Covid Protocol (17-09-2020)

Please read the following update regarding South Dartmoor Clinic’s protocols before attending or when booking your next appointment with us. Please bring and wear a face covering.

During this time the Osteopathic profession is striving to ensure that patient safety is our number one priority as we provide care within a healthcare setting that adheres to the current Government and Industry guidelines on minimising any spread of Covid-19.

With this information in mind there will be a few changes implemented. The following framework should be helpful to know what to expect. This will be subject to change over the coming weeks/months in response to prevailing advice.

1. When you made your appointment you were asked if you were experiencing any symptoms of Covid-19 (fever, new onset of cough, loss os smell and/or taste, etc for more details please visit the NHS site). Please check if you have Coronavirus symptoms. You will be asked this question again prior to your appointment. Also if you have been exposed to anyone with suspected or diagnosed Covid-19 in the past 14 days, you will be asked to reschedule your appointment.

2. Appointment times will 40 minutes with ample time between each appointment in order to clean treatment areas and other high touch zones/clinic furniture and prepare and change PPE. To adhere to social distancing we will have only 1 patient (with household members) in the clinic at any given time.

3. We will ask that patients arrive on time for their appointment and not too early. 

4. Please leave as many accessory items in the car/at home as you are able to. This includes watches, jewellery, bags etc. The less there is on you, the less chance there is of contamination.

5. If possible please bring your own PPE mask to attend your appt. You will need to remove any gloves that you have been wearing outside our clinic environment and wash your hands/put on another pair on entering the clinic or use the hand sanitiser supplied.

6. We kindly ask that patients do not bring friends or family to appointments unless required as a chaperone or for assistance.

7. It is advised that patients wear minimal, comfortable, loose clothing and a face covering.

8. The treatment format should remain similar to pre Covid-19. A 2 metre distance will be maintained when possible (taking a history, giving advice). 

9. The osteopath will be wearing the PPE. This will be sourced ethically (not taking away from the NHS). It will include single use apron and single session face masks. Eye protection and gloves may be worn depending on circumstances or if requested by the patient

10. Payment will be using the sterilised the mobile card reader provided. Cash will be accepted if no change is needed to be given

11. Further appointments will be made in a diary and an appointment card may be provided.

12. All magazines and reading materials have been removed from the clinic.

We trust that this level of care will prove satisfactory to you in providing a safe environment for you to receive your Osteopathic treatment in these Covid-19 times. We will continue to monitor our approach to delivering this care and modify these guidelines accordingly. Please remember that although every recommended measure will be taken at the clinic this will unfortunately not reduce the risk to zero and patients attending the clinic do so in full knowledge and acceptance of the risks.  If you have any further queries regarding this or your suitability for receiving treatment at this time, please contact me.

South Dartmoor Clinic

Long Covid – a guide for Self Help

It has been nine months since Covid-19 started to dominate the news. For the last six months it has had a dramatic impact on everyone’s life in the UK especially for the vulnerable and the unfortunate people and their families who became infected and developed symptoms.

Slowly our understanding and knowledge about the conditions and it’s ramifications are building and a lot of unexpected details are emerging. We still are only scratching the surface and the next months and years will no doubt produce more useful information.

One of the many worrying aspects of Coronavirus is the number of people who are suffering from Long Covid. This is development of long term symptoms associated with the condition especially fatigue. I have been supporting patients in my clinics in Newton Abbot and Ashburton for many years suffering from Myalgic Encephalomyelitis/Chronic Fatigue Syndrome which is also known as Post Viral Fatigue and closely associate fibromyalgia. The parallels with Long Covid are marked and may well be physiologically very similar. There is an excellent and detailed video about Long Covid produced by the BMJ here.

I have for the last few months been approached by increasing numbers of patients with Long Covid asking if Osteopathy can help. Previously energetic healthy individuals, many between the ages of 30 and 50 years of age who have developed troubling long term symptoms. Unfortunately there is little the GPs can do and so they are admirably researching different options and ways of managing their health.

So can I as an Osteopath help and support people with Long Covid? So far I have had a number of patients respond well to my work with them as an osteopath. Of course I make no claim to cure the condition but believe an individually designed course of treatment can support and aid their recovery. Drawing on my many years of experience with ME/CFS this usually involves supporting the fundamental basics of health. I help their musculoskeletal system, advise on diet, mindfulness practise, yoga based exercises, graded exercises, sleep, hydration and supplementation.

If you’d like to discuss what you have read above please call me on 01626 334036 (Newton Abbot TQ12) or 01364 652016 (Ashburton TQ13). More details about my clinics can be found here.

Low Back Opener

This is a wonderful stretch for gently easing stiffness and tension in the low back delivered from my clinics in TQ12 and TQ13! My mission is for everyone to become their own osteopath!

It also helps to bring space to the vertebral joints (apophyseal joints). When these joints get too jammed together from tight, stiff muscles it leads to too much pressure and load bearing on the joints. This then leads to increased wear and tear (osteoarthritis). The symptoms of this in the low back are pain and stiffness especially in the morning.

Doing these stretches yourself is like a form of self treatment. Much of my work as an osteopath is aimed at achieving what these exercises can do. Sometimes, unfortunately, we need some help from an osteopath to start things moving in the right direction. But hopefully, when the pain and stiffness has been reduced in the the low back, then the patient can build these stretches into their own exercise routine.

Feel free to contact me in Ashburton or Newton Abbot for more information, for treatment or for your own bespoke exercise plan. More exercises can be found on the News page. Have you looked at my Core Stability or Daily Routine videos?

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.