Fit at Forty - with Dance

An article by Jane Beazley in advance of her 40th!

Scary birthdays

It is a year of scary birthdays at Mulberry Osteopaths. Patrick has already announced that he is hitting the big 60 this year, although I’m not sure I believe him, he looks very well on it. Whereas I (Jane) will hit the big 40 in April - Eeeek - how did that happen, I’m sure I was twenty just five minutes ago? I have already made plans for my birthday week – yes I said week, I am going to embrace 40 and do it in style. If you are one of my patients, I apologise now, as I am sure I will bore you with the details as it draws closer.

Fit at forty

About two years ago, I made a pledge to be fit at forty, and I wanted to use my opportunity to write a blog to talk about that, in the hope of inspiring at least one of you to make some changes.  When I found myself post osteopathy school with a BMI that categorised me as overweight, I knew something had to change. I initially faffed around with diets, but they were not sustainable and I always fell off the wagon. I soon recognised that rather than starving myself, I needed to make a positive life long change, combining food and exercise. I now eat reasonably healthily, I have cut down on my refined sugar intake, only allowing myself treats at the weekend, which is much more achievable than banning sugar outright, and I have also reintroduced dance into my weekly routine.

Dance and its benefits

Without a doubt, the most important step has been to exercise. I danced from the age of about four to seventeen, learning ballet, tap and occasionally jazz. So it was no great surprise when I started dance again that I became totally obsessed - I’m currently taking two zumba classes, two ballet classes and a tap class a week. It is challenging, it is at times exhausting (to quote my ballet teacher “ballet is beautiful, beauty is pain”), but I am always motivated to go, and that is because I love it. I would probably do more if I could afford it.

Dancing is so beneficial to your physical and mental health. Physically, it improves muscle strength and tone, visceral health, aerobic fitness levels, posture, balance, coordination, agility, mobility, flexibility, bone health and energy levels. It also helps with weight loss. For me, and depending on the style of dance, I burn 500-600 calories in an hour class, which makes me feel far less guilty on the days I can’t resist a slice of cake.

The mental benefits are huge too, and often overlooked. The BBC broadcast a programme called ‘Darcey Bussell: Dancing to happiness’ in December, which followed four different groups, with differing health issues, to learn how dance was benefiting their lives. It is well worth a watch if it is still available on the BBC IPlayer, but a brief synopsis is that dance can benefit:

·         Teenagers coping with issues such as anxiety, depression and confidence/self esteem.

·         Those diagnosed with Parkinson’s, as dance benefits their mobility, balance, fatigue, social behaviour, mood, motivation and memory,

·         The over 50’s through the Silver Swan ballet initiative, which is targeting those nearing or in retirement who might be unfit, isolated or lonely.

·         People suffering with Dementia (filmed at the Eric Liddell Centre in Edinburgh), challenging and improving their memory and movement.

Am I fit at forty?

The combination of less sugar and my weekly struts around the dance floor has helped with weight loss. I am back to a normal BMI, although my weight seems to have plateaued, but maybe that is because I have found my healthy adult weight. My jawline and waistline have definitely made a comeback, as has the faint outline of some abdominal muscles, but most importantly, I feel fit and strong, I don’t get out of breath when I would not expect to and I don’t get reflux anymore. Additionally, I find such joy in dance, in learning a new skill, in perfecting something I already know, in challenging my memory and in meeting people and making new friends with shared interests.

Next steps

I still need to work more on flexibility. As much as I would like to, I don’t think I will ever achieve the splits, however, I would like to feel more flexible, and maybe hold my leg at ninety degrees in ballet class with greater ease. Also, if I am going to survive a career lent over a treatment couch all day, I need to find some sort of routine post work to look after my spine. So my next steps are more stretching and maybe yoga. Perhaps I will wax lyrical about that next time.

Have I inspired you?

If you’ve lost touch with dance, and want to return to it, or if you want to try it for the first time, you are in a fabulous city to do so, there are so many schools and different classes/genres available. Although I love to bang on about dance, I understand it isn’t for everyone. If you recognise that you need to make some changes, but aren’t interested in dance, perhaps think about what it was that you loved to do as a child, as chances are you will still enjoy it and this will be your motivation. If you can’t think of anything, why don’t you try fitting exercise into your day, such as walking to work. Walking is so much more enjoyable than getting the bus, and it’s free. With spring/summer approaching, it is the perfect time to try. A decent pair of trainers, a top you don’t mind getting sweaty and some headphones to listen to the radio or a podcast are all you need.  Whatever you do, just do something to make a positive change. It is never too late.

Five inventions that will keep osteopaths in business

I thought I’d look at a few inventions that will keep osteopaths in business for years to come . . .

1. The Chair – Once upon a time man would squat when having a rest or a chat with a friend. It might seem surprising to many today but the human body is actually well designed for squatting.  Then some bright spark invented the chair and with it came all the postural challenges that osteopaths thrive on today. Prolonged sitting can lead to low back pain, lower rib tightness from slumping, pressure on the abdominal contents, reduced breathing capacity, tightness in the muscles at the fronts of the thighs, tension across the upper back and shoulders . . the list is almost endless. Of course, this all depends on how much time you spend sitting, what sort of seat it is, how well you sit, but ultimately you weren’t designed for prolonged sitting no matter how wonderful the design.

2. High heels – Fashions come and go but high heeled shoes never seem to fade away especially when it come to dressing up for a posh do. Some women even decide to wear them to work! The only negative thing from an osteopathic business perspective is that this fashion item has never really caught on with men in the same way it has for women. Put on a pair of heels and the whole walking mechanism is thrown into disarray. The calf muscles shorten, the pelvis tips forward, the low back hollows out so even if you can manage to walk gracefully without falling over there’s huge potential for hip pain, pelvic torsions, low back pain and all manner of aches in pains in the legs.

3. Hedge Trimmers – The sound of a hedge trimmer on a sunny summers day can bring a smile to an old osteopaths’ face, especially if it involves a nice tall hedge and therefore a step ladder. Holding a heavy piece of machinery at arm’s length in full stretch, not just for a couple of minutes but repeating the action over maybe an hour is great for straining shoulders and arms. If you add the step ladder into the equation you also get the benefit of leaning forward and overreaching to get to that furthest bit of hedge so the low back gets strained as well!

4. Vacuum Cleaners – We’re talking mainly about the stick type models here rather than the upright ones and to be fair the problems caused by these devices are more down to operator error than anything else. There’s a tendency when using a stick vacuum cleaner to bend over too much and press down through the stick as if the pressure will make it work better. No wonder folk struggle to straighten up after doing the weekly chores around the house.

5. Smart Phones – As if computers and laptops weren’t good enough for generating osteopathic business they’ve now introduced the smart phone and folk are walking and sitting around with their heads permanently looking down towards their feet. Given that your  average head weighs in at about 5kg that’s quite a challenge for all the muscles in the upper back and shoulders as they support the weight of this heavy object for hours during the day. Tightness across the upper back and shoulders, neck pain, headaches and even pains radiating down into the arms and hands are all possible consequences of this wonderful osteopathic fee generating device.

MOT and Service?

This is the time of year when the car goes in for its annual MOT and service, which should mean that it survives another Scottish winter.

Obviously there is a legal requirement to put your car through this annual ritual to ensure that it’s safe enough to take out on the roads so there’s no way of avoiding it. If we’re lucky we get the all clear or maybe some minor faults need attention but hopefully nothing too big and expensive.

This is also the perfect time to mention that funny rattling noise that you’ve noticed in the past few weeks or the fact that the car seems to be demanding a bit more oil than normal so that the mechanic can check things out and hopefully prevent a major problem from developing.

Unfortunately some might say it’s a shame there isn’t the same requirement to put ourselves in for an annual MOT and service.  There could be an invitation to attend your GP’s practice when you reach a certain mile stone age for a ‘well women’ or ‘well man’ check when a practice nurse may check your blood pressure, take a urine sample and ask a few life style questions.

Women are also invited to have cervical smears every three years once they reach the age of 25, and once you reach the ripe old age of 50 you can also opt in to the bowel screening scheme every couple of years and mammograms every three years.  All these are optional.

However, there’s not as much pressure to get those little niggly aches and pains checked out and, because there’s no requirement or obvious prompting with official letters, it’s easy to start living with troublesome joint and muscle problems that can often be easily resolved.

This is where an osteopathic MOT and service can be useful. A problem doesn’t have to involve acute pain or major disability for it to start making life un-necessarily harder . . . . and the chances are it’ll be a lot cheaper to get sorted out than the annual car MOT. 

How Long Would You Wait?

If you wake up in the morning with an acute spasm of pain across your low back, or you injure yourself doing some crazy sporting activity, you want it to be sorted out and you want it sorted out now, today. How long do you normally wait for an appointment with your GP?

By the time you get to see your GP the acute low back pain has settled in and you’ve been out of action for a while. Then don’t be surprised if after your wait for an appointment the response is a prescription for some pain killers and anti-inflammatory medication that’s a bit stronger than the stuff you can get in the chemist.

There is another option, you could give us a ring. Backs are what we’re good at. What’s more we will probably get you in to see us a lot quicker than trying to see your GP. We carried out an audit of new patients during June and it came up with some interesting figures:

Just over 30% of new patients got an appointment to see one of our osteopaths within 24 hours.

45% got an appointment within 48 hours.

85% of new patients were in to see one of us within a week.

Of course, not everyone who rings in to see us for the first time is in acute pain.  A large proportion of our patients have had a problem for a while before they finally get around to having things checked out. So in these cases it’s not a question of the first available appointment but more an appointment that’s convenient.

If the problem has been there for weeks or even months you may not be interested in the earliest possible appointment, it’s more a case of trying to schedule your appointment around work or family commitments. We offer evening and weekend appointments to help with this. You may also decide to wait a little longer to see one particular osteopath that has been suggested to you and at a time that works for you.

A high percentage of our patients are referred to us by a friend, colleague or family member, and most patients (just over 70% according to our audit) ask to see a specific osteopath when they ring in. About 90% get to see the osteopath they want. This again is a bit of a contrast to seeing the particular GP you want to see.

So if you’re in pain we’ll get you in quickly and if you’ve got a busy schedule we’re pretty flexible with regard to appointments times.

Mulberry Osteopaths Slide Show

Here's a little slide show I put together for World Osteopathy Day

Bendy Yoga Teachers and Communication

 – or Does your yoga teacher know what it’s like to be stiff?

I had a very good yoga teacher not so long ago who admitted that when she started doing yoga she actually found it quite easy in many ways. Even without trying too hard she was naturally flexible and found that it wasn’t too much of a struggle tying herself into the various yogic knots.

It stands to reason that many yoga teachers maybe initially drawn to yoga because they were born bendy, can do a lot of the yoga poses well and find that they enjoy being good at it. So can someone like this really understand what it’s like to be a middle aged bloke who works in an office and struggles to touch his knees let alone coming close to reaching his toes?

A good yoga teacher will listen to their students and try to understand what difficulties they face and how they feel. If a teacher drops effortlessly in to a standing forward bend, places her hands flat on the floor and presses her chest against her thighs then she doesn’t really have a concept of what a tight hamstring is or a ridged low back and immobile pelvis. She has to rely on you, the student, telling her how it is for you.

It’s important to communicate with your teacher, and the same goes for a Pilates instructor or personal trainer.  They should be willing and keen to listen.  It’s also even more important to communicate with yourself. Yoga, Pilates and movement in general is a chance to check in with your own body and listen to what it’s trying to say. Don’t just rely on your teacher to tell you what you ‘should be feeling’, actually tune in and ‘really feel’ what your body is telling you.

Bottom line is that you are your own best teacher provided you take the time to communicate with yourself.

Also save a thought for the poor old bendy yoga teacher that is often too bendy. I treat plenty of yoga teachers and students that maybe bendy but they need to work really hard to gain and maintain the strength to hold everything together.

Avoidance or Remedy?

It’s always interesting to hear the stories patients have to tell to give the back ground of the problems they present on their first consultation. We will often find out that the problem that is causing enough pain to prompt the visit to see an osteopath is the tip of the iceberg.  The other thing that can initiate that first visit is an inability to do something enjoyable or important such as a sporting activity.

Of course rather than trying to rectify the problem another possible option is avoidance.  If a particular movement, activity or task causes pain then just avoid that particular action. If you develop Repetitive Strain problems in the arms or wrists through working at a desk and computer then just change the job to avoid the computer. If running causes recurrent groin strain then stop running.

Avoidance certainly is one option but the underlying problem hasn’t gone away and you run the risk of being able to do less and less. Is that really the best option?

I’ve been treating a patient recently who had to stop cycling because it kept triggering pain and spasm in his left thigh. During the consultation he also told me about his history of hand and wrist pain associated with computer work. Luckily he found himself a better job which doesn’t involve as much use of a computer. So that’s computer work off the list and cycling off the list . . . . . what next?

Essentially aches and pains are your bodies way of telling you it’s not happy but more often than not osteopaths can not only ease the aches and pains but we can help your body return to the activity that it wasn’t particularly happy with.

As well as the hands on osteopathic treatment advice relating to changing your technique, using your body more efficiently, or introducing a more balanced exercise routine may also be included.

Now surely that’s a better option than avoidance and simply giving up the activity even though it may involve a bit more work to get you back on track.

Looking Beyond Disease

A patient came to see me recently that I hadn’t seen for well over a year.  She came in with a flare up of the ‘old low back problem’ which we’ve successfully treated in the past.

Obviously we got to talking about what had been happening since her last visit. It turns out that a chronic cough she’d had that was put down as being an allergic reaction to something was now confirmed as being an autoimmune problem that has led to damage to the lung tissue in places.

As she described how the ‘very nice consultant’ had explained things and put her on long term steroids to help control the symptoms it raised the all to common issue whereby medics often don’t see beyond the disease.

As an osteopath I expect to help patients reach their potential and hopefully exceed goals. That might be something as ‘simplistic’ as lifting an arm above shoulder level or bending down to reach the toes. Simplistic achievements they maybe but of huge significance if you’ve been struggling to dress yourself or simply put on your own shoes and socks. 

Usually these sort of things resolve with a bit of help but there are some more chronic conditions where the stakes are even higher and it’s useful to look beyond the apparent doom and gloom presented by the doctors.

Breathing isn’t just about the lungs, there’s an entire breathing mechanism involved which also includes the diaphragm, the rib cage, the upper back and even the nerve supply to the relevant muscles

Just because the tissues of the lung have been damaged in some way doesn’t mean that the overall breathing mechanism can’t be made to function more effectively.

With any chronic breathing problem osteopathic input backed up with the right sort of exercise can improve the breathing capacity overall. Of course if you can breath more easily you can do more which in turn means that it’s easier to maintain your fitness and simply enjoy life a little more.

Don’t just accept the ‘keep taking the tablets and live with it’ attitude.

Luggage Damage

Here we go heading into summer and the holiday season.  So how much can you squeeze into your suitcase for that holiday and, more importantly, how heavy will it be once you’ve packed it?

The fact is that this is the time of year when osteopaths will be seeing patients with luggage induced injuries. If you don’t want to be one of those unlucky folk here are a few things to think about when it comes to surviving your holiday luggage.

How heavy? – Obviously the weight of your suitcase will determine how much potential damage it will cause when you come to lift it so try to keep it light. Let’s face it, most of us are guilty of packing too much stuff and we return home with somethings that never leave the case. Maybe even consider two bags instead of cramming everything into one. Of course the airlines would like this and I appreciate it’s not always possible.

Does it have wheels? – It’s a lot easier to wheel a heavy load than it is to lift it so opt for the suitcase with wheels. Also bear in mind you’ll probably still have to lift a suitcase at some point in any case to get up or down stairs, into the boot of a car or drag it off the airport conveyor belt.

Need a trolley? – If the airport or railway station has a luggage trolley it makes sense to use one to carry your load.

Pull or push? – Dragging a case behind you means walking slightly twisted which could put strain through both the shoulder and the spine. Pushing a case in front can be less of a strain on the body.

How high can you go? – You may be able to just lift your heavy suitcase off the floor but don’t assume you can get the same case above your head and into an overhead locker.

How long have you been sitting? – Whether it’s a couple of hours in the car or a long haul flight across the Atlantic bear in mind that you’ll be stiff at the end of the journey and therefore at more risk of injury when it comes to throwing luggage around. So don’t be in too much of a hurry to lift the suitcase out of the boot of the car after a long drive.

What’s the rush? – If you try to do something too quickly the chances are that you won’t do it properly so think about how you lift a huge suitcase and take your time.

Do you need help? – If it’s too heavy or too bulky don’t be afraid to ask for help.

Simply remember to view your luggage as a potential health hazard and be careful when you’re anywhere near it.

Beware Hair Twiddling

I like to think that osteopathy is a partnership approach to solving problems with both the Osteopath and the patient being involved in the process. So it’s always nice to hear that a patient has acted on their own initiative.

I’ve recently been treating a patient with a painful shoulder and she’s been making steady progress but I was surprised when she came to clinic and announced that she’d solved her shoulder problem by getting her hair cut short! She went on to explain that since a young child she had always had the unconscious habit of twiddling her hair with her right hand. When she wasn’t thinking about it whilst just sitting watching TV she’d fall in to the habit of fiddling with her hair.

It makes sense that when osteopaths start treating a patient with a particular problem not only do they have to come up with an idea as to what they are treating in the form of a diagnosis but we also like to think beyond that to figure out what caused the problem in the first place and what aggravates it. Most patients are looking for pain relief or better movement but unless the potential cause of the problem is identified it’ll happen again and again.

In the case of shoulder problems classic aggravating factors might be carrying a heavy shoulder bag, holding a young baby repeatedly over one shoulder or using a computer mouse for long hours. Of course an aggravating factor that I’ll now bear in mind is having long hair and twiddling it!

The thing is that with a lot of the aggravating factors that are associated with using the arm we have to remember that arms are quite heavy things. If you lift your arm above your head for a while it’s fine but leave it there for any length of time and things are going to ache and complain under the weight of the arm itself even if it’s not holding on to anything. So when folk sit at their busy, cluttered desk in front of the computer holding on to the mouse, unless the arm or wrist is resting on the desk the arm and the shoulder are going to get tired and they’re going tighten up and ache. And the same goes if you’re sitting in front of the TV twiddling your hair!

Stress and Feeling Old

“Every stress leaves an indelible scar, and the organism pays for its survival after a stressful situation by becoming a little older.”

~ Hans Selye

I think the majority of patients coming along to our clinic would relate to this quote from the endocrinologist Hans Selye. When you’re struck down with an episode of severe low back pain and every simple movement becomes a monumental task you feel like you’ve aged over night. Actually, it doesn’t even have to be a really bad pain to make you feel elderly. Tight achy muscles that reduce your flexibility and which make getting out of a seat hard work will make you feel old.

Interestingly, although now-a-days  we commonly use the term ‘stress’ and are so used to describing work, lives, or situations as being ‘stressful’, Hans Selye first came up with the term in the 1930’s. ‘Stress’ is actually only about 80 years old! He came up with a model to describe the biological effects of stress on the body when he introduced his General Adaptation Syndrome in 1936.

We’re all surrounded by varying degrees of stress and our bodies are designed to react to stress.  In its purist form this is where the ‘fight or flight’ reaction kicks in when we’re faced with danger. We’re designed to run away from danger or fight back if we can’t run. Unfortunately it’s rarely as straight forward as that. Modern day stresses are not about running away from a tiger they’re more about low grade persist stress in the face of things like a bullying boss, an abusive partner, or financial insecurities.

It’s fair to say that a lot of patients that find themselves coming in to see us at Mulberry Osteopaths with some form of physical crisis will also have an ongoing stress factor in their lives. Stress will highlight the weak spots and make the body more vulnerable to injury. There’s never a good time for an acute episode of low back pain but don’t be surprised if it hits at the worst possible time when you’re moving house, you’ve just lost your job, or there’s a family bereavement.

As osteopaths part of our job is to work physically to help you on the road to feeling better and feeling less old but we also try to give you ideas as to why things have gone in to a meltdown moment. Recognising the stress factors is part of that process as well as possibly offering some advice as to how to cope with the stresses.

Yoga or Pilates?

There may still be a few folk out there amongst you that haven’t yet got into the swing of things on the exercise front for the New Year. Delaying that trip to the gym or exercise studio may even be a wise move as by now those New Years resolution people will be starting to fall by the wayside so creating more space.

It’s also possible that you’re simply not sure what sort of exercise to go for. Whatever it is you choose it has to be enjoyable.  There is no way you’ll keep it up week after week if you really don’t want to be there.

As an osteopath I am very keen to get my patients involved in their own recovery and that will include not just specific prescribed exercises but also encouragement to start or restart general exercise. I’ll often be asked whether I’d recommend Yoga or Pilates.  If you ask Google the same question you’ll get numerous articles full of ‘useful’ information and celebrity advice. If you want to get confused take a look through these:

 http://www.oprah.com/omagazine/Is-Yoga-or-Pilates-Better-for-You

http://www.active.com/fitness/articles/yoga-vs-pilates-which-one-is-right-for-you

http://www.theguardian.com/lifeandstyle/2007/sep/29/healthandwellbeing.fitness

http://www.chopra.com/ccl/whats-the-difference-between-yoga-and-pilates

As a huge generalisation I’ll often suggest that if you need to improve your flexibility go for yoga whereas if you’re looking for more strength and stability opt for the Pilates.  Having said that there are plenty of toning and strengthening poses used in yoga and Pilates will also help with your flexibility.  The bottom line is that if you get a good teacher and they manage to provide a good combination of exercises you’ll end up being a bit more bendy and a bit stronger regardless of what you call the class. And this is where we come back to the need to enjoy the exercise. If you like and trust the teacher you’ll enjoy it more.

Why not try both, have a test run and see which you like best and stick to that? Of course it may also be the case that neither yoga or Pilates is your cup of tea in which case pick something else . . .running, cycling, dancing, hillwalking, tennis, swimming.  The list is endless and if you do nothing else think about breathing! If you do it properly even breathing is an exercise and there is never an excuse not to breath.

The Archaeology of Osteopathy

I often use the concept of an archaeological dig when I’m treating patients.  When a new patient arrives at clinic for the first time, tells you the story of what happened to them, what brought them to me and what the problem is the digging begins.

More often than not there are a few things in a patients past medical history, in some cases there’s a huge list of stuff, all of which is relevant on some level. One of my jobs as an osteopath is to figure out what is the new stuff and how to untangle it from the old stuff.

Backed up with clues from what the patient has told me and what I feel under my fingers I get a sense of which tensions are fairly fresh and those that have been around a long, long time. I get an idea of which joints are a bit stiff because of recent strain or injury and which haven’t been moving for years. Tensions are layered on older tensions and new injuries are layered on old injuries.

Getting an idea of what came first, how one old injury may have influenced a newer problem and which problem is freshest is important for a number of reasons.  For a start the newer stuff should be easier to resolve as it’s not so imbedded into the structure of the body and we can normally give an indication as to how soon we would expect to see a change in a condition with treatment.

However, whilst we’re on our archaeological dig through the tension layers in the body we’ll often uncover stuff that has been sitting quietly in the background unnoticed.  It may be an old injury that was never fully resolved or part of a postural pattern that’s been around for a long time.  Whilst this silent problem may have been happily minding it’s own business for years there’s a chance that osteopathic treatment may disturb it. If that’s the case, as a patient it’s as well to be warned that this might happen.  It’s all very well going along to have one problem treated only to find that it seems to trigger another problem.

Also if the old problem was in some way related to the newer injury then to avoid a recurrence the older archaeology has to be accessed.

Let it go, let it go

Those of you with children of a certain age will be well aware of the impact of the Disney film Frozen and how it has encouraged bursting in to song with ‘Let it go, let it go’. It’s scary to admit that it’s even had an impact on my osteopathy as I often seem to find the tune running through my head during treatment sessions!

It never fails to amaze me how much tension some folk can hold in their body and be totally unaware of it. I’ll sometimes try to trigger some awareness of this by asking a patient that is lying on my treatment table to relax fully whilst I lift an arm or leg in the air. I’ll then let go the limb and see what happens. Of course a nicely relaxed arm or leg will flop back to the table but it’s not unusual to find that many limbs stay exactly where I put them. As far as the patient on the treatment table is concerned they are completely relaxed despite the fact that their arm is amazingly suspended in mid-air as if held up with invisible puppet strings. This is when the Frozen tune filters it’s way into my head as I think ‘Let it go, let it go’.

Given that the patient in this situation is actively trying to relax, if that’s not a contradiction in terms, imagine what’s going on when they’re not relaxing.  I’m sure most of us have experienced the effect of shoulders rising up towards the ears after sitting in front of a computer, especially if there’s an element of stress thrown in to the mix.  There are many people whose heads are permanently sucked in towards their shoulders with no awareness that it’s happening.

In this situation often the first signs of awareness will be a stiff neck and even a headache and this is where the osteopath comes.  Stage one is to encourage the body to ‘let it go’ with some hands-on treatment.  Stage two has to involve some degree of encouragement to get the patient to ‘let it go’ mentally which has to involve becoming aware that it’s happening. Osteopaths can’t do this alone, it has to be a partnership with the patient to achieve lasting results.

So please forgive your osteopath if he or she starts humming a song from Frozen during a quiet part of your treatment.  You could argue that it’s a good sign that they’re focusing hard on one of the goals of the treatment.

You Know It’s Good For You

This time of year we have a recipe that comes out at home which we simply call ‘The Mixture’. It consists of crushed garlic bulbs (as many as you like), the juice of half a lemon, a dollop of good honey, all topped up with warm water. It has to mature over a couple of hours and then it’s ready to combat the coughs, colds, and snots.  This is essential weaponry against the lurgy, especially in a household that has kids all too keen to share their secretions. It tastes horrible but as it passes over the tongue and down the back of the throat you just know it’s good for you.

That’s sometimes what bodywork, including osteopathy, is like. When an experienced therapist hits one of those bits that’s really sore you know that it hurts but you also just know it’s good for you.  Those fingers and thumbs can become like guided missiles searching through the knots and tensions tracking down trigger points, tender points, problem spots.

That’s not to say that osteopathy should be painful.  I struggle with the idea of a ‘good pain’. If you’re on the receiving end of a treatment and you’re in pain I would say that the pain is telling you they should stop. There’s a difference between pain and discomfort, although when a therapists hits one of those good spots it can be a bit of a fine line. However, if I sense a patient is tensing up beneath my fingers I know I’ve crossed the line in to pain and I need to take the pressure off.

Most of the soft tissue work I do on patients is aimed at creating space around an area and encouraging the body to release or let go of whatever it is that’s being naturally protected. Pain or injury naturally makes us tense up to protect the area that has been damaged. When it’s appropriate to do so, releasing that protective spasm and tightness will aid recovery. However, inflicting more pain is not the way forward. Working just deep enough to encourage the tissues to release and let go is the aim.

Of course if tissues are encouraged to release and we create space it also means that everything that passes through those tissues will be less compressed. Now here’s how osteopathy can actually be seen to back up the work of ‘The Mixture’ mentioned above. If your head is full of mucous, be it a bad cold or an attack of sinusitis, having an osteopath work on your neck and upper back will effectively open up all the drainage pathways to allow for some of the sticky gunk to get away from the head.

Winter is a time of coughs and colds, it’s the time to brew up a batch of ‘The Mixture’ and it’s the time to visit an osteopath.  You’ll just know it’s good for you!

Osteopathy - Better than Diazepam

Here’s a quick reminder that osteopaths don’t just treat backs!

I had an interesting patient in recently who’s been coming along to Mulberry Osteopaths on and off for almost 10 years, so she’s pretty much aware of what osteopaths treat and how effective the treatment can be. We’ve treated her through the stresses and strains of motherhood, sporting injuries, and the effects of spending too long stuck at a desk for work. However, this time she came along with something a bit different from her usual problems.

Although I had treated her over the summer with a netball induced injury she didn’t think to mention at the time that she’d been having problems with tightness in her throat for a number of months. This eventually got to the point where she decided to see her GP who essentially decided that it was ‘just a muscular problem’ and probably ‘stress related’, so the way forward would be to prescribe diazepam.

Diazepam was prescribed quite commonly when I first started off in practice and it was often added to the prescription of pain killers for it’s muscle relaxant effects.  It still gets used now-a-days for low back problems associated with muscle spasm, but only for short periods because of the risk of getting hooked.

This particular patient wasn’t especially keen on the idea of taking diazepam but the mention of a ‘muscular problem’ made her think that maybe osteopathy could help.  Sure enough after a couple of treatments the problem that had been annoying her for about 8 months had more or less cleared. This just proves the fact that osteopathy is better than diazepam . . . at least in this case.  In this instance most of the tightness focused on a couple of muscles called the scalenes which run from the sides of the vertebrae within the neck and extend down to attach to the first couple of ribs. Not the most comfortable of muscle groups to be worked on but given that the treatment worked so well it was worth a bit of short term discomfort.

So I suppose one of the things to remember is to mention anything that is going on with your health when you are in for treatment.  It may well be that some osteopathic input can work even if you don’t necessarily think there’s a link.

Windy Back Pain

What’s the link between low back pain and a grumbly, windy gut? If you suffer from both have you even considered that the two might be linked? It could all be down to a tricky old muscle to treat called the iliopoas muscle.

Here’s the anatomy bit and you’ll have to use your imagination here as we’re talking about a muscle that isn’t visible on the surface because it lies deep within the abdomen. Don’t panic, I’ll keep it simple.  We have an iliopsoas muscle on both sides of the body and it runs from the front of the lumbar spine in the low back, underneath the intestines, then into the pelvis to eventually attach to the groin area.

Mechanically speaking it’s referred to as a hip flexor and if there are problems with this muscle it can lead to low back pain or hip pain.  However, it can also lead to a grumbling gut as a result of the muscle pushing forward into the intestine and generally compressing the passage of the gut. So this is why the achy back can also be accompanied by bloating and abdominal discomfort.

The other thing to bear in mind is that we have to think about this in a wholistic way by considering that whilst the iliopsoas might affect the gut the gut can also affect the iliopsoas.  If you have irritable bowel type symptoms this might in turn irritate the iliopsoas and cause it to spasm leading to an achy back.

Either way, from an osteopathic point of view we need to treat the muscle and the areas it attaches to. Given that it’s path is actually deep in the abdomen and beneath the gut you can appreciate that it’s not necessarily the easiest muscle to get to . . . Especially in those individuals with a touch of extra padding over the gut! However, it can still be worked on by working on the low back, pelvis and the hips.

It’s also good to find a stretch to reach the muscle to back up the osteopathic treatment to stop it from tightening up again.  This is where a nice deep hip flexor stretch is useful, especially in a kneeling lunge position. And you have to be prepared to hold the lunge for a while so as to get past the pull on the more superficial hip flexors like the quadriceps before it gets down to the iliopsoas.

So next time you’ve got a touch of wind along with your sore low back you might get the connection.

Yoga Holidays, airplane seats and squatting

I recently got back from a great yoga holiday in Spain.  Highly recommended and if you’re interested check out their website at www.yogabreaks.org.uk. Nothing too taxing, two sessions of yoga a day, lovely place, nice group of people and plenty of down time. What could be wrong with that? Nothing really, apart from having to cope with the joys of air travel to get there and back. Who exactly did they have in mind when they designed airplane seats? I’m not talking your top of the range business class comfy seats, I mean your standard Easy Jet seats which most of us use.

Where did they find a human that could sit comfortably in one of those seats? From what I can gather you have two choices.  Option one is to sit nice and upright with your low back pressing comfortably into the back of the seat so that the lumbar support fits in to the curve of your low back. Of course that means your head will be left unsupported by the head rest.  So you also have the option of sliding down the seat so that your head and neck get to rest on the head rest . . .but then your low back is left unsupported and your knees are jammed against the seat in front.  The choice is yours;achy low back or stiff neck and maybe bruised knees, or probably a combination of all of them.

In my 23 years of osteopathic practice I’m not sure I’ve come across anyone that would perfectly fit an Easy Jet or Ryan Air seat. I do however see lots and lots of people who’s problems are either associated with or aggravated by sitting on seats of some description. Office seats, whether or not they’re ergonomically fitted, ‘comfy’ sofas, car seats and of course seats on planes, all create business for osteopaths (and not forgetting physiotherapists and chiropractors).

Essentially the human body was not designed to sit on seats, especially for the length of time most of us spend sitting. We are better designed for squatting rather than sitting. Now, here’s a great health promoting challenge for you. Spend a few minutes each day squatting. Feet should be flat on the floor if you can, and if not work towards achieving it. It’s a great position to mobilise the hips, lengthen the low back, stretch the Achilles, and work all those core muscles. It’s great for the bowels too.  Who’s bright idea was it to design a toilet to sit on in the first place? Some things are best done squatting . . but that’s another story.

Give us a call after your next Easy Jet flight and we’ll sort out your back and neck issues and in the meantime happy squatting.

The Cheating Body

Why would anyone make life difficult for themselves if there is an obvious easy option? That’s pretty much the way the body thinks when you ask it to do a particular activity.  If you’ve always done something in a certain way the body learns that activity so the easy option is to simply repeat the movement it’s used to.

Take something straight forward like bending forward to pick something up from the floor.  If you were to perform this task ideally the spine would bend uniformly along its length, the pelvis would tilt with the movement and the hips would flex in to position.  Everything would do its job properly and your hands would reach the floor with no problem. Of course, whilst the movement was happening, all the supportive muscles would be working nicely to stabilise the body as it went in to its forward bend.  Abdominal muscles and pelvic floor muscles engaged and the big muscles along the back doing their bit to support the weight of the body as it rolls down to the floor.  That’s the most energy efficient way to do it.

So how many folk do I see that can actually do that? Probably nobody, even those that have invested years in to perfecting their Pilates or Yoga techniques will not be doing it perfectly.  Admittedly the people I see have generally come to me because the system has broken down in some way so they aren’t going to be moving at their best.  However, even when I get someone back to ‘normal’ I’m still not going to see perfection.

The body is designed to cheat which will mean that it will tend to opt for doing movements in the same way it has always done them.  If you’re the sort of person who has very flexible hips and can simply fold from the hips to put your hands flat on the floor without even bending the back why would you want to do it any other way? You can still do the movement, the hips and the muscles supporting the hips will do all the work and the back can pretty much not get involved. However, do that enough and the hips might start to complain about all the work they’re doing.  That’s the time to rethink your technique and get the spine woken up again . . . . if you can remember how to do that. 

As much as you try to get the whole thing working properly and more efficiently the default setting will be for the body to cheat again and over work the hips.  Breaking habits is hard work. An osteopaths work here is firstly to assess what’s gone wrong so that you know how you’ve been cheating.  Then, with hands on work, we can help you to prepare the body so that there’s a chance that you might be able to work the right areas and engage the correct muscles through work on the soft tissues and mobilisation of the affected joints.  However, that’s when the patient has to do some work by introducing the right exercises to effectively retrain the body to move more efficiently.  Not only the right exercises but also the right technique. That means hard work to get the exercise right because the body will still want to cheat and do it the old way.

However, it’s not all doom and gloom.  The good news is that the body is incredibly good at adapting. If one area isn’t working particularly well something else will work a bit harder to compensate.  Osteopaths are here to lend a helping hand if the compensatory mechanisms fall apart.

Do You Really Need an X-Ray?

Now, this may be a case of stating the obvious, but if you have back pain, neck spasm or a stiffened shoulder joint an X-ray will not solve the problem.  It might provide a bit more information about the problem but, by itself, it will not change anything.  The same is equally true of MRI scans, which will give a fantastic view of all the tissues involved, not just the bones, but again it’s not the cure.

Osteopathy is a very ‘hands on’ therapy.  We like to get our fingers and thumbs into the tissues to have a good poke around the joints and figure out what’s going on. Whilst we certainly get plenty of clues from a patient’s description of the symptoms, it’s our hands which really help us form the diagnosis and give us a picture of what’s happening.

Without an X-ray or a scan we already have a good idea as to what the problem might be, whether it’s a case of osteoarthritis, a worn out disc in the spine or a simple strain injury.  However, we will often get patients thinking that an X-ray or a scan is the way forward in their quest for answers.  More often than not the results of an X-ray or scan will not change the treatment plan. Indeed, because of the health and safety issues related to X-rays and the radiation doses involved doctors don’t request these examinations as often as they used to.

In the days when there were less restriction on X-rays I would often get patients arrive at the clinic with tales of ‘The X-ray says it’s arthritis’. I would have to carefully explain (not wanting to majorly disagree with the GP) that arthritis doesn’t happen overnight, it takes time to develop, so the fact that the pain has only been around for a couple of weeks probably means that it’s not all to do with the arthritic joint. Just because an X-ray shows a bit of arthritic wear and tear doesn’t mean that nothing can be done.  X-ray anyone over the age of 40 and you’ll find some arthritic changes somewhere but it doesn’t have to mean pain or disability.

Also, whilst MRI scans may in themselves be less of a radiation hazard than X-rays they are still often held in reserve unless surgery is a possibility and the surgeon wants a better understanding of what will be found during the surgery.

There are plenty of trials which suggest that MRI scans can almost provide too much information.  Research often concludes that if a completely healthy, symptom free bunch of people were to undergo MRI scans the results would indicate all sorts of ‘problems’. So with scan results we have to watch out for a host of red herrings that have little or nothing to do with the symptoms.

Of course, if there’s been some trauma, you’ve fallen out of a tree, been hit by a car, come off your mountain bike or something similar then A&E may well sensibly get you X-rayed to check for fractures and dislocations. However, if it’s not an obvious crash or collision don’t necessarily be in a rush to get to your GP to demand X-rays and scans.

There is no doubt that X-rays and scans have their place but it’s surprising what a good pair of hands, some sensitive fingers, a pokey couple of thumbs and some common sense can detect.