TURNING PEOPLE INTO COUCH POTATOES IS NOT A CURE FOR SPORTS CONCUSSION

Recognising and managing concussion properly is seriously important. After all, you only get one brain.  But if we do this, it is important we continue to advise people to take part in sport and physical activity- for the massive physical and mental health benefits that are available.

Here is a link below to a press release Catherine Calderwood Chief Medical Officer for Scotland, Willie Stewart who is a world leader in sports concussion and myself contributed to sharing these clear messages, based on an editorial in (the excellent British Journal of Sports Medicine).  If you agree, please feel free to share widely so we can work together to encourage safe sport for our children and adults.

http://news.scotland.gov.uk/News/Concussion-in-sport-1d9c.aspx

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PHYSICAL ACTIVITY- LEARNING AND TEACHING MATERIALS

Every single day, I get emails asking about resources to learn about physical activity for health, or resources that could be used to teach about this.  I think it is fantastic the momentum that is building, recognising that this can help ourselves, but it is also something we can share with friends, family and patients.

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Below is a list of really helpful resources, aimed largely at health professionals that can be used freely. Thanks a tonne to Profs Chris Oliver (@cyclingsurgeon) , Nanette Mutrie (@nanettemutrie) and Edinburgh University for pulling them together into one place.

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FANTASTIC PROGRESS ON CONCUSSION

In a real first, sports and medics in Scotland have come together to produce really clear guidelines on identifying and managing concussion.

Concussion when not identified can lead to short and long term problems and can sometimes be fatal.

It is a tribute to Peter Robinson, Willie Stewart and all the other organisations involved that their are now guidelines right across Scotland on this important topic. They are launched today at the Royal College of Physicians and Surgeons of Glasgow event at Hampden.

Details are below- please share widely

EMBARGOED UNTIL 0600 TUESDAY 19 MAY 2015

 

Attn: Sports / News / Health / Picture Desks

 

IF IN DOUBT, SIT THEM OUT

SCOTTISH MEDICS & SPORTS UNITE TO MANAGE CONCUSSION

New guidance on how to manage concussion sustained during grassroots sport was launched at the Scottish sports and exercise medicine symposium at Hampden today.

The Government’s Chief Medical Officer, Catherine Calderwood, and Concussion Campaigner Peter Robinson were joined by senior medics from the Royal College of Physicians and Surgeons of Glasgow, Universities of Edinburgh and Glasgow, Scottish Football Association, Scottish Rugby Union, and the sportscotland institute of sport, who have all worked collaboratively to produce the new set of guidelines.

For the first time the guidance is not sport-specific, but is intended for the general public and grassroots participants across all sports, particularly where medics may not be in attendance.

Clear advice is given to ensure that concussion can be recognised quickly and managed effectively from the initial injury to a phased return to play using World Rugby’s latest guidelines.

The overriding message is that ALL concussions are serious and if in doubt, sit them out!

Speaking at the launch, Scottish Government’s Chief Medical Officer Catherine Calderwood said:

“As a mother and a doctor, I know that regular exercise is one of the best things we can do for our health – both physical and mental health.

“Unfortunately injuries happen and when concussion occurs we cannot afford to take chances – you only get one brain.

“When recognised and managed properly, the vast majority of concussed patients will recover completely, but if not recognised, or not treated properly then concussion can even be fatal.

“Peter Robinson, who tragically lost his son Ben after sustaining a concussion in a school match, has helped bring sport and medicine together to produce clear guidelines for understanding and managing concussion in Scotland, and we urge parents, coaches, schools, sports organisations and health professionals to use the Scottish Sports Concussion Guidelines”.

Concussion Campaigner Peter Robinson, from Northern Ireland, whose son Ben died in 2011 as a result of sustaining a double concussion during a school rugby match when he was only 14 years old, was delighted to support the launch.

Peter said:

“Awareness of the dangers of concussion in sport is improving since we lost Ben but there’s still a long way to go, both in grassroots and professional sport.  For too long concussion has not been taken seriously, and that has to change.

“With these guidelines we want to help those involved in sport, any sport, to recognise the signs of concussion and know how to deal with it there and then.  If you have any doubts then don’t take the risk, sit them out and get them checked out.

“We are not saying that you shouldn’t take part in sport, far from it, there are many benefits to taking part in sport.  However there are ways to make it safer and what could be more important than that?”

A team of eminent sports medics worked together to produce the guidelines, which they hope will enable those involved in sport at every level to understand how to respond to suspected concussion and reduce the risks, particularly for children and young adults.

Dr Willie Stewart, consultant neuropathologist, NHS Greater Glasgow & Clyde, is the driving force behind bringing everyone together on this project:

“It is a significant achievement to establish a single, shared set of guidelines for sports concussion management across all Scottish grassroots and amateur sports.

“Through these guidelines, we have achieved a global first, right here in Scotland. However and more importantly for the management of concussion, we now have one definitive set of guidelines for everyone, no matter the sport or activity”.

Scottish International athlete Dr Andrew Murray from the Royal College of Physicians and Surgeons of Glasgow, and University of Edinburgh, added:

“We know that taking part in sport and physical activity has massive health benefits – helping participants be happier and healthier but it is not without risk. If not recognised and managed properly, concussion can lead to health problems and can even be fatal.

“These guidelines are crystal clear. We need to take concussion seriously and remove anyone with a suspected concussion from the field of play: if in doubt, sit them out.

“This is important for relatives, coaches, schools and health professionals amongst others to have guidance on. Recognising concussion and removing that player from the field of play for medical attention is the safe and the right thing to do”.

Echoing that advice, Dr John MacLean from the Scottish Football Association said:

“The Scottish Football Association supports an ongoing programme of Sports First Aid training in football and these guidelines complement this knowledge.

“Concussion is a serious brain injury and the guidelines make the recognition of concussion and return to play clear for all involved in grassroots sport. If in doubt – sit them out”.

Scottish Rugby Chief Medical Officer, Dr James Robson, said:

 

“Sports-related concussion has required a cultural change.

 

“No longer should concussion be seen as a badge of honour but, rather, as a potentially serious medical problem.

 

“The guidelines provide the most up-to-date, best practice for all sports. The mantra has to be ‘you only get one head, use it, don’t lose it.”

 

Also attending the launch was Dr Niall Elliott from the sportscotland institute of sport, who said:

 

“At the sportscotland institute of sport we work with athletes at the performance end of the sports pathway. When those athletes compete on the world stage, there will be a qualified medic in place to identify and manage a suspected concussion, using established protocols.

 

“However, the majority of concussions do not take place at that level but involve people competing in grassroots sport, particularly children and young adults.  What this guide is designed to do, is to simplify the guidelines already in place so that they can be easily understood and implemented by members of the public.  The ultimate aim is to make sports participation safer, irrespective of what sport that is or where it is played”.

 

Professor Frank Dunn CBE, President, Royal College of Physicians and Surgeons of Glasgow added:

 

“Concussion as a consequence of a sports injury provides a clear warning sign of impending serious complications. The evidence for this is incontrovertible and therefore the implementation of these well thought through and clearly set out guidelines is a major step forward in protecting participants from permanent brain damage.

 

“The pressure to get participants back on to the field of play must be resisted and acceptance of these guidelines by all will go a long way towards providing the best possible care for victims of concussion and potentially more serious brain injuries”.

 

Ends

 

Contacts:

 

Karen McCall, Senior Media Officer, sportscotland

T: 0141 534 6588 M: 07787 151015

Email: karen.mccall@sportscotland.org.uk

 

Royal College of Physicians and Surgeons of Glasgow:

Elaine Mulcahy 07757 021595 / 0141 2273204 / media@rcpsg.ac.uk

 

 

Notes to Editors:

 

  • The Scottish Sports Concussion guidelines can be found on the sportscotland website at: sportscotand.org.uk/concussion
  • The guidelines were launched at the Scottish sports and exercise medicine symposium organised by the Royal College of Physicians and Surgeons of Glasgow. The symposium is a major international event attended by more than 180 professionals in medicine and sport and features presentations from world leading experts including Sir Alex Ferguson and Dr Luis Serratosa (Real Madrid team doctor).  A full programme can be downloaded here. Contact Elaine Mulcahy (contact details above) for further information about the event.

 

UK PARLIAMENT RECOGNISES MAJOR ACTION NEEDED ON PHYSICAL INACTIVITY

I remember when en route running to the Sahara desert feeling a little ashamed. I had been a doctor for about 6 years, but ironically (given that I had just a 4300km run to the Moroccan desert) had not grasped just how good exercise is for health.  I had not been communicating this to my patients prior to this time

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Simply put regular exercise gets the happy hormones going and makes you happier. It also helps prevent and treat about 40 major diseases like type 2 diabetes, heart attacks and dementia (although athlete’s foot is more likely).

Worldwide (with a few honourable exceptions including Western Australia and Brazil, policy makers have been burying their head in the sand and hoping that the problem of physical inactivity would go away. This is consigning our children to a darker economic future than is necessary (type 2 diabetes costs the UK NHS £1million per hour) and stopping people be as happy and healthy as is possible.

So the report produced by the UK Parliament Health Committee is welcome, and highlights that major action is needed. I do think in Scotland more has been done, but we need to increase the pace and scale of what is happening.

http://www.parliament.uk/business/committees/committees-a-z/commons-select/health-committee/news/activity-diet-health-substantive/

http://www.publications.parliament.uk/pa/cm201415/cmselect/cmhealth/845/845.pdf

Here are a few really useful concrete recommendations from the Scottish Academy of Royal Colleges on what the NHS could do, which I contributed to in my role with the Royal College of Physicians and Surgeons of Glasgow.

http://www.rcpsych.ac.uk/pdf/SA%20Position%20Statement.pdf

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INCREASING PHYSICAL ACTIVITY

We know instinctively that exercise is good for health.  Our parents and doctors have probably told us so but this week highlighted the increased evidence that increasing physical activity for ourselves, our friends and family, and for the population in general will drive a huge increase in health and happiness. Surely no bad thing. 


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The study that hit the news this week looked at what kills people in Europe, and found that 7.5% of deaths (that’s TWICE the number of obesity related deaths) are directly attributable to physical inactivity.  The story was widely covered, here’s an example from the BBC who headlined the story

http://www.bbc.co.uk/news/health-30812439  . The case for regular exercise is open and shut, with memorable and huge studies (Lancet 2012) labelling physical inactivity “pandemic”, killing 5.3 million worldwide, and Steve Blair and Karim Khan teaming up to show that when you measure low fitness (as people tend to falsely overestimate the amount of exercise they do, it may kill more than the dreaded “smokadiabesity” – that is the combination of smoking, type 2 diabetes and obesity.

smokadiabesity

http://blogs.bmj.com/bjsm/2011/06/17/suffering-from-smokadiabesity-physical-activity-can-lower-your-risk-of-death/

So the argument is compelling.

The aim of “getting more people more active more often” is clear.

What can we do about it?

Fortunately most of the world’s top boffins in this area got together and worked out what worked, and what was cost effective in increasing physical activity.  It was clear that everyone can make a contribution, by being active yourself, helping friends, work colleagues or family sit less and move more, or by increasing physical activity in your community or even country through roles in communications, transport and the environment, urban design, sport, education, and health and social care.  In my opinion, this has been THE most important document ever produced on physical activity, as it offers a route map to guide people working in their workplace, community, local area or nationally.  I recommend keeping a copy yourself, and sharing a copy of “Investments that Work for Physical Activity” widely.

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http://bjsm.bmj.com/content/46/10/709.full

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Global experts like Nanette Mutrie, Karim Khan, Heather MacKay and Fiona Bull were generous with their time and helped us in Scotland.  This led to a National Implementation Plan for Physical Activity

http://www.scotland.gov.uk/Publications/2014/02/8239 as well as guidance for local and community planning.  This use of experts, and investing time and resources in the things that work as well as the hard work and expertise of many many brilliant people on the ground likely contributed to an increase in physical activity in both children and adults in Scotland. It is early and fragile data, but let’s celebrate a quick win.  It is great for Scotland. Increased physical activity gets our children better marks at school, makes them happier on average and prevents and they are 30% less likely to suffer an early death.

But good is the enemy of better. Physical inactivity still kills 2500 Scots (Chief Medical Officer report) a year, and 5.3 million (The Lancet).  What is required is co-ordinated action across the areas highlighted in “Investments that Work for Physical Activity”, and “National Implementation Plan for Physical Activity”.  Some of the big things are being done, for example 97% of children in primary school in Scotland now get 2 hrs of PE (up from 50% in the 90’s), and many of our inner city roads will have 20mile per hour speed limits soon making our streets safer and more conducive to walking and being outside.

As a doctor, I have been looking at what Health and Social Care can do to help increase physical activity. Our health service is one of the best, and safest in the world, and whilst many health professionals do help patients understand the benefits of physical activity, and offer brief advice and solutions, this simply is not happening as frequently as it does for smoking or alcohol, and in general the consensus is we should be aiming to move towards a service that promotes healthy lifestyles and creates health, as well as effectively treating disease.  To highlight the scale of the issue, only 2 of the 5 Scottish medical schools asked in 2012 said they taught the CMO guidelines on physical activity, whilst a group of the UK’s leading doctors ranked physical inactivity as the smallest contributor to death out of 6 risk factors, when evidence suggests it is 2nd or 3rd.  Nurses, doctors and health professionals ask a set of “clerking” questions when a patient is admitted to hospital. Despite the fact physical inactivity kills more than gallstones, varicose veins, thyroid disorder and high cholesterol combined, it is rarely included in these documents, whilst the others almost universally are.

 

The great news for health professionals is that we can move this forward together.  And our patients can help us.   There have already been huge contributions in Scotland in the area below from groups like the Allied Health Professionals Directors Group, Going for Gold, the University of West of Scotland, Scottish Government, National Education Scotland, NHS Health Scotland and Royal Colleges including the Royal College of Physicians and Surgeons of Glasgow and the Royal College of Surgeons Edinburgh.

 

Together we can

 

-Embed physical activity for health into primary care

-Embed physical activity for health into hospital and secondary care

-Embed physical activity into social care

-Increase teaching on physical activity in health professional education

-Be active and promote activity in the NHS workforce

-Show leadership, and spread awareness of how we can increase physical activity

Even last week one of the major colleges produced a position statement confirming their commitment to promoting and taking action on physical inactivity. It is a bold statement that I was delighted to contribute to

http://files.rcp.sg/filestore/1501120337_54b3e20d5eca0/Physical%20activity%20position%20statement.pdf

The great news is that there seems to be a real sense of collaboration to get things done.  The Scottish Academy of Colleges contain many of the great and the good of Scottish Medicine and have made clear their commitment to supporting and leading change.  They will outline actions that can be taken to achieve real and lasting change in a position statement in the next month or so, whilst our acting Chief Medical Officer Dr Aileen Keel is a real champion for physical activity and health promotion, and both her report  http://www.scotland.gov.uk/Publications/2014/12/1569 and the NHS Chief Executive report talk about the opportunity we can, and must grasp.

So 2015 promises much. Internationally there are some fantastic initiatives that will help increase physical activity. In Scotland and in particular in health and social care there seems to be a tangible chance of real progress, that can lead to an increase in gross national happiness and a healthier more active nation.

5.3 million deaths a year

RUNNING THE 10 HIGHEST MOUNTAINS IN SCOTLAND – IN A DAY!

Donnie Campbell and myself are going to try to run the 10 highest mountains in Scotland in a day. We are doing this because we had a free Saturday and fancied a challenge, but also to raise some money and awareness for SAMH (each penny makes a huge difference) and for the Fit in 14 campaign which is well worth supporting.

Some information about the challenge is going out to a few papers and magazines – give me a shout on docandrewmurray@googlemail.com if I can help with further information and the below

Scottish International distance runners Andrew Murray and Donnie Campbell are set to attempt a climb of the 10 highest mountains of Great Britain in a day. Taking on a challenge that may not have been completed before, on the 19th of July they will first run up and down Ben Lawers before driving to then take a route including 4 mountains through the Nevis range, followed by another drive to the Cairngorm mountains, where the final 5 mountains await. The challenge, billed “The Big 10” will be followed by a team from BBC Scotland’s “The Adventure Show”, and may well set a marker that will see others trying to go under the magical 24 hours, with faster folks going for any potential record.

Andrew & Donnie, running up Mount Kilimanjaro

Andrew & Donnie, running Mt Kilimanjaro 2013

Dr Murray, 33, races for Merrell UK, and is a GP based in Edinburgh, whose previous conquests include completing a remarkable 2,559 mile run from Scotland to the Sahara Desert, a 7 hour run up Mt Kilimanjaro and races won in some of the most spectacular and hostile locations on Earth. He is part of the sports medicine team at the sport scotland institute of sport.

He said:

There is nowhere I would rather be than in the mountains of Scotland on a summer’s day. This will be a tough but beautiful shift, but what we are hoping to do is raise awareness of the benefits of exercise, and being in the great outdoors. We know for example that even doing 30 minutes walking 5 days a week has been shown to make people happier on average, and live 7.2 years longer, so we’re urging people to build walking into their routine, and take advantage of schemes like Fit in 14. It’s inspiring what some people have achieved for example Paul Giblin running the entire length of the West Highland Way in 14 hours 20 minutes, but even a little exercise goes a long way towards happiness and health.

Training in Edinburgh

Training in Edinburgh

Campbell, 29 is a running coach, and a former Marine Commando based in Edinburgh who previously ran from Glasgow to his former home of Skye without stopping.
He added:

It will be a 4 am start, followed by a full day of up and down, up and down. It is a completely do-able challenge, and we hope people will give ‘The Big 10’ a shot after us. Some fresh air and a load of hills might give us sore legs the next day, but it’s much underestimated how good exercise is for mental health as well as physical health, which is why we’re encouraging everyone to get active in whichever way suits them ahead of the Commonwealth Games, and are looking to support the Scottish Association for Mental Health, whose Get Active campaign is doing loads to increase Scotland’s mental health through physical activity

The Route:

Mountain Height (metres)
Ben Lawers 1,214
Aonach Mohr 1,221
Aonach Beag 1,234
Carn Mhor Dearg 1,220
Ben Nevis 1,344
Cairngorm 1,244
Ben MacDui 1,309
Braeriach 1,296
Angels Peak 1,258
CairnToul 1,291

Andrew

Merrell UK

NEW YEAR TO GET OUT AND GET ACTIVE

lappingthecouchFirst of all the great news. Thanks to the huge generosity and efforts of family, friends, and companies like Footworks Edinburgh, Merrell UK, Tribesports, the Balmoral Hotel and UVU racing, and dare I say it many people reading this blog, we reached our targets from Lessons From Africa. A special thanks also to Arnaud le Marie for his fantastic and unstinting website work, and to Ross Lawrie for producing brilliant Graphic Designs, posters, and other great stuff all of which has led to the success of this project, and previous ones also.  Over 1000 pairs of shoes have been sent out to support Running Across Borders, over £10,000 raised to support African Palliative Care Association, and vital medical equipment has gone out to support Chogoria Hospital. Massive, massive thanks everyone.

New years bring new ambitions. I love the simplicity of a poster I saw “No matter how slowly you are going, you will still lap those on the couch”. It’s kept me going in December, when times were slow and the days cold.

2014 will be a huge year for sport in Scotland, and one that I’m looking forward to enormously.  There will be fairly major personal challenges from a running/ adventure point of view, and some great stuff going on at work.

Next week sees my first outing race wise of 2014, racing the Anglesey Coastal Trail Series  http://www.endurancelife.com/event-new.asp?series=82&location=267 . It’s a 34 odd miler, with about 1000metres of ascent and descent in a fabulous part of the world.   I’m usually one to pick races based on a place I fancy going and the seaside villages, coastal tracks and stunning beaches as well as the customary hills sound an ideal way to spend a Saturday morning.  As a bonus it is on a Saturday, so we can go climbing in nearby Snowdonia the day after.  The last time I was in Snowdonia, I did the Welsh 3000 feet peak challenge in winter, climbing all the 3000 peaks consecutively and running between them. The itinerary on Sunday might be a little less hectic.

The weekend also offers a chance to race in some new kit. My principal sponsor for 2014 are Merrell UK. I’ve enjoyed working with them last year, partly due to the top quality of their footwear and clothing but also they are good people- for example donating 150 pairs of new trainers to Running Across Borders during last year’s Africa trip.  I’m delighted to be a brand ambassador for both footwear and clothing this year, and a Merrell Pack leader. You can join the pack here, for information and lots of free giveaways.

Both weekends so far have offered the chance to do what I enjoy best- get outdoors. Last Saturday we had some fairly variable (glorious sunshine to white-out) weather up Beinn a Ghlo and a few of the Perthshire mountains and felt we’d earned a beer at the finish. In preparation for an epic challenge this summer, both Donnie Campbell and myself will be spending a load of time in the mountains.  This weekend I’m up in Crieff with the family enjoying some outrageous sunshine and doing a load of outdoor things.

Last year I had the chance to climb, run, bike and hike in a load of cool places, from the Dolomites to East Africa, but actually many of the amazing days were in the UK- running along the Giant’s Causeway and immense adjacent rock formations to days in the forests, on the coast, or in the mountains of Scotland. We also had some almost perfect weather for a week in the lake district.  This year will be no different, with trips planned at home and abroad- it is incredible what you can see in even a day.

Andrew & Kids

Work wise having largely worked in sport for the last year, I’ll start to direct more efforts into getting more people more active more often. For some of the reasons why check out a cool video called 23 ½ hrs, whilst January means that 6 Nations Rugby is round the corner, where I’ll be assisting Dr James Robson with the Scotland team during February as well as doing ongoing work with European Tour and Challenge Tour Golf, and the SportScotland Institute of Sport.

I’ve also started writing my second book – which will offer insights and smart solutions into the Science and Medicine of running for longer, and faster. I’ll share excerpts from this on my blog.

I’m speaking at a few (public) events in February, these ones feature some great line ups: Edinburgh Mountain Film Festival and Sports and Exercise Medicine Symposium.

Andrew
 
 

NEW WORK AHEAD

From February 2012 to February 2013 I worked full time pretty much for the Scottish Government as their Physical Activity Champion – I also did some work for London 2012 and others, but my focus was definitely Physical Activity. With Ministers, and our Chief medical Officer leading the charge, we got a lot done. Physical Activity for health is now a much higher priority in Scotland, at National, Local, and Community level.

The reasons for this are obvious – getting people more active saves lives, prevents disease, improves quality of life and saves the taxpayer about £800 million in Scotland. So it’s great to see this high up on the agenda, and great to pass on the role of Physical Activity Champion to Dr David White – no better man.

Here is a fun infographic that can be used freely:
30 Minutes of Exercise – The Key to a Happier Health

I’ll carry on looking to promote physical activity for health in any way I can, but this year my full time work is concluding SEM training, working in sport, with Scottish Rugby, Scottish Institute of Sport, The European Tour Golf, and UK Athletics.

The next 6 weeks will be concentrated on the 6 Nations campaign with Scottish Rugby, working with National Team Doctor, and British Lions doc James Robson. It will also involve work with Edinburgh Rugby, and it will be great to learn from the likes of James, and contribute to the mix.

The Scottish Institute of Sport is another place I’ll be lucky to work, with Dr Brian Walker, and Niall Elliot, working with the performance athletes in Scotland.

Additionally, I’m doing 9 tournaments for the European Tour and Challenge Tour Golf, which will come together to give me a great breadth of experience moving forward

It promises to be an intense, but fantastic year.

LESSONS FROM WEAKNESS – Why I run

Andrew Murray, running from Scotland to Sahara

Andrew Murray, running from Scotland to Sahara

Desire is frequently stronger than fear. For me, the desire for a challenge and to test myself tend to exceed a fear of failure. Love is definitely stronger than fear. Many life and death stories bear this out.

Setting a challenge that is sufficiently difficult and committing to it 100% is a sure way to learn more about your failings and yourself. I’ve been taught not to be proud and to accept help. Others seeing you visibly struggling know who you really are, rather than a controlled persona. If people accept you when you fail, when you are weak, then there is reassurance in that.

If experience is the best teacher, then we learn most when we are vulnerable and exposed. The light always looks more attractive from the shadows. I like most am reluctant to discuss my weaknesses and vulnerabilities but have gleaned much from times like these. Whether or not I’ve eventually achieved what I set out to do, the darker times reveal the most.

I learnt a bit of French, and read a few books when running from John O’Groats to the Sahara and learnt how to look at myself more honestly in the mirror, to embrace the lessons that difficulties bring. How can we be most resilient when this is needed? I enjoyed the good days but the bad ones were lessons. They helped me be more sympathetic when other people are struggling, and gave me perspective – my problems were only really sore legs when it came down to it.

I can’t guarantee success with RunTheWorld. We’re aiming to give prominence to the message of Physical Activity for Health, and raise some money for SAMH. I’ll aim to complete 7 Ultras on 7 continents in 7 days, after the Ice Marathon in Antarctica. There is a decent chance of achieving these things but there is close to 100% chance of me wanting to give up at times. I guess this is standard when normal people try and do things that are relatively hard.

Following any challenge, perspective becomes skewed – and the rose – tinted spectacles go on. We usually remember the good times. I guess the memories of good times and the prospect of more to come is why I run but difficult experiences can bring their own gifts. There is comfort in knowing what you are not, and how you can learn.

Thanks for your support,

Andrew