Tips and Advice

Trolley Dash to the Osteopath

Apr 19, 2012
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Recent conversations with patients have alerted us to the fact that many people may be putting unnecessary strain on their backs whilst doing the weekly shop.  The problems, apart from lifting heavy items into and out of the car stem from the way they push the trolley.

If you watch most people in the supermarket they will haul the trolley around to the side when they get to the end of the aisle.  This involves planting both feet on the floor and rotating the trolley to the right or left until it is pointing in the right direction whilst trying to maintain forward momentum and avoid people coming the other way.

This rotational movement puts a lot of strain through the sacro-iliac joints in the lower back/pelvis region and strain of these joints can produce severe, one-sided pain in the lower back.  This is a very common complaint amongst our new patients and fortunately osteopathy can be very helpful in relieving this type of back pain.  However, this can be eliminated by stopping, revolving the trolley on the spot until it is pointing in the right direction then moving off again.

In order to help avoid making your shopping trip more painful here are our top tips for pain free shopping;

  1. 1. Use the trolley correctly – when you get to the end of the aisle stop the trolley and walk around it holding the handle until you are pointing in the right direction then push off again.  This will avoid putting too much strain on the lower back.
  2. 2. Distribute the weight better – Most of us fill the far end of the trolley with fruit and vegetables first (as they are usually at the front of the supermarket).  This means that the trolley will be harder to manoeuvre.  Try putting the fruit and veg in the middle of the trolley, leaving space at the near end for heavy items and space at the front for lighter things.
  3. 3. Buy heavy things online – If your weekly shop includes pre-packaged heavy items, get them delivered.  Typical examples include bottles of water, tinned products and alcohol.  When you next visit the supermarket you will only need to buy the light, fresh products and may only need a small trolley.
  4. 4. Ask for assistance – most large supermarkets would be happy to provide a member of staff to help you pack your shopping and help you to the car with it if you are having difficulty.  If you have back pain or you feel it is very heavy ask the cashier if they would get someone to help.
  5. 5. Spread the load – when you get home in the car get family members to help unload the car.  They may not like it but it’ll get done much more quickly!

By following these tips we can’t guarantee you will enjoy the weekly shop but hopefully you will avoid back pain.

Shin Splints

Apr 4, 2012
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Shin splints can be a very painful and very common reason why people have to reduce their training or stop altogether.  We have seen several people in the clinic recently training for Brighton Marathon with these symptoms.
Shin splints (also known as Medial Tibial Stress Syndrome or Medial Tibial Periostitis) is caused by overstrain on the membrane around the tibia bone resulting from excessive strain placed on it by muscle attachments.  It often occurs in people who do a lot of exercise and who over-train or rapidly increase their training. Running on hard surfaces and doing a lot of stopping and starting are also reasons why people suffer from shin splints.
Having poor trainers or having poor foot mechanics especially when the foot rolls inwards during running (over pronation), weak ankles and tight calf muscles are also factors that can contribute to shin splints.
  1. 1. Firstly you need to stop the exercise that is causing the problem.  Two weeks is usually a minimum.  This allows the irritation to stop while the cause is addressed.
  2. 2. Use ice treatment – apply ice packs for ten minutes per hour for a few hours to reduce inflammation and therefore reduce the pain.  Repeat as necessary.
  3. 3. Check your training shoes – if they are worn on the sole under the big toe or ball of the foot in that area there is a good chance you over pronate and this needs to be addressed with different trainers and/or orthotics in the shoes.
  4. 4. Continue training using non weight bearing exercise such as swimming or cycling to maintain fitness.
  5. 5. Stretch your calf (including gastrocnemius, soleus and tibialis posterior) and shin. See the stretching page on our website.
  1. 1. Strengthen your muscles using;
            1. a. Calf raises
            1. b. Toe raises
            1. c. Toe/Heel walking
            1. d. Resisted foot dorsiflexion
  2. 2. Begin your training again slowly and build up gradually
  3. 3. Warm up and stretch the calf and shin prior to exercise
  4. 4. Consider wearing compression socks which allow heat to be retained and provide support to the calf muscle (they don’t look great but a lot of top athletes wear them!)
  5. 5. Get better trainers.  Go to a shop that assesses your running gait properly. We suggest Run in Hove or Tortoise and Hare, Cranleigh
  1. 1. We can assess your muscular and biomechanical function of your foot and leg
  2. 2. We can release the muscles effectively
  3. 3. We can ensure you are doing the correct stretching
  4. 4. We can strap your leg to take strain off the shin
  5. 5. We can ensure that your pelvic mechanics are working properly thus reducing the chance of secondary problems such as back pain and hip pain.
  6. 6. We can help to get you running again!

Avoiding Neck Pain, Shoulder Pain and Arm Pain at Work

Mar 28, 2012
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In response to a question we received on Facebook here are our 5 top tips for avoiding neck pain, shoulder pain and arm pain whilst at work.
1. Ensure your workstation is set up correctly.
You should be sat directly in front of your computer rather than at an angle and have your arms comfortably to your side. Your forearms should be horizontal and your eyes should be just above the level of the top of your monitor. Keep your shoulders relaxed and make sure your mouse is not too far away from you. Make sure your seat is at the right height and you have a small gap behind your knees between the knee and chair.  Put your buttocks right back in the seat so that when you sit up you have a good lumbar curve.  Keep your back against the back of the seat but don’t lean back on it.  Ensure your feet are flat on the floor.
Look at this diagram to ensure you have the right position.
Guidance can also be found on the HSE website (self-assessment guides) at
2.            Get the mouse right.
There are several ways you can use your mouse to minimise strain on your arm and forearm.  Try using the other hand or alternate your left and right hand.  Position the mouse closer to the keyboard to avoid having to turn your arm out to reach it.  Slow down the mouse and reduce the number of clicks required by adjusting the settings in the control panel of your computer.  Try using keystrokes instead of the mouse for certain actions (this can be done by looking in the tools menu).
Use different mouse devices and rotate them so you change them regularly.
3.            Get the right hardware.
There are various ergonomic designs of mouse and keyboard on the market so think about having a trip to a computer shop to try some out.  Talk to your employer if you think you may benefit from a different type of device – you never know they might even buy one for you!
4.            Take regular breaks from the screen.
Every 15 to 20 minutes you should look away from the screen to avoid your eyes getting dry and strained.  Try looking to a different part of the office and blinking repeatedly for a few seconds (though its best to avoid looking at a colleague whilst doing this as they may get the wrong idea!)
5.            Stretch
Stretch your forearms regularly by holding your arms out in front of you and pulling your hand towards you first palm up, then palm down. 
Hold the stretch for 30 seconds each.
Clasp your hands together and push them away from you whilst pushing your spine backwards.  This will give a good stretch across your back.  Complement this by pushing left, right, up and down also.
Stretch your head in each direction and allow the weight of the head to stretch the muscles of the opposite side.
Keep an eye on the website for upcoming guidance on stretching.
Follow these tips to help avoid pain and discomfort in your neck, shoulders and arms whilst at work.

Top Tip for Good Back Health at Work

Mar 7, 2012
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A recent Canadian study has shown that fidgeting and getting up frequently at work can help to keep you much fitter than sitting still at a computer all day.  This is because the muscles are activated more often and more energy is burnt resulting in increased fitness.

There is also a massive advantage to moving around at work for your back.  Many people recognise the importance of having a good chair at work that is adjustable in height, seat angle, arm positions and lumbar support according to guidelines for correct ergonomic work position and workstation assessments.  These help to prevent back pain and neck strain.  But it’s not that simple.  You can have the best chair in the world but if you sit on it badly then you will still have back and neck problems.

Imagine that you get to work and sit at your desk in a good, upright position with good lumbar (lower back) curve – a good ergonomic position.  After half an hour you may have begun to slouch, your lumbar curve is lost and your position is poor.  You may be sat at the
desk until lunch time, four hours after you sat down.  If the same is true in the afternoon you will have been sitting poorly for seven to eight hours!  That’s a lot of bad forces going through your back and neck possibly resulting in neck discomfort, back pain, headaches and
repetitive strain injuries.

Now imagine that every half hour you simply stand up …. and sit back down again.  Each time you sit down you adopt the correct posture and manage to maintain it for most of the next half hour until you stand up again.  In one day you will have been sitting correctly for more than three quarters of the day.  Total work time lost – none.

Why not take a look at our Facebook page to be kept up to date with more top tips like this one? Just click on the link

Marathon Training

Feb 29, 2012
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At this time of year we begin to see more and more people training for the Brighton marathon and suffering from a variety of ailments from back pain, neck pain and muscle strain to headaches and hip pain.  There are a variety of ways in which these injuries are caused and an equally diverse number of ways to treat them.
The following reasons are often the cause of running injury;

Increasing the mileage – At this time of year with Brighton marathon approaching in April people are increasing their mileage
above what their body has ever done before.  As a result the muscles are required to work harder for longer and require more nutrition and hydration.  Poor hydration and lack of nutrients and salts can cause muscle strain and muscle injury.  It is essential to take on plenty of fluids and nutrition before and during the training run as well as the race itself.

Poor technique – As the mileage increases the muscles become tired and find it difficult to keep good running posture and technique.  This results in the body trying to compensate to engage other muscles and use joints differently causing back pain, muscle
pain and joint pain.  Often people find that they are fine running for, say, ten miles but then they will begin to get blisters.  This is because their technique begins to change at the point when their body gets tired and their feet strike the ground differently causing blisters.

The camber of the road – Road running is known to be quite hard on the joints and can cause wear and tear in the knees after long periods.  But also, running on one side of the road all the time unbalances the body quite quickly.  The road is not flat and is higher in the centre than at the sides to aid drainage of rain water into the gutters but this also means that it causes you to run out of balance.  This effect is reduced if running on the pavement, in the park or along Brighton seafront.  The effect is, however magnified in the countryside where there are often no pavements and an increased camber.  Runners should try to run on alternate sides of the road, use footpaths or stay off the road completely to avoid back pain from asymmetrical running.  During the race try to run in the middle of the road.

Stretching and ice – Stretching has long been known about….and long been ignored by people training for marathons.  Stretching can be very useful in reducing the pain and stiffness associated with training session (known as DOMS).  Stretching helps the body get rid of all the lactic acid built up in the muscles which is known to cause pain.  Ice has a similar effect and many top athletes now have an ice bath after races to aid the recovery of the muscles.  Many people can be seen after the Brighton marathon sitting in the sea to gain a similar effect – it’s not icy but it’s still pretty chilly!  Ice baths should only be taken if you have sought advice from your GP as they can
be a big shock to your body and cause sudden health problems.

Sometimes osteopathic manipulation is used to treat these problems but often advice regarding the maintenance of good muscles is important.  We try to make sure that the body is functioning correctly and in a balanced way.  The muscles should be supple and strong and the back and neck free from restrictions (which are often caused by work!)
Follow the advice above for injury free training and an enjoyable
marathon experience.

The Dangers of Holidays!

Jul 22, 2011
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We all look forward to going on holiday to the sun but we often don’t think of the dangers for our backs.  Here are some of the top problems that people suffer with and tips to avoid pain and discomfort while you are away.
Most people are aware of the dangers from Deep Vein Thrombosis when taking long flights but they don’t realise that many peoples bodies are not used to sitting for extended periods of time.  If your job and lifestyle keep you on your feet all the time then sitting for hours on end will be a big challenge for your back.  Try to get up and move around during the flight, walking along the aisles or to the toilet regularly.  Also keep your legs moving.  Rolling your ankles in a circle, pointing your toes and lifting your thighs will all help to discourage joint and muscle pain and DVT.
Arrival at the baggage reclaim area usually means standing around for ages waiting for the belt to begin moving, cramming into the crowd to get to the bags passing by and then dragging them off the conveyor.  This is an ideal time to walk about slowly to get the muscles loosened.  Gentle stretching can make you feel more alert and drinking water will help to rehydrate you.
Try standing away from the crowded areas at the conveyor, that way you can see your bags coming and will have plenty of time to get them off without bending awkwardly between two people.  Bend the knees and get one bag at a time.
The best hotels in the world may have the best bed in the world – but it’s not your bed!  Your body is used to your bed and will often
feel stiff and sore after a night in another. 
Before you get out of bed try rocking your bent knees from side to side and hugging your knees up to your chest. This will help your lower back to loosen.  Get up slowly and carefully and move around the room before charging down to the pool.
Many sunbeds do not fold completely flat which is fine while you are tanning your front.  The problems begin when you turn onto your
front to tan your back.  When lying on your front your Lumbar spine will be held in an extended position (i.e. bent backwards) and the joints will be forced together.  When you begin to feel uncomfortable you may realise that you still have twenty minutes to go before its time to turn over so decide to ignore the aching. 
Don’t!  The discomfort you feel is your body telling you it is not able to cope with that position and that it needs you to move.
If you do get acute back pain use an ice pack immediately for 10 minutes every half hour and keep moving as much
as you can.  Lying on your back on the floor or bed with your knees bent may be comfortable.  Then give us a call when you get back.

5 Ways to Pain Free Gardening

Jun 25, 2011
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At this time of year osteopaths see a lot of people with back pain resulting from gardening injuries.
Whilst back pain is a very common ailment in the population there are ways to prevent back pain and neck pain ruining your love of gardening.
LIFT SMALLER LOADS – Often we see people at garden centres loading up their cars with sacks of wood chips, top soil and compost. 
Bear in mind that you will have to lift them several times; into the car, out of the car and to wherever you are working in the garden.  By taking care to lift one at a time (ideally between two people), bending your knees and keeping your back straight your back and neck will endure minimum strain.
USE A WHEEL BARROW – Moving heavy compost and plant pots around the garden can easily strain your back or give you neck pain. 
By using a wheel barrow even for short trips this risk can be reduced.
LITTLE AND OFTEN – As an osteopath, the majority of people I see at this time of year with acute pain are gardeners who have tried to do too much in one day.  Typically they have a job that does not involve lifting and so their back is not accustomed to that type of
activity.  Also they don’t spend much time gardening throughout the year and consequently they need to do a lot in the spring.  By doing a small amount several times a week the risk of back and neck injury is vastly reduced.
SWAP ACTIVITIES REGULARLY – Gardens and flower beds can be quite large and accordingly keeping them tidy can be big jobs. 
Weeding, pruning and mowing can all be enough to cause injury if done too much.  By doing a period of weeding then leaving it to mow a part of the lawn before returning to the weeding gives the back muscles a chance to recover and therefore reduces the chance of back
KNEEL TO WEED – Osteopaths often see people bending from the hips when working on the ground.  By simply kneeling on a pad the
spine can be supported by leaning on one hand and using the other to pull weeds.
AFTERWARDS – HAVE A HOT BATH OR USE AN ICE PACK – Tired muscles respond very well to heat and helps to prevent them from seizing up.  Alternatively, if you have any pain in the back or in the muscles put an ice pack on the area for ten minutes to reduce any inflammation.  Details of how to use an ice pack can be found on our website
If you do injure yourself and need help don’t hesitate to contact us at Back to Health.  We know about back pain!
  • Not sure if osteopathy is for you?

    If you have any questions regarding osteopathic treatment prior to booking an appointment, please do not hesitate to let us know and one of our osteopaths will be happy to discuss these with you. If you are still not sure we offer a Free Assessment. Just ask when you call.