“Overcoming the mental block”

The body needs to move, and those who really want to do something will find a comprehensive treatment program with Dr. med. Marius Gawlik in Neumünster/Germany, allowing them to safely stay active. “Carpe diem” is the motto of the general and sports physician’s practice, who is the best example for being active himself. He wants to help his patients do more for themselves and their health. Using supports, he helps the mind and the joint to overcome mental blocks.

life: What does fitness mean to you?

Dr. Marius Gawlik: I had a look on Google (laughs). ‘Exercising regularly, being physically fit,’ it says: that’s where the problems start. Fitness means different things to different people. A marathon runner has different goals and complaints compared to an overweight office worker. Fitness is closely associated with a person’s perception of his or her own body, understanding its signals and addressing them correctly. That applies to the cardiovascular system and the musculoskeletal system. The challenge is to get it going again, without subjecting the body to excessive strain.

Is it true that people like to be more active in spring than in winter?

Dr. Marius Gawlik: Of course, when the weather and the days are getting nicer and longer, people want to go outside. Then they realize: the running or hiking I wanted to do isn’t so easy. If you haven’t done anything for a while and then you do too much, there will inevitably be symptoms of excessive strain: around the plantar tendon, the ankle, the knee. I see a lot of problems with ligaments, shin splints and patella tip syndrome, not to mention hip and back pain. Then I have to take a holistic approach. I have to take time to perform a clinical examination and medical history. Searching for clues from everyday life to make patients aware of the appropriate amount of exercise and show them what they could do differently, rather than what they have done wrong. A lot of people have a sedentary lifestyle. Pain then quickly kills the initial motivation, as does worry about injuries.

How do you motivate amateur athletes who have already been injured, who are insecure, to get active again? 

Dr. Marius Gawlik: The fear of repeat injuries really is a huge problem. You can’t just get rid of that from their minds during one or two chats. It’s important to overcome this mental block. And that takes time and attention. Supports are a great way to help. Patients need something tangible, a support for both the mind and the joint that will help them get active again. Compression and the effect of the pads quickly result in pain reduction, and they get a sense of confidence. In cases of knee problems, I often prescribe supports like the GenuTrain to ensure stabilization. Half of my knee patients then need less pain medication, and they feel more confident. The medical product gives them something to touch and try out – a partner for the knee. Preventing recurring injuries helps increase their exercise level, allowing them to be more active. The interesting thing is: when I ask patients to keep a pain or food journal, I usually don’t get much back. But supports achieve immediate compliance, which I notice during the next appointment. I ask patients to bring the support they have been given by the medical supply retailer, and I can see that they’re wearing it. We then discuss the effects, I answer any questions they may have, and I can give advice where they may have been going wrong. We also often consider whether a follow-up product is required because the patient has developed muscles or has lost weight and the product no longer fits correctly. Ideally, the product is worn out from use. Feedback with regard to Train supports has been excellent. Patients like to stick with something they have had a positive experience with. Or they want the same for the other knee because it has been acting up in the meantime. 

Are back supports also beneficial during the active sporting season? 

Dr. Marius Gawlik: Nearly half of the patients in my practice have problems in the lower back or with the sacroiliac joints. That’s where I see the most frequent muscle deficit by far. In contrast to the knee, patients suffering from back problems often lack the understanding that the back also needs to be relieved and the autochthonous back muscles have to be trained. They think that putting on the product is enough, and it should have an immediate effect. A back support like the LumboTrain can stabilize and help, but patients have to wear it with patience and during activity to allow it to exert its full effectiveness. In these cases, I often have to raise awareness and educate patients, explaining that they still need to be active and that it takes time.  

What does a specialist in internal medicine focus on when they see amateur athletes suffering from excessive strain?

Dr. Marius Gawlik: I don’t only focus on early-stage orthopedic problems and how to prevent them. I work closely with medical supply retailers and gait analysis providers and exchange experiences and expertise directly with orthopedists from my network. To my patients, I offer regular, comprehensive sports medical check-ups. They include, for example, different ECG measurements, lung function testing, ultrasound of the heart, the throat, and the vessels supplying the brain as well as blood and other lab work. These tests can detect high-risk patients with structural heart problems, for example, allowing me to adapt my recommendations. If everything is fine, we can get going properly and do a lot for the patient’s health and personal fitness.

They say being active is the best medicine. Which indications does that apply to?

Dr. Marius Gawlik: Many studies show that the risk of getting cancer, whether intestinal, breast or other types of cancer, is significantly reduced when people exercise. Not to mention metabolic and vascular conditions, such as high blood pressure or atherosclerosis. You can get almost everything under control with activity and exercise. That includes osteoarthritis, by developing and strengthening the stabilizing muscles. And stress, of course. Exercise grounds you, it calms you down and relaxes you. This may be the most important insight I gained during the “Marathon des Sables”, a desert run in the Sahara: just get going to switch off your mind and focus on the body. Provided that the check-up was OK and you’re equipped with water – as well as a support.

Images: Pat Scheidemann