Monday, 2 January 2017

Make a New Years Resolution for Back Health

It's that time of year again...when we make resolutions and vow to change everything in our lives to make this year the BEST YET! I'm not so much about resolutions, but about goals and making small positive changes to make you grow and feel better.

One of the things I hear day in and day out, is how long people have been putting up with their back pain. Upwards of 85 percent of adults experience low back pain in their life, with 20 percent calling it disabling. We've come to accept these aches & pains and take it as a part of modern living. How many times have you said to yourself, "well, it's just the way it is..." So why not choose to do something about it!?

So I propose for this year, think about your back. Your neck. Your feet. Think about your musculoskeletal system like you would think about your car. It needs maintenance. It needs an MOT. It's a rugged, well oiled machine that needs the proper fuel and rest to function at full capacity. 

So stop accepting those niggling aches & get some treatment to feel the best you can! It's incredible how a couple of sessions of hands-on manual therapy like osteopathy can alleviate the pain you've been feeling for years! And when you're not in pain, you can exercise harder, work more efficiently, and feel happier.

So when you're thinking about a long list of unattainable resolutions, perhaps think of them in a different way:

1) eat more healthily to give you more energy and feel less sluggish
2) exercise regularly to help provide strong muscles to support your body and a strong heart to pump your blood
3) do a pilates or yoga class to not only relax but strengthen your back and stretch your legs
4) spend less time sitting and more time moving
5) take time to play, be silly, and have fun so that the stress and tension of modern life don't accumulate in your body
6) ...and sleep... it's the most important thing for your physical and mental health overall!!

Friday, 29 July 2016

How much do you use your thumb? De Quervain's Tenosynovitis

How much do you think you use your thumb? 

Evolutionarily, it's one of the things that's made us humans more advanced than other species. But do you ever think of how much work it does? Maybe not, until it's in pain. Then every time you move your arm, fill the kettle, hold a coffee cup, write with a pen, get dressed or carry a bag -- you realise your thumb is doing a lot of work. 

I've recently had a patient in my clinic with De Quervain's Tenosynovitis -- fancy name for a condition of the tendons running into the thumb. It's not primarily a condition of inflammation, but more of a mechanical change in the tendons and the coverings of those tendons. A tendon is surrounded by a sheath, which helps it glide, move, and reduce friction. 

The cause of this condition is unknown, but it is thought to be linked to overuse of the area (i.e.: texting, mobile phone usage, repetitive use, and occupations that require gripping & twisting with the hand. 

Many believe that this condition is an inflammation of the tendons and their sheaths. However, the pathophysiology is more that of a cellular thickening of those tendons and their sheaths with gradual degenerative changes too.  

This can be a slow condition to completely resolve, but it does respond to osteopathy. It's important to address the biomechanics and altered positioning of the upper limb, any restrictions in the Thoracic and Cervical spines, and myofascial adhesions and trigger points in the forearm muscles. I also use acupuncture (in the Lung Meridian) and RockTape to support the healing. 

As with any condition, using hands-on manual techniques isn't enough. Once the acute pain stage has lessened, it's of utmost importance to to get the patient into a rehabilitative exercise program to prevent the recurrence of the condition. 

If you suffer with pain on the thumb-side of your hand/wrist, have any burning sensations in your hand, muscle spasms, swelling, or difficulty using your hand, have it checked out by your osteopath. 

Monday, 11 January 2016

My love affair with the Instant Pot

instant pot
Now I don't usually do this, but I must talk about my new kitchen toy -- The Instant Pot 7-in-1 pressure cooker.

After spending the autumn watching Masterchef Australia (adore that show!) I became enamoured with the nifty gadget all the contestants were using on the side of their benches. Their pressure cookers. And I wanted one.

Now, I grew up with a pressure cooker in the house. It was predominantly used to make brown rice quickly and was one of those old stove-top versions. There was something very hippie-ish and wholesome about it (well, at least in my memories of it!), but until recently didn't think I needed one in my kitchen.

Then the vision of beauty that is the InstantPot came into my life. It's electric, so I don't have worry about having the stove on for hours; it's streamline and sleek, but most importantly it has 7 different settings/features, so it works as a pressure cooker/slow cooker/rice cooker etc and a YOGURT MAKER**! 

Since I got the InstantPot for Christmas, I've been pretty addicted to it -- looking up recipes, reading the blogs & forums, and imagining meals of ribs & brisket, cooked after work in time for dinner. It doesn't get much better! So every week, my Tesco order now includes a large hunk of meat that will be tenderly pressurised into a gorgeous paleo/low carb meal!

But the best part thing about the Instant Pot? I can make my silky-gelatinuous-nourishing-gut healing bone broth in a FRACTION of the time it would normally take. It's no secret that I love bone broth - heck, I tweet regularly about it, have reviewed mail-order bone broth companies & praise my local butchers for their continuous supply of bones. But honestly, making it is a FAFF. But not any more! Now, with this pressure cooker, I can make bone broth that gels (that's the important part!) in minimum 90 minutes (but I usually go up to 2-3hours), instead of a whopping 18hours in a slow cooker! And because the pot is completely sealed, there's no steam-room effect in my kitchen!

Needless to say, this InstantPot is the BEST thing I have bought (well, been given!) in a long, long time. If you want to make quick, homemade, nutritious food and if you want to utilise cheaper, tougher cuts of meat, do yourself a favour and invest in this product. 

**I've tried the yoghurt setting once...I wasn't overly successful, but I'm excited to try again & perfect it!

Tuesday, 1 September 2015

The Paleo Bone Broth Company...where have you been all my life?

It is no secret that I love bone broth. It feels like the most nutritious, nurturing substance I can put into my body and I believe that everyone should be drinking some on a regular basis. The list of its health benefits is lengthy, but does include supporting the immune system, healing the lining of the gut, lubricating ligaments/ tendons/joints, and making your skin & hair silky smooth and shiny. It's pretty much the nectar of the gods! 

There is nothing I love more than trundling down to my local butchers (Chadwicks in Balham, SW London) on a cold winter's day for a bag of beef bones, then setting them to simmer either on the stove or in a slow-cooker for what seems like an eternity. With our hectic London life hurtling around us, this simple activity seems to slow me down and transport me back to a slower time. It is a pretty amazing feeling to get from some bones!

To get incredible, health-promoting bone broth, the process is pretty simple. You source good quality bones, then you boil them for a long time -- a very long time -- up to 24-48 hours. Yup, that long! The longer you boil 'dem bones, the more collagen and gelatin you get out of them, so this aspect is really important. However, I must confess, I've never attained the required boiling time to make the BEST bone broth. I think the longest I sustained, before my partner complained of the sauna-esque qualities that our small London flat took on, was 16 hours. Such a waste when the bones still have so much more to give! 

Sometimes when I'm feeling a bit tired, a bit run-down, or need a good nutritious pick-me-up, I wish I could get some bone broth without all the time & hassle of making it yourself. I've heard of places popping up in NYC that sell bone broth by the cup, and I've been pineing for something like that in London, but to no avail. Then the Paleo Broth Company came into my life. Organic, paleo-friendly bone broth delivered straight to your door within 24 hours - AMAZING. 

Their bone broth comes in 2 different sizes, either 200 mL or 1 litre, depending on your consumption and needs. I personally like the idea of the individual pouches, as I find it difficult to regulate what I drink, as it's so tasty! The broth gets delivered frozen via a courier service and packaged in an Eco-friendly woolen cool box, so when it arrived I was able to whack the pouches straight into the freezer until I wanted them. That's pretty incredible, because then you can have some bone broth on hand either to have as your daily cuppa in the morning, or when you're feeling a bit run down and want that pick-me-up.

So what's the best thing about this broth? Well....these gorgeous people boil their bones for a staggering 48 hours. I can only imagine the pots simmering away, the kitchen which houses them, and the smell wafting out. That makes my soul very happy! The result is a silky smooth beef bone broth, gelatinous by nature, that tastes of hearty free-range beef. The convenience of this service is incredible and the product is top-notch. 

Check out their website for more information and definitely follow them on Twitter for tips on how to use your broth!

Saturday, 15 August 2015

Osteopathic Vocabulary: Defined.

Osteopaths are experts in the human body. We use terms relating to movement, anatomy, and health in an everyday manner and forget that not everyone has the same vocabulary! It's important -- as an expert in any field -- to be able to explain your work to people that don't have the same vocabulary. So in this blog post, I'm going to define some of the most commonly used terms in an osteopathic clinic -- just in case I forget you don't know what I'm talking about!

Soft Tissues
This term refers to all the muscles, tendons, ligaments, and connective tissue that hold us together. They're basically the rest of the stuff other than bones and organs. The majority of injuries that I see in clinic are to the soft tissues. As they don't show up on XRAY, this type of test won't diagnose damage to them. Damage to the soft tissues is usually diagnosed clinically (via a specialist like an osteopath) or an MRI scan. 

Fascia is everything in the human body!! It's the connective tissue that makes everything continuous in our bodies. In life, it's a very fluid substance and has recently been shown to help transmit nerve and sensory signals through the body. It helps all our soft tissues move and glide around with ease. If we are dehydrated, have poor nutrition or poor health, the fascia can get sticky and stuck in place. This is also the case after an injury or prolonged postural changes. So then when we do try move in a particular way, you might feel a painful pull in one area, which is usually where the fascia is stuck down.

Adhesions occur in the fascia, muscles, and usually close to where these attach to the bones. If there is an trauma in the body, you will get some scar tissue, which makes the fascia less able to glide around. So these areas where the fascia gets sticky and stuck down are called adhesions. It's important to address these adhesions with osteopathic treatment, as overtime they can restrict movement of the soft tissues and of joints. 

Trigger Points
Trigger Points are muscles knots. They have a nerve centre, so they can refer pain to areas of the body far away from the source. Even though trigger points seem like nothing, they can be very painful -- trigger points in your chest muscles can even mimic a heart attack! They are easy to treat and respond well to myofascial release and acupuncture needling.  

Myofascial Release
This is one of my favourite types of treatment. It's more than just a massage, and it works deeper on the reflex mechanisms within muscles and the fascia. It uses deep steady pressure with some rhythmical joint movements to relax muscles and help the fascia to unstick and glide with more ease. 

This treatment technique works to get joints moving easier. It focuses on the joint level, and uses slow rhythmical movements to increase movemet. It can start gentle and become stronger, as the body responds to the treatment and allows it. Mobilisations stimulate special nerve receptors within the ligaments, tendons, and muscles around the joint, which send messages back to the brain for improving movement. 

In the osteopathy world, the term manipulation is used in reference to 'the clicking' technique. The technical term is 'High Velocity Low Amplitude Thrust' and it uses a fast impulse movement to help get a joint moving. Sometimes there is an audible 'pop' which is just the release of gases from the joint space. With this HVT technique, a large number of nerve signals is sent to the brain from that area of that area of the spinal cord, and this helps reset the circuits of pain and stiffness. 

Flexion / Extension / Rotation / Side Bending
These terms refer to how you move. 

Flexion of the spine is when you bend forward (as to tie your shoe), whereas flexion of the knee is when you bend it bringing your foot towards your bum.

Extension of the spine is when you lean backwards (as to look up to the ceiling), whereas extension of the knee is bringing it back to straight.

Rotation is when you twist, which is a very important movement in the spine -- especially in sports like tennis, golf, cricket and football. There is very little rotation in joints like the elbow and knee, but it's big in the hip.

Side-bending in the spine is when you...well...bend from side to side!!

In life, functional-dynamic movement occurs with all of these movements happening together, so it's important to be flexible in all directions. 

Wednesday, 29 July 2015

Common Causes of Knee Pain

Not all knee pain is created equal.

We are constantly seeing stories in the news about professional athletes with knees problems. Most of the time the footballer has slid, tackled and ruptured their ACL (anterior cruciate ligament) or the tennis player has torn their meniscus. So it's no wonder many of the patients I see in the clinic believe these are the reasons behind their knee pain. However, ruptured cruciate ligaments and torn menisci are fairly rare in the general population. Knee pain is not. 

The knee joint is a complicated, yet very stable joint and works as a function of both the spine/hips and the foot/ankle. Osteopaths will always examine the entire "chain," to see whether your knee pain is resulting from the top down (as a function of the low back/hips) or from the bottom up (as a function of the foot/ankle). 

Most commonly, patients come to my clinic with knee pain that's a result of compressive forces across the joint (yup, that's physics speak!). Both the quadriceps muslces (front of the thigh) and the hamstring muscles (back of the thigh) attach below the knee, so when they are tight (which they almost always are) they exert a compressive force across the knee joint. This tightness decreases the space in the knee joint, which means the structures around the joint can rub and pinch more easily. If these muscles around the thigh and knee are out of balance, they will pull more on one side of the knee bringing the joint out of alignment.

The patella - your kneecap - sits within the tendon of your quadriceps and glides back and forth across the knee joint as the quads contract. It's like a train on a traintrack and often gets 'derailed.' If any of the muscles around the knee (quads/hamstrings/IT band) are pulling the knee out of alignment, then the patella gets pulled off its track and can cause pain. This is called Patellar Maltracking. 

It is also common to strain the ligaments around the knee, without fully rupturing them. This can happen if you over extend your knee or make a sideways movement with a planted foot. Often there will be some swelling in a sprained ligament, just like if you were to sprain your ankle. 

Although there are many different causes of knee pain, I have outlined only a few - which are the most common I see on a daily basis. Knees respond very well to osteopathic treatment, relieving pressure, tension and tightness whilst also working up and down the chain - from the foot up to the spine - to ensure the movement and forces going through the spine are evenly distributed. 

Just remember, osteopathy is NOT JUST BACKS, so next time your knee is niggling, perhaps call your osteopath to see if they can help. 

Tuesday, 28 July 2015

Osteopathy: Treatment vs. Prevention


Treatment versus Prevention

Pretty much all of my patients come to the clinic because they're in pain and their body's have hit a crisis point. Perhaps they hit the gym too hard, slept awkwardly, spent too many hours hunched over the computer, or had a specific accident that left them needing some osteopathic TLC. 

Osteopathy works wonders to relieve pain, restore movement and flexibility to stiff joints and to help your body out of that crisis back to a place where you can enjoy your favourite hobbies. 

Most of the time, once a patient is pain-free, they cease treatment and only call the clinic if the problem reoccurs. However, I'm forever explaining to patients the power of prevention. At the end of the day, our bodies are machines that require maintenance and the occasional oil change, just like you would your car. 

Osteopathy is as beneficial in preventing recurrences of pain, as it is in treating and curing them. The manual techniques osteopaths employ help relieve tension in the body (that builds up from our 21st century lifestyles!), relax muscles which ultimately pull joints out of alignment, and teaches you how to recognise and manage triggers which can worsen your pain. 

We all lead busy hectic lives, sitting for too long and carrying heavy bags, whilst doing our best to keep fit and healthy. But sometimes our bodies run on empty and require that maintenance to prevent a much worse problem from occurring.  

So next time you start feeling a little niggle or have an important trip coming up, it's much better to book an appointment with your osteopath to sort it out early, so that it doesn't develop into a bigger problem.