Back Injury – A Physio’s Experience

10519510_10152801588837889_6239433146789197033_nAs a Physio, I know what to do when I get an injury…theoretically… You see, we are taught how to listen and assess and work out what is wrong. We tell the patient what we have found, what we think is wrong and what needs to be done to make things better. We do our “manual magic”, we give appropriate advice and whatever things the patient needs to do at home.

What they don’t necessarily teach you is what it is like to be a patient. Even if I saw someone daily, it is still only 30-60mins in 24 hrs…I think too many physios and other health professionals need to think about that more.

I realised this quite a while ago when I had injuries. I have always been quite active so with that comes increased risk of injuries and I have had my fair share. What I want to write for you today is what happened when I strained my back quite badly and how I dealt with the issue. I will discuss what I was thinking and throw some commentary into why I chose what I did and how I made my decisions.

This is post is all about ME, NOT YOU. This is NOT what you should do. You should get assessed for any problems you have. This is about informing you what I was thinking and how I think as a patient and a physio.

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Gout – my personal journey

This is not a typical blog post. This is about my personal suffering and pain (which is nothing in the big scheme of things). If you don’t want to read it, I don’t mind. I think part of me is writing this because I feel miserable right now.

It is 3am in the morning. I am in LA, here for the CrossFit games as a physiotherapist in support of Aussie athletes and to watch this awesome spectacle. I am also currently lying here awake because my foot feels like someone has a knife in it and it is sore just lying here doing nothing. I don’t even have to move and it is sore.

But let me start at the beginning.

Gout is simply an inflammatory arthritis – Uric acid crystals form because it precipitates from the blood into my tissues. When it gets into the joints, those crystals cause pain and inflammation due to the immune response to deal with them. Now, I might be technically wrong here but that is how the doctor explained it to me.

Genetically, I have high Uric acid levels. That is against me. Secondly, the breakdown of purines produces Uric acid. That is basically eating meat :/

Now none of this is usually too much of a problem because you can take allopurinol and control the Uric acid levels…to a degree.

You see, it is the flow of Uric acid in or out (the gradient) that can cause the immune reaction and subsequent pain.

So, diet-wise I have tried all sorts of things but I am fat/overweight/obese. It is what it is. I am not being dramatic. I should be about 105kg (about 93kg lean body mass which I currently am and 12-15% fat…I would look like a weapon! Hahaha. But I am not. I am 125kg at the moment. I eat poorly because of laziness but there has been A LOT of negative reinforcement.

You see, I can eat junk food every day and I might ache a bit from the gout here or there but I am like an addict – I really can’t find an in-between level of junk food. It is either clean or I start to slip back into bad eating.

Don’t get me wrong, I am not blaming gout for my poor self discipline.

But since I was a kid, I have loved junk food. That is typical and normal. My parents fed me well and we had junk food for a treat. That is also normal. I was the stereotypical skinny Asian-looking kid. I didn’t become bigger and taller until later. Then, I started eating a lot of junk food. Too much. And I began to put on too much weight.

But here is the thing, I can lose weight. I know how to. I can eat well. I know how to. I have lost 30kg before by doing the old weight watchers point system on my own at home (never been to a meeting). I was as weak as piss and couldn’t do a bench press for 8reps at anything more than the 20kg bar. I was a cardio guy. I weighed 82kg and could 3 les mills classes back to back – body attack, body pump and body combat. No problem.

Even then, at my healthiest, I had Uric acid kidney stones. I had gout attacks.

Eventually, I put weight back on again because, remember, with me, it is all or nothing. I slowly put that weight back on just by starting with a can of drink here or a bit of chips there.

But my gout felt better.

And then the cycle continued. I would lose weight (I did vision PT) – I lost 15kg in 12 weeks but again, I would ache or get gout eating clean. And then I would fall off the wagon and I would feel better.

So then I started CrossFit. There was The Zone but lots of my friends were doing paleo. I lost 18kg in the first few months of CrossFit and maintained between 103-105 for over a year. But I would get gout attacks in my feet, toes, knees, hands. I was eating paleo but then wouldn’t but then get back on the wagon again. It got to a point where I was suffering gout in one joint or another for months on end with only a week or so relief from the pain. I swear I think my coach thought I was lazy or something. It really interrupted my training.

Eventually a doctor who I was observing operate sat me down and set me straight about taking the meds and pushing ahead with eating better. I did and I was pretty good for a while but I wasn’t eating clean. So I was still putting on weight. I was pretty proud of my 19:28mins in the CrossFit open wod 14.5 (thrusters and bar over bar-over-burpees). That was just below the average score of 19:30mins. I know fitter people than me who took longer than that! But do you know how hard it is to drag this rig up and down off the ground?

So those who saw me when I first started CrossFit will have seen me go from being pretty weak (80kg Deadlift was my first 1RM test) to being pretty strong for an average person but still slow…but getting stronger. I am currently 120kg and the strongest I have ever been but I have been eating poorly since a trip to the USA last sept/oct. Trying to come clean from that has been a nightmare.

Every time I try to go clean, BOOM! Gout attack. People have tried to help. But the bottom line is that every time I go clean, I get an attack.

Imagine every time you walk through a certain door, you get knifed in the body somewhere. That is basically what happens. I then use THAT as an excuse to continue to eat poorly because when I eat clean, I get headaches, I get gout, I feel lousy. If I keep eating the chemical shitstorm that is junk food, I actually feel RELATIVELY better.

I know that if I can just weather the storm, I can train better and continue to eat better. I can lose the fat and improve the fitness. But it seriously takes over a month or more of pain and I am not sure I had the will or the self discipline to do that.

It is embarrassing to be this weight.

I love my CrossFit. I love workouts. I want to run and do burpees and lift weights fast and quick and many times and I want more pull-ups and my first muscle up. I don’t want took at photos and think that I should be fitter than I am. I have never been stronger than I am now. Ever. But they are “dirty gainz”. I don’t talk too much about it. I laugh about the fact I am built to lift and not run but secretly, I want to run and be that cardio guy again but with muscles and strength.

So, in the land of California, I thought I would come over and because I have a different routine, I will eat cleaner. And I have. Compared to what I normally eat, I am doing pretty well.

And now I lie here with what feels like a knife through my foot. It is now 4am and I resorted to taking prednisone before I wrote this blog because I am here to work and help people. And I am. But prednisone comes with side effects – insomnia (brilliant! Perfect with the jet lag I was just getting over :/), increased appetite and weight gain through bloating and too much food.

So I am going to try to stay clean. I know what will help…eating dirty again will help. It will tip those scales back to slowly increasing my blood concentration of Uric acid and the gradient between my blood levels and in the joints won’t be so bad and I won’t have such a bad reaction.

If I can’t walk, I can’t get around. I know what this week involves and it involves a lot of running around and stairs and walking to and from car parks and working on my athletes – all of which is fine, except when every step is painful.

So if you see me eating dirty, please understand that my life in the short term is just simpler that way. I know that if I have junk food for the next 3 days, I will be right. If I keep eating clean, I will be in pain and it won’t let up. But junk food and prednisone is up to a 5kg gain almost in a week! Eating carbs and fried food helps my neck pain and headaches. I am a better Physio when I eat carbs, fat and meat but carbs and fat together, especially the junk food that works best, is not good for you…it seems the pro-inflammatory things I like to consume such as sugar and grains, are the very things that make me feel better.

So there you have it. Why do fat, overweight people who have gout keep doing the things that make them fat and overweight? I suspect for some, it is just like my story. Because I don’t feel as bad as when I eat clean.

I am going to try weather the storm. I am going to see if I can put up with the pain. This is the better way, just a REALLY PAINFUL way.

If you have read this far, thank you. I hope one day I can write a story about how I am 12-15% fat, no gout symptoms and still strong.

The meds are kicking in…the pain is easing. It is 4.30am. It still hurts. So what? I will push on.

The Physio Detective Way – Introduction For My Seminars

So, I finally did it. I recorded my introduction to the seminars.

It is 40mins long and goes through some of the basic definitions of what I do and how I go about doing it.

It isn’t rocket science. It is about results and how to get those results…

I can summarize the key points for you now… BE SPECIFIC!

Let me know what you think 🙂

5 Tips on Preparing for the 2014 CrossFit Open

2014 CrossFit Open is about to begin - Image from

2014 CrossFit Open is about to begin – Image from

The 2014 CrossFit Open begins on Feb 27, 2014. If you are smart, you will have begun preparations. Here are some tips on what you might want to focus on…
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2013 in review

The stats helper monkeys prepared a 2013 annual report for this blog.

Here’s an excerpt:

The Louvre Museum has 8.5 million visitors per year. This blog was viewed about 110,000 times in 2013. If it were an exhibit at the Louvre Museum, it would take about 5 days for that many people to see it.

Click here to see the complete report.

What does Christmas mean to me?


I thought today’s post will be about Christmas. It is Christmas Eve after all.

Christmas is about catching up with friends and family, going on holidays, reassessing the year gone by and planning the new year. It is about presents and summer and fun and good times.

Ultimately though, Christmas is about remembering that Jesus Christ came down from heaven, became a human and in the most humble of circumstances, came into this world. He was to grow up to be the unlikely savior for not only His nation of Israel but for the whole world.

At the time, the Israelites were subject to the Romans and previously been subject to the Greeks, Persians, Babylonians and Assyrians. They were looking for a Savior that would deliver them from their oppressors. They waited centuries for this savior, one that was promised from the time of Adam and Eve, one that would save them from their suffering.

What they got instead was a savior of greater importance…a savior from their sins…someone who could restore their broken relationship with God.

We celebrate Christmas to remember that Jesus came to Earth to save us from sin and death. We celebrate Easter to remember his death on the Cross for your sins and mine and His resurrection from the dead. We Christians live in gratitude and appreciation of His birth, death and resurrection.

So this Christmas, celebrate how you like. As a Christian, I celebrate this time for the above reasons – I don’t expect you do it for the same reasons. But I am happy for you to, of course!

Have a Merry Christmas and I wish you and your family a fantastic new year. My prayer is that God blesses you in what you do, because he actually blesses all people just like he causes it to rain on the Christians and Non-Christians 🙂

God bless and I look forward to spending 2014 with you 🙂

How I broke through my front squat plateau…and got a 12% increase in 2 months

Antony Lo's Front Squat - much improved form over the last 2 months

Antony Lo’s Front Squat – much improved form over the last 2 months – there is a prowler next to me in the picture!

Those of you who know me or have read this blog long enough will know that I am a stickler for technique. I love getting the “mechanics, consistency, intensity” right. I love improving people’s mobility, flexibility, stability, strength, power/speed, etc etc. Being the human that I am, sometimes I find it hard to take my own medicine. Please remember that in the Crossfit world, I am just your average (or below average) CrossFitter who will never make it to Regionals or the Games nor ever grace the podium at a local comp. If I ever compete, it will be fun or charity only. But I do have a desire to get better. I do want to improve…and I HATE plateaus in my strength.

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Announcement – Antony has resigned from Penshurst Physiotherapy Centre

Penshurst Physio - Corner of Railway Parade and Pacific Avenue

Penshurst Physio before Antony Lo sold it to Colin Phillips.

A short history…

On April 13, 2001, I took over Penshurst Physiotherapy Centre from Ralph Geary. We eventually bought a building nearby and gradually expanded our business into multidisciplinary centre. During my ownership, we basically quadrupled the business.

In 2012, Colin Phillips (the new owner of Penshurst Physiotherapy Centre) asked if we were willing to sell him the practice. We were and so negotiations commenced and an agreement was met.

On Oct 2, 2012, I handed over the business to Colin. I had agreed to stay on and really wanted to continue to be a part of the business. However, I found it more difficult that I had imagined. However, even until I went away on holidays, I still intended to stay on.

What will I be doing?

Antony works on an elite Regional Competitor

Treating Crossfit athletes of all standards is a passion of mine and I will be continuing to pursue this

It wasn’t until my first week back at work did I decide to leave. I think it will be best for Colin and the rest of the staff at Penshurst Physio to have a clean start and a fresh shot at making it on their own.

I have already had plenty of opportunities to work in many different locations and clinics however I haven’t finalised any plans at this stage. Due to the usual contract restrictions of working within a certain radius, I will be looking at renting some rooms in the Inner West, Parramatta and Sutherland Shire regions. I will finalise these locations and make them publicly available when they are confirmed.

I will be continuing in providing “second opinion” work, Crossfit specialised assessment and treatment and running seminars for health professionals and the public. I will certainly also be available for any of my past patients who choose to follow me – as usual, my goal/desire/mission is to go “above and beyond” in providing the best quality services I can. I won’t be setting up a clinic like I have run before – my new work will be a different type of business model to Penshurst Physio.

Thank You’s:

I wish Colin and the staff at Penshurst Physio all the best. Within 3 months, I expect that the shadow of my presence will have diminished and he will have a practice built on his own reputation.

Penshurst Physio staff - Thank you!

The staff at Penshurst Physio at the 2012 Christmas Party

I would like to thank my staff throughout the years who have made both Sans Souci Physiotherapy Centre and Penshurst Physiotherapy Centre an enjoyable place to work, a friendly place for the patients to come to and get healed at and for ultimately being the reason why we ran 2 very successful practices.

I would like to thank those who have helped me immensely with ancillary services such as Plumbing, Electrical, cleaning and IT services. Particular mention must be made of Peter and Shona Ross who are amazingly generous people…thank you!

I would like to thank my patients who have been very loyal and understanding as I made mistakes throughout the years and learned from them. Without my patients, their word-of-mouth referrals and their advocacy for me and the practices, we wouldn’t have had our businesses grow by so much. Thank you for your support.

Lastly, I would like to thank my family and my wife Dianne. Without my parents, I would not have bought my first practice – they took a punt on a 25 year old who said he could do it…without any experience! My brother Adrian who is now a doctor – he basically ran Sans Souci Physio for me while I took care of Penshurst. My sister Amanda for the graphic design work over the years. My children who taught me through the school of hard knocks how to relate to my ante-natal and post-natal patients on a whole new level! And to Dianne who righted the ship in the early days and then ran a tight outfit. Without her tireless work, I would be in an administrative nightmare.

Antony's family

Thank you to my family – without their support over the years, I would not have been able to achieve all that I have!

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Not All Physios Are Equal

“Aren’t all Physiotherapists the same?”

One of the most difficult tasks I have with prospective new clients is convincing them that I am different to other Physiotherapists that they have seen in the past. This is generally because people simply don’t know that there are different types of Physiotherapists out there with different levels of recognised experience and skills.

So who should you see and when should you see someone else?

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