Clapham Osteopathy and Functional Movement

Anatomy of Core Stability

An excellent video visualising the anatomy of core stability and how to establish that stability through uniform activation of all the muscles that make up the core. A very relevant video as core work is one of our staples at Backs Etc.

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.

 

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.

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.

 

Why It’s Good To Be A Slacker

‘Eat a balanced diet’. ‘Ensure a good work-life balance’. Balance your budget’. Notice a trend here? Balance seems to be considered a pretty important thing. Indeed it is, and perhaps nowhere as important as its role within our bodies. Without it, many of our basic motor functions get pretty damn difficult. Just ask anyone who’s suffered from Labyrinthitis, Benign Paroxysmal Positional Vertigo or Ménière’s Disease.

But even without suffering from one of those disorders, many of us struggle with poor balance. Our ability to balance is a combination of sight, vestibular (ear canals) and proprioception (our body’s ability to know where it is in space, even with our eyes closed). As we get older, our proprioceptive and vestibular systems decline, along with reflexes and coordination, resulting in diminished balance control. This is why so many elderly people fall down and break their hips or other bones. And that is one slippery slope we’d like to avoid!

So how to do that? Train your balance and coordination of course. The trusty old phrase ‘use it or lose it!’ applies here, I’m afraid. But the good news is that there are far more fun ways to train your balance than just standing on one foot. The brilliant folks at GMB recommend a programme consisting of jump spins, walking around with eyes closed (but shins beware!), as well as more advanced hand balancing techniques.

Here at Backs Etc., our training programmes often contain floor-based exercises that require a degree of balance control, as well as balance-challenging resistance exercises like single leg deadlifts and Bulgarian split squats. But one great tool that we’ve only recently started using is the slackline.

Jack on a slackline

Similar to a tightrope, the slackline is stretched between two trees or other anchor points with the aim being to balance and walk along it. Unlike a tightrope, though, the slackline is a flat webbing, usually around 2 inches wide, making it easier to learn than a traditional tightrope. As the name implies, the slackline is not tensioned as tight as a tightrope. Because of this, the line moves up and down and side to side as you walk on it. The real skill then is to anticipate these slight movements of the line and move your body to compensate for them, improving your balance and core strength. Anybody first attempting to balance on a slackline will experience a violent shuddering back and forth of the line. This is due to the brain trying frantically to overcorrect the sideways motion of the line. This is similar to the way a driver may oversteer the opposite direction when skidding, causing a car to spin out of control. Fortunately, slacklining is much safer than driving!

So, besides improving our motor control and balance, what are some of the other benefits of slacklining?

It’s a full body workout. I mentioned core strength earlier, but slacklining requires the complete use of your entire body, engaging all your muscles and focus to prevent you from falling off the line.

It can boost memory function. A 2011 study in the scientific journal Hippocampus said, “slacklining led to an increase in the structural and functional plasticity of the hippocampus, an area of the brain responsible for navigation and memory”.

It can improve your posture, help you jump higher, and improve lower-limb rehabilitation.

It’s inexpensive. You can buy a good quality slackline for £30-£40.

It’s portable. Take it to the park and stretch it between two trees.

It’s fun! (need I say more?)

It’s worth noting that slacklining is pretty challenging. I’ve been using ours for about a month or so and I’m still pretty bad. But I notice little improvements regularly, and that feels nice. It’s also encouraging knowing that every time I step on it, I’m making positive changes for my body and mind. Being a slacker has never felt so good!

 

The Forgotten Benefits of the Get-Up

turkish get-upThe get-up, sometimes referred to as the Turkish get-up is one of the most effective full-body resistance exercises one can do. A few years ago it was all the rage. Lately, for some reason, it seems to have fallen a little out of favour. In this article from StrongFirst, the author discusses how get-ups are a natural evolution from crawling, another form of exercise that has become hugely popular of late (and for good reason!). Both crawling and get-ups can be extremely beneficial for strength, stability and mobility, as well as for the vestibular, visual and proprioceptive systems.

At Backs Etc, we often work with clients on both of these outstanding exercises. get in touch if you’d like to learn how to add these to your training programme.

Read the full article, The Forgotten Benefits of the Get-Up

Channelling Our Original Strength

OS logoI recently spent a weekend in the Midlands on the floor rocking, rolling and crawling. No, I wasn’t just suffering from too many pints of lager. Rather I was participating in two workshops, Pressing Reset and Becoming Bulletproof run by the folks at Original Strength. OS describe themselves as ‘a human movement education company teaching health and fitness professionals around the world to Press RESET.  By teaching how to help people move the way we were designed to move, we can help them restore reflexive strength and stability.  When we have our reflexive strength, we have a solid foundation enabling us to live life better.’ What this entails is going back to how we originally developed our strength and motor control as babies and young children, teaching our adult minds and bodies how to reset poor motor patterns and allow us to perform physically (and mentally) as we should be able to.

Tim Anderson, one of the founders of OS, is someone whose videos I have watched on YouTube for a couple of years now, so I was pleased that he was running the course. He is a warm, passionate instructor with a gentle southern drawl, and made the weekend extremely enjoyable and informative. He began by introducing the concept of reflexive strength, one of the key components of the system. He describes this as the body’s ability to anticipate and respond to movement before and as it happens and stability and mobility in harmony with one another.

The focus of the first day’s workshop is what Tim refers to as ‘pressing reset’, essentially engaging the original operating system preprogrammed inside every individual’s nervous system. Engaging this can be likened to pressing the reset button on a video game, rebooting (or refreshing) the central nervous system to build new neural connections, restore old ones, and make existing ones more efficient. The result is a healthier brain and nervous system which leads to a healthier body able to utilise the mobility, stability and strength it is designed for.

According to the OS philosophy, there are five big resets:

  1. Diaphragmatic breathing
  2. Head Control
  3. Rolling
  4. Rocking
  5. Crawling (or other contralateral, midline crossing movements)

Those of you familiar with the work we do at Backs Etc will know that we already incorporate these into our therapy and training programmes, so this course was a natural fit for me.

Proper breathing is where it all begins as, without a stable core, our brains will not allow our bodies to achieve the stability and mobility they are capable of, so the initial portion of the workshop is focused on developing good nasal diaphragmatic breathing techniques in a variety of positions.

We then moved on to the oh-so-important vestibular system. The OS system focuses on mastering head control to reset and strengthen this, so we did a number of head flexion, extension and rotational exercises, again in a variety of positions, supine, prone and quadruped.

The third big reset, rolling, is a fun one. Rolling is the beginning of the human gait cycle, and helps connecting the opposite shoulders to the opposite hips. There is also a lot of head control involved, bringing the vestibular system into the equation. There are a variety of different rolling patterns, some forward to back, but most moving laterally, driven by either the upper or lower body.

Then it was time to rock out. Rocking on hands and knees is a primal movement pattern that helps children build strength, mobility and posture. By modifying foot position we can also use rocking to improve our ankle mobility, or start on our elbows instead of hands to further mobilise the thoracic spine and build upper body strength.

crawlingThe last big reset, which ultimately ties everything together, is crawling. There are a myriad of variations of crawling, all effective in improving contralateral coordination, developing neural connections and building strength. We started with variations on the classic dying bug and bird dog exercises, progressing to commando crawling, hands and knees crawling, and ultimately leopard crawling (sometimes referred to as bear crawling or beast crawling in other methods). People who haven’t tried crawling may not realise what a tremendous workout it can be. Crawling across the length of the gym floor as slow as we possibly could, for 5 minutes, left every participant in the workshop huffing, puffing and sweating profusely. I routinely train my clients to crawl in a box pattern (forwards, sideways, backward and sideways the other direction) for two minutes, which often feels like an entire workout compressed into a tiny period of time. Good stuff!

The workshop on the second day, Becoming Bulletproof, was designed to take these resets we learned and advance them in ways that make them more fun, more challenging and incorporate various other fitness tools that we may have at our disposal. For instance, lifting one’s knees off the ground whilst rocking really fires up the lower body musculature and provides a great little full body workout.

Variations on crawling including axis crawling, a brilliant exercise one can do in a hotel room, for instance, that requires no space or equipment; crawling sideways with the feet pressed up against a wall is an awesome core burner that again requires no equipment. If you do have access to some gym gear, you can try exercises such as crawling pulling a chain or kettlebell.

We also played around with battling ropes and upside-down kettlebell carries, both tremendous workouts. One of the wackiest exercises we performed involved using a cup to scoop water out of one bucket and use it to fill another, all whilst holding a plank or elevated crawling position, showing that exercise does not need to be boring or mindless. In fact, putting play and fun into fitness was one of the big messages of this course.filling a bucket

And fun it was. Hard, too! I had major DOMS (delayed onset muscle soreness) for days after the weekend, even in places that I don’t normally feel it.

In conclusion, I found the OS training to be a great addition to the toolset we already use here at Backs Etc. We are huge supporters of what we call primal therapy and training in systems such as Original Strength, DNS, Animal Flow and Immaculate Dissection. If you’d like to learn more and/or start channeling your inner baby, get in touch. Let’s work together to help you reclaim your original strength!

 

Jack