Feel Better, Live More with Dr Rangan Chatterjee - How To Run And Walk Without Pain & How To Tackle Stress Incontinence When Nothing Else Works with Helen Hall #481

Episode Date: October 1, 2024

Today, I am delighted to welcome back my dear friend, Helen Hall, for her 3rd appearance on my podcast.    Helen is a movement therapist, running coach and pain expert with over 40 years of experience and, she is one of the best coaches in any modality, that I have ever come across. With a lifelong passion for analysing posture and movement - her clients include elite athletes - whether they be cyclists, runners or premier league footballers - but also ordinary amateurs - regular, everyday people who simply want to walk or run without pain.   Due to her incredible results, Helen is often booked up in her clinic for months, so, to help more people, she first shared her movement philosophy in her wonderful book ‘Even With Your Shoes On’. Since then, she has created a series of online courses for professionals but also for member of the public who simply want to move better and without pain. In fact, she has just launched her brand-new course: ‘A Troubleshooting Checklist For Walkers And Runners: The 6 Most Common Fundamental Movement Patterns That Seem To Need Help.’ This is her shortest and most practical course yet and listeners of my podcast, can claim 20% off until the end of October, using the discount code FBLM20. You can see all details about Helen, her book and her online courses at her website: www.helen-hall.co.uk    Helen’s first two appearances on my podcast have already transformed countless lives and in this third conversation, we continue where we left off. We touch on crucially important themes from the first two conversations - like the importance of our head position and our foot health -  but we also explore many new topics, including why walking is a super-power that affects everything from our gut health to our lymphatic system, how cultural differences influence our approach to balance and posture,  how exactly we can start to become experts in our own bodies and we also do a deep dive into stress incontinence for women - something that is extremely common and not spoken about enough. Helen shares her approach to tackling it, especially when conventional approaches have failed.   I have been working with Helen for over 5 years now and as a result, I am moving better today than I ever have before. She is someone with a high level of expertise and many decades of real world experience, but I think what I love the most about Helen, is just how passionate she is about helping everyone move more efficiently, without pain. I hope you enjoy listening. Support the podcast and enjoy Ad-Free episodes. Try FREE for 7 days on Apple Podcasts https://apple.co/feelbetterlivemore. For other podcast platforms go to https://fblm.supercast.com. Thanks to our sponsors: https://www.boncharge.com/livemore https://drinkag1.com/livemore http://www.vivobarefoot.com/livemore   Show notes https://drchatterjee.com/481   DISCLAIMER: The content in the podcast and on this webpage is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your doctor or qualified healthcare provider. Never disregard professional medical advice or delay in seeking it because of something you have heard on the podcast or on my website.

Our aesthetically driven society has a lot to answer for. I am just as susceptible to this as everybody else, but I have just learned it is to my detriment if I'm forever holding my belly in. No, I will not. I will not hold my tummy in. Because if I hold my tummy in, how do I breathe? tummy in, how do I breathe? So, so often when people are running with me, as soon as they stop holding their tummy in, they move more freely. They move more. They move better. They are faster for less effort. Hey guys, how are you doing? Hope you're having a good week so far. My name is Dr. Rangan Chatterjee, and this is my podcast, Feel Better, Live More. Today, I'm delighted to welcome back my dear friend, Helen Hall, for her third appearance

on my podcast. Helen is a movement therapist, running coach, pain expert, and quite simply, one of the best coaches in any modality that I have ever come across. Now, Helen has had a lifelong passion for analysing posture and movement. Her clients include elite athletes, whether they be cyclists, runners, or Premier League footballers, but also ordinary amateurs, regular everyday people who simply want to walk or run without pain. And she has over 40 years of experience and study. And her passion is to help people find the root causes of chronic pain and injury and help them move more efficiently. Due to her incredible results, she is often booked up in a clinic for

months. And so to help more people, she first shared her movement philosophy in her wonderful book, Even With Your Shoes On. And since then, she has created a series of online courses for professionals, but also for members of the public who simply want to move better and without pain. for members of the public who simply want to move better and without pain. In fact, she has just launched her brand new online course, a troubleshooting checklist for walkers and runners, the six most common fundamental movement patterns that seem to need help. This is her shortest and most practical course to date, and it basically gets to the absolute essence of the key movements she has seen time and time again that we could all benefit from working on. The price of this course is only £25, which is just incredible. But for listeners of my podcast, she has agreed to give a further 20% off

until the end of October using the discount code FBLM20. You can see all details about Helen, her book, and her online courses at www.helen-hall.co.uk. Now Helen's first two appearances on my podcast have already transformed countless lives. And in this third conversation, we continue where we left off. Yes, we touch again on crucially important themes from the first two conversations, like the importance of our head position and our foot health. But we also explore many new topics, including why walking is a superpower

that affects everything from our gut health to our lymphatic system, how cultural differences influence our approach to balance and posture, how exactly we can start to become experts in our own bodies, and we also do a deep dive into stress incontinence for women. Something that is extremely common and not spoken about enough. And Helen shares her approach to tackling it, especially if conventional approaches have failed. Helen is someone who I myself have been working with for almost five years now, and I'm moving better today than I have ever done so before. She is someone with a high level of expertise and many decades of real world experience.

But I think what I love the most about Helen is just how passionate she is about helping everyone move more efficiently without pain. Helen, you've been on the show on two previous occasions game-changing conversations for people thank you so much in our first conversation I asked you if humans were born to run and you made the case that they are so today I want to ask you about walking. Are humans born to walk? And if so, why? Well, I think that our movement development speaks to us of the goal from blob to upright on two little feet, whether we like it or not. So all of our initial reflexes gain us the stability, the strength, the organisation in terms of movement, the complexities of movement to be upright in the field of gravity

with our precious commodity, our head containing all of the raw materials in order to orchestrate all of this incredible movement far away from our two little feet, which are innately unstable because there are so many joints down there. So if we're not born to walk, I'm not quite sure what else we would be born to do. But walking has more gears than one. We can slow walk, we can pigeon step, we can fast walk, and then we can break into a run. So for me, putting one foot in front of the other is what humans do and what humans do best and what they've done for millennia best. One foot in front of the other, as fast as you want to go for as far as you want to go.

Yeah. I think we've very much undervalued walking, haven't we? I think that exercise, the word exercise, words are very powerful. And people feel as if exercise needs to involve much more than just putting one foot in front of the other, keeping one foot on the ground, so i.e. walking. I think that if we just called it movement rather than exercise, people might attach a little bit more value to just the action of walking. If we think about what we do habitually. So we might go to the supermarket, but search for the parking spot that's closest to the entrance door, instead of maybe parking the furthest away, walking to the supermarket, pushing the trolley around and then having to walk with the trolley loaded now back to the car. That adds value, movement value to the day because of all of the effects of walking. Walking is a whole body movement practice. Every single bit of you is moving. Even the head is moving, but you just don't realize it because the eye reflexes

are ironing out the bobbly nature of the head movement. But it's the top of the body is moving because of the arm swing. The bottom of the body is obviously moving because you've got putting one foot in front of the other. There's a twist in the middle, which is an internal massage for your internal organs. And because it's loaded in the field of gravity, whilst you're not having particular impact forces, you're still having your body weight impacting. When you leave the ground and run, you've got more than your body weight impacting, but there is still load and impact going through the joints, the bones, the muscles. Yeah. I mean, as you said in our first conversation, running is a fundamentally human movement. Walking is also

a core human movement. And I think that many of us, myself included a few decades ago, I would say, would neglect walking, right? And if I think about why has walking been neglected so much, there's quite a few reasons come to mind. First of all, I think for many people, they look at movement or exercise as it's commonly known as a way of burning off calories, right? So everything around health and well-being or many things for many years have been boiled down to how many calories are you consuming and how many can you expend by exercising, right? So when we look at walking through that lens, I think a lot of people go, well, you know, I don't have long. I can't be faffing around walking. I need to get in some

intensity and get moving and running and actually skipping and get my heart moving. So I think that's one thing. I think another part of it for me, and I definitely want your perspective on this, is that we don't think enough about the innateness of walking within us, about what it does. Things that I've learned from you, this contralateral movement, you know, the kind of twist in the body as you walk, you call it a self-massaging... We are a self-massaging, innately self-caring, self-healing organism. Yeah. And that, I think I wanted you to expand on that because people look at walking, okay, well, how many calories does it burn? Well, we forget that actually it's meant to be really efficient. It's meant to not burn many calories at all. That's the goal of walking. It doesn't mean it has no value. It's good for your, as you say, your tendons, your ligaments, your brain function. And even what you said about self-massaging

and a theme throughout today's conversation is going to be how the whole body is connected, Helen, right? Because I think that really speaks to your work and what I try and do with health on the show each week is this idea about self-massaging. So many people have gut problems. So many people struggle with constipation. And they don't realize that actually walking regularly

can kind of compress and sort of massage your guts. So people think that a venous return, a strong pump of the blood back up to the heart from our hard-working, you know, below the knee area, the calf raises are going to pump that blood back to us because we're a little bit of a giraffe. You're particularly a giraffe. So our heart is way up here and our hardworking legs are below. So we need a strong pump to draw that blood back up. And people think of calf raises. So they're

going up onto their toes to contract the calf tissue. And actually, for a very long time, it's been known that the strongest venous return, the strongest draw on the venous system is actually dropping the heel into the step, i.e. walking. the strongest venous return. So you are getting the circulation action through just popping the heel into the step, rolling through. It's an innately human movement. Yes. We have to do it. And I think a lot of, I mean, I'm trying to think back now to when we learn about this.

I mean, obviously I learned about this at medical school, but if we go back, I'm pretty sure people who do GCSE biology probably learn about the fact that the heart is a pump. It pumps blood out all around the body. And of course, the extremities, the bits furthest from the heart, especially me with my long legs, are your feet, right? But there's no pump. There is a pump, but there's no kind of pump from the body, as it were, to return that blood back to the heart. So the question is, how does it come back up? And obviously people have ankle swelling. They have all kinds of issues when their venous return is not working well.

And you're basically saying that walking is the most powerful way of keeping that venous return going. Yeah, rolling through from the heel to the toe. You can't micromanage it. Don't be thinking about touching down and rolling around the outside and coming off the foot in a particular way. It's all happening so fast, you can't micromanage, you'll mess with timing. But it's just allowing a walking action to be part of your movement daily practice. Don't underestimate it because your lymphatic system is entirely connected to your venous system. There's the amazing anatomist who takes the skin off to reveal what is happening just underneath. And he's dissected to arteries

and veins. And you can kind of see the form of the person just with the motorway. It looks like a roadmap of arteries and veins. When he dissected to the extent of the lymphatic system, you could see facial features. The lymphatic system is so vast and so fine. And so with no skin on, you could literally see the contours of the person's face just with the lymphatic vessels being visible underneath the skin. And what does that tell us? That there are so many lymphatic vessels. It's a vaster network than the cardiovascular system.

Okay. So a lot of people may not have heard of the term lymphatic system before, right? They might have heard of cardiovascular system, all these blood vessels and blood flowing through them to deliver oxygen around the body. What's the lymphatic system for? So it's for metabolic waste fluid. So it collects everything that you have used or is broken or is dead cells, broken cells. And the lymphatic system is responsible for gathering all of those up, organising them and eliminating them. And walking is also good for the lymphatic system. Well, the lymphatics are attached

to the action of the venous system. So if the strongest venous return known to man is dropping the heel into the step in the walking action, then it is the same for the lymphatics. Walking is the thing to help the lymphatic circulation stay optimum. It optimizes it. So we are born to walk. It would appear so.

Well, let's just really dive in here, Helen, It would appear so. Well, let's just really dive in here, Helen, because I want to upgrade the way people view walking. And, you know, to share my own experience, I've worked with you now for, when was it? It was probably around January 2020. Yeah.

It was literally two weeks after Chris Evans challenged me to do the London Marathon, right? So I remember it well. Four and a half years later, we're still working together and I'm still improving my movement. I've learned many things from you, which I've shared on the first two podcasts. But I'd say one of the most important is that I really understood how important walking is. And I have made changes in my life so that I walk every day, right? Brilliant. You know, because I can see how important it is for my running, for my general health,

for my lymphatic system, for my cardiovascular system. It is who we are as humans. You know, not many animals, if any, I think, can walk like humans. Is that right? Nobody walks like a human because we're the only upright mammal that has the twist in the system that enables us to move within the field of gravity rather than having to bounce in and out of it. So we do, when we're running, we leave the ground. So there's a degree of bounce. But when we're walking, when we ambulate, we're pretty steady. We're twisting within the field of gravity, which is more efficient. And if you were to sit in a cafe in the middle of London, okay, and with all your decades of experience of helping people get out of pain, move more efficiently,

walk better, run better, faster, and all those kind of things, if we take the state of Western society today, right, and you were to sit in central London in a cafe and you were people watching, what would you see or what are things that you commonly see when people are walking by in terms of what they're perhaps not doing as well as they could be doing? Oh gosh, what a fascinating question. I think what I would see is heads down, eyes down, eyes looking at things rather than just seeing everything. So peripheral vision not being present, just looking at stuff. And I don't think people are aware of their movements. I think we are not aware of how we're moving until something goes wrong. Then we become aware. So the people in pain will show themselves to be in pain because there'll be maybe a facial

expression or an avoidance of a certain area. So you'll see asymmetry of movement. You'll see timing off. You'll see all the things that for me, I feel are born of a collective. We're not shown at any point in our lives to become aware of our movements. We just walk and then we break into a trot. And then at some point, for the most part, sadly, people stop running. When did that happen? When did we stop running? When did we stop making ourselves dizzy? When did we stop playing? And then the demise starts because you stop noticing how you're moving because you're moving less. Yeah. The whole use it or lose it, right? If we're not using something and giving our brain the

stimulus, then it's going to start downgrading those things because it feels it doesn't need them anymore. I think we all recognize what you're talking about. We recognize it in ourselves. We recognize it in other people, this idea that people are walking around now with their heads down. And instead of having that wide peripheral vision, that relaxed, low stress state,

people are often walking focused with concentric vision on something on their phone, for example, right? Yeah. So let's unpick all of that. I guess if I think about our first two conversations, and I know you've been drowned in direct messages, as have I since then, because people have found them so useful. I would say two of the most helpful things people have reported back to me,

and I think you, was the idea of having your head position in the right place, basically having your head on right, as it were. And you explained in both of the conversations, the impact when our head is not sat and perched on top of our rib cage and our pelvis, right? And many people will recognize that they have head forward positions. So many people have got in touch to say, since you help them become aware of that and they put their head on right,

all kinds of pain has gone without medication, without seeing a therapist. They've managed to use that awareness themselves, right? Hip pain, knee knee pain back pain all kinds of things have gone the second one i think which has also been really helpful for people is foot wiping yes right the simplest things yeah so people just you know for want of a better term waking up their feet every day which have gone to sleep because of the way we live now, cushioned shoes, socks, not being barefoot much, right? For people who haven't heard those first

two conversations, there's a lot there, right, for people. So let's just zoom out and go, one of the central things I feel we want to get across is that the whole body is connected. Yes. Right. And if there's, as you said before, the site of the symptom is not always the site of the problem. Yes. Right. Okay. So let's go back to what you observe in a London cafe. Head forward. Does it surprise you that people have said that all kinds of different pains around their body has got better just from addressing their head position? No, it doesn't surprise me at all, because I've been in clinic for too many years and measured it for so long, I see it unfold in front of me. So if you consider your head as a Christmas decoration and you put your Christmas decoration close to the trunk of the Christmas tree, doesn't matter how heavy that Christmas decoration is, that branch is going to be fine.

fine. So you haven't changed the weight of that Christmas decoration, but the further you send it along that branch all the way to the last little tip, it influences more and more and more the branch of that particular tree. So if we consider the Christmas tree decoration right next to the trunk on the branch. And the branch is not bothered. But now you're further away from the trunk towards the extremity of that branch. It's going to start to bend the branch. To the extent of its weight, it will be more and more and more and more. And it's not really very linear.

This change in effective load isn't particularly linear. So when your head, the Christmas tree decoration, is right next to the trunk at the end of the branch, closer to the trunk, it's about five kilos, roughly, an adult human head. Its effective load is five kilos which is pretty heavy which is heavy and but our amazing bodies are well versed in managing that mass managing it from one foot to one side to the other then you shove that christmas tree decoration 15 degrees further along the branch now that christmas tea direct christmas tea decoration easy for me to say is effectively on the trunk of the tree now 12 kilos its effective load is okay it's more than double so you have a

five kilo weight when we're talking about the head here basically and you're saying if it's 15 degrees forwards, that five kilo weight effectively becomes 12 kilos, right? So if any one of us have a 15 degree head forward posture, and you can explain in a minute how common that is and how much you've measured that, right? We're looking around seven extra kilos. That's a lot of weight just to go around. We're weight training things that we shouldn't be weight training when we walk. So I guess it's not surprising then that that would cause pain. But some people say, okay, but if it's forward, presumably I'll just feel it on my neck, right? But how does that affect my knee and my back? Yeah. So there's no absolutes in movement. You can't, I can see a forward head and I would, if somebody is in pain, I won't be able to predict

where the pain is. It could be in the neck. It could be in the lower back, where the lower back is the area that's taking the most strain. It could be the knee, it could be the sole of the foot with plantar fasciitis. It could be anywhere. You can't look at a frame, any asymmetry in the frame, whether viewed from the side or viewed from the front or the back. You can't predict where the pain is. What you can do is then understand when you know where the pain is, you can then understand, okay, well, that's a compressive pain born of too much load, or it's a pulling pain born of the load being in an unhelpful place. So the importance of the head position, people would say, well, I have no pain. You know, there is no pain. So, what do I care?

Well, from my point of view, it's only efficiency. So, you are moving less efficiently than you could do. Things could be easier. You could go further or faster or both with your head in a better place. And you've got to, well, I'm not in any pain, but it's not just pain, is it? Our whole movement system, our whole body isn't designed just for being in pain or out of pain. You need health for your internal organs. And if your head is too far forward, that is bowing. So the trunk is being bent over, the branch is being bent over,

and that is squishing your internal organs. So you have less circulation around those organs that we rely on to do all the things that are invisible. Movement is visible on the outside. Internal organs are invisible until they complain. Yeah, this is such a key point, right? Are we looking at our movement, our ability to move, or our inability to not move only through the lens of pain? Because that's a problem. Of course, pain... It's a limited view. the lens of pain because that's a problem of course it's a limited view it's a limited view of course nobody wants to be in pain and i think for many of us we get away with and tolerate poor movement habits and patterns until we get pain because until we get pain there's no motivation for us to change things

we think there's no feedback you're not getting feedback because you're not aware you're not even thinking about how you feel you're just oblivious to everything until something goes wrong until there's pain until your gastric system doesn't work well. And then it doesn't mean that when you go and see the physio or the doctor or the osteopath or you or whoever they're going to see to help them, it doesn't mean just because the pain started four weeks ago, it doesn't mean that the problem started four weeks ago. No.

The problem could have been going on for five years. You were just getting away with it. But maybe the stresses in your life got to the point where you tipped over your threshold. Now it manifests in pain. Yes, exactly. Which I think is a key point for people. And that tipping point could have been more movement. It could have been less movement. It could have been a stressful time in your life. It could have been, you know, food poisoning. It could have been a really bad meal that you ate. Bereavement. Yes. Divorce. So pain is, people say, it's so commonly said, but it's so true. It's multifactorial. It is not a thing. It doesn't stem from a thing. We're not

so fragile. The one little thing throws the system out. Yeah. resilient until, okay, now we're struggling. So let's unpick why we are now struggling. It won't just be a thing in my experience. And I think another key point there for me, which I really want people to understand is that, as we said, it's not just about pain. Although putting your head on right will help you potentially with many of your pains right or you won't know what it will help with until you sort it out yeah yes yes that's a good point how much of what is happening in my body is simply attached to the position of the head. Just taking a quick break to give a shout out to AG1, one of the sponsors of today's show. Now, if you're looking for something at this time of year to kickstart your health,

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the four pillars of health as I call them, until I've addressed them. Yes. So I cannot say that this person has depression yet. They may have symptoms that make me think that those symptoms are consistent with a diagnosis of depression. A, I'm not a fan of labeling things anyway, because I think those labels become our internal beliefs about ourself, and I don't find it that helpful, even though the medical system kind of wants you to label what a patient has. I've never really liked that. But the amount of people I've seen with joint pains, stomach issues, mood issues, that when you help them go to a whole food diet, move regularly, like walking 30 minutes a day,

have good circadian biology, right? Get natural light in the morning, focus on a regular sleep time, six to eight hours of sleep per night, something like that, and help them manage stress. I feel that's the equivalent of your head position, right? Get those things right, then let's see what's left. Yes, sometimes there's stuff left, but sometimes there isn't. Sometimes everything goes once you start living in harmony with your biological reality. Yes. And there are cultures across the world where head position is an integral part of their movement development. And I feel it's lacking in this culture in Western civilization. So people have told me that, oh, well, our backs aren't meant to support our body weight. They're not designed to support our body weight.

That's why we all have back problems. And I think, well, actually, we don't all have back problems, actually. And if you speak to the cultures that carry things on their head, they don't have back problems. And we can't say it's because, because again, it'll be multifactorial. But they are aware of balance and posture all the time. Otherwise, things will fall off. So there's that sweet spot of where can this bucket of water or whatever it is on the head, which is so much easier to carry centrally than it is in one arm or the other. There's a place where it can sit there and stay there, and there's a place where it won't. And any other and there's a place where it won't and any other

place other than there and it won't and even three-year-olds are balancing little teacups of something on their head to practice and it's not about deportment it's about the innateness of our structure that if the head is perched effortlessly we can move underneath it in a less restricted way in a more elegant way. Yeah, as you describe that, I just think back to my childhood summers, six weeks spent in India, and I can still remember just being on the streets of Kolkata in India. And you'd see women usually in saris, walking barefoot, and just carrying water big just water effortlessly on the head and if I think now I just think they just had something I didn't appreciate at the time

but the straightness and this um just almost like a majestic posture it it's always, I find, stunning to watch when people carry things on their head. In our civilization, it tends to be in the circus acts where two heads are joined and one guy is upside down on top of somebody else's head. And even that is incredible. But this is day-to-day stuff. Of course, their posture is going to be great if you have to carry water on your head each day. Yeah. It's in your interests. It's not even in your interest. You simply have to know where your head is. Yes. In our culture, you don't. And the problem, I feel the problem, we're so getting wrapped up in carefulness. Oh, be careful of that. Oh, be careful of the other. And to, we would, if somebody started talking about,

oh, put things up on your head, oh, be careful of your neck. Well, you obviously don't put straight away loads through your head, but your neck has loads of information channels which give us awareness of every part of our body through our neck. So we need to, in my experience, we need to start to feel and to think a little bit more and just become a little bit more aware. And then the person, the most important person to benefit

from this would be you. Yeah. And what you said before, I think it's also really interesting about you will move faster and more efficiently, right? Many people might be listening to this and they're not in pain. Yes. But they like their Saturday park run or their quarterly 10K, right? And they're always trying to get faster. And often faster means more training, more speed work. And we're definitely going to get to that. There's been a lot of questions about that, Helen.

But in the context of this part of the conversation, again, people may not know how fast they can get if they have a head forward posture until their head is on right. And they will just start to move more efficiently. You've measured that. You mentioned 15 degrees before of head forward posture would turn a five kilo weight of your head into 12 kilos. 15 degrees sounds like quite a lot to me. How common is that? And what ranges have you measured in your clinic? It's ridiculously common. 30 degrees is ridiculously common 30 degrees 30 and you said it's not linear no right so 15 15 degrees is making that five kilo weight 12 kilos yeah so the fact that it's not linear means that it's not that that will go up another 7 to 19 kilos will it no it's not linear so they're the very clever scientists have done the maths for us

and thankfully, so 30 degrees is roughly 18 kilos. So you go from 5 to 12 to 18, then it goes, so 45 degrees, which I do measure, it's not common, but they're in a world of trouble. 45 degrees of forward lean of the neck is roughly 22 kilos. And then 60 degrees is 27 kilos, roughly. 27 kilos. Helen, I'm just thinking back to my... People are epically strong. They're stronger than they realize. I'm thinking back to patients that I've seen over the course of my career and thinking how many cases of headaches and neck pain have come in when nobody has assessed the head position.

Because if you just think about that through the lens of the weight that your neck muscles will have to carry how do we know and the pressure at the base of the skull because unless you are looking down at the floor you're going to have a forward posture a more rounded posture but then the head tilts back a little bit so you can see where you're going so then you've got pressure at the base of the skull yeah which adds to the complication of things like headaches. I know, it says Gareth in the corner there, just adjusted his posture as we were talking, bit straighter there, head position. That's what happens when we hear this stuff, right? This stuff kind of happens. Awareness, yeah.

Awareness, right. Okay, so Helen, I put it on my Instagram that you're coming back on, so Helen I put it on my Instagram that you're coming back on and does anyone have any questions oh wow we got hundreds okay now we have grouped a lot of them together I'm not sure we're going to be able to cover them all I hope we can but there's all kinds of things we're going to cover training advice things to get people out of pain stress incontinence for women all kinds of things we're going to get to but let's just stick at the moment all kinds of things we're going to get to. But let's just stick at the moment with head position, right? We're going to get to foot wiping because I said that these are the two things that have really moved the needle for people. Many people heard those conversations that bought your book or got some of your online courses and

they've learned how to put their head on right and they've experienced the benefits. Quite a few people have sent a message saying, listen, I totally get it, I want to, but what happens if I have a forward head posture and I have done for many years and all my ligaments and tendons are tight, so I can't put the head back. What do you say to those people? That's a really good question. So the first thing you do is you don't force anything. It is, we need to be kinder. So when we become aware of the problem, we can't just wade in and just fix it immediately. Sometimes you can, and sometimes you have to just be a little bit more patient and a little bit kinder. You start the process through understanding, well, why is

my head over there? Why am I stuck in this posture? What am I doing day in, day out to reinforce this and what aren't I doing to help myself get out of this posture so it's some people can just because they had no idea about it they find that place where they have maximum head rotation and all is well marvelous remind ourselves of that head rotation piece because I think it was so helpful for people yeah Yeah, so if you jut your head forward and you rotate your head to look over each shoulder, you have a certain range, whatever that range is. Don't force it, just end your movement and come back to the middle again. So we intentionally are jutting our head out

into a posture we don't want and trying to rotate our head to each side and just paying attention to how far we can go. Okay. And then you just, you find the most wibbly wobbliest place for your head. So if I go, if I've jutted my head forward, I have not much in the way of movement.

I feel a bit stuck. So then I'll just send it back a little bit more and I'll have a little bit more movement and then I'll just send it back a little bit more and I'll have a little bit more movement. And then I'll settle myself in my most wibbly wobbliest place. And then I'll have maximum movement. And you want the head should be there with maximum movement. Yes, because then that reflects down the system. So if you're standing up when you do that, you'll find that it's not just your head that has more range of motion rotationally. It

will also have more range of motion with tilt. The shoulder girdle will tilt more, the shoulder girdle will rotate more, the pelvic girdle will tilt more, and the pelvic girdle will rotate more. Or from your head position, which also explains why people were saying hip got better, knee got better, you know, shoulder got better, because the head being in the right place ripples down like a chain throughout the entire body. Absolutely. So you are maximising your movement potential when your head is in its perfect place. And sometimes it doesn't have to look perfect whatever that is if it's better you will get more if it's less forward than it was you will gain your whole system will gain to the degree you can come back so we're not looking for perfection we're just

saying where you currently are now if your head isn't perched on right and if you're getting an increased range of motion in your neck when you start to pop it back, it probably means it wasn't on as well as it could be. Just practice there. Yeah. And you will notice some things, and then some people will find themselves continually slumping. So when they're thinking about it, they can access a better position. But when they're not thinking about it, they collapse again. So the innateness of a structure that has maximum movement potential, it seems to be stuck somewhere in a corner. It's not immediately available. So then the question is why? Well, why if you know all about it, but you can only have it through awareness, where is the innateness? So then, so I've talked about

lying on your back and using the skin contact to find where your head is. That was in our second conversation, yeah. And what you can also do is explore a little bit further down. So if you imagine where the necklace sits on the back of your neck, so where we put the Doris sticker when you're being measured, but it's where a necklace would sit at the back of the base of the neck. Just, you mentioned Doris there. For people who didn't hear the first two, just briefly explain what Doris is. So Doris is my German technology,

the most advanced motion analysis technology in the world. She is more accurate than an x-ray measuring in three dimensions in movement up to, she has her limitations even Doris, up to 30 kilometers an hour and nobody's made it anywhere close. So I have my expansive, I can't look at the problem, I can only view the person as a whole. So I'm looking at the whole, Doris is measuring everything and she gives me the data as if I'm looking at this and that and the other. So together, we get a little bit more joined up thinking just i think that's a key point are you been teaching people coaching movement helping them out of pain for decades but also since you acquired doris um you have an insight into movement which very few people

on the planet have because of that technology so So you can make these changes with people. Let's say foot wiping, for example. You can get someone with tickly feet and stiff feet, get them foot wiping for two or three minutes, then get them back on Doris and measure and see what has changed. So you can directly go, yes, but when someone foot wipes, when they've got A, B, and C, suddenly their stride length gets bigger. They're using their feet more. They're walking faster for no more effort, et cetera, et cetera. Okay. So I just wanted to make sure people understand what Dora says. So you were saying about the necklace. So you're lying on your back and you're imagining where that place is. And you can even use your finger and tap where your necklace might sit or even where your necklace is sitting if you have one on.

And then all you do is gently, just gently, send that point down to the bed. So you're lying nice and relaxed. You imagine it descending down to the bed. And I was watching you and your body responded. It wasn't just the neck that moved. Did you feel the base of the rib cage come up? And did you feel your chin drop down? So it's almost like you've got a button at the base of your breastbone, where your ribs kind of start to flare from the middle. It's almost like the chin and that button there come together as you send the base of your neck down to the bed gently.

Now, you do it always within a pain-free range of motion. You never force anything. And what often happens is the head doesn't move or the rib cage doesn't move. doesn't move. So then you've now identified something really important that whilst you have an awareness of the base of the neck, it's not talking to either the head or it's not talking to the rib cage or both. So then with that new information, you can then start to join the dots together, knowing that if all things being equal, when the head talks to the neck spine talks to the ribcage spine, there's a communication that should result in a spinal extension, which is the head in the right position relative to the ribcage to the pelvis.

Yeah. Okay. So we all need to have our head on right for a number of reasons which we've outlined. If when you do that, things get better, great. If when you do that, you're still struggling and you don't quite think that it's working the way it should and you feel that you're restricted, you're saying, okay, line of beds, do the exercise you've just outlined see if you can get that point where the necklace is back into the bed

and if at that point rib cage you know the bottom of your breastbone neck if these things are not moving fluidly it indicates that there's a block in the system. Yes, a lack of connection maybe. And you've now just become aware of it. So even that awareness alone is helpful, isn't it? Yes, because now you can start to self-solve. You have found a disconnect between the neck and the head and or the rib cage. So the answer is then, so you keep sending whichever part of your body didn't move. So say the head didn't tip forward, say the chin didn't tip forward. You then join together, this is a way, but it commonly works.

You then join together. This is our way, but it commonly works. You join together the movement of the neck down to the bed with a little gentle head nod and just move in and out of that gently and slowly. If it was the rib cage that didn't move, the button didn't come up as the back of the shoulders went down to the bed with the neck, which would seesaw the base of the ribs up. If that didn't happen, you can just help a little bit, just help the connection. And then when you've done it a few times and it feels a bit smoother, don't do loads and loads. The brain will get bored. It'll switch off and it'll start thinking about a shopping list. So do a few. As soon as you think, well, that feels a bit smoother,

go back to the initial test. So that's your marker for change. So you just relax without doing anything apart from sending where the necklace was down to the bed. See if anything is now moving of its own volition. Yeah. Okay, great. So that's progressing it on for people beyond putting your head on rights for those people who are getting stuck. Yes. Okay. So we've talked a lot about head position.

Let's talk about foot wiping. Yes. Because I think then when we talk about these different pains that people have written in with, I think it will perhaps be helpful to frame it around both of those. Now, the question that's just come to me is, I've realized that the two or two of the practical interventions you have mentioned to people on the last two podcasts we did together that have had a huge impact are to do with the extremities of the body, right? The head and the feet. Before we get into foot wiping, is there something we can learn from that, that getting your extremities right can solve a lot of problems?

Yes. Topping and tailing, I call it. And because it feeds into the system. The brain accesses the information from our extremities, feeding into the spine, the spinal cord, the brain, everything on that central axis, in order for the brain to organize the movement. It's a very complex business movement. We don't understand it because we don't yet understand the brain. And the brain is moving us. So until we fully understand the brain, we don't understand movement. So there is no certainty of anything really, there's only experience and you are your best marker for all of your experiences and your knowledge of your own body. So whilst there's lots of research out there, which can be very helpful, if it didn't work for you, if whatever

research you read and you tried and it didn't work for you, your body is telling you something. Your body knows best and we still don't know everything about the body. So that is by a torturous way, I feel, of saying don't lose sight of your sixth sense. Don't lose sight of your innate knowingness, your gut feeling that you're trying this and this and this and you're not getting, your body isn't receiving the information in the way that you might have hoped it would have

or you might have been told it would have or you've read that it would have. We still don't understand it all. So we have to go, okay, well, it worked for my friend, but it didn't work for me. Let's explore a little bit more and cast our web a little bit, our sticky exploration things a little bit wider. Yeah, I love that point.

I'm so passionate about that, that we actually know at our core what is best for us when it comes to our health and wellbeing. And I feel we've outsourced our own inner expertise to external experts far too much. There's nothing wrong with listening to, in inverted commas, experts and learning from their experience and their research and their knowledge. But also you have to put it through your own filter and go, is that for me? In the world of running, and in many worlds, frankly, there's a lot of different running techniques out there that people teach.

One thing that has always appealed to me about your approach, and I remember this very early on when we were working together, when we started working together, is that you said something like, well, I don't have a running method. There is no Helen Hall running methods, right? That would be, first of all, really, really arrogant is what you said to me. And secondly, it's like that the whole idea is that, no, run in a way that is most efficient for your body. And certain techniques work for certain people. That's why they became techniques. But it doesn't mean they work for everyone. Yes.

And might I just say that you express what I was trying to find the words for so beautifully that when I listen back to this, I'm going to write it down. So thank you for that. Um, yes, there is, for me, we need to let our body run us. And if it's uncomfortable, we then need to explore why that might be. Is it because walking is uncomfortable for us and we're taking that same body with us into our run? Is the root cause of the running problem actually within the walking body? Yeah.

Not just in the running body. And you're just getting the symptoms either during or after a run because now you're adding impact into the equation. This is something I've learnt through my work with you, Helen. And you've shown me on Doris and it's been so clear that some people run better than they walk. So many. Right. This is, I think, going to be brand new information for people. I think a lot of people think that I can walk fine. It's when I run that there's an issue. Perhaps you could just elaborate

and explain why it is that some people are seemingly better when they run, but that doesn't mean that they shouldn't neglect their walking. No, quite the reverse, because the problems are stemming from the walking action, which is more complex than running. So neurologically, the most complex thing we do is walk. So all of our initial movement is organizing the brain's development so that the brain has an innate knowing of where everything is, where your head is, where your left arm is, your right arm, where the front is, where the lower half of the body is, where the back is. We need to make this neurologically most complex thing of one foot in front of the other whilst one foot stays in contact with the ground walking. The arm and leg are on opposite sides of the body. So the lead arm and leg are on opposite sides of the body. One limb

is in the upper body. The other one is in the lower body. We have a twist through the system. So we have a top, bottom, front, back, left, right on the diagonal. This is astonishingly complex. And we can't make a robot do it. We can make a robot run like a human. We can make a robot do all sorts of gymnastic stuff like a human. But if you see a robot walk, they walk robotically because it's so complex, we haven't fathomed it. It reminds me, Alan, of a conversation I had with this elite cyclist, James Golding, maybe two years ago or so on this podcast. And he's got an incredible life story. He's had cancer twice. He's beaten the cancer, I think in his words, and has done some incredible cycling feats around America and the world. But I always remember something he said to me. He asked me in

that conversation, what's the hardest thing you've ever done before, Rangan? Now, I knew the answer because I'd seen his TED Talk, right? But essentially, the answer was learning to walk. Because he had lost the ability to walk. I think he was in hospital for months, lost a ton of weight, really, really seriously ill. And he had to teach himself to walk again. And he said that was the hardest thing he had ever done. And he was just using that as an example. And it really fits in with what you just said, which is that walking is neurologically really, really really difficult we can't get robots to do it yet right but it's something we spend a lot of energy as children as babies as toddlers you know falling over falling until we can actually do it yeah and there's a beautiful saying that that speaks to it, speed hides need.

So if you run, you hide the fact that there are limitations on restrictions within the system, within the walking system. So if we go along with the premise that humans are designed to travel on two feet, one foot in front of the other, at different paces, different gears. Then speed, leaving the ground and only landing on one foot, gives freedom within a system that otherwise, when one foot has to stay on the ground and you have to have that twist through the system and you have to have the contralateral limb movement,

it is saving us from that. It is, you can, it's ironing out or eliminating the problem of the top-bottom opposite limb contralateral movement. So do you see people who struggle with their walking, they have pain, they have limitations, but when they run, they feel way better. Vivo Barefoot are one of the sponsors of today's show. Now, I am a huge fan of Vivo Barefoot shoes

and have been wearing them for over a decade now, well before they started supporting this podcast. I've also been recommending them to patients for years because I've seen so many benefits. I've seen improvements in back pain, hip pain, knee pain, foot pain, and even things like plantar fasciitis. And contrary to what you might initially think, most people find Vivos really, really comfortable. But I have to say, especially at this time of year, as the temperature is starting to drop, their winter boots are absolutely fantastic. And I myself am really enjoying wearing their brand new Gobi Warm Lined Winter Boots. Now, as well as adults, I think they are a fantastic option for children. And I really hope that in the future, more and more children

start wearing barefoot shoes like Vivos, as I think this can prevent many downstream problems in the body later on in life. And remember, whether for your children or yourself, if you've never tried Vivos before, it's completely risk-free to do so as they offer a 100-day trial for new customers. So if you're not happy, you just send them back for a full refund. If you go to vivobarefoot.com forward slash live more, They are giving 20% off as a one-time code to all of my podcast listeners. Terms and conditions do apply. To get your 20% off code, all you have to do is go to vivobarefoot.com forward slash live more. yes the problem is then after the run then it hurts again so so people can be in pain walking run without pain but then be in pain walking and they think that the uh the running is causing the

pain but they don't want to stop the running because they feel so good with the running is causing the pain, but they don't want to stop the running because they feel so good with the running. They love it because it gives them freedom from the pain because their body is moving more freely. It's less restricted. And the problem originates in the restriction in walking, but they haven't, they don't notice that there's a restriction in the walking because they've connected the problem to the running. So the person will come and I always ask what their goals are in clinic. So their goal, I want my running assessed to find out what I'm doing wrong with, what is wrong with my running? What am I doing wrong with my running?

And they're doing nothing wrong with their running? What am I doing wrong with my running? And they're doing nothing wrong with their running. Their running is beautiful. This is, in my experience, there is no forethought. There's just the thought of, oh, it's connected to the running. That's the end of the thought process. The blame is being pointed at the running because there's pain afterwards, whereas the running per se isn't the cause of the problem. They can't believe that they're running beautifully. They can't,

when they see themselves run, they can appreciate that, oh, actually, that looks a hell of a lot better than when they were walking. And when they were walking, they can see the awkwardness or the lack of coordination

or the fact that one limb is moving more than another. So one arm is swinging more than another. They can then see it and appreciate it. But it's not even existing when they're running. They pick their arms up out of the equation and that asymmetrical arm swing just disappears. So let's say someone is not in pain when walking, right? Because if you're in pain, that suddenly immediately will draw your attention to things. But let's say someone has an incline that they're not walking efficiently.

How can someone listening to this right now assess next time they walk whether there's an issue or not? Well, if we all did a little checklist, if you all did a little MOT in what, in my world, if we backpedal a little bit, I started creating course content on how to observe. So observational skills, because it seemed to me that people say, well, how can you see that? And I don't even understand how I can see that. I just see because my eyes are telling me stuff. But maybe I've been doing it for so long, for as long as I can remember, I've been watching, people watching, not stalking, just... You're fascinated by movement.

Yes, yes. And it's not to criticise anybody. I'm trying, I'm not judging, I'm thinking, oh my goodness. So, for instance, in the London Marathon, you're watching all these amazing people out there giving it everything. And all you can do is applaud, doesn't matter what it looks like, everybody looks different. And so there can be no way so you know totally there can be no way to move it's just is it more or less efficient so it is um so when i'm looking at people moving it's with curiosity and always wow my goodness me you can do that even though I can see that that arm isn't involved. So you're actually moving with three limbs rather than four. That's brilliant, but we can make it easier.

Let's see if we can make it easier with finding the reason why that arm doesn't want to move, as a for instance. doesn't want to move as a for instance. So the people watching led to me having this idea of creating some to help people discover what to look for, how to see. How they can self-observe. Yes. How do you see? And it got a bit, it got too big and overwhelming. So then I thought, I'll make it smaller, which is how I came up with the pilot course, which was what am I seeing all the time when, when everything else hasn't worked? So when every single mode of therapy out there has worked for enough people for it to be a mode of therapy. So it stands to reason. So there is a reason for us all to be here helping people. And when the, whatever that person is, has as their standard on their radar, whatever that person has as their standard on their radar, whatever that person has tried

because they feel that's their first go-to option. When that hasn't worked, the question is, it's not about the person helping them being no good. It's about, well, maybe that wasn't the tool for the job to help you. So it's, okay, can we cast our web, our sticky web of investigation a little bit further

to find, well, what tool is going to help? Because what is missing? And through all of my years of work, always being challenged by Doris, always Doris keeping me on the straight and narrow. It's not about my opinion. My opinion doesn't matter. What we need is the truth of what I'm seeing,

because it may be that it looks like a side bend to the left. And it isn't at all. That person can't side bend to the left in a million Sundays. And Doris shows you that. And the story shows you that. Yes, yes. And I've had osteopaths stood next to me saying, there was one time it was her partner, and she said, if I hadn't have seen it for my own eyes, I wouldn't have thought it was possible.

So I am seeing what nobody else, or very few people are seeing. So I know it's possible. So I have all possibility going on in my head. And what I continually saw was, okay, but they haven't got the most basic elements of movement. They haven't got their ducks in a row, as it were, before they even start to think about more complex movements, like weight-bearing in the gym, which would be on top of not having their ducks in a row, on top of a movement pattern that didn't exist organized in their body, they're now adding strength training to that lack of foundational movement.

We've got to talk about strength training and what it does to us when we have unstable foundations or what it could potentially do, right? So let's just back up a second, right? So we're talking about the difference between walking and running and how some people run better than they walk. But they attribute their problems in life to the running when it may not be the running. It could be the running, of course, but it's not always. Right. And then we're talking about self-observing. We've already mentioned head on neck, you know, and the exercise they can do on their beds, just to start becoming aware of how do I walk? Where does my head sit? These are things that are brilliant to build up our self-awareness to help people more because you have had this unique insight through Doris,

this kind of incredibly advanced motion technology software, right? And I know because you're booked up for months, because you help people get out of pain when people feel they have no other options. You just have an incredible track record of helping people do things that they didn't think was possible. So that more people can benefit from what you do, you've created these online courses, right? So Pilot is for healthcare professionals, physios, running coaches, osteopaths, people who help people with their movement who are looking for more tools when the patients or clients they have are not getting better

they're coming and they're doing the online course the pilot course and I know because I've spoken to people who've done it and I've seen the reviews people are loving it right and they're gaining new insights but you've also got a course for the public, haven't you? Which is very, very cost effective and walks people through this as well, right? Yes. So that's like for all the people who, the feedback was, I don't like books. And I will get round to doing the audio book, but it's such a practical skill. So off I went into the woods and filmed me coaching you doing all the drills to explore your own body movements, to find your own restrictions. Yes, if people want to, Helen, and they want to learn more, I mean, you know, if it's their

interest enough so they can start assessing themselves. Hopefully that's enough and people will get better. But if they want more, they can check out these online courses where you're kind of walking them through a bit more. I think that's really, really helpful for people. Let's get back to foot wiping. So we're talking about these extremities and we're talking about how people, I think people now understand if your head's on right, they can feel and understand that there will be a knock-on effect in many different parts of the body. What happens with the feet? of many, many multiple measurements that there's better flow through the feet, there's better timing through the feet, there are more even forces through the feet, more of the foot is being involved in the roll through the foot. When the stride is effortlessly extending, when the feet were too close together and the tracking, the space between

the feet as you walked was too narrow and they were effectively walking a tightrope, when that naturally widens, when 100% of people you measure have that result, measurable result. So they're all saying things like, well, it feels different. It's hard to put my finger on it, really. But you know, it feels, I feel more stable, or I feel more balanced, or I feel more grounded, or, oh, I feel more of my foot. And then some people say, well, I'm quite sure I can't, I can't quite find the words. And then as soon as they see on Doris, what has happened? Oh, I felt that. Yes, I could feel that. And that as soon as they see on Doris, what has happened? Oh, I felt that. Yes, I could feel that. And that's the advantage of going on it, isn't it? Because you don't have

to go on it, but having been fortunate enough to go on multiple occasions, it's really awesome to see what happens on Doris beforehand and see the limitations. And then you do something like foot wiping for two minutes yeah right cheap super accessible to everyone and then you go back on doris go oh my god i can't believe how much better i'm moving yeah and you've obviously seen that way more than me yeah it's pretty incredible isn't it yeah and so when when it's so um when 100 of people people have these changes to varying degrees, but there's always change in the right direction, then it feels, even though it seems like an implausible movement practice, it behoves me to share it, to get it out, because I feel that we don't understand movement. And when we make things overly complex, it makes it more and more inaccessible for everybody. And it's not necessary. Well, let's look at the downside here, right?

Well, I can't think of one. Exactly, right? So for any sceptics out there, you've downside here, right? Well, I can't think of one. Exactly, right? So for any sceptics out there, you've measured it, right? We've got hundreds of people, if not more, getting in touch saying foot wiping has made significant improvements for them. And these are people who don't even have access to you and Doris, right? What is the harm in doing that? And it kind of intuitively makes sense that because of the way we live now, cushioned socks, thick socks from a young age, cushioned shoes where we're

losing our connection with the ground, our feet are going to sleep. I think that's well recognized that our feet are not functioning optimally. So it doesn't surprise me at least that if you're going to wake up your feet by rubbing them front and back to the sides on a cheap five quid mat from Amazon. Or even a scratchy old knackered towel. Yeah, anything just to give texture and friction. You may start to get all kinds of benefits. Because it's not just that we have separated ourselves from the ground with socks and shoes. The separation tends to have the same feel. So the same texture, the same consistency, if you like. So your socks feel like socks, your shoes feel like shoes. So you're getting the same information,

you know, this idea that my feet are going to sleep. Of course, they're not going to sleep because they can't sleep. But it is that, it's seemingly that effect. But it's not just the inflammation coming through the skin. It's not just, yes, there's lots of, you know, hundreds of thousands sensory nerve endings. And yes, the information is coming through from the skin of the feet. And yes, if the skin of your feet is hypersensitive and you want to run around on them or even walk on them, then we can't expect great things from feet if literally the skin doesn't want to move because it's so twitchy. But something else is also happening. twitchy. But something else is also happening. When you are wiping one foot vigorously, so you're standing on one leg and you're scrubbing vigorously the other leg, you are balancing on that stance leg. There is a balancing effect. So when people say that they have

solved their back problems and their hip problems, for me, it's not necessarily just the skin of the sole of the feet that has spoken to the back and the hip. It could equally be the fact that they have spent a religious two minutes, maybe twice a day when they're cleaning their teeth, standing on a leg while they scrub the other. So you've got movement. So this is not the same as, you know, standing still on a leg while they scrub the other. So you've got movement. So this is not the same as, you know, standing still on a wobble board. You are deliberately creating movement for the system to organize so that they don't fall over. And then they swap and you will feel a difference between the two. And you've got the stubbing out a cigarette type of thing where you're getting into the skin where the toes meet the foot. Again, this is an internal and external rotation. So you're sneaking in all this delicious movement

that otherwise wouldn't have happened. And that is in addition to the inflammation coming through from awake skin of feet that isn't hypersensitive. I love it. It's a root cause intervention, right, which I like. big fan of things which go upstream and by doing them can impact multiple things. It's very accessible. It doesn't take long at all. It's win, win, win. Yes.

If you can suspend disbelief and just give it a go and just see what happens. Yeah. So once we've created a scenario where the skin of the sole of the feet is less sensitive, this is especially useful for rigid feet, stiff feet. That's something to do with high arch, low arch? No, because you can have a stiff foot and have a completely flat foot okay so uh what you can do you could park your phone at the end of the room on the floor and you could press record and you could walk towards it and you could see well how

much of my foot is moving 33 joints down there that foot should be moving if you are putting one foot in front of the other. So you mean you're videoing yourself walking and just seeing what your feet are doing? Why not? Because you can't see what's happening inside your shoes. So when people come to clinic, they're always quite surprised that I'm measuring them walking without their shoes on because they don't walk without their shoes on. And I say, yes, but I need to know what's happening inside your shoes before we put your shoes on or actually more accurately, what is not happening inside your shoes. So to know whether your feet are very active and even to see with just a selfie, not a selfie of your face, a selfie of your feet. In my experience,

a selfie of your feet. In my experience, nobody has any idea about their feet. Apart from what they look like, they would recognize their feet maybe from when they put their socks on every day, if they wear socks. So there is a deep unknowing. It's these extremities. Even though our brain is right inside our head, we seem to be unaware of the head. We seem to be unaware of our feet. We intimately know our hands because they're right in front of us and we use them as our tools. We don't seem to apply the same knowledge to our feet. We don't see them as anything other than something to shove in shoes and then go and be on, expecting them to be able to perform our whole lives. So we just need to get to know our extremities. Hands, to a degree, we already know. Heads, we don't seem to. Feet, we don't seem to. So let's get to know these extremities,

feed inflammation in and get more movement. With feet, we start the ball rolling. We start, you do your selfie, back to the selfie, and you see yourself walk towards the camera. There may be more movement in one foot than the other. Isn't that interesting? You're not one foot than the other. Isn't that interesting? You're not seeking to tell the feet what to do. You're seeking to find better and more symmetry between the feet because at a gross level, we want our feet to feed into the system the same. So we've got the movement availability now because we've desensitized the soles of the feet. We've got some movement going on in the hip because of the balancing on one leg. Now you can take those newly, freshly, more easily mobile feet onto a big piece of rope. So something that you might use in the garden as some kind of decoration.

For me, this is probably the only piece of equipment that I feel should be in everybody's house. You don't, you don't, everybody has a doormat or a scratchy old towel or something that they can rub their feet on. Not everybody has a big piece of rope. In my experience, 30 millimeters diameter works well for children's feet, 40 millimetres diameter works well for adult feet. You can have whatever material you want, whether it's nylon or jute or whatever it might be. But you then walk along the rope because so many, the point of this is so many drills for feet are done statically,

but we don't use our feet statically. We are moving forward on them. So to what in my experience, measurably so, when people go from their foot wiping onto the rope and spend, say, five minutes playing, walking up and down on the rope, they can have the rope parallel. So they just fold the rope in half and just have it parallel. And they just drape their foot in a myriad different ways on it. It feels great. Yeah, it does, isn't it? And because people get to ask, right? I don't know when you recommended I get one,

but it's been a permanent fixture in my house for a number of years now. I went onto Amazon, I chose the cheapest rope I could find, and I ordered it. That's what I use. There's no particular thing. It's just something to give you feedback and for your feet to wrap around and

change shape to. And it's really enjoyable. And you find if you're going forward and backward, maybe it's okay if you start to go sideways along it. Ooh, God, I'm feeling a bit of tension. So it's like a massage where you feel you're actually ironing out some of the tightness that you might have in your feet from your footwear or your job or life stress, basically. Yes. So, so many people talked about, can you please talk to us about plantar fasciitis? Yeah. So many. But if I include with rope play, I would include plantar fasciitis, anything with the feet, frankly.

Knees, because unless the feet joints are moving, you can't expect the next bone along to have its freedom of motion because everything has a knock-on effect. Makes complete sense. When you put it like that, if your feet are locked and you've got knee pain, well, you don't know if that's because of the feet until you free up your feet. Exactly. So shin splints was another one. If your feet don't move, your shin bone is going to either have to do crazy stuff or it won't move much either. The site of the symptom is not necessarily the site of the problem. Exactly. The whole body is interconnected. So I really like this framing. I know we've retouched on head position and foot wiping, which we've covered before, but I don't think we can over cover it. Let's say someone heard our first conversation, paid attention to their head position and felt an improvement.

position, paid attention to their head position and felt an improvement. Well, they could probably go back and revisit it now and see, well, I got improvement, but could I get even more improvement now? Perhaps they're out of pain and so they stopped where they were. But perhaps they were at 30 degrees forward head position and they'd gone back to 15 degrees and they're pain-free. But if they got back to 10 degrees, their Saturday park run might be faster. Their 10K may be faster for no more effort, right? Beautiful. Lovely. Yeah. So we circle around. It's MOTing. It's checking in with your body. You don't have to make it onerous. Just every now and again, just checking

in with the fundamentals of movement. Now, of course, there can be local issues with the knee, right? You might have knee pain because there's an issue with your knee, right? Of course, you know that. I know that. Hopefully, people know that. But the point I think we're trying to get across is that sometimes, a lot of the time, a pain in the knee or the hip or the back isn't coming from the knee, the hip or the back. It's coming from somewhere else. If you first of all focus on the head and then your feet, get those things working better, moving better, you might get an improvement in these kinds of pains. Yeah? Yes. And it's what's interesting just on that point is a knee problem is often only a knee, not both knees, but we've only got one head. So then quite a few people quite reasonably have

said, well, if it's my head position, why isn't my other knee hurting? It's only one knee, which is a really good observation. So there's two things. If organizing your head position has helped the pain in the knee that was hurting, then there was an overload on that side to the extent that that knee hurt. The fact that the other knee didn't hurt speaks to you of something else because the head is in one place unless there's a tilt to the head. Well, you can see that in a mirror. If there's a tilt to the head, maybe bringing it back to a better position, took a little bit of the tilt out as well. And it speaks to maybe that side is overloaded because so many people come to me and all of their pains are on one side. And when that happens, you can sometimes see it in the feet.

So you'll see as you do your selfie walking towards the camera, you'll see one foot doing nothing, the other foot doing everything, one foot's on holiday, and it's the side that is actually moving, which is the side that has all the complaints. So often, in my experience, the side that hurts is the side that needs a holiday instead of poking and prodding it uh we need to be stroking it and saying thank you very much whilst waking up the other side well that's something that we've had to do continually with me right it's so common yeah so you you're thanking the side that's in pain for doing all the work and saying hey listen i'm going to help you now yes by getting the other side to do its fair share so you don't have to do as much.

Yes, so we have this, the thought process of the site of the pain might not be the root cause of the problem and the side of the pain might be the symptom, the whole side of that body might be symptomatic of the other side. Okay. I mean, this is great. Okay. So a lot of people asked about specific pains. And of course, if we take the logic which we've been talking about further, it's of course impossible to say what to specifically do for anyone's pain because we don't know what's causing it. And 10 people with knee pain could have 10 different reasons. Right? 10 people with a headache could have 10 different reasons, right? So you got it. This is

where personalized medicine, personalized care per se is so important for me because we've just got to look at the individual and figure out what's going on in that person's life. In the context of that person is the only question. There are no absolutes in movement and there is not one single answer for anything. I think that's why we share such common philosophy because we've spent years seeing a lot of people. We've just seen time and time again that different things work for different people. Of course. You've got to find what works for you.

Exactly. Yeah. It is somewhere you will sit on every spectrum there is, you will be somewhere. And it's about finding where is that? What works for you? Because you surely are the most important person. I love it. So we've covered foot wiping, head position. We made the case of why people should

do them, how they can advance their practices if they are starting, or if they've never heard this before, they can just start. We're talking about how the body is interconnected, how everything affects everything else. Okay. There is a lot more we could talk about with pain, but we must get to stress incontinence for women because it's so common. I don't think I realized how common, right? This is something that affects a lot of women that causes them a lot of, I guess, embarrassment and a fear of doing things. I mean, I, over the summer, put out a challenge, a skipping challenge on Instagram just to inspire people to get moving in a fun, enjoyable, very cheap way to get moving, skipping. And loads of women have said, listen, my skipping days are over. I've had three kids. I've had four kids. Right. So

we want to talk about stress incontinence. I think your approach very much speaks to the idea that the body is connected. You can't just look at one thing in isolation. But first of all, maybe say, you know, how common do you think it is? Well,% of women, of whom 75% have been helped by Kegel exercises. So these are basically strength training for the pelvic floor pull-ups, if you like, of the pelvic floor. There's still a lot of women who it doesn't help. So if we, along with every modality that exists, it works for some. So everybody who has come to me with problems with stress incontinence, they have already tried what their doctor has suggested, and they might have been sent to physiotherapy. And they have tried that, and they've been diligent. And it hasn't helped

them. So what is in the way? Because if you are strengthening a muscle, the muscle will respond by getting strong. So if you are diligently doing something, but it's not solving the problem, what else within the system is influencing the role of the pelvic floor? So if we actually start with the role of the pelvic floor, things get a bit easier. So, of course, the symptom is leakage. Spontaneous, small, large, random, it's the problem is the support of the inside organs and the pressure on those inside organs, either prolapsing coming out or putting too much pressure on the bladder. So we know that the pelvic floor is like a hammock of muscle attaching front and back. Everybody knows where their pubic bone is. Everybody knows where their tailbone is. Everybody knows where their sit bones are because they sit on them. So there's four points, front and back,

left and right. So it's like a little diamond. The pelvic floor is like a hammock. Like a hammock. Okay. And some people call it a diaphragm, which is really helpful. That term, thinking of it as the pelvic diaphragm, is very helpful. So if we think of, well, one of the roles, and it's not the only role, one of the roles is the support of the inside organs. And these muscles move. So they're going to move at least up and down. And because there's a left and a right, there'll be a left and a rightness too. So,

their role as support, yes, it's a gravitational force role, which means gravity is pushing us down and it pushes up or holds us against that push down of gravity. Okay, so that's a downward force. Yeah. So that's almost counteracting that downward force. Yes. And it's interesting that in embryo, that musculature, that diamond of musculature starts developing before even heart and lungs. It's so important. It starts, we're the size of a little tiny bean and our perineum is already getting busy. Wow. So it's unbelievably important. So, but it doesn't act alone because nothing, nothing on our system

acts alone. And we are not just muscles and bones. We're not even just muscles, bones and pressure. We are a brain that connects everything to everything. So the brainstem, and we know this, just even think about the brainstem. The brainstem makes sure that your blood pressure is right in your thumb and the blood pressure is right in your big toe. And there's no apparent fascial or skeletal or muscular connection between the two, but they are connected because the brain connects them. So we have this supportive hammock, which is also contributing to intra-abdominal pressure. So the pressure of our insides in our abdomen, in the bit between the pelvic diaphragm and the breathing diaphragm, so the base of the ribs. So that's our abdominal area,

which has pressures in it, intra-abdominal pressure. So if part of the role of the pelvic floor is contributing to intra-abdominal pressure, then we cannot not talk about the abdominal muscles because they also contribute to intra-abdominal pressure. They help us, our abdominal muscles help us wee and poo, not to put too fine a point on it. So we've got the pelvic floor at the bottom. Yeah. Right.

On the sides and around. All the way around to the spine. These abdominal muscles. Yeah. You've got your obliques. Yeah. The six-pack muscles. Six-pack muscle, which attaches to the pubic bone. Right. So you've got all these muscles. You've got your obliques, the six-pack muscles. Six-pack muscle, which attaches to the pubic bone. Right. So you've got all these muscles. You call this a tin can, don't you?

I do. I'm getting to the lid of the tin can. Yes. I think it's a good concept for people to have in mind. It's like this cylinder inside us, right? Where we think of the core, right? This cylinder is there. So the bottom, well, you call it a tin can, right? So the bottom of the can is the pelvic floor. The sides are the abdominal muscles. All of the abdominal muscles that go all the way around to the back, to the spine, to the quadratus lumborum, which is a deep breathing muscle, actually. And the top of the tin can. Or deep abdominal muscle, rather. I beg your pardon. Yes. And the top of the tin can... Or deep abdominal muscle, rather. I beg your pardon.

Yes. And the top? Is the breathing diaphragm. Right. So I think people, if they've been listening to this podcast for a while, they, I think, will have heard of the diaphragm. I've had multiple conversations about breathing.

Yes. So just to sort of summarize where we're at, we're talking about stress incontinence for women. You're saying that if the methods you've tried already haven't worked and you're still struggling, which is a lot of women, perhaps instead of looking at isolating muscles, we should be looking at the whole units there and going, let's get this whole unit working better, more efficiently. And at the moment we're saying the unit is this can, this tin can, pelvic floor to the bottom, abdominal muscles up and around, and the breathing diaphragm at the top. Yes. So far, so good? Yes. And Paul Cech calls that the inner unit. I call it a tin can. Okay. Because I can visualize it.

So we've got all of our innards between the lid and the base of the tin can. We have our insides, all the organs below the breathing diaphragm, everything in our belly. Who wants to squish their tin can? Who wants to stand on the top of their tin can and squish the tin can to the base of the tin can? We're not recycling our tin can. We want health for our tin can. Where are our innards going to go if we squish lid to base okay i think what what certainly for me what might be helpful at framing this part helen is something you told me last night which is that you've never ever come across anyone with stress incontinence who hasn't also had poor breathing mechanics.

Yes, correct. I want people to think about that. So you have never seen in your decades of doing this, anyone, any female with stress incontinence who does not also have poor breathing mechanics, right? I think that's really important because we're about to talk about the diaphragm and the pressure inside the can. So what happens when we breathe then? We don't want to squash. So what happens when we breathe? So when we breathe in the diaphragm, a big sheet of muscle, like a drum top at an angle, it domes down in order for the lungs to expand like a balloon. So the lungs expand down and out in all directions. Okay, so when we're breathing in, which we all have to do,

Yes, hopefully. multiple times a day, in theory then, if we don't do anything with the bottom of the can, the pelvic floor, and we're just doming down the top of the can, which is normal when we breathe, which is what we want, you're going to be squashing everything inside there. Yeah. Okay.

So you're increasing intra-abdominal pressure if the base stays where it is. And that will increase the likelihood of incontinence because you're squeezing what's in there. Or prolapse over a period of time. So a vaginal prolapse. Yeah. Even hernias. Hernias, of course. Yeah. Yeah. They're just pressure. It's where the pressure builds up and the body will find the weak spot to release the pressure. So it's like a pressure cooker, a valve leak. So a hernia, a prolapse, they're just pressure leakages. And that makes complete sense. So on that logic, given that we have to breathe,

and the diaphragm has to come down, so the top of the tin can has to come down, I'm no engineer, right? But it would seem logical then that the bottom of the tin can would in harmony also have to go down. Yeah. Otherwise, the inside is going to get squashed. Yeah. Okay. Exactly so. And then when you exhale, the breathing diaphragm domes up. up. It just relaxes up on a natural exhale and it, on a forced exhale, it will dome even further up to really squeeze the air out of the lungs. And guess what? The parvic floor will come up with it.

So our tin can, if you like, I imagine it traveling up and down in space. The height of the tin can, if you like, I imagine it traveling up and down in space, the height of the tin can remains pretty much the same. It moves up and down in space and it gets squeezed by the wall. So the tin can walls get squeezed where we kind of, it's a bit like a jellyfish. So it's a squeeze from all the way around, an expansion all the way out with the jellyfish, and then a squeeze all the way around the circumference in on the exhale. So for someone who's struggling with stress incontinence, and let's say they've tried Kegel exercises, and for whatever reason it hasn't worked,

and they're going, well, could there be something else I can try you would say 110% yes there is something else you can try yes and so given that we want optimum breathing mechanics yeah and I spoke to Professor Peter O'Sullivan from Australia recently who's done a lot of incredible research on back pain and he also talks about, you know, this whole thing about contracting the core, whilst it can work for some people, can also become problematic if it starts affecting breathing function and how the diaphragm works and how our ability to contract and relax. We don't just want contraction all the time. We want relaxation, don't we? Of course. And so this is, my tin can is totally an oversimplification. But the system is so complex.

We are internally massaging. We're keeping the circulation going. We're keeping the pressures normalized or optimized. And then we interfere. So our system is set up. If we go along with the idea that we are well made, we are fit for purpose. Every time we intervene with our opinion on something, we're in danger of upsetting, not the status quo, but the how we are made to be. So my oversimplification, and hands up, I'm a generalist, not a specialist. So I see the world that holds their tummy in, that braces, that is forever holding breath, pulling up, everything is pulling to in, everything is to do with increasing intra-abdominal pressure.

Compressing the tin can. increasing intra-abdominal pressure. Compressing the tin can. And I worry for the pressure, the tiny little weaknesses within my tin can and something is going to pop. And I've had hernia surgery. So I'm talking from experience. I've got Ironman levels of double mesh in my innards because of hernia. So I empathize, I understand. And my husband says for me always, he's, hold your tummy in. No, I will not. I will not hold my tummy in. Because if I hold my tummy in, how do I breathe? So, so often when people are running with me, whether we're inside or outside, Often when people are running with me, whether we're inside or outside, as soon as they stop holding their tummy in, they move more freely. They move more.

They move better. They are faster for less effort. As soon as you stop squeezing the walls of your tin can and just allow the top of the tin can to do its job, then the system can start to self-normalize. We interfere at our peril. We don't need to micromanage everything. Sometimes we have to go in a little bit deeper and coordinate the movement of the top of the tin can, the breathing diaphrag deeper and coordinate the movement of the top of the tin can, the breathing diaphragm, with the bottom of the tin can, the pelvic floor diaphragm. I've just had a memory, Helen. We've been working for over four years together,

so obviously we've done a lot during that time. But did we not once, in your old clinic, work on breathing, but on the breath in, you're breathing into your perineum. Yes. And again, even saying that, I'm aware that people don't want to talk about their perineum, and it's, you know, it's like people would rather avoid this. They don't want to talk about their feet. They don't want to talk about the perineum. Even though they might be sitting on it right now. You've kind of got to, guys, right? You have to get familiar with different parts of your body and actually learn how to use them if you want to be in good health. Yeah. Right?

I so want this conversation to help women who are struggling with stress incontinence. Me too. I think we understand the tin can analogy. Okay, great. Right? I think we hopefully understand that you have to have the top of the tin can come down as you breathe in because you want your diaphragm to come down. That's what it should do. But that also means, look, this was a helpful key for me. I don't know if you found it helpful for

people. When you're breathing in, you're focusing on the diaphragm coming down, but you're also focusing on breathing into your perineum. Is that right? Yeah. But without forcing it. Okay. So it's not a doing, it's a letting go. You are allowing the breath to fill you. Just fill you. If you're sitting down, allow the breath, just let go go and for so many people i work with they cannot they can't even let go they cannot because or is one of the reasons the fact that so many of us hold our tummies in all the time yes because uh so men's health has a lot to answer for. You mean the front cover images of men's health. And our aesthetically driven society. And I am just as susceptible to this as everybody else.

But I have just learned it is to my detriment if I'm forever holding my belly in. Far better eat so that I thrive and my belly doesn't need to be held in. So I eat to feel really, really well. And when I do that, my belly doesn't bloat and I don't need to hold it in. And I refuse point blank to hold it in because then I can't breathe. Or my breath is with my accessory muscles. So the important thing with the breath is the diaphragm is the primary or one of the primary breathing muscles. It's a great big, great big, enormous muscle. So in terms of making this really practical for people, Helen, right? If someone's listening and they think, okay, this applies to me,

I do hold my tummy in all the time. I have done for many years. I've got stress incontinence. I've tried stuff diligently for years and it's not worked. I want to try broadening my approach out and dealing not just with my pelvic floor, but my abs and my diaphragm together. So in harmony, everything starts to work and move better, right? Could this be as simple as for five minutes a day, practicing deep breaths where you feel your ribs, you feel the diaphragm come down. Maybe your belly go out a little bit, although we've got to be careful calling it belly breathing because then people push their belly out and ignore the ribs. But let's say you could breathe

perfectly well with intentional practice, which I know a lot of people can't, is a helpful exercise for five minutes, maybe in the morning five minutes in the evening you're just lying there and you're just practicing consciously this kind of breath yes so we're spreading our sticky web of connectivity a little bit further in the same way that we can think about the base of the neck where our necklace lies, moving down to the bed as we are lying on our back and that tilting the chin down and pulling the base of the sternum or the base of the breastbone up. In that same connective way, we can lie on our tummies. And if we lie on our tummies, we can feel the belly. We can feel the filling of our breath. So you just get

comfortable lying on your tummy. Yes, you'll have to turn your head to one side or the other. On a bed or a hard floor? Yeah, on a bed. Just be comfortable. If you're going to be there five minutes, definitely be comfortable. So you can just be on a bed. You can have your feet hanging off. There's no rules here. All you're doing is connecting the movement that you want. So if you, if strengthening the pelvic floor has, maybe it's done something, but it hasn't solved your problem to the extent you want the problem solved. Yeah. It hasn't fully solved the problem. Then investigate further.

Spread your web of exploration a little bit further. so the walls of the tin can and the lid of the tin can you line your tummy and you just start to notice your breath first you do nothing except notice your breathing and because you are on your belly your belly can't swell because you're lying on it or if it does well it'll be'll be tiny. What it'll do now is it'll fill wherever it else can, wherever it can other than the belly. It'll swell the lateral ribs maybe, the sides of the ribs, and maybe it'll swell at the back of the ribs. Because a lot of people don't realise that... All the way around. When you've taken a breath in, your ribs should be expanding out. Yes.

In this element of our body, think much more jellyfish than front or back. What do you mean jellyfish? So jellyfish moves by expanding its whole circumference and then contracting its whole circumference. It gets a bigger circle and then a smaller circle. So we need to think... The whole circle, the whole shebang. There's a jellyfish in our tin can. How's that?

Fantastic. I love it. I love movement. So tin can is a bit static, isn't it? So now we have a jellyfish tin can. So it's perfect. So a flexible tin can. So not tin, like some sort of movable material. But the jellyfish tin can so it's perfect so a flexible tin can so not tin like some sort

of movable material yes jellyfish is inside yes a jelly a jelly can okay a jelly can so you're lying on your tummy you've started to notice your breath and when you start to notice that it's lifting you a little bit your easy breath in is somehow lifting. You can imagine that the back of your body, maybe your bum, maybe the lower back, maybe the base of the ribs is kind of going a couple of millimeters up towards the ceiling. You might not notice that bit, but then maybe you'll notice, you'll realize that you were higher because as you exhale, you seem to sink. You seem to then go back down to the bed. So once you've got that going, you then start to notice, well, what is my pelvic floor doing?

So now we know that the diaphragm is doing its thing if you're breathing in and you're lifting because then your lungs have got room to swell. So the diaphragm must be going in the right direction. So number one, you get the top of the tin can working. Get that working first. Get the diaphragm must be going in the right direction you get the the top of the tin can working get that working get the diaphragm working first okay and then observe can you feel the pelvic floor moving some people are so disconnected from their pelvic floor they won't even have a clue what you mean by that no so then you can there's several ways of doing it. There's never one way, but you can start to breathe more deeply. Stay in your rhythm.

Don't lose the rhythm of the breath, but breathe slightly more deeply. And the bigger movement, you probably, in my experience, you probably start to notice because your awareness is being sent there, you'll notice what the pelvic floor is doing. is being sent there, you'll notice what the pelvic floor is doing. And for so many, so I want to say 100% of the people I've suspected a tin can that's getting squished, it's happened. So the diaphragm is coming down, but their pelvic floor is coming up. So then there's the realization, because we've had the chat about the tin can and then they realize it's happening. They're not doing it. It's happening to them. So then it's just a case of rewiring, connecting the way we want it to just the same as the head

with the neck with the rib cage. We just start to move in the way we want the brain to rewire itself. And we know it does. So we have all the hope in the world. We just need to do it consistently enough. So most people, well, not most, but all I've worked with who have gone, they've got somewhere with the Kegels or nowhere. They are still troubled by the problem. So they are very good at the up of the pelvic floor, the pull up. Is that what Kegel reinforces? Yes.

So it's the strengthening. So it's the pulling up, the squeezing, as if you're holding onto a wee. You don't want a wee, you're hanging onto that wee. Which kind of on the surface makes sense, doesn't it? Because if people are leaking urine, it's like, yeah, I need to pull it up. It's counterintuitive. They think that they need to pull up, but of course that is in them,

in them because it's not solving the problem. It's probably doing something to increase the intra-abdominal pressure. So if they know up, I always work with, well, what does that brain know? What does that body know? If they know up, let's work with that. So we connect the up with the exhale. Everything is going up. Okay, okay, hold on. So we're saying when we inhale, the diaphragm's coming down, the ribs are being expanded as well yeah okay on the inhale and really on the inhale you also want your pelvic floor going down but you're saying if they already if they don't know down but they know up then do that up but on the exhale yeah So by virtue of if you, with your knowing how to pull up, because you've done the Kegel exercises, with that knowing, as you exhale, you pull up, and then you have to let go in struggle to then let go. The exhale is so strong or the pull up is so strong, the brain doesn't quite know how to let go. But if you keep asking it to, because it's designed to,

it will. So you just relax and wait for, and you won't even feel it let go. You've just realized that on, you know, the 10th exhale, you actually feel it move back up again, because it did come down with the inhale. And so if people can do this, right, and it's going to take a bit of time, they're gonna have to practise, because obviously, if we have a default pattern that is in opposition to that, initially, it's going to be conscious, reminding ourselves, consciously practising what we want it to do at some point after enough practice it will become unconscious won't it at some point well uh in an ideal world if if holding of tummies in wasn't so prevalent, it would probably all happen a lot quicker in that way, yes. The problem is you can't micromanage your breath as you go about your daily business.

So it's about step by step. There's this big problem. You've got somewhere, you haven't got where you want to, you're going to use what you've learned. And just instead of talking to that particular area, you're expanding the inclusion of more of your body. So when you get good at that, that's lying prone. The next stage is, can you do that seated? Because so often I will start people seated, but they can't do it. They can't let go of their belly even when they're sitting up. So if you change the body's orientation, it seems like it's like a disruption of the norm. So you're doing an exercise lying down on your tummy, which is not the norm. So the brain starts to notice it because there's a disruption.

It's different. It's like, oh, that's interesting. So then you go to seated, which is where we spend a lot of our time. Then go, can you do that same breathing practice seated? And then maybe you'll start to feel the weight of your perineum as you breathe in and as it comes down between your legs and as it then disappears as you breathe out and it goes up and when people practice this and get it and also try and rid themselves of the habit of holding their tummy in which is a difficult habit

to rid people of but as soon as you become aware, you continually, oh, I've done it again. Yeah. Oh, I've done it again. Yeah. And that with anything when it comes to change is not failure, it's progress. It is. It's massive progress.

Because as soon as you're aware, you let it go. It's the beginning of great things starting to happen. And so once you've gone from prone to seated, then we are talking about movement. So, and this is covered in my book in level two. Yeah. So the book's called Even With Your Shoes On. Yeah. In level two, we talk about tracking width and the importance of tracking width. So that's when you're walking or running, how far are your feet apart from each other? Yeah. And because I felt the world might not be ready for me to talk about stress incontinence

in a finding efficiency in your movement, I didn't mention stress incontinence per se, but I talk about hanging on to a non-urgent we. I even talk about the stories of me coaching just outside the London Eye, yelling as we're running along, pull up on your scrotums. And so because we were doing exercises and I had to find out from the chaps, well, what does that feel like for a girl, you know, pulling up on our pelvic floor? We all know, we all know how to do it, but what does it feel like for a bloke? Because I didn't know what it felt like for a bloke. And so we described it all and then somebody come up, well, it feels like I'm pulling up on my scrotum. You think, okay, great. Thanks for that. So there it is for the chaps. So in the book, I talk about

tracking width, which is our ability to effortly weight shift from one side to the other. If you are on a too narrow tracking width, so there's not enough space between your foot landing. This is the realm of IT band issues, which was another question. This is the realm of knee issues, ankle sprains, outside foot issues, stress fractures of the fifth metatarsal, the long foot bone leading to the pinky, hip issues, often lower back issues. Because if you like, your pelvis is the top part of the V and your feet are landing effectively at the pointy end of the V, which is putting huge strain on the outside of the lower limb, all the way from the outside of the foot, through the ankle, through the knee to the hip, into the back. hip into the back. And it is the realm of, remember we started with the anatomy of the pelvic diaphragm. It's got a front back and a left right. So in order for our pelvic floor to have its innate strength, the legs, the foot lands in this Goldilocks place.

Where is it? It is the place where you access the full breadth of your foot as you roll through it. So for everybody, it is that sweet spot. What do you need to do? Where does your foot need to be to access the full breadth of your forefoot as you roll through it. And when that happens, you will find, so to briefly describe level two in the book,

you're running along with your tight rope running action with feet closer together than is ideal. closer together than is ideal. And you will be able to pull a long way with your pelvic floor. You'll be able to pull it up because it's not actually doing much. When your feet are underneath your hips, and we're not getting a laser beam out here, we're not getting a plumb line. It's just an organization of the system. The left foot is on the left side, the right foot is on the right side. And that gives innate tension to that side of the pelvic floor. And then the other side of the pelvic floor. So your tracking width when you move also helps you with that whole central tin can unit and also helps you... With the innate strength of the pelvic floor, yes. So it helps improve stress incontinence.

It is a very good way of finding out if there's any other influence. So because it's not just holding your breath, the function of the pelvic floor one of the functions it's critical function is in assisting you getting from one side stably the pelvic stabilization and the information from one leg to the other through the middle so as you walk and we started off the conversation about how important walking is, in order to transfer our weight from one side to the other, it has to go through the pelvic floor, right? And again, just zooming out for a minute, we isolate individual parts of the body, often to our detriment without realizing how they're all connected. But we also can say things like,

oh, the pelvic floor is to do with holding your wee in, right? Yes. Which may be one of its roles. It is one of the roles. But it does other things as well. And if you get the whole pelvic floor moving efficiently, also through movement, it's going to help that entire tin can. And so potentially could be contributing to an improvement in your symptoms.

Yes. And what is extraordinary is the person walking might have what looks like an ideal tracking width, space between their feet, and Doris will measure it. And then when they're running, they, some, they, bizarrely, they go into one foot in front of the other, a very narrow tracking width. And for me, that's a spatial organization of the brain. The brain, when, and so they'll fold their arms a lot, they'll cross their legs a lot. He says, unfolding his arms. Their posture, they will want to hold one side to the other with their folded arms. To hug, I read it as hugging the midline.

They're not defensive. It's not a defensive posture. They are hugging the midline that they don't quite know. So if I see a broad static stance and arms crossed, I think, oh, okay, I bet you that they will run with a narrow tracking width. And they walk beautifully. In this instance, they're walking beautifully, and they've got an ideal tracking width. And then when they run, because the brain has no clear perception on left and right spatially, so you might cognitively understand left and right, you don't have to do the L with the left hand to know that that's your left.

You know left and right in your brain. But your brain map, the spatial map of the brain, doesn't have clarity on left and right. So what it does have clarity on is the midline because we have to have a middle. Before anything, we have a middle. So it will hug the middle. Statically, it hugs the middle by crossing arms. When you're airborne, it seems to hug the middle by bringing the feet close together. So then we do the work to encourage the brain to understand clarity on left and right.

even then have a cue, which often works really well, where the person thinks left is left, right is right. So as they're running, left is left, right is right. So even that thought, and it becomes left, right. So a bit like when I was in the Air Force, left, left, left, right, left. And they don't have to think too much, but their foot just lands in this space. And it feels mad. It feels when I go, oh, that looks great. That looks great. And they can feel the full breadth of their forefoot. I felt it, Helen. We've been out so many times and you know, it's amazing. It's like, as you say, it circles back around. You improve it, then you work on other things, then you have to revisit it again a little bit later, maybe a year later. But again, highlighting awareness. Once you become aware,

but again highlighting awareness once you become aware you start to self-correct as well because you know when we've done it I've gone really narrow and I've gone really wide and it feels all wobbly and unstable and then you come in a bit you're like oh that feels good I can feel the whole foot now not not the outsides and not the insides I can feel the whole foot now, not the outsides and not the insides. I can feel the whole foot. And then, you know, in the past, I've had pains that we were working on and they all went when I got the right tracking width. Yeah, for you. For me. And critically, if in the walking gait, the tracking width looks natural,

if there's just the look, you just thought, well, that looks great. That just looks like the leg is pretty vertical. It's not leaning in. It's not leaning out as you walk. When they go to that tracking width running and it feels good, even though it feels mad at the time, it measures the exact same measurement as walking. So I've seen people go from their space between their feet measurably on Doris is 10 centimeters when they're walking, one centimeter when they're running. One centimeter. They are literally one foot in front of the other. to land in the right place for them, the right place for them where they feel the whole breadth of their forefoot. And guess what?

It measures 10 centimeters. Wow. The same, exact same as walking. Walking, it felt nothing. They didn't notice where their feet were. It was innate. As soon as they were airborne, they had no idea they were tightrope running and it felt mad to have the exact same tracking width running as walking but that was their innate positioning it just blows my head every time just is amazing so so just to finish off stressing continence then okay consonants then. Okay. So we've explained the mechanics of it. Very overly simplistically.

Yeah. But hopefully people have got at least the overarching idea of pressure and tin cans and the roof and the floor and the surroundings. And this idea that you want that tin can really to have the same length and same volume as you breathe in and out, which means when you breathe in, your diaphragm comes down, your pelvic floor also should go down. When you breathe out, your diaphragm comes up and your pelvic floor should also come up. So that depth, that sort of height of the tin can kind of stays the same. And the squeeze comes from the abdominal. So the volume changes with the abdominal squeeze, but we don't want it to be permanent.

Yeah, and we're acknowledging that we are oversimplifying this. Massively. In the spirit of trying to help people understand what's going on so that they can actually do something about it. Yes. Right, I think it's important to say that. So you've outlined an exercise that women and men, frankly, can try, right? Men have hernias.

Exactly. So I think that was really useful to know that wherever there's a hole or a leak potential, if you're increasing the pressure there, that's where things will start to pop out, right? That makes sense. So they can work on that, you know, they're lying prone on their tummy, they can do that breathing exercise. Once they've got the diaphragm, they understand what the diaphragm is doing, they can move to the pelvic floor and try and build up that awareness. diaphragm, they understand what the diaphragm is doing, they can move to the pelvic floor and try and build up that awareness. They can also think about their tracking width, which is helping the different lateral sides, the left side of the pelvic floor, the right side of the pelvic floor. For more on that, they can get your book even with your shoes on. You now have it only available on

your website as opposed to Amazon. So people have to go to the website because basically for independent people, it's quite expensive to have things on Amazon, right? Yes. But you've also got these online courses, right? Have you seen individuals where doing this completely gets rid of stress incontinence? gets rid of stress incontinence? I haven't seen anybody where it hasn't helped. Right. So because I've got no control over what happens once they leave me. I'm not talking about magic wands here. I'm talking about if you, what I have had, I have had heard back 100% success solved the problem. And I have also had, well, I've, I'm better. And there's still something in the way. So, because we have to be transparent here, this isn't about making out that this is easy, simple, it's not, it's complex, It's not, it's complex because there is more to it than just even the tin can.

So then if, so for me, the gold is in, well, if it's helped, but you're still not exactly where you need to be, what else might be in the way? And then it's invariably, we're back to the head. We're back to the head because of the influence of the head on the spine is the spine extending well is it giving space for uh the tin can to move or is it being squished is the default sitting posture that of squished yeah so the whole body's connected. It is. And I would love to sit down with you and say, oh yes, do this and everybody's problems will be solved. And I can't do that because that's not possible. Because it's different for everybody

and the influences on us, on our systems, is different for everybody. Yeah, I know I love that. And it really speaks to this idea that the whole body's connected. Let's stop looking at things in isolation. Potentially, these exercises that you've shared will help some women completely resolve their stress incontinence, right? For others, it may just improve things significantly, which many women will take and go, that's so much better than it was. And if it helps a little bit, but it's not fully, it doesn't mean it wasn't worth doing. It means it's still great because

getting the tin can working better ain't just helping the pelvic floor, right? And stress incontinence is helping your movement. Exactly. It's helping your breathing, which if you've heard any of my other podcasts on breathing, you know will help your stress, your anxiety, the way you interact with the world, your fitness, your endurance, all kinds of things, right? So it's not that this is just a stress incontinence exercise. We were doing it for me. I've not had a hernia. I is just a stress incontinence exercise yeah you know we were doing it for me i've not had a hernia i don't have stress incontinence yeah right yet we were still doing it to improve my mechanics in my body it's an important aspect of our movement because it's

the bit that joins the top to the bottom yeah if i could wrap it up to give people an incentive to give it a go, just even noticing whether or not your legs chafe when you run, connecting that if you have stress incontinence to any degree, that is giving you an indication of, well, just even start. You could start without specifically the pelvic floor. You could start with just level two in the book and just see what happens if you have a little bit more space between your feet. It will feel a little bit mad at first, but so often, which is why it's in the book, it's level two. It's early on, it's straight after heads. Yeah, because there's eight or nine levels, aren't there?

There's 10 levels. Yeah, so this is just at level two, but that's obviously how important you regard it in terms of a foundation. It comes after heads. Yeah. Straight after heads, it's, okay, do you have space between our feet? Because of all the injuries that are associated with narrow tracking, which include, it's not an injury as such, as the problem of a weak pelvic floor. Okay, Helen, so there's

plenty there for people to be getting on with. Hopefully for some women, it will make a huge difference. I'm sure for some of them, it will solve the problem completely. But for others, I hope it makes a significant improvement. Also for men. And more efficient. Oh, of course. So you can be moving faster for less effort if you have enough space between your feet, allowing you full access to the full breadth of foot. So it's not even to do with injury. It's not to do with stress incontinence. It's to do with movement efficiency. Getting that translation from left to right. So I'm looking at all these sheets and these questions, and I'm not even sure we've got into 15% of them. Okay. You're coming on again very, very soon, right? So we are going to be covering things that we didn't get to,

the problems with strength training. You know, what are the exercises that go wrong often for people when they've got these unstable foundations bunions how do you transition to barefoot feet um running advice which i was hoping to get to you know how to run a fast 5k why warming up is important how to recover stretching good or bad we're going to get to all of this in part four which which we'll do very, very soon, if that's okay. Okay. Okay. Yeah. I want to give a shout out to you. I think you're utterly incredible. I think very few people have the knowledge of the human body that you do. You've completely transformed my life and how I move. And I really want your wisdom to get out there to more and more people because it's our innate right to move well without pain and to move efficiently. So guys, check out Helen's book,

Even With Your Shoes On from your website. Check out your online courses. There's two up there already. You're filming a third one. Next week. I think you're going to have to do a stress incontinence one soon, Helen. I feel, I feel. I just need a model. I'll get a model and we'll do it. Okay. So I think another super helpful conversation. Guys, if this is your first time listening to me and Helen, please look at the first two conversations. They're full of gold. So many people are running faster. They're moving without pain just from what was in them. Hopefully this one will add to that, right? So there's a lot of content out there for free for people.

To finish off, Helen, one question that people wanted to ask you was this, and I think it's a really good one. If tomorrow was day one of your personal sort your life out body-wise, where would you start? Oh my goodness, that is a good one. Okay, so of course we can just say, well, just walk more. But this is not particularly helpful because they might be moving poorly in their very complex neurologically most challenging thing we do walking. So I would be thinking about making sure doing a little MOT on the extremities. the extremities. So we've got... The head and the feet.

And because the feet inform the pelvic girdle, which moves the lower back area of the spine, the hands and the arms inform the ribcage, so the shoulder girdle informs the ribcage, which moves the upper part of the spine. And they kind of meet in the middle. And then of course, the head's perched on top. So for that person, I would be looking for, I would be saying, shall we find freedom for all your extremities? So where is the head most free?

Work towards finding where that position is and find where you fall out of that position. Become aware of where you fall out of that position most commonly. Okay, so become aware of the head. Do you have freedom of feet? So you can do the selfie as you walk towards your camera and just see if your feet actually move and if one moves more than the other. And then you can give more freedom to feet via foot wiping and maybe rope play. And then the shoulder gaddle, the shoulder gaddle moving the thoracic spine. So what you can do is just even notice if there is a tilt to the shoulders. If there is a tilt to the shoulders, there is not freedom in the shoulder girdle. So just notice that first. Is that in the mirror? You're just looking?

Looking in the mirror. And you just see, are your shoulders level basically, or are they tilted one way? Or are they tilted? And you can just do it, I would get some experiential understanding of your body by not assessing and making a decision on day one. So you look in the mirror first thing and you say, oh, my left shoulder seems to be higher than my right. And then when you go to bed, just check, is it still the same? Do you get that a few days running? Now you have some understanding about your body and the fact that there is a tilt to the shoulder girdle. So then there is an asymmetry, which means less freedom in the shoulder girdle,

which is feeding into the system. So the pelvic girdle might have to work harder because of that. The head might be influenced because of that. This strange place in the middle, this shoulder girdle, for me, the shoulder girdle is key because it connects the head to the body. It's because it's in that neck area and because it influences the pelvic girdle. They talk to each other. So once you have established, so if they're level and you do a rotation, you know, one shoulder forward, one shoulder back, and it feels the same in both directions, then you will just gain with more and more movement, more and more head awareness, more and more feet work, you'll just gain. You should see that translate into the shoulder girdle. If there's an asymmetry, let's do something helpful for the asymmetry. See if the improved head position changes the shoulder girdle line, so the line of your shoulders. So very often, a tilted shoulder girdle is merely where you just got stuck with the forward head position

because rarely do I see forward heads land, end up forward perfectly in the middle. Yeah. Rarely. So really this day one of their movement journey is all about awareness. Yes. Yes. Just checking in to the very beginning and then topping and tailing and seeing what happens in the middle between the topping and tailing. Yeah.

And then maybe if there is a time next time Helen often do collaborations together. We're going to film exercises together at some point and put them on Instagram. So plenty of resources out there. Helen, I think you're doing great work. You're helping so many people. You're helping me and my family, which I'm eternally grateful for. Thanks so much for coming on the show. Thank you for having me again. It's always my pleasure. Really hope you enjoyed listening to that conversation. Don't forget to check out Helen's website, www.helen-hall.co.uk. And also, if you need some help with your movement, do check out Helen's brand new online course, A Troubleshooting Checklist for Walkers and Runners,

the six most common fundamental movement patterns that seem to need help. This is a really practical course. It is only £25. But also, for listeners of my podcast, Helen is giving a further 20% off until the end of October using the discount code FBLM20, which brings the cost down to £20, which I think is just incredible value. Now, before you go, just wanted to let you know about Friday Five.

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