The Hip & Knee Manifesto: Part II 📃

LIFETIME HIP & KNEE

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#036: The Hip & Knee Manifesto: Part II

10x more people in the Sardinian Blue Zone live to be 100 years old.

What's their secret?

- Eating locally produced food + in season garden vegetables.
- Moving more throughout their life (there is mountainous necessity).

Nutrition and Activity.

All aided and abetted by
- Strong, family-centred communities and
- A low-stress, relaxing lifestyle.

..and 10x as many people live to be 100.

Our ‘modern’ society has in many ways moved in the opposite direction.

We eat less ‘locally produced food’,
Move about less and live higher stress lives.

If we want to live long, we need policies that nudge our artificial system back towards the Blue Zone.

And the same goes for healthy hips & knees...

More Blue Zone.. to do more with less pain.

So, last week our hips & knees nudged us to seek out and vote for:

Better Public Health to support those who are overweight or obese.
A National Food Strategy to tax the bad and support the good.
More education and healthy school meals.
Less junk food advertising on TV and online.

This week let's look at..

Activity

Get it right and our hips and knees will thank us.

I saw this 69 year old woman back in clinic the other week...

She was cycling more and keeping her knee pain at bay.
(that pain + function lie is staying high)
And she's avoiding knee replacement.

However, it's all too easy for our daily lives to slip outside the Blue Zone..

We sit down to eat breakfast.
We sit down and drive to the office,
We sit at a desk, sometimes all day,
We sit and drive home,
We sit and eat dinner,
We sit watching telly,
We go.. to bed.

Sleep, sit, work, sit, repeat.

Movement has all but been designed out of our daily routine.
It’s easy to become inactive without thinking about it.
Without conscious effort to move more.

Our ‘modern’ society has moved away from 'activity by default'.
Towards, 'sitting as default'.

We need policies that nudge our artificial system back towards more activity.

So where to start?

Well, the World Health Organisation's GLOBAL ACTION PLAN ON PHYSICAL ACTIVITY 2018-2030 is as good as any.

4 strategic objectives, 20 evidence-based policy actions...

WHO GLOBAL ACTION PLAN ON PHYSICAL ACTIVITY 2018-2030

That’ll do!

104 pages of evidence. A quick summary goes something like this...
(I love this list)

1. Create active societies
Communicate through campaigns / programmes to increase awareness (1,2) 📣

Give free access to enjoyable and affordable activity via regular mass participation initiatives (3).

And a big one for me: training the professionals, both inside and outside healthcare (4). It’s unusual to see a doctor writing down advice on how to move more.

As one of my patients you’ll no doubt be tired of me banging on about the benefits of, particularly, cycling!

However, another one of you came back the other day saying you’d ‘lost 3 stone in weight and completely changed your life’.

Just wonderful. So, I’ll keep banging on for a bit longer...(!)

2. Create active environments
Strengthen urban + transport planning for connected neighbourhoods and active travel (5) 🚎

Improve walking and cycling infrastructure (6) and the surroundings of our buildings (from schools to hospitals and housing) (9) 🚲

Improve safety (7) and access to green space (8) 🌳

I cycle and run to work, and have been lucky enough to live in Cornwall, London and now Somerset.

Each town or city has a moat of danger around its centre. A pinch point that is dangerous to cross.

This danger moat on my old cycle commute in Cornwall has recently been bridged. It's brilliant! We need many more...

3. Create active people
..in schools (10) 🏫 in healthcare (11) 🏥 using parks / beaches / rivers (12) for everyone, for older adults (13) and for other less active groups (14)

And do it at city, town and community level (15).

Our eldest is in his first year of school. I'm seeing for the first time how these early years are crucial to forming active habits.

4. Create active systems
Systems that improve accountability (16), data (17) 📈 research (18), financing (20) 💰 and advocacy, from anyone who can- from our leaders to our media (19)..

..to, dare I say it, this very newsletter 👊

I get quite passionate about this WHO document. About that list (from 1 to 20).

A bit more focus on each of those 20 points and our health and happiness as a population will compound. Changes that will keep on giving..

Our hips and knees would definitely vote for that ♥️

So those are the BIG societal changes that our hips & knees need.
Without these changes, our own individual changes are hard.

That said, let's now focus in on what we all need to do...
Evidence based actions that have helped me.
With 1 or 2 confessions along the way.

If you want to get ahead and go deeper, my new and improved course, The Hip Pain Toolkit, is re-launching soon and will take the guesswork out of doing more with less pain. Click on the link to find out more and add your name to the waiting list

It's a one hour course where I share my entire evidence-based framework that I use now and plan to use to look after my own hip- from the first twinge of groin pain to getting the lifetime timing of hip replacement right and asking the key questions of the surgical team.

Advocacy!

On the subject of advocacy, we can all play our part. Help anyone you know who needs to do more with less hip or knee pain by forwarding this email on.

Tell them to join 100s of readers subscribing for FREE at www.danhwilliams.com/#subscribe or hit the button below.

Everyone can catch up with past Newsletters at the same link.
And hit reply if you have any questions that I'm missing.

Good luck :)

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Duchy Hospital
Truro
TR1 3UP
United Kingdom