Injuries, Exercise and New Year’s 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 when the exercise they do doesn’t have the desired effect.

What kind of Exercise

“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 David Isherwood. “Different types of exercise will be more appropriate, depending on what you’re hoping to accomplish.”

“As a general rule”, he 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.

Weight Loss

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).

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,” David 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.”

Injury Prevention

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 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: http://www.nhs.uk/Livewell/fitness/Pages/physical-activity-guidelines-for-adults.aspx

Posted in Osteopathy on 18th January 2015

Good Mattresses Pillows & Sleeping Postures

Patients regularly ask for advice on correct pillows and mattresses to prevent onset of problems that may bring them to the clinic seeking assistance for various discomforts and sleep disorders. What may be the best position for sleeping is a common question. Presentations in the Practice often are in the form of a “cricked neck” or torticolis, considered by many patients as “a trapped nerve in the neck”. Symptoms may well be in the following form. “When I awoke I tried to lift my head off the pillow and could not move as the pain was awful, or, I cannot turn my head and I have pain travelling down my arm!”  When I turned over in bed and tried to stand up my “low back just went” now I am unable to stand up and I have pain across the low back.”

I will attempt here to address some of these many questions that may help.

First and foremost, Sleep is Necessary, therefore get it any way you can, without quality sleep regularly a host of other ailments are likely to head your way.

Addressing the above presentations it is important to understand why they occur in the first instance, particularly why the following suggestions are presented.

Pillows

Reducing likelihood of awakening with a stiff neck or trapped nerve like symptoms. This often happens after periods of extreme exhaustion, stress, illness, over exercising, a heavy night’s drinking and very often after reading on the side in a park on hot days or in bed.

My preference is to use a quality feather pillow (with an allergy cover if needed). One pillow is normally adequate, however two with slightly varying density of feathers give better options for varied positions of sleeping. Prior to sleeping I recommend turning the bottom of the pillow up to give a wedge shape which the larger part can be snuggled into the neck when sleeping on our side. This allows the Cervical spine to remain in a neutral position with the rest of the spine.

If sleeping on stomach with one arm up, one down, head to one side one knee up and the other down! Common position for many, the less dense pillow works well tucked under the neck with little that may raise the actual head up. When sleeping on the back I it can be helpful to place the pillow under the head and neck. If this makes the chin tuck in, excellent as this will traction the back of the spine opening the joint spaces. Sadly it may promote snoring.

Anatomical reasons for a neutral or straight spine are worth mentioning. When we sleep with two pillows under the side of the head we effect a tilting upwards of the head and neck. This causes the uppermost muscles attached from the Occiput, Temporal bones ( bones of the cranium/head) and cervical spine to the various ribs and lower vertebrae to slacken. These muscles rely on being in a state of constant tonic contraction. When muscles slacken  spindles within these muscles send signals to the Cerebellal part of the brain to reset the resting tone of the main muscle fibres to a shorter length. Once his happens, these muscles in their new shortened state pull joints closer together. This may irritate the area causing a responsive inflammation causing increased pressure in the area affected. Thus when turning over or getting up there may be sudden impingement of the joints, rotated or leaning neck and elevated shoulder on the shortened side. The inflammation around impinged joints presses on nerves and causing protective postures. These presentations by patients are what an Osteopath is faced with daily and may take between two and as many as four or more sessions to resolve. Hence prevention is better that cure.

Mattresses

Depending upon weight, shoulder and hip size, form medium firm mattresses are recommended, with a softer top layer built in. This enables the hips and shoulders to sink into the soft part without pushing the spine out of position. When this occurs there may be a bowing of the spine downwards causing again a shortening of the upper side muscles and resetting of resting length. This may lead to a lifting of the pelvis and subsequent bacl or leg issues, trapped nerve like symptoms of a sciatic nature. There also be restrictions on the twelfth rib affecting the diaphragm and subsequently breathing difficulties. All of these may not present for some time. It is an interesting coincidence that many patients begiing to share life with a partner have a tendency to sleep facing away from them. This normally means sleeping on the same side regularly. If this is the case and the mattress or pillow are not correct we very well may see you in the clinic at some future stage. Especially those sleeping in rented accommodation.

We are very fortunate to have an arrangement with the foremost designer and producer of Organic bespoke mattresses both for adult beds and baby’s cribs and cots, particularly of use to those with allergy concerns. For more information on mattresses to suit yourself body size weight etc. Please contact david@theosteopath.net for further information.

Good Posture

Good posture refers to how we relate to the ubiquitous pull of gravity. The fact that most of us will lose a couple of inches in height over a lifetime and that we are nearly always taller after a good night’s rest provides sound proof of the strong forces being exerted on our bodies.

While we cannot escape these gravitational forces, it is possible to consciously change our postures so that we can minimize the potential damaging effects of gravity. Over time, and particularly after the age of 25, poor posture can lead to chronic muscular strain, disc degeneration, osteoarthritis and trapped nerves.

The challenge we face when trying to improve our postures is understanding that by altering our habits we can have positive and preventative long term effects. It is all too common to only make an effort once the proverbial ‘horse has bolted’ i.e. when we are suffering from pain and stiffness.

So What Makes Good Posture?

Good posture can be achieved by maintaining neutral spinal and joint alignment so that there is minimal strain and compression placed on all the muscles and joints in the body.

Below are examples of good and poor postures in sitting and standing positions:

 

In each picture you will notice that the position of the pelvis is paramount to neutral spinal alignment. While it is difficult to hold a good posture all day, you should strive to hold it as much as possible.

A Note On Chairs

While good posture requires a conscious, active effort, some chairs are worse than others in helping to sit correctly. Deep sofas and low seats are notoriously unsupportive.

Patience

Changing posture may seem akward to begin with and often people complain of feeling slightly unbalanced. It’s important to be patient and persevere as your proprioceptors (tiny sensors in your muscles, ligaments and tendons) relay new feedback to your Central Nervous System. With time, the CNS will adjust to a feeling of normality.

Spinal Misalignment

Osteopathy considers the patient from a mechanical and functional point of view to allow the body to work with minimal stress, strain and energy. The mechanical problems occuring within the body can create imbalances within the normal tension of the spine. Misalignments of spinal vertebrae may cause irritation to the nervous system and affect not only the functioning of the musculo-skeletal system but also the organs that drive our bodies.

Below is an overview of ailments that a patient can present with if the spine is misaligned:

spine_numbered
C1
 Headaches, nervousness, insomnia, head colds, high blood pressure, migraine, chronic tiredness, amnesia, dizziness
C2
 Sinus trouble, allergies, eye troubles, earache, fainting spells, deafness
C3
 Neuralgia, neuritis, acne or pimples, eczema
C4
 Hay fever, catarrh, hearing loss
C5
 Laryngitis, hoarseness, sore throat
C6
 Stiff neck, upper arm pain, tonsilitis
C7
 Bursitis, colds, thyroid conditions
T1
 Asthma, cough, difficulty breathing, pain in lower arms & hands
T2
 Upper back pain
T3
 Bronchitis, pleurisy, pneumonia, congestion
T4
 Gall bladder conditions, jaundice, shingles
T5
 Liver conditions, fevers, low blood pressure, anaemia, arthritis
T6
 Stomach troubles, nervous stomach, indegestion, heartburn
T7
 Ulcers, gastritis
T8
 Hiccoughs
T9
 Allergies, hives
T10
 Kidney troubles, hardening of arteries, chronic tiredness, nephritis
T11
 Skin conditions such as acne, pimples, eczema
T12
 Rheumatism, gas pains
L1
 Constipation, colitis, diarrhoeas, hernias
L2
 Cramps, difficulty breathing, acidosis, varicose veins
L3
 Bladder troubles, menstrual troubles such as irregular or painful periods, bed wetting, knee pains
L4
 Sciatica, low back pai, frequency of urination
L5
 Poor circulation in the legs, swollen ankles, weak ankles, cold feet, leg cramps
Sacrum
 Sacco-iliac lesions, spinal curvatures
Coccyx
 Haemorrhoids (piles), pruritis (itching), coccyx pain when sitting

Trapped, Pinched and Compressed Nerves

A ‘trapped nerve’ is a common and unpleasant condition in which a nerve can be irritated by either the chemical or mechanic effects of inflammed tissues. Symptoms that may suggest that you have trapped nerve include:

Neck pain and stiffness with a combination of radiating pain, tingling, numbness and weakness down the arm, forearm and fingers
Low back pain and stiffness, also, with a combination of radiating pain, tingling, numbness and weakness down the buttock, thigh, legs and feet.
A typical case history of a patient presenting with a trapped nerve may sound like this:

‘I woke up one morning with an incredibly stiff neck. I could hardly turn it. It took me a lot longer to get changed for work – brushing my teeth, putting my jacket on and reaching for things were particularly painful. I took some Nurofen which seemed to free off my neck a bit but later in the day, I started to get a pain down my arm and a couple of my fingers went numb. Although the stiffness has improved somewhat, I’m still getting these symptoms down my arm 3 days on.’

Sciatica is another example of a trapped nerve. Sciatica can be caused by a number of different injuries such as a slipped disc, arthritis, a sacro-iliac injury or a muscle tear in the low back.

Because there are many injuries that can cause a ‘trapped nerve’ it it worthwhile visiting an Osteopath to determine the root cause of the symptoms. If the Osteopath is unsure, you may be referred to have an x-ray, MRI scan or ultrasound to confirm the diagnosis.

Once a diagnosis is made, a treatment plan can be hatched that will firstly reduce the pain and discomfort and secondly help to prevent recurrence of the injury.

Neck Pain

Here at the clinic we see many patients with various pains and aches in the neck along with tension headaches.

Non-Specific Neck Pain

Many people develop a stiff and painful neck for no obvious reason. It may happen after sleeping or sitting in a draught or perhaps after a minor twisting injury, for example while cleaning or gardening. The underlying cause for this type of neck pain is not fully understood, so it is called ‘non-specific neck pain’. Having non-specific neck pain does not mean that your neck is damaged and often it happens in people whose necks would appear completely normal under an x-ray. It is the most common type of neck pain and often disappears after a few days. If it doesn’t resolve within a couple of days it is wise to have an examination and treatment before the body begins compensating with altered posture.

Cervical spondylosis

With everyday use over many years the discs and the facet joints become worn. This wear varies from person to person. The discs become thinner and this causes the spaces between the vertebrae to become narrower. Also, ‘spurs’ of bone, known as osteophytes form at the edges of the vertebrae and the facet joints. In a way this is a particular form of osteoarthritis but it is known as Cervical spondylosis.

Whiplash

This type of injury often follows a rear-end collision in a car. In this type of collision, first the body is carried forward and the head flips backwards. Then, as the body stops, the head is thrown forwards. Following a whiplash injury there is often a delay before the pain and stiffness start. Although whiplash can badly damage your neck, the majority of people who suffer these shunt accidents do not have major damage. In most cases injuries feel better within a few weeks or months. Seat belts and properly adjusted headrests in cars have significantly reduced the damage from whiplash injuries.

Tension

Most muscles of the body relax completely when they are not being used but some muscles (known as ‘anti-gravity muscles’) have to work all the time in order to keep your body upright. Muscles at the back of your neck must always be tensed, otherwise your head would fall forwards when you are sitting or standing. When these muscles work too hard or are not strong enough, it can cause neck pain and tension headaches. People who are worried or under stress often sub-consciously tighten their muscles more than is necessary to hold their head upright. Tension headaches are very common and are often wrongly called migraines. Working at a computer station and sitting slumped with head forward loads the neck muscles and may create tension headaches.

Osteopathic Treatment

After assessing the function and quality of neck and joint movement, we check the muscle and fascial tension along with it’s relationship to the spine and head. We apply soft tissue massage to soften muscle tension with positional release for the fascia. We may follow this up with articulation and manipulation for joint release where necessary. We also use gentle Cranial Osteopathic techniques to rebalance the rhythmic function of the spine and cranium. Recommended exercises for correcting poor posture are also a part of treatment and consultation.

Sinusitis, Sinus Headaches and Blocked Sinuses

Many patients come to the clinic for the treatment of sinus problems. These often feel like pain located in the forehead, eyeballs, cheeks, temples, teeth and even the back of the head and neck. Feelings of being ‘blocked’ or ‘stuffy’ similar to cold or flu are typical descriptions. There also may be headaches.

What are Sinuses?

They are air filled spaces within bones of the face. Their purpose is debateable but the following are suggested

Decreasing the relative weight of the front of the skull, and especially the bones of the face. The shape of the facial bones is important, as a point of origin and insertion for the muscles of facial expression.
Increasing resonance of the voice
Providing a buffer against blows to the face.
Insulating sensitive structures like dental roots and eyes from rapid temperature fluctuations in the nasal cavity.
Humidifying and heating of inhaled air because of slow air turnover in this region.
There are four pairs of sinuses:

In the Frontal bone above the eyes
In the Ethmoid bone behind the upper nose
In the Sphenoid bone behind the eyes and more central than the Frontal
In the Maxillary or cheekbone
The lining of the sinuses is similar to the upper respiratory tract and is subjected to the same infectious processes and allergic responses. Oedema (swelling) or tenacious mucus as well as slowing of the ciliary movement may affect the discharge of secretions out of the sinuses, fluids build up, the passage of air is blocked, and unequal pressure results, leading to pain.

The nerve junctions to the sinuses are in the upper back area and need to be evaluated when assessing sinus complaints.

The goals are to relieve obstruction and pain
Improve venous and lymphatic flow from the area
Effect reflex changes
Improve mucociliary clearance
Treatment

Several gentle Cranial osteopathic techniques are designed to aid all of these symptoms.

Headaches & Migraines

Many patients present at the clinic with neck pains, back pains and related headaches or migraines. We are lucky to be able to help many of our patients to overcome and prevent the onset and recurrence of some headaches and migraines by addressing the root causes. We hope the following article may help patients to determine if they may self help or seek our assistance.

Before the various causes are discussed an example of a patient presenting in the clinic may be useful:

‘Miss P is a 27 year old lady who arrived in dire straits having suffered continuously from a headache for over two years. She had exhausted many sources of help and was currently under the care of a Consultant Neurologist. The treatment was heavy duty analgesics which were helping slightly but reproduced side-effects of drowsiness. Sadly this should have been the prime of Miss X’s life, however she was avoiding socialising and understandably so. After an in depth consultation it was decided that the root cause of these headaches was coming as a result of poor seating posture at the desk causing restriction of the joints in her neck with contraction of the posterior musculature of the neck. A treatment plan was put together and commenced immediately. Miss X was treated weekly for 4 sessions and by this time the headaches had resolved by 60%, a further 2 treatments reduced the headaches to background annoyance. Regular check ups every 3 months have resulted in analgesics not being necessary. The last visit Miss X had was for knee pain and has no reported headache for 3 months’.

Headaches originating from the Neck (Cervicogenic-Cephalgia)

These are benign headaches unrelated to increased inter-cranial pressure, infection or haemorrhage. They usually begin as a vague ache in the base of the head (occipital area) or top of the neck. Within hours, it progresses over the top of the skull to involve the entire head. People may complain of pain behind the eyes on one or both sides. The headache usually worsens as the day progresses yet improves with lying down and sleeping. If severe it may trigger Migraine style symptoms of nausea, photophobia or vomiting. There are a number of trigger areas for the onset of this these forms of headaches.

Muscular attachments from Cervical or Thoracic Spine to the periosteum of the occiput
Restricted Facet joints in the cervical spine
Restricted function of the Cervical or Thoracic Spine
Restriction of blood supply
Poor venous drainage from the Intracranium
Dural restrictions within the Cervical Spine and internal cranium
Restricted function of the joints of the various yet distinct 29 bones of the skull
The causes are often a combination of poor seating postures, week abdominals, long hours in front of a computer and stressful status.

Treatment of patients with headaches takes a whole body approach. A combination of soft tissue techniques, articulation, manipulation, stretching and gentle cranial Osteopathy plus advice on stretching exercise and correct posture and seating positions.

A full discussion of headaches in their various forms would fill an extremely large textbook. It is well beyond the scope of this article to encompass all the causes of headaches and or migraines. Therefore this presentation is limited to the poorly understood but surprisingly common phenomenon of headaches originating from the neck.

lower back pain: exercises, stretches and treatment for back ache

Low back pain is one of the most common complaints that GPs are presented with today. It is estimated that up to 85% of the population will suffer from low back pain at some stage in their lives. Although the vast majority make a full recovery over a three-month period, nearly 50% will have at least one recurring episode.

Risk factors which are associated with low back pain include women who have given birth more than once, physical workers whose occupation involves excessive bending, twisting and hard physical labour. Jobs that involve prolonged standing or sitting such as drivers or office-based workers are also more likely to lead to low back pain.

Osteopaths spend much of their time assessing, treating and managing low back pain due to it’s high incidence. There are many structures in the low back which can cause pain locally but can also lead to pain spreading elsewhere. More complex back issues that involve a sharp pain radiating to the leg can indicate a trapped nerve. Other symptoms such as numbness or weakness in the legs can also suggest a trapped nerve.

Low back pain can hugely vary in it’s nature. Severe low back pain can come on suddenly and render a patient almost unable to move. In such cases, a relatively minor and trivial movement such as bending over to pick something up can cause this reaction. This can be immensely frightening as well as debilitating.

More chronic issues can involve a more gradual low-grade back ache with some stiffness that is aggravated by activities such as coughing, turning in bed, sitting with bad posture or bending.

In both cases where discomfort is present, it is worthwhile a short course of osteopathic assessment and treatment to identify structures that may be failing and in need of some attention.