Episode #23: Do Something Different with Antony Lo
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In this episode, we get the exciting opportunity to chat with one of our mentors Antony Lo (aka The Physio Detective).
Antony Lo is a physiotherapist from Australia and runs The Physio Detective service and My PT Education. He has been working at the junction of Musculoskeletal, Sports Rehab and Performance, and Women’s Health for his whole career. He has experience participating and coaching a range of sports and has been a consultant for a number of different types of elite sports athletes of all ages. He is privileged to teach health and fitness professionals around the world in person and online, in addition to his clinical work. Antony has a wife and 3 beautiful children in (what he says) the best city in the world – Sydney, Australia!
We’re so thankful for Antony for sharing his passion and wisdom with us. We touch on a lot of topics in this episode including:
🔹What initially got Antony into physiotherapy and pelvic health
🔹How he became the Physio Detective
🔹How Antony’s approach as a physiotherapist has changed over time
🔹Why it’s important for clinicians to learn to “do something different” with their clients
🔹The importance of language choice when working with clients
🔹The most important considerations when working with a postpartum client
🔹Why he’s so passionate about helping clients with diastasis
🔹Why it’s important to ask clients “what do you want to do?”
🔹The importance of minimizing fear when communicating a prolapse diagnosis
We’re excited for you to listen to this episode and hope you get as much out of this conversation as we did.
Reach and learn from Antony here:
Instagram
Website
Book with Antony
The Physio Detective Consult Series
Antony Lo Courses
The Women’s Health Podcast
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Episode #23: Do Something Different with Antony Lo
We're excited to have you join us for this episode of Pelvic Health and Fitness. I'm Dayna Morellato, Mom, Orthopedic and Pelvic Health Physiotherapist. And I'm Rhonda Chamberlain, Mom, Orthopedic Physiotherapist and Pre Postnatal Fitness Coach. On this show, we have open and honest conversations about all phases of motherhood, including fertility, pregnancy, birth, postpartum, menopause, and everything in between.
We also provide helpful education and information on fitness, the pelvic floor, and many aspects of women's health, including physical, mental, and emotional wellness. Please remember as you listen to this podcast that this is not meant to treat or diagnose any medical conditions. Please contact your medical provider if you have specific questions or concerns.
Thanks so much for joining us. Grab a cup of coffee. Or wine. And enjoy!
Welcome everyone to episode 23 of the pelvic health and fitness podcast today. Dayna and I are super excited to welcome one of our mentors who we talk about on the podcast a lot, Antony Lo, AKA the physio detective. So Antony Lo is a physiotherapist from Australia and he runs the physio detective service and my PT education.
He has been working at the junction of musculoskeletal sports rehab and performance and women's health for his whole career. He has experience participating in coaching a range of sports and has been a consultant for a number of different types of elite sports, athletes of all ages. He is privileged to teach health and fitness professionals around the world in person and online.
In addition to his clinical work, Antony has a wife and three beautiful children in what he says is the best city in the world, Sydney, Australia. Welcome Antony. We're so excited to have you here. Welcome. Thank you very much to you both for having me here. And I guess it's not really a matter of opinion.
Some things are just right. Some things are just facts. I'll take your word for it until I go visit one day. Absolutely. Make sure that you bring the armor for the drop bears and the flame throwers for the spiders. And I guess the machetes for the snakes. Oh my goodness. And there's a few other things too, in the ocean, but it's hard to swing a machete in the ocean.
So, you just have to wear a very thick wetsuit. Oh, what are, what are the birds that swoop at your head? I'm not impressed by those. Uh, magpies. They're, they're like aggressive crows. Yeah, no thanks. Oh, if you feed them, they're okay. They're kind of like gangsters. If you're, if they're your friend, um, then they're good to you.
But if they're your enemy, well, then they make life hell for you. So you just be nice to them. And they've got long memories too, you know? So they'll never, ever say forget about it. Definitely some interesting wildlife in Australia, for sure. Yeah, for sure. You know, even stingrays can kill you as. We sadly witnessed with Steve Irwin, so yes, yes, yes, yes.
There's lots, lots there, but it's beautiful. I have, I have visited Australia. I've been to Sydney. Uh, we stayed in and around there. It is lovely. And I hope to be back soon with my children. Yeah, we'll always have you back. Um, thank you for coming and visiting. And I know it's a long trip, particularly from Ontario.
The jet lag is just wicked. From from that far away. One third around the world. So yeah, I know you're making it. It's kind of a feat, but it was worth it. Alrighty, so we'll just jump right in. We would love to hear a bit more about your story. What initially got you into physiotherapy and what led to your focus on women's health.
Um, okay. A bit more about my story and what led me into women's health. Uh, I'm a physiotherapist, physical therapist, and, um, I started in the hospital system and that's how I got started on pelvic health, women's health. It was antenatal, postnatal at first. Um, and then it just naturally grows from there because if you're going to be doing, uh, healthy.
people with, uh, antenatal and postnatal issues, you're going to want to learn more about the pelvis. So I went down that road, MET, Diane Lee stuff, LJ Lee stuff. And then, um, you know, the thorax as well, because, uh, the, the, the pregnant. The pregnant belly also gets affected by the thorax and went down that rabbit hole and been there ever since combining it with my love of coaching my love of playing sports and watching sports and using my physio skills and saying the same principles.
In all the different areas of my work as well as my personal life and how they tend to apply. So just applying the same principles, um, which seem to make sense. And then being confused when people told me to do things that didn't make sense. So that's pretty much the summary of my career. A lot of things confuse me about what people say.
So I say no. So I'm just curious then in that early part of your career, you were saying you were sort of questioning and getting curious about some of the things you had been taught. So along that journey, what led you to become the physio detective and where did that come into play? The physio detective name was not me.
Um, I had no. No, uh, , I had a, I had a business coach who, you know, all business coaches sit down with you and say, tell me more about your business, blah, blah, blah. And I, I told her what I did and she goes, um, oh, you're like a detective. You are like a physio detective. That's what we should name your business.
All right. So that's how the blog started. It started off as a blog. Okay. And then it went from there. Yeah. Cause I had a, I had a clinic in a location. So the clinic name tends to be the location name, right? So that's what it was. Um, and then, um, when I moved out on my own. Like I just was on my own, so I became the physio detective.
That's just how that evolved. That's cool. So in that early stage, what, what sort of things were you questioning about with the women's health sphere? Um, so look, it's, it's a bit of an overlap because you're asking me about different areas and different layers. So when, when I started the physio detective name stroke blog, that was probably, uh, 2010 ish.
So to me, diastasis was not an issue. Even back then, I was stronger into the, the TA multifidus breathing pelvic floor thing. But even then it wasn't that big a deal because we decided that if you can demonstrate segmental movement, uh, if you can show. that you have control. Um, you can hold positions, but not only that, when you move, you can move segmentally.
Well, then you're demonstrating the very definition of what core stability is, which is segmental control, despite, you know, kinematic, um, kinetic control disturbances. Um, so we decided to just assess people moving. And if we could get them to do a segmental motion, like a roll down or a rotation, or whatever movement it was, if they showed a segmental control, we didn't need to go there.
For those who moved in a very blocky way, you know, they always hinged at one joint, or they, uh, they, they, um, kept one area of their back very straight or very flexed or very extended and they moved everywhere else but that place. Well then we might try to start breaking it down, but we prefer to use movement rather than cueing.
So cueing became the last thing that we did as opposed to the very first thing that we did. And that, that was probably a little bit earlier. That was probably 2008, 2009, we started doing more of that. Um, and, and so then it just evolved from there. And I, I call it peak complexity. You know, I finished the series with, uh, discover physio, and I would say I was at peak complexity.
I had lots of complicated explanations for lots of complicated things. I could hang with them all. I could do the assessments, um, and. I still couldn't help everybody. And that's when I decided that something was missing. Um, I had a bit of a fight with Greg Lehman, who is good at that. And he was very generous.
It was between Christmas and new year. I think it was at the end of 2013 and. You know, we had a bit of a back and forth and, and it was because I helped somebody who was looking down the barrel of surgery for her knee pain. Um, and I, in one session, I got her from only doing quarter squats to being able to do full squats.
And after two sessions, she was pain free and it was through some thoracic ring type work that I did. Um, and he was challenging that. And, uh, I just remember thinking that he was saying that I didn't help all these people. Yeah. Um, and after about three days of literally back and forth on social media and messaging and websites and stuff like that, like we were everywhere doing this.
Um, I said, I said, are you saying that I didn't help this woman? And he goes, no, I'm sure you helped her. I'm sure you're good at what you do. I just think it's for a different reason to what you. You know, I think paraphrasing, and it's like all the defenses just dropped away. And I realized, oh my goodness, I, I felt attacked because he was attacking ideas, but I placed my identity in those ideas.
And so that's why, that's why I teach about identity all the time, because it feels very personal when the things that I've spent a lot of money. Doing courses and traveling and my masters and a whole bunch of stuff. And it feels very wrong for somebody to come along and say, yeah, that was kind of worthless.
So I don't think it was worthless. The question of what I'd be here today, if I could, if I didn't do all that stuff is a difficult one to answer. We can't go back in time, but I think there are, I think there are better ways to explain why What we do helps, and I'm working on a few little side projects to see if I can bring that to fruition.
I think ultimately, in the end, it's not about the tools in the toolbox. It's about the concepts that we use to underpin and explain why. Yeah, it should be good fun. Just letting that sink in. Yes, for sure. I think as physiotherapists and Rhonda and I've talked about this a lot, when we come out of school, we're sort of armed with this, um, very step piece way to assess clients.
And we both had points in early on in our career where we just thought I guess. Yeah, it doesn't really make sense or what happened. We did this and that's not what the textbook told me should make them feel better, but it did. And so starting to ask those questions and I listened to you speak at, um, an online workshop and you gave me permission and Rhonda to, I think, to just try something different.
And that has been so fantastic for myself professionally. So it's, uh, it's important to just ask questions about, I think if you're a clinician listening to this, or if you are someone who is just practicing CrossFit or running and something's not working, ask some questions, try something different, seek out some health professionals that can.
Ask questions and try something different with you. Yeah. Absolutely. And part of the problem really is that, um, people don't like breaking rules. You know, somebody was asking me yesterday, um, because she said that, um, her boyfriend gave her a fantastic foot massage and then the other foot, um, and you know, 45 minutes and she said it was just so fantastic.
Um, and she wanted to return the favor. And, and she said, you know, but then I started massaging his traps and it's like, uh, she said to me that she, she thought that she would go learn as the birthday present for him to go learn how to do a massage. And I said, Oh, you know what? Save your money because.
What he's probably feeling in not that great a massage is actually your lack of confidence, right? And so you don't need to know the muscles. You don't need to know all the anatomy. You just need to know what makes people feel better and what people don't like. And the rest of it, you can kind of explore and make up.
So I said to her, why don't you instead focus on. Touching him in a way that you would not touch any other person like, you know, how to make him feel good. Use that when you massage his traps. It doesn't have to be sexual, but it can be sensual and, you know, be confident. In that and he'll probably feel the love that way as opposed to your pokey.
I don't know what I'm doing because that's going to come across. And so a lot of what my education work is about changing the way that we think about people changing how our assumptions about what people are like. Because it, it comes across in our words and it comes across in our actions. And like what you were saying, if, if we, um, are taught to do things in a certain way, it feels wrong to break the rules.
And then that person consciously or unconsciously senses that, uh, you don't feel confident about doing something different. And, um, you know, I said to her that that piece of a few hours just to learn how to massage partner type thing, right? But that piece of paper wouldn't have helped her as a massage or to help her massage a partner.
That, that piece of paper wouldn't have been because of what she learned in a few hours. It would have been because she had the confidence to say, okay, I feel like I've at least had some training in this and you can get that confidence just by thinking about it differently. And, um, you know, it's, I'm glad when I hear about pelvic health therapists who come from a sporting background or, uh, an author background, as opposed to going straight into it.
Going straight into pelvic health doesn't mean that you're going to be limited. It just means that if we have a broader space of possibilities, then things can happen. That's good. Yeah, I love you sort of touched on I find your messages so helpful in the sense of just being mindful of the language that we use with our clients and Dayna and I, we bring up your name a lot in that regard that.
We're both very focused as practitioners of not using fear mongering, and just being very positive and encouraging with our clients. And I think that's something I still catch myself with. And just in the sense of trying to explain, you know, if a client saying, so like, you're doing this, you know, treatment to me.
Why is this working or why is this helping? And it's challenging to not sort of get into the scientific and sort of those, the stories you always say, like the stories we tell ourselves of why something works. And so, yeah, I just, I, I'm getting better. I find over time of just using that empowering language and just.
reminding people that their bodies are strong and resilient, capable of healing, all those things. So, is that something you've changed over time, is just being more mindful of your language with your clients? Yes, absolutely. So, number one, I've got all these acronyms that you've probably heard, you know, SCAR is Strong, Capable, Adaptable, Resilient.
BAMS is Beliefs, Attitudes, Meaning, Stories, stuff like that. And, The reason why I teach these things is because it's a daily struggle for me too, right? And educational theory and research will tell you that if you want to remember things, then the best thing to do is to teach it. So, um, that's what I teach.
I teach two things that I struggle with. They're not because I've reached the summit and now I'm imparting my wisdom of my journey onto you. That's not how I work. I work by saying I'm on a journey. I'm old enough to have gone down some different paths. And if you want to hear what I've learned, Oh, I'm happy to show you.
But what's been really helpful is that nobody ever takes the same path as me. So here are the principles on which we can work. you know, walk the same path together, um, in the same way, in the same direction. So, um, yes, that is something that I have changed over time a lot. Uh, I grew up with very fearful language, you know, about all the alignment, all the biomechanics.
I'm actually, I think, you know, without tooting my horn too much, I think I'm okay at doing the, the biomechanical analysis, the postural analysis. So, you know, I, I can, I can do that and still use that, but with a different way of looking at a person, not just as a, as body parts moving and muscles activating, but, you know, the whole integration of what it means to be working in a biopsychosocial way.
Wonderful. So I'm just curious. We a large portion of our clients that we see are pregnant and postpartum. So they're in that zone. What would you say when you're working with the postpartum client is one of your biggest considerations? A postpartum client? Yeah. Yeah. Um, look, there's a lot of considerations, but one of my biggest considerations is, uh, ensuring that they know That I'm there to support them no matter what decisions they make.
I think that is one of the biggest considerations that I have. Particularly if they're a new, uh, parent. It's difficult already. Everything is difficult. Your life has just been turned upside down. So, You know, I try not to judge, um, if they do things that I don't like, for example, I remind myself that that's my opinion, and unless they've gone out and murdered somebody with a knife, like, I can, you know, reserve my judgment, I don't have to speak it, but understand, okay, what led her to do that?
Why, why did that person murder Choose that. Um, and just seek to understand. So I think that is probably the biggest consideration from a health point of view, ensuring that all the different health things are met. So we've got good research for pelvic floor muscle exercises. We've got good research for, um, Returning to physical activity.
So the physical activity guidelines for adults 18 to 60 or 65, 64, whatever it is, um, they, they don't say, Oh, by the way, if you're postpartum, just pause these guidelines for a little while. And yeah, when you look at the guidelines for pregnancy and postpartum activity, the most that I've ever seen is four paragraphs.
Um, in, in those guidelines and the IOC one I think had a paper to the postpartum period might have been mixed in with something else. I can't remember. It's from 2016. So there's not a lot out there because there's not a lot of research out there and it's unethical to experiment on people in ways that could be detrimental to their health.
So, you know, thank God we still have ethics. So, uh, I think that's a consideration. So for me, uh, bearing down, particularly if they think they're doing a pelvic floor contraction, but they're bearing down. One of the things that I want pelvic health therapists to hear is that when you do an internal assessment on somebody, that's a lot of feedback.
It's a very sensitive area. Uh, it's a lot of feedback to have somebody's fingers inside you and you squeeze on them because when you are not there, now they have no feedback. And a lot of people I've noticed will bear down to try and feel that feedback. And so people are bearing down when they're practicing, but then when you go assess them, you do an internal again and they do the internal properly because they've got the feedback and you're like, yeah, yeah.
I checked them. They're not bearing down. And I've done the assessment the next day and it's like, they are bearing down, like they're bearing down. So instead of saying, Oh, look, you know, you don't do it internal properly. I had to really think about, well, why would this happen? And that's what I came up with.
So I always urge internal therapists to think about doing an external visual assessment, as well as an external palpation with clothes on and teach a patient, teach a person how to feel that bearing down. Um, with the cough, for example, and, and helping them understand what normal perineal descent is and what ballooning or increasing that hiatal area feels like so that they can distinguish and determine for themselves what's going on.
Yeah, that's, that's one of them. I will check people's diastasis only because they. Might leave and then go, he didn't even check my diastasis. So I will do things because of what's out there on social media land. I don't say to people, don't look at Google. I might say to people that most of the stuff you see on social media is not good.
Um, but I, I won't, I won't say don't go look. In fact, I say, I know you're going to look, so what I want you to do is anything that sounds different to me, share it with me so that I can talk to you about it. Um, because yeah, telling people not to go on Google is just the dumbest thing. People are going to do it.
So what are you, their parent? They're sticking behind your back. If we don't want to have a patriarchal system, let's not patronize people. Yeah, I love that. So you. Do a lot on diastasis. I feel like that sort of is, would that be, do you think the thing that people come to you most about or not necessarily?
No, no. Okay. They come to me. Oh, like most of my clients come to me for all sorts of reasons, but I have a particular love for diastasis because I think that like, it's my passion because so many people are trying to make money out of people, uh, through fear. and preying on people's insecurities. And I am just not for that at all.
So I've got the diastasis project for that. And, um, and just showing people that it doesn't have to be complicated, you know, like, why are we making this thing more complicated than it is? And all these, like, I never, I'll tell you what never ever made sense to me is that if transversus abdominus pulls laterally, How does doing your TA exercises bring your linear alba narrower?
Like that does not make sense to me at all, right? You would think it would like pull it apart more. Is that what you? Yeah. And Diane Lee's research showed that like you maintain the width or even increase it with a TA contraction and then the curl up task. That's what happens. It doesn't make sense to me.
And it hasn't for a long time. Like I'm talking, I'm an old man. So 15 years or so. It just doesn't like people would say, Oh, I get to do the TA in the pelvic floor. And it's like, number one, what's the pelvic floor got to do with it? It's got nothing to do with their diastasis. Yeah. So let's just ditch that.
And then people will tell me, Oh, but the fascial connection is like, have you looked at the fascia? Because when you look at the fascia, it has bony attachments before it gets to the pelvic floor, and you're telling me that it attaches to the bone because it wants something to pull on, but it bypasses all of that to get to the pelvic floor, like if the diastasis, if your pelvic floor could support your diastasis, how is it?
that we think that it's so strong that it's going to support your diastasis in your spine and yet you have a prolapse or incontinence or you're like stress urinary incontinence. Oh, but it's not good enough to do that. So come on. We're just kidding ourselves. Let's not do that. I'll continue with the diastasis for a second.
Um, if you have a client that comes to see you then with, um, questions about the gap that they have in their belly, what does an assessment look like with you? And what does continuing with treatment look like with you? So an assessment looks like, do they have what I think might be a hernia? I'm not in a position to diagnose as a physio if you have a hernia or not, but we can kind of tell when there's a hernia, right?
So referral to, uh, to the doctor if we think it's a hernia. Um, so first of all, is it a hernia or not? I know lots of people love Feeling the depth of the diastasis. I'll do it because people on social media say to do that. And it's like, I don't care. I can manipulate that depth just by contracting other things that you may not even realize I'm doing.
Like, if you want to change that depth, just tense up your upper traps a little bit, just a little bit, or your throat, and that tension will change because you change the pressure in your system. So it's not a reliable indicator of anything to me. Yeah. Um, and if it's super loose Who cares? It doesn't mean that your, your abdominal contents are going to fly out.
So there's a lot of reassurance. There's a lot of, um, assessment for how they manage pressure. So when we start doing tasks that require a lot of pressure, how are you managing that? Am I seeing you use your breath? to create negative pressure? Are you breathing in to do that? Or are you, um, are you bearing down by, you know, trying to contract everything?
And, and for those who tell me that they see a link between diastasis and pelvic floor dysfunction, I understand and I see that stuff too. But if I'm going to be honest, I'm going to tell you that I think it's a lot of the transversus and core work focus that we've put on people because we've told people that diastasis is a problem.
I think the reaction to the, to the diagnosis is a reason why people are having these symptoms in the pelvic floor. Because if you're told that you're weak, that your diastasis can't give you Uh, circumferential stability for your spine and you've got to contract all the time. All you're doing is creating a rigid container instead of a dynamic one, which will then, and then you start talking about cylinders and pistons and all this other stuff.
Like where, where's that pressure going? It is going down. Yeah. Cause it ain't going up. Like very rarely does the pressure go up. Like it does. Right. That's the burping. That's the, that's the, um, oh my goodness, my words. But, um, like when you've got acid that goes up your throat, acid reflux. I don't know why I don't remember that, but, um, all of those things.
Sure. Yeah. But wow. Why, why do we do this to people, you know, like their reaction, telling them to have their core on. If you can't activate your transversus, you can't do these harder exercises, despite the fact that you're going to get up, carry your kids, pick up all the bags, chase after toddlers, bend, twist, lift, Lor, push, pull, carry, hold, do everything that you normally do.
But I'm just going to remind you that because you can't isolate, You are weak. That's just terrible. So I want to swear, but I didn't know what to do with swearing. So I'm cool with it. I, I, women aren't fragile, right? Like, yes, yes, they're doing all the things they're doing. Yeah, I know. I love that. I love it.
So do you just get the moving? What's your approach with the diastasis? Let's just try it. What do you want to do? Like, if somebody came to me, and they're late, uh, they're late pregnancy, or Like earlier pregnancy, like most people are okay to exercise with them, but late pregnancy or the early postpartum, I try to have them lifting up to 15 kilos or 35 pounds as soon as possible because that's how much a stroller weighs.
Um, you've got to learn how to do it. You've got to learn how to do it. You've got to learn how to do it with an SUV. You've got to learn how to do it while you're Carrying bags or wrangling kids, all the rest of it, you know, I try to get people to reach out with some sort of way, trying to simulate what they have to do to put that carrier into the middle of the car.
One foot in the footwell, one foot on the ground, lifting this thing, twisting to get the right angle, otherwise it doesn't slot in, you know what I mean? Like if we don't train people on how to do this and we can assess them and help them work out strategies to do this, why don't we do this? You know, people say that they want to run a marathon and we can help them with a training program for running people want to do some sort of race or competition or do Tough Mudder or Spartan race or whatever and we can help them do that.
They want to compete in CrossFit, we can help them do that. Why don't we help women learn how to lift and load and put kids in the car. And not only that. Have you ever tried to put a sleeping baby that you spent a lot of time getting to calm down, they're now at the stage where they can stand up a little bit.
So you've Lored the cot bed and try keep your back straight while you do that. Yeah. That's not going to happen. And the easiest way to make somebody feel guilty is to say that bending your back is bad. Yeah. When you're lifting. All right. Why don't we just train people to do it? I love that. Yeah. You always say move all the ways.
I always use that with my clients. Just got to learn how to move all the ways, move all the ways and breathe all the ways. Cause I think that's another. Oh my goodness. Oh my goodness. Yes. I said to answer your question, Dayna. Yes. I get them moving. What do you want to do? I know what you have to do. If you don't have help, if you do have help, it doesn't matter.
But what do you want to do? Uh, do you want to go back to CrossFit? Do you want to go back to your, your, uh, running group, peloton class, whatever it is. And then we look and we try to help them do that. Pilates classes, you know, boot camp. I want to go back to boot camp. Okay, cool. Let's, let's work backwards from your goal and figure out what that's going to look like.
Because at two weeks postpartum, you will not be deadlifting, snatching and doing mirth. As a workout at two weeks postpartum are X with a weight vest on and all the rest of it. It's probably not going to happen. So, you know, people say, Oh, he doesn't care about technique. That's not true. I care about helping somebody be empowered to choose.
What is appropriate for them because it's not my life. It's theirs. It's not, it's not my body. It's theirs. So I always ask people what, what core exercises do you like to do? What are you going to do when you leave this room? Um, or if they say, uh, I'm sure we all hear this one. Can I do X, Y, or Z? Can I do this?
And let's try it. Cool light bulbs go on for them. So here's a question for you. Is there an exercise that you can think of that does not involve the core in any way? True. Yeah. Every freaking exercise is a core exercise. So we have to stop with this. Artificial. Your brain does not go, Whoa, hold on a second.
I've got to go find the core, switch it on first. And then we got to, then we can, then we're alLod to move our trunk and our arms. Like, it doesn't think like that, you know? So there is no artificial division in the brain of what the core is and what the core isn't. Like it certainly pays attention to certain things because they have certain functions, but yeah, it doesn't go, Whoa, that's a core activity.
So therefore we're going to do this. And, and yet that's what we do. I don't know why it's silly. Um, we should just help people move. Yes. One of the ways that does help, sorry to, you know, time and time difference, but one of the, one of the things that, um, does help is isolated contractions. I know what the research says about isolated contractions, motor control exercises, and all of that.
I have no problem that they're helpful for people. I have a problem when they become the prerequisite. For everybody, because that is not supported by the research. All of those things are helpful, according to the research, but none of them are better than the other. Yeah. So you've got to find out what works for that person in front of you.
And if that person wants to do something and they show me that they can segmentally move with control, you know, flexibility, mobility, control, strength, power, speed of repetition. Then yeah, let's go. Let's meet you where you're at. Go lean on the fences and let's go from there. I was just going to say, I think hypothesizing why we are obsessed as a society with core work, I think a couple of reasons.
I think we have been taught that aesthetically, if we do core work, then we'll have a six pack. I think that's one of them, which, you know, we talk about on this podcast a lot that, you know, aesthetics, if that's an important goal for someone that says, great, that's awesome. But we can't also lead people to believe that we can do a bunch of core work and expect that your tummy is going to shrink.
That's just not possible. And also, I think, um, one of the biases I still find myself working through is the belief that if you have back pain or hip pain or pelvis pain, that you need a stronger core. It means your core must be weak, right? And so. I, I find that bias really hard to work through. I don't know if that's something you still work through, Antony.
Um, like the thought does pop into my brain, but there's research to support that the activity of those muscles is actually greater in people with pain than it is in people without pain. People in pain or people with pain have blocky emotion than others. And so one of the ways. To, to change that could be to do the isolation type work, but it's not usually because of weakness.
Uh, there could be deconditioning, you know, it's, it's usually not weakness. It could be endurance, but then they're going to have times where they'll tell you I'm okay for 10, 15 minutes and then it starts to come on and then I can't do anything. Okay, fine. Let's just build your endurance, your tolerance.
That's not a problem. That's strength and conditioning one on one, right? So there's nothing special about these particular muscles. And that's why, um, you know, when we, we all went to university, we learned about skeletal muscles. There's, you know, fast twitch, slow twitch. There's the two different types of fast twitch.
And then there's heart muscle, skeletal muscle. That's in a, in its own category. And that's it. You know, oh, there's the, there's the sphincters, which are, you know, autonomic nervous system driven, not under voluntary control, but you know what I mean, like muscles and muscles. Yeah, that's it. Like there's nothing special about them.
So train them in all the different ways. Keep it interesting. That's why athletes need, you know, those massage guns and, and, you know, the pressure pumps and all the gadgets. I honestly think those things help athletes because it gives them something to do. It's like giving a kid a new toy and this is not to diminish athletes, but it's a distraction.
Right. And those things aren't any better or any worse, but they help people continue to keep doing what they're doing because it helps to settle the mind. And wow, if you don't think that elite sports is a mental game, then you really haven't worked in elite sports or participated in it because it's a mental game.
All of it. Yeah. I've been watching the Olympics. I don't, it's, you see them, they're so focused. It's amazing. Yes. I think I truly early in my career was like, really, we have to consider all of these extra things like the central nervous systems of all, all of these things. But the further I get into my career, I'm like, yes.
We do. We should all be focusing on dialing down that central nervous system sometimes and focusing on sleep and drink the water and all, you know, that kind of thing. Yeah. And there's nothing wrong with those things. Um, it's, it's when we start to forget the big picture. Yeah, that it becomes an issue.
Right. And so ensuring that the little simple things like telling somebody who's got a newborn baby that you need more sleep, that's kind of like telling Canadians that it's cold in winter, like, sometimes you just can't do stuff about stuff, you know, so, you know, strategies on how to snatch sleep when you can.
Yeah, you know, yeah. Uh, ways that you can get to sleep faster, simple things you can do to stimulate the parasympathetic nervous system, uh, which doesn't involve sleeping, uh, you know, different things like that are really helpful for sure. Um, but, uh, yeah, and that's any one particular, uh, I suppose philosophy, any, any time we start to really focus in on this is the most important, apart from a holistic, let's just remember the big picture and the principles here.
I think anytime we do that, we run the risk of over focusing and missing the individuals who will not be suited for that focus. Yeah. Yeah. Yeah. It just made me think too when you were talking about the massage guns. I find, you know, as we start to realize things might not work for the reasons we once thought they did.
I find sometimes in the physio world, then people are like, well, foam rolling is useless. Right. Because it doesn't work for the reasons where I, you know, I try to find myself in the middle of the pendulum swing. So clients will say to me, like, what about foam rolling? You know what, if it feels good and you like it and it, you know, modulate some of your pain for a while, go for it.
Right. It's not going to damage you. So I think, again, we have to be careful about not. Swinging in the opposite way, just because something doesn't work for the reasons it does. It doesn't mean it's not beneficial for people. Yeah. Like you said, if people like foam rolling foam roll, uh, I don't have a problem with it, but if the goal is to loosen up before you do whatever.
Well, then test it after 30 seconds because you could save yourself 10 minutes if it works in 30 seconds and you max out it at 30 seconds to a minute. Well, then you just save yourself nine minutes, you know, getting to where you want it to be. Just test it. Um, and there's, you know, for long before foam rolling was a thing, Rhonda, uh, we used to rub sticks on our shins.
To toughen up our shins for kickboxing and things like broomsticks. So, you know, foam rolling desensitizes you just like hitting trees or rolling a stick up and down your shins desensitizes you too. So yeah.
Ouch. It doesn't have to be painful once you get past the pain.
So we've been focusing mainly on diastasis. Um, another topic that at least comes up for our clients a lot is pelvic organ prolapse and what we should avoid in terms of exercise and lifting. Um, You mentioned with, with diastasis or diastasis that you look at pressure mainly, is that similar for pelvic organ prolapse with your approach to pelvic organ prolapse?
I look at pressure for pelvic organ prolapse more than I do with diastasis. Um, you know, for me, diastasis, I see a lot of people. Just because of the influence of social media where they don't have enough rectus, like they're focused so much on transversus and the lateral muscles. By the way, there's a lot of people, there's a lot of people out there teaching transversus contractions, which are internal oblique contractions.
Just want to say. Um, so anytime you feel that that point pop up medial to the ASIS, that's not transversus. Transversus does not pop up. Um, so if anyone teaches you that, sorry. I always thought that too. Like it wasn't anyways. It does not pop up. Like you watch transversus on an ultrasound, it does not go towards the skin.
It will, it will straighten out and it will bulge, excuse me, it'll bulge down. Um, so yeah, so that's number one. Number two, they all So they're all doing obliques, they don't do rotation because, you know, you don't have this connection between both sides of your body, like, of course you do, it's called skin, it's also all the way around.
And directus can serve as a flexible column to help control that rotation because it does twist. So, um. I, I, I like to focus on that now in terms of pressure and like, really, are you going to compete with a pregnant baby? Uh, you know, sorry, a pregnant belly with a baby inside and the uterus grown like that is sustained loading over time, right?
Yeah. Uh, you're gonna have to do something really, really extreme. Um, to be able to put enough pressure on there and it can be done. I'm not saying that it can't be done, but most people don't go close to doing that. And the people I work with people who do high level things and they know in themselves that it doesn't, it shouldn't feel like that.
So they don't do it. Um, so there's that, but for pelvic organ prolapse, it's a funny thing. There's research to like 20 years ago. Research, which said, you know what? Maybe we should consider it a problem when it's past the level of the home. Um, and before that, there's very little correlation. I think there's a 67 percent correlation.
Um, when it's at the level of the hymen or further out with the classic symptoms of prolapse. But before then, it's a crap shoot like, um, and more, much more than once I've had people tell me that they've got prolapse symptoms, heaviness, dragging, bulging, all of those feelings. Um, and of course, I'm not saying that they didn't have these feelings.
But when I can put my finger on your perineum and you tell me that that is where the heaviness is, that ain't your prolapse because I'm not pushing on your prolapse, right? I've got my hand on your pelvic floor and your skin. Like I often wonder if again the diagnosis of these things Is made based on the symptoms and then people go have a look and they go, oh, you've got some anterior wall movement.
It's stage two. Um, and they go, oh, it's, it must be the prolapse because you've reported heaviness and you've got this thing that I can see there. But like I say to people about knee MRIs or back MRIs, nobody ever goes, you know, nobody ever wakes up and goes, I feel fucking awesome today. I'm going to go get an MRI.
Who goes and gets an MRI? Not those people. You're going to go get an MRI when something's wrong. And then we go find things and we go, Oh, that's the reason why you've got these things. I think it's the same sometimes with pelvic organ prolapse. Um, now I am not in a position to say for sure. I'm just hypothesizing here, but if it causes the internal therapist to think twice about it, then I'm happy with that.
Because just because you see a bulge doesn't mean somebody feels a bulge. And how many times have you told somebody that you've seen a bulge? And I'm not saying don't tell them because once you do the examination, it's their information, not yours. So once you've done it and you've told them how many people, particularly other physios have gone and said, you know, After that appointment, I started feeling more bulgy.
I started feeling more fullness. I started feeling something there. You made them aware of that. They weren't aware of it before. What does that say about it? It's not like, you know, your assessment increased their symptoms. Yeah. It's, there's a lot to be said about how perception works and our, our contribution to increasing people's, Experience the symptoms and, and, and suffering really.
So interesting. I run that. I have that internal dialogue with myself almost daily, but you know, for listeners, if you're walking around wearing a shirt, you don't think about your shirt. As soon as I tell you to pay attention to your shirt, you feel your shirt. Right. So yeah, I run this, I have this internal debate all the time, but you're right.
It's their body. And I tell them what I see, but I also just lots of education about what that does or doesn't mean. Yeah. Yeah. And I think that's where movement is so powerful too. So I. Similar to you, Antony, I get people moving and loaded, you know, as soon as they feel confident to do that. And so many of my clients report as soon as, cause then, you know, I explained to them, okay, now stop thinking about your pelvic floor.
Like, I don't want you to think anything about what your pelvic floor is doing. They're like, really? But what about my Kegels? No, drop it. And then, you know, that's when their symptoms start to get better because they're not. Thinking about what their pelvic floor is doing. Yeah. Yeah, a hundred percent. My favorite one is, um, Touch your nose.
People don't think about what it takes to touch your nose. And yet, if you've done any neurological training at all, you know that touching your nose is actually one of the activities that you can ask people to do if they've had a stroke. Because when you've got neurological damage, it's not that easy to touch your nose.
So, um, you know, if you didn't think about your pelvic floor before, why do we think we have to think about it forever? Right. It's not forever. It's just for now. And, and having people do that, um, other ways that it could be, Hey, you know, you report these symptoms of prolapse, but did you know that these could be other things as well?
Oh, what else could that be? Well, you know, the tiredness, heaviness feeling could actually be your pelvic floor, which is really working a lot to help support you. Let's, let's have a see and see if there's that. And so now they've got two things that it could be instead of I've got this, um, and going down the rabbit hole.
And, and being able to sift through that is really important. Being able to say, look, you know, your early postpartum, everybody's hormones affects their tissues differently. Now is not the time to say that definitively, this is you for the rest of your life. Because how many times have we seen and heard People with a stage two or even stage three prolapse and they finished breastfeeding and it's a couple of years down the track and they're actually back to like a stage one type thing or asymptomatic stage two.
Like how does that work? That's because sometimes it's just not relevant that that's there, you know? Yeah, makes so much sense. Postpartum, early postpartum is such a wild time, right? It's amazing what the body does to reproduce. So I'm in awe. That job's easy. You, you have, I know you have a daughter. What are your other kids, Antony?
I have, uh, two boys after my daughter and how old are, how old are your kids? Um, my daughter is 19 and a half. My son is 18 and a half and there's less than 364, there's 359 days between them. Wow. And then, um, my youngest son is, um, six, 16 in May. So three quarters. 15 and three quarters. Wow. That's a whole different stage.
We were talking to Teresa about that on our last episode. Yeah. It gets easier in a sense, but I'm sure there's also challenges when they're older too. Yeah. Look, part of, you know, I teach all the ways. I teach variability is key. I teach that there's no right or wrong. I teach a whole bunch of stuff that I know that you're familiar with.
Um, and the reason why I teach it just like all the other things that I've told you about is because I naturally want to find the best way, I want to find the right way, I like to find the most efficient way to do things, and I have to remind myself as a parent that all of the things that I teach at work apply at home too.
But there are some lines that you just can't cross, like food inside the bedroom. What are we doing? No. Oh. I found apple slices on the bookshelf today. I was like, what's happening here? Like, why? How old are your kids, Dayna? Uh, I have a three year old son and a five year old daughter. Oh, yeah. Look, having girls first, I, I only ever having this experience, but having girls first is such a blessing.
Um, and maybe it's a personality thing because she was able to walk, right? Remember, she hadn't turned one when, when my son was born. Yeah. Uh, she, we could say to her, can you grab a nappy from the change table? And she'd go pull out the nappy and come back. She couldn't talk, right? She had one word. You know, like one word sentences type stuff, but she could go get a nappy.
Whereas we tried that with my son, and it's just like, Nope. So, sorry. I realize that I'm not on video. You know, they just look at you and then they go back to what they're doing. It's like, ah, who are you? Are you related to her at all? Um, Stereotypes exist for a reason. Um, and you know, my daughter just so happens to be very helpful and very smart.
And, um, she sees like, even as a kid, you could see her eyes were just taking everything in and calculating. Um, so, and, and my son, honestly, and I say this, knowing his final marks, um, we thought, Our son was not particularly smart because he would just sit there and smile and dribble at you. And that was pretty much it for ages.
Then we thought, Oh no, like maybe there's something wrong with him. And you know, he would just be quiet. Whereas my daughter would talk your ear off. Um, and, and our youngest son would talk our ear off and we sent him to school early because at the age of four, four and a half, he was ready for school.
Yeah. He probably is the least academic of all of them. And my son, he's, he's quite smart. He did well, uh, didn't do quite as well as his sister, but there was a bunch of things that contributed to that, that was outside of his control. Um, you know, COVID and stuff, but you know. They're all going to do okay.
And I have to remind myself that that is despite me, you know, not because of me. It's despite what I've done, um, as a parent that they're going to go okay. So hopefully we showed them a few. few things that are helpful and ask for forgiveness for all the other things that we did. Very similar approach with, uh, clients as parenting, you know, ask the questions, support what they want to do, right?
Similar theme. Yeah. Well, a hundred percent. And, um, you know, I, I, just before getting on here, there was a Facebook post from a friend who, um, who was talking about comments that people make when you're pregnant, she's like, why do people say stuff like this? You know, and one of my comments, uh, I think somebody else, right.
That they, you know, they see people and they say these things instead. Um, I think that was some sort of. Um, I don't know, body worker, maybe, or therapist, and um, and I said, oh, I just asked them how they're going with it all. I think it's safer. Yeah. Don't comment on how you look. It's just going to be safer.
Otherwise, if you do ask me, you know, do I look okay being this pregnant? It's kind of like saying, you just asked me if your ass, if this dress makes your ass look big, is that true or not? I was like, are you happy with it? Because I can tell you that you're average and does that make you feel better or worse?
I don't know. You know, some people don't like to be average. Everybody wants to be above average, which makes everybody average. So it's how maths works. That's a whole issue in our society. Just commenting on people's bodies. Let's just get rid of that. It's not necessary. And it cuts both ways though, right?
Yeah. Like I found a scale that could give me the number that I weigh, uh, cause I weigh a lot and. You know, people have been very polite and, and sometimes I, like I needed that shot to go, holy crap, I've got to do something about this because I don't want to be this number and it's not about the number, it's about the health risks and all the rest of it.
Right. So, you know, um, It cuts both ways, but you certainly don't need the, uh, the cultural, feel free to comment on people's bodies type stuff as well, because that can be harmful too. People are complicated. Oh, totally. Yes. People are complicated. Yes, for sure. Well, Antony, this has been an amazing chat and we would love to hear more about, so you yourself have a podcast, which is great, and some educational courses.
So do you want to just tell our listeners a little bit more about that? Yeah, sure. There, there is the women's health podcast. So Marika and I are just organizing ourselves and we'll get back to it when we can. Um, there's just a lot going on at the moment. Um, I've got courses, I've got, uh, you know, consults that you can watch for as little as 29 us dollars comes with a webinar.
Uh, I think about people, um, You know, feeding kids in the middle of the night, so they're captioned, so, so, you know, they're captioned by a physio, a pelvic health physio, um, so there's that, they've got reflection questions, there's a webinar that goes with it where I answer some of the common questions that came up from the consult, um, and there's like 15 or 16 of them that you can get through if you really want, um, there's the female athlete, And Uh, level one course, if people are interested, there's a foundations course, which talks about the thinking, there's a diastasis reframed course, if you're interested in, um, really challenging your brain about diastasis.
So, um, you know, there's lots of different, uh, options out there for people. And of course, one of my most favorite things to do actually is when. physios call me in for a joint consult. So, you know, um, they, they're working with somebody, they don't quite know how to help them get back to CrossFit or whatever exercise.
And, and, um, they've taken them as far as they think that they can go. I love working together. So they're still your client. Uh, we do the zoom consult and then. I don't throw people under the bus. It's, you know, it's all very supportive and the client is happy. The physio is happy or whichever health professional exercise physiologist, physio, whomever.
Um, and that's really fun. I really love those. So, um, you know, you can do that too. Very cool. Wonderful. And are you still treating in clinic? Can clients find you in Sydney, Australia? Where can they find you? Yes, they can. Well, I take clients from around the world. I do online as well as in person. So I'm in Sydney in the St. George area. Antonylo.com is the best website. Because you can find what you need and then it sends you to all the different places from there. So Antonylo.com is the easiest and whether people want to book me for a podcast or they want to book me to run a course, either virtual or in person, or they want to book in to see me as a client online or in person, it's all there.
Antonylo.com. Amazing. And we'll put all that in the show notes. Thank you so much, Antony. You are such a wealth of knowledge, and I just love your approach. So, so great chatting with you tonight. Yes, thank you. Happy Saturday. Thank you very much to you both, and I really appreciate the time and letting me just rant unfiltered.
Uh, and uh, it's been great. Love what you both do. So keep it up. And um, you know, part of the reason why I love doing these is because it helps other people and supporting people like yourselves to, to keep doing the work that you're doing is, is one of the best ways we can change the world. So, um, you know, keep going and, and, uh, look forward to catching up with you more.
Thank you. Thank you. Thanks for listening to today's podcast. We hope you enjoyed the conversation. If you liked what you heard, we would love if you could share this with a friend, leave us a review or subscribe to anywhere that you listen to your podcasts. Thanks for being here.
