Posts in Rehabilitation
How can osteopathy help with acute low back pain?

🚨If you've just pulled your back or it's just "gone" while you were putting your socks on this morning, then you need this!
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🙋🏻‍♂️Hi, I'm Shaun and I'm a Registered Osteopath based in Colchester, UK. Every week I have patients who see me with acute low back pain. We define acute low back pain as pain that is less that 6 weeks old. Most acute low back pain will resolve within 4-6weeks depending on the onset and severity of your symptoms. Here's six points that I find really helps my patients and will give you an insight in how I treat my patients with this condition.
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1️⃣ Relative Activity Modification
I'll start by addressing what's causing you pain and discomfort. I rarely advocate complete rest. Complete rest is old thinking. It can lead to fatty infiltration of muscles, decondition your muscles, increase pain and can delay your recovery. That said, some people will need some sort of rest. It’s not as cut and dry as one size fits all. I will often get you to modify your work positions or bring in a pacing strategy to reduce stress on painful structures. It might be changing your exercise routine or training schedule. This is where having a clear line of communication with your therapist helps. See points 2 & 4, there should be constant feedback finding what works for the individual and what does not.
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2️⃣ Build a Therapeutic Alliance
I want me and my patient to become a team. I want to build trust so they can approach me with any questions or queries. I will in turn advocate for you and support you along your back-pain journey. Treating and recovering from acute low back pain is not a case of ‘go away and do these exercises.” I see patients who’ve been given a list of tens of exercises and are unsure if they should be doing them because they cause pain. By regular communication whether it’s face to face, by text or email we can build trust and really individualise your treatment and recovery.
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3️⃣ Osteopathic Assessment & Treatment
I start by listening to you (a lot), and taking a case history. We investigate different parts of your health & lifestyle because putting that plate in the dish washer should not have caused a muscle strain. There's often an accumulation of factors that snowball up to that point. I will assess you physically to see how your body is moving and functioning. This might include muscle testing and moving joints around. We will investigate what’s causing pain and what positions give you relief.

Osteopathic treatment might include soft tissue release & massage, dry needling, taping, stretching & spinal manipulation. The goal is to reduce pain and improve your movement, function & confidence. Most of my patients will leave confident that they have a plan to get them back to work, sport or doing what they enjoy.
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4️⃣ Education & Communication
I really try my best to make sure my patients firstly understand what's going on with their back. I advise on prognosis as all too often back pain doesn’t go away overnight. I like them to know what they need to do to help themselves. If they understand this then they seem to have less worry, less fear avoidance and better outcomes.

5️⃣ Rehab Exercises & Return to Activity
Whether you like exercise or not, you need to be increasing your activity levels to help your back and reduce pain. I tend to tailor specific exercises to my patients to begin with. I find this builds confidence in their body and spine. Often a back injury can leave someone thinking their back is weak or degenerative. The exercises will increase your mobility and range of motion. They will also increase strength, stability & endurance. On top of this we know regular exposure to exercise has a pain modulation and relieving effect on the body. My plans are often progressive so I can have them integrate themselves back to work or activity.
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6️⃣ Reassurance & Follow Up
Chronic low back pain can sometimes develop in a small number of patients who have acute low back pain. It's also thought that up to 80% of people will have a relapse over the following year. I educate my patients about this and keep our channels of communication open. It’s often useful to have follow up appointments to progress your exercises as your body gets stronger and moves better.

As you can see a big part of my osteopathic treatment is developing a relationship with my patient. If we can build a strong therapeutic alliance and you understand the reasons behind why we are doing or not doing certain moves or activities then you’ll be more likely to follow the plan and have long term results.

If you’d like to work with me then please get in touch.

📲07900363938
📧info@shauntyler.com

Strategies to Help Minimise Daily Chronic Pain

Living with chronic pain is disabling. For some sufferers it is the primary complaint of diseases such as fibromyalgia and for others it might be a progression of a degenerative disease such as osteoarthritis (Mao 2017).

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It's widely accpeted that you cannot treat chronic pain the same as acute pain. Patients have to manage their lifestyles and their own expectations (and possibly the expectations of family, friends and work colleagues). A more long term approach must be taken and patients encouraged to reflect and self-manage themselves with the guide of a clinician . Too often patients with chronic pain problems are looking for a magic bullet and will hang all of their hopes on a single treatment such as steroid injections. It’s only when they start to reflect on their activities, lifestyle and stressors that they can truly manage their condition and move forwards.

I've put together a list of techniques that I use myself to help manage my chronic pain that's resulted in a total knee replacement revision. I paticularly find exercise really helps me. If I am consistent and don’t push too hard then my knee feels loose and I can manage the pain quite well. However, if I get over zealous in the gym or do a really long walk I will suffer for a couple of days afterwards.

Read through and let me know what you think. Feel free to leave your tips in the comments.

References:

Mao J. Challenges of managing chronic pain BMJ 2017; 356 :j741 doi:10.1136/bmj.j741

Four Mistakes New Runners Make

I treat lots of runners in my Colchester osteopathy and running clinic. They range from people of all ages and abilities. I really like the challenge of each runner with the pressure of getting someone ready for an event combined with their unique biomechanics and training methods.

Over time I have seen patterns in new runners. I see the same mistakes being made repeatedly causing injury, pain, and time away from running. Here’s my top four mistakes that new runners are making.

1. TOO MUCH TOO SOON

New and experienced runners are guilty of this. You get the runners high, the more you run the better you feel. It can be intoxicating. But I will let you into a secret. 99% of running injuries I see in my clinic are from doing too much too soon. I performed an audit for 2021 and I saw one runner who was injured because of an accident and that was twisting their ankle in a pothole. Every other runner was direct result of a training error.

Whether you’re trying to increase your long run and weekly mileage, interval training or hill sprints - introduce them gradually. Yes, you might be able to complete the session, but can your body recover and adapt from it? For instance, did you know it takes tendons three times longer to recover than muscles? While there is nothing like looking back on a good training week and counting the miles make sure you plan recovery. Take time to assess your body and note how it feels. A niggle might be the start of something not having enough time to adapt.

Employ the 10% rule. If your goal is to increase your long run or your weekly mileage try not to exceed more than 10% of the previous week’s volume.

2. RUNNING THROUGH THE PAIN

While a little pain is good for us and strengthens us physically and mentally, it’s important to differentiate between a “working” pain and a “hurting” pain. The working pain might be your thighs burning while running up a long hill. We kind of expect this pain if we want to get better at running. A hurting pain might be a joint or tissue that gets sore the more you run and inevitably worse when you stop running especially 24hours afterwards.

3. NOT WEARING RUNNING SHOES

Running is a repetitive and high impact activity. If you’re new to running then your bones, joints, muscles, tendons, and other connective tissue will not be used to these high levels of impact and force. You need to get the right tools for the job. They will help cushion your feet and joints from the impact. Good quality running shoes help reduce your risk of pain and injury - meaning you’ll have a longer running career.

Get a pair of running shoes. They don’t have to be the most expensive pair on the shelf, and you probably don’t need a gait analysis for now. I advise using www.sportsshoes.com as they have shoes for anyone’s budget.

https://www.sportsshoes.com/running/

4. NOT TAKING REST DAYS

Running will absolutely improve your cardiovascular health, improve endurance, tone you up, help manage your weight and do wonders for your mental health. But let’s make one point clear. You’re not getting fitter during your run. All that’s happening is you’re stimulating your body and overloading your tissues whether that be the heart and lungs or muscles and tendons. Your body gets fitter after the run if you have enough rest. New runners should probably not run-on consecutive days to avoid overtraining and breaking down tissue. Think about creating the best environment for your body to recover. Good hydration, a healthy diet with plenty of fruit and vegetables and lean protein and prioritise sleep.

I hope you found these tips useful. Feel free to leave a comment if you have any tips to add.

 

Identify the weakest link in your body, Then make it stronger...

It doesn’t matter if you want to run faster, longer, perform better or move without pain then you need to identify your weakest link & then have a plan to strengthen it. I try to treat all of my patients as athletes. Like the athlete on the start line I want my patients to get the most out of their lives. I try to create a professional, supportive environment to help coach them to being happier & moving with confidence & without pain.
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Your weak link might be your stiff hip, the ankle you always twist or that nagging back problem that always seems to "go" just as you get on holiday.
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For an athlete or sportsperson this might be a weak muscle or restriction that makes another part of the body work harder. This might lead to increased fatigue, sub optimal technique & biomechanics. This often leads to niggles and eventually injury. Injury means pain and pain means reduced playing time.
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In periodisation there is a phase of training called GPP or General Physical Preparedness. In football this might be pre-season, in athletics the pre track phase. Basically, it's where you work on specifics in your fitness, co-ordination, movement & mobility so that you can improve on more skill related work later in the season. It might also be rehabbing an old injury or niggle. Think of this phase as finding the persons weakness & then making a plan to eliminate it.
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To MY patient I see in my clinic, this would involve finding out what that person wants to achieve. What do they love doing? What do they want their body to be able to do? How often would they like to do it? How far away from that activity are they now? What barriers are in their life stopping them from getting there? I assess where they are now physically and mentally. Then I design a plan to get that person to where they want to be. This is often based around osteopathic treatment, exercise and lifestyle changes. In my experience only by working with my patient collaboratively can they improve their physical performance so they can work towards that goal.
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Here's some examples of my patients goals I’ve helped them work towards.

"I want to be able to pick up my grandchildren"
"I want to complete a marathon for charity"

“I’d like to be able control of my back pain better”
"I want to run a sub 40minutes 10km"

“I want to be able to have less pain so I can lose weight” “I’d like to be able to manage this problem on my myself”

"I want to join the Para's"
"I want to be confident doing the gardening"
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Once you know where you want to go then you can identify what's holding you back. It's only by addressing the weak parts that you can truly move with confidence and less pain. I take a biopsychosocial approach to this. Not only will we address the physical factors but also investigate other parts of your lifestyle. How much stress are you under & is this effecting your pain levels? How much sleep are you getting? What relationships are supporting you & which are holding you back? Is time management holding you back from putting the work in? It’s is an active process. You will need to take action. It will take commitment, consistency & effort.

At some point you have got to put the work in.
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I’m not your average therapist. I’m a modern osteopath who combines 20years of personal training experience into helping patients transform their lives. I’ve suffered with chronic pain myself & I’ve had the obligatory 3 sessions of physio on the NHS. This didn’t work for me. I’m passionate about making people healthier so they can lead happier lives. I’m based in Colchester, Essex. If you're ready to take the next step & invest in yourself then drop me a line to discuss how we can work together. This might be face to face or virtually.

Email: info@shauntyler.com

Instagram @shauntylerosteo
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It's the 1st of March 2020!

Pinch 👌punch 👊 it's the 1st of the month ⏱. I can't belive March is upon us already. Have you made any goals for this month? There are 31 days in March so that's 31 opportunities to make a positive change. 

My personal goal is to try a gluten free diet and to try to get into a daily routine of performing my knee exercises. 

I've been in quite some pain and had a lot stiffness in my knee over the past 6months due to an infection and it's really taken its toll on me. Being in constant chronic pain is draining both physically and emotionally which is overwhelming. 

I've decided to put myself back into the driving seat and see what this month brings. To keep up my motivation I will be posting some of my sessions on here and on my Instagram stories over at @shauntylerosteo .

Goals for march copy.png