A Complementary View of Health
What is Healthy?
Health is not an absence of disease. Health is achieved when your body’s structure, emotions and mental states are secure. These three states or triad of health, are interdependent upon each other, each state directly impacting on the others. Where your constant low back pain begins to make you tired and irritable, we can see that that your structure is having an effect on your emotional state. When you consult with your osteopath they will more-often-than not limit their main interest to your musculoskeletal health. A small minority of osteopaths consider the wider person and ask questions about diet and intoxicants, which for many people is very personal, and perhaps, too personal for the initial consultation. At Derby Osteopath where your progress seems less than can could be reasonably expected, given your age, history of participation in contact sports / sports, career history, medical history and medication consumption, then the wider person may be considered to shed further light upon your pain.
Weight A Burning Issue.
We do not recommend viewing yourself in terms of weight, calories and clothes sizes. Rather we recommend monitoring your actual shape and your feeling of well-being as more reliable measures of health. Low calorie diets starve your body of essential nutrients needed to build, maintain and repair it. Crash diets burn pounds off quickly commencing with mostly water, then your body will seek calories from the next available source, that being your bodies protein not fat. Research demonstrates you waste your muscle tissue when you crash diet. Thus you will lose body weight by starving yourself, but at what cost to your health? Your body will realise that you are not eating properly and in-turn lower your metabolism, thereby using fewer calories.
Better is an approach that accepts that your body needs a wide variety of foods to supply it with all of the raw materials that it requires to build, maintain and repair itself. Dieticians recommend an ideal diet that delivers 15% fat, 15% protein and 70% carbohydrate. Carbohydrates include fast-releasing sources like honey, milk and sweets, and better slow-releasing sources including whole grains, vegetables and fresh fruit. Where possible we recommend your foods being as least processed as possible. Recently in the news the issue of horse meat in Findus Lasagne has been prominent. You really are in the dark when you eat ready meals! To produce a frozen horse lasagne the company has to put the ingredients through too many different processes. Vitamins and minerals are leeched out during these processes. Additionally the horse meat has added Phenylbutazone or bute that vets give to horses as an anti inflammatory. Cheap ingredients are made more palatable by high levels of salt and fat. Instead try to eat fresh, locally sourced and whole foods. Consider the added processes needed to make white flour and sugar; white flour and sugar have been stripped of vitamins and fibre to reveal their intense flavours. The energy derived from white flour and sugar is absorbed quickly by the body, creates a spike of energy and then a low, where you will crave a further quick boost of energy.
Should I Become a Vegetarian?
Is the vegetarian diet better? Much debate rages regarding this question. Certain issues need to be considered before you can make an informed judgement.
You are what you eat and manage to absorb. To be absorbed your body squeezes and breaks down your food in your stomach. This fragmented chime then is then ready to be absorbed. At this point it is unrecognisable as the food on your plate. It is now individual molecules of amino acids, fats and carbohydrates. Doner kebab meat is certainly a source of class “A” protein, (the best type of protein), but is also is a source of low quality saturated fat, salt and any drugs that were given to the animal to enhance the animal’s growth and taste. Instead of eating a lot of low quality foods, encourage the food industry to sell high quality protein foods, by reducing your meat portion sizes but buying organic or Freedom Food protein sources. By reducing the size of your protein portion you spend the same money on less weight. This then means your dinner plate needs more vegetables and whole grains to provide you with a complete meal. This then means the proportion of animal protein on your plate reduces. It is philosophically and nutritionally acceptable to be concerned about the treatment of animals. To eat an animal that has been reared in a stressful environment ignores the affects that stress has on the animal’s Neuroendocrine system. Animals given sufficient room and diet variety are less stressed, have less cortisol within their bodies. Long term exposure to excess stress hormone changes the taste of meat. Vegetarians can say that avoiding meat makes their diet healthier. What if a diet with less meat means you therefore eat more fruit and vegetables? Will this diet deliver all of the nutrients that you need to thrive?
We recommend eating foods that deliver a diet that is 80% alkaline in nature. Many factors affect the balance between acid and alkaline including intake of minerals, amount of dietary vegetables, exercise intensity and depth of breathing. Foods that have a high acid content raise the pH of the body’s fluids and predispose health problems like arterial disease, autoimmune irritability, arthritis and some cancers.
Sensible eating with a weekly day off the diet will maintain a normal metabolism. Work towards adjusting your meal planning to eat fresh, locally sourced and unprocessed foods. In time, aim for eating 80% alkaline foods. Combine healthy eating with exercise that supports your body.
Osteopathic treatments that can benefit your symptoms and health:
Derby Osteopath Can Support You With Your Pain And loss Of Function
A traditional yet powerful method of affecting the fluid balance and tone of your painful muscles and tendons.
It briefly restricts your blood supply and stimulates your body’s healing mechanism, or discourages your motor nerves from firing so frequently.
Here your own strength is used to relax and lengthen tight muscles. After a short phase of muscular contraction there is a window of opportunity where the therapist can passively lengthen your tight or contracted muscle. This contraction relaxation does not occur naturally in day-to-day living.
Your joints are gently moved stimulating the absorption of synovial fluid which feeds your restricted or damaged joints. If your joints are not moving properly then they will suffer from reduced nutrition.
Manipulations / HVTs
These techniques are direct joint adjustments that allow the muscles around your spine or joint to relax, thereby allowing a proper supply of blood to enter the joint. These high-speed, low-distance thrusts often create a pop or a crack that is completely normal and considered healthy when used appropriately. Often considered to be the main therapeutic tool of chiropractors, these are effective methods, but are all the more effective when combined with articulation and massage.
Deep Tissue Massage
Directed at specific muscles, tendons and connective tissues which are then treated with greater pressure directed below the superficial tissue layers. Deep tissue work is often done slowly, where tissues are allowed to give rather than be massaged over.
Allows your bodies’ connective tissues to give and slowly change shape. Gentle pressure is applied in opposite directions. The last tissues to adapt, when your body tries to change your posture to avoid pain are the connective tissues. These tissues provide support and shape for every part of your body and as such are resistant to change.
Soft Tissue Release (STR)
A method of anchoring and lengthening connective tissues where the client has a role in the process! Little journal evidence exists for this method, however often clients report a reduction in symptoms immediately.
It may be necessary to recommend the use of arch-supports shoe-inserts, modest heel-lifts or bespoke made-to-measure shoe orthotics to correct a variety of problems focused in the lower extremity.
Reading Your Pain:
- Aching Discomfort – muscle, joint, bone or ligament pain
- Pulsating Pain – arterial disruption
- Stabbing / Lancing – nerve root irritation and compression
- Numbness, Pins and Needles – nerve axon disruption
- Vague Deep Ache – visceral pain (organ pain)
- Hypersensitivity Pain – autonomic nerve disruption
Please note, these are an illustration only.
Common Tissue Conditions
Inflammation and pain are your body’s natural response to damage where blood is moved into the injured area. Where the healing process is delayed or prolonged, your body will continue to react to irritation or damage, giving further inflammation that will, in turn, continue and maintain your pain. Over time your muscles can take on a stringy or rope like feel.
Sprains affect ligaments, where you may feel an ache when you move a joint to the limit of the joint’s normal movement. For example, when you bend forward to touch your toes, the Interspinous ligament may sprain, resulting in discomfort when the individual bony spines in your back separate and open.
Strains affect muscles, where the muscle has suffered damage from repeated trauma, or becomes irritated by every-day activities, like driving or PC use. Muscular injuries account for between 10 to 30% of all injuries in sport. Muscles can be damaged traumatically or overloaded.
Headaches can be debilitating and distracting. When we ask you about your headache we will consider the following possibilities:
Migraine pain can be sensitive to light, sound, certain foods and hormonal changes, is worse with movement and is described by some sufferers as pressing or tightening. Often migraine pain is one-sided, can induce sickness and can last up to three days.
Tension headaches are the most common type of headache. Their pain can travel to your eyes, neck and back. Pain is often on both sides of your head, and feels vice-like. Triggers include disturbed sleep, posture, stress, hunger and eye strain. Often tension headaches stem from muscular tension in the Temporalis or neck muscles.
Cluster headaches are one-sided, excruciating and last minutes to hours in their duration, come in groups which then self-limit or resolve. Sufferers describe a drilling like pain behind the eye or in the temple. Cluster headaches are caused by the dilation of the Carotid artery which irritates the Trigeminal nerve. The Carotid artery originates from the Brachiocephalic artery and travels up your neck just below your ear. Conditions which affect the side of your neck can disrupt this artery.
Conditions of the neck:
This issue often stems from holding a position that the neck is not used to for too long. Similar to head aches it stems from neck and shoulder muscles becoming too tight. A classic presentation would be of someone who is reading, studying or on the computer for longer than normal. It may happen acutely or take many weeks to develop. It can produce unsettling symptoms into the arms or hands such as tingling, pins and needles, numbness or pain and weakness by compressing or trapping nerves in the neck which supply the arm and hand. Usually osteopathic treatment and advice on posture or activity adjustment is more than sufficient to put you back on the road to recovery.
Conditions of the shoulder:
Our shoulder’s provide a paradox of great range of motion and considerable strength which requires a high degree of stability. Treat the shoulder well and it will allow you to scratch your spine between your shoulder blades and also reach forward and up to lift something of a high shelf. The muscles which provide stability are: Serratus Anterior, Rhomboids, Traps, levator Scapulae, Pec Minor and Lat. Each of these relies upon each other, often called force coupling, a biomechanics concept. Over-use one of these structures and possibly the whole stability system may suffer. The Rotator Cuff provide a more specialist role, which move and stabilise the head of the arm bone in the Glenoid Fossa.
Important connections exist between the shoulder, neck and upper spine. The neck is linked directly via the fascia of the Levator Scapulae muscle and Upper Traps. The shoulder is linked directly to the Thoracic spine via the fascia of Rhomboids and Lats. Deep into the shoulder the Rhomboids blend fascially with the Subscapularis, (one of the rotator cuff). The Lat has a fascial connection with Infraspinatus and Teres Minor. So if any of these muscles are chronically tight or weak the functioning of the Rotator Cuff will be affected.
Most shoulder pain is ameanable to treatment, it tends to be associated with problems related to tight muscles in the neck and shoulder and restricted movement of vertebra in the upper back and lower neck. True shoulder pain and injury, that which restricts movement of the arm, can be difficult to deal with as it significantly affects your daily activities; Washing your hair, doing up your bra, driving and, reaching for the cookie tin can become almost impossible to do. Some occupations place significant daily stresses on their shoulder.
Frequently there is no obvious reason for the onset of pain. frozen shoulder, painful arc syndrome, rotator cuff tear, tendinitis and bursitis are all terms used to describe the pain you may be experiencing. The terms are commonly overused and it is not until a thorough and detailed assessment of the shoulder, neck and nerve supply to the arm have been completed that a proper diagnosis can truly be made. We will consider if appropriate the possibility of shoulder pain referring from your liver and gall bladder and heart.
Conditions of the pelvis and groin:
Pelvic problems are often a result of a bad back, or may even cause a bad back. For mums, they can be as a result of a difficult pregnancy or labour.
Groin strains tend to be part of the life of young, athletic sports people and occur as a result of stretching too for the ball in a game of football, rugby or racket sports. The same may be true of the older, active individual and may indicate a degree of arthritic change in the joint but, in general, if the problem has suddenly come on after any form of physical activity, it usually indicates the supporting muscles have become tight in an effort to protect the joint from further damage. Generally, careful applied work to the area will reduce the pain and allow you to return to normal activities. Often groin strains go hand-in-hand with pelvic problems.
Conditions of the sacrum:
The Sacrum sits between the hip bones and forms the fused bony continuation of the spine. The Sacrum nods or nutates and moves backwards or counter nutates. Sacral movement can be in a variety of axis, bends, rotations and twists. As the spine sits directly on-top of the Sacrum problems at the Sacrum can have effect on the function of the spine. The Sacrum can be treated by accessing the Sulcus directly behind the Sacroilliac Joint (SIJ) and at Inferior Lateral Angle (ILA). Important postural muscles like Piriformis, Latisimus Dorsi and the LES attach to the Sacrum.
Conditions of the hip:
Usually the problem is part of a bigger picture and can be seen as an element of back pain or a knee or ankle injury.
Occasionally, hip pain is the result of wear and tear, or osteoarthritis. As a practice we have had good results with treating the painful side effects of this debilitating condition and, although there is little evidence based research, the general consensus within the profession is that assisting in increasing the range of movement through joint articulation and soft tissue massage considerably helps reduce pain. Arthritis of any sort is a degenerative process and we cannot stop this but we can, in most cases alleviate the pain. It is our experience that an initial short course of treatment followed by maintenance visits is the most effective and, we have been able to keep patients on their feet, away from the surgeon for a couple of years using this approach.
Conditions of the chest:
At first chest pain can be very distressing, it can mimic heart attack, be severely painful on breathing or pass shooting pain into the ribs. When we come across chest problems we ask about the way it started and when. If you are in your fifties, never exercised before trying to run a ten mile race for the first time, it might be reasonable to suspect that your heart might be involved, if you have fallen off your cycle one might suspect a fractured rib or two– we shall check. More often than not we will look at the way your spine and ribs move around the area of pain, usually the pain is muscular and we shall loosen up the offending structures, leaving you free to move pain free and breathing normally.
Conditions of the knee:
Knee pain is generally straight forward to assess and drops into two convenient categories: those we can help and, those that need surgery! If your knee suddenly becomes, hot, swollen, stiff and you cannot stand on it or bend it, likely as not you need to see a surgeon. Sometimes, we are able to help in these situations, particularly post operatively. Usually our job is to deal with knee strains and muscle tears around the joint not inside it.
Knees are thought to be a simple hinge joint, whereas there is also considerable rotational play. The extreme stresses of twisting can cause ligamentus and connective tissue problems. Overuse injury often occurs in the joint between the knee cap and the femur (Patelofemoral joint). The knee gains much of it’s stability from ligaments including: ACL, PCL, MCL and LCL, to name the main ligaments. Each limits movement in a certain plane. Where the femur meets the tibia we have a piece of cartilage called the Meniscus, that can be injured in rotational traumas. Plica pain is felt on the inside of the knee where the end of the Femur pinches a fold of the knee’s synovial membrane between the knee cap. The Plica is connected with the Genu Articularis muscle at the base of the Femur.
Conditions of the ankle and foot:
Heel pain can originate from either nerve pinching or irritation of the flexor tendons. Tarsal Tunnel syndrome occurs just behind the medial ankle bone, where the Tibial Nerves pass close to the tendons of Tibialis Posterior, Flexor Digitorum Longus, and Flexor Hallucis Longus. Excessive rolling in or over pronation can compress the nerves giving pain. Over pronation also can compresses the posterior tibial nerve on the inside of the heel, especially common with runners. Heel pad pain stems from the bursae inbetween the heel bone and the fat pad becoming inflammed. Plantar fasciitis is aggravated during heel take off phase or when running up hill, where the angle between the metatarsals and the toes become greater, over stretching the fibrous band that runs from the heel to the toes. Normally as the runner takes off the plantar fascia is elongated and stabilises the foot’s longitudinal arch. The nerves between the 2nd and 3rd, 3rd and 4th metatarsals can become compressed during the toe off phase or by ill fitting shoes. This is caled Morton’s syndrome.
Many conditions can benefit from conservative physical therapy but can occasionally require the involvement of your GP. Conditions such as osteoporotic compression, meniscus tears in knees and acute intervertebral disc lesions can result in a referral to your GP. Many conditions can mimic back and extremity pain and must be ruled out prior to commencing your treatment.