Therapy Intensives

Mike Poole of Walk This Way Oxford is well known as The Coach for children with Cerebral Palsy. In today's episode we discuss therapy intensives and explore topics of expectations, mindset an accountability.

Edited Transcript

Marsh Naidoo (00:13):

Welcome to the Raising Kellan podcast. My name is Marsh Naidoo and I blog at www.raisingkellan.org where we curate resources for parents raising children with disabilities. On today's episode 81, we are joined by Mike Poole of Walk This Way, Oxford. As always remember, the information provided on this podcast is purely educational, and if you are seeking advice for your specific situation to contact a trained professional. So put your feet up, grab that cup of coffee and get ready for some awesome conversation.

Marsh Naidoo (01:01):

Guys, we are joined today by Mike Poole of Walk This Way, Oxford. Mike, thank you for taking the time to chat with us.

Mike Poole (01:10):

Oh, you're very welcome. It's nice to see you again.

Marsh Naidoo (01:12):

You as well, Mike. So we got to spend a week with you this winter in the first week of December in Houston Texas and we took away so much from that therapy intensive.

Mike Poole (01:33):

Did you find it hard?

Marsh Naidoo (01:34):

Yes.

Mike Poole (01:35):

It's hard to watch, isn't it?

Marsh Naidoo (01:38):

Very hard. And, you know I think the hardest part for me as a parent was kind of the mental work that was done. I think you know, stepping away from it, it was work that needed to be done. It kind of gave me a jolt and reason to kind of set different expectations of what I needed from Kellan in terms of our therapy and our home program.

Mike Poole (02:13):

So, do you mind if I ask you a question? Right,

Marsh Naidoo (02:16):

Go ahead.

Mike Poole (02:17):

You're, I, I really enjoyed working with you. It's, it's unusual to get somebody that's as highly trained as you to actually work with as well, right? So, I mean, you're a highly trained, highly specialist physical therapist that focuses on pediatrics and neuromuscular, so you get this job. But I think you've just nailed something there as expectations. What were you? And it's harder what It's your own kid. I mean it is really hard coaching your own child to do anything, you know, a coach that coaches your kid to do soccer or rugby. You just, you're so attached that sometimes you to sort of take that bit out and plunk it there and, and let somebody else do it, right? But I feel a big difference between what we do in our program and what a lot of therapists have is that our expectation doesn't start at ground level. Our expectation is set where we want you to get in five years and where you want to be going, not setting it at a low level. And is that something that you found as well? That the way that we guide the course we have, we have direct goals that we want to achieve, and everything that we're marking towards is that.

Marsh Naidoo (03:37):

So I've always in my head, had the opinion that yes, I need to train Kellan as an athlete, but I very much worked within his comfort level, not trying to push through and level up.

Mike Poole (03:53):

You also brought me a child that was already used to working. It was, you didn't bring me Kellan that had done virtually no therapy, no hard therapy, no intensive therapy, no dedicated strength therapy, no dedicated movement-based therapy. You brought me a child that was used to coming in and working and was used to having an expectation and rising to that expectation. So actually what, what I did and what you did was actually not that dissimilar, but the difference was I looked at it with a fresh pair of eyes and looked at it with coach's eyes as opposed to looking at with physical therapist eyes. And there is a slight difference.

Marsh Naidoo (04:33):

That was a learning point, I think for him. For me, I really enjoyed the program with you, Mike. And I also think Kellan. Tt's kind of given him, as I said, that whole mindset of get it done,

Mike Poole (04:46):

Nstitute <laugh>. It is that though, isn't it? I mean, what you do, the, the way we coach and you, you saw me coaching other kids as well. It, it is very different from each child, right? You know, the way that I trained Jayden, if I trained other kids like that, you'd be like, yeah, you can't get away with that Mike. But the way that I trained Kelllan you'd be sitting there going, you can't get away with that Mike. But it was exactly what each individual needed. And it's knowing that coaching ability to, to actually take the individual. So you gotta take into consideration the mindset of the person that you're working with, right? And the mindset of the pearent that you're working with. Also, because if the parent has an expectation of results but isn't prepared for what you have to do to get to them, so pushing, sometimes you have to take two courses or three courses to get the parent to that so that they're ready.

(05:39):

So they're primed. And the home workout program we give you to go home with is there to teach the parents just little bits of information so that next time I see you, it builds on top of that knowledge and on top of that knowledge. But you learn so much in physio school. We learn so much when we are doing s and c training or we're doing sports science. So we're, we're doing massage therapy, but you learn massage therapy as part of your physio school. But arguably how much of it do we actually use? And it probably not as much as what we maybe should do. We spend so much time doing static stretches and so much time doing dynamic movements and it all sounds buzzy and good, but actually how often do we sit there and actually feel the kid's muscle moving or feel the kid's body moving or feel the joint and go, oh, that's bound up.

(06:31):

How can they release that? Well, the popliteal, the gastro, the seven-member nose semi-tendonosis, the bicep more, these muscles are tight and bound and they're not allowing for knee extension. And you know, the tightness that they've got is causing secondary problems into hip flexors and their glutes aren't working because of it. And we sit there and we go, so what do we do for that? Oh, use estim Or we bring it down to another level. What about we actually try massaging it and we try opening it up. We do some capping, we do dry needling, we do some str techniques, soft tissue release, some muscle energy techniques. And the METS arguably is, is stretching. You know, back in the old days when I trained we did PNF stretching, right? But now we, we do more METS. It's a little bit softer, but the result is better If we can teach that to the parents.

(07:25):

Basic massage, basic STR basic METS, -'s a lot nicer for the kid or for the person having it done to them. And it lasts an awful, awful lot longer cuz you're making the fibers actually realign. But we forget about it because we get so focused on walking, we get so focused on movement, we get so focused on all the things that we want to achieve, but we forget that actually the minutiae, the little things are actually what make the big things happen, right? You know, you can only teach a kid to take their first step once right after that. It's building on that. So you've made this big wow moment, but how do you get to 10 steps and 20 steps and 15 steps? Well, you have to break it down. And that's I think what we forget sometimes We forget in therapy, right? That we actually need to have a plotted goal and a plotted achievement.

(08:17):

So my expectation level is that I'm looking five years down the line and breaking that into years, quarters and achievable bite-size pieces. And we're looking at what we can in a course, what can we maximize results on today that's gonna impact tomorrow and the next day. And I think that's the key thing. Don't you think it's, it's when we, and it is, this isn't me taking anything away from anything at all, or physical therapy or strength and conditioning or anything. But when you work with athletes, we've got a beginning, a middle, and an end. We're told we've got this competition here. I have to be ready for that. We have this competition here. We have to be fit and conditioned for that. We have to be on it for this competition. But in therapy in general, we know it's a chronic condition that's lasting for a long time.

(09:10):

So we don't plan, but we have to plan, right? Because otherwise what are we doing? We're just going through the motions of little circles. Oh, we did this today, great, but what's it leading to? Oh, we did that today. Great. What's it leading to? What's the functional improvements? What's the functional gains? And I think that's the difference on the intensives. And when people come weekly for us, it's what are we trying to achieve? What can we get? How do we improve you? And if you're not looking for that, then we shouldn't be working with you because we should all be working towards maximizing your potential, right? Otherwise, the kids' training so hard, but they're not seeing any results. So we don't think about it. But if you and I were working with a personal trainer and we weren't losing weight, we would stop. But we forced the kids to keep going to therapy and never see improvements.

(10:05):

So sometimes, sometimes I will push the kid way beyond where they are to get that step to show that they can take it. Yeah, we might have had a few tears in tantrums, I get that. But to prove to them and to the parent that actually it's there. And then strip it back and go, we know we can do it. This is how we make it functional because three steps, four steps, and five steps, that's a party trick, right? Mm-Hmm. <affirmative>, it is, it's not being horrible by the way. It's is a great achievement. But if you can only walk three steps and you've got someone beside you the whole time, it's, it's a party trick. It's a, it's a training modality. You've gotta be able to do that on your own. So you gotta get mentally, you've gotta be prepared for that. So that's what the physical training is for.

(10:52):

It's teaching the kids to fail is teaching the kids. That stuff is hard. It's teaching the kids that it's okay to fail. It's okay to get upset. It's okay to be annoyed and pissed off. And teaching them that it's okay to have an emotional response to that. Who cares if they cry? They're allowed to cry As long as we're not being horrible to them, which we're not. Let them get upset because, you know what, how many times is a parent with a kid with a special need? Have you sat there and got upset? How many nights have you had? Or you sat there and you've gone, I don't know if I can do this anymore. This is really hard. We had that conversation, you and me, and you're like, no. And then two days later you're like, this is hard Mike. And I'm like, boom.

(11:33):

You're like, dang it. Because we all sit there with it. I, as a coach sometimes sit there, I go home. It, it's not, I've forgotten about after the session, I go home and I chastised myself on what I did wrong. What could I have done better? How could I got better goals? And then I come back tomorrow and I start again. And sometimes I come back and I give the kid a hug and I go, you did really well yesterday. I'm sorry it was so hard, but you did really well. Did you imagine? Remember what you did? And that's sometimes for them, sometimes it's for me, sometimes it's for both. But sometimes it's breaking bread and just like resetting and starting again. But they have to understand like, we do that an emotional response is just that, an emotional response. Let them have it, let them move on from it.

(12:15):

Don't hold it up, cry, get upset, get angry, get furious. But we're not stopping because we're angry and we're furious and we, we failed. That has to be a driving force into success. And if we remember that, the kids can do amazing. We've had, oh God, thousands, eight, 9,000 courses I've run in the eight, nine years now. 10 years. Oh my god. 10 years. And in that, one of the things that we do is we teach people to fail. Teaching you to fail is massively important because I've failed so many times, like tons of times. And the failure teaches you how to succeed because you, what are you learning from that failure? But we forget about it, don't we? Because we don't want our kids to fail. Cause it makes us feel sad, but actually they kind of need to and it's, it's okay that they failed. So it's a case of working through that failure and teaching them to succeed.

Marsh Naidoo (13:15):

Let me ask you this, Mike mm-hmm. <Affirmative>, you know, I think, I mean, I'm curious. Tell me a little bit about how you came to do the training.

Mike Poole (13:25):

So I grew up with, on livery yard with hundreds of horses. So we were always schooling horses, breaking them, selling them. I was a show jumper. We did dressage. Om was an inventor. I, as a show jumper, I, I enjoyed it. But we were always breaking new horses or taking in owners horses and re-schooling them for them. So we had like, I think at some point we had like 30 or something at delivery yards. So there was quite a few up there. But I was, I was quite young at the time, so the numbers could be a bit all over the place. And then really young, I got into martial arts. So five, six years old. Started karate kickboxing, bit of judo here and there and competed at quite high level for that. Was a swimmer

(14:18):

Hated swimming. Absolutely hated swimming, but loved water polo. So got into play water polo at international level. I think I was 15 or 16 by the time I was playing for my country. And did that for many, many years. And then I still did martial arts and then taught martial arts. And love it. It's, it's great fun. And kind of fell into coaching by mistake. I'm chronically dyslexic so I couldn't read and write properly until I was about 15. And the interesting thing is the answer to learning to read and write was not to do less of it but to do more of it. But make the training to do it a bit more specific to you as an individual. So I hated books on, you know, when I was growing up, it was the Famous Five and Edith Blyton, typically English books.

(15:22):

It's terrible, terrible. My grandmother always be like read these. I'm like, is that, they, there, them, than I don't know what that word is. I mean, it was boring. They were going on these adventures, but they were sappy. And I was like, I was having way cooler adventures than that. I was like riding the horses around fields without any stirrups or saddles or bridals on falling off and climbing trees and falling out of them. We were building dams and, you know, doing crazy stuff. And it, it just, nothing enthralled me. And then I got this old motorbike in a Hanes manual and it, Hanes manuals it like a, a workshop manual for this motorbike. And, you know, started reading it on how to break this motorbike down and started rebuilding it. And it kind of just gave me the impetus.

(16:12):

Then I got a really cool math teacher at, at school. Cause I never really went to class as much. I more stayed in PE and did all that jazz. And then I got this math teacher that did what I do to the kids and every objection I had, he whittled it down in there. But why? But why? And then it turned out to be, if you worked as hard at maths and English, you would learn to, you know, do that just as well as you can run. Just as well as you can play water polo just as well as you do other things. You just haven't learned how to do it properly. You just haven't had someone to guide you and show you and kind of changes your brain a little bit. And then I suppose it kinda went on to, it became a challenge not to fail more than anything else.

(17:05):

Still preferred doing sport though. Books are, were still pretty boring. And now I will only read books or research papers. I must read 15 research papers a month. And not always just the abstracts, but just find something that's relevant to what we do because you're always just looking for something, right? And you get to a certain level where you go on a training course and what you're learning is mostly recap. I mean, let's be fair, you know, most of the bones in the body, you know, most of the muscles in the body, you know, the peroneal longus, you know, you might have forgotten the exact origin and insertion point, but you know where it goes from a two, but you might have forgotten the exact name. It's the lateral epicondyle or whatever it is, or the medial epicondyle or, and you're like, ah, it's spout there and there, but you, you know what you're on.

(18:02):

So you'll take 5% away and that might be remembering the origin or insertion point and or a technique that you didn't think of or a technique you didn't know. And that when you're at a certain level is gold. And just learning that one thing. And I got into it completely by mistake. I was the head of sports science, well, I was working with the juniors and the, and the under 19 pro youth at Dundee United. It was a great job. So much fun. I was working with a guy called Ian Cathrall and he had me working with the kids and I loved it. And then I started doing quite well at it and I had a really good personal training business as well. And then went from there into maybe I should, I should just do this as my full-time job and get back into sport.

(18:56):

And I already had a lot of coaching qualifications, level fives, level sevens and strength and conditioning, biomechanics. But it's really hard to make money out of it. You have to have, be something different. And I wasn't wanting to be a personal trainer in the gym. And so kind of one thing led to another and there was a child with cerebral palsy that a parent asked if I would work with. And I kept turning it down and saying, no, it's not my forte, it's not my thing. It's not what I know anything about. And to be honest with you, working with kids that young, he was four scared the snot outta me. You know, child protection, you know, and then parents are like, oh, but it's fine, you know, we'll be there and you're like, oh God, what if I dropped the child? And you know what, what if you know, something was, oh God 'twhat if they start crying and, and you know, you sit there and you, you get the anxiety sweats from the thought of doing it.

(19:52):

And then you're like, no, I, I can't, it's, it's not what I do. And then a couple of weeks later they come back to me and ask me again. I was like, look, I can, they says, well our therapy's not working for him. We've been told we need to find somebody who's a strength coach. You are a strength coach. And I was like, oh, I dunno. And the child had this operation sdr and you know, I was like, what? What is this? They cut into his back and cut the nerve roots. I'm like, they did what? And he was like, yeah, they cut the nerve roots. I'm like, you're grabbing a laugh and what do you want me to do? I mean, must be paralyzed, right? And, and they're like, no, no, it's just remove the spasticity. Like the what? And it's just all these things.

(20:32):

I'm like, oh god, you know what? I need to send me the research. So they sent me loads of research papers and I started reading them and I was like fascinated. And I'm like, wow, it's amazing. So I get back to them and I says, look, I still won't work with you, but you know, I'll give you some programs and some things to do for strengthening. And he says, well, would you come and watch 'em in therapy? I was like, sure, come and watch you in therapy. That's, that's not a problem. So I have a sitting down, how long ago it was, had a not, I had a an iPhone. It was a three Gs so the original iPhone. And I'm sitting there with this thing, it was basically an iPod that took calls, right? I'm sitting there with this thing in this physio room with this kid and I'm like taking avid notes on my phone.

(21:21):

And the physio hated me cuz he is like looking at me on my phone thinking I must have been playing snake or some random game. And at the end he's like, so what do you think? I was like, oh, it was really interesting. Thank you. In the back of my mind I'm like, that was the worst session I've ever seen. He never said hi to the child. He never spoke to the kid. He never held the kid, he never really engaged with them. There was no toys. He wasn't, it's fair enough not having toys as long as you're engaging with them, right? You have to at least speak to them. And, and I'm sitting there and looking at this session going, God, what were you trying to achieve? And you know, they had him standing at a physio table, but the table was so high that he was up like this and it was above his eyes.

(22:04):

And I'm like, I don't understand the benefit to this. What are you trying to achieve? And you know, afterwards they stretched them and the kid's screaming and I'm looking at the stretch being like, wow, that's pretty severe. And I'm like, just do a bit of massage on there and open it up that way. And so I'm taking all these notes and asking questions of myself and then afterwards you kinda berates me and I was like, oh, I'm sorry, you obviously thought I was just on the phone. Just I wasn't checking text messages. Look, I've taken notes and I had these screens of notes and he is like, oh. And he is like, well what do you think then in your opinion as a strength coach? And I was like, I know nothing about it. I've just got back and speak to the parents.

(22:43):

So I did and I told him what I saw and I asked lots of questions and I says, well, we don't know, but could you speak to the team in St. Louis? And I was like, didn't really know much about them. I was like, St. Louis, like, yeah, the St. Louis Children's Hospital. And I'm like, sure, I'll speak to them and you know, I, I know what they wanna know. And they said, they just wanna know what it was you're seeing and what you think and your opinion. It's like, of course I'll happily do that. And then you google it and you go, oh, this is quite serious. This is like, this is like one of the top-rated children's hospitals in the world. And I'm like, who is Dr. Park? Who is Deanna Walter? And I'm like, oh, now I start to get real big sweat panics.

(23:23):

And I'm like, oh, this is, I need to up my game here a little bit and phoned Deanna and introduce myself. And she's like, yeah, hi. Couldn't be nicer. And then she's like, tell me what it was that you saw and explain to me the session. And she's, and she's like, yeah, you know, that doesn't sound like it's gonna be that productive. And she's like, what would you start with? I was like, well, you can see that he's not engaging any glutes. There's no core muscles. You know, QL looks pretty bad. He doesn't have range in his hamstrings, but he's not getting any vmo. He is onto his toes. You know, I, I mean I would personally, if I was looking at him and I was gonna work with him, which I'm not, I, I would start at core and she's like, great. And then go where from there I was like, probably this though.

(24:09):

And go from there and then come back to core and then work slightly more, you know, upper body maybe, and start to get that to engage a little bit more and you know, try and reduce the tone and separate patterns down and you know, but work in that order. And she's like, great, when do you start? And I was like, oh no. And she just was lovely and just told me that, you know, she would coach me, she would help me, she would guide me, her and Dr. Park give me all the help and encouragement, anything that I needed, they'd be there on the end of her phone and they were a hundred percent. So I got into this completely convoluted and thanks to the team at St. Louis for not taking no for an answer. And then I suppose about 10 years later, I'm close to 2000 clients.

(24:58):

I did have at 3 or four therapy centers, but Covid knocked that on. But we're working on that one. So it, it was a, it it was very interesting. I came very quickly to, to deciding that this, it, it, there had to be a structure and it's like we were speaking about before where we have had to have a beginning and a middle and an end, right? And I think a weekly sessions you forget to have a beginning and a middle and an end. Cuz it's almost ongoing. It's open-ended. But actually we probably should every 12 sessions go back to square one.

Marsh Naidoo (25:34):

In my personal opinion, and this is strictly from me talking from a parent standpoint I do think that the neurodevelopmental therapy to teach the motor planning is necessary that that early intervention piece. But I do think

Mike Poole (25:51):

Rolling right? Rolling is key.

Marsh Naidoo (25:54):

Yeah. But we do have to, you, we do have to move towards that strength and conditioning and you know what, you are right? Our kids work hard. However, that level of intensity, I see no reason for it to be open-ended. I see for us having therapy intensives for a week to two weeks, then the parent and the child teaming up to work together to carry that at home. And then coming back for review and that cycle kind of continuing because this is not something that's gonna last three or four or five years. This is something that's gonna be forever in all likelihood.

Mike Poole (26:43):

Into adulthood. Yeah, it's not gonna change cuz they're an adult. Doesn't change. We just have to set them. We just have to give them some really good tools so they can live the rest of their life.

Marsh Naidoo (26:54):

Agree

Mike Poole (26:55):

How is that different to the neurotypical child that does football, basketball, hockey, rugby, American football and then games at weekends? It's really no different. I mean when I was, when I was a swimmer, a poor swimmer, but when I was a water polo player and a martial arts, I was, I was playing, I was in the pool sometimes at seven in the morning. I was doing the horses early in the morning with my mom. Sometimes I'd be riding before school and then I'd be, you know, doing martial arts in the evening. And then sometimes I'd also then go straight from martial arts to water polo and I'd double up and I'd be ruined by the, by the weekend. But weekends were game time. So, you know, or I'd be, show jumping at a competition or I'd be at a martial arts competition or something, right?

(27:46):

I'd, I'd be doing an activity. What we're asking of the kids is the same thing, but for them unfortunately it's a requirement just now. And as horrible as that is. So we need to make it in such a way where it's not just play and we can't just make it play therapy. You have to understand as well that it is quite serious and important that it is there to benefit them. And there is there, there is a necessity to do it and it will help them. And once they get on board with that and they start to see themselves improving, surely that in its own right gives them the, the sort of catapult effect to move forwards as well. Right.

Marsh Naidoo (28:24):

The internal drive

Mike Poole (28:27):

It's hard

Marsh Naidoo (28:28):

Very much. I mean that is very much how you learn to, to manage and to self-manage and I mean that's the reality as well, isn't it?

Mike Poole (28:42):

A hundred percent. It's hard though. It's hard for the kids, but I think it's harder for them if we play the therapy. And I don't mean if we do play therapy, right when they're young, yes we have to play games and we have TVs on in the gym and we put TVs on in the clinic because I want distractions for the kids. And then to snap them out of those distractions and learn the noises or white noise and that they can learn to walk, have a TV on and a movie that they want to watch but not allowing them to watch it and forcing them to do the therapy. And it sounds terrible, I'm forcing them, but I'm asking them to concentrate on the task that I'm asking them to do but make the noise and the TV background noise and not make it the prime focus so that they learn to focus on something else as opposed to the thing that they really want to see.

(29:29):

Because if we get the kids to walk and something distracts 'em over there and they look at it and they're not concentrating on where they're going, what's to say they're not gonna walk out in the middle of the road or they're gonna somebody or fall into something. So we're trying to teach them to be aware of their surroundings by learning how to distract themselves from stuff, right? That's functional training that's teaching you to be prepared for life. But if we just make the therapy just fun, so we're almost tricking them into doing it mentally. They're never putting the pieces together that it means something. They're never sitting there going, you know what, that leg extension's really important because that teaches me to kick my legs forward. That teaches the muscles to work in the way that they're supposed to work. Because when we come through swing through, we are doing a leg extension, you know, we're kicking that leg forward, we're putting it onto the ground.

(30:24):

That leg press is similar to us pushing and transferring the load into it. That single leg movement switching the weight over, that's like when we're on the balance board and we're shifting our weight from one side to the other so that they can start to see how these pieces all link up to improving their quality of life. But if we just turn it into a game and they don't understand, there is a necessity, obviously it depends on age and the maturity of the person, but as a coach we have to also kind of help them to mature and help them to grow up and help them to understand the necessity. And you know, we had chats with Kellan and said to him, you know, this, this, right now it's hard but look at how it's helping you to stand. Look at how it's helping you to walk.

(31:09):

Look at how better you can stand and walk now than you did four days ago. And you'd see his brain tick over and go, yeah, actually that's right, I can, so you're making that cognition improvement as well. Ut that's also because you brought us a child that was used to hard work and used to working and he was in really good shape. We didn't have to build up everything strength on him. We could just build on what you'd put in him and allow him to grow and do what we do on top of what you'd already done. And that's the difference. That's that symbiotic. Ooh, I like that symbiotic relationship where two therapies that are quite different, but actually were not that different joined together to create constant improvement. And that I think is the keys between, you know, strength and conditioning coaches, biomechanics, movement, you know, we're not that dissimilar from physios.

(32:11):

And physios are not that dissimilar. The difference is how we approach it and you know, you learn to do massage but we forget to do it so we do it and you go, damn, why don't we do that? I don't know. Why don't you, okay, so kind of away doing everything else. I know sometimes we need to take a breath and reevaluate and why didn't I do leg extensions? I'm like, because you spent so long doing tool taps, which are valid and doing glute lifts, which are valid. But actually he's beyond that now. But we didn't think about that because we didn't look at where the next point was. We needed to get to it.

Marsh Naidoo (32:52):

And I think that's what I, I would like to say that's when it is so valuable for a parent. And I do understand us doing the therapy, but sometimes you really need to get a different opinion. And, and you need to actually seek out different providers because it's just not about having one point of view. For your child to grow, you're gonna need different input coming in. I mean it's those

Mike Poole (33:23):

Hundred percent.

Marsh Naidoo (33:24):

Yeah, you're gonna need those separate pieces gonna need those separate pieces working symbiotically.

Mike Poole (33:33):

It's good isn't it? I remember that one. Do you know what? I've never said to parents that you shouldn't do this therapy or you shouldn't do that therapy or our therapy is all encompassing. It's really not. You know, I get so many people out there and therapists, physios, whatever. He's just a personal trainer, I'm just a personal trainer and that's absolutely fine. That doesn't bother me. And the slightest, I am a personal trainer. I personally train individual people. I'm not training groups. So actually you're a personal trainer as well. We're all personal trainers. We're personally working with that individual. If we want to look at the actual semantics of the name, but forget all of that. It shouldn't matter about what each individual person's, individual qualifications are. If you, let's say you've got a PhD in splints, right? You've done a PhD in how splints can help somebody to walk.

(34:24):

Your PhD is in that, right? But that doesn't mean that you're already automatically because you have a PhD in that one thing no more than somebody else about building strength or building muscle because your PhD is very focused on one thing, right? So the point being is that no one has the right answer. So I would never turn around and say to somebody, oh you absolutely should never do that therapy. I'll give an opinion on it. For instance, there's therapies out there which I think at certain times in a child's progression work really well. They work really well with spasticity, they don't work so well when the spasticity's gone and we do S D R because we need full range of movement. We need the whole joint to activate. We need all the muscles to work not just holding into a tight position, but when we've got spasticity we can build strength by holding a position outta this spastic range and do movements that are building movements and strengths that don't just kick the spasticity in, right?

(35:29):

But I would never turn around and say don't try something. You should always try it and make up your own opinion whether it works or not. Not one. Therapy is for all and and there's a lot of therapies in a box where everybody does spider, everybody does suit, everybody does groundwork, everybody does this, everybody does that. And that's unfortunate cuz you're basically shotgunning it. And I think we need to look at these kids as an individual, right? You saw one of our clients that you work with who I've worked with since they were what, five, four. And you know them very well. I know them very well. I didn't train that client the same way as I trained Ken trained them completely different because guess what? They're completely different. It's not turn to page 62 of the, of the CP manual and we do X, Y, and Z.

(36:22):

It's throw the manual away, get your hands on the person you're working with, feel the weakness, feel the strength, see the issues, work through each point as you go and come up with a plan. But we do that with our weekly clients, not just our courses. So clients that come to us weekly that we see week on, week out, twice a week, sometimes we do exactly the same. We do a massage on a Tuesday or we'll do a massage on a Friday for half an hour or 40 minutes. We'll strengthen. Sometimes it's upper body, sometimes it's lower body, sometimes it's upper body then movement. Other times it's massage and lower body and movement. It doesn't matter. But we have a plan of where we're going to and it's always quite intensive. It's always quite tough. But our goals are slightly different than when we do a one, two or three week intensive because I only get 20 hours or 30 hours or 10 hours to make an improvement. And you parents, you expect an improvement. You expect to come in for your 10 hours worth of therapy and see my kid improving. And that's why we ask at the start of the course, what's your expectations? Because we have to manage them. Cuz I've got a child who has never walked, never taken steps before. And I get it, they come in and they say, I want my child to walk. And I go, great, what's your time scale?

(37:45):

10 days, right? And you're like, oof. Okay, well let's see where we're at. And quite often or not, we manage to get steps. So manage to get, because the parents already know that the child should probably be there or can do things but they're not being taken outta their comfort zone quite a lot of the time because you get quite attached to the kids when you work with them every week. And I don't, I'm not, when they're coming in in a course, I'm not attached to that child. Not cuz I don't like them, I don't care for them. Quite the opposite. But I don't have that same bond. I haven't had them from three years old or five, they're coming in on a course. So I'm gonna push them and we're then I can send them home again with this course. But in that time I've got to make a result and the change. So it's a bit different for us if we're working with them weekly. Okay. It's a little bit softer and we're not pushing quite as intensively, but we have to make goals. Manageable, achievable, sensible and timed. And you know those smart nonsense. Right? And it does work. We have to plan that out.

Marsh Naidoo (38:52):

Mike, thank you so, so much for

Mike Poole (38:55):

You're very welcome. It was lovely to speak to you Marsh.

Marsh Naidoo (38:58):

Oh my word. You as willing. Listen, I I hate to run. I

Mike Poole (39:03):

Have. I know, I know, I know. Busy times. I've gotta order some food. I've been on the go since six.

Marsh Naidoo (39:08):

Alright, well take you. Okay,

Mike Poole (39:10):

Thank you. See you Marsh. All the best. Bye. See you soon. Bye bye.

Marsh Naidoo (39:14):

Bye.

Marsh Naidoo (39:16):

Mike, thank you for taking the time once again to talk to us on the podcast. Guys, if you would like to contact Mike, he can be reached through his website, which is Walk This Way Oxford. And I will attach that information in the show notes. Guys, until we see you all again the next time, remember as always, get the top of your mountain. This is Marsh Naidoo signing off.