Respecting you – Your modesty matters

It is important that you feel comfortable during your osteopathic treatment, particularly around matters of modesty and privacy.

At the start of your first session we will ask questions about your medical history and lifestyle as well as your symptoms. This is very important as it will help us to make an accurate diagnosis and suggest appropriate treatment. This information is kept confidential in conjunction with the Data Protection Act 1998.
We will need to examine the area(s) of your body causing discomfort. Sometimes the cause of the problem may be in a different area to the pain, (for example, a difference in leg length may result in compensations in the upper back which might result in neck pain) so we may need to examine your whole body.

We will need to feel for tightness in the muscles and stiffness in the joints and may need to touch these areas to identify problems. We will explain this as we go along, but if you are uncomfortable with any part of this then let us know, we can discuss this with you or stop if you prefer.

As with a visit to a GP or other medical professional, for us to examine you effectively it may be necessary for your them to ask you to remove some clothing as appropriate for the condition. This may mean undressing down to your underwear. If this is a problem for you then let us know and we will try to make arrangements that make you more comfortable.

You are also welcome to bring someone with you for all or part of your consultation, and children should always be accompanied by a parent or guardian.

Remember, if you have any questions we will be happy to discuss this with you.

Rehab My Patient

I’ve always given my patients exercises to do and as a patient myself I’ve always been given many over the years for different injuries.

It’s important not to give patients too many at once and explain exercises well, otherwise they won’t remember them and will be overloaded with information. It is important to explain to patients why they should do them and how they can help them improve their symptoms and pain. There should always be a reason why you are doing the exercise.

I’ve found patients are much more compliant if I have explained stretches well or attempted to draw pictures for them – drawing not my strong point! I like patients to help themselves and play a part in their recovery. Most patients are prepared to do the most they can in order to get better and I always encourage patients to play an active part in their treatment and recovery.

I have started to use an online exercise prescribing software called Rehab My Patient. It enables me to create specific exercise programmes for patients suited to their needs and recovery. It has a whole host of exercises for stretching, flexibility, strength, mobility work and rehab for all areas of the body. There are easy to understand descriptions, pictures and videos so patients know exactly what to do. I’m able to set the number of sets, repetitions and how long stretches should be held for and I can continually update programmes and add or remove exercises accordingly. Patients are able to log in to view their exercises online or save, download and print a PDF. I’ve been using Rehab my Patient for about a month and have already set many programmes for patients alongside their osteopathy treatment in order to provide them with a holistic treatment plan. I hope to continue to explore all the different exercises available to patients – there’s over 2000 so I think there are plenty more useful ones to look at and learn. It’s extremely convenient to use with an excelled app for iPhone or iPad and a very user friendly website.

Visit www.rehabmypatient.com for more information

 

#throwback to…The Jonathan Betser Legacy Project

Throwback to London 2012…

During July and August 2012 I volunteered at the Massage Centre in the media centre at the Olympic Park, Stratford providing massage to the world’s media and press before, during and after both the Olympics and Paralympics.

The massage centre for the media was a concept of LOCOG and Jonathan Betser, who was the Lead Osteopath for the 2002 Commonwealth Games and one of the top 10 Osteopaths in the country, Jonathan wanted to bring Osteopathy and Sports Massage to the media’s eye. Jonathan sadly passed away in 2011 and his friends and professional colleagues have brought the project together, now named the Jonathan Betser Legacy Project.

There were over 110 volunteers, plus staff involved. It was a donation based project and some of the proceeds were donated to the Isabel Hospice in Welwyn Garden City, where Jonathan spent his last days.

Most of the volunteers were student Osteopaths and Sports Massage Therapists from the surrounding counties to London, but some volunteers travelled from around the country too, volunteers were observed by Lead Therapists in Osteopathy, Physiotherpy and Sports Massage.

We  received great support from the BOA (British Osteopathic Association) and SMA (Sports Massage Association), whilst also assisted by local Osteopathic and Sports Massage colleges, BSO, ESO, LSO, BCOM, Oxford Brookes, College of Osteopaths and NLSSM.

We were also very pleased to have been able to use designer furniture courtesy of ByAlex for the massage centre.

Everyone worked together tremedously well in a great team effort, the atmosphere was electric, we were so thankful to the media in making donations of over £20,000 and almost taking in 3000 appointments during the Olympic Games (not including the Paralympic Games!)

Are you tired all the time?

Do you commonly report feeling excessively tired and lacking in energy? Fatigue as a concept is extremely hard to define as everybody has their own idea of what being tired means. Everybody experiences tiredness once in a while and the most common reason is lack of sleep however there can be a number of reasons and some obvious or not so obvious ones are as follows.

SLEEP

It is obvious that getting too little sleep will make you tired; most of us have experience of this! A minimum of 7 hours sleep is required every night for most adults in order for their body to rest and gain the benefits of deep sleep which allows the body rebuild and restore cellular health.

People with irregular sleep patterns are more likely to be tired than those who regularly get only 6 hours sleep per night. Most tiredness is seen in those who sleep around 6.5 hours night Monday to Friday but then sleep in at the weekend as this upsets your body clock resulting in a worse sleep pattern.

A study has found that those who had a minimum of 1.5 hours of sleep before midnight had significantly higher concentration levels throughout the day than those who did not.

TOO MUCH CAFFEINE

Small amounts of caffeine may help you feel more alert but too much can raise your blood pressure and increase your heart rate. In turn your body is constantly ‘ready to go’ and buzzed up causing your muscles and organs to fatigue without any physical demands actually being placed on them. Caffeine can make you more anxious however if you are to completely cut out caffeine you may show signs of an addictive withdrawal.

DEHYDRATION

Your body needs water to function. It is the body’s principal chemical component and makes up about 60% of your body weight. Without it you are putting extra pressure on your body which causes it to simply fatigue. Every cell and system in your body depends on water and cannot perform at their optimum without it; from concentrating and working to performing essential life functions such as digestion, flushing toxins out of vital organs and carrying nutrients to your cells; it is important to remain hydrated.

The amount of water you need varies from person to person and depends on size, diet, climate and activity levels. However the Institure of Medicine determine than an adequate intake for men is roughly 3 litres (13 cups) of total beverages a day and for women 2.2 litres a day. It is important to drink little and often to keep hydration levels up, don’t drink it all at once!

A study asked those drinking less than 1 litre of water per day to increase this to 2 litres per day for 3 weeks, at the end over 84% felt their tiredness had significantly reduced.

UNDIAGNOSED MEDICAL CONDITION

Diabetes: Causes abnormally high levels of sugar in the bloodstream as the body doesn’t make enough insulin or it can’t use it as well as it should be able to; insulin helps glucose get into the cells and convert to energy. In diabetes this doesn’t happen and can result in you feeling excessively tired as your cells don’t have enough ‘food’, despite eating enough. Diabetes can be checked easily by your GP with a blood test.

Hypothyroidism: When your thyroid gland (located in your neck) becomes underactive characterised by low thyroid hormone production. The results are tiredness and fatigue, weight gain, feeling sluggish, decreased concentration and excessive sleepiness. A blood test is needed to confirm the diagnosis.

Low grade Urinary Tract Infection (UTI): Most people are fully aware when they have a UTI due to the sense of urgency to urinate and a burning pain! However if the UTI is in early stages or is of a low grade then fatigue and a light increase in the need to urinate may be the only signs and in the long term this can result in increased levels of tiredness as the body is trying to fight infection. A urine check by the GP will confirm this.

FOOD

Food intolerances have been found to make people sleepy as this is the body’s reaction to a food it does not like or finds difficult to process. A lot of people still eat food which their body maybe intolerable to and according to Allergy UK up to 45% of the population suffer from food intolerances.

It is easy to assess your own intolerances by writing down what you eat for 2 weeks and also making a note of when you feel particularly tired or sleepy or unable to concentrate. You may spot a pattern, then simply eat those individual parts of those meals and see what happens; try taking them out of your diet and see if there is an improvement. Often people are just eating too much of the same food so their bodies are overloaded and once the food had been eliminated from the diet for 6-8 weeks it could be reintroduced in small amount with no problems.

A study found that those eating ready-meals more than 3 times a week are 6 times more likely so suffer from tiredness than those who eat less ready-meals; they also consume between 15-36% more calories than the same type of meals but home-cooked! Eating a health, balanced diet is important for maintaining good health and can help you feel better.

LACK OF EXERCISE

With the pressures of home and family life it can often feel like there is little time to fit in exercise; it’s certainly tough to get started but once into a routine you will definitely feel the benefits.

Exercise makes you feel more energetic whilst sitting around not doing much makes you feel sluggish and unable to do anything. It improves your sleep as your mind and body feel like they have actually done something and are ready for rest at night. Reduced activity over a period of time can slow down your metabolic rate and unbalances your hormone system so you increase in weight whereas exercise can help keep you at a healthy weight. A lack of exercise causes you whole body to ‘shut down’ making you tired, lethargic and unable to concentrate.

HOW TO HELP YOURSELF…

If you are tired, give this programme a go for 4 weeks and see what happens! A study that involved 44 participants who were re-evaluated after 4 weeks found that their tiredness and lack of energy scores had reduced by an average of 78%.

1. Get into a regular sleep pattern. Try and get to bed before 10.30pm every evening and get up no earlier than 6.30am but no later than 8.30am

2. Drink a minimum of 1.5-2 litres of water every day

3. Drink no more than 2 measures of caffeine per day

4. Plan your meals at the start of the week, aiming not to repeat meals and to have lots of variety with fresh fruit and vegetables

5. Do a 30 minute (minimum) walk every day, preferably in daylight

Daylight is the best way to control the hormone melatonin which regulates our sleep/wake patterns in response to daylight hours. With the clocks having gone forward it is much easier to do this but take care in the winter if you go to work and come home in the dark and don’t get outside during the day.

Ouch! What to do when you sustain an injury

Sprains and strains to muscles and joints happen to all of us and for most they are a painful, but temporary, reminder to be a little more careful. Prompt action can help your body to heal faster and may prevent further injury or prolonged pain.

Strained or ‘pulled’ muscles often happen when we over exert untrained muscles, train without properly warming up or try to go beyond a joint’s natural flexibility. Sometimes we feel the pain straight away, however some injuries might not cause pain until later on. What can you do?

Remember RICE (Relative rest, Ice, Compression and Elevation), using these can help to relieve the pain and start the healing process.

Relative rest: The first thing to do if you feel pain is to reduce the offending activity – pain is usually your body’s way of telling you that there is something wrong that needs your attention. It can be normal to feel a little sore after exercises for a day or two, but if it is more that this, pushing through the pain is rarely beneficial.

However, movement stimulates the healing process so stay as mobile as you comfortably can. Try to keep the joint moving through a comfortable range of motion, without forcing it to the point of pain. This will help to encourage blood flow and keep your joint flexible whilst it heals. This is particularly relevant for back pain as gentle exercise, such as walking, can help. You should slowly build your activity levels up as soon as your symptoms begin to resolve and as soon as you are able.

Ice: Cooling the area using an ice pack can help to reduce swelling and pain. Wrap a thin tea towel around the area so as to avoid direct skin contact and then apply the pack to the injured area for 10-15 minutes. You should repeat this several times per day for the first 72 hours. This will help to control inflammation, making it easier for your body to get blood and nutrients to the area and resolve the injured tissues.

Compression: Gently appling a compression dressing may help to temporarily support the injured joint and reduce swelling, though remove this immediately if there are signs that this is reducing circulation to the area (numbness, pins and needles, the skin turning white or blue etc).

Elevation: If the injury is in the lower limb (knee or ankle), elevating the area a little can make it easier for your body to drain fluids that might accumulate around the area, causing swelling. For example, if you’ve hurt your knee, sitting down with the knee raised on a low foot stool may ease your pain.

Seek medical attention: If you have pain that can’t be controlled with over the counter painkillers, can’t put weight on the injured limb, experience paralysis or loss of sensation or the swelling is very bad seek help from your local A&E department, urgent care centre or telephone 111 for advice.

If the pain or swelling fails to improve within a week, a visit to an osteopath may be beneficial. They will be able to assess the injury, advise you on the correct treatment and can provide some manual therapy which may help it get better faster.

Why women should do weights

Osteoporosis is a condition that makes bones more brittle and prone to fracture. Although osteoporosis can effect men and younger people, post-menopausal women are most at risk. One of the best ways to help maintain healthy bones is to exercise regularly – which encourages the bones to absorb calcium and other mineral salts that keep bones strong.

Weight bearing exercises and weight resisted exercises are best for strengthening bones and muscles and as well as helping to keep bones in good health may also reduce the likelihood of falls as you age. Weight bearing exercises are those where your body is supporting its own weight, such as walking or housework or carrying groceries. Weight resisted exercise involves pushing or pulling against an additional weight, like a dumbbell or barbell or resistance equipment in a gym.

The younger you start, the better

Anyone can benefit from weight training but it has been demonstrated that younger women who trained using weights have stronger bones later in life, this essentially means that you can bank bone when you’re younger to help prevent fractures later in life – a kind of insurance scheme for your body. A life time of active living not only protects your bones but also keeps your heart healthy and may protect you from other diseases such as cancer and type two diabetes.

But starting at any age will help

Everyone can benefit from increasing their activity levels. Studies have shown that people who have already been diagnosed with osteoporosis can improve their bone health significantly through weight bearing exercising, the key is getting good advice on how to move well and how to self-manage.

Some more benefits

Strong muscles burn more calories, so if you need to control your bodyweight, lifting weights can help. It also helps with balance and can help you to regulate your sleep patterns.

‘I don’t want to look muscled’

It takes women a lot of heavy weight lifting, and sometimes the use of controlled substances like steroids and hormones, to achieve the physique of the heavily muscled power lifter. Women don’t normally have enough testosterone in their bodies to develop bulging muscles, but can, with regular, moderate training achieve lean, toned and strong muscles.

‘I hate gyms’

No problem. There are plenty of other exercises you can do that don’t involve a visit to the gym. Dancing, yoga, tennis, Pilates, walking, running, gardening and even housework count – all you are aiming to do is increase your heart rate and make yourself feel a little warmer. You can do it in several short blocks of 15 minutes or more but aim for at least a total of 150 minutes per week over at least 5 days per week for the best results. If you’re unused to exercise, start slowly and build up to this target.

I don’t know where to start

This is where your friendly local osteopath can help. They can screen you for any health concerns that might affect your ability to exercise, help to resolve any injuries or pain that might be holding you back and advise you on what exercises might suit your goals best. Many can teach you how to exercise correctly, avoiding injuries and how to gradually build up as your ability and fitness levels improve.

Osteoporosis Awareness and Prevention Month – May 2016

It is estimated that around 3 million people in the UK have osteoporosis. Osteoporosis is a condition in which the usually strong support struts that make up the inside of most bones becomes thinner, which can lead to bones becoming fragile and breaking easily, resulting in pain and disability.

In the UK, one in two women and one in five men over the age of 50 will fracture a bone, mainly due to poor bone health. But osteoporosis is often a silent condition, giving no pain or other symptoms to alert you to the fact until the worst happens and a bone breaks. As such, many people living with osteoporosis are unaware that they have fragile bones until this happens, sometimes with devastating consequences. Indeed an alarming new study published by the International Osteoporosis Foundation suggested that 37% of men that sustain an osteoporosis related hip fracture will die in the first year following the break.

Those that smoke or drink in excess of the recommended daily alcohol intake are at greater risk, but gender, genetics, age, race and low body weight are all contributing factors.

However, it’s not all doom and gloom. There is a lot you can do to prevent the condition, and to reduce your chance of breaking a bone if you do get it. Your local osteopath can screen you for the condition using a special online screening tool called the FRAX questionnaire and can give you dietary, exercise and lifestyle advice to help manage your risk factors to reduce the impact of the condition on your lifestyle.

To find out more about the prevention, diagnosis and treatment of osteoporosis, contact the National Osteoporosis Society via their confidential helpline (0808 800 0035) or by visiting their website at: www.nos.org.uk

What to expect at your first appointment

You’ve booked an appointment with the osteopath – good start! Attending your first appointment can be a little disconcerting to begin with, especially if you have no experience with manual therapy. Below will explain exactly what to expect and answer some of the questions you might have. If you have any other concerns, contact your osteopath prior to attending your first appointment.

At the start of your first session, your osteopath will ask you to tell them about your problem. They will ask questions about your medical history and lifestyle as well as your symptoms. This is very important as it will help them to make an accurate diagnosis and suggest appropriate treatment. They will right down what you say in your records. These will be kept confidential in compliance with the Data Protection Act 1998. If you wish, you may ask for a copy of these notes, an administration fee may be charged for this.

The osteopath will need to examine the area(s) of your body causing discomfort. Sometimes the cause of the problem may be in a different area to the pain, (for example, a difference in leg length may result in compensations in the upper back which might result in neck pain) so they may need to examine your whole body.

They will need to feel for tightness in the muscles and stiffness in the joints and may need to touch these areas to identify problems. They will explain what they are doing as they go along. If you are uncomfortable with any part of this, you have the right to ask them to stop at any stage without prejudicing your future treatment.

In order to examine you effectively, it may be necessary for your osteopath to ask you to remove some clothing as appropriate for the condition, which might mean undressing down to your underwear. If this is a problem for you, make your osteopath aware of this, and discuss whether it might be appropriate for them to treat you while you wear shorts and a t-shirt.

The osteopath will suggest a course of treatment, which may require several visits. They may be able to give you an estimate of how often they need to see you and any associated costs by the end of the first session. They will ask for your permission to provide treatment and you may be asked to sign a consent form.

Most osteopaths will begin your treatment at your first appointment, but sometimes they may require further tests first i.e. blood tests or scans. Occasionally they may diagnose an illness that they are unable to treat and may suggest that you consult your GP or another appropriate health professional.

You may experience mild discomfort with some of the treatment techniques used, but osteopathic treatment if usually a very gentle process. Your osteopath will let you know if any discomfort is likely and it can be helpful to let them know what you are feeling. If pain persists after treatment, contact your osteopath for advice.

You are welcome to bring someone with you for all of part of your consultation. Children should always be accompanied by a parent of guardian.

If you have any other questions, ask your Osteopath!

 

Your osteopath – referring to other health care professionals

As a primary healthcare professional osteopaths, in addition to their osteopathic skills, have been trained to undertake detailed medical histories and a comprehensive range of clinicalexaminations in an effort to diagnose the cause of your symptoms.

It is due to this extensive training that we are able to determine if you may need to be referred on for further tests to determine an accurate diagnosis, or if your condition may require the intervention of another health professional.

When this happens we can write to your GP outlining their findings and requesting further investigations or referral to an appropriate consultant.

In addition to referring to your GP, many osteopaths know their local medical community well, so are well placed to recommend treatment from other health professionals who are able to treat specific conditions, or even another osteopath with specialist knowledge of the condition.

Before we make any referral, we will discuss with you the diagnosis and explain why you feel you might need help from someone else.

If you are happy to be referred we will ask your permission to write to the person we are referring you to with details of your case notes and any other information from the examination that they feel might help the clinician to treat you most effectively. This may help you to get better or faster treatment because the next person to see you won’t be starting from scratch and will have the benefit of another expert’s insight into your condition. If you prefer, you can ask for a copy of your notes to take to your GP or another doctor. If you are referred, do keep your osteopath informed about your ongoing treatment, and feel free to continue to consult him or her about any other aches and pains you’re experiencing.

Back Pain and Children

The 5th to the 11th October is national BackCare Awareness Week, which this year focuses on back pain experienced by children.

Like adults, children can suffer from back pain as a result of a variety of lifestyle activities. And like adults, there are number of things that parents and carers can do to prevent issues arising.

If your child does complain of back pain, it is important to seek advice from qualified professional, such as an osteopath. An osteopath will help to establish the cause of the problem and will provide advice on treatment, or refer you for further examinations if required.

Good school bags

Children are often required to carry bags full of books, PE kits, musical instruments and other equipment to and from school. Parents should try to limit the weight of school bags as much as possible and invest in a good quality back pack that the child should wear across both shoulders, ideally with a strap across the chest to keep the load close the their body. Packing the bag with the heaviest items (such as laptops and heavy books) closest to child’s body, will also make carrying more comfortable and less likely to strain the muscles of the back.

Limit screen time

Looking down to use smart phones, tablets and laptops for an extended period can pull the back and neck into an unnatural posture, resulting in pain. Placing limits on the time spent using devices and encouraging regular breaks may help to avoid problems. If your child has to use a laptop for homework, consider purchasing a support that elevates the screen to a height that allows him or her to sit up straight to look at it.

Regular exercise

A sedentary lifestyle is known to contribute to the risk of developing back pain, as well as contributing to obesity. Regular physical activity helps to keep the core muscles that support the spine strong and maintain flexibility, which will help to avoid back pain. Encourage lots of active play, walking, running, swimming, cycling etc to keep your child fit and healthy.

The right bed and pillow

Good quality sleep is vital for both physical and mental development. Make sure that your child has a good sized comfortable bed with a firm mattress and a pillow that supports their head without lifting it too high.

Osteopathic Treatment for your child’s back pain

Your child’s back pain may benefit from osteopathic treatment. Using gentle manual therapy an osteopath will help to resolve any stresses and strains that are affecting their body and relieve their pain. They can also provide lifestyle advice that may help to prevent the problem from coming back.