Core Stability

A simple, adaptable exercise for core stability.

Core stability is defined as “the capacity of the muscles of the torso to assist in the maintenance of good posture, balance, etc., especially during movement”. Reading this definition it comes as no surprise how important it is. In fact I believe that just about every movement we do in day to day life involves the core.

A few of the exercises I’ve posted from my Newton Abbot clinic address this and much of my time as an osteopath is helping patients rebuild these areas or treatment often caused by a weakness in their core.

Regaining strength and flexibility will lead to greater confidence which will in turn encourages more movement. Please call me if you’d like help with this in come and see me if you’re in the TQ12 or TQ13 area of Devon.

Restrictions are easing.

Lockdown restrictions are easing and so now is the time to start easing those restrictions that may have built up in your body.

After a few unprecedented months of being limited by lockdown we now have the freedom to move a little more. We are still living in times of stress and those stresses easily find their way into our bodies. This can cause us to hold pain and tension especially in our neck, low back, shoulders, jaw and even our face and nostrils. This causes pain which reduces our movement which increases stiffness and around the vicious circle goes. Osteopathy can help this!

There are some videos of stretches to do that will help you on News page of my website but sometimes we need a helping hand from an osteopath to get things going again. I’m pleased to say the clinic has been open for a few months now using the appropriate infection control and PPE. So please contact me at Newton Abbot (TQ12) or Ashburton (TQ13) for a chat about how I could help you find the Freedom to Move again.

The Importance of the Pelvic Floor (and what you can do to keep it healthy).

The pelvic floor is often an under-appreciated but nevertheless very important part of our anatomy.  It plays a vital role in keeping our low backs and rest of our bodies healthy and functioning well; it is directly linked to the role and importance of the “core” ie in core stability; it aids the functions of our internal organs and perhaps most well known is that it plays a huge role in bowel and bladder function especially after the effects of pregnancy and childbirth.

So what is the pelvic floor?  It’s best thought of as a “sling” of muscles the covers the outlet of the pelvis.  A little like a hammock, the contents of the abdomen lies on top of it and is supported by it.  Being made of muscle it is contractile and therefore is a dynamic structure capable of movement.  When it has good tone (the resting contraction of the muscles) it helps gentle close the structures that pass through it, most importantly the urethra and the lowest part of the large intestine – in other words the tubes that our pee and poo travel down to find their way out of the body.  More on this later.

How is it important in low back pain and posture?  As an osteopath this is of particular interest for me.  The low back relies on a number of different structures and their health for good low back functioning.  Some of the most significant are the shape and alignment of the lumbar spinal vertebrae, ligaments, intervertebral discs and the muscular support of the spinal muscles.  The pelvic floor blends with the diaphragm and abdominal muscles (if core stability is good) making a balloon like container.  When we move or lift this container acts like a support – a little like a weight lifters belt.  These days people are more aware about the abdominal muscles and their importance of this but the pelvic floor is a vital component playing a very important part in supporting the spine and keeping it strong, stable and free from pain.

How is the pelvic floor important to general health?  One way of looking at the abdomen (the area below the rib cage but above our thighs) is as a muscular container within which is our viscera (large and small intestines; kidneys; liver; spleen; pancreas etc).  These organs all individually need to function well for the for the health of everything things else in our body and minds.  For this to happen we need the usual things for health eg good diet; exercises; posture etc but also it needs a good blood and lymph supply and drainage.  Again many things influence this but often forgot is movement.  Movement at a the level of the body but also within the body.  When we breathe well (more on this in another blog) our diaphragm descends and rises gently massaging the the organs, helping the gut to transport things along its length, aiding the blood supply and improving the lymphatic health.  So where does the pelvic floor fit in?  The rest of the muscular container is comprised of the abdominal muscles to the front, the spinal and posture muscles at the back and the pelvic floor underneath.  As the diaphragm descends the overall function of the abdomen will be that much better if the pelvic floor and the rest of the container are functioning well.  The pelvic floor will allow the abdominal organs to return back up receiving gentle compression and relaxation with every breath.  This helps the blood and lymph flow and, you guessed it, improving all the organs functioning and health.  As well as gently moving the spine with each breath and aiding its health in the same way.

How does the pelvic floor help bowel and bladder function?  As I mentioned above the urethra (pee tube that leaves the bladder) and lowest part of the large intestine travel through the muscular pelvic floor.  As well as supporting the bowel and bladder the muscles offer some ability to close off the tubes.  If the floor is weak then it can lead to urinary incontinence, haemorrhoids and other pelvis disorders.  These conditions are not uncommon but can be a source of embarrassment and inconvenience.  Can anything be done?

Can I improve my pelvic floor?  Yes!  But as with all self help regimes it takes a bit of time, effort and self discipline.

Pelvic floor exercises:

Take a seat and imagine you’re sitting on the loo. Now imagine you’re having a pee and want to stop the flow. What muscles would you contract?  If you’re unsure, next time you’re going to the loo then experiment with stopping the flow of wee.  Contract these muscles and hold for a count of 10 seconds.  Next squeeze and relax the muscles quickly five times.  You can then see if you can isolate the muscles mid way back on the pelvic floor and repeat the same set of exercises.  Then again for the muscles at the back of the pelvic floor.  Over time try increasing the number of sets of exercises.  Remember not to strain and if you get any pain then stop and let me know. 

For more complicated exercises imagine you’re contracting diagonally across the pelvic floor (eg right of the pubic area to left of the tail bone area and vice versa).

Do these exercises at least once a day.  When you get proficient the exercises can be done anywhere and in any position.  If you have any questions then contact me at either my Ashburton or Newton Abbot Clinic.

You should feel the benefits in a couple of weeks.  Good luck 🙂

Persistent Pain

We all feel pain from time to time. When someone injures themselves, specific nerves recognise this as pain, which in turn triggers the body’s repair mechanism. As the problem resolves, the pain tends to improve and usually disappears within 3-6 months. This type of pain could be argued to be beneficial: if it hurts, you are likely to try and avoid doing whatever it is that has caused the pain in the future, so you are less likely to injure yourself in that way again.

Occasionally the pain continues even after tissue healing has finished. When pain continues after this point, it becomes known as persistent (or is sometimes referred to as chronic) pain. This type of pain is not beneficial and is a result of the nerves becoming over-sensitised, which means that a painful response will be triggered much more easily than normal. This can be unpleasant, but doesn’t necessarily mean that you are doing yourself any harm simply by moving. You could think of this as a sensitive car alarm that goes off in error when someone walks past.

Persistent pain is very common and effects over 14 million people in the UK alone. It often does not respond to conventional medical interventions and needs a different kind of approach, but there are many things that you can do to manage your pain yourself with the support of your osteopath, your family and loved-ones. Keeping active, performing exercises and stretches can help, learning to pace your activities so that you don’t trigger a flare-up of your pain as well as setting goals and priorities are all very important and can help you to maintain a fulfilling lifestyle.

For more information on how to manage your persistent pain please contact me.

Osteopathy for Work

The health and safety executive estimate that in 2013/14 there were 526,000 cases of work related musculoskeletal disorders (MSDs) – about 42% of all work related illnesses MSDs are the second biggest cause of absence from work, effecting over 1m people at a cost to the economy (estimated in 2007) of £7bn.

If you are self-employed, taking time off work with musculoskeletal problem can have a devastating effect on you and your family’s financial security, so getting back to work as quickly as possible is essential. That can seem impossible when you’re in pain and unable to complete your usual daily activities, but movement really helps.

The Work Foundation recommend that you work with your employers and healthcare professionals if effected by MSDs to find ways of returning to work as soon as possible using a combination of treatment, lifestyle changes and adjustment to working conditions. They also suggest that early intervention is key to recovery, hastening your return to a normal, healthy lifestyle and limiting the negative psychological effects of an extended period of sick leave.

How our osteopaths can help;

• Fast access – our osteopaths are usually able to see you within a couple of days of seeking an appointment. As osteopaths are primary healthcare professionals you don’t need to be referred by a GP unless you are seeking NHS funded treatment or your health insurance provider insists that you see a GP first.

• Treatment and advice – once they have assessed your condition an osteopath will usually begin treatment straight away. They can also provide advice on how to avoid making the condition worse or re-injuring yourself.

• Inexpensive treatment – Many MSDs can be treated by osteopaths over a few visits.

• Fit notes – A fit note provides your employer with advice on what they can do to help an employee return safely to work. This may include adjustments to working conditions, such as reduced hours, a different work station set up, or recommending avoiding activities that may prevent or slow recovery, heavy lifting for example. Osteopaths are able to issue fit notes which will give employers this expert advice.

• Onward referral – With your permission, osteopaths are able to share information about your health with other healthcare professionals, such as your GP. If your condition requires the intervention of another expert, an osteopath can provide a letter of referral detailing the diagnosis and any treatment that they have been able to provide, which may help you more rapidly get the help you need to return to health.

Working from home during Lockdown?

Many more people are working from home during these challenging times. I thoroughly recommend setting up a good, dedicated (if possible) working space at home. Of course this can be very difficult with lack of equipment, lack of room and sharing your space with family, children, housemates etc.

Despite these challenges there are usually things that can be done to at least improve our environment. The following short video is a taster of some of the things to look into.

I also recommend that if this is likely to be a long term arrangement that some investment in equipment should be looked at if one’s finances allow it. It’s also worth discussing this with your employer as they may be able to assist in the purchase of kit.

The least expensive and most useful addition is a laptop stand which can be used with a separate keyboard, mouse and/or trackpad. This lifts the screen up meaning the head doesn’t drop down. Looking down at a screen increases neck pain and tension, and puts strain through the shoulders. It even adds to low back pain and soreness as the centre of gravity moves forward and the lumbar muscles have to work harder. If we are in discomfort and pain then our ability to focus and concentrate is impacted leading to reduced efficiency in our ability to work well.

Document holders work in similar ways and are also inexpensive. They keep the head looking forward in a more neutral way.

A good chair (and importantly) properly set up will significantly help to reduce pain. Ideally one that will tilt as we lean our weight forward and back depending on what we are doing are the desk. The one above is an excellent example and kindly loaned by the people at Back World in Exeter, near my osteopathic clinics in Newton Abbot and Ashburton. You will also receive great advice on setting up a home work station.

Please feel free to contact me if you’d like some advice on your particular situation.

Befriending the Inner Critic

The inner critic is a powerful force and sadly it is all too familiar in today’s culture. It appears in many guises but frequently as self criticism, shame, disconnection and difficulty in expressing ourselves. It saps us of confidence and energy, triggering conflict and misunderstanding, and brings untold amounts of misery. It has a powerful effect on our body and on our health often shaping our posture from the physical hold it has on us.

Held within our bodies these contraction patterns interfere with the function of our breathing and digestion further impacting on our health. Classically the person with a strong inner critic may feel slightly hunched almost as if they’re being put upon by an external force.

I’ve copied a link here to one of Rob Burbea’s talks given at Gaia House – a well known and respected retreat centre that I’m blessed to live a short distance away from. It offers a detailed and deeply insightful exploration of why and how this has become so insidious in Western culture but more importantly it offers a possible path of what can be done to help erode the habits of mind that can at times seems unrelentingly imprisoning and suffocating. His insights draw heavily on the Buddhist tradition of mindfulness and befriending these darker elements of ourselves by bring a sense of kindness, warmth, awareness and understanding that can not only free us from our own suffering but can also improve our creativity, connection and confidence. This is likely to then ripple out away from us benefitted the people around us, most likely to those close to us that we hold dear.

https://www.dharmaseed.org/teacher/210/talk/9815/

As an osteopath I’m not only concerned with releasing people from pain in their bodies. I’m also interested in trying to help him deal with other forms of pain within their own lives in whatever form it takes. I’m also hoping to somehow reduce their burden. When our burden (both physically and emotionally) is lighter we put ourselves under less strain, we have more energy, tensions can dissipate and we stand taller.

During my own practice of meditation I’m often aware how emotional knots manifest in the body and in those lucky moments when release occurs a greater sense of freedom and opening can be reflected in the body, freeing me of low back pain, tension around the shoulders, holding in the jaw and neck and the other familiar places where we store tensions.

Butterfly Stretch for Happy Hips

This is a wonderful stretch for opening the hips, reducing pelvic tightness, aiding breathing and digestion.

More from my stretch studio in Newton Abbot! This is part of my daily routine and I often prescribe the for my patients. It’s good for low back pain and helps with the effects of osteoarthritis in the hips.

Like so many good yoga based exercises for back health, it is also very grounding.

Enjoy! Max the osteopath 🙂

Cat/Cow Stretch

A great simple exercise to help improve low back and thoracic health. Co ordinate with the breathing for improved diaphragmatic function.

My Personal Daily Stretch Routine

Every morning (nearly) I start the day with 5-10 minutes of stretching. It has a profound effect slowly but surely improving posture and energy whilst reducing stress and pain. It’s amazing how we look after so many of the objects that fill our lives but often overlook the most important – our bodies. It’s also an act of self love, sending a message of positive self respect and value to ourselves.

This routine covers most areas of the body. It will gently open up the low back and stretch import postural muscles like the hamstrings, quads and deep hip flexors like psoas. It stretches out the ribs and thorax and helps improve diaphragmatic breathing.

Remember that our bodies take time to soften up in the mornings so it’s preferable to have been up and about for at least 30 minutes before stretching. Choose a comfortable area of floor (carpet or rugs), make sure you’re warm and maybe use a pillow under your head. Take your time and stay mindful with the breath – let it soften areas of tightness and pain. Breathe into the areas of discomfort and don’t force anything.

You should start to feel a difference very quickly and this will slowly build with time. Hopefully you’ll get to a point where you’ll be wanting to do more each day.

More exercises will be appearing here from my stretch studio in Newton Abbot.