Delivery From The Pain Trainer Download
Thora Buckner
The ESCAPE-pain programme is a 6 week (12 session) rehabilitation programme for people with chronic joint pain, that integrates educational self-management and coping strategies with an exercise regimen individualised for each participant. It helps people understand their condition, teaches them simple things they can help themselves with, and takes them through a progressive exercise programme so they learn how to cope with pain better.
The two programmes compliment each other, and are taught together within a 1.5 day facilitator training course, however, they are two separate programmes, with their own participant eligibility criteria and session content. The flexibility of ESCAPE-pain means it can be delivered in a variety of locations and by a range of professionals. The programmes have been successfully delivered in outpatient physiotherapy departments, leisure centres and local community settings by physiotherapists, osteopaths and exercise professionals.
If you are working outside of the NHS or would like more information on the benefits of engaging clinical support staff in ESCAPE-pain delivery, eligibility requirements, and best practice/support required, please view this decision tool. Exercise professionals
- Level 2/3 gym instructor/ personal trainer or equivalent (demonstrating underpinning anatomy and physiology knowledge).
- Level 3 exercise referral OR a level 4 qualification.
- At least 150 hours previous experience of working with specialist populations (e.g. exercise referral, cardiac, back care, falls etc.)
Over 2,000 facilitators have been trained to deliver the ESCAPE-pain programmes, demonstrating a strong commitment to increasing access to the ESAPE-pain programme for participants across the UK. Watch the videos below, to see what facilitators have said about the programme:
The 1-hour sessions will be focused on answering questions from facilitators on various topics related to implementation of the ESCAPE-pain programme(s). The sessions are open to facilitators trained to deliver either ESCAPE-pain for knees/hips or ESCAPE-pain for backs.
In order to make the most of the sessions we ask that you let us know, in advance, what questions you have or areas you would like covered in greater detail, within the registration form so that we can ensure this content is covered during the session.
Most athletes have experienced muscle soreness at one time or another. This can be especially true if you are just starting out. DOMS or delayed-onset muscle soreness is a result of exercise-induced muscle damage with symptoms showing up 48-72 hours after exercise. These symptoms can last for several days and up to 5-7.
DOMS is considered a mild form of muscle damage, but one that indicates excess. DOMS is not required for improvement or positive adaptations. The severity of DOMS also depends on several factors. In general, the more unaccustomed stress you place on your muscles, the greater the symptoms. DOMS can occur during any stage of training if it is unfamiliar.
Additionally, DOMS is strongly associated with eccentric muscle contractions. Eccentric contractions occur when the muscle is under tension while lengthening. Lowering the barbell during a bench press is one example. Generally, type II or fast-twitch muscle fibers are more susceptible to DOMS than type I or slow-twitch fibers.
Primarily the muscles used for cycling are the ones that can experience DOMS. That would include the quadriceps, glutes, and the posterior chain in the back. However, this is highly dependent on cycling discipline. For example, if you are a road cyclist going on your first MTB ride, you can probably expect to have sore upper body muscles. Again, DOMS will depend on how unaccustomed you are to the activity.
You can do several things to help sore muscles feel better with varying degrees of effectiveness. The only way to completely prevent DOMS is by avoiding unaccustomed exercise altogether, which is difficult for active athletes. However, you can limit DOMS by slowly progressing your training load, especially if you are just starting out. You may find that some treatments work better for you than others, but more than anything, recovery requires time.
Easy recovery activities increase blood flow to your sore muscles and may provide endorphins that can help relieve the pain associated with DOMS. The research shows mixed results, but active recovery does provide temporary pain relief. This includes light exercise, stretching, and foam rolling.
Another treatment of DOMS is applying something to sore muscles. The classic ice bath has long been used for DOMS, with the thinking that the cold reduces tissue temperature, causing a redistribution of blood away from the muscle. This can help carry metabolites out of the muscle. However, it may also impair nutrient delivery. Studies show that spending about 13 minutes in water between 52 and 59 degrees can significantly reduce symptoms. Heat therapy can be useful after DOMS has hit its peak. However, if used too soon, applying heat to the muscle can actually increase the inflammatory response.
There have been several studies regarding the use of compression wear for DOMS. However, the results are mixed, and a conclusion on the timing and duration is far from settled. Compression clothing has been shown to enhance the circulation of damaged muscle tissue, which may affect recovery.
A well-balanced diet will give your body the nutrients it needs to repair damaged muscles. Supplementing post-exercise with vitamin D, BCAAs, and antioxidants (like tart cherry juice) offers little to moderate muscle soreness relief. BCAAs are most effective if consumed before a workout with low to moderate muscle damage, while Omega-3 fatty acids (1.8-3 grams) can reduce DOMS when taken after exercise.
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Chronic spinal pain poses complex challenges for health care around the world and is in need of effective interventions. Pain neuroscience education (PNE) is a promising intervention hypothesized to improve pain and disability by changing individuals' beliefs, perceptions, and expectations about pain. Pain neuroscience education has shown promise in small, controlled trials when implemented in tightly controlled situations. Exploration of promising interventions through more pragmatic methodologies is a crucial but understudied step towards improving outcomes in routine clinical care. The purpose was to examine the impact of pragmatic PNE training on clinical outcomes in patients with chronic spine pain. The cluster-randomized clinical trial took place in 45 outpatient physical therapist (PT) clinics. Participants included 108 physical therapists (45 clinics and 16 clusters) and 319 patients. Clusters of PT clinics were randomly assigned to either receive training in PNE or no intervention and continue with usual care (UC). We found no significant differences between groups for our primary outcome at 12 weeks, Patient-Reported Outcomes Measurement Information System Physical Function computer adaptive test mean difference = 1.05 (95% confidence interval [CI]: -0.73 to 2.83), P = 0.25. The PNE group demonstrated significant greater improvements in pain self-efficacy at 12 and 2 weeks compared with no intervention (mean difference = 3.65 [95% CI: 0.00-7.29], P = 0.049 and = 3.08 [95% CI: 0.07 to -6.09], P = 0.045, respectively). However, a similar percentage of participants in both control (41.1%) and treatment (44.4%) groups reported having received the treatment per fidelity question (yes or no to pain discussed as a perceived threat) at 2 weeks. Pragmatic PT PNE training and delivery failed to produce significant functional changes in patients with chronic spinal pain but did produce significant improvement in pain self-efficacy over UC PT.
I made it. Over the last years, I have spent some amount of time obtaining the highest of Agile Pokemon badges: the Professional Scrum Trainer. I have to admit this is one of the best moments in my career so far.
I already obtained my Professional Scrum Master I (PSM I) certificate. That empirical way of working was a big shift in mentality for me, something that felt a lot more natural. After doing some research, I found that I could connect, inspire, and help a big group of people by becoming a Professional Scrum Trainer for Scrum.org. The vision and mentality of the people connected to this organization resonate really well with me. Some might relate more with their competitors, but to me this was it. I set my sight on becoming a PST. Now what? Where do I start?
Another highlight in this journey has been my interaction with the great Gunther Verheyen. We had a long lunch together and discussed how the process goes, challenges, and things that I could do. What I remember all too well is how calm, yet passionate Gunther is about Scrum and the way he can articulate organizational pain points really well.
In all my arrogance, and also insatiable drive to prove to everyone, I could pass these things WITHOUT the expected 4 years of experience, I started studying for the PSM III exam. This particular exam is different from its brothers. This one consists of 34 mostly essay-based questions. There are two or three multiple gamble questions, but still, 31 open questions remain. The timebox at the time was 2 hours, which has now changed to 2,5.
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