Michael

@cboyack Love the balance you bring to the instinctive fear we all feel with change. Thank you. I’ll be quoting some of the ideas you shared in my work.

@bmay It’s too painful to watch again … I must be a masochist 😬

Reform have gained one of the greatest minds of all time and this timeless classic is now all theirs. It is simply impossible that people this stupid should be allowed to govern, no matter which party they run off to when they’ve destroyed their own.

@hjluks Another insightful post. I’m going get my lactate levels checked 🤓, despite thinking that I move enough and maintain my ‘metabolic flexibility’ (great phrase!) 💪🏼

Bryan Adams…. Masterclass in live performance 👌🏼💥🎤🎸 #R2InThePark

Oh dear! Belinda Carlisle 🧐🙈 #R2InThePark

@hjluks Howard… another beautifully insightful post! Thank you. As a physio (who is still involved in the profession) your approach is so refreshing.

@hjluks As a physio, I love this! 👏👏 Thank you Howard

Let Your Muscles Be Your Pharmacy Exercise isn’t just about burning calories or building strength—it’s about also about biochemistry. Building muscle mass as an older adult has always been more about the overall health benefits more than the size of your biceps. The more we know… the more we realize how interconnected each system is in our bodies… and how reliant each system is on other systems. Your muscles are more than engines of movement; they are biochemical factories, releasing a cocktail of molecules that influence your entire body. When you exercise, your muscles secrete myokines, signaling proteins that travel through your bloodstream and exert powerful effects on distant organs. Some, like irisin, help convert white fat into metabolically active brown fat, increasing energy expenditure. It also improves insulin sensitivity and improves production of BFNF. BDNF (brain-derived neurotrophic factor) is a growth factor for your brain. It can enhance neuroplasticity and cognitive function, potentially protecting against dementia. Inflammation, the silent driver of chronic disease, is also modulated by myokines like IL-6—which, paradoxically, reduces systemic inflammation despite being a pro-inflammatory cytokine in other contexts. Meanwhile, SPARC (Secreted Protein Acidic and Rich in Cysteine) has been shown to suppress cancer cell growth. Your muscles also regulate metabolism beyond fat burning. Exercise improves insulin sensitivity, reducing diabetes risk, and influences cardiovascular health by boosting nitric oxide production, which relaxes blood vessels and lowers blood pressure. People who are insulin resistant ( some studies suggest that over 90% of us are) can shuttle glucose into their cells without the need for insulin after exercise. And effect can last for up to 24 hrs. In essence, movement is medicine, and your muscles are your pharmacy. Each workout triggers a cascade of biochemical signals that not only strengthen your body but also help prevent disease, enhance brain function, and improve longevity.

@AdamMeakins Doesn’t it stem from the separation of the pathological definition of acute v chronic inflammation. And then with acute on chronic where, for example, fractures (acute) on top of OA (chronic), where pain will persist for longer but the tissue changes are different

Why do we label any pain felt for >3 months in duration as ‘chronic’ when many many many painful patholgies and conditions have average durations much longer than 3 months? 🤷‍♂️ Make it make sense? 🤔

This painting by Caravaggio, Master of Light, is one of the most revolutionary in history. Why? Notice the empty space left at the table for us. Sit down at it, and a strange symbol reveals itself... 🧵

@KCMO_Neal @HeathrowAirport Actually ok. Everything worked, just a bit slower and flight was delayed by 2 hours (mostly because the IT system couldn’t load the water for hot drinks 😝). You should be fine for tomorrow

@Saffronsteer How was your experience out of @HeathrowAirport today? I have a flight scheduled for tomorrow and I'm wondering if I should make alternate plans.

Good morning and welcome to Heathrow Airport. We hope you are looking forward to the weekend ahead of you! Anything you need to know? - Our inbox is always open! 📥

@DarrenLoos @bekkikennedy @HeathrowAirport Don’t know yet… when I get to LHR I’ll post an update

@bekkikennedy @Saffronsteer @HeathrowAirport Is it causing delays checking in and security lines?

@bekkikennedy @HeathrowAirport 😫thanks for the update…

@Saffronsteer @HeathrowAirport I’m not certain about later but as of now…doesn’t seem like any planes are taking off.

@keaneofficial Bravo! Bravo! 👏🏼💪🏼👏🏼💪🏼🤩. Flawless set at #Glastonbury2024 Superb vocals, world class musicianship and authoritative yet approachable and accessible to all who watched. Simply wonderful 💖

#TheApprentice Final! 🙈🙈… perpetuating the notion that you don’t need a #strategy and that #branding is only about logos.

@imperialcollege Well done on storming into 🥇place on #UniversityChallenge #proudalumnus of @ImperialBiz

@hjluks Fabulous post Howard! Over diagnosis and over management (supply side) is where most costs are driven in healthcare… and shared decision making is key to getting better outcomes. Don’t treat the scan! 👏🏼👏🏼👏🏼

Orthopedic surgery office based decision making isn’t easy …

@Filbell2 I don’t watch this show but the audience whooping at every turn used to be a thing on #strictly and pissed me off too… but I think the producers had a word! Now each dance goes un-whooped until it’s complete! 👌🏼💃🏻🕺🏼❄️🥶👨🏻‍🏫

Only 20mins into the new series of #DancingOnIce and already the studio audience are beginning to piss me off. Why to they have to scream every time someone does a moderate move or lift? Why can’t they just shut up and enjoy the skating!

@Physisnow @AdamMeakins My advice: assign those targeted exercises if appropriate. Don’t be crushed by the ‘cost saving’ issue: focus on the outcome for patients and help managers understand that outputs are more important! Good luck 👊🏼

@AdamMeakins 3rd year part time student currently working as a band 4 physio assistant in an inpatient setting - I would LOVE to give my patients specific targeted exercises after an assessment, but the powers above keep telling me to use the predetermined sheets of exercises as it saves 1/2

If you only train physios to hand out pre printed sheets of exercises and don’t give them the training and skills to assess, communicate, and reassure people well… this is the result! 🤨 The physio profession does itself no favours! 🤦‍♂️ dailymail.co.uk/health/article…