Exercise and physical activity with Liz Hewett

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Episode: 19
Guests: Liz Hewett
Duration: 49:48
Tags: Exercise, Staying Healthy
SoundCloud: Episode 19 Exercise and physical activity with Liz Hewett

Nurses and midwives walk!

Nurses and midwives spend a lot of time walking.  A 2006 study published in MEDSURG Nursing, “How far do nurses walk?”, found that the 146 nurses studied walked an average of 4–5 miles during a 12-hour shift! That is almost 8 km!

Have you ever used a pedometer or step counting app when at work? I have. I regularly walked 15,000 steps on an 8-hour shift. Some of us might be justified thinking that is quite enough exercise for 1 day! While this is undoubtedly a large number of steps it’s considered incidental activity, and we need to exercise outside of our activities at work to keep in shape.

I explore this and other interesting facts in this podcast all about exercise.

What is an exercise physiologist?

Accredited exercise physiologists are university-qualified, allied health professionals who specialise in developing clinical exercise interventions. Exercise physiologists like Liz understand why exercise is important to health and well-being and can assist clients in finding the right type of exercise for every stage of life.

In the podcast we discuss the importance of establishing exercise as a routine, returning to exercise after injury or a break and making exercise an integral part of your self-care routine supporting you to enjoy your best life.

Exercise the best medicine

According to Liz, “If exercise was a supplement or a pill it would be a worldwide bestseller. It would be gladly taken every day by everybody. Moving and being physically active is seriously the best medicine that we can take for both prevention of health conditions, as well as treatment and managing the conditions that potentially don’t have an overall cure.

“The human body was built to move. If you think about our evolution as hunter/gatherers, always moving, we aren’t designed to sit still or stand all day. It really doesn’t make us feel very good. Our bodies simply feel better on so many levels when we move regularly.”

Liz reassures us that if you have fallen off the exercise wagon, you should be kind to yourself. Liz gives us advice and hope for how we can keep trying. If life gets in the way of being healthy, it will always get in the way. That's what life does. We just have to march on and get back into it.

So put on your runners, charge up your phone – download this podcast, put in your earphones and stride out the door as you engage in the joy of exercise. Your health matters!

If you would like to chat to someone you can call our confidential support line 24/7 on 1800 667 877. Or visit our website for more tips on exercise and health.

Mark Aitken RN

Stakeholder Engagement Manager

Nurse and Midwife Support Podcast

Exercise

Mark Aitken: Welcome to the Nurse & Midwife Support podcast, your health matters! I’m Mark Aitken, your podcast host. I’m the Stakeholder Engagement Manager with Nurse and Midwife Support and I’m a registered nurse. Nurse & Midwife

Support is the national support service for nurses, midwives and students. The service is anonymous, confidential and free. You can call us anytime you need support: 1800 667 877. Or contact us via the website at nmsupport.org.au.

Welcome to the Nurse & Midwife Support podcast. Today’s podcast is all about exercise and its benefit to the health and wellbeing of nurses and midwives. My guest today is Liz Hewett, an accredited exercise physiologist, strength and conditioning coach and Pilates teacher with over 20 years’ experience. Liz is a frequent presenter and educator, having presented at conferences for the Australian Pilates Method Association, Exercise and Sport Science Australia, International Association of Dance, Medicine and Science and conducts workshops for the wider Pilates community. As well as being a former president and committee member for the Australian Pilates Method Association. Liz, what an impressive career! Hello, and welcome!

Liz Hewett: Thanks Mark, it’s an honour and a privilege to be here. Thank you.

MA: Great to have you here Liz. We’re very excited about hearing about exercise physiology and your work as an exercise physiologist. Would you please tell our listeners a bit more about your background? How you actually became an exercise physiologist?

LH: Yes, sure. I think I’ll start by saying perhaps what an exercise physiologist actually is. It’s a relatively new profession on the allied health landscape. It’s a university pathway in exercise science. Back in the old days of the 1990’s, when I went through, it was a human movement degree. Some of the nurses and midwives of that era of university training may recognize that bachelor degree, or physical education. I did a Human Movement degree back in the late 90’s and then it was a Graduate Diploma in Exercise Rehabilitation. I fell into that pathway because my passion growing up, my exercise of choice, was dancing. Classical ballet. I did it very seriously, I moved to Melbourne from Brisbane. Did a year full time training at the Victorian College of the Arts, but I spent more time in the physio room than in the actual ballet studio. Also, I had a very academic background going through school. So, I moved sideways. I realised that the performing arts as a professional on stage wasn’t what I wanted. I wanted to help performers instead. Particularly, help them in rehabilitation and strengthening movement.

But I didn’t know what there was at the time, other than physiotherapy and medicine. I love physiotherapists, but I’d spent way too much time in their businesses as a young teenager so I thought the human movement pathway was interesting and it would open doors and hopefully give me some options in professions. And it really has. It’s a fantastic profession. After my university, I then trained as a Pilates teacher in the early days of when teacher training was new in Australia. In the early noughties. I started Pilates because I had a chronic back injury that I sustained while dancing. Within a couple of years of doing Pilates regularly, it blew my hypermobile, floppy body together and gave me  strength and  stability. 20 years on, I still do my Pilates regularly to keep me together. It allows me to do other types of exercise that I enjoy. 

MA: Liz, I think that’s really interesting. Many nurses and midwives will connect to that. Particularly with sustaining an injury, and then finding your way again, in relation to exercise. I’m going to talk a bit more about that later, returning to exercise after injury. But, we actually all now that exercise is really important to us in our lives. Nurses and midwives generally know that. But it might be good to explore, Liz, why exercise is important to health and wellbeing. What are the benefits?

LH: It’s a really good question. I think, if exercise was a supplement or a pill it would be a worldwide bestseller. It would be gladly taken every day by everybody. Moving and being physically active is seriously the best medicine that we can take for both prevention of health conditions, as well as treatment and managing the conditions that potentially don’t have an overall cure. The human body was built to move. If you think about our evolution as hunter/gatherers, always moving, we aren’t designed to sit still or stand all day. It really doesn’t make us feel very good. Our bodies simply feel better on so many levels when we move regularly.

I’d like to clarify that that doesn’t have to mean full on sports. Or, an intense commitment to something really structured like a sport or a serious hobby. That’s not everybody’s thing when it comes to physical activity or exercise. For example, a single walk in fresh air or shooting basketball hoops with your mates. Or even a day in the garden, it makes people feel good. It’s being outside in the fresh air. The research is really strong, that just being outdoors does really fantastic things for our mental health. There’s the mood benefits, the emotional uplift after just one short bout of movement. If somebody is a little grumpy, or they’re irritable from lack of sleep. Or they’re a bit stressed, or pre-menstrual.

Let’s talk about the elephant in the room, the research is quite strong now that if women are at various stages of their cycle you can really use movement to help how you feel. On a pure physical level, movement lubricates our joints. It gets our synovial fluid released within our joints. If somebody has an osteoarthritic knee, for example, the best thing they can do is learn some movements. Learn some exercises to actually get it moving, not exercising it just makes it stiffer and sorer. But, moving it regularly is actually equally as potent and as effective as some of the pain relief medication that people equally need to take. So, movement and exercise lubricates our joints. It keeps our muscles elastic and our fascia and all the other soft tissue.

Exercise can also help you when you're tired. You know, if you're a little bit fatigued from lack of sleep. Or it's the end of the day, or you just want to give yourself an energy kick to get through a day. It may sound like a contradiction, but actually, if you do some movement or do some exercise it will actually make you be more invigorated to get you through the day. Or to wake you up. The flip side to that is it can help wind you down. Lots of people use some movement, or exercise of their choice, to help them transition mentally from a big day at work to winding down in the evening and helping them get ready for sleeping and resting. Then get back up and do it all again the next day.

MA: Thanks Liz, that’s such great advice and information. I know our listeners will really connect with that. You’ve recently written a blog post for our Spring newsletter edition, which is on exercise. This podcast is part of that newsletter. What I was really interested in, in that blog, that our listeners will be able to read after (or maybe they have before this podcast) is that there is actually a difference between exercise and physical activity. To be quite honest, I hadn't really connected with that until you’d written about it. So, could you talk a little bit about the difference? And why it’s important?

LH: Yes sure, it’s a great topic. I’ve already been conscious of how I've used the two words seemingly interchangeably, as if they're the same thing. But, they are slightly different. Physical activity, as defined by the World Health Organisation, is any movement that requires muscle contraction. That can be, essentially, anything. From doing the housework, doing the dishes, gardening, playing with the grandkids, kicking the footy, doing the vacuuming, cleaning the bathroom. Anything that requires movement. Whereas exercise is a subcategory of that, where there's structure and form. Prescribed movement that’s working on something in particular, like strength or fitness. That’s the two major differences there.

MA: Thanks Liz, that's really interesting. A lot of nurses and midwives I meet say to me, “I don't really need to do any more exercise, because I run around on my ward,” or in their clinical environment all day. This can be 8, 10 or 12 hours on their feet, being physically active. So, they really think that that’s enough. But, I know that's really considered incidental activity. Or movement, or exercise. Liz, what advice would you have for those people who wonder if that's enough?

LH: The first thing that comes to mind is that I’d actually love to know, I haven't looked this up, but whether there's been any actual data collected on say the number of steps? Or the heart rate, to research and prove whether that’s actually a valid observation or not. Fatigue at the end of a work shift doesn't necessarily equate to physical exertion. I’d be curious, you know, how active is a nurse's shift? Has the research actually been done on that? It would make for a fabulous honours project, or a PhD for an exercise science university student. Or even a nursing exercise science collaboration, I'm sure that there's a research project in there. I've heard that as well. I had a great discussion with my mum, who's a retired nurse, about this. While she was working, I remember very well that she would come home from an early shift particularly knackered from being on her feet for 8 to 10 hours. Late and night shifts were often little bit different.

To be honest, it's a little bit hard to say, because I'm sure shifts do vary. The exercise professional in me would say, and I re-read the World Health Organisation website in preparation for this talk, to meet the criteria of those physical activity guidelines you need a minimum of 150 minutes a week of physical activity. You need to be non-stop walking at a pace that requires your heart rate to be a little bit lifted. So, a nurse or a midwife that’s strolling around at an easy strolling pace for a couple of minutes to get from the nurse's station to a room and then back again. Say they do that over and over, obviously, it's better than sitting down for a shift. But, because it's so low intensity and they’re not actually generating any heart rate elevation it wouldn't be meeting those guidelines. So, the key does seem that it's not just about being on your feet and slowly walking. There does need to be some heart rate elevation in there and a little bit of general cardiorespiratory effort.

For example, if I'm walking and I can if I can talk as easily as you and I are right now, that's not a cardiorespiratory based physical activity. I'm just strolling along. We, as humans, are very very good at walking. We’ve spent just a few million years evolving, so we actually don't expend much energy or many calories by walking at a slow comfortable pace. If a nurse or a midwife walks very quickly, enough to actually feel a bit puffed and they're potentially pushing a trolley or moving a patient and it lasts several minutes, then maybe that would be one bout of a few minutes they could add to their contributing physical activity. But, I think, as a general rule…

MA: That actually makes me laugh Liz, because there is a thing in nursing and midwifery culture about nurses and midwives walk. That, you know, we have a certain walk. We have a certain pace, and that means we're faster than most people. I've got to say that when I walk with friends, they say, “Could you just slow down? You’re walking like a nurse!”

-Laughs-

MA: So, I really love that advice. But, I think the take home here is that even if you're walking at nurses’ pace around the ward that's probably not enough exercise. We advise and encourage you to do a bit more, something else that raises your heart rate and your respiratory rate. So, thanks Liz, that's great.

LH: I’d also like to add in there that cardiorespiratory health is simply one facet of physical and emotional health. We need to look after our bones, we need to look after our muscles, so that means we should all be doing some sort of strengthening and balance training as we go through life. This could be all types of different movement, it really is about finding what rocks your boat. What makes you want to get out of bed, or off the couch to do that type of movement. Nurses and midwives definitely need to be strong. They need to have good balance. They need to have good control of their bodies, and again, that's not going to be developed through a typical shift.

MA: Thanks Liz, we know that exercise changes for many throughout the various life stages. Indeed, when I reflect on my life and my exercise (I'm in my mid 50s) I've really tried many different types of exercise. If you read my introduction to the newsletter, you’ll read a bit about that where I talk about growing up in a family that was pretty much addicted to exercise. I’d say it had an element of exercise ADD about it, when we try one exercise form as a family and then we’d jump into another. From family swimming competitions, to table tennis matches, to tennis to kicking the footy. I went through an aerobics phase in the 1980’s.

-Laughs-

Zumba, another form of dance. You can tell I love dancing. Of course, because I aggravated a chronic back injury I then discovered yoga and Pilates. Like you, Liz, it really helped me to manage that injury. Given that we change through the various life stages that we experience, what advice do you have for adapting exercise to fit into whatever stage of life you're at?

LH: It it's a great topic. I love hearing about the diversity and the variety, from giving things a go. I think sometimes what holds us back, is that we are our own worst critics. If you've got a hint of perfectionism about you, as a person, then fear of failure and fear of not being good at something actually stops us from having a go. The other thing that I find, and what I have noticed over the years, is that people hold back from exercise or putting anything new in their life because they're waiting for something to happen. Usually it's that they’re waiting for time. Or, and I’m going to generalise here, women often wait to lose weight before they do something. Particularly if it's related to exercise or physical activity, so they're the things that I've noticed from working with people over the years.

But, I think in terms of exercise throughout life’s different stages, it's about forming the habit as early as possible. Figure out how to fit exercise in when you’re a busy human. That problem never goes away. If anything, it gets more complicated and we get busier through our 30’s and 40’s. I think they're the hardest decades. Then, sometimes into the 50’s as well. I’m not there yet, but I've worked with lots of people who are. The juggling of priorities, time, finances, access, ability to exercise changes. But If defined think it's getting it into our lifestyle as young as possible is key.

One of my pet hates, hate is a strong word but I'll get on my pedestal about it, is when kids go through school and they’re encouraged to cut back on exercise in order to study. Particularly in years 11 and 12. I’m sorry, but how is that going to help them after high school with finding the time? When life will just continue to get busier? I think if anybody is listening to this podcast and they are parents or a grandparent, one of the biggest messages I can say is to encourage the young people in your life. Whether they’re high school students or university. For listeners at that young graduate university or vocational education stage of life, do not give up sport or exercise because you don't have time right now. Yes, it can be hard, but it doesn't have to be this big commitment. There are little, small things, ways of keeping it in that can be beneficial. I think that’s one of the biggest things I can say, for when you're younger, is work at getting it into your life.

Experiment with what you like and dislike. Are you a loner when it comes to exercise? Or, do you need to leave the house to mingle with people and find a tribe of like-minded people? Whether it's high intensity exercise, or dance class, or a walking group. The other thing is, do you like to learn something through exercise? Is it about learning a new skill? Or is it just, you don't like to think and you just want to go and thrash yourself and dance around to music and zone out? There are different elements to movement. Some people actually like to engage their brain when they exercise. Others don't, if they're a very cerebral person in their work, sometimes they don't like to have to think too much when they're exercising. That, I think, is an element worth exploring throughout life as well. They’re the main things that I can think of.

MA: Thanks Liz. I think that's really great advice. I think the key to that is:

• Making exercise a routine
• Creating a habit 
• Finding what type of exercise gives you joy

Or floats your boat, or connects you to other people if that's your thing. Or, indeed, soothes you because you need time for yourself. I think that's really important here, really understand your personality type and what it is that works for you.

LH: I think another thing I’d like to add there is, I think a lot of people have a very narrow view of what exercise is. Partly because of the exposure through social media, through the internet, that exercise is about what you look like. We exercise to influence our shape, or we exercise to try to change the way we look. Or, what we are on the scales. But that actually can just be a very small and probably the most unimportant part of why we should be moving as humans. As you say, it’s about social connection. It's our mental health. It's about getting lost in something. We've all experienced hobbies or things that we love where time goes by, where we wonder where the time went after one, two or three hours. So, try to explore ways of moving where it's not a chore and you actually look forward to doing it. That usually doesn't involve trying to lose weight. If you exercise purely to try to influence the scales or what your dress size is, sadly, we know that that doesn't actually keep us going with exercise. It's one of the reasons why we stop, or struggle with it.

MA: Good points Liz, thank you. How could an exercise physiologist support nurses an midwives to enjoy their best life? Indeed, if you’ve lost your exercise mojo (or never had one) how could you work with us to help us get it back?

LH: I think some of what we've already discussed, I spend a lot of time in my consultations chatting through behavioural change strategies. So, really, this conversation we've already had just now is a common one I’ll actually have in my sessions with my clients. Sometimes in my consultations, I'm not actually exercising with my clients. We're sitting down chatting about their exercise program, what’s happened with it? Why haven't they been doing it? What have they struggled with? What are the barriers? Say, I gave them a home program, but it's not working because their husband's home or you don't have space. Then we go through all the barriers and logistical issues, as well as some of the emotional barriers that come up. Exercise physiologists are very extensively trained in behavioural change and motivational interviewing. This breaks down the barriers and the reasons why people perhaps are not exercising. We try to make it non-threatening and not an intimidating experience, where exercise is something that we help them to explore and discover. 

As exercise physiologists, we are trained to use exercise like it's medicine. For people who have chronic medical conditions: osteoarthritis, diabetes, heart failure, osteoporosis, cancer, that's our peak area. Helping people to use exercise as a part of their medical treatment for lots of those chronic medical conditions. Another profession that I should mention is an exercise scientist. They are bachelor trained, undergraduate exercise professionals. Exercise physiologists all have that level of education, an exercise science bachelor degree. So, if you're fairly unencumbered with chronic health conditions. Say you’re fairly healthy and you just want to learn how to get exercise in your life, then an exercise scientist is also very well equipped. You often see them working in gyms and strength and conditioning environments. But an exercise physiologist has the injury and the chronic conditions management training.

If somebody loses their mojo and it's fallen out of their routine, start small. Don't wait, like we said before. Something I've heard a lot over the years is, “I’ll wait until my five-year-old starts school, then I'll have more time.” Or, “I'll wait for this to happen.” There’s so many different scenarios, as if exercise is this big commitment that they need a lot of headspace and a lot of time for. Now, yes it can be a big commitment. If somebody wants to play AFLW or join a local soccer club than yes, a commitment is needed. But, if you just want to get active and get a bit fit it doesn't have to be. You don't need to wait to have time and getting advice on how to slip it into a busy routine can be really helpful. That's why actually getting some professional advice on how to start and how to get back on the horse can be useful.

I think that the other thing is acknowledging that it is hard. If you haven’t exercised for years, or you used to but it’s been a few years, acknowledge that you will have lost some fitness and some strength. If it's been a couple of months, because you've been traveling or moved house or been sick or whatever, be patient. Remember what you used to be able to do and let that go. Don't compare yourself to who you were 10, 20, 30 years ago. Find what you’re capable of now and then build very slowly.

The other thing I often see, and experience myself, if you've had a break for just a few weeks or a couple of months be ready for the first couple of sessions to feel horrible. The first run after two months off, or three months off, or a month off, is always the worst. Your legs feel uncoordinated, you feel unfit, everything feels shabby. You think, oh my god this is really awful! Push through that. The run, or the swim, or the bike ride after that (whatever it may be) will always get better. The other big tip I give people is, whatever length of time you had off, you normally have to double it to get back to where you were. I have no science to back this up, this is pure anecdotal and clinical experience. But you need to double it to get you back to where you were before the time off. Just be kind. Keep trying. If life gets in the way, it will always get in the way. That's what life does. We just have to plod on and get back into it.

MA: Thanks Liz. One of the things I commonly hear from nurses and midwives is that shift work and the unpredictability of work routines makes it difficult for people to be able to establish the routine. I know you talk a bit about this in your blog, our listeners can read that if they haven’t already, but do you have any particular information or advice for people? Particularly early career nurses, who are just getting their head around doing shift work and they're struggling to fit exercise in? Or indeed, find an opportunity or a moment where they can make it happen?

LH: I think it may be a matter of exploring what types of physical activity, exercise, sport or dance actually allows flexibility in scheduling. If your sport, or passionate area, doesn't allow that … for example, football training on Tuesday and Thursday with a game on Saturday may clash with your shift work. If your shift work doesn't allow that commitment, then maybe find a more recreational version of that same sport. Casual indoor mixed netball, maybe? This may be a bit easier going. Or, if you're a team sport ball sport person, then find another ball sport. Maybe you've got to move sideways. Maybe you’ve got to identify some of the key ingredients of movement that you love and identify a more flexible way of doing it. If your original sport, that you loved in high school or university, doesn't allow you to keep doing it then that's one option.

I was speaking to a nurse the other day, she just tries to swing her shifts around her salsa dancing. In some ways, you guys actually have it better than the 9-5 crowd because you do have this lovely constantly evolving and changing roster. Something else that particularly appeals to the younger population of nurses and midwives is the 24-hour gyms, or the larger gyms which perhaps have more extensive opening hours and more extensive group fitness timetables. These may cater to you a bit better. If you're into aerobics or dancing group fitness, there are so many different ways of learning dance-based group fitness. You've got barre classes, you’ve got a million different versions of Zumba offshoots these days. All with different schools and casual and serious ways of doing them. I think, just experiment. I think that's the short answer.

MA: Yeah, I'm loving those tips because it takes me back to my early days as a nurse where I used to roster myself. I'd put a roster request in so that I could regularly go out with my mates to a nightclub and dance all night. 

-Both laugh-

Some might say a misspent youth, but we had a lot of fun and we had plenty of exercise.

LH: And it’s great for your mental health! I know so many people who say, if they just go out and dance for a few hours it makes them feel the world of good. But, on a very practical level, going back to my mum who's now retired but she went back to nursing in her 50’s after 20 years of being a mum. She re-trained and worked on the seventh floor in the Royal Brisbane Hospital. She would walk up those seven floors every single day as her aerobic exercise. Her colleagues thought she was nuts, as she was the only one. But she swore by it and did it for the next 20 years of her continuing to work. I think in a workplace there are ways of becoming more active, if you get a little bit creative and actually think about it.

MA: Love that, creativity and giving it some thought. Now Liz, we’re coming to the end of the podcast but I can't let you go without talking about nurses and midwives with an injury. How they continue to exercise or manage that injury and get back into exercise? Or, keep it on track?

LH: The phrase that keeps coming to mind is strength training. I say that because I actually shared what I was doing with you guys on an exercise physiology Facebook group. I asked my colleagues for tips about what I could mention in the blog and an exercise physiologist shared a story of her sister who did dual training of being a paramedic and a nurse. Very early in her career, she injured her back bad enough that she gave up paramedical work and turned to full-time nursing. She started doing strength training and that has really helped her injury substantially. I think the best advice I can give to anybody who’s carrying any sort of injury is getting good, solid knowledge about what sort of strength training would work for you. It could be yoga, it could be Pilates. It could be strengthening in a gym, it could be strengthening exercises at home. Get good advice. Exercise physiologists really are the experts in incorporating somebody's injury into their whole-body training. We work very closely with physiotherapists, osteopaths, sports medicine doctors. We can speak the lingo of technical jargon. We’re very used to that multidisciplinary approach. If somebody is worried about exercise because of their injury, then actually seeing an accredited exercise physiologist is worthwhile. Bring us information from your physiotherapist or your general practitioner, bring us your MRI reports, give us that knowledge as well and we can really set you up with a good whole body strengthening program that gets you ready for whatever your typical workplace occupational demands are.

MA: Thanks Liz, how would somebody find an exercise physiologist if they were looking for one?

LH: Great question. Our professional association is called Exercise and Sport Science Australia (ESSA). The website is essa.org.au and there is a find an exercise physiologist database (or directory) on that website. We are quite a well-known profession now, which has been fantastic to see us evolve through my 20 years of working. Initially, nobody knew, I didn't even know what I was. So, a lot of general practitioners around Australia who support exercise as a part of their medical care are often a good person to talk to as well. But, the ESSA website would be a great resource.

MA: Thanks Liz, well we have come to the end of this fabulous podcast on this very important topic of exercise. We've talked about:

• Why exercise is important to health and well-being
• Exercise throughout the life stages
• Exercise as a routine
• Creating the exercise habit
• How an exercise physiologist could support nurses and midwives to enjoy their best life
• Getting your exercise routine on track and
• Returning to exercise after a break, or as a result of injury

Liz, you've been a wonderful guest. I thank you very very much, I know our listeners will really enjoy this this subject we talked about today. Do you have any final words of wisdom?

LH: We have one body. Nobody else is going to look after it, except you. I don't just mean physical body, I mean emotional and psychological wellbeing as well. These are all equally important and moving regularly (whether it be physical activity, sport or exercise) will help all three more than you'll ever know.

MA: Thanks Liz, please remember everybody that you can contact Nurse & Midwife Support on 1800 667 877 or via the website at www.nmsupport.org.au for anything you need support for. Check out the newsletter on exercise, where you’ll get to read Liz’s great blog. Take care, keep exercising and look after yourself and each other. Your health matters!