29th August 2017
I've just turned ONE, hip! hip! hooray!
No wonder that I'm feeling gay
The practice has grown since that first day
And Broads Osteopath is here to stay
So to you, my patients, I would like to say
"Thank You" for putting yourselves my way!
12th July 2017
Once a year Wimbledon opens its door.
Tennis fans pile-in by the score.
They spectate in silence and awe
then cheer winning shots with a roar.
(The games that take place are like war,
so the champ who succeeds they adore.)
In the weeks that will follow (not before)
they will play till their elbows are sore!!!
As Wimbledon currently dominates sporting headlines, it seems appropriate this month to talk about ‘lateral epicondylitis’ again or ‘tennis elbow’ as it known colloquially. This painful condition is a result of strain and inflammation of a tendon that attaches just above the outside bony part of the elbow joint. And it isn’t just a problem that affects professional and amateur tennis players – the symptoms can be aggravated by any repetitive action requiring a strong grip. The reason for this is the unique muscle and tendon arrangement at the wrist and fingers.
Most muscles work in pairs as reciprocal opposite numbers i.e. when one contracts (shortens) the other must relax (lengthen) to enable movement at a certain joint. In the case of the wrist and fingers, this pair are the forearm flexors (palm-side) and extensors (nail-side), with tendons that attach at the elbow at one end and run over the wrist to the finger-tips at the other. Strictly speaking, the action of the extensors is to lift the wrist upwards and straighten the fingers, whilst the flexors bend the wrist downwards and curl the fingers in a grasp. However, to maintain the sustained grip required by all racquet sports, the wrist must remain extended upwards whilst the fingers grasp the racket handle simultaneously. The duality of the action then causes strain at the anchor end of the muscle at the elbow. (The dual action is only made possible by a network of interlinking tendons between the muscle pair in the fingers.) Since the game of tennis has now become a game increasingly about speed, power and endurance, the already compromised extensor tendon is made further vulnerable to the condition by these factors.
Tennis elbow symptoms will respond to careful management including cold treatment together with anti-inflammatory medication, regular forearm stretches, and the use of a special clasp worn below the elbow for all wrist activity.
As one ambles along in the breeze
Enjoying the birds and the bees
The strong scent of hay
On a warm summer’s day
Can cause one to feel some unease.
The pollen, one’s eyeballs will tease,
One’s throat will react with a wheeze.
Then, propelled through one’s nose
A violent urge flows
(one’s dignity, surely, to sieze!)
One fights, and is brought to one’s knees
As one tries this sensation to freeze.
But, one’s put on the spot
When out, like a shot
Comes that ghastly, irreverent sneeze!!!
ALLERGIC RHINITIS (aka HAY-FEVER)
Traditionally, hay-fever has always been a seasonal condition associated with grass seeds and pollen, making the summer months a miserable time for sufferers. However, two factors have changed this picture: climate change due to Global Warming, and the ever-increasing number of chemical pollutants in our atmosphere. So, for 1-in-5 people in the UK, it is a more widespread problem throughout the course of an entire year.
The embarrassing symptoms are well-known: runny nose, streaming eyes, and uncontrollable sneezing fits, all caused by the body’s immune reaction to invading foreign particles named “allergens”. Mast cells (a type of white blood cell) are present in the matrix of all the connective tissues of the body, including the skin and protective membranes, and it is the histamines that they release in response to allergens that produce the inflammatory response.
Unfortunately, there isn’t a definitive cure for the allergic reaction, but avoiding known triggers e.g. pollen, animal dander, dust etc., and taking anti-histamines can help reduce the intensity of symptoms. There are two types of anti-histamines: the older drugs which cause drowsiness, and newer drugs which are non-drowsy. Both have side-effects and both are contra-indicated when taken with certain other medications, so it is always best to seek the advice of your GP or pharmacist before embarking on a course of these drugs.
If you’re a keen gardener, BEWARE!!
Those jobs that are waiting out there-
the digging and sewing
the weeding and mowing-
your elbows and wrists will not spare!
Your forearms they work as a pair,
but the work that they do, they don’t share!
The dominant hand
does activity planned,
but the weaker supports without care.
So the next time you prune something rare
consider this unequal wear.
The use of a clasp
takes stress of your grasp
without it affecting your flair!
TENNIS AND GOLFER’S ELBOW
People love their gardens and at this point of the gardening season, all kinds of injuries can happen because it is such an absorbing and physical pastime. We would expect problems like low back pain to be associated with lifting, bending and all-fours activity, or neck and shoulder issues due to activities requiring elevation of the head as in lopping etc., but most people don’t ever give their elbows and wrists a second thought when they tackle gardening duties. However, it is quite common to inflame the tendons of the forearm muscles at their insertion on the elbow through long periods of grasping or intricate finger work – commonly known as Tennis and Golfer’s Elbow. In order to hold even a small tool, the wrist has to extend by contraction of the uppermost forearm muscles (extensors) – if the contraction is sustained the tendon pulls too forcibly on the elbow bone causing the pain and inflammation that is Tennis Elbow. Conversely, if the fingers are engaged in heavy duty work like weeding or pruning, the underneath forearm muscles (flexors) are working maximally and likely to do the same thing at their tendon insertion on the elbow – causing Golfer’s Elbow. To avoid causing an RSI of either of this muscle pair, a strap or clasp worn just below the elbow will ease the force of muscular contraction short of the joint and prevent the problem occurring.
LIPS, HIPS and QUIPS!!!
You’ve heard that old jingle ‘bout lips?
(The relation they have with our hips!!)
Well, the fat we consume
Our weight it will DOOM!
Affecting our joints and our zips!!!
So, the next time you fancy some chips
Remember the following tips –
Your knees, hips and back
End up taking the flack
For the excesses you cannot grip!!!!
Most people probably have wear-and-tear somewhere in their body by the time they reach the middle decades, depending on both life-style and job-related factors. The most common joints to be affected are the lumbar spine, the neck spine, the knees and hips – the joints predominantly associated with weight-bearing function. However, fracture or injury to any other joint will predispose it to early arthritic changes in the future. Osteo-arthritis, the common term for age-related degeneration of cartilage and bone in the joints, is a fact-of- life for us all, but there are certain precautions we can take to help minimise the effects. Diet, naturally, is of huge importance and apart from the huge selection of available supplements that exists commercially, there is also a lot of nutritional advice to be had on the internet. Small adjustments to the normal diet can often make a huge difference, along with weight loss and gentle exercise, such as walking and swimming. If you experience some discomfort and/or restriction in any of the joints mentioned, you may have early stage arthritis and therefore should look at all the options to manage it. (See your manual therapist for details).
PETE’S FLAT FEET
At the top of the island of Crete
Lived a regular rambler called Pete.
He walked up and down
From his home to the town
In spite of the sweltering heat.
And tho’ passers-by he would greet
With a wave and a grin that was sweet,
En-route he would groan
And inwardly moan
On account of the pain in his feet!
He owned sturdy boots, worn but neat,
But still by the aches he was beat,
So he sought help from Max
Who explained all the facts
And how flattened arches she’d treat.
PES PLANUS and PLANTAR FASCIITIS
“Pes Planus” is the medical term for the common mechanical problem of falling arches and flat feet. The “insteps” as they are referred to, are the inside arches on the sole of the feet, and they are important for foot-health because they facilitate the even distribution of body weight throughout the gait cycle i.e. from the heel, to the metatarsal heads, to the toes. When the arches start to drop, the feet tend to strike the ground in one complete movement, and this can lead to inflammation and pain on the sole. Over time, these symptoms may develop into a much worse condition known as “Plantar Fasciitis”, whereby the sheaths binding muscle fibres and individual muscles become constantly inflamed and make walking a torture. There are many ways to help relieve the flat-foot issue – firstly by reducing the inflammatory aspect of the problem, and then strengthening the muscles responsible for creating the arches. Sometimes, the answer may be a simple change of footwear or the insertion of an orthotic appliance. If you are a keen rambler and suffer from sore feet, ensure that you show your practitioner the shoes or boots you wear on hikes as they could be highly relevant!
A melodious tenor called Linus
caught ‘flu, then got a blocked sinus.
Tho’ he sneezed and he spluttered,
the notes came out cluttered –
the result was a noise simply heinous!!!
So he conquered his natural shyness
(and it has to be said with some wryness)
paid for treatment from Max,
got his voice back on tracks
and reduced nasal sounds to a minus.
SINUSITIS AND MANUAL TREATMENT
At this time of year, head-colds and respiratory infections are all too common and often result in the discomfort caused by blocked sinuses. An understanding of the basic anatomical structures in your head helps explain why this happens and how simple manual drainage techniques may bring some relief.
There are four main paranasal sinuses, which are cavities found in the maxillary, ethmoidal, sphenoidal, and frontal bones of the face, and therefore named after them. Their function is to provide resonance to the voice and to reduce the weight of the skull because ordinarily they are filled with air. If they become blocked with mucous fluid, the quality of the voice is noticeably flat and heavy and the sufferer feels “bunged -up”. The sensory nerve that supplies the frontal sinus (above the nose) also supplies the skin of the forehead and part of scalp, so head pain and headache are a common side effect if this sinus is blocked. Similarly, the nerve that supplies the maxillary sinuses (either side of the nose) can refer pain to the upper jaw and teeth. And, unfortunately, as these two sinuses are close together, people often end up with a double whammy!!
Another side-effect of recurrent or chronic sinus blockage is middle ear infection, leading to dizziness and hearing problems. The eustachian tubes which lead from inside the ear to the pharynx (the drainage area at the back of the throat) can accumulate mucous if the openings are obstructed, and this impairs the function of the cranial nerve controlling sound and balance. Children and infants under seven are more likely to be affected with these symptoms because their eustachian tubes are less formed and more horizontal than in the adult skull, so drainage is not as affected by gravity.
If you or your child suffer from sinusitis, it is worth knowing that direct pressure at the apex of the symptomatic sinus, followed by effleurage towards the local chain of lymph nodes can often provide short-term relief, even if it can’t prevent the problem from occurring. (See your osteopath for details).
An avid young gymnast called Bolder
Had sudden sharp pains in his shoulder.
He sobbed to his mum
(whilst he knocked-back a rum)
“it makes me feel twenty years older!!”
“An ice-pack will help it feel colder.
The heat, son, will just make it smoulder!
Get yourself to see Max –
She can help these attacks-
And stop using those dumbbells -I TOLD YER!!!
We abuse our shoulders badly, it’s a fact! The combination of daily activities such as working long hours at the computer or tablet, driving, carrying, lifting, dealing with stress etc. all takes its toll on shoulder-girdle health, but then we pile-on the insult by spending our spare time working-out at the gym with resistance machines or free-weights in an attempt to improve upper body definition. The result is overworked, undernourished shoulder muscles, especially the stabiliser group known more commonly as the “rotator cuff”.
Acute pain and restriction of general shoulder movement are usually the first signs of rotator cuff irritation. As the problem deteriorates, the cycle of pain-followed-by-restriction, spirals downwards until eventually the shoulder can do very little at all - a condition known as “Frozen shoulder”. Although there are various structures that can cause this condition, the key to preventing it from becoming a chronic 18month issue is recognising the initial symptoms, and dealing with the inflammation aspect (anti-inflammatory medication in conjunction with-ice packs), whilst trying to maintain range-of-movement. Then seek the help of a manual practitioner.
I’ll tell you the tale of Tom Whittaker
Who was prone to attacks of sciatica.
He hoped to impress
A young lady called Bess
With moves verging on the erotica!!
Ignoring all signs of rheumatica,
His twists and his turns were spectacular!!
(He’d been to see Max
Who’d helped him relax)
Now he’s not got just Bess, he’s got Monica!!
(And Trish, and Mary, and Lilian, and Sue….and etc etc)
If you haven’t ever experienced sciatic leg pain then you won’t appreciate the full extent of how debilitating it can be, but it is a very common condition in this century, mainly because we live such sedentary lives. It used to be known as “lumbago” due to its association with degenerative changes in the lumbar spine, but the causes of sciatica are more widespread than that and not necessarily connected to low back pain.
The sciatic nerve is the largest nerve in the body, supplied by fibres from lumbar and sacral nerve roots L4 to S3, and travelling from either side of the lumbar spine through the internal pelvis, buttocks, and down the legs to the feet. All divisions of the nerve are responsible for sensation and muscle power in most of the lower limb, so traumatic damage to the nerve can result in adverse changes to these functions. If superficial fibres are affected the symptoms will be connected to feeling e.g. burning, tingling, numbness, electric shock or pain described as tooth-ache anywhere along the sciatic distribution. More seriously, if the deeper nerve fibres have been damaged the effects will be visible through compromised mechanics in the limb joints. Fortunately, most people suffer from the sensory form of damage that is linked to inflammation of the trunk of the nerve, or the roots that supply it, due to direct or indirect compressive forces. Typically, sciatica can be caused by any of the following problems; disc herniation or degeneration; irregular positional changes in the lumbar spine; piriformis syndrome (buttock and leg pain); activities that involve either long periods of inactivity e.g. driving, or conversely,short bursts of exertion e.g.gardening, even coughing/sneezing fits!!
If you think the above description sounds familiar and that you could be suffering from sciatica, your first step should be to seek expert advice regarding analgaesic and anti-inflammatory medication, plus a physical examination to establish the likely cause of the symptoms and how to manage them.
Osteopathy for Pelvic Girdle Pain (PGP).
Osteopathy for Pelvic Girdle Pain (PGP)
During pregnancy women undergo many mechanical changes to accommodate the growing foetus and to prepare them for the act of childbirth. The hormone relaxin is released in the early stages to soften ligaments and therefore increase the mobility of the lumbar spine and sacro-iliac joints, and the pelvis itself rotates forwards and backwards as the baby changes shape and position in the womb. Just how well a woman will adjust to these changes is extremely individual and will depend on her own body shape, level of fitness and pregnancy history. However, it is generally accepted that most women will suffer from PGP at some point in their pregnancy, and most commonly in the 2nd or 3rd trimester. PGP is usually not a serious condition but a convenient generic term covering a wide range of symptoms including low back pain, Symphysis Pubis Dysfunction (SPD), coccyx inflammation, hip pain, urinary incontinence and sciatica. Most of these problems are short-lived and will disappear after the birth, but in the majority of cases osteopathic treatment offers effective, non- invasive relief, leaving the patient to prepare-for (and enjoy) the more important event ahead.
SHOULDER PAIN and the three "C's"
When I began my training as an osteopath in 2001, the most common mechanical
problem seen in clinic was low-back pain, usually following a bending/lifting incident and quite often job-related. It is a sad indictment of life in the 21st century that shoulder and neck pain is
not only more prevalent, but that the causes are less traumatic and therefore harder to identify. I guaranty that most patients who present with aching shoulders and necks and who can experience
pins-and-needles in their arms and hands, or regular headaches associated with shoulder girdle tension, are suffering from an overdose of one (or a combination) of the three “C’s” – COMPUTERS, CARS
and CARRIERS!! In 2016, we depend upon digital technology for 90% of our communications, so not only do we spend a large part of our working life hunched over computers or sophisticated electronic
gadgets, but we also volunteer to spend our spare time doing exactly the same thing -and sometimes for even longer periods of time!! Given the option between walking or driving to a location not far
away, most people will decide that time is the priority and will not hesitate to jump in the car. Finally, the supermarket chains have lured us into stores because we can park, fill-up the petrol
tank, and then fill our trolleys with bargains that we probably don’t need, but we that we can transport home in as many 5p carriers as it takes!!! It sounds cynical, but the three “C’s” are
predominantly responsible for most shoulder and neck issues. The reason for this is simply that all three “C” activities necessitate the stabilising muscles of the shoulder girdle to remain in a
state of prolonged contraction so that the arms and forearms can engage in more intricate actions. Chemical reactions in the muscle fibres quickly lead to a deficit of oxygen resulting in a build-up
of waste products and inefficient function - the result is shoulder blades that “crunch”, pain that is as relentless as tooth-ache, and the ineffectual need to keep moving the neck or applying
pressure to the painful origins or insertions of the stabilising muscles of the shoulder. Add a little bit of stress to the mixture, and we have the modern shoulder pain phenomena!!
If these symptoms sound familiar, then please do get in touch as manual treatment can really help relieve and keep the pain under control.