Muscle sprain

We often hear this from patients when they first come to our Uxbridge or Ealing clinic, and although there are conditions where “it’s a muscle problem” is a reasonable (if limited) statement, there are far more instances where it really is not the case.

Muscles are the galley slaves of the body; they do the hard work, but do not make the decisions about what work is to be done or issue the orders, and they tend to work faithfully under whatever circumstances they encounter to the point of exhaustion and failure. Their persistent complaints (aches and pains) are usually the warning sign that something is wrong, i.e. muscle pain is the symptom, but the problem is wider, and the solution should accord with that.

A typical example would be where a patient has persistent neck and shoulder tension; massage may help, but the tightness returns, often because of restrictions in the vertebral joints around the base of the neck.

At the very least, more aspects of the musculoskeletal system will be involved. Muscles move bones like levers in relation to each other by articulating joints, and they must coordinate in a cascade of events for their effort to be synergistic with the whole. The nervous system performs this role of communication and coordination of action and movement, and the cardiovascular system takes care of the raw materials (such as oxygen and nutrients) and disposal needs of the muscles themselves. Any compromise in the function of any of these systems is likely to produce symptoms local to the site of action, i.e. the muscles. How a problem is defined will most likely tell you something about the practitioner – e.g. a massage therapist may tend to describe conditions in terms of muscles. As Abraham Maslow said

“If the only tool you use is a hammer, you are going to tend to hit things”.

How can an osteopath help?

It is the task of an Osteopath to strive to understand the processes involved in creating a condition of unease or pain, and introduce appropriate measures (such as treatment, exercise or nutrition) to relieve the symptoms and undo the causes.

In fact the Osteopath aims not only to provide symptom relief, but also to ensure that the patient is equipped to reduce the incidence and severity of recurrences as well. Or to put it another way, Osteopaths can help you keep your galley slaves happier and for longer.

Can we help you? We are registered osteopaths in Ealing and Uxbridge. Please do explore our website to see what we treat and learn more about us.

Tennis elbow – a.k.a. lateral epicondylitis – is one of the most common overuse injuries.

It is usually associated with repetitive finger/wrist movements such as in typing, using a mouse on a computer, wielding a hammer or a racket, or using a screwdriver.

It commonly affects a wide range of office and manual workers: typists, computer operators, carpenters and plumbers, cashiers etc and… yes, racket athletes.

Although there may be no swelling or redness, the condition manifests with pain on the outside of the elbow or in the forearm, worse when gripping a handle or lifting a weight. When it is particularly bad, it may even prevent the sufferer from working.

To the extent that the elbow is an integral part of the upper body at work, tennis elbow is often related to poor working posture, and may be accompanied by wrist, shoulder and/or neck pain as the condition becomes entrenched.

Initially, treatment of tennis elbow involves:

• Resting the joint until the pain subsides, and limiting any aggravating movements of the wrist, elbow or shoulder;
• Applying an ice pack to the elbow for a few minutes at regular intervals to reduce the inflammation
• Light massage therapy of the forearm, and gentle easy movement of the wrist, elbow, shoulder and neck / mid back;
• Increased water intake (not tea or coffee) to facilitate tissue repair.

If the condition has been present for 2-3 months or over, treatment is more involved and diverse:

• More intensive mobilisation of the elbow, but also upper back, neck and other upper limb joints;
• More extensive massage of the elbow and forearm muscles;
• Contact hydrotherapy (application of hot/cold water) to encourage local blood supply and tissue repair;
• Home and workplace exercises emphasising stretching of the wrist muscles and movements of the upper limb and neck;
• Adapting the work station, e.g. bringing the mouse closer to the keyboard, using wrist rests, using larger, shock absorbing handles on work tools.

If you think you are suffering from tennis elbow, please call us on 01895 20 00 50 to discuss your symptoms and seek further advice. Our clinic is located on Uxbridge high street. Bridge to Health also arranges drop-in employee health checks on site at local businesses and organisations as part of its Corporate Services offer, providing busy workers an opportunity to discuss and take action on health issues that might otherwise go unchecked. Do contact us if we can help!

Several of our patients are being treated for Repetitive Strain Injury (RSI for short) – most frequently tennis elbow and achilles tendonitis – and other patients often ask us about what lies behind RSI. Today’s post aims to provide some basic answers to these queries.

What is Repetitive Strain Injury?

Repetitive Stain Injury is an “umbrella diagnosis” that accounts for a wide range of musculoskeletal pain disorders as a result of overuse of the body. This is most often experienced in the arm due to occupational strain.

(Musculoskeletal = bones / muscles / tendons)

The pain is usually a sharp stabbing pain which initially comes on once the aggravating cause has ceased, however this may then go on to flair-up more often. There are many conditions that fall under this term such as Tennis elbow, Carpal tunnel, Thoracic outlet syndrome, Tendonitis and many more.

What is the cause?

When a movement or action is repeated over and over, the tissues of the body become overused and begin to break down. This leads to a build-up of inflammation as the body tries to repair the damage. Typical triggers are sporting injuries where an action is constantly repeated, for example running, swimming, serving a tennis ball can all trigger these conditions. Also, hobbies such as playing the guitar, fly-fishing, you name it! However, the most common cause of RSI in the modern age is overuse due to occupational strain and the biggest culprit of all is the computer keyboard – especially laptop computers.

How to fix/cure RSI

The most important element of the healing process is rest to allow the body to heal the tissue; however the dilemma faced by most patients is how to recover from an injury such as this when the causative factor is the one which puts food on the table. Other treatment methods are cryotherapy (using ice/cold water to help heal sprains) to reduce the inflammation and manual therapy such as osteopathy, physiotherapy and acupuncture.

Others methods involve applying a joint splint or forearm compression bandages to alleviate the pressure on the muscle insertion point.

How can I prevent Repetitive Strain Injury?

For many office-bound people, inevitably the bulk of the day is spent on a laptop but this needn’t be a guarantee that you will be affected by RSI.

• Seek advice on correct setup of your workstation, both at work and at home;
• Take regular breaks throughout the day, even if some are just 2 minute breaks, to stretch the arms, shoulders and back;
• Maintain good hydration at all time: you should be aiming for 1.5 to 2 litres of water each day. Tea and coffee are diuretics which lead to an increased expulsion of water from the body, leading to dehydration;
• Ensure a well balanced natural diet which avoids refined and processed foods and includes plenty of fruit and vegetable intake, as it is vital for promoting tissue health;
• Maintain good posture, this is important at all times but especially when at your desk as long periods in a poor position (typically slumped) will lead to poor circulation and nerve conduction and increase the risk of developing RSI;
• Ensure regular exercise, which is essential for muscle health, 30 minutes of walking a day is a great boost for circulation and will improve overall health in many ways;
• Seek good manual therapy, as it is a great way to keep muscles and joint moving correctly; a regular Osteopathic maintenance treatment will help.

If you have the symptons of RSI, don’t put off doing something about it. Bridge to Health Osteopathic Healthcare is based in Uxbridge, West London where we specialise in workplace based musculoskeletal complaints – visit our website at www.bridgetohealth.co.uk.

One of the oldest, cheapest and most powerful remedies available to man is widely forgotten or misused today – we are referring here to hot and cold water, and treatments known as hydrotherapy.

As holistic osteopaths, we routinely prescribe hydrotherapy to support musculoskeletal treatment (treatment working on muscles and the skeleton): well used, water has a unique ability to stimulate the body’s tissues and healing mechanism.

At a very basic level, hot water attracts blood to the area to which it is applied, cold water draws blood away from the area.

A common misconception is the use of a hot bath or hot water bottle to calm an acute backache or joint sprain – whilst it may provide immediate relief, you will feel much worse shortly after, as the hot water draws more blood to already inflamed and congested tissues.

It is important to use hydrotherapy in a specific and reasoned manner – a few helpful examples include:

• For a kitchen low-grade burn, run the wound under cold water for 10-15 minutes, then apply a lightly-wrung cold water compress (e.g. flannel or tea-towel) for several hours thereafter.
• For any acute muscle strain or tear, or ankle sprain, apply a cold water compress or an ice-pack wrapped in a paper towel (frozen peas from the freezer will do as well) – apply for roughly 10 minutes every hour until the pain and inflammation abate. After a couple of days, the tissues can then be more actively treated by manual therapy.
• In the case of more chronically inflamed tissues, hot and cold applications are used to stimulate local blood circulation and tissue repair, and drain waste matter and toxins away from the affected area. Hot and cold packs can be used for localised applications, but a shower head is excellent over a larger area like the back. Apply hot source for one minute, cold for 30 seconds, and alternate 3 times, finishing with cold, then rubbing local area vigorously.

Routine contrast (hot/cold) showers are an excellent form of whole-body revitalisation treatment. For the brave, whole body dry frictions, followed by a cold shower or bath, form a powerful routine treatment to boost the immune system. However, they must be avoided in the case of people whose immunity is already weak or run down.

A final thought for migraines, which are thought to be caused by excessive blood vessel constriction, followed by rebound dilation causing the migraine through increased cranial pressure. At this point, distraction hydrotherapy – using a hot water footbath combined with a cold head compress – can have a powerful effect in drawing blood away from the cranium, and thus reducing or shortening migraine symptoms.