Blog | Allan Besselink Allan Besselink | Official Site Of The Smart Life Project, Smart Physio, Rhubarb Diaries, And Mobius Intermedia Sat, 19 Apr 2014 07:13:24 +0000 Joomla! 1.5 - Open Source Content Management en-gb Learning From Loss water or tears?Wise men say that we won't face more adversity in life than we can handle. Wise men say that each moment of our lives prepares us to live life more fully today and tomorrow.

I can say that over the past few weeks, I have been a little hard-pressed to feel or truly appreciate the wisdom of the wise.

Loss. It is something that invariably and eventually appears in our lives. We will all experience loss in some way or another: a friend, a family member, a love. Loss makes an appearance in our world and can challenge us to the core of our being – but there is much to be learned.

It doesn't matter whom (or what) you've lost or how. It brings with it emptiness, a virtual hole in your heart that you feel won't ever fill in. The tears flow freely at first. Moments become hours. Hours become days. Maybe the edginess wears off quickly - and maybe it doesn't.

With any luck, the tears become intermittent, interspersed with moments of peace within. Until, of course, a thought or memory brings the groundswell of emotion back again.

There comes a time when we somehow manage to peer through the tears to reflect upon what was once an integral part of our lives. We can finally see how those past experiences made our life more vivid. Although we feel the pain today, we have had the beauty of the life experiences we shared yesterday, and the vibrancy of a future blessed with the reflections of this beauty. It moves forward with us.

Over the past week, I have been at a loss to describe the sensation of, well, loss. I've found myself challenged to understand why, to comprehend the wisdom of the wise, and to truly, deeply believe that that wisdom is there for the taking. As much as I understand intellectually, the reality of life moving forward and everything getting better eventually, it oftentimes fails to quell the angst within. I know the peace and tranquility of life will return, but it seems furthest from reality right now.

We try to learn from it and grow through it and simply be persistent in getting to that "better place" in the journey, hopefully more vibrant and transformed than before. But there is a not-so-subtle reminder that slaps you in the face repeatedly: we only have now. Right here, right now.

That's where the learning hopefully comes in. Don't wait until tomorrow to tell someone you love them, or that you appreciate them, or that their presence makes your world a better place. Don’t wait to do something tomorrow. Because you know what? The truism is simple: we only have now. The sooner we learn that, the better.

Photo credits: gre.ceres

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]]> (Allan Besselink) Rhubarb Diaries Mon, 07 Apr 2014 02:50:29 +0000
In The Zone No [Storage] ZoneThe zone. It's a magical place to be. The zone is a moment in time when everything is clicking and flowing.

We often think of it in terms of sports. With March Madness upon us, I always think of the point guard who is shooting the lights out. He's in the zone. He can't and doesn't miss. Shots are flowing. There is a rhythm, a tempo, a feeling of insurmountable confidence.   

We find ourselves in the zone in all aspects of life at one time or another. It's a place that we all seek, be it in our work lives, our athletic endeavors, or our creative pursuits. But we also find ourselves struggling at times to find it.

It's a sweet place to behold, that zone.  Some have called it "flow". It can be a hard feeling to describe but you definitely know when you're there!

And there are times when you simply aren't there - for whatever reason. No matter how hard you try, you can't hit that shot or put the paint on the canvas the way you want to do so. The words just don't fall onto the page the way they typically do. You can't wrap your head around a problem or brainstorm to save your life. It can be an ugly sensation.

You may feel disconnected. The more disconnected you feel, the bigger the struggle is to find the zone once again. This can lead to frustration which never seems to end. Now the shots really don't drop. The paint dries on your brush before ever hitting the canvas. Those words barely come out of the pen, let alone in sentences that are grammatically correct.

The problem is that the harder you try to get into the zone, the more difficult it is to actually get there. It is a conundrum of epic proportions.

The solution is almost counter-intuitive but Zen-like. Just step back and breath. Accept what is as it is. Let go.

But I will be the first to say that it can be a huge challenge to let go. It can be hard to accept. Surely I must be able to force the words out, or just keep practicing harder or longer. Or so we think.

When it comes to intellectual pursuits or creative challenges, taking a step back is the best option. It is what it is ... and that is ok.

Enjoy being in the zone when you are there. The sweet spot is a beautiful place, indeed. But if you're not, no worries. Breath, relax, and accept what is - and you'll find yourself heading back in no time.

Photo credits: thatjonjackson

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]]> (Allan Besselink) Smart Physio Mon, 17 Mar 2014 03:43:36 +0000
The Olympian In All Of Us The Temple of Olympian Zeus (VII)The 2014 Sochi Winter Olympics are now officially a part of Olympic history. We've witnessed the highs and lows and the tales of victory and defeat with unprecedented clarity through countless cable TV stations and social media outlets. 

This year, I didn't get mesmerized by curling (Note: that phrase might actually be an oxymoron, but I digress). But having been born and raised in Canada, I probably don't have to explain my desire to watch hockey.

The beauty of the Olympics every couple of years is that we are exposed to special performances from what we think are special people. However, one quick look around you and you might just find that there is an Olympian in all of us.

One of my greatest life experiences was the Summer Olympics in Atlanta in 1996. I served as a physical therapist for the ACOG medical services in track and field. Our services were available to all athletes. Most of the larger countries had a large medical contingent that traveled with their team. It was the smaller delegations, those not traveling with many (if any) medical staff, that utilized our services extensively.

There was one consistent theme amongst all of the amazing athletes I crossed paths with in Atlanta. It didn't matter what country they were from - they were all people with a story, an individual tale that brought them to this moment in their lives. Yes, many of those in Atlanta (and Sochi) are more muscular, faster, or graceful on a set of ice skates. At the end of the day, though, they have all set their goals and path, faced their own challenges and struggles, and pursued it to this moment in time called the Olympic Games.

They are all just like you and me.

Each one of us lives our own Olympics every day. At the end of the day there might not be a gold medal on the line, and you probably won't hear your national anthem or watch your flag raised before you head to bed.

But each day, we write a vivid story to be shared. Each day, we live something special, if we choose to view it that way. Each day, we contribute something to the world - ourselves, our being, our presence.

We may be an Olympian to our employer. Or our partner. Our just ourselves. Oftentimes we just don't see our own story as "special enough". However, we all have our struggles, our challenges to overcome, and those in our lives that support us with unconditional love along the way.

Take a moment today to appreciate your Olympic journey. Reach out to those around you, even for a moment, and thank them for being a part of your Olympic experience.

There may not be a gold medal, but your story is yours - special, shining, and golden.

Photo credits: isawnyu

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]]> (Allan Besselink) Smart Physio Mon, 24 Feb 2014 04:30:42 +0000
The Logical Fallacy And The Curse Of Modern Medicine Logic LaneIt occurs in countless clinics and facilities around the world every day. It may, in fact, be the curse of modern medicine as we know it.

The logical fallacy.

It rears its ugly head in any number of ways. Take, for example, the premise underlying the "logical" (yet arbitrary) concept of asymmetry and muscle imbalance. In our world today, there are countless examples of normal anatomic variability being "treated" as a problem when in fact they are, as I mentioned, normal for that individual.

Forget about what you think you witness in the clinic for a moment. Forget about what you were taught about asymmetry and imbalance. Let's step back and take a look.

Statistically speaking, asymmetry is the norm. Yet we continue to hammer away at how subtle anatomical variability - which has, perhaps, been there for life - is the root of all evil. We review MRI and x-rays after the onset of symptoms, yet we don't have a reasonable reference point pre-onset for comparison. Change? We would never know. There is a rapidly expanding scope of literature that reminds us that normal, asymptomatic people have anatomical issues like partial thickness rotator cuff tears, hip labrum tears, knee medial meniscal tears, and herniated lumbar intervertebral discs - and still have full pain-free function. Oh, and they don't necessarily serve as predictors of a future full of pain and suffering.

Yet how many of these have ended up in surgery? Or endless chiropractic treatments? Or interminable PT sessions that focus on the minutiae of the moment?

We assess asymmetry with tools that have poor reliability. Nobody can agree with what they see, but so what? Carry on and treat the anatomical variability nonetheless. And don't even mention that the human body, asymmetrical or otherwise, does wonders in adapting to the imposed demands of life on the planet without pain or loss of function.

Logical fallacy is a bigger problem than anything else in health care. It should constitute it's own syndrome, but for the clinician in question. It ends up in confirmation bias that oftentimes reflects the profit and loss statement of the practitioner more so than good clinical reasoning.

The worst part of all of this is that we actually have some valuable yet highly under-utilized tools for assessment. A consistent understanding of the responses to mechanical loading (be they symptomatic, mechanical, or functional) and concordant signs and symptoms pave the way to the development of an appropriate intervention strategy to increase the body's loading capacity.

In the meantime, we stabilize hyper-mobility and mobilize hypo-mobility, regardless of whether either is normal for the individual or not. Worse yet, neither may have any functional relevance to the problem at hand.

The problem isn't in our capacity for clinical reasoning and sound thinking. The problem is that we choose to deny ourselves the opportunity to do so, maintaining contradictions of thought in order to maintain our beliefs. Unfortunately, the patient - and health care as a whole - suffers in the process.

Photo credits: arenamontanus

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]]> (Allan Besselink) Smart Physio Sun, 09 Feb 2014 03:11:09 +0000
Physics And The Peaceful Coexistence Of Cyclists And Motorists 02a.BikeLane.NicholsonStreet.Hyattsville.MD.17June2013Let me start this post by saying that I am a cyclist. But don't think for a moment that I am just going to rant about crappy drivers. It's not that simple for me. I am a motorist as well.

I live on a street that has two northbound lanes and two southbound lanes divided by a median. There is also a very wide, well-marked bike lane northbound and southbound. It is a popular thoroughfare for cyclists riding to and from Austin and San Marcos.

As a motorist, I always try to be aware of cyclists. I have heard too many horror stories over the years, and I do my part to give them the space necessary to ride safely. With that said, as a cyclist I try to be cognizant of a motorist's challenge in seeing us and understanding how we function on the roads.

One day, I got into my car and headed down the aforementioned street. I approached a group of cyclists. I noted that even though there is a broad bike lane, many of them were wandering aimlessly into the path of traffic in the right hand lane.

Before we go any further, I will add that I know that it is a cyclist's right to occupy the far right lane of traffic.I don't take issue with that.

But as I approached the intersection, there seemed to be no rhyme nor reason to what this group of cyclists was doing. In the lane, out of the lane, it was hard to tell.

Fortunately, we were approaching a red light at a busy intersection. In times past, I have watched far too many a cyclist simply ride through lights and stop signs while barely adjusting their speed, let alone stopping. Of course, the same is true of motorists.

The problem with all of this is that both cyclists and motorists are at fault. Frankly, I am not sure that one is more so than the other. Take out mutual respect and physics is firmly on the side of the motorist.

Motorists are in vehicles that weigh many times that of the average bike and cyclist combined. They have a contact patch of tire to ground that is far greater than the small contact patch of a 700x25C tire on a road bike. One quick opening of a driver side door could take down a cyclist in an instant. They have a responsibility to respect the laws of physics – and to be aware of those around them.

Cyclists, on the other hand, are as much at fault. "I have the right to ride here" isn't enough. Respect for a 2000 pound vehicle is important. You can't just ask for the benefit of the rules of the road, then break them arbitrarily at stop signs and lights. Your consistency makes it far easier for motorists to be able to coexist with you.

With rights, comes responsibilities. Welcome to the world of cyclists and motorists.

Unfortunately, due to the nature of force, mass, and acceleration, cyclists will bear the brunt of this burden. The physics of the scenario isn't changing any time soon. But the problem is shared.  We won't coexist peacefully until there is mutual respect, consistency, and awareness. I just hope it happens sooner than later.

Photo credits: Elvert Barnes

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]]> (Allan Besselink) Smart Physio Sat, 01 Feb 2014 21:31:33 +0000
When The Teacher Becomes The Student Magic pebbleI have had many years of guiding athletes through the maze that is injury recovery. I've witnessed not only the physical effects of injury and illness, but also the struggles faced by the athlete mentally and emotionally as they work their way through it.

I've mentored them through the process, offered insights, and advised them regarding the attainment of life balance throughout this challenging time in their lives. I have always seen injury not as a failure, but as an opportunity - to learn from the experience and to put good strategies in place for the future. Through it all, I have gained a deeper understanding of the psyche of the athlete and the fine balance between all the factors required to make it all work.

That is, until I became the athlete in question. It is amazing how when the tables are turned, your head spins with the reality.

This year was going to be my 11th consecutive 3M Half Marathon. I truly enjoy the event. It is a fun course with amazing race organization. It also provides a great mental boost to train throughout the winter months. For these reasons, it stays on my running calendar.

I was, admittedly, a little behind schedule on my training in early December. However, I've done this race so many times, I knew exactly what the timeline was and how my training would piece together. No worries. Besides, I thought, I always build some extra time into my training program "just in case" something goes awry. It's all in trying to be proactive and have a long-term plan.

But then I got some nasty upper respiratory crud. No running. Barely breathing without coughing something up. Fatigue. Tick-tock-tick-tock. I can feel the stress building inside. What should I do?

Then, I heard the voices that all those athletes over all those years had told me about. Should I? Shouldn't I? What was prudent? Is this race really that important? I may be able to get through it, but will I put myself at risk of injury in the process?

Countless questions clouding my mind.

The thought of this was all new to me. I've never had to withdraw from an event, so surely I can't do so now - or so I thought. And there was that streak of consecutive finishes looming if I could just find a way to toe the start line.

My own best advice - that which I had successfully delivered to athletes throughout the years - was now my own to take. Bitter medicine, in some ways.

Master Kan: Quickly as you can, snatch the pebble from my hand.

[Young Caine tries to do so and fails]

Master Kan: When you can take the pebble from my hand, it will be time for you to leave. (“Kung Fu”)

I decided not to run the 3M half marathon this year. As a coach and as a physiotherapist, I knew better. I was still (slowly) recovering from an illness, let alone trying to get my immune system to recover from and adapt to any level of training stimulus. Was it a challenge to be "good" with the decision? Certainly. But I know that it was the right thing to do. There will be many more events ahead, many more opportunities to step to the starting line with all the right factors squarely behind me. Sometimes, though, the timing just isn't right and it's just not worth the potential consequences to forge ahead.

The teacher became the student.

For this experience, I will be forever thankful. No failure, just opportunity. Lessons learned. Now if I could just grasp that pebble ...

Photo credits: antony_mayfield

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]]> (Allan Besselink) Smart Physio Fri, 24 Jan 2014 03:24:23 +0000
Smart Sport International Turns 10! Birthday CakeIt is with great pride that I announce that Smart Sport International (SSI) turns 10 years old today. Oh, how the time goes by quickly! This anniversary is marked by a new location (at H.E.A.T. Bootcamp in Austin) and upcoming open house on February 7. More details on that later.

The roots of SSI go all the way back to 1992. By 2004, a vision had evolved to create a seamless integration of sport science solutions for training, rehab, and life. Another 10 years later, and SSI is moving into decade number two and has become the home of competent self care. Be it injury recovery or endurance sport performance, SSI has always focused on sports science-based and athlete-centered approaches to both injury prevention and injury recovery.

At times like these, it is always good to reflect upon the road you've traveled. It helps to bring perspective to the road ahead.

SSI started in a spare treatment room at the Spine And Rehab Center in Austin, Texas. From there, it evolved into its own space and has, for the most part, been associated with fitness facilities. SSI is one of just 84 Certified McKenzie Clinics in the world. With that in mind, I am one of just a handful of clinicians that have attained not only the highest level of training in the Mechanical Diagnosis And Therapy (the McKenzie Method), but have specialized in sports- and fitness-related injuries. From a coaching perspective, SSI has guided first time runners to experienced Ironman triathlete in the pursuit of their sport performance goals.

Now, SSI has moved into a new space at H.E.A.T. Bootcamp at 2210 S. 1st Street in Austin. It is an exciting time to work alongside some great, innovative personal trainers in a fun environment. The future is bright!

In 2008, I authored the book "RunSmart: A Comprehensive Approach to Injury-Free Running" which continues to receive solid reviews. Whether the run is 800 m or 100 miles, the training principles remain consistent. As an example, in 2011 I coached a double World Masters Athletics gold medalist in the 800m and 1500m - just one month after one of my age group athletes completed the Western States 100 mile endurance run in 23 hours!

More and more people are being exposed to both the training principles and the application of MDT in the sporting community. This continues to take place via seminars and educational sessions, this website (almost 100,000 hits) and social media (followed by over 4100 readers).

Of course, none of this is possible without the athletes, clients, patients, and readers that support not only the Smart Sport International mission but that of the Smart Life Project and Competent Self Care as a whole. Thank you to all of you that have given SSI a degree of longevity in the sports community.

To celebrate this anniversary, H.E.A.T. will be having an open house on Friday February 7 from 7:00 - 9:00 pm. Stop in and say hello, check out the new facilities, and come see the home of competent self care. I look forward to celebrating with you!

Photo credits: Will Clayton

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]]> (Allan Besselink) Smart Physio Sun, 12 Jan 2014 23:39:11 +0000
Minimalism, Motion Control, And The Track Coach Time Machine BarcelonaTrack coaches may have had it right all along.

I am one of the first people that will advocate for science-based strategies for training and injury recovery. But I am not averse to acknowledging what may have been done well in the past, without the benefit of sports science. This is where the track coach of yore comes in.

You see, track coaches in the 1970's probably had a lot of sound concepts already in place to make better runners, long before the running community evolved into a mass of fads, testimonials and marketing plans.

Let's jump into the time machine and go back to 1970. Back in the day, long before marathon training groups popped up on every street corner in the United States, there was the track club. These clubs focused on interval-based training. Track coaches focused on improving your running mechanics. As I have found over many years of working with runners, running mechanics are typically better when you run on the faster end of your individual running pace continuum; alas, the biomechanical benefits of interval-based training. The track coach had you do drills and plyometrics on the infield (or perhaps even on the track itself) to encourage eccentric strengthening. You might have done so in your bare feet, a lightweight trainer, or a track spike. The coach probably put you in as little shoe as you needed: the athletic demands were placed on the strength of the lower extremity, and it was simply easier to not lug a heavy shoe around the track.

Oh, those were the days. The focus was on running, and running fast - relative to the individual, of course.

Then, as I mentioned earlier, came the premise that you could train for a marathon in 6 months, regardless of your starting point. There was money to be made throughout the running community. It started with the advent of the countless marathon training groups. The trend could be seen in midsole design, motion control shoes, and orthotics. Countless runners were put in shoes with more support. Then, there was the minimalist "revolution" in which athletes were moving towards shoes with a minimal, zero drop midsole - or no shoes at all. And now, if we look at the market place and the community as a whole, it is swinging back in the opposite direction yet again.

Ugh. If there is one thing I despise, it is fads.

Sometimes, with the benefit of hindsight, you discover that things were done well from the get-go. Case in point: that which was done by many track coaches 40 years ago without the benefit of the sport sciences. They put you in as little shoe as necessary. They focused on your running mechanics. They emphasized drills and intervals. They made you a better runner.

They didn't focus on slogging out 10 mile runs at a pace that is 2:00 slower than your goal marathon pace. Or put you in compression socks. Or some other similar garbage geared to "help you to burn fat".

You simply got out and ran, much like children do when left to their own devices.

Is there a shoe that is right for you? Absolutely. But with that said, it is time to go back to the track - with as little shoe as you need, while building your pace, your eccentric muscle strength, and your running form.

Let's get back to making better runners - and make them smarter along the way with the benefits of our current understanding of the sport sciences and how these principles apply to training and recovery.

The running community as a whole would be a better place because of it.

Photo credits: Sean MacEntee

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]]> (Allan Besselink) Smart Physio Mon, 06 Jan 2014 03:56:41 +0000
Top 10 Posts Of 2013 No 10 - embedded brickThe year 2013 is now officially a part of history. Hard to believe, but another year has come and gone, leaving us with plenty of challenges and beautiful memories along the way.

Once again, I have compiled my annual Top 10 list. In 2013, my goal was not only to write consistently but to also write more focused posts. With that in mind, I had fewer overall posts this year: 117 (compared to 172 in 2012). Hopefully that also makes it a little easier for you, the reader, to consume regularly!

I don’t necessarily believe that the posts with the most traffic are my best posts or my best writing, but it provides a good starting point for the Top 10. I’ve also added five personal favorites, just to round-out the list. So without further ado, here are my Top 10 posts of 2013. Count them down, and enjoy!

10. The Low Back Pain Paradox: Part I (3/13/13)

9. Branding Physical Therapy - Use Those Eight Words Wisely (6/14/13)

8. Physical Therapy Is A Movement Profession (5/30/13)

7. Consumer Direct Access To Physical Therapy: It's All In The Language (1/8/13)

6. Clinically Complex, Or Just Poor Clinical Reasoning? (1/24/13)

5. The Four Best Physical Therapy Methods For Patient-Centered Care (1/15/13)

4. The Three Musketeers Of Physical Therapy (2/12/13)

3. HB 1039 And SB 402 Improve Patient Access To Physical Therapy In Texas (2/7/13)

2. Perpetuating The Myth Of Hands-On Care (8/13/13)

1. Running And The Dastardly Leg Length Discrepancy (2/20/13)

Bonus round: Here are five of my personal favorites:

Vision Now Revisited: Being And Becoming (6/4/13)

25 Thoughts On 25 Years Of Physical Therapy (5/28/13)

Seven Reflections On Life's Lessons (8/28/13)

Laugh. Think. Cry. (3/10/13)

Load It (11/21/13)

I would also note the passing of two of my clinical and teaching mentors:

Robin McKenzie 1931-2013

Barbara Melzer: Colleague, Educator, Friend

Just in case you missed it, you can find the Top 20 from 2012 here.

All the best in 2014!

Photo credits: kirstyhall

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]]> (Allan Besselink) Smart Physio Thu, 02 Jan 2014 05:12:08 +0000
In Illness, A Reminder Of Health ThermometerThe pages of my blog have been eerily quiet recently. You could almost hear a pin drop around here. I could use the holiday season as a fine excuse. But it isn't the presence of festive cheer that makes my writing world silent of late.

You see, the evil crud hath struck me down.

Gone are the days when you had a little stuffy nose or tickle in your throat. Nowadays, you get some bizarre strain of strange upper respiratory crud that seems to wipe you out, drain you of your energy, and put you in a haze for a few days. Or longer.

Welcome to my world of late.

I consider myself a fairly healthy guy. I will admit, I don't always eat enough veggies or get enough sleep or stay as consistent with my running (or cycling) as I would like. Life is like that sometimes. And it's not like I haven't been sick before. It happens to the best of us. We don't live in a bubble, do we?

But this time around, the evil crud threw me for a loop.

It reminded me of how fragile our health really can be. You may have it today, now, but you can watch it slip away so quickly. Illness forces us to re-assess our efforts with friends, family, work, and possibly even the most basic daily activities. It challenges our routines. It probably forces us to re-examine our time demands and to re-factor those efforts, whether we like it or not. It can also be a strong and not-so-subtle reminder that we simply can't go 110% all the time. Sometimes, we need to step back from the edge - hopefully before we get sick, rather than afterwards.

And to think, it's only the evil crud. It's not a long-term chronic illness. At least I know that with rest, some good food, and plenty of fluids, this crap is going to get better. But what if it was something with far greater magnitude than just the evil crud?

Sometimes, we have to have darkness to remind us of the beauty of light. And so goes our health. We have moments of illness - hopefully, nothing more than the evil crud - to make us acutely aware of our health and what it takes to live fully, completely, vividly. It is in these hopefully-fleeting moments of sickness that we can fully appreciate our health and the beauty provided to us with moments of quality time with those we care about in life.

We don't have the liberty of getting those moments "just because". When we are ill, we don't automatically get them. Our health - and the health of those we love - is sacred. We only get one go-around with it. 

Thanks to everyone for being patient during this period of relative absence. I appreciate each and every one of you for taking the time to read. to comment, and to share. You have made the process of writing a hugely enjoyable one. Fortunately, the path of writing ahead is looking better now that the crud is receding. Here's to an epic 2014 ahead for all!

Photo credits: matsuyuki

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]]> (Allan Besselink) Smart Physio Mon, 30 Dec 2013 00:01:55 +0000