Many therapist have some kind of calling for their job. Often it is due to personal experiences of finding something meaningful to do or something that has helped themselves. My journey is not different.

Most of my life I’ve been overweight, even in my early teens. In the army when I was probably at my slimmest and looked normal, but still bulky. Over the years I steadily put on weight. My weight ballooned, when I got a job at a big IT company. I was working in high stress environment, I was going my Masters part-time and DJing on weekends. This lead to chronic insomnia, obesity and to some extent to depression due to chronic inflammation caused by excess adipose tissue, poor diet and high cortisol levels.

The turning point came when I hit my highest weight in 2007. My weight wasn’t that far from 200kg / 440lb. I was able to function but I wasn’t healthy and felt miserable all the time. I was on my first trip to Thailand and fell in love with the Thai culture and Muay Thai. Since then I’ve saved all my holidays and travelled to Thailand every year to spend as much time as possible. I spent my time in Chalong, Phuket, on a street called Soi-tad Iad, also known as the ‘Fitness Street’. I’d go there for a few weeks every winter, workout once or twice a day, soak up the sun and recharge for the rest of the year. I was doing Muay Thai with a private trainer everyday, for a measly price of £6 / session, have meals prepared, laundry done, and room cleaned daily. I stayed in modest hotels, but they were clean and affordable. It was a stress free environment in the sun. What more one could ask for?

One of my running routes by the River Wey.

As my fitness & weight loss pursuit continued, back in the Surrey I hired a personal trainer and worked out with him couple of times a week. I felt ok, I was losing weight and making progress despite eating strict calorie controlled low fat, high carb diet. Over couple of years, I lost over 30kg / 70lb. I thought I had cracked it. I didn’t continue with the trainer and took up running. Initially I ran lazy 5k’s graduating to 10k runs once a week. It was just so easy to put on trainers and walk out the door with music blasting in my ears and only focus on running. I wasn’t super into running, but I thought it was an easy and cheap way burn calories and keep up the fitness.

Then one morning I woke up with massive pains in my lower legs. Chronic ache, throbbing and tightness like you’d already done a 20k run. My ankles had lost flexibility. Using the stairs was agony, it was so painful I had to move sideways when going up or down. Did I mention I lived in a house with two floors and my bedroom was on the top floor. This lasted for months. I was hobbling around like I was walking on stilts. What I had wasn’t just shin splints. Shin splints can be regional, either on the front of the shin or the side. My pain was all around lower leg.

I’ve retrospectively (self-) diagnosed myself having a compartment syndrome. Compartment syndrome is when the fascial (connective tissue) bag around the lower leg gets too tight and squeezes the muscles constantly reducing blood & fluid flow, pressing on the nerves and reducing movement. This is caused by muscles growing or swelling too quickly and the fascial layers get stuck or keep up with the muscle growth. In order for us to move and function, different layers of tissue from fascia to muscle, need to be able to slide and glide freely. If they don’t, the get stuck and start pulling and pressing on surrounding areas and restricting movement. It’s like trying to run in a too small neoprene diving suit. Dr Google revealed the treatment options to be rest or an operation, where the fascial bag is cut open to release the pressure. I wasn’t keen on surgery, so I chose the former.

After about two or three months, the pain subsided. It was mostly due to swelling caused my inflammation reducing with loss of muscle tissue due to lack of stimuli. I was able to walk again, but I didn’t take up running again, at least for awhile.

Me with Kru Dam at Dragon Muay Thai, Phuket.

The following winter I was again off to Phuket. I was going to have 5 weeks of training Muay Thai, relax and enjoy the sun. I arrived in Phuket. After settling in the hotel, I went to Dragon Muay Thai where I trained to book private sessions. I booked a session for the following day. I was excited to be back in training with my Kru Dam. During my first session, I could only train about a minute or two and then I’d need break being completely exhausted. I thought I can’t be this out of shape, it’s just not possible. I’d try to continue, but needed a break every few minutes. I figured that I just push through it and it’ll be ok, so I booked another session for the following day hoping things would improve. When I was going up a flight of stairs, I’d have stop on every floor to rest, as my legs would just be too tired to continue. When trying to train, same thing. I was completely exhausted. My legs felt like I’ve run a marathon. They just wouldn’t carry me when doing anything that require more movement than just gentle walking. I was disheartened and angry.

At the time I didn’t know much about mobility. In Thailand the concept of mobility was not very clear, it was more about flexibility for the fighters. Most tourists coming to Thailand on a health & fitness holiday could be divided into three different groups; fitness, fighters and yogis. People would come to do fitness classes, training Muay Thai or do yoga classes and this what was offered. Anyone wanting body care would have the options of having a Thai massage or doing a yoga class. There’s nothing wrong with either, but different issues require different tools. I had frequent massages when in Thailand as they were inexpensive and helped my body to certain extent. Thai oil massage can be a bit strong at times. The therapists use forearm on many areas, which is understandable, as many of them are small women treating bigger people. This, however, can be very uncomfortable when pressed on stuck, inflamed tissue. Every time my shins were worked on, I was crying out in agony. My shins just were super tight, tender and the tissue was stuck. Thai oil massage was not helping, despite being mostly enjoyable otherwise.

The second option was doing yoga. Luckily close to the fitness street, Becky, an English woman, had a little yoga studio where she ran classes every day. I had nothing to lose, so I visited Becky and explained my situation. Becky welcomed me to her Ashtanga class. If you’re not familiar with Astanga Yoga, it’s essentially a series of poses done in a sequence. There’s Primary Series, which is basic poses and then there’s Advanced Series. The poses are linked with a Vinyasa flow between the poses. I decided to go every day. And I did. Initially I would struggle a lot with holding the poses, even getting into poses. I would not do the Vinyasa flow between the poses, it just was too much for me. Becky was patient. She’d let me do things on my own pace and correct me when needed. The great thing about Ashtanga Yoga is that even though it’s done in a class, it’s often done at one’s own pace. By the end of my holiday, some four weeks, I had done a yoga class every day, sometimes even twice a day. I was better at yoga. I was more mobile, more balanced. I would do the Vinyasa flows between the asanas. My legs were better. My movement was better. In retrospect, I assume that yoga movements, stretches improved the tissue mobility in my legs. The layers of fascia would rehydrate better.

My defined, but so stuck calves. Note the minimalist shoes Inov8 Bare-X 1.0.

I returned to UK to continue my active life. I had moved to London, and there was a gym quite close to my house. I signed up and hired a personal trainer. My PT was an ex-footballer who also loved boxing. I’d train with him three times a week and take his boxing classes. He was a great trainer and I enjoyed training with him. He used free weights, kettlebells and slam balls in his training. He focused on moving as well as training for strength. You might’ve noticed that I didn’t say movement, but rather moving. Despite being a great trainer, he’s knowledge of movement and posture was a bit outdated. He couldn’t tell I had restrictions on my body, that my movement wasn’t free or optimal. I was training hard. I worked out 4-6 times a week. I was even doing some gentle running. I made progress. I lost weight, burnt fat, built muscle, but on one area I wasn’t making much progress; my movement. My upper body was fine, but when doing things like squats, I wasn’t able to go very deep and I was struggling with even light weights. I just didn’t have full range movement. I did try to do some stretches after the training, but as I learned later on, stretching stuck tissue is not very productive.

I trained with my PT for a year. I was getting ready to go for my annual escape to Thailand for Christmas. I wanted to be in top shape to maximise my training holiday. Everything’s been going well, until end of November. Just couple of weeks before I was to fly out. My PT put me doing split squats, or some might call them lunges with a barbell. Pushing myself hard, I lunged down and immediately felt agonising pain in my inner thighs. I had to finish of the training session and cancel the remaining ones before my holiday, so I could recover and be ready for my training holiday. My adductors were jammed up. I kept having adductor cramps. My body really didn’t live that particular movement. I couldn’t really blame my PT. He did his best, got great results, but he just wasn’t knowledgeable about body’s fascial tensioning network, the Anatomy Trains. I’ve since come to believe that every PT should be familiar with Anatomy Trains and focus on doing movement assessment first and then focus on getting the basic movements before loading any weights on any part of the body.

Note the wrist supports. I had to wear those as loading the wrists was painful (due to lack of mobility).

This holiday I was spending at a different fitness camp, PhuketFit. I wouldn’t be doing any more Muay Thai, mainly because I couldn’t really kick well due to limited mobility, but also due to kicking pads would bash my shins’ fascia into muscle, making it thicker, denser and also harder to mobilise, which is needed for full range motion. At PhuketFit I met Justin, who nowadays runs his own successful coaching business in Phuket. Justin was movement oriented PT, unlike most PT there at the time, who were more focused on bodybuilding. I took his classes, which were circuit training, bodyweight exercises hitting different areas of the body at a time. It was very different from what I’ve done before. I’ve gone from more static reps, rest, reps approach to compound movements and high intensity training. Even after adjusting to this different approach, I was still struggling. Lower body movements were uncomfortable and awkward. Even with just bodyweight only, I couldn’t do more than a quarter squat. I was still very stuck. I took yoga in the afternoons. It was very different from Ashtanga. It was Yin yoga, with longer, gentle poses and focusing different areas in different sessions. I learned a lot from Justin during those weeks I spent at PhuketFit. We kept in touch and every time I’ve been to Phuket, we’ve worked and worked out together. He’s been teaching me about training and I’ve been teaching him about Anatomy Trains. I even pushed him to do the Anatomy Trains In Training course to further increase his knowledge. He’s since applied that knowledge to coach world class fighters. On the last week of visit, I caught tonsillitis. I thought it was just a sore throat, but when I wouldn’t go away, I visited my GP and he sent me directly to E&A for IV steroids & antibiotics to prevent accidental suffocation.

I had been curious about Crossfit for awhile. I didn’t relate to bodybuilding or normal gym training as I found them not really supporting function and movement. I was interested something that made me function better. Crossfit is called functional fitness, and it is that more than most other weight bearing exercises. After my tonsillitis had passed, I bit the bullet and signed up for Elements class. Elements is the foundational class that introduces new members to basic Crossfit movements such as squat, push-up, pull-up and so on. After finishing the Elements, I was allowed to join the regular class. I started attending 2-3 times a week. The classes are intense. DOMS (Delayed Onset Muscle Soreness) were common after classes. I can’t say classes were easy. Not because there wasn’t scalable options for the movements, but because I was overweight, stiff, top heavy and at 6’3”, I’m not the most optimal size for Crossfit. Top Crossfit athletes are are around or under 6’. I kept going to classes and started running again. Through Crossfit I’d learned about Kelly Starrett, physiotherapist based in San Francisco and the founder of MobilityWOD, now renamed as The Ready State. MWOD was about taking care of mobility to be able to perform at optimal level in life and in Crossfit. While most people would show up to the class 10 minutes before the class, I had to spend minimum 20 minutes just to warm up my joints, grease the groove, as they say and foam roll to hydrate the fascia. This was the only way I could even dream about taking those classes. If I didn’t do my mobility work, I wouldn’t be able to move properly the following day.

Everything was going well again. I was doing the work. Well, until we had a guest Coach, who hadn’t coached me before. We were doing a strength cycle, meaning we’d focus on building strength over number of weeks. On that particular class were focusing on back squats. We were trying for 3 rep max PR’s (Personal Records). I can’t remember the weight I had on, it wasn’t that much, maybe half my own weight. I did 2 reps at my 3 rep max, and wasn’t sure if I could do a third one. I felt I wouldn’t be able to a third one, I was already knackered enough from the 2 earlier reps. The coach kept telling me I should go for it, so I did. Immediately I felt pain on my right hip. I had to abort the lift and not continue the class. I thought the pain would subside over time, but it continued and it spread. My right hip had a constant throbbing pain. My GP couldn’t tell anything specific. I used my health insurance to pay for a private MRI scan at Parkside Hospital in Wimbledon. The MRI scan was an ordeal. I didn’t fully fit into the tube, so I had to lift my arms over my head. The scan took maybe 20 minutes, maybe more and I was in agony. Not from the experience, or the noise, but the strain of having to hold my arms over my head. It felt like someone was hanging from my arms and I had to keep them from falling. Later I’ve come to realise that it was because my frontal fascial lines were so stuck, locked short that any movement that required full extension of the body and the arms would be very uncomfortable as I was fighting not just gravity, but also against my own tissue.

Bursitis & Greater Trochanteric Pain Syndrome, was the diagnosis. Bursitis is an inflammation of the bursa, which is a small fluid filled sack over many of the joints, in my case, over my hip joint. Greater Trochanteric Pain Syndrome is a regional pain around the area of trochanter, hip joint. The surface inside my hip joint had worn and became irritated causing the inflammation, probably due to doing too much or forcing movement which the area was not capable. Safe to say my training was to be put on hold for awhile. Six weeks is an average time for soft tissue to heal from a trauma. I don’t remember if it took one month or two, but I wasn’t the same after the injury. The acute hip pain gradually subsided, but it was replaced with constant low level pain in my shins, calves and upper legs. I could move, I could walk, but constant pain was there. I resorted wearing compressions socks to ease the pain, which seemed to help. I visited my GP. He didn’t know what to say other than lose some weight, which is ironic, since my pursuit of losing weight had led me to this. I visited an Osteopath, who did some spinal manipulation, dry needling and taught me some movement exercises. I followed these for awhile but that didn’t work. I visited a massage therapist explaining my issues, she gave me a treatment but that felt more of relaxation massage than actually addressing the issue. I was googling to find answers, but since I didn’t know exactly what to search for, I didn’t come up with the answers. I had to resolve this issue myself and reclaim my health.

James Earls teaching at Anatomy Trains course.

I had worked in IT as a Project Manager for 10 years at this point. I was making good money, but my heart was not in it. I thought that in order for me to heal myself, I need to learn more about anatomy. I thought about becoming a Paramedic, as that would also be directly helping out people or a Physio Therapist, helping people to recover, but both of those options would take three years of University which I would not be able to do and it would be too long of a time to find what was wrong with me. Then I came across a introduction to massage therapy at Jing Institute in Brighton, which would be convenient for me, as I lived close to Clapham Junction. I signed up for the Bodywork Beginnings course which took a few days. This course introduced me to bits of anatomy, massage techniques and pathologies. We even got to try couple of myofascial techniques, which would’ve never happen had I chosen any of the other study options. As soon as I learned about fascia I was hooked. I knew I was into something, but wasn’t sure yet what. I signed up to Introduction To Advanced Clinical Massage course, then I took couple of other courses and even took two myofascial release courses. When summer arrived, I was laid off from my IT job as part of a merger, which gave me a great opportunity to pursuit this new interest. I signed up for the Advanced Clinical Massage Therapist certification intensive which was taking part that summer. I also took RockTape course as well as Anatomy Trains 1 & 2, which is the foundation for ATSI, Anatomy Trains Structural Integration practitioner certification. While studying at Jing, I finally found a therapist who not only did massage therapy, but also myofascial release. I booked 10 sessions with Hernan from Everybody Health and he knew how to release the tensed tissue in my lower legs. Eventually my chronic pain, which had lasted for months was gone. I was able to move and be active again and I was on my way to become a therapist who can help others suffering from similar ailments.

There you have it. Long story short…ish. What did I learn after all this? Here are few things that hopefully will help you too in your search for better health.

You and only you are responsible for your own health. You can ask for help, you can get advice from professionals, but more than anything, take constant steps to achieving and keeping your health. Do not blindly believe everybody, but do not dismiss anyone without consideration. You can learn from every query, every interaction and ultimately you are the person who needs to put the pieces together and find a solution. Educate yourself, don’t rely on others.
It’s better to a little often than a lot infrequently. Consistency is the key for anything you want to achieve in life. When you get older, you can’t push as hard as you did before, especially if you don’t have a background in what you are trying to do. After you hit 40, it’s advisable to drop the intensity to 80-90% so that you can train again next time around, rather than doing 100% and not training for 3 weeks due to injury.
I learned that I was 67% muscle fibre type 2, which is best with short bursts of high intensity activity (sprinting) and power (powerlifting). I also learned that my fascia (extra-cellular matrix) has a fast regeneration rate. In practise this means, that if I don’t move or mobilise regularly, I get stiff. Fascia also stiffens to support the body in movement if the body doesn’t have enough muscle strength to control the movement and as lower legs, calves are the stabilising muscles for the whole of the body, someone who’s heavy, but not having enough strength to control the movement, will get stiff around ankles and lower legs. I’ve treated overweight people as well as big athletes (rugby players) with the very same problem.
Find your support network, people who understand you and your body and are there to help. That network can be a massage therapist, PT, coach, yoga teacher. Make sure what they say makes sense and resonates with you and your experiences. If you don’t like the way they are conducting themselves, then find someone else. There’s a difference between pushing yourself to do a bit more and having that feeling of something might go wrong if I do this. Be brave, but trust your instincts. If you need to visit your therapist every week without results, maybe he/she is not doing the right thing. Don’t be afraid to try other therapist, your biggest loyalty should be to your health. My personal opinion is that not every therapist can help everyone. Sometimes one therapist can help you in certain stage of your life or healing, but then you may need to move on to someone else who has a different perspective. This is why I offer free 20 minute consultation to see if I can help you and you can see if I feel like the right match for you. Come and have chat.