5 Tips to Avoid Winter Sports Inuries

Following a six-week training plan to build strength can reduce the risk of injury on a winter sports break. According to a past US study, falls account for 75-85% of all ski injuries, mostly causing sprains, fractures, tears and dislocations. Of these, 30-40% affect the knee area, with women most likely to suffer this type of injury, the American College of Sports Medicine in Indianapolis reports.

An unexpected accident on the slopes can happen at any time and a training regime combined with winter sports travel insurance can avoid an enormous medical bill!

Get a fitness plan

Although some injuries are unavoidable, improving strength and fitness is the best way to decrease the chances of getting hurt. I recommend following a structured six-week training programme before going away, addressing any areas of weakness.

My 5 tips to avoid winter sports injuries

1) Vary your training

I advise people to mix up their training ahead of their holiday. It should include 30 minutes of aerobic or cardio three to five times a week, strength training three times a week, and flexibility and balance training to improve key areas such as quads, glutes and hamstrings.

2) Build up slowly

Once out on the slopes, skiers and snowboarders should take a sensible approach to how much they do, building up gradually. That gives the body time to adapt to the strains of winter sports and will reduce the risks associated with exercising while tired.

3) Rest if needed

Winter sports vacationers shouldn't be afraid to have a lie-in or take a day off to give their muscles a well-earned break if their body is telling them they need time to recover.

4) Check your equipment

I cannot stress enough the importance of making sure everything is in good working order, whether it be ski boots or bindings. Check everything fits well (not too tight or loose) and does not to place unnecessary stress on the body.

5) Stay hydrated

A day on the slopes is tough, and keeping the brain and body well hydrated will maintain both energy levels and mental alertness, which is particularly important for those skiers and snowboarders fond of après-ski.

Pain and Stress: A domino effect

"The back carries the weight of the world" as a counselling, osteopathic lecturer of mine once said. I would not go quite that far but I do approve with the general principle that what we feel can manifest in our physical body, almost as if the brain does not want to deal with certain emotions and consequently, will create a physical pain. That is not to say the pain is not real, it is but there may be no obvious physical or physiological changes to be seen in painful area.

But to admit that pain is being caused by mental suffering seems to many people to be a massively taboo area, as  if it labels them as shirkers or making it up. This is most certainly not the case and it is imperative for people to realise that mental suffering, stress and so on are very real and that our brains have a host of ways of dealing with them, one being getting rid of and ‘off-loading’ onto the musculoskeletal system. Addressing both parts is a really key component of the treatment but the client must be open to the concept that some of their pain is being created by the brain.

Recent clinical research, as mentioned in Talk Back Magazine, the journal of the charity BackCare suggests that our ability to cope with stressors in life has a direct connection with the amount of pain we experience. Stress can worsen pain and conversely pain can lead to more stress. The symptoms may occur together, they do not necessarily always cause one another, they do though, share a common origin.

The connection in the brain is between the area of the brain that processes emotional responses and the parts of the brain that relate to the glandular, endocrine (hormone) and immune systems. The hormones released into the bloodstream affect every system of the body and for every type of receptor in the brain there is an equivalent in the body. This is the mind/body connection that as a term is regrettably associated with the more esoteric and obscure types of healing therapies but it is a s real as you can get!

One obvious response to pain or stress is the fight or flight response. Like a dark cloud hanging over us, stress or pain can change our biochemistry. Increased production of stress chemicals, such as cortisol are can affect sleep cycles, disturbing the rejuvenating deep sleep that is essential to our well-being. This can lead to decreased energy levels and an increased fatigue. The pain can be enough of a disruption to cause increased irritability, low mood, poor dietary choices and so on. The pain can lead to feelings of depression and relationships can become strained. Brain studies in people with persistent pain shows a rearrangement in those parts of the brain involved in understanding and perception. In other words, long term pain sufferers are inclined to think, feel and act like a long-standing sufferer.

Evidence from studies exploring the link between personality and long-term pain proves that long-term pain is preceded by the creation of predictable behaviours. So how we respond to pain can be understood as a consequence of many aspects including personality, how we manage our feelings and past experiences.

Osteopaths are taught the very basics of psychology and one significant reasons why I have invested a lot of time and energy on my own further development in this area, is to empower me in practice to help people explore the ‘other story’ behind their pain/ suffering. Recognising the factors that may intensify the symptom(s) of pain can really help one cope, deal with and finally and find peace with the issues, past or present.

Ask the Osteopath: Sciatica

By Chart Clinic Osteopath, Pavlos Pavlidis MOst.Med.

Hello everyone,

My name is Pavlos and I am a new member of the Chart clinic. I am a qualified Osteopath and have received a Masters degree in Osteopathic Medicine with First class honours.

In this article I will attempt to provide some insight for “Sciatica”, a term commonly used between clinicians as well as patients. However, it is also being commonly misused, especially by the latter.

In this article I will describe the meaning of this term in order to promote a better understanding. I decided to write this after many cases of patients that presented to our clinic thinking that they have “Sciatica” while in fact they did not.

To begin with the origin of the word “sciatica”, it derives from the Greek Ischialgia, with Ischio: Hip and Algos: Pain, and literally translates as Hip pain. In clinical practice it is commonly used to describe pain that radiates along the Sciatic nerve, usually as a result of compression at the lower back.

Now let’s get a closer look at the anatomy. The roots of the sciatic nerve exit from the space between the last two bones in the lower back vertebrae and the first three of the “tailbone” or sacrum as it is known to us, clinically referred to as nerve roots of lumbosacral plexus L4-S3.

                                       

It then travels to the buttock and back of the thigh area and divides into two branches at the back of the knee that goes all the way to the leg and foot. The Sciatic is the longest nerve in the human body and along with its branches supplies the majority of muscles at the back of the thigh, leg and foot. Furthermore, its branches provide sensation to the skin at the back and outside portion of the leg, as well as the top and bottom aspect of the feet.

Therefore, when this goes wrong or you get a  dysfunction of this nerve can lead to weakness of the above-mentioned muscles as well as burning pain, pins and needles or numbness to the back of the leg and foot.

(Note that any symptoms at the groin, front of the thigh or leg ARE NOT associated with the sciatic nerve and Sciatica would be completely inappropriate to describe them)

The term “Sciatica” describes any of the symptoms caused as a result of injury or compression to the nerve and therefore it represents a group of symptoms and NOT a diagnosis.  There are numerous causes of impairment of this nerve and its brunches, anywhere from its roots exiting the lower back to the lower limb. Some of the common causes include severe arthritis of the lower back, a “slipped disc” – a protrusion of the discs in the spine that compresses its roots, or tight muscles at the buttock (such as the piriformis muscle) and back of the thigh, as the nerves passes through them. Nevertheless, there are also some rare but potentially life-threatening causes of sciatic nerve impingement. 

Therefore, it is extremely important for anyone presenting with such symptoms to be properly examined by a clinician so a specific and appropriate diagnosis can be made.

Due to the variety of symptoms caused by dysfunction of this nerve and the numerous causes of it, it is often misused by patients that tend to use it to describe any low back pain that radiates downwards. However, self labeling must be avoided before a proper examination and diagnosis by a qualified practitioner, as it can be associated with diagnostic errors, misdiagnosis and therefore mismanagement.

Nowadays, the term has been labeled as “Archaic”, as it is non-evidence based and inaccurate as it literally translates to hip pain. The literature suggests that it remains from an era of poor understanding of the physiology of back pain.

To conclude: “Sciatica” is a generalised and non-descriptive term, as various conditions might lead to irritation of the sciatic neural tissue, in multiple anatomical sites with different presentation of symptoms.

Patients must avoid using this term and self-labeling themselves, especially if appropriate examination and diagnosis has not been carried out. Patients that experience any of the symptoms described are highly advised to seek help from a clinician with experience working on the musculoskeletal system to exclude any dangerous causes for that and provide appropriate diagnosis and management plan. This includes Osteopaths, Physiotherapists, Rheumatologists, Orthopaedic surgeons etc.

Please do not hesitate to contact me or any of my colleagues for any further information or advice concerning “Sciatica” or any other condition. 

Pavlos Pavlidis MOst.Med

Pavlos qualified in 2017 and received a Masters Degree with First class honors from the University of Surrey. During his time as a student he demonstrated a great passion for the profession, both in academic and clinical settings and was awarded with the Rising Star Award from the Institute of Osteopathy. 

In practice, he follows a multidisciplinary and personalised treatment approach, tailor-made for the needs of the patient. Pavlos has undertaken additional qualifications in Kinesio taping and Medical Acupuncture. Those extra skills have been found to be extremely useful in practice, as they provide additional treatment options, especially useful for pain management and rehabilitation. 

 References:

• Beers, M., Porter, R., Jones, T., Kaplan, J. And Berkwits, M. (2006). The Merck manual of diagnosis and therapy. 18^TH ed. Whitehouse Station, N.J.: Merck Research Laboratories.
• Bogduk, N. (2009). On the definitions and physiology of back pain, referred pain, and radicular pain. Pain Journal, 2009 Dec 15;147(1-3):17-9.
• Fairbank, JC. (2007). Sciatic: An archaic term. British Medical Journal, 2007 Jul 21;335(7611):112.
• Helianthus Holistic Health Clinic. (2017). Acupuncture Balance Method for treating lower back pain and sciatica. Helianthus Holistic Health Clinic, IMAGE. Available at: http://helianthusclinic.com/wp-content/uploads/2016/12/sciatica.png
• Koes, B. W., van Tulder, M. W., and  Peul, W. C. (2007). Diagnosis and treatment of sciatica. British Medical Journal, 334(7607), 1313–1317.
• Matsumoto, Y., Matsunobu, T., Harimaya, K., Kawaguchi, K., Hayashida, M., Okada, S., Doi, T. and Iwamoto, Y. (2016). Bone and soft tissue tumors presenting as sciatic notch dumbbell masses: A critical differential diagnosis of sciatica. World Journal of Clinical Oncology, 7(5), p.414.
• Valat, J.P., Genevay, S., Marty, M., Rozenberg, S. and Koes, B. (2010). Sciatica. Best Practice & Research Clinical Rheumatology, Volume 24, Issue 2, April 2010, Pages 241–252.

Not just backs! - What is Osteopathy?

Chart Clinic Osteopath, Francesca offers her insights on what Osteopathy is in her following introductory article.

Hello everyone!
My name is Francesca, I’m Italian. My first approach to the osteopathic world started 5 years ago with the beginning of my studies.

Before that, I was sceptical as most of the people in my country (well, now it’s hopefully getting better!) It’s a common belief that the osteopath heals bones and, to be honest, I thought that as well, at least once in my life!

Let us think about the etimology of the word: -osteo, from Greek osteon (that means "bone") and -pathy, from Greek patheia (that means “disease”).

However, in this case, the suffix –pathy derives from the english word “path” as to say that the osteopath acts through the musculoskeletal system (-osteo) in order to promote structural integrity and restore/preserve health.

In the UK the figure of the osteopath is much more well received. However I feel the need to make a step forward, dispelling a myth: osteopathy is not just about backs – it’s even more than that!

Recent research has showed that osteopathic treatments are effective in treating low back pain, whose life-time incidence has been estimated to be of 51% to 84%.

The question we need to answer is: what is causing the symptomatology right there? A type of pain so common, in fact, can mistakenly target toward hasty diagnosis and it is interesting to note that two patients that have symptoms apparently identical, have totally different etiology.

Apart from strained ligaments, nerve root’s compression or inflamed facet joints etc., the low back pain could also be caused by altered function of the gastrointestinal system: recent studies pointed out improvements in the quality of life of patients affected by the irritable bowel syndrome, following osteopathic treatments.

This is just one of the several conditions that could be managed by the osteopath, in association with a medical support where it is deemed necessary, thanks to a functional rebalancement between the neurological and vascular support between back and digestive organs.

Every body has its own innate capacity to heal itself: it could be impaired because of trauma or functional overload and overuse – our role is to find out what is causing the issue, and to activate that physiological healing flux once again.

FRANCESCA CAVALLARO

D.O. M.Ost. RQ (UK)

Francesca completed a 5-year course at the International College of Osteopathic Medicine in Turin, Italy. 

Her post-graduate experience includes studying at the Surrey Institute of Osteopathic Medicine (NESCOT), where she achieved a Master’s Degree in Osteopathy, internationally recognized as the highest academic achievement obtainable. 

Francesca works in Reigate at our Osteopathic Clinic on Tuesday and Thursday.

Call 01737 248 023 or book an appointment online at our website

3 Moves To Save Your Back

Exercises that specifically target the core muscular system can be a helpful addition to treatment for low back pain.

As a preventative measure, they can help your posture and the supportive structures of your spine.

At Chart Clinic we use the bespoke exercise prescription software Rehab My Patient to help or patients not only improve their symptoms but enhance their muscle and joint well being after the pain has gone.

1) Plank

Rest on your forearms and your toes. Hold this position. Keep good straight posture, and do not let your back arch too much. This is a core strengthening exercise. 

Repetitions: 3 | Time: up-to 1 minute holds

Video: http://youtu.be/noeBz0JoW-4

2) Horse-stance horizontal

 

Go on to all fours, and keep good posture. Draw your tummy inwards (towards the ceiling). Carefully straighten your arm in front of you, and your opposite leg behind you, moving in a slow and controlled manner. Repeat each side. This is a great core stability and core control exercise to work the deep abdominal muscles. The exercise will also strengthen the lumbar erector and gluteal muscles.

Sets: 3 | Repetitions: 10-15
Video: http://youtu.be/BTaCXKy53wc

3) Supine bridge basic

Lie flat on your back, with your knees bent, squeeze your bottom muscles and slowly lift your body upwards. Keep your arms by your side and use them to help you balance. Make sure you maintain good posture (do not over-arch your lower back) and contract the deep abdominal muscles by squeezing your tummy towards your spine. This exercise helps to strengthen the abdominal, lower back, gluteal and hamstring muscles.

Sets: 3 | Repetitions: 10-15
Video: http://youtu.be/fK_xUE3OKIE

To book a consultation, treatment or for a bespoke exercise programme call us on 01737 248 023 or email info@chartclinic.co.uk

Book Online Click Here

Why women should do weights?

Can lifting weight benefit the women's bone health? Reigate Osteopath and Chart Clinic Director James Clapham shares his knowledge on the area of female bone health and Osteoporosis. 

Osteoporosis is a condition that makes bones more brittle and prone to fracture. Although osteoporosis can effect men and younger people, post-menopausal women are most at risk. One of the best ways to help maintain healthy bones is to exercise regularly – which encourages the bones to absorb calcium and other mineral salts that keep bones strong.

Weight bearing exercises and weight resisted exercises are best for strengthening bones and muscles and as well as helping to keep bones in good health may also reduce the likelihood of falls as you age. Weight bearing exercises are those where your body is supporting its own weight, such as walking or housework or carrying groceries. Weight resisted exercise involves pushing or pulling against an additional weight, like a dumbbell or barbell or resistance equipment in a gym.

The younger you start, the better

Anyone can benefit from weight training but it has been demonstrated that younger women who trained using weights have stronger bones later in life, this essentially means that you can bank bone when you’re younger to help prevent fractures later in life – a kind of insurance scheme for your body. A life time of active living not only protects your bones but also keeps your heart healthy and may protect you from other diseases such as cancer and type two diabetes.

But starting at any age will help

Everyone can benefit from increasing their activity levels. Studies have shown that people who have already been diagnosed with osteoporosis can improve their bone health significantly through weight bearing exercising, the key is getting good advice on how to move well and how to self-manage.

Some more benefits

Strong muscles burn more calories, so if you need to control your bodyweight, lifting weights can help. It also helps with balance and can help you to regulate your sleep patterns.

‘I don’t want to look muscled’

It takes women a lot of heavy weight lifting, and sometimes the use of controlled substances like steroids and hormones, to achieve the physique of the heavily muscled power lifter. Women don’t normally have enough testosterone in their bodies to develop bulging muscles, but can, with regular, moderate training achieve lean, toned and strong muscles.

‘I hate gyms’

No problem. There are plenty of other exercises you can do that don’t involve a visit to the gym. Dancing, yoga, tennis, Pilates, walking, running, gardening and even housework count – all you are aiming to do is increase your heart rate and make yourself feel a little warmer. You can do it in several short blocks of 15 minute or more but aim for at least a total of 150 minutes per week over at least 5 days per week for the best results. If you’re unused to exercise, start slowly and build up to this target.

I don’t know where to start

This is where your friendly local osteopath can help. They can screen you for any health concerns that might affect your ability to exercise, help to resolve any injuries or pain that might be holding you back and advise you on what exercises might suit your goals best. Many can teach you how to exercise correctly, avoiding injuries and how to gradually build up as your ability and fitness levels improve.

To find out more, get in touch with the team at Chart Clinic, where one of our Osteopaths will be more than happy to help you.

How to get the most out of your New Year’s resolutions

We all tend to over indulge a little at Christmas and doing a little more exercise is a common New Year’s resolution. But how do you get the most out of your gym routine and how much exercise should you do to stay healthy? Chart Clinic Osteopath & Clinic Director, James Clapham tells us more.

There is no denying that exercise is good for you. We know that those who perform a moderate amount of exercise on a regular basis are considerably less likely to suffer from diseases such as diabetes, stroke and heart attack or experience insomnia.

Exercise helps older people maintain their independence and is one of the most effective methods of weight management, a growing problem in western societies. It is also very important for our psychological health, as it stimulates the release of endorphins, natural pain killing chemicals that can also improve our mood.

However, some people become a little disenchanted when the exercise they do doesn’t have the desired effect.

“Most of the time, it’s because people are not clear on the type of exercises that are most likely to achieve their goals” says, James Clapham. “Different types of exercise will be more appropriate, depending on what you’re hoping to accomplish.”

“As a general rule”, he continues “if you are trying to build larger muscles, the most effective method is to use a weight which you can manage to lift 8-10 times before the muscles fatigue, in order to get the desired effect. If you are looking for stronger, leaner muscles, a weight programme based upon 20 repetitions would be more appropriate. 

If you are trying to lose weight, cardiovascular exercise (anything that gets your heart rate up such as running, swimming, dancing or football) is the way to go. In order to be most effective, this should be performed at 60 – 80% of your maximum heart rate, which is a lot less strenuous than you might think (Subtracting your age from 220 will give you your advised maximum heart rate. You can buy a heart rate monitors from most good sports shops or online to monitor this).

It’s also important not to train every day. The body needs time to respond to the strain of the training, and it’s during the recovery period that the gain takes place.”

But going to the gym for two weeks before you go on your summer holidays to shed a few pounds is likely to end in frustration. “It takes 4-6 weeks to start noticing the health benefits of exercise,” James advises. “Doing something you enjoy makes it more likely that you will persist, which is important if you don’t want all that hard work to go to waste.”

But how much exercise do you need to do to be healthy? If you are aged between 19 and 64, research suggests that you perform at least 150 minutes of moderate-intensity, or 75 minutes of vigorous-intensity cardiovascular exercise that is at least 30 minutes of moderate exercise, 5 days each week plus muscle strengthening exercises on at least two separate days of that week. The good news is that this exercises does not need to be all in one go, and activities such as walking briskly to work (if your journey is more than 10 minutes) counts as part of the total.

If you want to know more about what would class as moderate or vigorous exercises, or if you are outside of this age group, visit the NHS choices website at:http://www.nhs.uk/Livewell/fitness/Pages/physical-activity-guidelines-for-adults.aspx