Clapham Osteopathy and Functional Movement

Movement Matters

Sue McCall testing legMost patients begin their journey at Backs Etc receiving a combination of manual therapy and exercise protocols designed to retrain basic movement patterns. Some may wonder what is actually happening when a patient is being treated on the table, and why we emphasise exercise and movement retraining. Does the hands-on therapy physically lengthen muscles and connective tissue that have become contracted and fibrotic, thus changing their structure? Or is treatment more of an interaction with the nervous system, improving its ability to control the body, thus reducing pain?  (If you’re interested in reading more about pain, see our posts here and here.) Does a muscle feel tight because it is physically shortened, or is it from changes in neurological control? We have always believed it to be the latter, which is why NeuroKinetic Therapy® (NKT) is one of the main tools used at Backs Etc. Sue’s adventures dissecting cadavers at St Andrews medical school have solidified our belief in this.

First off, working on dissections of various body types, it’s clear that there are deep layers of superficial fascia (AKA fat) covering the muscles in even the skinniest of us. What this means is that manual therapy is not directly affecting muscles and joints, especially those deeper inside the body. It is like the pea affecting the princess through the layers of mattresses, not impossible but hard to do. The only thing we can directly affect is the skin.

Furthermore, muscles, tendons, and other connective tissues are so strong that the force a manual therapist can exert is unlikely to change the nature of the tissue. In the four elderly cadavers that we worked with, the muscles looked completely healthy, with no evidence of fibrosis, trigger points or adhesions.  In fact, the only adhesions found were caused by surgery or injury. From their case histories, it was apparent that they likely had aches and pains and restricted joints, but this would be coming from their nervous system and not the physical structures. The experience of pain is primarily due to the overall level of threat that the brain is experiencing, rather than an indication of tissue damage.

Therefore, when opting for manual therapy, understand that it will not necessarily be physically changing your body. What it can do is bring increased blood flow to an area which can improve the body’s ability to heal itself. It may also feel therapeutic and relaxing, which can be extremely important in these stressful times. The interaction with the nervous system using therapies such as NKT allows tight muscles and joints to relax as the brain receives more positive sensory input and so and reduces the threat level. This is why NKT has been so successful for us at Backs Etc. It is designed to correct the fundamental issues stemming from the way the brain and nervous system are interpreting sensations and inputs.

However, this is just the beginning, you need to consolidate these neurological changes by moving and breathing well on a daily basis.  Exercise utilising quality controlled movement patterns and proper breathing technique will improve muscle function, mobilise your joints, and consolidate the changes initiated with the therapy and can positively affect the structure of your tissues much more than passive hands-on therapy.

Jack McCall trainingWe offer functional fitness sessions with Jack, our trainer at Backs Etc, as we believe that poorly executed exercise habits – excessive ‘balls to the wall’ pushing through pain, lack of quality movement, and poor breathing habits, are the root causes behind the majority of pain and injuries.  Taking some time to learn good movement patterns, and then practising them regularly and incorporating all the elements of a balanced exercise program, is the key to avoiding the revolving door of repeated injuries or chronic pain. We strongly believe that your exercise program should enhance your longevity and fitness and not be the cause of pain and injury, and we’re here to help you achieve these goals.

 

Is Sunscreen the New Margarine?

tub of sunscreen on beachCurrent guidelines for sun exposure are unhealthy and unscientific, controversial new research suggests—and quite possibly even racist. How did we get it so wrong?

In this article, author Rowan Jacobsen discusses how our obsession with protecting ourselves from the sun is contributing to many health issues. Studies have shown that supplementing with vitamin D is not very effective, whereas moderate amounts of sunlight exposure is. But that’s only the start. Sunlight triggers the release of a number of other important compounds in the body, including nitric oxide, serotonin and endorphins. It reduces the risk of prostate, breast, colorectal, and pancreatic cancers. It improves circadian rhythms. It reduces inflammation and dampens autoimmune responses.

 

Read the full article, Is Sunscreen the New Margarine?

Scottish Doctors Are Now Issuing Prescriptions to Go Hiking

person hikingBeing active out in nature can have positive benefits for both physical and mental health. And now some doctors in the Shetlands have begun issuing “nature prescriptions” as part of an initiative to address health issues without drugs. We love hiking, so this is one prescription we’d eagerly look forward to having filled and refilled!

 

Read the full article, Scottish Doctors Are Now Issuing Prescriptions to Go Hiking.

The Top 5 Health Benefits of Coffee

coffee beansCoffee. Love it or hate it, you probably can’t escape it. (We love it, BTW) There have been many stories in the news over the past few years discussing its potential health benefits, and in this article, Chris Kresser details 5 big ones. For balance, he also includes a section on people that probably shouldn’t be drinking the stuff.

So kick back with a cup o’ joe and read the full article, The Top 5 Health Benefits of Coffee.

Joint Noises, Popping & Clicking: Should You Worry?

man cracking knucklesThis article, from the talented folks at GMB, offers a good explanation of joint pops and clicks. As they say, you don’t need to get too concerned if there isn’t any pain. However, pops or clicks may indicate poor motor control in the joint which can lead to problems down the line. At Backs Etc, we utilise NKT, breathing and exercise to get your joints working the way they are supposed to.

Read the full article, Joint Noises, Popping & Clicking: Should You Worry?

To Stretch or Not to Stretch

Woman stretching

Must. Stretch. More. This seems to be a mantra for so many of us, and it’s no surprise why. From a young age, we’ve had the message drilled into us that we must always stretch before and after exercise, when we wake up, when something feels tight, etc. Stretch, stretch, stretch. Of course, there absolutely is a time and place for stretching, but it shouldn’t necessarily be done willy nilly. Many of our patients and clients have developed habits of endlessly stretching and rolling tight muscles as a form of self-therapy and treatment, a habit that is encouraged by many trainers and other professionals. We would like to highlight two reasons why this may not be helpful.

  1. The tightness and tension we feel is just a sign that a muscle is dysfunctional.  It’s a Goldilocks problem in that it can be held overly shortened, or overstretched.  Both states will feel tight, but the overstretched ones will not respond well to more stretching. For example, many people complain about tight hamstrings, yet are able to touch their hands to the floor in a forward bend. Here the hamstrings are overstretched and the tightness is a message from your nervous system asking you to stop stretching out and possibly tearing the muscle.  In this case, an activation exercise to shorten the muscle is going to be a much more effective strategy.

  2. If a muscle is short and tight, it is due to the body creating tension to help maintain postural stability.  The first priority of your nervous system is to keep you safe and stable, and it sometimes shortens muscles to do this, creating a scaffolding of support. This is especially true when you are not breathing well and unable to generate good core stability. This can lead to tight hip, mid back, neck and/ or jaw muscles.  Attempting to loosen these patterns without getting to the root of the problem is futile, as you are trying to defeat your nervous system’s prime role in movement control.

In both cases, we often hear patients describing that foam rolling or massage feels good for a few hours or even a day, but then the symptoms return because the underlying cause has not been addressed. So your brain recreates the stability strategy it has got used to even if it is not optimal.

At Backs Etc we use NeuroKinetic Therapy to assess the strategy your brain is using to keep you safe and stable, and then design a treatment plan incorporating both stretches and activations that work with your nervous system.  This leads to normalisation of the tensions and tightness in the muscles so that you don’t feel the need to constantly stretch, roll or massage them.

 

Marvelous Madagascar

We’re going to present something a little different for this post, highlighting something near and dear to us: travel. Last month we spent 2 ½ weeks in Madagascar, a well-deserved break, especially for Sue who has been working very hard of late!

For those of you who are unaware, Madagascar is a huge island, roughly the size of France, so there was no way we were going to see all of it in the amount of time we had. We were keen to do a variety of activities, though, including wildlife spotting, hiking, and chilling at the beach. Fortunately, Madagascar has plenty of options for all of these. With a couple of exceptions, we followed the classic RN7 route from the capital Antananarivo in the central plateau down to the southwestern coast. What really surprised us was the extreme variety of landscape in just this small section of the country. We took in lush rainforest, lunar landscapes, pine forests, and white sand beaches. Madagascar really does have something for everyone.

Of course, the big something, probably what the country is most famous for, is the lemur. Madagascar is the only country in the world where you can find lemurs in the wild, over 100 different species of them, in fact. We managed to see only about 10 of these species, but certainly didn’t feel hard done by, as the ones we did spot were plentiful, beautiful and fascinating. Some of the coolest lemurs we encountered were the Indris, or Indri Indri, as they are known locally. They brought the concept of the dawn chorus to a new level, with their haunting cries  – described as a cross between a whale and a car alarm – being heard for miles. (Check out a video here) Fortunately, due to the time difference, we were getting up early anyway! Some of the other species we spotted were black and white ruffed lemur, mouse lemur, sifaka, bamboo lemur, and of course the ringtailed lemur. Some of these were shy and hung out high in the trees, whilst others such as the ringtails were quite happy to walk right up to us, even with babies clinging to their backs.

chameleon

 

Lemurs are not the only fauna that Madagascar is famous for. The country is also home to about half the world’s 150 or so species of chameleons. In our humble opinion, these are the coolest lizards out there, with their bulging eyes, zygodactyl (good word, eh?) feet, and beautiful colours. Perhaps the most impressive feature of the chameleon, however, is its tongue. On average, a chameleon’s tongue is roughly twice the length of its body. In humans, that would be a tongue about 10 to 12 feet long! And it’s not just big. A chameleon’s tongue can go from 0 to 60 miles per hour in a hundredth of a second! Pretty impressive stuff. (See it in action here)

On the subject of guides, everywhere we went we seemed to wind up with more of these than anticipated. In addition to a driver and guide taking us around the country, every national park we visited supplied a local guide and sometimes an animal spotter or two as well. We came to realise that this is the Malagasy attempt to spread the wealth around. Madagascar is one of the poorest countries in the world and is largely a tip-based economy, so the more helpful bodies foisted upon tourists, the more money potentially makes it into the local economy. At first, we were a little put off by the number of people who seemed to be ‘assigned’ to us at every stop (as we are typically avidly independent travelers), but we soon realised the deal and settled into the routine. It just meant calculating a lot more tips. That said, salaries there are so low in Madagascar that even a Euro or two is a huge amount of money for many of the people, so ultimately it was still relatively inexpensive.We always try to include some hiking in our holidays, and this was no exception. We spent several days in Andringitra National Park, well-known for its spectacular mountainous scenery. There, we summited Pic Boby, the country’s 2nd highest (and highest-climbable) mountain. One of the highlights was drinking ‘rum arrange’ (the local hooch infused with various fruits or other aromatics, in this case, ginger) whilst soaking in the singing and dancing performances of our surprisingly-large posse of cooks, porters, and guides.

feetMoney is so scarce that many of the poorer people can’t even afford shoes. Being somewhat barefoot-obsessed, we found ourselves marveling at the ease with which these shoeless people went around their daily business. In particular, the runners of the two-wheeled rickshaws known as pousse-pousse, found in many Malagasy cities. We quickly noticed that none of the pousse-pousse pullers wore shoes. Even pounding up and down paved city streets all day long, the feet of these guys looked really healthy. Not a bunion to be seen! This should be a lesson to all of us. Whilst we don’t necessarily advocate going barefoot around the streets of London, getting out of our ‘foot coffins’ as much as possible could potentially do us a world of good.

Despite a lack of money, the Malagasy people seem to place a high emphasis on good food. Even though the typical local cuisine is reasonably basic – meat or fish and rice – it is generally well-prepared and tasty. Add to the mix the fact that the country was once a French colony, and you have a recipe (pun intended) for yet another great feature of the country: yummy food! Little did we know before arriving in Madagascar that French staples such as steak au poivre, crepes, foie gras, and duck confit would be gracing our plates so frequently. We ate plenty of the local dishes as well, our favourite being a stew of eel and pork served with (of course) lots of rice. The local wine we sampled was nothing to write home about, but the beer was cheap and tasty!

As is the case in so many developing economies, the poverty of Madagascar can be heartbreaking. At times it took great effort not to dole out coins, pens or trinkets to the frequent child beggars, some of whom were barely old enough to walk, yet still had their hands out for bonbons or cadeaux. But we believe a better way is to donate to charities that can help the people in a more sustainable manner.  Upon returning to London, we identified PSI as a reputable and efficiently-run charity whose stated  goal is to ‘make it easier for people in the developing world to lead healthier lives and plan the families they desire.’ Please feel free to join us in donating here. Then do yourself a favour and get yourself to Madagascar. You won’t regret it!
The Backs Etc Team

Jack and Sue

 

The Dangers of Acetaminophen

bottle of pillsAcetaminophen, most commonly known as Tylenol, is one of the most popular over-the-counter painkillers. Most people don’t think twice about taking it for the occasional ache or pain. Yet acetaminophen may be one of the most dangerous medicines in the drugstore. In this article, functional medicine practitioner Chris Kresser discusses the potential liver toxicity of the drug, as well as its negative effects on cardiovascular health, kidney disease, and even cancer.

Read the full article, The Dangers of Acetaminophen.

The Great Con-ola

bottle of oilThis article from The Weston A. Price Foundation takes aim at one of our most popular cooking oils, canola. The food industry has been lauding the benefits of canola oil since its arrival on the scene in the mid-1980s, calling it ‘heart healthy’, ‘high in Omega 3s’ and ‘widely recognized as the healthiest salad and cooking oil available to consumers.’ However, there is a dark side to canola oil, as studies have shown it to actually be potentially dangerous to humans. This article details the history of the oil and documents the health risks associated with canola and other industrial seed oils.

Read the full article, The Great Con-ola.