Great, Healthy Boobs!

If you see me as a patient, or viewed any of my previous blog postings. You may have heard me talk about posture once or twice? Supporting your boobs in a well fitted bra can contribute to good posture and is important for ladies. The purpose of a well-fitting bra is to offer support of the breasts for comfort, wellbeing and appearance. It is estimated that 80% of women in the UK are wearing the wrong size bra.
Sometimes problems that I deal with as an Osteopath, can be caused by, or contributed to by a poor fitting bra.

Problems that can result from an ill-fitting bra
  • Pain from direct pressure.
  • Postural problems related to poor support, this may then cause pain.
  • Alongside changes in posture, you may get a knock-on effect on the internal organs/structures. Then possibly changes in breathing, circulation and digestion. Heartburn, indigestion, IBS have all been documented.
  • Skin rashes from direct pressure.
A well fitted bra can contribute to better posture and wellbeing


How to fit your bra – what to look out for
Look at the band around your torso. It should fit securely. You should be able to slide 2 fingers underneath the band at the back, and one under the middle part at the front, “the gore”.
If the band at the back of the bra rides up, then it is too big. In this scenario, you would tend to compensate by tightening the shoulder straps. So other signs that this may be the case are indents on your shoulders from the straps. Or maybe pain in the shoulders.
The central part, “gore”, at the front of the bra should also sit on your body. You should be able to raise your arms up above your head and for this to remain the case. If this doesn’t happen it maybe the case that you should increase the cup size and reduce the band size.
Another sign of an ill-fitting bra is the “quad boob”. So this is when breast tissue bulges over the top of the bra. The bra needs to encapsulate all the breast tissue.
To measure:
Measure with a fabric tape measure underneath the bust where the band should be. The tape measure should be tight, ideally you should do this naked. Make sure the tape measure is parallel. This is where 90% of the support from your bra comes from.
Bra sizes come in even numbers, round it up if necessary. This is your band size.
Next measure around the fullness of the bust. Do this naked and bending forward. This is so all your breast tissue moves forward and can be incorporated in the measurement. The tape measure should be looser on this measurement.
Then take the difference between the two measurements to get the cup size. SEE CHART.
Difference between 0″    <1″    2″    3″    4″    5″    6″    7″    8″    9″    10″   11″    12″
2 measurements
Cup size                  AA    A      B     C     D    DD   E     F     FF   G     GG    H      HH
So this is a basic guide. There will be variations between brands and so your bra size may alter between styles and brands. Remember that the band size is proportionate to the cup size, so if you reduce the band you will likely have to go up in the cup and vice versa.
In conclusion, if your bra doesn’t fit snugly and encompass everything, and/or causes pain. Then it is best to take the advice offered here today.

Why worry about posture?

We all know we would should probably take more care of our posture. Do we know why we should do this? Here are my top reasons for the importance of maintaining a good posture:

1          Poor posture may not cause pain or problems immediately. However, if you hold your body awkwardly or out of balance for any length of time. You will inevitably be compressing, tightening, weakening and over-stretching areas. This might then be the slow build-up for potential issues in the future. Perhaps when you challenge your body, it won’t be able to cope and you may suffer an injury. HELP TO PREVENT INJURY.
2          For similar reasons to number 1. If you hold your body in a way that stresses it. It maybe that wear and tear of these compromised areas could occur more quickly, or to a greater degree. HELP TO REDUCE THE INCIDENCE/SEVERITY OF WEAR AND TEAR/OSTEOARTHRITIS.
3          A poor posture may effect other body systems, not just the muscles and joints. A change in position could mean you don’t breathe as well as you might. This may effect the mechanics of respiration, your body’s ability to take in oxygen and expel CO2. A slumped posture might also have negative knock-on effects on circulation and digestion as you compress and restrict the diaphragm and abdomen. IMPROVE GENERAL WELLBEING.
4          Not only do we function and feel better as a whole with good posture, we also look better too. AESTHETIC IMPROVEMENTS.

            We’re all different, and quite possibly asymmetrical. We may have different predispositions for posture relating to disability, natural structure, occupation and activity. Some of these things can be worked on and improved. We can only do our best with what we have.
            Try and consider balance in your body, between left and right, and front and back. So think about how you position yourselves in an activity. The shoes you wear, how you carry a bag……..any daily activity you regularly undertake.
            To make improvements first identify risk factors in your day-to-day life. Then think how you may reduce them. Try and lead an active lifestyle, also giving yourself time for good quality rest, sleep and repair. Consider exercises that will help improve your mobility, and increase your strength for postural support.

            Osteopathy can help if there are any problems. Treatment will address the issue and advice can be given for long term prevention.

Hand and Wrist

There are many different issues that might cause pain in our hands and wrists.
Common problems in the hand tendons are a trigger finger or thumb. People who are insulin dependent diabetics can be prone to this, but anyone could get it. It is caused by thickening in the tendon which causes the tendon to catch and “trigger”. People who suffer with rheumatoid arthritis may develop nodules on their tendons and this might cause triggering too.
Tendons may be strained, or even cut and ruptured. A cut or fully ruptured tendon may need surgical repair.
Ganglion cysts commonly appear on the hands. These cysts contains synovial fluid that has leaked from a joint or tendon tunnel. They are harmless and may well go spontaneously of their own accord. Sometimes removal, or work to remove the fluid from the cyst might be necessary.
Fingers and wrists can suffer with arthritis. Most commonly osteoarthritis. This is the normal wear and tear changes that we are all likely to get to a greater or lesser extent. This could cause localised stiffness and pain in the joint effected.
If you have a problem in the hand and wrist area, it may effect the way you use your arm. So problems higher up the arm might occur due to excessive strain placed on them. Even into the shoulder, neck and upper back.
The above is a sample of some reasonably common hand and wrist issues. It is important if you have a problem that you get it assessed and diagnosed so the correct treatment/intervention can take place.
To try and keep your hands generally mobile. Consider doing some simple daily exercises.







Extend your arm out ahead of you with your palm facing up. Gently stretch your fingers back towards your body. Repeat on both sides holding for a count of 10 to 15.

Extend your arm ahead of with your palm facing down. Gently stretch your fingers back towards your body. Repeat on both sides holding for a count of 10 to 15.




Spring Into Spinal Care!

Our spine is important and a vital part of our body. It transports information from our brain to the rest of our body, and vice versa. It is involved in all activity and it has to put up with a great deal – sitting for long periods at a desk at work/home, long car journeys, carrying bags and schoolbags, strain through sporting activities, lifting and carrying, and strain accumulated through poor positioning and posture. From a functional and comfort perspective, we all want to remain active and be able to carry out our lives as we wish to, free from pain. 

Osteopathic treatment can help. By looking at your own individual body position and possible issues. An Osteopath can diagnose a problem, or highlight areas of concern that may need to be addressed to avoid a problem. So Osteopaths can be consulted if you are in pain, or even as a check-up if you’re not in pain. In both instances, you can receive the physical treatment and also receive advice on how best to maintain good spinal health for you.

Some general tips:

  • A rucksack is the best bag to carry to try and avoid back problems. It should be carried over both shoulders, and adjusted so the bag sits close to the back.
  • De-clutter bags so you’re not carrying around unnecessary items.
  • We all need to stay as active as possible. Take regular exercise to help general fitness and improve your mobility.
  • Wear a decent pair of shoes that will be comfortable, supportive and appropriate for the sport, job or task you’re undertaking.
  • Stay mobile generally. If you find you’re at the computer, or TV, on a car journey or just sitting around. try and get up every 40 minutes to avoid getting too stiff.
  • Check your computer set-up. This can make an enormous difference.

It’s February! How are the New Year resolutions?

How to get the most out of your New Year’s resolution 
We all tend to over indulge a little at Christmas and doing a little more exercise is a common New Year’s resolution. But how do you get the most out of your gym routine and how much exercise should you do to stay healthy?
There is no denying that exercise is good for you. We know that those who perform a moderate amount of exercise on a regular basis are considerably less likely to suffer from diseases such as diabetes, stroke and heart attack or experience insomnia. Exercise helps older people maintain their independence and is one of the most effective methods of weight management, a growing problem in western societies. It is also very important for our psychological health, as it stimulates the release of endorphins, natural pain killing chemicals that can also improve our mood.
However, some people become a little disenchanted with the exercise if it doesn’t have the desired effect.

“Most of the time, it’s because people are not clear on the type of exercises that are most likely to achieve their goals” says, local osteopath Claire Webster. “Different types of exercise will be more appropriate, depending on what you’re hoping to accomplish.”
“As a general rule”, she continues “if you are trying to build larger muscles, the most effective method is to use a weight which you can manage to lift 8-10 times before the muscles fatigue, in order to get the desired effect. If you are looking for stronger, leaner muscles, a weight programme based upon 20 repetitions would be more appropriate.”
If you are trying to lose weight, cardiovascular exercise (anything that gets your heart rate up such as running, swimming, dancing or football) is the way to go. In order to be most effective, this should be performed at 60 – 80% of your maximum heart rate, which is a lot less strenuous than you might think (Subtracting your age from 220 will give you your advised maximum heart rate. You can buy a heart rate monitors from most good sports shops or online to monitor this).
It’s also important not to train every day. The body needs time to respond to the strain of the training, and it’s during the recovery period that the gain takes place.”
But going to the gym for two weeks before you go on your summer holidays to shed a few pounds is likely to end in frustration. “It takes 4-6 weeks to start noticing the health benefits of excercise,” Claire Webster advises. “Doing something you enjoy makes it more likely that you will persist, which is important if you don’t want all that hard work to go to waste.”

But how much exercise do you need to do to be healthy? If you are aged between 19 and 64, research suggests that you perform at least 150 minutes of moderate-intensity, or 75 minutes of vigorous-intensity cardiovascular exercise each week plus muscle strengthening exercises on at least two separate days of that week. The good news is that this exercises does not need to be all in one go, and activities such as walking briskly to work (if your journey is more than 10 minutes) counts as part of the total.
If you want to know more about what would class as moderate or vigorous exercises, or if you are outside of this age group, visit the NHS choices website at:
Claire Webster is a member of the Institute of Osteopathy and can be found at The Rivermead Osteopaths, Chelmsford. She can be contacted at: Tel 01245 280636 or 07771 591298.

Keeping your spine mobile

Last month I talked about spinal joints. This month I want to show and describe a few great ways to try and keep your spine mobile.

I recently read a caption. “Have you ever heard of a spine transplant? Neither have we. Take care of the one you have.” I wholeheartedly agree! Osteopathy can help solve and manage spinal issues. The ideal would be to try and practice staying mobile regularly, to help yourself as much as possible too.

These exercises shouldn’t cause pain, if you experience a problem, stop the exercise and consult your Osteopath or other medical practitioner. If you have an existing complaint, it would be wise to consult your practitioner to check these exercises are appropriate for you.

Spine Curl Exercise

This is a great way to work through stiffness in the lower back and coming up to shoulder blade level.

Start laid down on your back with your knees bent. To begin the move tuck your pelvis under so that your lower back flattens to the floor. Then think about raising your spine off the floor one vertebra/spinal segment at a time. Come up to shoulder blade level to avoid over-straining your neck in this position.

From the initial tucking of the pelvis, to raising up into your upper back, Really try to focus on moving one vertebra at a time to get maximum benefit from this. There may be sections of your spine that are very stiff, and this will be more difficult. Keep practicing to gain more mobility. Or/and seek some treatment to help if you feel its necessary.

Reverse this process to come back to the start position. Replacing your vertebra to the floor one at a time.

Repeat gently 5-6 times.

Upper Back Rotation With shoulder “Opening”

Lay on your side. For an ideal start position, make sure your hips and shoulders are stacked on top of one another. So you are laid in a balanced position. To try and allow the movement to focus through your upper back and shoulder, you will need to try and fix your hips in this position whilst performing this exercise.

Start with your arms out straight ahead of you on top of one another. They should be at shoulder height and around 90 degrees to your body. 

Raise the top arm and bring it as far back as you can. This will encourage a rotation in your upper back and a stretch to the front of your shoulder. Allow your neck to rotate with this movement, but keep the hips still. Return to normal. Repeat this exercise, with care and control 3-5 times on each side.

(This exercise is demonstrated below by a Pilates professional. Stewart Heath. Stewart owns Bodysense in Hatfield Peverel. They provide a wide range of Pilates tuition.)

Upper Back Extension

The natural shape of the upper back means that it is often held in a slightly rounded position. It is an area that we may struggle with posturally if we get into slouching habits. It naturally doesn’t move so well, as it is surrounded by rib cage too.

This exercise is a very gentle way to counteract this rounded position. You will need to really think about your spinal movement as you perform this, to get the sense of the movement in the right area.

Start in a knelt position, body resting forwards, with arms ahead of you, and the forearms resting flat on the floor.

Raise your body up. Allowing your forearms to leave the floor. Try and keep your neck as straight and in line with the rest of your spine as you can. You want to try and feel the slight arching movement between your shoulder blades/mid upper back. Return to the start position and repeat 5 times.

These exercises demonstrate ways to mobilise your spine. They can also be performed whilst considering your core muscles, and thinking about effective breathing. If you wish to pursue this, and it would be advised. Seeking out a good Pilates instructor is the way to learn all the exercises and techniques properly.


Spinal Joints
The spine is formed of 33 vertebrae. The spine is divided into regions – the neck, upper back, lower back, sacrum and coccyx. All these regions show differences in anatomy and function, but there are similarities throughout.

Each vertebra (bony segment of the spine) articulates with the segment above and below. These areas of articulation are the spinal joints. These joints allow mobility through the spinal column. Some areas of the spine will move better in different directions. The joints form part of a system that allows us to bend forwards, bend backwards, bend or twist from side-to-side. Or combinations of these.
Most of the spinal joints are covered in cartilage, and form a synovial joint. The same type of joint as the knee.
Spinal joints can be injured. They can become very stiff or “locked”. They can become inflamed and painful. They are often the cause of what is commonly referred to as a “cricked neck”. This could happen anywhere in the spine.
Osteopaths are very well trained in anatomy and physiology. So when examining a patient it is possible to identify what area is causing the patient the problem. Examining the area hands-on, Osteopaths are able to feel whether a spinal joint is mobile, and also to assess the quality of the movement.
Osteopaths don’t just treat spinal joints. So this examination would take into account other tissues. Other symptoms experienced alongside such an issue may require further assessment.
If a joint is found to be the cause of the problem, then an Osteopath can work to improve the mobility. There are many different ways to encourage this mobility, it may be done in a repetitive way, or it may be possible to gap the joint quickly to encourage movement. It will very often be the case that other tissues would need to be worked on alongside this work on the joints. So specific soft-tissue massage techniques would more than likely be incorporated into the treatment.
Your Osteopath would also provide additional advice on helping to settle the area, and perhaps some exercises and advice to manage and/or avoid the problem in the long-term.


Shoes are accessories that most of us are going to utilise, at least for parts of our day. They obviously can affect the way we hold our bodies, and have the potential to cause us problems.

Poorly fitted shoes can cause problems. They may be local problems in the foot and ankle area. Or may cause issues elsewhere in the body, if they alter our gait, or cause a change in body position.
98% of babies have perfect feet, yet by adulthood 65% of us are experiencing problems with our feet. A lot of damage can be done in our teenage years where we really don’t concern ourselves with ideal footwear. Girls (predominantly) in their teens run the risk of damage if they wear high-heeled shoes. The bones of the feet aren’t fully ossified until age 17 or 18, and so more vulnerable to damage before this.
When considering footwear we should consider general health issues. A diabetic, or possibly someone with other vascular issues will need to take greater care to protect their feet.
Perhaps we should also consider keeping our body weight within an ideal range. There are clearly many health benefits for this, not least, reducing strain through our joints.
Our footwear should also be appropriate for the activity we intend to do. So this may be related to a sport, for protection at work, going for a walk, standing all day at work, or may be getting dressed up to go out.
Some considerations for trying on shoes

Try on at the end of the day when our feet are at their largest.
Bring the socks or tights you intend to wear with the shoes to try on.
Look at the heel counter. Try and find shoes that contour well with the heel to prevent slipping.
Leather on the inside and outer of the shoe is ideal. First for breathability, and also for it’s ability to mould to the foot.
Try and find shoes that are seam free on the inside to prevent irritation.
Fastenings are important. Laces, Velcro or straps will secure the shoe far better. Are slip-on shoes staying on because they’re too tight, or are you having to curl your toes to keep the shoe on?
There should be a 1cm gap between your longest toe and the front of the shoe. The front of the shoe should match your foot in shape. Make sure the width of the shoe accommodates the widest part of your foot.

High Heels
Try and reduce the time spent in heels each day. Take them off where you can.
Aim for no bigger than 1.5/2 inches.
The heel takes a great proportion of weight when it strikes the floor in walking. Aim for a broad heel to give greater pressure distribution.
Buy the specific footwear necessary for the activity.
For running activities, or if you suffer with persistent problems, gait analysis may be useful to assess your specific needs.
In the running world, there is ongoing debate between wearing trainers, or running barefoot/specialised barefoot shoes. There is some evidence that indicates reduced pressure through the foot with the weight bearing position of running barefoot. With the knock-on effects of reduced lower extremity injuries, better proprioception, and increased ligament and muscle support at the foot arch. More research needs to be carried out. Any runners thinking of changing should do so slowly, as adaptations to barefoot running may take a while. It wouldn’t be recommended for those with reduced sensation in their feet, a very rigid foot, and to those that have osteopenia and osteoporosis.
On the flip-side of this. There is little evidence to support the decision-making process in relation to foot position when choosing trainers. Buy what feels comfortable to you, and/or seek advice.

These can be inserted into footwear to alter the position and mechanics of the area. They also may be used to address problems higher in the body. Changing the position of your foot, will inevitably have an effect elsewhere.
If you feel this may be an option for you, seek advice from your Osteopath and/or Podiatrist.


The spinal disc is a cartilage structure, there is one in between each vertebra in the spinal column. They have a tougher outer case, and a softer gel-like substance contained within this. They function to improve the shock absorption through the spine.

Spinal disc injuries are not uncommon. They can be damaged to varying degrees.

Discs are subject to wear and tear, the same as other areas of our body. This would tend to create some stiffness in movement, and this may be associated with pain.

A common disc injury is a “slipped disc”. This may occur to varying degrees. You may hear descriptions like herniation, prolapse, extrusion and sequestration when a disc injury is described. They define the degree of bulge of the disc, and if the outer casing of the disc has burst, and the internal parts of the disc have leaked out.

Depending on the degree of bulge, the nerve may be pressed upon or irritated by these processes. This can cause pain local to the injury, and into the area the nerve travels.

A disc injury can happen in the neck, upper back or lower back. It is very common in the lower back, and this is where you may experience leg pain, sometimes “sciatica”. Other leg symptoms, or nerve related symptoms anywhere, could include a burning sensation, pins and needles, tingling and numbness.

The picture above is an illustration of a disc prolapse, as seen as a cross-section through the spine. In this example. The disc is pushing against the nerve, and this would more than likely cause pain in the area that nerve travels to.

Anyone may experience a problem with a spinal disc. Typically (although not all disc injuries occur this way) a bending activity through the spine might cause the problem. Especially if in combination with twisting and lifting. Slumped postures may upset discs too. Perhaps if a disc is degenerative it will be more susceptible to further injury.

A disc can be diagnosed through taking a case history (so the details of the onset/pattern of pain). A lot can be determined by further nerve tests. So reflexes, power, sensation and nerve stretch tests. An Osteopath would also palpate the area in question to assess movement, tone and reaction of soft tissues, and any palpable inflammatory changes.


Treatment can consist of physical therapy and pain medication. Discs don’t tend to heal quickly, and may take in the region of 6 weeks to 3 months to resolve. The patient should be monitored to ensure that recovery is taking place, and to see if referral for further treatment is necessary. In the worst cases surgery might be necessary.

A definitive diagnosis can be made with an MRI scan, this gives a good image of the disc.


As with many mechanical problems in our body. If we try and keep ourselves mobile and strong, we can hopefully prevent a lot of injuries. The same applies with discs. So take regular exercise. Try and maintain a good posture as much as possible. Avoid slumped postures, slumping will really over-stress a disc. Perhaps it could cause an injury, or predispose to one if the area is weakened. Practice good lifting technique. Use your legs as much as you can when lifting to avoid the strain coming through the back. Stand straight onto the object you’re lifting, and hold the object close to your body where possible. Don’t overdo it! If its too heavy for you, ask for help or wait until someone is around to help you.

Link to NHS lifting tips

Link to NHS tips for sitting correctly


Link to previous newsletter for extra guidance on workstation set-up.


Swimming is a wonderful exercise suitable for all ages and abilities. The water supports our body as we exercise, so much less stress is placed through our joints. Regular swimming will help improve our general health, and reduce our risk of developing some chronic illnesses. It will also help us stay mobile and strong.

Its never too late to learn! As well as the health benefits, it may save your life. Swimming lessons are readily available in local sports centres and gyms. For complete novices, or those wishing to improve. Classes are often tailored to gender, age and ability. So there is likely to be a class to suit you. If you haven’t exercised for some time, check with your GP to see if swimming is appropriate for you.

Although swimming is a great exercise, supportive of our bodies. You could obviously still injure yourself. So try and take care around your swimming session with warming-up and cooling-down. This should help reduce your chance of injury, and improve your athleticism, and athletic performance.

First consider warming up. The purpose of this is to gradually increase your heart rate and body temperature. Swim some lengths/laps of the pool, slowly increasing your speed. 

Then think about doing some stretches. There is mixed results from research and some controversy into the effectiveness of warming-up and cooling-down. I personally find it useful, and I recommend my patients to try and do this.

When you have finished your initial warm-up, your body can cool-down quite quickly. So keep jumping up and down/running on the spot to stay warm between stretches. The legs and arms are particularly important in swimming. Think about performing windmills (so circling the arms) in opposite directions. Clap your hands in from of your body and behind at chest height. Bring your elbows into your side and hold them at a 90 degree angle. Rotate your forearms outwards and squeeze your shoulder blades together.

Follow this link to the British Gas Swimfit website. It gives good direction to different stretches that can be performed in the pool.

With any stretching you should expect to feel a pull, but no pain should be felt.

After your workout, cool-down. Here are some cooling down ideas:

  1. Try swimming 5 laps/lengths gradually reducing your speed. Make the last one at a very leisurely pace. Try using a mix of strokes to stretch out different areas of your body.
  2. Grab a float and do some laps/lengths using different kicking styles – dolphin legs, breastroke legs, alternate kicking legs. It could be on your front, back, or both.
  3. At the pool edge, hold on to the edge and face the wall. Walk your legs up the wall until your knees are against your chest. Then lower your head forward to between your shoulders to stretch the whole spine. Relax and repeat.
  4. Stand in the shallow end and raise up onto your toes. Then relax to a neutral standing foot position. This will work/stretch your feet and calf muscles.
  5. Have a warm shower. For your muscles, and to wash the chlorine off!

If you decide to take up or continue swimming try and follow the above advice to remain injury free. If you feel you struggle with your swimming stroke, or want to perform more than one stroke. Think about having some lessons. Other options to work out in the water are aquafit/aqua aerobic classes. Hopefully these classes will guide you through a set of warm-up and cool-down routines.



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