Men’s Health Tip for Health Professionals


As a health professional there are two singularities when working with men that amuse and concern me. The first is their ability to understand all the good health messages (exercise, nutrition, sleep, etc) and the risks associated with non-compliance yet continue to engage in a fierce campaign of non-compliance. The second is their concept of what exactly comprises being healthy.

Taking the second one first, it seems to me that for a bloke, being healthy is simply the absence of death. As long as he can function in his life to some degree he sees himself as ‘in good health’. As demonstrated by the first response to the standard clinical interview question, ‘and how is your general health?’, to which he inevitably replies, ‘pretty good’. Only to reveal later (once rapport and confidence have been established) that he has type II diabetes, high blood pressure, sleep apnoea, two coronary bypasses, kidney disease and an unexplained tremor on movement. None of which have anything to do with health in his mind because he is still walking, breathing and working. The message for us is – don’t believe him! Dig deeper on health matters and try to get him to see how his current state is the end-game of his lifestyle decisions.

Back to the first issue on non-compliance. This is a second defense mechanism deployed by his male ego filter which may acknowledge at a cognitive level the links between lifestyle decisions and the prevalence of non-communicable diseases but seeks comfort in the fact that this only applies to other men. Every bloke believes he is outlying data – the exception, the maverick, the hero. Compliance is for those other men who are at risk, and as ‘I am not at risk I have no need to change my attitudes, thoughts and behaviours’. This is the blank canvas upon which we try to paint a treatment plan. Until the man acknowledges his risk he is not able to make vital changes. Note: acknowledges risk, not just understands it. Sometimes our job may include scaring the invincibility out of them to over-ride the ego filter defense. For example you could try this, ‘I had another client like you who did well for a while then it all went belly-up and his stroke left him totally disabled. If only he had done the exercises…….’. This line is best delivered while gazing into the distance over the client’s shoulder and gently shaking your head. Then pause, and make eye contact until he looks away.

Men’s Health Tip – Strong Posture

The only cost of improved posture is effort. The effort of working against gravity which continually drags you down into a lazy slouch. A slouch that can reduce your income, impair your health and change how people regard you.

Strong posture is a tall but relaxed stance or seated position where your sternum (top of your breast bone in your chest) is elevated but your shoulders are loose and relaxed.When teaching clients I asked them to imagine a string attached between belly button and top of sternum and to keep the string taut at all times – when standing, sitting, walking, driving, lifting, coughing, pushing a shopping trolley, wherever.

The benefits of a strong posture are well documented and it is the foundation upon which all your body language is delivered – your posture can reinforce or undermine your words, messages and signals without you even being aware. Just as others’ posture colours their communication. Imagine if James Bond slouched into a hotel lobby instead of arriving with a strong and relaxed posture which commands respect and attention.

Health-wise, a strong posture improves breathing function, oxygen supply to the brain and possibly clearer thinking. It aligns your joints and muscles into their most optimum position for action and protection. It improves transit and absorption in the gut, improving digestion. A strong posture engages the muscles that control pelvic floor, balance the head and stabilise the lower back (curiously, they are the same muscles!).

When working with men following prostate cancer treatment to restore their continence posture turns out to be a crucial element. As I learned from Stuart Baptist (Sydney Men’s Health Physio) using postural control strategies for those men who struggle with continence later in the day can help build a muscular pattern that enables better control.

Employers, negotiators, judges and mothers know the value of a strong posture, meaning you are likely to improve your job prospects and salary, win a debate, be found innocent and make your mum proud if you fight against gravity and don’t slouch.

Finally, if nothing else tips the scales (pun intended) you will look slimmer and taller with strong posture. Try it for a day and discover how many people remark that you have lost weight!

So if you want to be more healthy, successful, attractive and make your mum proud without spending any money – just straighten up.

More men’s health week tips each day this week.

Updated Dental Care – apologies to my children

Like most of us I was taught (and taught my kids) to brush their teeth after meals, at least twice per day. Apparently modern dental science has updated the optimal care and it is no longer necessary and possibly harmful to brush your teeth straight after eating.

Here are new guidelines:

Don’t brush your teeth straight after eating.  Chewing food stresses the enamel coating on teeth and it takes several hours of bathing in saliva for the coating to be restored. Brushing within this time-frame is a second episode of stress on the weakened tooth protection system. Wait at least a couple of hours following eating.

Use a circular action electric toothbrush. Most of us are too vigorous with a manual brush and can damage the gum line.

Apply the toothbrush to the gums not to the teeth. Brushing the gums stimulates blood flow and ensures you access the deeper crevices. The teeth will be flushed with the run-off (like a shower) and be cleaned without insult.

Once a day is enough for brushing. Seriously? Yes. The damage to teeth and gums is due to bacteria on the surface. The bacteria take several days to mature and begin to damage the tooth structure. Provided you brush well within the two to three day window you can remove immature bacteria before damage is done.

Your tooth care routine should take around four minutes. This includes a couple of minutes of picking and flossing followed by two minutes of gentle, circular brushing and rinsing. Dislodge the food scraps first then brush them away.

Mouthwashes (antiseptic or fresheners) are a well marketed but unnecessary part of the dental hygiene routine. Spend your money on a better toothbrush.

See your dentist at least once per year for a super clean and inspection. Then stick to the four minutes per day routine to maintain a quality mouth environment.

Special sensitive toothpaste does work to reduce sensitivity but is often very abrasive. Better to brush with regular toothpaste then when finished apply a small smear of the sensitive past to your gums using a finger. Then rinse.

There you go – an update based on current dental science. So, apologies to my children for being a ‘Tooth Nazi’ – turns out I was a bit over the top.

Craig Allingham
Men’s Health

The Huddle

American sports utilise the Huddle extensively: the action is interrupted by meetings of the participants to review and implement strategy. For example, in basketball there is the time out and in American football the quarterback calls a huddle pretty much before every play. In golf the player and caddie huddle all over the course. The business Huddle is an extension of this concept.

Key Points for Effective Huddles in the workplace:

  • Meetings are short, no more than 15 mins
  • Stand, don’t sit
  • Timing is up to you – first thing, or later in the morning when all are in. eg. 11.45am
  • Huddle is high priority
  • Everyone must speak. Who first? Vary it.
  • It is not an interrogation – it is a communication tool
  • Honesty is critical
  • Stick to facts not opinions
  • Huddle time is NOT for problem solving. Identifying yes, but not for solving
  • What to share:
  • Project updates
  • Client updates
  • Wins – celebrated
  • Roadblocks
  • Individual priorities for the day
  • What you achieved yesterday
  • Review couple of team or company metrics

 Not all these are part of every huddle, but the list provides examples to get it flowing

  • Problems identified are flagged for follow up meetings
  • Discussions are shut down – this is reporting only
  • Off site team members can join via skype – as it is NOT a discussion they can make their contribution and also hear from others

How do you know if Huddling is working for you? (Give it six months at least):

  • Your KPI metrics will improve: check them
  • Your team awareness of strategy and projects and how they fit together will improve
  • Your leadership will improve as you have a clearer grasp of all the elements
  • Stuff gets done on time, accurately and profitably

Post Holiday Desk

How did you feel arriving back to your work desk after the holiday break? Did the sight of it fill you with excitement for a clean start for the new year? Or were you confronted by the unfinished work of last year?

Client files waiting for discharge notes, letters to stakeholders, follow up calls, reports to insurers or a half completed file waiting for the most recent client encounter to be documented with all the accuracy a ten day break can generate.

I wise mentor once described to me the presence of ‘heart sink’ patients. These are the clients who when you see their name on the day list your heart sinks. I believe you can get the same lack of joy from a desk littered with unfinished and non-prioritised tasks.

To ensure you begin every year, month and week in a better frame of mind and clarity of purpose try this one sneaky trick – complete the paperwork as you work with the client. Simple but difficult, especially if your habit is to make cursory notes and fill in the details later. If you are an employee you are probably donating your private (unpaid) time to get this done. If you own the business you most certainly will be donating time that does not generate income. Neither is acceptable nor necessary.

For the details, I refer you to a post from 2010 (yes, you could have been doing it better for years). Click here for a short read that may gain you up to an extra one hour per working day.

5 Hints for Successfully Managing People

Human Resource Management evolved from personnel departments which were previously called common sense. However the gradual  disappearance of common sense from modern life has allowed a new professional body to arise who are experts in managing humans for improved performance.

My experience working at the pointy end of sports science and medicine for twenty years brought me into contact with coaches who are masters of this dark art and other who were technically skilled in their sport but could not bring it out in their teams or athletes.

So in an effort to short cut your learning process in Human Resource (people) management here are five key points to take on board.

  1. People generally don’t or won’t manage themselves. Never assume because a person (employee, partner, contractor, patient, referrer) is intelligent, conscious and cooperative that they will manage their efforts in any way to your advantage.  You will need to provide a structure and systems to ensure their performance is contributing to your goals as well as their own.
  2. Hire attitude over talent. It is much easier to teach skills than it is to teach personality. When looking for staff be very clear on the skills you are seeking and once the base line for those has been met turn your attention to which remaining candidate possesses the right balance of values, aptitude, attitude and capacity to deliver within your organisation.
  3. People don’t leave jobs, they leave people. The most common reason for loss of quality staff (the only ones you will miss) is some conflict or discomfort in the workplace. It may be a workmate or it might be you. Recognise the problem and if you can’t change the dynamic to the advantage of both parties one of them will leave. Be very clear who you want to keep and why.
  4. Workers contribute to their maximum when they feel valued. Not when they are valued, but when they FEEL valued. If the first acknowledgement of value appears in an employees departing reference it is way too late. Shame on you. Take the greatest care not to be so busy with your own tasks and roles such that you don’t see and remark on the ordinary efforts your team puts in day after day. And if there is an extra-ordinary effort CELEBRATE it in front of everyone.
  5. Money is rarely the strongest motivator for improved performance. There is no doubt money is important as we all need to meet our obligations, but  beyond a certain level more money won’t create engaged, motivated and high performance employees. A fair compensation package will bring adequate performance, but add some of Number 4 (above) and you will see a greater return from your human resources (people).

Across all professional disciplines that I have worked with (allied health, legal, finance, personal care) the common woe is how to manage the people in their business. How to recruit, train, manage, engage and dismiss the right people to ensure the business grows and the day to day worries are reduced. This is not easy, and it is not a skill business owners are trained in. But if you are interested in improving this area of your business I believe you will get great value from my workshop on herding cats. To find out if this workshop is scheduled soon go to and check out the upcoming events column.

Why do they leave? This is a good place to work.

I was chatting with a respected, long term physio colleague recently and he pinned me with the question, ‘How long do you expect physios to stay?’ Meaning, what is a realistic expectation for professional staff turnover? I asked him some further questions and it seemed a more common problem with recent graduates (one, two or three years out of uni) and he told me he does exit interviews.

‘What do they reveal?, I asked. He indicated some move onto formal post-graduate study which necessitates leaving the area but the others seem to feel they have exhausted their learning opportunities at the current practice. One departing employee said, ‘I feel like I have learned all I can here, and need to move on.’  One reason she can move on easily is she had no ties to bind her geographically: no partner with a job nearby, no children in school or other family nearby.

We observed that recruiting staff a little further along their life journey provides some of these anchoring factors that aid retention, perhaps up to around 5 years as opposed to the 1-2 year expectation for the more recent graduates. I guess I felt that the curiosity and mobility of youth was a fact of life, probably not limited to physiotherapy and resiled myself to it being an unalterable tenet.

However, on further reflection this may not be the case, at least in all cases. Over the first year or so of being employed by an experienced colleague there is a steady knowledge transfer from senior to junior. This tends to be intense at first and gradually tapers as the lessons are passed on. There may reach a point of equilibrium where the teacher runs out of new material and the learner has the skills and knowledge close to that of the teacher; and being hungry for more, starts to look elsewhere.

What can be done to encourage a longer tenure in such a situation? Perhaps we need to be counter-intuitive and reverse the roles somewhat, helping the learner become the teacher and the teacher open their mind to the learner.

Lovely words – what does it mean?  I distinctly recall having talented employees who could have taught me much but my ego and inflexibility blinded me to this opportunity. They were ready and able to teach, but I was unready or unwilling to learn.

Developing talent is a wasted process if once developed it is not deployed where it can make the greatest contribution. In our mini-case-study, what may have eventuated if the physiotherapist who had filled her learning quota had been asked to take over the development of staff for a year or so? Including the principal. Not by re-teaching the same stuff, but by adding from her unique knowledge and experience base, by bringing in new information to the organisation, by developing leadership and development skills in her role and by being rewarded for this contribution.

Sure, she may still leave even after this extension of her role (and tenure), but she would be leaving a more enriched organisation behind and leave as a more accomplished practitioner and employee. She would also have contributed to the training of those who followed her.

As employers we often see how much we give to our teams and resent any feelings of not being repaid by output, loyalty or even simple thanks. Step back, stop giving for a while, and ask what you might receive if you realised everyone has something to teach. Have you ever asked your reception staff how they ‘read’ clients?  Asked them to explain how they manage to multitask with phones, computers, people, money, files, letters, reports and the rest? Or asked your cleaning staff how they know when they have done a good job? Or your professional staff what skills and knowledge they may have that can be adding value to the organisational goals or client outcomes? In order, these represent customer service skills, time/task management skills, self-managing team skills and self-knowledge/development skills.

The answers to such questions may surprise you (as much as being asked may surprise them!) and potentially restless staff may even stick around to see if you have learned anything from them and are prepared to put it into practice. Who knows, you may discover your eventual replacement and they may discover a career path.


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Strategic Learning – Do You Have a PD Plan?

I recall in my early days of practicing, I pretty much did every PD course available. Which was not difficult and probably only took three or four weekends per year. My how times have changed, you could fill every weekend now if you set your mind to it.

We are spoiled for choice with a huge range of professional development opportunities advertised every month. So how do we select what is most appropriate for each of us?

Do you go for new topics? Or base your selection on the presenter? Are some topics fashionable (think dry needling or fascial planes)? Each course involves significant outlay in terms of cash, time and energy so it makes sense to select wisely.

Your workmates or employers can offer guidance based on your current role or aspirations, but it is based on their opinion of what you need or what you can bring to the workplace. But is it the right fit for you?

Strategic Learning is a practice of aligning your professional development with a longer term strategy of where you want your career to go. Or at least to give you the tools to respond to career opportunities that may arise.

To be strategic, you must first have a strategy. To have a strategy you must have some overarching idea of where you and your career are going. The old ‘where do you see yourself in five years’ type of exercise. Or ten years. This is a difficult exercise to do on your own without input and challenging from a trusted mentor or panel of advisers.

I like the option of reverse engineering a strategy by starting with the end in mind, asking ‘What would be my ideal job at the time of my retirerement?’ and back track a strategic course from that end point. Like any good strategy it can be modified and adapted as the career landscape changes.

Once you have developed your strategy you can then evaluate PD opportunities based on how they align with your path. Do they add knowledge, skills, networks, contacts or connections to advance your strategy? When you see an event advertised ask yourself these three questions:

  1.     Will this event contribute toward my long term professional pathway?
  2.     Will this event deliver skills to improve my understanding or performance in my current role?
  3.     Will this event enrich me as a person?

The event should get at least one tick, if it gets more than one it is starting to look like a good investment. Three ticks and it is a ‘must do’. If you are not certain from the advertisement you should contact the provider and seek further specific information to make a considered choice.

Still going ahead? Great, now there are two more questions –

  1.     Can I afford to attend?
  2.     Can I afford NOT to attend?

The first one relates to resources (money, time, logistics) and is a totally practical decision. The second is a more important consideration in terms of the cost of not pursuing your strategy. If you have a strategy and the event is well aligned you are retarding your plans if you don’t attend.

As a provider of professional development I have a vested interest in you as a potential client. In my experience the best teaching happens when the learner is truly engaged in the topic, the process and the long term outcomes of the knowledge exchange.

Think carefully when evaluating PD options. Understand your long term strategy not just short term needs. Plan your learning to align with where you want to arrive rather than where you starting from and you won’t go far wrong.

Is it Possible to Overservice a Private Client?

This was a question posed to me by a participant at a business workshop and my immediate response was, ‘Good Question’. This is a time honoured strategy to gain time to formulate a considered answer thus avoiding saying something like, ‘You wish,’ or ‘How do you mean?’

If a considered answer still remains elusive, the second strategy is to ask the questioner to clarify the question. Eventually however I had to respond.

Who decides if a client has been over-serviced?  The health professional or the client?  In the case where a third party is paying for the treatments, it is often that party making the call of ‘enough already’. But what about when the client is paying for their own treatment? Who decides when enough treatment is enough?

I am sure we have all had clients that proved difficult to discharge. Everytime we got close there was a relapse or new problem that necessitated extending the treatment plan. Then there are those patients with chronic, degenerative conditions that are never going to be cured. How many sessions are sufficient for a condition that is always going to need management?

And what is overservicing? Too many sessions over a short period of time? Or too many over a long period? When (if ever) do you say to a client, ‘That’s all. No more treatment for you’, even though they are prepared to pay for further sessions?

What if it wasn’t a medical service, let’s say I really love a particular restaurant or cafe and frequent it several times per week. Are they over-servicing me? Or am I simplyl meeting a need, paying a price and receiving what I consider to be fair value?

Does a cinema refuse admission if you have already seen the movie twice? Does your butcher say ‘No more, you have eaten enough meat already this week’? I don’t think so.

Are these purchases that meet needs such has hunger and relief of boredom any more or less valid than purchasing a service that fills a different need and does so at a price that represents good value?

The evidence-base theory of treatment would place this decision on the practitioner, who has the knowledge of what further benefits are likely with ongoing treatment. When the benefits dwindle, according to the evidence, we must then discontinue treatment lest we be operating fraudulently.

The customer focused practitioner would have access to the same evidence base, and upon reaching a point of diminishing returns would ask the client if they were receiving sufficient ongoing benefit to justify the ongoing cost. Perhaps the evidence isn’t measuring all the benefits that the client is perceiving, and even though the condition is no longer improving the process of treatment is meeting some other as yet unmeasured need.

Ah, if only it was that simple: if the client believes it is helping then it can’t be over servicing. Now into play comes the gray areas of fully informed consent, unequal power relationships, the concept of ‘the expert’, and self interest.

Continuing to offer treatment based on authority, fear, dependence, self-interest or mis-information is unethical and unprofessional.

Continuing to deliver treatment at the request of a fee paying client where clear professional boundaries are respected, full information about the limits of treatment are explained and acknowledged and where the client has the power to regulate and/or cease at any time can, in my mind, be optimal servicing.

At all times the benefit equation must fall on the side of the client. Repeated questioning regarding the perceived benefits of ongoing treatment, benefits that can be described in a logical, rational manner rather than emotional (I just like coming here), should ensure the level of service represents a value proposition for the client.

Alongside that process should be regular reviews where the practitioner and client document the treatment plan for the upcoming period and identify where the benefits are likely to appear.

The final test: if you can’t explain to a professional colleague why the client is attending, they probably shouldn’t be.

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A Fast Way to Manage Body Weight, Hunger and Energy

This plan has been around for hundreds if not thousands of years. In fact it is probably the way our evolutionary ancestors were obliged to eat and perhaps our DNA is molded toward it. More recently it has received some mainstream publicity on TV and in the press under different guises: it is Intermittent Fasting.

Our prehistoric forebears would hunt for protein in the form of animals. It might take days for the group to make a kill and upon returning it would be devoured promptly due to the lack of refrigerators. Meat had to be stripped from the carcass, prepared and eaten before it became bad. It might then take several more days (at least) to make another kill, so the diet between kills was collected from nature in the form of berries, roots, leaves, stems, flowers and so on. There were energy dense days (after a kill) interspersed with energy lean days (vegetarian).

Intermittent fasting is similar – days of full on eating and days of very light eating.  Like all eating plans it has its fans and its detractors, currently I am a big fan and let me tell you why before I tell you how.

Firstly, forget all the guff about fasting being a ‘detox’ for the body. The body does a very good job of detoxing every day, there are complex systems to prevent toxins getting in, for neutralizing them once they are identified and for eliminating them as quickly as possible. Ever had a dose of food poisoning? See how effective your body is at detox?

The benefits of Intermittent Fasting include:

  • Learning to manage hunger – most of us are unlikely to starve to death or even sustain any damage from not eating for a day. Learning to ride the hunger waves and become comfortable rather than immediately seek food (usually high in sugar and/or fat) is mastery of your body and mind.
  • You can eat what you want, but not on fasting days. After a day of denial, you have one or more days of no restrictions at all so this program is sustainable and low maintenance – no daily counting of kilojoules or calories, no portion control, no denial of what you enjoy.
  • It is a flexible program, you choose which days are fasting to fit your social or activity calendar. It doesn’t even have to be a full day without food, you can fast from 4pm to 4pm the next day, for example, meaning no day is totally without eating.

There are a range of fasting plans but the one I have found most compatible with my lifestyle (I love food) and my goals (losing the 5, maybe 7, OK 8 kilograms I have gained in the last 10 years) is the 5:2 Fasting Plan.

This involves five days of normal eating per week and two days of fasting or near fasting per week. I like the option of near fasting in the early weeks of starting the plan, but moving on to the full fasting is even more powerful. The partial fasting recommendations are – five days unrestricted and two days of limiting intake to 2500 kilojoules (around 600 calories) or less for a man and 2100 kJ (around 500 calories) for a woman.

Warning: complying with this limit puts you in the zone of ‘very low energy diet’ and should not be undertaken by pregnant women, diabetics or others with metabolic disorders. Check with your doctor beforehand.

For blokes, 2500kj will be consumed with:


  • Small bowl of fruit salad
  • 1 slice of multigrain toast (no butter)
  • 1 teaspoon of yeast spread (who needs a full tsp?)


  • Undressed salad – cup of lettuce, slice of tomato, 1/4 of a capsicum, 1/2 cup grated carrot, 4 olives, slice of ham, small can of tuna in water


  • 1 grilled fish fillet
  • 1/3 cup of beans
  • 3 florets of broccoli
  • 1 small mashed potato (no butter or milk)

Snacks through the day

  • 1 banana
  • 1 green apple
  • 10 glasses of water (alcohol free on fasting days)

Tomorrow – Anything you want! Just wait until tomorrow. So you can see you are most unlikely to starve. Yet you will start to see weight and girth loss within the first three weeks, but only if you stick to the plan.

How does this plan work? As usual, lots of theories but I think the critical ones are:

  • Breaking the habit of  ‘I am hungry, I will eat’
  • Resetting your metabolism twice per week from growing to repairing (there is some evidence for this one). Repair mode includes resolving inflammation in the body, which is perhaps the single highest health risk for all of us.

And if you still remain to be convinced, imagine the impact on your weekly food shopping bill if you (and everyone else in the house) fasted for two days per week! A reduction of around 25% is possible. What a bonus.

As always, be careful when making changes and be prepared to trial it for at least a month to see if it is right for you and those who live with you.


  • My starting weight – 98.5 kg.
  • Weight four weeks later – 93.2 kg (5.4% of my body weight).
  • This was on the 5:2 fasting plan with limited intake on the two fasting days of around 2000kj (500cal).
  • The initial hunger pangs of weeks one and two are now much less intense.
  • Sweet food (eg. breakfast cereal or jam) is starting to taste too sweet for my palate and leaves a furry mouth feel afterwards.
  • Energy levels are good, still able to do everything I need – yard work, writing, cycling, weight training.
  • Sleep is good – going to bed hungry is no effort if you know you can eat what you want tomorrow.
  • Mood – no complaints from my wife.
  • Productivity – excellent – I have lots more time on the fasting days to get stuff done with no food prep or eating time eating into it (sorry).
  • Savings – probably around 15% on weekly grocery expenses.

‘All Day’ fasting actually results in far more than a 24 hour fast. There is the additional 8 hours from 10pm the previous night (more if you don’t snack after dinner) making a fast time of 32 hours twice per week for a total of 64 hours not eating. Out of a possible 168 hours in a week!  This is 38% of the week in a fasting state. No wonder my body is resetting it’s metabolic priorities and energy metabolism.

This is only one story. Keep an open mind.