Covid 19 and The Immune System

There really is no one diet, supplement or exercise regime that can boost your immune system, the network of cells, tissues and organs that band together to defend your body against anything with the power to make you sick. The list is long and includes bacteria, viruses, environmental triggers, some natural and some man made. Your immune system is always working hard, whether it’s reacting to something floating in the air like dust and pollen, or offering protection from a virus. 

The COVID 19 pandemic has high lightened how important it is to be the healthiest version possible of ourselves and there are definitely some healthy living habits that can help to fine–tune your immunity.

THE IMMUNE SYSTEM AND YOUR GUT:

The human immune system holds the catalogue of millions of different potential trigger molecules or antigens. Access to this huge library is built into every gland and cell involved in immune function, so that they can produce what is needed to combat these threats. Scientists are becoming increasingly aware of how much your gut microbiome is involved in the process.

Microbiome refers to the bug and their genes. Your microbiome impacts your physiology, both in health and in disease, and it contributes to the enhancement or impairment of your immune function. Alteration in your gut’s microbial communities plays a major role in the risk of you getting a certain disease. These alterations are known as “Dysbiosis” a term that used to be the sole property of alternative and complementary practitioners until doctors discovered that it really is “a thing”.    

The immune system is pretty homogeneous in nature, alas it may react in different ways according to the individual, their lifestyle, their diet and genetic predisposition.

We do know that your immune system cannot fight off every invader, as very sadly has been the case for so many people with Corona Virus. But we also know that your gut microbiota is involved in the secretion of antimicrobial peptides that have been seen to enhance antiviral immunity by increasing the number and function of immune cells, improving symptoms related to a compromised immune system and stimulating production of signalling proteins, e.g. interferons, made and released by immune cells in response to the presence of viruses such as COVID 19. In turn respiratory viruses are known to influence bacterial composition in the lungs and intestine.

WHAT’S THE MORAL OF THE STORY 

Your immune system will never win all the games but keeping track of changes in your microbiota during theses COVID 19 times is more important than ever before, particularly knowing about the diversity of your gut bugs and the stability of this diversity.

Knee pain and Osteopathy

Osteopaths don’t just treat back pain, and you may be surprised to know that 35 % of my patients come to the clinic for symptoms related to the knee. Patients suffering from knee pain tend to either consult an Osteopath or Physio, rather than conventional medical help.

A survey from a Rheumatology article where individuals with knee pain were identified through postal questionnaires of patients aged 50 and over from two GP practices in southeast London. In this sample nearly half of those who reported knee pain had not seen their GP and were self-managing their condition. A mixture of physical, social and psychological factors predicted visits to GPs and rates of referral to secondary care.

Did you know your knee is the largest joint in the body?

It is a major weight-bearing joint and is one of the most frequently injured joints in the human body. Knee pain can have several different causes and can be painful and debilitating, and although some conditions may require surgery, many can be helped with the right advice, exercise and treatment.

The knee joint lies between the femur and tibia and at the front are the patella or kneecap. It is made up of many structures including ligaments, muscles, capsule, synovial membrane and two ‘c’ shaped pieces of cartilage which sit between the femur and tibia known as the menisci.

What Causes Knee Pain

Common symptoms in the knee include pain, stiffness, aching, pain, locking, swelling, limping and difficulty fully straightening or bending the knee.

Here are some of the more common knee problems:

• Referral pain – knee pain may be a result of the compression of the nerves supplying the knee at various levels down its course from the low back. It may also be referred from trigger points in muscles further up or down the leg or the pelvic area.

• Osteoarthritis - This can happen as we age, and natural wear and tear happen to the knee. Symptoms may include aching in the knee area or painful after certain activities such as climbing stairs, walking long distances or stiffness present mainly in the mornings or after rest. Pain may be experienced within the joint, all around it or in one place.

  There are many causes for osteoarthritis of the knee, often worsened with mechanical issues with the pelvis and indeed the foot / ankle can have the same effect resulting in more pressure being put onto one knee than the other or it may be due to secondary to osteoarthritis of the the respective areas discussed.

• Sports Injuries – Repetitive pain due to running and jumping. Ligament tears commonly cruciate ligaments tears which are found in the knee joint. Tears can occur with repetitive training or strain or not balancing your weight while training and putting too much pressure onto the knee joint. Damage to the joint capsule and the ligaments on the inside and the outside of the knee are also common.

• Meniscal/cartilage tears – the meniscus/cartilage is found lining the ends of the tibia and femur (shin and thigh bones that meet in the knee). Damage often occurs to these structures when the knee is over-rotated.

• Biomechanical issues such as kneecap lateral tracking (moving towards the outside) - occurs as a result of many problems including dropping of the foot arches, knock knees, lack of tone of the quad muscles nearer the inside of the leg. Sometimes it’s a result of different length in the legs or pelvic torsions.

  How can an Osteopath help with knee pain?

  Osteopathy is based on the principle that the wellbeing of an individual depends on their bones, muscles, ligaments and connective tissue functioning smoothly together.

  Osteopaths use physical manipulation, stretching and massage with the aim of:

• increasing the mobility of joints

• Relieving any muscle tension

• Enhancing the blood supply to tissues

• Helping the body to heal naturally.

• We are also very proud to have laser therapy, interferential, ultra sound and shockwave that also helps us manage our patients pains and symptoms.

  We use a range of techniques, but not drugs or surgery, if we feel a patient needs further treatment or surgery, we will refer them to a GP or Orthopaedic Surgeon.

• Check our our Instagram page for exercise tips and advice related to knee pain.

Source: Institute of Osteopathy and NHS.

Pilates Strengthening Exercises for Skiing

Get Strong for the Slopes

There are some things that you can’t control on the ski slopes. Things like the weather, visibility, how much snow there is, or other skiers! But thankfully you can control your own preparation with a pre-ski strength programme to ensure you feel strong, confident and have fun.

3 major muscle groups that you should strengthen before hitting the slopes are:

1)    Quadriceps– These help you cope with the demands of the speedy downhill forces, the bends and the slaloms.

2)    Glutes– These will help stabilise your pelvis and legs, and keep you balanced on your skis.

3)    Abdominals– Will help with balance, posture, and prevent back ache after a long day of physical acitivty.

Pilates can help train all of the above muscle groups, using a variety of matwork exercises, the Reformer, and here at The Osteopathic Clinic Croydon, the CoreAlign. By starting a strengthening programme before your ski trip, you will be strengthening your core, improving your posture and building endurance in your legs, all of which will help you once you are in the mountains!

You can try these exercises at home which focus on leg and core strength:

Clams

Strengthens the glute medius muscle, a vital postural muscle during running.

Side lying, knees bent with hips and feet stacked. On the exhale lift the top knee and return it on the inhale. Imagine your hand is in the “back pocket of your jeans” to feel the glutes are working.

Keep the feet on the floor for the first set of 10 and then lift the feet for the second set of 10

Shoulder Bridge Exercise

Lie supine with knees bent and feet hip width apart. To find this foot position start with your feet together, take the toes out then bring the heels out in line with toes

Imagine rolling the pelvis backwards as if tipping water out the back of a bucket, squeeze the glutes, and on the exhale lift each spinal segment off the floor until resting on shoulder blades.

Keep your rib cage flat (no flaring) and body in a straight line. Inhale and hold this position at the top, then exhale and roll the spine back down, segment by segment until tail bone is back down. Repeat this 10 times.

Variations include lifting one heel off the floor at a time once in the bridge position (image 3), and also extending one leg out straight Ensure you are activating the glutes to keep the pelvis level during these variations.

Single Leg Ball Squats

Start standing with a small ball/cushion/towel tucked into the knee joint closest to the wall. Bend that knee and lift the foot off the ground. Engage the core, and perform a mini squat, keep chest lifted.

Think about “sitting back in a chair” as you squat as this keeps the knees aligned over the ankle joint. You should be able to see your foot during the move.

At the bottom, squeeze and initiate the return with the glutes. Repeat 10 timeson each leg.

Or book a session in the Pilates studio for a specifically tailored strengthening programme using the equipment.  In particular the CoreAlign is a great way to increase your strength in a fun, ski specific functional way.

Glute and Core Exercises on the CoreAlign:

Pilates helped Joseph Pilates enjoy his time on the slopes, so book an appointment today and start your pre-ski preparation! 

Contact The Osteopathic Clinic on 020 8662 1155 for appointment availability.

Written by Rhea Malkin BSc (Hons) Sports Therapist and STOTT/APPI Pilates Instructor.

Why We Experience Hip Pain

Are you struggling with Hip pain?

Osteopaths are presented with patients with localised pain in the hip, but the source could be multifold, for example. 

 1. The patient could be sporty and directly damage or overuse the hip joint.

2. The patient could be pregnant and have what is called Pelvic Girdle pain

3. The patient could have symptoms relating to Osteoarthritis 

4. The patients hip pain may be referred pain from the lumbar spine or sacroiliac joint 

5. The patient often is presented with hip bursitis.

 The Role of the Osteopath

The role of the osteopath is to diagnose what’s wrong and what can be done. Often MRI’s and blood work is needed to get to answers, and indeed we work closely with our local orthopaedics who regularly send us their patients.

Osteopaths cannot cure Osteoarthritis 

Osteopaths cannot cure Osteoarthritis; this point must be clearly understood. However, this can be helped gently stretching/mobilising the hip joint itself and also massaging the hip muscles. Exercises are also given and we also refer to our Clinical Pilates studio for comprehensive help when a course of rehabilitation is needed. We also may need the help of our resident Nutritionist Dr Zeeba if we clinically feel this is correct.

 The osteopaths at the Osteopathic Clinic Croydon also use the following to help our patients hip pain if needed, 

1. Dry needling 

2. Laser therapy nice new word ‘Photobiomodulation.’

3. Interferential Therapy 

4. Ultrasound 

5. Shockwave Therapy 

Exercises for Hip pain.

I often share simple exercises on my Instagram page.

This exercise is a simple functional warm up to get those hip rotators switched on. This is very helpful for lower back pain, hip pain and knee pain. I’m using a  strong loop.

I would suggest 5 of each and repeat 3 times.

Challenging your bridge exercise

Click for Bridge Exercise

1. Always neutral small ball to help align, link abductors and pelvic floor
2.Maintain length at all times -aim knee to wall / ceiling meet.
3. Shift pelvis laterally R&L, no loss of height - hang on to your deeper stabilisers of spine
4. Add in a rotation of the pelvis / lumbar spine.
5. Challenge all these with heels off the ground.
A must is the length of thigh and effective core recruitment ( no tucking under! )
Suggest 5 at a time, usual all about control

Pilates Exercise for the Hip

Martine demonstrating how we work the area of your hip called the ‘posterior chain’ on the Pilates Trapez Table.

Written By Paul Morrissey

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Deep Tissue Massage Versus Spa Massage

How Deep Tissue Massage Benefits to the body

Deep Tissue massage is so beneficial if you have experienced any stress on the body, strain or injury because that is the only way to get to the root of the problem. It is embedded deep under the surface where adhesions develop, causing pain and rigidity in muscles, tendons and ligaments. If left untreated adhesions to obstruct circulation in the affected areas to limit the blood flow, which leads to the pain, restricted movement and can lead to inflammation.

How Deep Tissue Massage works

If you apply firm pressure to the muscles, the Deep Tissue massage aims to break down those troublesome adhesions to restore proper blood circulation and full movement and heal the inflamed tissues. The therapists performing the Deep Tissue massage may use fingertips, knuckles, hands, elbows and forearms during the therapy session and alternate them during the various stages. Clients are sometimes asked to take in deep breaths as the therapist dig deeply into a particularly tense area.

What Symptoms can Deep Tissue Massage support?

• Chronic or acute pains

• Diminished mobility or limited range of motion.

• Healing areas after traumas or injuries caused by falls, sports injuries, whiplashes from car accidents, and so on.

• Strains from repetitive motion such as the carpal tunnel syndrome.

• Pains due to incorrect posturing of the body.

• Pains from osteoarthritis. 

• Fibromyalgia. Statistics have shown that Deep Tissue massage is more successful in easing symptoms of Fibromyalgia than any other available curative remedy.

• Muscle tension, contractions or spasms.

 To flush out metabolic waste from the massaged tissues, clients should drink plenty of water after the Deep Tissue massage therapy and enjoy the fact that they are as good as new again.

 When Deep Tissue Massage is not suitable

Deep Tissue massage is somewhat intense, and in some cases, it should not be used if you have the the following:

• Infectious skin disease, rashes, bruises, inflamed skin, tumours or open and unhealed wounds.

• Immediately or soon after surgery or if you have had a recent fracture.

• Osteoporosis patients, unless approved by your doctor.

• Clients who are prone to blood clots. Heart disease patients, unless recommended by their doctor.

• If you suffer from an abdominal hernia.

  The good news is that Deep Tissue massage really works, and you tend to experience the results very quickly. Often, clients will walk into a session with excruciating pain and walk out a couple of hours later with smiles of relief on their faces. However, depending on your tolerance level to pain, most clients experience it to one degree or another at a certain point during the session. Also, there is usually some measure of soreness immediately after the treatment.  

After a Deep Tissue Massage Treatment

Although, the pain of the Deep Tissue massage therapy and the lingering soreness afterwards is nothing compared to the pain before the treatment, and it comes with the knowledge that it will all be over very shortly.

Paulo, our Massage Therapist, may suggest applying an icepack to the sore area, but it is rarely severe enough to warrant it. To flush out metabolic waste from the massaged tissues, clients should drink plenty of water after the Deep Tissue massage therapy.

Spa Massage / Swedish massage

If you are looking for a more relaxing style of massage, then a Spa or Swedish massage is the most popular massage, and it's much more gentle. Since it started the early part of the 19th century, it has become one of the most widely used massage techniques, and it is the basis for several other massage therapies which include the Sports Massage, the Deep Tissue Massage and the Aromatherapy.

The massage involves long strokes of muscles and tissues with light or medium pressure. Spa massage is for pure relaxation and the therapist adjusts pressure to the individual preference and sensitivity.

The Benefits of a Spa Massage

There are many benefits related to massage and here’s are few listed below:

• Reduce stress and tension and produce serotonin or endorphins, which are known to give people the feelings of wellbeing.

• Helps you relax and improve sleep patterns which are essential to pain control.

• Increases circulation.

• It can promote better health by stimulating the lymphatic system to increase the flow of lymph, which is the secretion that carries disease-fighting cells through the body.

• It can sometimes lower high blood pressure.

• Can also be instrumental in effecting beneficial changes in the body by preventing fibrosis through the process of breaking up scar-like tissue.

  As mentioned earlier, it also increases endorphins; reduces anxiety, tension, depression and pain. Many additional studies confirm that massage therapy can reduce heart rates, relaxes stiffened and tense muscles while stimulating weak and inactive muscles to compensate for lack of movement due to an illness or an injury; speeds up the healing process.

  Paul Morrissey at the Osteopathic Clinic say “Massage therapy is a complimentary and effective treatment to our Osteopathic treatment along with our Clinical Pilates for building strength and preventing injury. I am delighted that we can offer a combination of these three treatments to our patients and I have witnessed many positive outcomes as a result.”

  So, is massage therapy beneficial? Yes! Massage therapy is helpful on, oh, so many levels and the outcomes are undeniable by anyone's standards.

  To book an appointment with Paola our Massage Therapist contact the clinic on 0208 662 1155

Osteopathy and Neck Pain.

Osteopathy and Neck Pain.

Approximately 65% of patients at the Osteopathic clinic, in Croydon, present symptoms related to neck pain, shoulder pain or scapular pain. The number of instances has increased over the last few years, possibly due to the increase in mobile phone and tablet use. We are regularly stooped over our desks, bent over a computer or driving long distances. This can all have an impact on the neck and upper-back. 

 In many cases the neck is prevented from moving freely, resulting in a trapped nerve in the neck or in the neck muscles becoming ‘hypertonic’, meaning they are abnormally tight which effects both movement and causes pain.  This pain can then cause symptoms in other areas of the body, such as headaches, migraines or stiffness in the arm and shoulders.

 How can an Osteopath help?

• Osteopaths can use a wide range of gentle techniques to reduce the muscular tension in the neck and increase movement in the joints of the neck and upper-back. A popular method is to gently massage the soft tissues in the joints to release tension, or to gently manipulate the neck to get joints moving.

• Sometimes we need to treat other areas of the back and shoulders as well as the neck.

• We will give you advice on how to maintain good posture at work or in the car and advise on exercises/stretching to help your neck and upper back muscles and joints become relaxed.

• If the condition is serious, we can refer you for a scan or X-ray or to your GP for further investigations.

 The Benefits of seeing an Osteopath

 The main benefits are to stop symptoms recurring and to restore balance. Osteopathy treatment not only reduces pain but also helps improve natural movement, posture and helps increase the blood flow to the affected areas. This helps to prevent stiffness from recurring.

 What exercises can I do to prevent neck pain.

 We regularly recommend the foam roller at the clinic as it is so versatile and a device you can use at home to help prevent symptoms recurring.

Heres are a simple exercises you can do at home or in the workplace:

Exercise 1 - Good for improving your posture.

This exercise eradicates the effects of gravity and adds more stability to increase mobility. It’s not mentioned in this video but I would also include a small pilates if possible.

Place the foam roller in a vertical position and lie on the full length of it. Ensure your spine is in a neutral position. Extend throughout the length of the spine. The chin should be down. Breathe out sideways into the ribs (using the diaphragm) five times.

We also have a number or exercises that cover challenging rotation and improving balance and stability.

 What Patients think:

“ I've been treated by Paul for over 20 years. 
He has proved to be an expert in diagnosing and fixing my neck, upper back and shoulder problems.
Paul has given me lots of help in addressing postural issues caused by my computer-based job. 

Paul convinced me to try Clinical Pilates.
He and Martine have developed a tailor-made programme for me which has produced very good results.
Martine is a very patient and observant instructor. She gives me lots of encouragement and guidance.
She has a great sense of humour and I really enjoy our one-to-one sessions.

The practice is well-organised and efficiently run.
The facilities and equipment at the practice are excellent and well-maintained.
I have found all the staff at the practice to be professional and very welcoming.”

By Sarah H

 If you are suffering with neck pain symptoms, please don’t hesitate to get in touch with our Osteopathy team. 

Why Detoxing the Liver is Important

The concept of internal cleansing and detoxification has been around for quite some time. In modern times, as society has increasingly been exposed to toxic compounds in the air, water, and food, it has become apparent that our ability to detoxify substances to which we are exposed is of critical importance in our overall health. We can enhance detoxification primarily by promoting improved liver function.

 Detoxification of harmful substances is a continual process in the body. The ability to detoxify and eliminate toxins largely determines an individual’s health status. A number of toxins (heavy metals, solvents, pesticides, microbial toxins, alcohol, etc.) are known to cause significant health problems.

The Role of the Liver

Liver plays several roles in detoxification.

• It filters the blood to remove large toxins.

• Synthesises and secretes bile full of cholesterol and other fat-soluble toxins, and enzymatically disassembles unwanted chemicals.

  This enzymatic process usually occurs in two steps, referred to as phase I and phase II, with phase I chemically modifying the chemicals to make them an easier target for one or more of the several phase II enzyme systems.

 When The Liver is Over Loaded

Your liver is a workhouse that can even regenerate its own damaged cells. However, it is not invincible. When it lacks essential nutrients or when it is overwhelmed by toxins. It no longer performs as it should. Hormone imbalances may develop. Fat may accumulate in the liver and then just under the skin or in other organs. Toxins build up and get into your blood stream. Among the signs of ‘toxic liver’ are:

• Weight gain especially around the abdomen

• Cellulite

• Abdominal bloating

• Indigestion

• Fatigue

• Mood swings

• Depression

• Skin rashes

How a sluggish liver effects Other parts of the body

When your liver is sluggish, every organ in your body is affected, and you weight loss efforts are blocked. Blood vessels are enlarged and blood flow become restricted. A toxic liver is unable to break down the adrenal hormone aldosterone, which accumulates to retain sodium and water and suppress potassium. The liver fails to detoxify the components of oestrogen oestrone and oestradiol) for excretion, so symptoms of oestrogen dominance arise. It is unable to carry out its activities to control glucose. A toxic liver can lead to hypoglycaemia, which can produce sugar cravings, weight gain, and Candida overgrowth. A toxic liver is unable to process toxins, enabling them to escape your blood stream and set off an immune response. With repeated assaults from escaped toxins, you immune system becomes over worked. A liver overloaded with pollutants and toxins cannot efficiently burn body fat, and thus will sabotage your weight loss efforts.

Q. What is the basic philosophy of detox?

The goal of a detox programme is to help the elimination of toxins and waste substances that build up during the day in the body and make us feel below par. Causes can include stress, tobacco, alcohol or an unbalanced diet.

Under normal conditions, the body has the ability to cleanse itself thanks to its major detoxifying organs- the kidneys, the liver and the intestine. However, when our toxin elimination process is overused, it ends up being blocked and the body loses its tonicity. A ‘detox’ break is consequently necessary.

Q. What benefits can this bring to the body?

In concrete terms, a detox programme will help us to restore lost vitality, to maintain good health and to drive away small symptoms which are usually the sign of intoxication such as feeling of tiredness, lack of concentration, skin problems, digestive disorders and even weight gain.

 Q. What is the best way for someone to detox properly?

The rules are simple. You just have to adopt a light, balanced and diversified diet with fresh fruits and vegetables. The aim is to provide your body with all the nutrients it needs to stimulate itself- cleansing mechanisms. It is also recommended to drink 2.5 to 3 litres of still water a day.

Regular exercise is highly supportive as well.

 A rational approach to aiding the body’s detoxification involves:

1. Eating a diet that focuses on fresh fruits and vegetables.

2. Adopting a healthy lifestyle, including avoidance of alcohol and exercising regularly.

3. Using special nutritional and herbal supplements to protect the liver and enhance liver function. 

Written By Dr Zeeba, Nutritionist  

Treatment for Frozen Shoulder

Primary shoulder adhesive capsulitis (pSAC) otherwise interpreted as Frozen shoulder occurs without any known precipitating cause. According to the American Shoulder and Elbow Surgeons pSAC is defined as a condition of uncertain etiology characterized by significant restriction of both active and passive shoulder motion that occurs in the absence of a known intrinsic shoulder disorder.

There are a number of predisposing conditions for developing pSAC / frozen shoulder including prolonged shoulder immobility secondary to trauma or surgery. There is also evidence that the use of protease inhibitors as antiretroviral therapy may predispose to the development of pSAC.
Diagnosis is based on the clinical features of the disease.

The four clinical stages of frozen shoulder (pSAC) are defined as follows:

1. Painful stage (3 months) with aching pain and moderate limitation of the range of motion

2. Freezing stage (3-9 months) with severe pain and reduction of ROM;

3. Frozen stage (9-14 months) with predominant stiffness that may be accompanied by pain;

4. Thawing stage (15-24 months) with minimal pain and gradual improvement of ROM.

Biopsies of the shoulder capsule from patients with frozen shoulder pSAC showed the following stage-related pathologies: synovitis and capsular hypertrophy during the painful stage, perivascular synovitis and disorganized collagen deposition during the freezing stage, and dense and hypercellular collagenous tissue during the frozen stage (thawing stage not yet investigated).

The lifetime prevalence of frozen shoulder pSAC is approximately 3-5%, with women (typically aged 40-60 years) more frequently affected than men. In 20-30% of pSAC cases, the disease occurs bilaterally. It may resolve spontaneously within 2-4 years.

There is no consensus regarding the best treatment for pSAC, and many different types of conservative treatment and invasive procedures have been described.

Frozen Shoulder is Common in Diabetic patients

Frozen shoulder is common in Diabetic patients, Adhesive capsulitis (AC) has a prevalence of 2% in the general population, but is reported to occur in 10 to 29% of those with diabetes. Studies have shown it is caused by glycosylation of the collagen within the shoulder joint triggered by the presence of high blood sugars.

Osteopathic Approach 

My thoughts on Adhesive Capsulitis is to get a clear diagnosis and your Osteopath will be very well equipped to do so. Theres an enormous amount of poor diagnosis of frozen shoulder (pSAC) often we find the patient has an impingement which can be resolved quiet nicely, and not taking an age to resolve. Your Osteopath will analyse your structure, look at your lifestyle and also address consequential problems such as elbow or neck pain, pressure techniques, stretching your soft tissues applying direct and also in direct techniques.

Dry needling for Frozen Shoulder

Your Osteopath may use dry needling, all the Osteopaths at our clinic use in adjunct to Osteopathy, its similar to Acupuncture.

Trigger point dry needling is a treatment approach often used by physical therapists and osteopaths that has been purported to be effective for reducing pain and improving range of motion along with improving function. 

Other approaches 

Hydrodilatation is a procedure that aims to improve the movement of the shoulder joint and decrease pain in the shoulder. It involves stretching the capsule of the joint and reducing the inflammation within it by injecting a mixture of sterile saline, local anaesthetic and steroid. All the osteopaths work very closely with upper limb surgeons and often refer for this treatment and the patients return for continued support in terms rehabilitation, this is often carried out in our clinical pilates studio.

Shockwave Therapy

Shockwave Therapy many of you know that the principle of the practice has been an educator in this world for sometime ( 2003 ). Shockwave can be extremely useful at stage three evidence to support this very disabling condition and another published in the Journal od Diabetic Care,

The study, "Extracorporeal Shockwave Therapy Improves Functional Outcomes of Adhesive Capsulitis of the Shoulder in Patients With Diabetes," is published in the journal Diabetes Care. Diabetic patients who received non-invasive shockwave therapy for frozen shoulder had improved range of motion and diminished pain.

Clearly a very disabling condition. At Cheyne Walk our clinicians can diagnose, treat, refer to a Local Consultant or indeed use Shockwave to help!

Sprint distance to ironman this one’s for the triathletes

So the off season is coming to the end and for most of us the training programmes have started kicking in.. 

Perfect time for triathletes to treat injuries

Now is the perfect time to get any niggles or old nagging injuries that has reduced training intensity or total rest over the last few months haven’t cleared up. 

If we can go into the new season fit and injury free there is a higher chance we’re going to stay that way throughout the season as training intensity and frequency increases!

As triathletes we are always looking at ways to improve performance from the best protein powders to lighter more aero kit; But forget about the engine that actually drives that kit around! Investing in our bodies and getting them functioning as best they can while we swim, bike and run through the season is by far the most valuable and performance improving investment we’ll make! 

Repetition of Movement

Triathlon by nature, especially when it comes to the longer distances, requires massive amounts of repetition of the same movements whether it be swim stroke, pedal stroke or foot strike; so therefore the majority of injuries we see are repetitive strain related issues that come about due to imbalances in joints and muscles throughout our body, which is where osteopathy and Pilates are really able to help!

Common triathlon related injuries

Some common triathlon related injuries we see and can help to treat include: 

• Rotator cuff issues 

• Shoulder impingement & ‘swimmers shoulder’ 

• Neck pain 

• Hip flexor problems 

• Lower back pain 

• Patella tracking issues 

• Shin splints 

So if there’s a niggle you’ve been meaning to get looked at, do it now... before the miles kick in and it turns into something more significant! 

With some experienced triathletes amongst our team all having dealt with injuries ourselves over the years we can understand and work with you to get you firing on all cylinders this race season! 

The Doctor Said I Have Plantar Fasciitis or something...HELP?!

Sound familiar....

So Plantar Fasciitis is the fancy term for pain along the bottom of your foot, usually around the heel or arch. It is caused by straining the plantar fascia which becomes inflamed. The plantar fascia is a piece of tissue that connects your heel bone to your toes.

WHAT MIGHT CAUSE IT?

There are many factors that might cause plantar fasciitis. Some include:

·      Exercise on hard surfaces

·      Exercising with a tight calf muscle

·      Recent increase in exercises such as walking, running and standing.

·      Wearing shoes with poor cushioning and support such as flip flops, ballet pumps and really old trainers.

COMMON SYMPTOMS:

If you experience pain when you start walking after sleeping or resting, if it loosens and feels better during exercise but then comes back after resting, and if it is hard to raise your toes off the floor – it most likely could be plantar fasciitis. 

HOW CAN I HELP IT?

Initial rest, ice, and elevate will help to reduce any inflammation within the plantar fascia. It is important to wear shoes with adequate support and cushioning, You should not be able to feel the ground you are walking on through the shoes you are wearing. A period of non-impact exercises such as cycling, x-trainer, or swimming. 

Here are some exercises to try at home to stretch and mobilise the plantar fascia. Hold the stretches for 30-45 seconds.

Towel Stretch:

Use a towel to apply gentle pressure through the foot and calf as you pull it towards you.

Plantar Fascia Rolling:

Use a roller, massage/tennis balls, a can of cold drink to roll the bottom of the foot. Apply pressure so you can feel any tender spots, and hold the foot over that point for a few deep breaths or until it releases.



Towel Pick Up:

Place a towel on the floor and use the toes to scrunch it up. 

 Plantar Fascia Stretch:

Place toes against the wall and apply a downwards pressure. This should be felt along the sole of the foot.

 Sports Massage can also help to relieve any tightness through the sole of the foot, shins and calves, and used alongside the above exercises and correct footwear; your plant-y-fas-y-something should start to improve!

Written by Rhea Malkin BSc (Hons) Sports Therapist and STOTT/APPI Pilates Instructor.