tears and your laughter ready as we join a little montage of the journey of violet yeah let's do that now i'll put it in here i'm hoping everyone

can hear sound if you can't hear sound then let me know in the comments. Music.

Not a dry eye in the house it's such magnificent if you listen to the podcast and all you got was quite a powerful kind of like anthem song but you need to really pause your podcast and go and see that on youtube because you don't see the messages coming on the screen so obviously we're seeing i think i mean it'd be wonderful if we could meet violet in person but obviously that's too late for that to happen now but um hang on a minute because i'm she never lets me go alone actually she is she's

here she is in person she is big ears and all and you actually know again this is just like a fan from creels i'm the biggest fan i just you know what breed she is now as well don't you we do so we now know that violet is the majority of her is staffy but she also has a mixture of french bulldog and greyhound hello sorry to wake you up the internet is here the power you're an influencer yeah you've got to do your looks so this

was the dog that had been dumped for at least a couple of days couldn't even bark yeah and as we saw in the videos both, particularly her left is it was unable to support herself on the on the foot on the toes and it was kind of as you say a commando walk which there's so many things to take away from this video.

I mean so many things the the robustness in a sense of an animal who can still continue i think there's a celebration of the robustness of human body she might have been in massive pain but the fact she was still managing to walk like that but then yeah you managed to rehab her and the messages that are on the screen now i think one of the most important messages because we could talk about violet for ages was for people who couldn't quite see the words your message was you don't

have to be an angel to make a difference yeah tell us a bit more about that message i mean what you hope to people to pick up the message from that video i think i'm a believer and this is kind of you know what what my whole work is around ld physio is that you know we all you know the world is on connections and each one of us has the power to do one small good thing quite often we are all looking for some savior of the world some savior of a certain

situation we're waiting for that thing and actually you can be that thing for yourselves or you can be that thing for somebody else we need to almost to an extent stop waiting i probably spent the first five years of my career if i'm honest maybe first seven years of my career not wanting or not having the confidence to get on this ld physio train even though i knew that was the correct train to get on and where i needed to go to be able to try and affect change.

And I've seen and I've had having feedback from individual clinicians who just said, you know, I had one patient in today and what I've taken from this reel or this post or this tweet has really, really changed my perspective. And I did this differently. And I think, you know, to that person, you might have made a small change in the whole universe, but to that person, you've changed the world.

So that those small things do have a large effect and whether that's you know adopting a little puppy you know has made a small change for a lot of people you know she's gained thousands of followers on social media it's transformed our lives but more to the point that we've.

Saved her life for want of a better phrase and that's not to sound like oh aren't we great and blow smoke her own bottom but you know she's she was we hosted a party for the veterinary staff who helped save her and took her in and she was a week away from being euthanized when when we took her in one week away from it and actually to see the value that she's you know given and how we saw her and saw the inherent value in her just enabled

us to make a small change to our daily living habits because each day now it is sort of a small change and it's trying to form a life for her and that's what i sort of take into my teachings you know people would learn this of that is if you can make one small change or two small changes they're going to be small things that are small things to you but to other people they mean the absolute world so never undervalue.

And underestimate the the power of small changes because even little pebbles thrown into big lakes create ripples very cool yeah love it and there's again we talked a bit off air there's there's so much in that journey which people reflect with and i like the fact that obviously i mean i've heard you talk before about we think our communication skills are great but put someone in front of us who doesn't communicate the way we're used to and we realize we're i don't know what to do now so when

you've got like an animal which is just got again is is is someone who's got different communications especially if they're scared and then these emotions and i guess with violet it was a whole journey as well to to get her trust her confidence to give her confidence to do things and try things out and walk differently so what was there parallels there or am I just being kind of romantic and trying to?

No, I think there are. I think there are. In terms of adapting, you could see that Violet is just a dog, but Violet is a person who has her own thoughts, wants, needs. I have two Labradors that I swear are part otter in their breeding because they'd rather be subaquatic mammals, maybe like water hippos, I'm not sure, than dogs.

And Violet absolutely detests all things related to hydrology, moisture, apart from drinking it she hates rain hates wet ground hates being in water and so she has her own little quotes my other two dogs like to come for a snuggle every now and again. One of them doesn't really stay on the sofa for very long. She's more happy on the floor. But you can see behind me, this is Violet's favorite space. She's a head behind you or a head in something, and she is just happy. So she's an individual.

And in the same way, people, not just people with disabilities, but all people are individuals, and therefore people have their own preferences.

And when it comes to people with learning disability specifically, you mentioned we all think we're good at communication, but then put it in put you in excuse me in a clinical setting with a person who is unable to understand what a question is then then how are you going to undertake an objective how are you going to do that and that's that's kind of those are the challenges that we face every day and there isn't a this is how you do answer there's a there's a this is how you approach

it but knowing and thinking on your feet and adapting yourself to each person is part of the skill set that we to develop a specialist learning disability clinicians. And hopefully it's part of a skill set that will enhance everybody's clinical practice with every patient they work with.

If they can be more receptive to communication methods that the person uses, and whether that is, it's cart back a few weeks, you know, dropping the occasional swear word, it might be that. It might not be that. It might be that for some people I work with, I have to use symbols and pictures to communicate.

It might be for some people I work with, with a brain injury, their perception of spoken language is worse than their ability to read information so for some people i'll back up what i'm saying with written down things it might be that i support people who we use sign language to back up what we're saying at the same time so we'll communicate in ways using things like makaton everybody has that individualistic approach and it's our job as

clinicians to find that and when you can find that everybody has a hook everybody has something that helps them to engage and our job is to find it excellent yeah so there's definitely a crossover and and people could learn so much from being put into that challenge of of working outside of their norm of experience because people not everyone is going to be the same who comes to see you so the more you can learn how to deal with the unexpected the better and it

could well be the clue to getting them sufficient successfully rehab rehabbing the whole person and their ecosystem and taking into consideration everything around them rather than the old fashion way of just thinking i'm going to make this knee move better in a certain way because that's symmetrical now and everything's gonna be fine and you're forgetting about the person on the end of the knee so amazing right three minutes very

excited to see you again in about four weeks now so that's gonna be exciting. Apart from Therapy Expo, which obviously is coming up, have you got anything else exciting coming up or people should know about? I mean, nothing that rivals the grandeur that is Therapy Expo. Obviously. Obviously. There is some Norwegian boy that after Therapy Expo, he's going to have decided to shelter from other British people for a short period of time coming over, hoping he keeps his clothes on this time.

Yes, he has paid homage to you. Actually, he said it seems like a big buffoon of an ogre can also do good. So I think you've touched him. I think he shed a little tear as he sits there in his pants and drinks his beer. That was always rhymes then. Gosh, I'm a poet and I know it. I'm going to write that down when I forget this. Right. Excellent. Yeah, no, it's been great to have you. And because Martin, obviously, Martin was a guest on the podcast two or three weeks ago.

And again, that was all about very much flexibility and us being able to not stick to a stereotype way of health care.

And why is it a health care? I believe we should all work with a certain way professionally.

Affectionately and it was a really interesting chat and made a lot of people think and contact us and we appreciate always contact us if you've got any questions or feedback and I think this feeds into it nicely as well you have to be a little bit of a chameleon in healthcare because you're working with different people in front of you and you've got to know how to read and react differently and that's the way to help people's health not just by it's not a car it's the

classic thing isn't it you're not repairing a ford cortina there's no kind of manual it's much trickier than that and that's what i hope is what makes it fun that's part of the sometimes it'll be amazing reward sometimes it'll be really difficult it doesn't get a plan but we work with people and sometimes people surprise us like martin for example is not sitting there in his pants because he has just shared the fact

that he says no pants so great thanks and this is the gentleman i'm welcoming into my home.

Good luck with that yeah yeah fortunately we'd like to remind remind people that martin is not a representation of every norwegian out there there's very much a spectrum sort of spectrums in norway and martin is the one end of it and yeah there's plenty of yeah but we accept him nevertheless because yes we value him value and it was equal opportunities blah blah blah blah right people thank you so much for joining us if you're listening to the podcast and you'd like to follow i'm

alistair beverly like i said probably i find the best places are instagram or tiktok it's all the same username so it's at underscore the ld physio underscore you'll find there also the website and the website i think's got an email on it as well isn't it at the top i think yes there's a contact me page yeah there's a contact me page yeah but there's an email address on there as well yeah the ld physio at gmail.com and why what sort of emails do you encourage people to

send you ones that involve money yeah oh they give you some money thank you there's a lot there's a lot of people who purport to give me money they don't actually that's quite disappointing but yeah if anybody's got any questions i have a lot of people who get in touch just asking about information resources or directing them you know to ways to find more information about these things i'm more than happy to try and support people with those.

And you've talked about courses and things maybe that's something for the future or yeah yeah yeah so i've run online courses as well and i have done some in-person courses unfortunately my clinical work has skyrocketed late for the better but it's left me less time to put on courses but it is something that forms part of my repertoire so maybe in the new year i'll get my my butt in get something that's organized.

That'd be amazing. Right. Well, thank you so much for giving us up your time, Alistair. I'm happy to say that it looks like we have been recording and no one's disappeared at all, which is amazing. Thank you as well, people who joined us live. Thank you for your comments and your questions. Cecily, sorry, I didn't read yours out. Let's have Cecily. You were in a sandwich of Martin nonsense.

So I'll read yours out now. When I was managing a charity shop, the majority of my volunteers had learning difficulties and disabilities. Respect, understanding and encouragement was to me all that was needed to work together.

Exactly. can we throw these words around like everyone can do it and we're not judging people who lack in those departments but it's not you're not necessarily born with it you might have come from circumstances where that was just not involved in your upbringing so that's where cpd, needs to be doesn't it a lot of it is learning how to get these things which we think is just a human quality and often it's not not through a fault not

for because of us so yeah if you got it you got it but yeah respect understanding encouragement it's just the end of war isn't it solve the middle east if all those three words are actually easy with no problem at all.

Anyway that's getting a bit deeper political so thank you people if you listen to the podcast as always sorry to sound like a broken record but do please leave a review and five stars would be nice four if you're not quite sure but five would be even better because it just helps the good word of our guests get out there no one gets paid for this it's just trying to be a conduit for quality information and every single topic we cover

is obviously quality but this in particular is something which we need to get out there for people to talk about. So do please leave a review and it will appear high up in Google when people search. Next week, if you want to know who's on next week, we will be here. But to find out, you'll have to follow UK underscore STA and we will give details of that shortly. But as always, it'll be recorded live if you want to join us at eight o'clock on Tuesday. In this case, it'll be 29th of November.

So if you can join us then, then join us, ask questions to the guests and share some experiences. Until then, once again, thank you very much Alistair Beverley of theldphysio.com thank you thank you Matt and thanks everyone take. Music.