Fighting Work Stress by Calming the Sympathetic Nervous System

Stress is almost an inevitable consequence of modern life, yet few people have any practical tools with which to manage it on a routine basis.

Beyond the particulars of each specific patient presentation, one simple form of treatment stands out in the care of most, if not all, patients betraying signs of stress: that of calming (manual therapists will say “inhibiting”) the body’s sympathetic nervous system – a.k.a.the “fight and flight” system – which tends to be in overdrive at that point.

It is a simple form of treatment involving gentle but firm finger pressure on specific spinal intersections, it can be taught to anyone in the space of five to ten minutes, and most significantly it works.  Many patients will report a sudden feeling of being “steadied”, and will recount that after treatment, they had their first night of good sleep in a long spell…

It works not just for adults, but also with children.  An exhausted mother recently brought me her “hyperactive” 8-year old son, whose energy appeared never to flag, and who would rarely go to bed before his parents as a result.  My diagnosis was one of a strained and over-stimulated nervous system, irritated both emotionally (his younger brother had just been diagnosed with type I diabetes) and physically (by a diet dominated by fat, sugar and processed carbohydrates).

During the initial consultation, I treated the youngster’s sympathetic system, but also gave his mother a short tutorial, as well as providing some relevant dietary advice.  A week later, the mother reported her son was demanding treatment every evening, and falling asleep at 7.30pm sharp.

If you have any questions relative to this blog or this form of treatment, simply contact us by phone on 020 8566 0767 (Ealing) / 01895 2000 50 (Uxbridge) or by email at help@brigetohealth.co.uk

Is tennis elbow just about an inflamed tendon?

Occasionally, a patient reminds you not just of what osteopathy can do to reduce pain and improve health, but what is truly distinctive about its outlook and approach.

power lifter

Weight Lifter (this is not Liz!)

Liz (not her real name) is a successful personal trainer with a distinguished sports career in kick-boxing and competitive weightlifting at a national level.

Three years ago, she sustained an elbow injury whilst training. She initially tried to power her way through the pain, but rapidly found that the slightest stress – even carrying a mugful of tea – caused sharp, debilitating pain.

Her GP referred her to a local orthopaedic unit which rapidly confirmed his diagnosis of lateral epicondylitis, more commonly known as tennis elbow. She was initially referred for physiotherapy, followed by acupuncture. When this initial approach failed to deliver results, she was then given two successive steroid injections, equally unsuccessfully. The next step involved an arthroscopy and “extensor tendon release” surgery, and finally an injection of platelet enriched plasma into the tendon – none of which provided durable relief from the pain and handicap.

In desperation, Liz decided to consult the local osteopath in Uxbridge, located in her main gym club. The young woman I met was complaining of crippling shoulder as well as elbow pain; she was on a prescribed combination of strong drugs (Neurofen Plus, Tramadol and Diazepam) that had no lasting effect; and above all, she was angry and depressed at feeling so crippled and making no progress towards a recovery she viewed as vital if she was to pursue her fitness career.

My clinical examination confirmed all the soft tissue features typically associated with tennis elbow, but careful palpation of the elbow joint provided another critical clue: the articulation between the radial head and the humerus was slightly subluxed (i.e. “out of alignment”), generating structural soft-tissue stress that would remain unaltered until the joint was realigned.

From the instant the radio-humeral joint was reset, Liz’s relief was palpable. It required a few more sessions to rehabilitate the chronically strained related tissues in the shoulder, neck and mid-back; but essentially, Liz had not looked back, is making steady and increasingly rapid progress towards full recovery – and is gradually resuming weight-training.

Osteopathy’s view of this case is that body structure and function are permanently interrelated. If Liz’s elbow tendon was chronically injured and inflamed, was another related anatomical mal-alignment inhibiting the healing process? Addressing that question provided the key to solving Liz’s “intractable” elbow pain.

If you are suffering from tennis elbow or any other repetitive strain injury, do not hesitate to contact us for help or advice.  We are an osteopaths in Ealing and also in Uxbridge.

“So when can I stop doing the exercises?” An answer and explanation

When we see patients at Bridge to Health we invariably give home exercises designed to work synergistically with hands-on treatment, and from time to time someone will ask how long they need to keep up with the exercises. The answer I give is often one they do not want to hear.

What I tell the patient is that there is a broad difference between exercise prescription and medication prescription: whereas medication is usually intended to have short-term effects such as control of infection, inflammation or pain, exercise is not a time-limited cure: it is long-term prevention, and the specific exercise is only the starting point of restoring necessary movement to a specific part of the body. When that motion can be translated into more wide-spread integrated exercise (eg. such as swimming), then there is a case for dropping those exercises. There is hardly any chance of an exercise (as opposed to medication) being beneficial in the short-term and detrimental in the long-term: it may become therapeutically neutral, but it is usually the case that the people who want to stop doing the exercises are the very ones who are unlikely to replace them with anything else.

The issue I am raising here is not about drugs and exercise: it is about attitude and understanding.  Most of the problems we have with our bodies come about due to a mismatch between our physical form and our lifestyle, and in most of those instances the problem is a lack of appropriate movement rather than a surfeit (the exceptions usually involve extremes such as weight training, impact sports, excessive stretching or high-endurance activity.) Most of the time, the problem involves insufficient regular gentle normal-range movement to maintain body tissue health, such as is often the case in chronic low back or neck/shoulder problems associated with deskwork and sedentary lifestyle.

So in answer to the question ‘when can I stop doing the exercises’, I could use stick psychology by saying: ‘when you’re happy for the problem to come back’, or perhaps for a more carrot-oriented answer: ‘when you are so interested and involved in regular gentle mobility exercise that they are effectively redundant’. The good news is that when you get it right, restoring normal motion often generates messages of comfort and ease that provide all the motivation you need to persist with those lifestyle changes.

When stretching a tight hamstring or calf muscle does not seem to help

Sometimes patients come for treatment for an apparent hamstring or calf strain when persistent massage and/or stretching has not helped.

Muscle tissue tends to recover from injury quickly due to the rich blood supply; it is designed that way in order to repair and restore mobility as quickly as possible, so if it does not seem to be improving, the chances are it is not just a ‘muscle problem’.

In fact a problem is rarely isolated to just one muscle; the chances are that associated muscles will be involved, (both those that assist it and those that do the opposite movement), and the joints that are moved by the muscle action, since these are all part of an integrated musculo-skeletal system. Also, the fact that body movement tends to require a cascade of multiple joint motion and muscular coordination implies that an apparent strain in one place may be the symptom that something else is not able to do its job properly, and the pull won’t resolve until the primary cause is corrected. In addition, all these structures rely on constant and plentiful blood nutrient supply, waste product drainage and controlling nerve supply to function adequately.

London Marathon 25.04.2010 (217)All these factors are important considerations when dealing with an apparent muscular impairment, and osteopathy can assist the process towards optimal recovery by suitable evaluation, diagnosis and treatment.

Incidentally, I have seen several cases where a muscle injury turned out to have been exacerbated or even caused by excessive stretching itself. In particular, watch out after exercise when muscle fibres are already fatigued, and stretch slowly and gently to restore normal working length rather than going for broke.

In general, my take on stretching does not focus on specific muscles per se; I think of it as moving the joints through their full normal range of motion (and not beyond). After all, that is the function of muscle action, and if the joints are healthy and happy, then the muscle groups tend to take care of themselves.

Training for the London Marathon? You probably realise there are just 3 weeks to go! If you would like a sports massage in Ealing (or deep tissue massage) or Uxbridge – please get in touch.

Preparing for the London Marathon

London MarathonWith less than four weeks to go until this year’s London Marathon I just wanted to highlight one of our very first blog posts – Treating injured marathon runners osteopathically.

We hope your preparation is going well, but if you have picked up an injury, as osteopaths in Ealing and at the Fitness First gym in Uxbridge, we may be able to help. You may also find James’ experience of receiving osteopathic treatment for an Ironman race helpful.

Good luck with the training – not long to go now!

New prices from March 2011

Due to rising running costs, Bridge to Health is introducing a modest increase in treatment fees as of 1st March, 2011. This will amount to £5 on osteopathy or massage sessions, and £10 on nutritional assessments; the new prices will be as follows:

Osteopathy: £45 (£40 for Fitness First Uxbridge members, corporate clients and concessions)

Massage: £35 (30 mins) and £55 (1 hour)

Nutritional assessment and diet plan: £60

We understand that most people are feeling the pinch at the moment from price increases, the squeeze on the labour market and the government spending cuts etc., but our fees have been held steady for the last 3 years, and we will once again try to hold these prices for as long as possible.

Best wishes
Peter and Mathieu

Recommended podiatrist in Ealing?

Recently added to our list of helpful health services in Ealing and Uxbridge are two podiatrists.

Laura Cooper has been in Uxbridge for many years and has a well-established practice on the High Street, very close to our own clinic. I have personal experience of Joanna as she treated my daughter for a recurring ingrown toenail, and did so painlessly, effectively and kindly; I have also referred several patients to her for in-soles, and they have all been satisfied with her professionalism and effectiveness.

Our aim in sharing local resources is to provide our patients with a range of good local contacts from which to select professional help. Also updated – podiatrist, Joanna Ashton in Ealing, and Enrida Kelly, a therapist providing colonic irrigation in Ealing.

We welcome first-hand feedback from patients or website visitors who have used the services of anyone listed on our health links. Please email us at help@bridgetohealth.co.uk or call us on 020 8566 0767 (Ealing) or 01895 2000 50 (Uxbridge) with your impressions.

Osteopaths open between Christmas and the New Year

Christmas Tree

We will be available for osteopathic treatment between Christmas and the New Year, although we will be operating a reduced service.

Please contact us on 020 8566 0767 (for Ealing) or 01895 2000 50 (for Uxbridge) to arrange an appointment.

Substitutes – stay warm and ready for action!

Rugby in the rainI am an osteopath during the week, but an assistant coach on Sundays at Ealing Trailfinders, my son’s rugby club.

At the various tournaments the club enters, I am always struck by the sight of the substitutes standing shivering-cum-frozen on the side of the pitch. They are not waiting to join the fray so much as exposing themselves to the risk of injury.

I have witnessed many half-hearted and selective warm-ups on the rugby pitch, but no matter which team sport is involved, there are two conditions necessary to ensuring a substitute is ready for action:

  • Firstly, he or she (and the rest of the team) must have engaged in a credible, whole-body, warm-up routine;
  • Secondly, he or she must keep active and warmed-up (with runs, lunges and passes) whilst awaiting the call onto the pitch.

Having taken this opportunity to moan about athlete’s insufficient readiness for sudden bursts of physical performance, let me also point out that many, if not most, of the athletes we treat in our clinic experience injuries because they do not have convincing warm-down and stretch routines at the end of a session, or get warm-up and stretch routines mixed up.

Confused? Please don’t hesitate to contact us at the Ealing clinic (020 8566 0767) or Uxbridge (01895 2000 50).

Boosting your body's immune system and managing fever: The Cold Compress

At this time of year, many of the families we treat in Ealing and Uxbridge are steeling themselves for yet another round of stiff medication as parents or children contract various chest infections, flu or viruses

At home, we tend to use one very powerful form of non-medicated treatment, frequently used to excellent effect a couple of generations ago, now sadly forgotten: the cold compress.

Applied in the right manner and at the right time, cold compresses stimulate key waste elimination organs such as the liver and kidneys, whipping up the organism’s ability to evacuate not only disease-related toxins, but also the residue of medication that the body has been unable to process.

Cold compresses also help to curb a high fever, bringing it down to a safer level where it can actually assist in the cleansing and recovery process!

Instructions for use are very simple indeed:

  • Keep the couple of old cotton sheets and woollen pullovers you were about to throw away;
  • for each member of the family, cut a first strip of cotton wide enough to overlap the lower third of the rib cage and the upper abdomen (covering both liver and kidneys), and long enough to wrap around the body a couple of times; then a second strip to fit around the neck in a similar fashion;
  • Cut two strips of wool that will fit comfortably around the body and neck lengthwise, and overlap the cotton by one inch each side on the width to isolate the cold compress;
  • Make sure the person is warm before applying the compresses;
  • Soak the cotton in cold water, wring it to the point where it is no longer dripping, apply around the neck and waist, swiftly covering it with the wool surround which is secured with a couple of safety pins;
  • Cover up the person warmly and bundle them off to bed, where they may rapidly fall asleep…
  • After 10 minutes, run a finger under each compress to check that the skin underneath is warm and reactive; in those rare cases where the skin is cold and clammy (and the person may be shivering), the immune system may be too run down to use the compress to good effect; in such cases, you will need to take the compresses off and wrap your home-patient up extra-warmly with a hot drink;
  • Where no adverse reaction is noted, leave the compress on overnight or until dry;
  • Keep repeating every night (and two-three times during the day if the person is staying at home) until full recovery.

The waist compress is a staple treatment whenever our children (or their parents!) are unwell and have a fever, and we’ll add a neck compress when they are coughing and spluttering – So far, we have thankfully been spared the need to administer any stronger form of medication, and we’ve noted that our children tend to recover faster than most of their pals.

Bridge to Health are registered osteopaths in Ealing (on The Green, 3 minutes walk from Ealing Broadway) and Uxbridge (On Uxbridge High Street, inside Fitness First). If you have any questions about cold compresses please contact us (email help@bridgetohealth.co.uk or telephone 020 8566 0767 (Ealing) or 01895 20050 Uxbridge).