I often hear, “I only thought you treated backs”. A common misconception. Osteopaths treat musculoskeletal problems from head to toe. That is problems that relate to the joints, muscles, ligaments, tendons and fascia directly. Often we are also working on the nerves and blood vessels in relation to where these structures pass, and how we can effect their function.

Today I’m going to highlight a fairly common issue I see, but one you may not expect? Golfer’s and tennis elbow. Misleadingly named as these are not the only activities that might cause this. They are a form of repetitive strain injury. Their official names are medial (golfer’s) epicondylitis, and lateral (tennis) epicondylitis. Logically named as they are an irritation of the muscles that attach on the structure called the epicondyle at your elbow.

They can be caused by repetitive elbow or wrist activities. Also gripping and lifting repetitively. Occupations requiring the use of vibrating machinery may create these issues.

The pain may just be at the elbow, but sometimes above and below. If nerves and blood vessels are compressed additional tingling and/or pins and needles symptoms may occur.

The objective of treatment is to calm down the local source of inflammation and work into the effected structures that lead up to and attach to the elbow. Sometimes working on the spine and shoulder can help if someone has had to adapt their body position. This may either be one of the issues that has caused the problem, or may be a result of the pain.

Osteopathy will take an objective and holistic view of you in examination, treatment and self-care advice in order to get on top of the problem.

Are you wonky? Well I know I am, and I haven’t met a person yet in my clinical life who isn’t “wonky” to some degree.

Our bodies are a combination of what we’re dealt with naturally, and the way we use and position ourselves and are often an expression of the way we feel. Bodies are also very clever. Commonly they will adapt and allow us to get on with our chosen activities.

Inevitably however, if our bodies are used in a repetitive and misaligned way an imbalance is created. This very often manifests as restriction, weakness and tissue shortening in varied combinations depending on the pattern we have adapted to.

This can be a feeling we get used to. We may not even recognise we are feeling restricted or tight as these changes tend to accummulate gradually over time.

They might be the reason why our bodies don’t accept a challenge so readily. For example, the sudden pain when you lift a box or reach up to the top shelf. Pain that occurs seemingly out of the blue.

Everybody is different and as such will experience these issues to varying degrees. If you are aware that you are becoming uncomfortable – stiff, experience twinges, adapt to activites differently. It may be a sign that poor movement patterns are developing. It is better to act sooner than later.

Poor movement patterns can be addressed through physical therapy which will help facilitate positive change, and specific and tailored exercises for your situation.

Change can take a little time, but TIME, PATIENCE AND PERSISTENCE EQUALS PROGRESS, and happier bodies.

To ‘Put Your Best Foot Forward’ originated from when ladies looked for a well turned leg in men. This phrase was first recorded in 1613 by Sir Thomas Overbury (a poet and courtier).

A good phrase perhaps to start a new year? However, this post is really about footwear. If I wasn’t an osteopath I would love to be a shoe designer. I often consider the design of a ‘perfect’ shoe – for both health and style. Nothing yet I’m afraid! However in my current capacity as an osteopath I am made aware in my daily work that foot care is 100% necessary. Not only for the health of the local area, but also for the rest of the body and it’s position and consequent well-being. Good fitting footwear is an essential contributing factor towards foot and general musculoskeletal health.

In our shoes we should consider:

1. A stable heel, approximately 25mm in height. The heel of the shoe shouldn’t slip up and down at the back.
2. Adequate width and depth to the mid/front part of the shoe.
3. Enough room in the toe portion of the shoe to allow proper foot function. A minimum of 6mm in front of the longest toe is suggested.
4. A soft and flexible upper and lining to the shoe.
5. Laces, Velcro or buckle fastenings allow the most adjustment and potentially a better fit.
6. The tread on the undersurface of the shoe should extend over the whole area.
7. A supportive insole may be a consideration for some. Consulting a health professional like myself, other manual therapist, chiropodist or podiatrist could advise you around any need for this.

Please get in touch if you need any help with a problem.

Wishing you all the best for a happy and healthy new year.

A lot of people come in to the clinic to see me in the weeks running up to Christmas and explain to me how they have hurt their back. Or often strained their neck and shoulders wrapping Christmas presents! So here’s a few considerations to try and make this process more comfortable.

• Not all gifts are table-sized, but where possible sit at a table (as opposed to on the floor) to wrap your gifts. A patient told me this week they sit at an ironing board as they can adjust the height to make it work perfectly for them. I think this is a great idea.
• Avoid twisting and bending at the same time.
• Take regular breaks away from the wrapping activity. Go and do something different or just have a move around regularly.
• Be mindful of where your shoulders are. Are they up around your ears? Relax them down.
• Try and stay calm, try not to hold your breath -practice relaxed breathing. This will support both body and mind.

I personally am a bit of a Christmas Grinch on this subject as I have very little patience for sticky tape! So I definitely need to monitor my breathing and shoulders. Happy to help if any issues arise in you.

Claire

A systematic review into the risk of adverse events following manual therapy treatment, concluded that the risk of major adverse events is low. The relative risk of adverse events appeared greater with drug therapy. They did find that about half of manual therapy patients experience “minor to moderate adverse events” after their treatment.

It isn’t uncommon for people to experience a non-serious treatment reaction. The most common of which is feeling muscle soreness or a temporary increase in pain beyond your treatment session. This is most often felt much like the discomfort you might be familiar with – the muscle soreness you can get after an exercise session. It varies, but commonly starts the evening or day after the session, and may be apparent for 1-3 days.  A further study found that the majority of these reactions (67%) resolved within 24 hours.

People very often respond the same way to any manual therapy. So if you’ve experienced post-session soreness after chiropractic or physiotherapy sessions, you will probably have the same experience with osteopathic treatment. There are clearly variables that will contribute – a new injury will feel different to a pain that’s lingered for some time, the treatment modality used, the area you’re having worked on, the time in a lady’s menstrual cycle, someone’s emotional state… We all follow rhythms and variations in our bodies which may affect our response to treatment.

I am mindful of people’s treatment reactions following their visit to me and will try to factor this into my treatment plan. Not always, but very often, a reaction gets less or doesn’t occur at all as a treatment course progresses. However some people always follow a familiar pattern to them. I will let you know how to deal with any treatment reaction in your session. Often tactics like hot or cold applications will alleviate any discomfort.

Another common treatment reaction is feeling tired. If you experience this and you’re able to, have a nap. Your body perhaps needs a little rest-time to deal with the problem being experienced.

Following osteopathic treatment:

• Think, rest and regular gentle movement. Don’t go to the gym or embark on a major DIY project. But do stay gently mobile.
• Have a drink of water beyond your session. A hydrated body will work better and respond more swiftly.
• Follow any additional self-care given to you. Such as cold or hot applications. Maybe specific exercises.

Give me a call if you’re experiencing any problems.

The more recently titled problem of “text neck” grows ever more prevalent. This is neck pain as a result of ongoing use of and looking down at a mobile phone or other device.

It may cause pain, muscle tension, sometimes nerve interruption and if practiced regularly enough, maybe speed up wear and tear changes. Long term practice of any postural bad habit will cause some areas to get over-worked and others to weaken, creating an imbalance in the way the body is held and consequently functions.

Some tips to avoid this problem:

1. Raise your phone or other device more to eye level to avoid tilting your neck forward.
2. Stand or sit up straight.
3. Take frequent breaks away from the device you’re using.
4. Stretch and strengthen your body to maintain good function. 
5. Treat pain as a warning sign and address any potential problems if and when they arise.

Follow this link for some basic neck mobility exercises. Let me know if you need further help.

https://www.rivermeadosteopaths.co.uk/neck-pain/

Trigger points are recognised by most of us as sore spots or knots in our muscles. However not every sore spot is a trigger point. They can be long-term and cause deep discomfort and aching.

They are painful “lumps or nodules” found within tight bands of muscles and they are characterised by the following factors:

• The pain is intense and felt at a specific point.
• A “lump/nodule” can be felt within a tight band of muscle.
• Applying pressure to the area reproduces the pain and may sometimes cause referred pain elsewhere. These referred pains are specific in their distributions.
• It is not trigger point pain if it can be explained by findings from a neurological examination.

There is often no known mechanism of injury. Sometimes trigger points might cause unexpected symptoms due to their interaction with the autonomic nervous system. For example skin blanching, goosebumps, increased sweating, dizziness, earache, stiffness, difficulty breathing… Of course other possible causes to such symptoms may need to be ruled out first.

Trigger points reduce the efficiency of the muscle they lay within, so they are important to identify and address in order to reduce pain and restore normal function. Other benefits of addressing them are improving posture and increasing range of motion.

In clinic I can identify and interact with these trigger points through examination and hands-on treatment, laser therapy can also produce quick and profound changes. Exercises can be a useful approach to try and prevent the return of the problem.

At home it is possible to use various tools, most commonly foam rollers and spiky balls so you can address the problem yourself or support a course of treatment at home.

They’re an acquired taste, but spiky balls may help you?!

As the weather becomes more consistently Spring-like, we now may be more inclined to get outside. This should be positive for the health of our bones.

• The sunlight triggers a reaction in our skin producing vitamin D. Good news as this helps us use calcium which is necessary for strong bones.
• If we become more active, the pressure through our bones will increase their strength.

A loss in bone density is normal as we age. Some illnesses and medications may also cause problems with bone density. Sometimes the losses are greater causing conditions called osteopenia or osteoporosis. These put you at a greater risk of a fracture. These conditions don’t hurt. They are often not discovered until someone unfortunately experiences a fracture. Other consequences of these problems can be changes to body position and the discomfort and disability that may bring alongside this.

These changes affect both men and women. In ladies they are often more prevalent due to the sharp shift in hormones around the menopause.

It is never too late to be looking after your bones and we should encourage the younger people in our lives to take good care of themselves in order they effectively build a “bone bank”. So they are in good place before these natural changes occur.

Care needs to be taken to exercise regularly. To create controlled stress into our limbs and spine to allow the bones to remodel. There is something that everyone can do, but depending on your situation you may need guidance as to what is most appropriate for you regarding activity and exercise.

We should also maintain a healthy diet. Balanced and varied containing those vitamins and minerals required for ideal bone health. Sometimes supplements might be appropriate.

If you receive a diagnosis of osteoporosis there may be prescription medication you need to take to assist with this further.

I am very happy to complete a FRAX questionnaire on your behalf. This assesses your susceptibility to these kind of fractures. This would be most appropriate for ladies over 65 and gentleman over 75 years of age.

When you’re next in the clinic, let me know if you would like me to do this for you. If needed, I can also help advise you on the care you should ideally take for good bone health.

In the meantime take care, look after yourselves and stay well.

• It is non-invasive.
• Painless to receive.
• It is time efficient, often just 3-10 minutes.
• Benefits are sometimes felt within minutes.

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.

Follow this link to take a look.
https://online.appihealthgroup.com/ref/29/?campaign=Don’tLetSelfIsolationMakeYouStiff