You have an injury or a pain. Osteopathy addresses musculoskeletal problems from head to toe. Problems relating to muscles, joints, tendons, ligaments and fascia. Not just the spine, also the peripheral joints and associated tissues. The problems we address are wide-ranging. From sciatica to sports injuries, neck-related headaches and postural issues, knee injuries and problems from stress and tension… A typical course of treatment is around 4 to 6 sessions. Sometimes slightly more or less. Everyone is different and as such assessed and treated as an individual.
Osteopathy isn’t only the hands-on manual therapy treatment. There is very often additional advice I can give you to benefit your recovery and general health. This includes advice on pain relief, posture, diet, sleep, exercise, relaxation…
Often people like to see an Osteopath on an “MOT-type” basis. We can find we look after our cars better than ourselves – terrible! Osteopathic treatment can form part of a management strategy in looking after your musculoskeletal self and regularly assisting general improvements in well-being. View yourself as a finely-tuned sports car.
I am also a certified Pilates instructor. I work with people on a one-to-one basis. Either this is used as a means to assist rehabilitation of a specific injury. Or, can again be part of a way you choose to care for yourself on an ongoing basis. I provide the equipment and the expertise.These sessions are bespoke to your own abilities and needs.
Someone observed yesterday that it’s called Pilates practice because that’s exactly what it takes, that couldn’t be more accurate. It’s never been called Pilates perfect. It can be uncomfortable sometimes as you develop your skills. Areas of your body will try and work harder for you whilst you gain more mobility and strength. This should always be “comfortably uncomfortable”. You should never be in pain, please stop if that’s ever the case.
When you’re working with me I can identify some of these issues and give you modifications to help you move forward. Whilst you’re working at home, unless you did wish to train online, this isn’t possible. You may need to make a movement smaller, bending the knees can often help in some exercises, or perhaps find a prop – legs up on a chair or Swiss ball for instance.
The following are a few common issues that could crop up. So take a look and see if any of this could be of help to you:
Struggling to sit up straight. One option is to bend your knees or adopt froggy legs! This may make it more comfortable. Or you could sit on a yoga block or a couple of hardback books.
Neck strain. This is common with abdominal exercises ( eg. your abdo and oblique prep exercises) whilst you’re building up the strength in these muscles. So you could try placing a towel longitudinally underneath your body. Hold on to the two upper corners of the towel and allow this to act like a hammock for your head – offering support. A similar support can be gained from the Pilates Circle if you have one.
Not everybody is happy laying flat on their back, sometimes if someone has a very rounded upper back, or a deeper curve in their neck this can be uncomfortable. So use a small pillow support or folded up towel, or a small Pilates ball. Just to note, that the bridge exercise is not generally performed with any head support, as this would place too much strain on your neck as you come up into full bridge.
Struggling to get up from the floor. Try rolling onto your side and using your arms to push yourself up to sitting, then kneeling before coming up to standing. This is great back care regardless of any struggles you do or don’t have and a habit I would advise you to try and adopt. Even having a chair nearby before you start practising might be useful, it may support you on your journey back up to standing.
You feel tight in your hips and your lower back. If this is the case when you’re lying on your back or on your side then just bend your knees and this should help with the positioning and comfort in your lower back and spine. Remember to maintain your neutral spine position whilst exercising.
Uncomfortable pressure on the wrists. It’s really great to do some work weight bearing through your wrists, it helps to keep them strong. If you struggle you might try rolling up the edge of your mat, or use a towel and create a wedge for your palms to rest on. Or alternatively use your fists to lean on, or simply transfer your weight down onto your forearms. If you are exercising laying on your side, extend your outstretched arm underneath your head, as opposed to resting a hand under the head to reduce wrist strain.
Lower back discomfort whilst laying on your front. Use a small cushion or rolled up towel underneath the abdomen to prevent lower back strain in this position.
Stick with your practice, you will graduallyfeel stronger and more flexible, this will reduce the strain you feel in your body. You may find some of these modifications unnecessary with time and you might want to revisit an original exercise in the future. Any problems don’t be afraid to get in touch.
Out of your normal routine and feeling restricted. Maybe you’re needing to work from home. More time spent at the computer, and ongoing online meetings. You find yourself screaming at the screen because technology just isn’t playing the game! Your normal daily movement is possibly limited, and with the best will in the world. Our posture can slip stuck at a computer for hours.
Maybe staying in has reduced your motivation, and you find yourself on the sofa for longer periods. Or not sure how to fill the new amount of free-time.
Maybe the lockdown has affected you financially. You’re worried about how long this could all last. Possibly feeling tense and anxious.
You maybe worried about keeping friends and family safe. Or perhaps spending 24/7 with your family is driving you around the bend!!
Any of these factors, or a combination of, could quite understandably make you feel stiff and uncomfortable. We can’t control the external factors working upon our current daily existence, and we don’t know how long this is for. We can however do something practical, and relatively simple to try and look after ourselves.
So the following exercises give you a short routine to limit restriction and try and relax for a moment. Remember, nothing should be painful. So stop if you have a problem.
Unfortunately I can’t help you in the usual way, but am available for online consultations should you have any more pressing issues.
Sitting on a chair. Place your right hand to the back of the seat, left hand onto your right knee. Keep the gaze level and twist to look behind you. Hold for 5 relaxed breaths. Reverse the position to repeat on the other side.
Do this with arms up or down. Bend to one side. If your arm is raised. Then add a little more upward energy with the opposite hand to increase the stretch to the side. Hold for 5 relaxed breaths, then repeat on the other side.
To stretch the shoulder blade area. Bring one arm across the chest. Add pressure above the elbow with the opposite arm. Repeat on the other side.
This could be a chair or a low step – your choice. Place a heel onto whatever you’re using. Hinge at the hips to lean forwards and feel a stretch at the back of the leg. Repeat on the other side.
Hold onto something for support. Swing your leg back and fourth 5 times. Try and make sure your back remains still. This will probably make the moment smaller, but will be purer at the hip joint. Repeat on the other side.
Finally chill-out for as long as you can. Lay down, or practice sat down. Think about breathing deeply into your lower ribs and diaphragm muscle in a relaxed way. Placing a hand on the tummy area will give you a better sense this. If you are breathing into this area, you will feel this hand rise with the in-breath.
An announcement! I have been training away in the background so that I can add to my care of you in the clinic. I have been training in Pilates rehabilitation.
Unfortunately, in the time of COVID 19, as it requires closer contact, I don’t feel its appropriate to start this now. So when we get back to normal, this could now form part of your care at Rivermead Osteopaths.
However, in the meantime, and to avoid getting stiff in isolation. Take a look at this excellent selection of online Pilates classes. Created by the people I have trained under. Some very knowledgeable manual therapists.
If you experience problems, check with your health practitioner as to whether these exercises are appropriate for you. Do not continue with them if you feel any pain whilst performing the exercise.
Standing Side-bending Articulation and Stretch
Standing up tall. Slide your arm down to the side of one leg, try and keep the shoulders and pelvis facing forwards. Repeat 5-10 times on each side. For an extra stretch, raise the arm up to be alongside your ear. Use the opposite arm to support and increase the stretch. Hold this for three relaxed breaths into the lower ribcage, and then repeat on the other side.
Lay on your back with your knees bent, feet and knees in-line with your hips. Scoop/rotate your pelvis backwards so your lower back flattens into the floor. Then try and peel your vertebrae up off the floor one at a time until you get to shoulder blade height, your body in a diagonal line (be sure you are not placing pressure onto your neck). Then reverse the process, by returning each vertebrae to the floor one at a time. Until you return to your start position. Repeat 5 times. Try and avoid holding your breath through the exercise.
If we’re lucky we don’t need to think about it. Its automatic and hopefully unproblematic. So the importance of breathing:
It means we’re still alive! It may need to work in different ways for different people due to injury or illness.
How we breathe has an effect on the mechanical parts of our body. Directly related to the process are – ribs, and associated muscles, the spine and diaphragm muscle. If we breathe “well” then hopefully these areas will work effectively and without discomfort. Common issues with breathing mechanics can occur with respiratory disease, ongoing stress and problems that effect our spinal position, including general poor posture.
There are many important structures that pass through the diaphragm muscle, notably the oesophagus (food pipe) and major blood vessels. Poor use of the diaphragm muscle can also have a knock-on effect on digestion and circulation due to these relationships.
Ideally, on taking a breath in you want to use the full capacity of your lungs. Really feel the lower rib cage and diaphragm expand. Shallow breathers tend to breathe far more through their shoulders and upper ribcage.
If you experience tension across the shoulders and in the neck, it can sometimes relate to alterations in breathing mechanics. Also, in other areas of the spine in relation to the rib and diaphragm muscle connections. Sometimes mechanical pain issues need to be considered more holistically, including breathing changes alongside other mechanical aspects. People who are in a lot of pain breathe differently. Other factors might include underlying illness, mental wellbeing and lifestyle factors.
There is much talk about meditation these days in relation to the benefits that can be gained mechanically, also for relaxation, and in the ways it can help people manage persistent pain. The focus on breathing in this practice may be enormously useful.
Whether you struggle or not, taking time for yourself to chill-out and stop is beneficial for general wellbeing. There is no need to over-think it, just note what you’re up to, and if necessary, gently try and implement some changes. Don’t panic! We all need to do what feels right for us, but if you fancy giving it a go. The following is a simple breathing meditation you might wish to try.
Lay on your back or sit in a position you feel comfortable, try and keep your spine straight.
Close your eyes if you feel comfortable to do so. Soften your gaze if not. Focus your attention on your belly. Feel your belly rise or expand on the in-breath. Then fall and recede on the out-breath.
Focus on the sensations in your body as you breathe. It may be the physical action of breathing as described, or the air travelling in and out. Or any other sensations that work or are noticeable to you.
Sometimes placing a hand over your belly/lower ribcage is a nice way to provide a better sense of the movement.
Spend as long as you want/can focusing in this way. Focusing on the in and out breath in the way that works for you. Trying to note your own pattern of breathing, and trying to breathe deeply into the diaphragm and lower ribcage, gently and without force.
It is inevitable that your mind will wander. When you recognise it has, accept it, and take yourself back to focusing on your breath.
“The core muscles” is a collective term for a number of muscles that add support to the spine, and contribute to maintaining a beneficial posture. These muscles include several back muscles, abdominal muscles and the pelvic floor. Even some shoulder and thigh muscles are considered as core muscles. If you haven’t been trying to strengthen your own core, why not give it a go? Here are a few basics to get you started.
Please remember. If you do have any problems. Check with your osteopath or other health practitioner to check these exercises are suitable for you.
Find your core. Think “zip up and hollow”. “Zip up” refers to pulling up your pelvic floor, as if you were stopping yourself having a wee. ‘Hollow’ means pulling your navel back towards your spine, so you feel your abdominal and back muscles engaging. Have a go at finding them, then practice using them. When you do the following exercises aim for 25% contraction in the first instance. As you challenge yourself in an exercise though, you may have to ramp up that contraction.
Basic core, hip abduction.
Lay on your back with your knees bent. Allow your spine to rest in it’s neutral position. That is, with the lower back not too arched, and not flat against the floor. Find the mid position. You need to use the contraction of the core muscles to maintain your neutral spine and pelvic balance as you perform the exercise. For this exercise (as in the picture) placing your fingertips on the front of your pelvic bones will allow you to feel if you’re keeping the pelvis stable.
Let one knee drop out to the side whilst maintaining your stable position. It is certainly a case of quality over quantity. Depending how strong your core is, it might be you don’t move very far to begin with. Do what you can, and repeat 6 times on each side.
Start seated, spine in an upright position, knees bent. Extend your arms ahead of you at shoulder height. With your core muscles engaged, tuck your pelvis under, and imagine you’re moving your spine down towards the floor segment by segment. Go to the point you are comfortable. Then imagine rebuilding your spine back up to sitting segment by segment. Repeat 6 times. Try and keep your shoulders down and away from your ears as you’re doing this.
To train effectively and develop good habits, attending a core strength class would be great. Or Pilates is another option that gives great core benefits.
in women, this may be felt as a bulge in the vagina or a feeling of heaviness, discomfort, pulling, dragging or dropping
in men, this may be felt as a bulge in the rectum or a feeling of needing to use their bowels but not actually needing to go
they help with recovery from surgery in men and women, and post-childbirth
improve sexual sensitivity
maintain confidence socially, so a good quality of life.
Its important to do the exercises correctly. Speaking to a professional for guidance may be necessary, and definitely if you are continuing to experience bowel or bladder disturbances. The literature is inconclusive, but would seem to indicate that a weakness in the pelvic floor muscles may contribute to spinal issues too. It seems logical to me that if there is a weakness or loss of integrity in one area, then there could be a knock-on effect/pressure added to another?
The following links offer a guide for both men and women individually.
Around 8.5 million people are estimated in the UK to be struggling with joint problems attributed to osteoarthritis. One in five adults over the age of 45 have knee problems, and 1 in 9 are experiencing hip problems relating to osteoarthritis. Not all joint problems are the result of these changes. Day to day activities and injuries will inevitably cause problems occasionally. Whatever the underlying reason, osteopathy may help by improving the function of the area and reducing pain. Also providing a plan and advice to manage the area into the future.
If your car broke down you’d take it to a mechanic. If your pipe leaked you’d call a plumber. If your laptop malfunctioned you’d seek help from an IT engineer… So if you have pain in your body, and it is stopping you from working, or doing the activities you love. See an expert – visit an osteopath.
Taking time off work because of a problem with your muscles or joints doesn’t just cost you money, it can also affect your home life. Treatment from an osteopath may accelerate your recovery, helping you return to your normal activities quickly.
It costs less than you might think for a short course of treatment and could be a worthwhile investment in your health and wellbeing. So please give the clinic a call for advice.
Forward this to a friend if you think it could help.
The following are a couple of factors that are natural and normal changes in bone as we get older.
There is a reduction in calcium and other minerals. It can begin at about 30 years of age in females, and typically starts around 60 in males. In females, often around 45 to 50 years of age, there is a dramatic reduction in the amount of the hormone oestrogen produced. This has an effect on bone density and strength. The loss can continue until as much as 30% of calcium is lost from the bones by the age of 70.
Worse case scenario, osteoporosis can develop. This is a condition of low bone density and so greater susceptibility to bone fracture. It isn’t exclusively a female problem. Males get osteoporosis too, but the changes around and following the menopause might be more dramatic.
These are natural occurrences. Sometimes different diseases and medications can cause lowered bone density. In whichever case, it is important to look after your bones. Osteoporosis is a “silent” condition. It often isn’t identified until someone has a fracture. The condition, if it progresses, can have many implications on lifestyle.
Another factor is that of the reduction in the rate of protein synthesis with ageing. So namely the collagen that makes up the matrix of our bones. This will reduce bone’s tensile strength. Again, this has a similar overall effect, in that it creates a greater possibility of bone fracture.
So to look at it more positively! What can we do to help ourselves?
Take regular exercise. It is the pressure through bone that allows it to re-model. So walking, jogging, lifting weights…anything that adds resistance to the bone will help.
Take your exercise outside, or take part in outdoor activities. Vitamin D, important for bone health too, is created in our bodies via a reaction to sunlight. Paler skins can be served well by around 10 minutes exposure a day (so no sun lotion, and not all the skin covered by clothes), darker skin may need a little longer. In the UK, the sun is not strong enough to be effective all year around. Some people might need to consider taking a vitamin D supplement.
Make sure you are eating a balanced and varied diet. If this is the case, and you aren’t avoiding food groups or have an issue that prevents you from taking up nutrients into the body. You are probably getting what you need. Calcium, vitamin D, vitamin K, magnesium and boron are some of nutrients needed for good bone health.
If you feel there is a problem with your digestion. Seeing your doctor may be necessary to assess any potential issues and receive the appropriate care. Sometimes seeing a nutritionist or nutritional therapist can also be very useful.
If you need more general guidance on making sure you have a balanced diet. My new Nutrition and Lifestyle Coaching service could be useful. Please get in touch if necessary.
Registered Osteopath led, one-to-one, modified Pilates sessions now available - view yourself as a highly tuned sports car!