Back Pain 101 

Back pain is the fly in the soup of your life. 

Unfortunately we’re all likely to get back pain just as everyone at some point will get a headache or abdominal pain. The vast majority of back pain is “non-specific” meaning there no specific disease of injury found on tests but that may be no solace... 

Whilst intermittent back pain now and then can be a normal part of everyday life, there are some things to take not of which might suggest you need to see a doctor (p.s most back pain is not worrying) 

Assuming you have back pain with no other symptoms at all, you can actually give it 4-6 weeks before visiting your doctor. 

However red flag symptoms like tingling, numbness, difficulty evacuating your bowels & bladder are things which could suggest a neurological or spinal nerve related problem so don't wait to see a doctor in these cases. 

One of the biggest unhelpful myths which circulates about back pain is the need for rest. There may be specific cases for this – for example, you’ve had some major back or spinal surgery and are undergoing careful, slow rehabilitation.... but in most cases of back pain, movement is good. 

Movement not only helps to prevent back pain but it can alleviate pain associated with it as it can increase muscular strength in the muscles surrounding the spine but also improves blood flow and thus nutrient delivery to the soft tissues in the back.  

Another myth we need to bust is the need for “correct posture”. 

There’s not really such a thing. 

Slouching is fine as long as it doesn't cause you pain. In fact no study has correctly identified one specific posture that can prevent injury or back pain. 

Move, keep an eye out for red flags, take pain medication as necessary and see a musculoskeletal physiotherapist for specific exercises if you need and don’t worry about your posture or lifting things the “correct way”. 

P.S If you want to learn more about your biological scaffolding we call the bones, muscles and ligaments and why your baguette spine is so prone to injury, grab my book This Book May Save Your Life: 

P.P.S if you’ve already read it, drop a review on Amazon! 

How Your Gut Controls Your Mood... 

I came across an interesting new study published in the journal “Cell Metabolism” that suggested that your gut microbes can play a role in how you respond to stress, further deepening the link between the gut and the brain. 

Your gut microbes fluctuate in their activity levels and colony makeup throughout the day, and this then has an impact on how the body releases various stress hormones like cortisol and adrenaline. 

If the levels of specific microbes drop too much this could impact hormones which influence your biological clock (i.e the circadian rhythm) which then has a consequences on sleep, metabolism, weight gain, stress and more 

Of the various microbes, it seems that the levels of one of the “good guys”; lactobacillus might have a huge role in influencing our stress response. 

This is one step closer to bridging the gap between gut and brain but also coming up with targeted strategies to influence our mood and mental health using gut directed therapies! 

P.S If you want to learn more about the gut brain connection, how you can improve yours though diet, and lifestyle, check out the recent podcast episode I did with Professor Jonathan Swann one of the world leading Gut-Brain scientists! 

Which Music Makes You Most Productive? 

I’ve wondered this often and the answer isn’t black and white. It depends on the work you’re doing and the type of music! 

For example in the operating room, anecdotally I’ve always found that music without lyrics works well and sharpens my focus. This correlates well with studies which suggest that surgeons who operate to classical music had improved speed and accuracy. In contrast loud music with a high BPM could be distracting... not ideal if you’re fiddling with squiggly organs! 

However factory workers became less productive with relaxing music and required a higher BPM tune to optimise their productivity according to another study. 

Ultimately most studies agree that your emotional state has the highest impact on your workflow, so if something can improve your mood, chances are your work rate will improve too, so you might be best playing something which makes you happy. 

3 Life Lessons It’s Never Too Late To Learn 

1) Feeling afraid of failing is normal. Success and failure although seemingly polar opposites are in fact close bedmates in a spectrum. In a way, success is achieved through failure, multiple failures are the building blocks of success. So think about it this way, every time you fail, the closer you get to mission complete because you've learned a new lesson each time. 

2) Don’t neglect movement. As a surgeon a lot of my time is spent in an operating room standing in one position, sitting in a clinic seeing patients or sitting in front a computer screen reviewing scans, blood tests and patient notes... not great! In fact that’s been my life for over 10 years. When I was 24 it was easier to do that without consequences compared to when I’m 35! Whatever the circumstances I try to move for 20-30 minutes everyday even if it’s just taking a break from screens or limited movement, my future self (and yours) will thank you! 

3) Say ‘no’ a lot more. In my 20s and even first couple of years of my 30s I wanted to please every single person, often at the cost of my own time, happiness and health. I took on multiple projects, committed to more than I had time for and ultimately this wrecked my social life, affected the quality of work I produced and led me close to burnout. I always think back to something my dad said “Don’t mortgage your happiness to pay for other people's respect”. 

Women and Gut Health... 

Women are considerably more likely to suffer with gut issues than men; higher rates of autoimmune conditions like inflammatory bowel disease, coeliac disease, even gut-brain conditions like irritable bowel syndrome... but why! 

There’s a number of factors at play here, many out of control from a biological perspective. 

Firstly the sex hormones like oestrogen and progesterone don’t just act locally in the reproductive tract, they have systemic effects and can influence both bowel function, gut motility and shape the gut microbiome. 

So during periods of hormonal fluctuation (periods, perimenopause and menopause) there can be associated shifts in the composition of the gut microbiome which could cause havoc on gut function. 

Another key player in driving gut health issues in women is the heightened gut sensitivity.

The digestive tract is highly sensitive and influenced excessively by oestrogen and progesterone.

One biological fact we cannot change is the anatomy of the GI tract. Women have longer intestines on average than men which gives them a higher risk of things like constipation! The pelvic region is more packed full of reproductive organs, the muscle mass in women is usually on average lower than in men so for all these reasons there’s a higher chance of things like pelvic prolapse which can lead to digestive dysfunction too. 

However when it comes to gut health and gut dysfunction as mentioned above, there is one consistent ally which might offer some aid... fibre. 

I don’t like the phrase “hormone balancing” but in essence, fibre has a role in the metabolism, re-absorption and levels of the sex hormones oestogen and progesterone due to how it affects the circulation of blood levels of them. 

Additionally it can influence the microbiome composition favourably which is important at certain physiological stages of a woman’s life, e.g. menopause transition and menopause. 

Fibre helps gut motility, the gut microbiome and regulating sex hormone levels.

Overdue Life Update... 

The last few months have been hectic. 

August was wiped out with a horrible chest infection. I even went to the emergency room because I wasn't getting better after 2 weeks and still had shortness of breath! Chest xray and blood tests all came back clear and thankfully I improved around week 3. 

Before then I was training hard and in a really good routine. 

Energy levels post chest infection were low but managed to keep up some movement in the form of trying to do 10k steps every day in my garden/treadmill. 

Gut also suffered somewhat after 2 weeks of antibiotics for the chest... that's why I'm more obsessed than ever about my gut because it can take several months after a course of antibiotics for the microbiome to recolonise properly. 

Early October, Shadow was unwell with a random swelling on his jaw which landed him in the hospital on intravenous antibiotics for 3 days! A stressful few days were had but he's back to his naughty self again thankfully. 

After 3 months of low activity levels, stress both physically and mentally.. I am back on track with life. 

I’ve got an exciting announcement to make next week. It’s something I never thought I would do, in fact I hate doing it... 

Back in the gym, back into a routine. 

Sometimes the low points make you reflect on how good you had it. A reminder to savour the small things, the moments of boredom. Cherish the banal, the slow pace and the periods of “average”. You’ll miss them when they’re gone. Those are the good old days you’ll look back on. 

And one last thing. Unexpectedly I've been nominated for High Quality Content Creator of the Year in the TikTok Awards!

So if any of you reading this are on TikTok and based in the UK & Ireland.. drop a vote everyday for me on this link so I can tell my parents there's a good reason I'm on TikTok: