Here at Herts Osteopathy we aim to look at the whole picture. This is why will often do a full assessment of your mechanics, feet, hips, spinal biomechanics, gait analysis and force production and absorption in order to get to the crux of your pain.
So many problems and pain patterns are caused by your feet, and your overall biomechanics.
This can be the turning point for most pain prevention and injury healing.
At different points in the gait cycle we have very different, and sometimes opposing, needs of our body. This is why running, and even walking in some people, can cause issues. Our muscles have to change jobs from lengthening under tension (eccentric loading), shortening under tension (concentric), or building up a kinetic potential energy in the form of a coil or spring at relative speed. The requirements are huge, and there is a whole chain of movements, force production, shock absorption, and the whole body working together (beautifully) to produce movement. Our bodies are amazing, and mostly this just goes on beneath the surface without us even really knowing about it. We never have to tell our body how to walk!!……..BUT sometimes a whole load of issues we may have compensated for throughout our lives, all come to the fore. And repetitive loading of the wrong tissues, or in the wrong way, can then lead to injury.
So where do we come in….????
We provide full biomechanical assessment, assessing the way you move through the foot, ankle, knee, hip, pelvis, spine…… We look for how you control forces at the feet, and then work through helping the foot to generate the correct amount of force, load, and at the right time in the gait cycle. It is so interesting, that at certain points we need stiffness and stability through the foot, and at other points we need mobility and supple strength. We need the foot to be able to supinate (roll outwards), and pronate (roll inwards) effectively.
YES, we do need PRONATION!!!!!!!!!
Pronation is actually a super important force required to get over and through the big toe correctly, without it, we get a super stiff big toe, too many forces through the other toes (that horrible painful numbness you can get: Morton’s neuroma and similar issues to this) and a whole host of other problems all the way up to the hip and spine, as the whole body is trying to compensate. As osteopaths we can use various exercises and hands on treatment methods to get your body moving through the correct mechanics. And our bodies are actually amazingly brilliant at adapting to this.
You may want this approach for injury prevention and also specific injury rehabilitation, like those who are suffering “shin splints” “plantar fasciitis” “heel pain” “lower back pain” “runner’s knee”……or those healing from ankle sprains, and other mechanical issues.
We can also help to get you a PB!! Love that this happened with one of our patients a few weeks ago who was coming in just because his wife said he hit his calf with his foot when he ran!!!
So this is fantastic for sports people and those who run and train hard.
However, it’s not just an exercising issue….. We encounter many pelvic issues here from excrutiating, debilitating pain, to low level constant SPD, (and everything in between) here at HO. I will often look at what is happening at the feet in these issues. Significant changes at the feet and force control at the feet are often common in pregnancy and postnatally, so by addressing these, we can usually make a much longer lasting effective change to the pelvis.
So looking at how your foot moves relative to the rest of your body is so important, whether you are pregnant and experiencing pelvic pain, whether you are training for a marathon, trying to get back to exercise postnatally, or a leisurely walker. We’re here for your #prehab and #rehab
You don’t need to be in pain to come and see an Osteopath. We look at prevention as well as long term cure. Here for you at every stage!!
So I have felt compelled to write a short blog post on this overused term “sciatica” and how frustrating it is when patients have been told this is what they have. As a patient it gives you no information other than telling you that your sciatic nerve is inflamed (at some point along its very long journey!!). And it absolutely tells you nothing about why it got there, and therefore you are completely disempowered to be able to do anything about it.
Unless you know the cause of your pain or issue, you will never be able to fix it, and escape from your “diagnosis”.
Often when people come to me in acute debilitating pain, they have been given the diagnosis of sciatica, often with a prescription for some high strength painkillers or anti-inflammatories and told to rest. Obviously you don’t want to be running any marathons at this time, but gentle mobility, movement, walking is needed.
So, what is it?
Hayley our senior osteopath has written a nice succinct article on sciatica in one of our other blogs so do take a quick read of this. But sciatica is when the sciatic nerve becomes inflamed, compressed, pinched, irritated or annoyed at some point along its journey. It exits the spine right at the bottom in the lumbar and sacral area at the base of the spine, so can get irritated at its point of exit, or along its path, through the buttock and down the leg. However, unless we know why the nerve has become irritated we cannot get rid of it.
It is mostly caused by a change in load through the spine and pelvis, and often over a period of time, so the altered mechanics place pressure through the nerve or the spinal segments repetitively, and over time they become inflamed. Sometimes we are able to withstand quite a lot of compensation for a long time until a very small event tips us over the edge “the straw that broke the camel’s back”…. Something small like a sneeze, or something more significant like the growing bump through pregnancy.
So we look at how you move, how you walk, how your spine moves, how your feet bare load. We assess how you sit, work position, how you carry your children, breathing, exercising….. We look at the mechanical causes to the sciatic nerve becoming irritated so we can remove these and give you the information about your body, and why it happened, to give you the knowledge of what to do to prevent it coming back.
As osteopaths we use hands on treatment involving massage, stretching, articulations, mobilisations, acupuncture when needed/desired, and taping. We give you advice and exercises to do to prevent it coming back. Our aim is to empower you with the knowledge of your body, not just to get rid of the symptoms (although we do this too!!).
Spinal and pelvic assessment
We treat a lot of people at the acute “agonising” point of sciatica and can make huge differences within one appointment for many people who walk (or hobble/crawl) through our door. It really does work, and the NHS and NICE also support this.
Come see an osteopath here and get to the crux of your pain. You will learn about your body, and what to do to prevent it coming back. We are on your side, and we absolutely love what we do.
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The Mighty Iliopsoas*
(*AKA HIP FLEXORS!!!!)
So how many times have you been told your hip flexors are tight by one person or another???
It really isn’t that simple….unfortunately…..
Look how beautifully they weave from the spine and the diaphragm, across the ribs, through the abdomen, the pelvis, and then into the hip, groin and thigh. Affects everything, and can be affected by everything from the breath, to the bowels, the pelvis, the foot, and everything in between. Cheeky little thing! Always involved but not necessarily ever the “answer”. Stretching “tight” hip flexors often told that this is your issue from prolonged sitting for example is not often what you need. In fact, look at all of the things that can affect it, or affected by it……Phenomenal!
Sitting for prolonged periods will compress and compromise the lumbar spine, the ribs and diaphragm, shortening the space for them to move freely, and setting up a shortened chain reaction of muscles and fascia, which over time is quite hard to alter. Pelvic and abdominal viscera are “squashed” into a smaller cavity with less mobility and freedom to move as needed. The iliopsoas group are inadvertently altered but not necessarily “tight”.
As osteopaths we will look at the body as a whole, and get to the crux of the issue from the outside in. By getting to the cause, we affect the symptoms.
When we walk, we require a loading effect through the iliopsoas which loads like a coil to allow it to contract purposely and as it should. This group of muscles have a different job, and effort requirement throughout the gait cycle. We need them to load and then explode correctly and efficiently in order for everything else to do the same. For example, if the iliopsoas muscles are too short, they will produce a rotational force through the hips which counteracts that of the glute muscles (main muscles in the buttocks). This means that we do not allow the glutes to load up and then explode and activate properly and effectively. And of course these issues can be caused from the ground upwards, if we are not loading correctly through the foot and ankle this will place the wrong force through the pelvis, iliopsoas, glutes…. And also from above.
The diaphragm is also super important. This provides a tension from above which will preload the iliopsoas group effectively too. Don’t you just love how everything is connected!!??!! So if we have any postural compensation which will restrict how beautifully we can use our ribs and diaphragm to move whilst we breathe and try to expand our rib cage, then this in itself can affect the iliopsoas.
So just remember this when you are sat hunched over a phone, computer, or steering wheel for hours on end….when you spend hours on a road bike without an equal amount of time spent looking upwards, opening up, standing, walking, running… There are a good many issues contributing to your back pain, hip pain, “hip flexor pain” and it may not just be coming from one place. Come and see us and get a full biomechanical assessment. We can help get you out of pain, but also moving, breathing, training better.
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Sports massage for runners
Written by Lucy Hurley Sports injuries and rehabilitation practitioner at Herts Osteopathy
With the St Albans Half Marathon in just under 2 weeks’ time and the summer running season in full swing, now is the perfect time to start thinking about how to optimise recovery and prevent injuries through sports and remedial massage therapy.
Although running has so many amazing benefits, such as:
- Improving physical and mental health
- Allowing some “me” time
- Increasing cardiovascular fitness (and adding thousands to your step count for the day!!)
- It can be done anywhere, anytime
- It requires minimal equipment,
…it is also important to recognise that running is a high impact activity that puts stress on the joints and involves repetitive movements that can cause over-use injuries especially if there are discrepancies in your biomechanics or running gait.
Common causes of running injuries are:
- a sudden increase in mileage,
- lack of stretching/foam rolling,
- not allowing enough time for recovery i.e. overtraining,
- not cross-training/varying your training
- lack of core strength, stability and flexibility
- incorrect footwear
Common running injuries are:
- Patellofemoral pain syndrome (knee pain)
These injuries can be treated, managed and prevented through sports massage therapy. Sports and remedial massage therapy can help treat musculoskeletal pain, help to enhance recovery, prevent injury, improve posture, alignment and function and can prolong your running life.
At Herts Osteopathy we look at your posture, test your movements and gait and check that your running trainers are suited to your feet. Our treatments are not just hands-on, we also help to correct movement, use kinesiology taping, prescribe exercises and advise how to self-manage at home through stretching, foam rolling, cross-training, yoga, Pilates and strength & conditioning.
Having regular sports massage treatments alongside your running training can help to keep your injuries at bay, help repair your muscle fibres and help to re-balance any muscle imbalances. It can also help you to keep in tune with your body and learn to manage and maintain healthy muscle tissues.
Pre and Post race treatments are also advisable;
Pre-race massage focuses on preparing the muscle tissues and allows them to fully recover in time for the race. It helps to identify any particular areas of tension within the soft tissue and can help prepare the tissues so they are in a healthy condition for optimum function for the race.
Post-race massage focuses on muscle tissue recovery- helping blood flow and speeding up the recovery process. It also lessens DOMS (delayed onset of muscle soreness) and will get you back to training sooner.
Sports massage perfectly complements osteopathy as it can help to free up soft tissue areas of tension while osteopathy can resolve any structural issues alongside treating musculoskeletal imbalances. A combination of both treatments can lead to a speedy recovery and injury-free training.
Here is one of our patients telling you his experience of a combination of osteopathy and sports massage and how it has helped him in his lead up to the St Albans Half Marathon:
“I have been building up my running over the past 6 months for the St Albans Half Marathon . More recently, averaging around 25-30 miles a week, there were warning signs that not everything was right even though I was completing my runs.
When my back eventually gave way, a combination of osteopathic diagnosis and sports massage quickly got me back up and running. The massage not just provided pain relief but freed up muscles that had simply stopped functioning as they should. It was a painful lesson to learn but also a valuable one. Sports massage and regular osteopathic check ups need to be part of my training plan as much as the runs themselves”.
Herts Osteopathy patient running St Albans Half Marathon on Sunday 11th June 2017.
Book online at Herts Osteopathy now for your initial consultation.
Article written by Lucy Hurley, Sports massage and injury rehabilitation practitioner at Herts Osteopathy. May 2017
Shin splints?? Been told to rest and it will get better?….. Wrong ??
Shin splints are an adaptation to your biomechanics, and therefore a product of an issue further along the chain. They are a symptom of a whole chain of dysfunction, and cannot be fixed without figuring out why they got there in the first place (pretty much like every other pain in the body!!).
So, “shin splints”, medically known as MTSS (medial tibial stress syndrome), is a repetitive strain injury, caused by repetitive trauma to the soft tissue around the tibia (shin bone). At worst, it can cause a stress fracture at the tibia, at best inflammation to the attachments to the periosteum (outer sheath of the bone) due to repeated trauma. Mostly this is from a lack of shock absorption through the tibia and surrounding structures. Some causes of this are below:
- Poor glute function (either one or both sides)
- Incorrect muscular firing patterns
- Pelvic misalignment
- Mechanical and hormonal changes of pregnancy
- Compensation for old injuries
- Flat feet (pes planus), loss of arches in one or both feet
- Incorrect footwear (not enough cushioning, not doing shoelaces up properly, too much or not enough arch support)
- Hypermobility and EDS
- Recurrent ankle strains, asymmetry of ligamentous support around the ankle
- Poor foot mechanics (altering ground reaction forces, and load through the door, ankle, leg…)
The list goes on.
But….. It is not a symptom of running!!
Running is not your issue, everything else is! Often people will spend all day sat down, sitting in the car, sitting at their desk, sitting on the sofa…. Then go for a run, then assume the run is the cause of the pain. When actually the whole “sitting down all day thing” is the problem. Sitting for prolonged periods turns off your glutes, shortens and strains a whole bunch of other muscles. You need to be fit to run, so get yourself assessed properly, make sure your body is working how it should be, and is as strong as it needs to be.
You can get back on track with your training and get out of pain, with a little help from your Osteopath.
Drop us an email firstname.lastname@example.org or head to www.hertsosteopathy.co.uk where you can book online in a matter of minutes.