Changes in Personnel at Village Osteopaths

In June, Village Osteopaths said farewell to Martin File who was travelling from Kent to work with Helena.  Martin was offered an unmissable opportunity closer to home, we wish him well with his new practice.

We are planning  that a new osteopath will be joining Helena in September – full details to follow by newsletter once everything is finalised, so register now to make sure you receive the details.

Details of Helena’s Dorset practice

You can find details of Helena’s Dorset practice, Jurassic Coast Osteopathy in Weymouth at her website http://www.jurassiccoastosteopathy.co.uk and on her Facebook page for the clinic https://www.facebook.com/jurassiccoastosteopathy/ .  Helena is in Dorset from Wednesdays to Fridays, working in Weymouth and Dorchester; she is also able to see animals in and around the Portland, Weymouth and Dorchester area – contact her on 07805 650667 for further details.

Clinic Update November 2016

Martin is now offering appointments late on Tuesdays (6pm-9pm) and early on Wednesdays (from 7.30am).  He is also available for home visits or to give talks to groups on Wednesday evenings if he is not in clinic.

Helena is currently in Newdigate on Tuesdays from 8pm-6pm but can sometimes offer emergency appointments on a Monday afternoon.

If you need an appointment, text or call Helena 07805 650667 or Martin 07970 627762 and we will do our best to accommodate you as quickly as possible.

New Osteopath Joins the Practice

Welcome to Martin File, who has been covering the clinic while I have been recovering from surgery.  I am very pleased to announce that Martin will be staying with the practice on my return from 1st November 2016, initially covering Wednesdays but potentially expanding to include other days.  Martin can be contacted directly on 07970 627762.

News May 2016 – new clinic locations and times

Exciting times… Newdigate Clinic has moved next door at Greens Farm, to give us more space and light in the treatment room with a ‘cosier’ feel in the waiting area (according to all the patients who have been there) and easier access with much lower steps than the previous room.  I am still working the same days at Newdigate (Tuesday all day and Thursday mornings) and nothing else has changed – it is still the same lovely location with easy parking between Dorking and Horsham.

Moving on… with the departure of my colleague on maternity leave and my recent house move to Dorset, I am no longer in Reigate on Mondays, Wednesdays and Fridays.  This has been replaced by the following clinics:

  • Ocean Therapy, Weymouth – Monday mornings 9-12 (from June)
  • Priory Osteopaths, South Nutfield near Redhill – Wednesdays either am or pm
  • Dorchester Osteopaths – Friday afternoons 2-6.

My number, for advice or for appointments, never changes – 07805 650667 – give me a call.

Sleep Apnoea – a bit more than just snoring

As an osteopath, patients come to me with one problem but often during our conversation and my assessment, it becomes apparent that something else is going on. In the last few months, I’ve had a few patients come in who I’ve known or suspected have had sleep apnoea.

So what is sleep apnoea and how does it relate to snoring?

Lots of people snore and the reason for most of us is that at night, the soft tissues of our neck and palate relax and become narrower, causing the air to move in and out faster and causing the tissues to vibrate. Things that make this more likely are being overweight, drinking alcohol (which is a muscle relaxant) particularly in the evenings, smoking or being congested in either the nose or throat (e.g. from colds, nasal allergies or inflamed tonsils) or taking sedatives  (source: http://www.nhs.uk/Conditions/Snoring/Pages/Causes.aspx)

This can become a vicious circle, since it is thought that the vibration damages blood vessels that supply the muscles of the head and neck, hence increasing the likelihood of the airways narrowing as the muscles relax, thus making the problem worse. In some people, it might be a relevant factor in neck pain and jaw problems (which might also affect the snoring) – and it’s often a big cause of friction with partners, whose sleep is disturbed (often more so than the snorer’s).

So it’s important if you snore to try to do something about it – this website gives lots of helpful suggestions http://www.helpguide.org/articles/sleep/how-to-stop-snoring.htm.

Another reason for doing something about it is that it may indicate (or progress to) sleep apnoea – which is a condition with potentially serious implications.

Sleep Apnoea occurs when the relaxing and narrowing of the airways during sleep is so severe that it interrupts the sufferer’s breathing, reducing oxygen supply to the brain and causing them to wake up. This can happen 100s of times a night, but the sleeper may not be aware (although often partners will be), however they often suffer from symptoms that are more than just snoring e.g.
– restless/unrefreshing sleep
– frequent trips to the toilet every night
– morning headaches
– excessive daytime sleepiness and irritability
–  impaired concentration
– loss of libido
(source: http://www.nhs.uk/Livewell/snoring/Pages/sleepapnoea.aspx)

Daytime sleepiness increases the risks of accidents while driving or operating machinery at work and sleep apnoea increases the risk of high blood pressure, diabetes and stroke, but many people are living with this problem without realising.

If you want to know more about snoring and sleep apnoea, this video explains the difference between them and talks about some of the treatments http://www.nhs.uk/Video/Pages/snoring.aspx

The British Snoring and Sleep Apnoea Association, just round the corner from my Reigate clinic, has a great website with lots of information (www.britishsnoring.co.uk) and offer consultations, or you can see your GP if you suspect you may be suffering from sleep apnoea.

In the meantime, if you are a snorer, there are lots of things you can do for yourself – lose weight, give up smoking, don’t eat heavy meals or drink alcohol less than a couple of hours before bed and tone up your neck and throat muscles.

In a small study of people with sleep apnoea who were given exercises to do, a significant number had improvement in their symptoms and a reduction in their collar size just by doing exercises – you can download my compilation of exercises from that study and other sources here Throat exercises to reduce snoring and sleep apnoea you don’t have to do them all but pick a few to do each day in rotation.   Or if you want to tone up your throat muscles while having a bit of fun and stimulating your brain why not take up singing or playing the trumpet or even the digiridoo – another study showed reduction in snoring for taking up this instrument, which (like the trumpet) requires a technique called ‘circular breathing’ to play it successfully.

Make Exercise Fit Your Life… not the other way round!

As an osteopath, I’m often giving exercises, either stretches or strengthening, as ‘first aid’ to help patients out of trouble, but also to prevent problems recurring in the future. Because people are so busy these days, I’ve always tried to find ways my patients can fit simple exercises into their normal day instead of having to find a particular time and place to do them, so that there’s some chance they can fit them into their life and reap the benefits.

Examples might be – stretching shoulder or calf muscles while waiting for the kettle to boil; strengthening the pelvic floor while waiting at the bus-stop or in the supermarket queue (no-one can see you doing them!); turning your core muscles on and off while walking the dog or pushing the buggy or walking the kids to school; doing neck and shoulder stretches while at your PC. Most people find these kind of suggestions really helpful in fitting beneficial exercises into their daily life.

However, when it comes to my own exercise regime, I’m less successful at applying the same principles. I often work long days (12 hours including travelling) and then have things to do at home (chores, cooking, teaching preparation) so I find it really hard to find the time to exercise. If it involves going somewhere to swim/train/take part in a class, I struggle with both time and motivation.

Plus I always have plenty of excuses: swimming – never been again since I bought a pair of goggles and saw what was in public pools; Zumba – too cardiovascularly intense (I have a history of a minor heart problem); running – doesn’t do my left knee cartilage problem any good and besides, I don’t like running in the cold/wet/rain/snow – yes I’m a wimp! Regular classes are hard because my diary is flexible to fit my patients and I struggle to make them regularly; and ‘regularity’ is a really important concept with a new change to one’s routine, because it takes several weeks of repetition to establish a habit.

I tried to think about things I like to do to help motivate me and focus on the things I want to achieve. I love walking and I have a fantastic place to walk at my village clinic location in Newdigate.  But in the winter that involves a lot of mud and a change of clothes, which isn’t exactly convenient in the middle of a clinic day. So, great idea – but it doesn’t fit the practicalities of my working day.

As far as goals, I want to lose weight because I’ve some great dresses I want to wear for a special event later this year – but I know won’t fit into them by simply sitting around. Dieting always loses the first half stone but then I get stuck; I know that changing my metabolism through exercise is a simple way to move that on (I must have lost the same half stone about 4 times now – if I’d lost it sequentially, I’d have made my target weight long ago!).

Another principle to successfully starting something and keeping the habit (apart from motivation, goals and regularity) is making small, easy changes – nothing too radical. I occasionally do a bit of yoga/pilates at home between when I get in and when I eat, which is a good start to fitting my exercise into my day, but I know need to do more, particularly to get a bit of cardiovascular stimulation (which is good for my heart – the fitter it is, the less my problem will affect me).

So I was thinking the other day, what can I do indoors at any time of year, at home or clinic, that’s fun, that won’t hurt my joints, that will get my heart rate up? I was watching BBC this morning and Mike Bushell’s regular segment (where he’s sent off to do some sport for the entertainment of the masses) was on trampolining – and then it struck me – rebounding!

What is rebounding I hear you ask? Rebounding was really popular in the ’70s and 80s after NASA published a paper about how it was more efficient than running for stimulating heart and lungs and increasing oxygen uptake and it’s becoming popular again.  I haven’t looked at the latest research (although I will now, more of which another time). But the idea of bouncing up and down on a small trampoline (inside or outside) to music or while watching TV, with weights to make it harder or just a gentle bounce for health benefits (it’s supposed to help lymphatic drainage) really appealed (and did away with all my excuses too – damn!).

So one E-Bay purchase later, I hope soon to be the proud owner of a portable rebounder – watch out for the videos and posts of my progress on my Facebook page, I can’t wait to share with you how I get on! And the upside is, even if it doesn’t work out for me, my 18 month old grand-daughter (with supervision) will probably love it.

There is another practical point too – as all my patients know, I rarely recommend an exercise or a therapy (or therapist) unless I’ve tried it myself – so I’ll be able to tell any of you who are interested in buying your own rebounder whether it’s worthwhile or not.  Although if I offer to lend you mine, it probably means that it didn’t turn out to be quite as much fun as I imagined….

Look out for my updates on Facebook and comments here – I’m happy to receive yours if you’ve used a rebounder in the past – what did you think of it?

An Osteopath’s View of Carpal Tunnel Syndrome (CTS)

After SPD last month, another TLA (three-letter acronym) this month – Carpal Tunnel Syndrome (CTS). CTS is a relatively common problem with symptoms of pain, numbness, tingling/pins & needles in the hand, commonly (but not exclusively) at night, often temporarily relieved by shaking or ‘pumping’ the hand.

Sufferers can also experience weakness in the thumb and ache/pain in the arm. Symptoms are caused by compression of the median nerve which controls movement & feeling in the hand as it passes through a ‘tunnel’ formed by the small bones of the wrists and a ‘roof’ of fibrous tissue.

The NHS website says that ‘it isn’t known why’ the nerve becomes compressed in most cases, although certain conditions are thought to increase the risk of having it:
– genetic predisposition (family links)
– being pregnant (probably due to fluid retention; this often clears in the 3 months after the birth of the baby)
– direct trauma to the wrist (falls, repeated trauma)
– systemic conditions like rheumatoid arthritis or diabetes which cause swelling in the wrist or nerve damage respectively
– repetitive work with the hand e.g. typing, knitting, sewing & many other activities

However osteopaths DO have a model for ‘why the nerve becomes compressed’.  We look at the function of the nerve from where it starts in the neck and all the points between there and the hand where the nerve could have its function compromised through muscular tension, poor joint mobility or compression, all of which could affect the quality and efficiency of circulation to & drainage from the nerve, leading to inefficiency in its conduction.

In our model, compression in the wrist in carpal tunnel is the ‘last straw’.  So unlike medical treatments, which focus purely on the wrist (using splint, cortisone injection or surgery in extreme cases to release the ‘roof’ of the carpal tunnel to give the nerve more room), osteopaths look at how the wrist sits of the end of the arm and all the things that influence that, for example:-
– tension/restriction in the neck joints and surrounding muscles that relate to the nerve’s origin in the spine
– breathing mechanics, muscular tension,  and history of shoulder trauma (since between the collarbone & the upper ribs is an important ‘junction box’ for the nerve as it passes from the neck through the shoulder & ribcage into the arm)
– tightness in the forearm muscles and the fibrous tissue between them (very common in anyone who types or uses a computer), since this can affect the efficiency of the low pressure drainage systems of the arm which runs between these tissues
– stiffness in the wrist bone (again common in typists, but also in anyone e.g. who uses tools which need to be grasped all the time)
– and many other factors individual to the person in terms of what has happened to their body, their posture, their job etc.
– and not forgetting that the neck sits on top of the rest of the spine, so it has to accommodate any problems below, and the position of the shoulder is dictated by the shape of the ribcage, which can be affected by breathing problems such as asthma- so sometimes relevant factors may also relate to other areas of the body.

So for me as an Osteopath, the symptoms in the hand in CTS are just the ‘tip of the iceberg’ – which is why my assessment will look at more than just the wrist, and my treatment is aimed at is making the whole iceberg smaller, not just the bit that pokes above the water!

Of course, Osteopathy is not the only non-medical approach that may help – stretching, massage, changing activities or even diet may also influence how irritable the nerve is or the degree of fluid around it.. but an osteopath can certainly assess what physical restrictions may be contributing to the problem, and treat these as part of an approach to improving overall function & reducing symptoms.

If you suffer from CTS or any other condition and would like to know if and how Osteopathy may help you, do get in touch.

SPD – Symphysis Pubis Dysfunction (Pregnancy Pelvic Pain)

This is pelvic pain that arises predominantly in pregnant women due to the softening effects of pregnancy hormones on the ligaments that support the pelvis. Classically it is felt at the front of the pelvis, but can also be experienced in the groin and low back, and can vary from mild to extremely painful. Typically walking, climbing stairs, getting in and out of the car or bath and standing all aggravate the symptoms.
Medically, not much can be done, since the options for pain-killers in pregnancy are very limited, most medical advice revolves around management, for example:-
• engage your core muscles & pelvic floor, avoid lifting & carrying or stepping over things
• avoid ‘straddle’ movements of the legs, bend the knees & keep the legs ‘glued together’ when turning over in bed, getting out of the car etc.
• avoid twisting movements of the body, sit down for tasks where possible
• avoid sitting in low sofas – try to sit on higher chairs with arms for support
• place a pillow between the knees at night when sleeping on your side

In extreme cases, crutches or a wheelchair may be necessary, but for most women it isn’t that severe, and there are some aids which may help:-
Sacro-iliac support belt e.g. Serola . This stabilises the ligaments of the pelvis and provides support for the muscles of the back – I have a loan belt at the practice which you can try before deciding whether to buy your own, every mum-to-be I have lent it to has gone out & bought their own, which may not be scientific evidence for whether it helps or not, but certainly says something!
Axiss Car Seat – for those mums who already have another child between 9 months & 4 years, getting them in & out of the car can involve all sorts of movements on the ‘things to avoid’ list – straddling, twisting & lifting! The Axiss Car Seat has a lockable swivel so that you can turn the seat to face the door to get your child in and out before turning it back & locking it in position. Comes highly recommended by a patient who has suffered from SPD in all her pregnancies.

From an osteopathic viewpoint, with many of the pregnant ladies I see who are suffering from SPD, there are often other areas of the body that are in some way restricted or limited (for example, sacro-iliac joints themselves, pelvic floor & diaphragm tension, old ankle/knee/hip injuries, tension in the upper back and neck) which means that the whole body is not adjusting to the postural and physiological changes of pregnancy as well as it could. Often by working on these other areas, releasing tension, getting stiff joints moving etc., the impact of the changes on the pelvic joints themselves can be reduced, helping mums to be more comfortable during this period of change and preparation for the birth.

To discuss your individual circumstances, please call Helena on 07805 650667 for further information.