Health and Wellbeing

1. Stop smoking.
   This is the single most important factor in improving the quality of your health. Smoking is linked to a host of serious diseases, including cancer, heart disease and stroke. If you are a smoker, stopping should be your first priority. The healthcare assistants and nurses can help you by providing advice and we have a smoking cessation clinic where the counsellor can prescribe nicotine replacement therapy (such as patches).
   
   There is a wealth of information regarding smoking and vaping on the NHS link below. If you are looking for help to stop smoking, have more information as to what help is available, or simply want to talk to someone regarding smoking, please visit the website by clicking to the link. We operate smoking cessation clinics. Please contact us to book you an appointment.
   
   Quit smoking – Better Heath – NHS (www.nhs.uk)

2. Diet.
   The word “diet” need not imply calorie counting and constant hunger! The main principle is to cut down on foods rich in saturated fats and replace them with more healthy alternatives. High concentrations of saturated fats can be found in foods such as dairy products, red meat, cakes, confectionary, butter, margarine and cooking oil. Healthier alternatives include cereals, pasta, rice, fruit, vegetables, pulses, nuts, olive oil, salad and oily fish. Current recommendations include eating five portions of fruit and vegetables per day, and to eat oily fish once or twice a week. You should try to drink six glasses or water per day. Try not to add salt to food – most prepared foods contain more than enough for your daily needs and too much salt can raise your blood pressure.
   
   Please follow the links for the websites which have a lot of information about eating a healthy balanced diet.
   
   www.nutrition.org.uk – British Nutrition Foundation
   
   www.heartuk.org.uk/low-cholesterol-foods/choose-low-cholesterol-foods

3. Alcohol.
   Alcohol in moderation can actually be good for you. Some experts say that drinking a glass of red wine a day can reduce your risk of developing coronary heart disease.
   
   Please visit the website
   
   UK low risk drinking guidelines: the Chief Medical Officers’ advice | Drinkaware
   
   it also has a lot of resources to help you identify resources available.
   
   Safe alcohol consumption as advised by the Chief Medical Officer is to keep it below 14 units/week. One unit of alcohol is contained in a glass of wine, a single measure of spirits, and in a half-pint of normal strength beer.

4. Exercise.
   Keeping physically active is a very important part of a healthy lifestyle. Some people spend a few hours per week in a gym, but you don’t necessarily need to spend a lot of money to keep active. Cycling, swimming, jogging or even a brisk walk can all serve as providing you with healthy exercise. As one gets older, keeping active helps prevent osteoporosis (thinning of the bones) and osteoarthritis (wear and tear of the joints), as well as reducing you risk of developing high blood pressure and heart disease.
   
   Visit the website below for information about exercise and health www.nhs.uk/live-well/exercise/exercise-health-benefits/

5. Reduce stress.
   These days, we all suffer from various degrees of stress. Balancing work and family lives can be difficult, and financial and social difficulties can make life a struggle. Try to recognise when you are suffering from stress. Common symptoms include headaches, irritability, difficulty sleeping and poor concentration. Sometimes people find that they are smoking more or drinking more alcohol to ease their stresses, but this is a dangerous path which can lead to severe health problems.
   
   There follows a few ideas to help:
   – Identify the cause of your stresses and try to tackle them.
   – Try relaxation techniques, such as deep breathing exercises.
   – Talk to family or friends about your problems.
   – You might like to try a counsellor.
   
   If your symptoms are worsening despite your best efforts, consult your doctor.
   
   Visit Stress – Every Mind Matters – NHS (www.nhs.uk)
   
   This website is full of very helpful advice and links to resources and self-referral to IAPT services if you feel stressed. Please visit for very helpful tips to avoid and mange stress especially during the Covid-19 pandemic.

Health and wellbeing coaches help people make positive and lasting changes to their health. The coach guides the individual through the process of creating a vision for their health and well-being, developing a healthy mindset and healthy habits, and encouraging them every step of the way until they accomplish their goals.

We have arranged training for 7 of our Healthcare Assistants who speak a number of languages to help provide support to our patient population.

They will focus on some specific different areas: Exercise, Sleep, Wellbeing, Diet, Smoking and Alcohol consumption.

This service is available for any patient registered with Thistlemoor Medical Centre. We will be helping anyone who wants help with lifestyle factors, pateint referred by a health professional, with a long term condition such as a breathing or heart condition.

Patients will be supported to make changes to their life and prioritise improvements. This will be monitored through questionnaires at the begining and at the end of treatment. This will be supported by a GP lead – Dr Emma Hamilton.

We have been reaching out to local contacts in Physiotherapy (Ultimate Performance Lifestlye – (https://www.upl.life) who are putting together some video’s to help people stay more active. We have also worked with a local Personal Trainer (Giuseppe Polvere) who has put together information on Nutrition and Staying Active with exercise. We are interested in working with local dieticians and if you are available and would like to be part of this work – please contact us.

Screening questions to be asked:

What two things in your life could you change that would make you healthier and happier?

If the mention other issues such as housing, financial struggles they may be referred on to other appropriate services such as the social prescribing team

Are you ready and able to make that change right now?

(this might reveal that they would like to make a change but have circumstances that mean they are not in the right position to target it right now)

If the answer is no at this stage we would ask

Would you like us to provide you with some written information?

Are you happy for us to contact you again in 3 months to revisit this?

Would you like our support in making these changes?

If the answer is yes we will add them to the health coaching waiting list.

• General Practitioner lead
  • Oversight
  • Clinical governance
  • Debriefing
  • Review of plans
  • Review of service alongside other leads
  • Consideration of development of resources to support patients
• Personal Trainer
  • Information – Where to start with exercise
  • Goal Setting
  • Planning / Plan to follow for patient
  • Discussion about benefit of Exercise
  • Discussion re effective nutrition to support exercise goals
  • General lifestyle advice – re smoking, stress, alcohol and impact on these goals.
  • Goals: Weight loss, Improve CVD fitness, Improve Strength, Energy and Mental Wellbeing

• Physiotherapists
  • Importance of keeping active
  • Keeping mobile and strong
  • How to keep fit and strong if you have a pre-existing condition / MSK issue
  • Prevention of injury (stretching / balance etc)
  • Virtual physio

• Mental Wellbeing
  • Why is it important and how do do it
  • How to manage stress, low level anxiety and mood
  • What are the different therapies how do they work and what might be right for you
  • Self-help – what can people do to help
  • Effect of alcohol, caffeine, diet etc

• Nutrition (could be part of PT or dietician / physio)
  • How to have a healthy balanced diet
  • Food groups
  • Food and different conditions
  • Differing options to help i.e. intermittent fasting. dietdoctor.co.uk

Please see some useful links:

Weight Loss (Weight Reduction) | How to Lose Weight | Patient

Physical Activity | Healthy Exercise Advice | Patient

BMI Calculator | Check Your Body Mass Index | Patient

1. Get up and moving– a minimum of 30 mins a day walking can really benefit the body if you can’t do that then break up that 30 mins into two 15 min slots,
2. Track you progress– use a pedometer to really keep you motivated by tracking the amount of steps you do, set a goal (10,000 steps) is equivalent to around 5 miles! If you have a goal you are more likely to lose weight and improve your fitness
3. Work out with a friend or family member- one of the best motivators out there and it doesn’t cost a penny! By training with a friend or family member can be a great stimulus to not give up and push on further
4. Set SMART GOALS- Specific, measurable, achievable, realistic and time bound. For example, 15 min walk, 3x a week Mon, Wed, Fri this initial goal is more than achievable, realistic and doesn’t take too much of your time up. Always write your SMART goals down
5. Use visual goals/reminders- using notes of fridges, computers or having alerts come up on your mobile will mean your walk or activity is more likely to happen not to mention you’re more likely to be successful long term if you focus on one thing at a time
6. Use your initiative- if you use your car for a 5-10-minute drive- WALK If you take the lift at work-TAKE THE STAIRS Simple options like that can make all the difference long term and will always have a benefit for your health
7. Keep mobile- If you know you work a very sedentary job or are at home a majority of the day use 5-10 breaks to walk, stretch or change the scenery in order to keep your mind and body awake
8. Test yourself regularly- Keep up with your haemoglobin and blood glucose testing. Good test results can encourage you to keep with an exercise program, even when it feels tedious.
9. Reward yourself- have a positive approach to everything you do whether it be exercise, work or your lifestyle as you get fitter, lose weight you will have more energy which in turn will make you feel more alive and give you a sense of achievement
10. Look at the big picture- building up your fitness/exercise levels isn’t important, in terms of the bigger picture what you need to look at is your health long term and having a sustained level of health and fitness making it a behavioural change and not having the mind-set that everything will be perfect in 2-3 months

Importance of pre/post workout care)

A huge aspect of exercise that is neglected by many people is stretching and care after both before and after they have exercised. However, both have great benefits and should always be integrated in order to help recovery and boost performance next time.

The main benefits:

BODY

• Helps improve flexibility (increase range of motion)
• Assists correction in posture (lengthening muscles that are usually tight, (because of so much time at our computers, many of us have tight chest muscles which pulls the shoulders and head forward, leaving us with a hunched shoulder look)
• Potential to decrease injury by preparing muscles for work before activity
• Increases blood and nutrient supply to muscles, thereby possibly reducing muscle soreness

MIND

• Even a short amount of time (10-15 minutes) of stretching can calm the mind, provide a mental break, and give your body a chance to recharge
• Classes like yoga or Pilates offer you a chance to spend an hour releasing tension physically and mentally

To get the most out of the stretching you do, here are some suggestions

• Commence with dynamic stretches, think of dynamic stretching as more of a warm-up for your muscles. These involve wide range movements, instead of static holds for your muscles. An example could be moving your arms in circles to get the blood flowing in your muscles, or a few low-impact squats. The goal here is to get your entire body ready for the workout, and to loosen up your muscles. Dynamic stretching can also elevate your heart rate better than static stretching and get your entire body ready for the rigours of your exercise program.

Warming up, stretching & foam rolling (SMR)

Warming up regardless of what exercise, fitness level and age you are it is essential you do some sort of preparation in order to prime your body what activity below is a great simple full body warm up, in addition to the warm up stretches (diagram below) can be done after exercise

The super 10 full body warm up

• 10 reps on each exercise

1. Open chest/back push & pull
2. Arm circles
3. Scapula (upper backretraction)
4. High knee to chest (10 on each leg)
5. BW Squats (Slow and hold at bottom)
6. Leg swings
7. Hip abductions
8. Shoulder rotation
9. Hip rotation (leg swing out to the side)
10. Side lunge/rotate torso/ arms overhead

Stretching

Foam rolling

Myofascial Release is a safe and very effective hands-on technique that involves applying gentle sustained pressure into the Myofascial connective tissue restrictions to eliminate pain and restore motion. This essential “time element” has to do with the viscous flow and the piezoelectric phenomenon: a low load (gentle pressure) applied slowly will allow a viscoelastic medium (fascia) to elongate. (John F Barnes) Is an internationally recognized physical therapist, lecturer, author, and the leading authority on Myofascial Release. This can be used pre, during or post training and also very beneficial on a rest day as active recovery to speed of your body’s recovery process.

Exercise

Reps/ Sets

Notes

Feet (Base of foot)

5 x 3

Inside-outside of foot

Soleus (Inner calf)

8 x 2

Find trigger point use other leg

Gastrocnemius (outer calf)

8 x 2

Find trigger point (upper calf)

Quads

5 x 3

Start together then go to single leg (increases pressure)

Hip Adductors

5 x 3

Be cautious as this area is very tight above the knee joint

IT band

8 x 2

Foot on ground then go to elevation

Piriformis (Glutes)

8 x 2

Use other leg across knee

Lats/trapezius/ neck

10 x 3

Use ROM available

Following on from the beginner myofascial release programme a great way to see how affective it has been is to do controlled static stretching of both the lower body and the upper back region:

• Hamstrings
• Quadriceps
• Groin/Inner thigh
• Lower back
• Upper back/trapezius
• Shoulder rotation/ROM (range of movement/motion)

Simple 30 min training program

Bodyweight to start

Progress with light weights