Here at The Whitchurch Clinic, we do see an increasing amount of patients with back, neck and shoulder pain during the festive period.  

The most common reason for this is due to carry large heavy bags and poor posture when sitting for long periods of time.  These both add extra strain on the joints, ligaments and muscles in your back and shoulder which can lead to an episode of pain.

We have put together some tips in order to avoid back and shoulder pain this Christmas:

• Wear sensible shoes - to avoid any abnormal stresses through the lower back.
• Avoid carrying heavy bags, including a hand bag - check your hand bag before leaving and only carry the essential items required.  Spread your shopping into different bags to lessen the weight, and try to have an even amount on each side.
• Park Nearby - try to park as close as possible to the shops, to limit the amount of time that you are carrying bags.  Also try to make regular trips back and for of the car to reduce the amount of bags carried at one time.
• Take your time and plan your journey - allow your self plenty of time and make a list of the places you need to visit. This will not only reduce the amount of time that you spend shopping, but will help to reduce down your stress levels.
• Take regular breaks - if shopping on foot, try to take regular breaks on benches etc to give the body a rest and to ease the loads.  If shopping online, take regular breaks every 20-30 minutes away from the computer.  Try to stretch out tired and sore muscles to encourage activation and loosen up the area. 
• Be conscious of your posture - take time to look at your posture when walking or sitting.  If walking try to maintain a neutral pelvis and stand tall.  If you sitting for long periods ensure that you back is fully supported and you are not leaning to one side.  Make sure that you are not slouching or dropping the shoulders forward.
• Breaking it up into stages - avoid doing anything in one go such as shopping, putting up the decorations or cleaning the house.  Try to break them up in stages and get help with heavy items.  Carrying these out in one go can cause the muscles to fatigue and taking awkward movements which can result in you straining the muscles, ligaments or joints and hen resulting in pain.  
• Keep active - Christmas is about of time of relaxing, however keep yourself moving about often.  Try to do 30 minutes of light exercise every day to keep your body supple.

If however the above advice is too late or you are currently in a pain episode, we at The Whitchurch Clinic are here to help.

Our Chiropractors, Andrea, Sarah, Amy and Katie can help by:

• Soft tissue massage
• Trigger point therapy
• Acupuncture/dry needling
• Spinal manipulation/mobilisation
• Home exercises/stretches
• Ergonomic and postural advice

Other treatments that may be benefit and are available at TWC:

• Deep tissue massage to help release trigger points or provide relaxation

As with any new symptoms it is always important to visit your GP or chiropractor to rule out any other disorders before reaching a diagnosis yourself.

As the clocks go back and the change of seasons are here, we start to feel tired and sluggish.  As well has stressed and less motivated.

So here at The Whitchurch Clinic we have develop a some tips and advice to help you through these winter months!

Stress is something that will affect most of us at this time of year, due the demands of the Christmas season.

“Stress manifests itself as a physical, psychological or social dysfunction resulting in individuals feeling unable to bridge the gap with the requirements or expectations placed upon them.”

http://isma.org.uk/about-stress/facts-about-stress 

People deal with stress in different ways. The symptoms of stress can effect your body, thoughts, feelings and behaviour.

Stress and pain are very closely linked together, but does stress cause pain or does pain cause stress?

Chapman et al, 2008, studied a review of psycho-physiological systems in relation to pain whereby a  physical injury or wounding can generate a complex stress response. They concluded that acute pain is an effect of multiple dimensions, and are products of the bodies 'supersystem'.  They also proposed that when the 'supersystem' is dysregulated, then health, function, and sense of well being suffer, and can be a result of chronic pain. 

Here at The Whitchurch Clinic we have a few tips on how to manage with the seasonal stress:

• Make lists - not only does it help you put your thoughts to paper, but gives you a self of achievement when you tick one off your list.
• Relax -   find ways to help you relax such as breathing exercises, meditation, yoga, time away from daily stresses.
• Treat yourself - try to help reduce tension with a massage or reflexology; find new ways to relax with Hypnotherapy; treat those aches and pains with a Chiropractic treatment; or take it all out with a personal trainer session.

There are many contributing factors to stress, and it is important to identify the cause. If you are not sure what is causing stress, or if you are unable to control your levels of stress, then it you will need to seek professional help.   

One of the most important factors for getting a good night sleep is getting your mattress and pillow right for you.  We get asked many of times which mattress would you recommend, please free to ask for some bespoke advice on your next visit

Vitamin D is necessary in order to protect musculoskeletal health, as it assists with the absorption of calcium.  During the summer months our vitamin D levels are maintained by the amount of sun we exposes our bodies to.  However in the winter months most of us do not have the luxury of chasing the sun, so our Vitamin D stores maybe depleting.  The department of health, as well as a recent publication from the Scientific Advisory Committee of Nutrition (SACN), recommend a daily supplement of 10 micrograms of Vitamin D.

More research is being carried out into the benefits of vitamin D, and recommendations may vary depending on what you read.  Therefore the above information should be taken precautionary.

It is important to note that too much sun exposure can increase the risk of skin cancer, and this information should only be taken as advisory.

For further reading on the SACN Vitamin D and Health report please click on the following link:

https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/537616/SACN_Vitamin_D_and_Health_report.pdf

and the following for an additional press release:

https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/539596/SACN_Vitamin_D_Press_Release_July_2016.pdf

DISCLAIMER

All of the above is advisory and therefore we would recommend that if you have any queries to either contact us here on 02920 617700 or contact your local healthcare practitioner.  

Chronic stress can have a negative effect on our physical health as well as our mental wellbeing. It can play a role in our susceptibility to illness and disease, but also in day-to-day functional problems such as aches, pains and stiffness.

There are many steps we can take to improve our ability to cope with stress and the role of nutrition is an important one. What and how you eat can help manage your stress.

To cope well with stress we need our food to provide us with balanced, sustained energy. Foods that quickly break down into glucose and are quickly absorbed - such as sugary foods and fast-releasing carbohydrates - may give us a burst of energy but can cause blood sugar to peak and then dip. This can actually increase our body's stress response and stress hormone levels, as well as making us feel irritated and out of control. As well as eating regularly, getting enough food is important when you're dealing with stress. 

Going on a weight loss diet - whether it's low-calorie, low-carb or low-fat - during a stressful time can add to your stress levels and in fact lead to yo-yo dieting. Instead, focus on balancing your blood sugar as outlined above, by eating regular meals, getting enough protein, healthy fats and non-starchy vegetables and cutting the refined carbohydrates and junks foods.

“Stress manifests itself as a physical, psychological or social dysfunction resulting in individuals feeling unable to bridge the gap with the requirements or expectations placed upon them.”

PAS 1010

http://isma.org.uk/about-stress/facts-about-stress 

People deal with stress in different ways.

Stress can arise from many of life demands such as work, relationships, money and society.

The most common cause of stress being work related. 

• "In 2015/16 stress accounted for 37% of all work related ill health cases and 45% of all working days lost due to ill health".
• http://www.hse.gov.uk/statistics/causdis/stress/ 

Our body firstly determines if a situation is stressful or not, by using our sensory and input sensors, and combining with our stored memories.

If the situation is thought to be stressful then the hypothalmus is activated.  This will then send a signal to The Pituary Gland and The Adrenal Medulla.

The short term response is to produce 'The Fight and Flight Response' via Sympatho-medullary Pathway (SAM) and the long term response is regulated through Hypothalamic Pituitary-Adrenal (HPA) system. 

Short Term Response - Fight or Flight

The Adrenal Medulla secretes Adrenaline with triggers the sympathetic nervous system causing:

- Increased Heart Rate

- Increased Blood Pressure

- Increased Sweating

- Decreased Digestion

Once the stressor has stopped the parasympathetic nervous system takes control and brings back the balance.

Long Term Response

HPA stimulates the release of Coritsol from the Adrenal Cortex, which controls the body's ability to steady the supply of blood sugar.  This response allows a person to cope with a prolonged stressor and help the body to return to normal state.

The effects of a long term stressor is a decrease in immune system, making them more prone to illness, disease and injury.

Stress and pain are very closely linked together.  But does stress cause pain or does pain cause stress?

Chapman et al, 2008, studied a review of psycho-physiological systems in relation to pain whereby a  physical injury or wounding can generate a complex stress response. They concluded that acute pain is an effect of multiple dimensions and are products of the bodies supersystem.  They also proposed that when the supersystem is dysregulated, then health, function and sense of well being suffer and can be a result of chronic pain. 

Here at The Whitchurch Clinic we are committed to helping you on your road to recovery. Through a detailed case history with/without an examination we can advised if we are able to assist with your complaint.  If we feel that we are unable to help we will point you in the right direction.

Our Chiropractic team can help through:

• Soft tissue massage
• Trigger point therapy
• Acupuncture/dry needling
• Manipulation/mobilisation
• Home exercises/stretches
• Ergonomic and postural advice

Other treatments that might help with back pain available at TWC:

• Hypnotherapy for stress management and help reduce tension
• Deep tissue massage to help release trigger points
• Diet advice

To summarise there are many contributing factors to stress and it is important to identify the cause.  If you are not sure what is causing stress or if you are unable to control your levels of stress then it you will need to seek professional help.  

As with any new symptoms it is always important to visit your GP or Chiropractor to rule out any other disorders before reaching a diagnosis yourself.

Stress is the feeling of being under too much mental or emotional pressure.

Pressure turns into stress when you feel unable to cope. People have different ways of reacting to stress, so a situation that feels stressful to one person may be motivating to someone else.

Many of life’s demands can cause stress, particularly work, relationships and money problems. When you feel stressed, it can get in the way of sorting out these demands, or can even affect everything you do.

Stress can affect how you feel, think, behave and how your body works. Common signs of stress include sleeping problems, sweating, loss of appetite and difficulty concentrating.

You may feel anxious, irritable or low, and you may have racing thoughts, worry constantly or go over things in your head. You may notice that you lose your temper more easily, drink more or act unreasonably. You may also experience headaches, muscle tension or pain, or dizziness.

Stress causes a surge of hormones in your body. These stress hormones are released to enable you to deal with pressures or threats – the so-called "fight or flight" response. Once the pressure or threat has passed, your stress hormone levels will usually return to normal.

However, if you're constantly under stress, these hormones will remain in your body, leading to the symptoms of stress, which can cause other illnesses.

Hypnotherapy is a positively great way to help alleviate and manage stress on a daily basis, as it works with our minds and bodies.

For more information on hypnotherapy visit:

http://www.karen-thomas.co.uk/

THE VEGANUARY CHALLENGE, challenges people to eat an exclusively

 plant-based diet, throughout the month of January

During the 2021 Veganuary Campaign, more than 500,000 people took the pledge to try a vegan diet, while more than 825 new vegan products and menu options were launched in key campaign countries.

Throughout the year, Veganuary encourages and supports people and businesses alike to move to a plant-base diet as a way of protecting the environment.

If you have ever thought about becoming a Vegan Loretta could be the person to speak to.

 Loretta Daley, is a Physiotherapist and Sports Massage Therapist, and Ultra Marathon Runner, based at The Whitchurch Clinic .  Loretta is a long-time Vegan and has a Level 3 Diploma in Plant Based Nutrition, and is just the person to help you to your exciting new challenge and will guide you towards:

·         Veganising your life from where you are now

·         Key nutrients and how to ensure you get them

·         Truths and myths about plant-based weight loss

·         Addressing health problems the plant-based way

·         Vegan nutrition for sports, young people and the elderly

·         Transitioning to Plant-based, long term

Osteoporosis Prevention

Things to avoid

Sodium is an essential mineral which helps to maintain fluid regulation, electrolyte balance, cellular function and blood pressure. Salty food can cause a loss of calcium leading to bone loss. The World Health Organisation recommended daily intake is 5gm salt, less than a teaspoonful in total a day.  Too much salt can cause loss of calcium and therefore loss of bone so it is best to avoid processed food with high salt and to avoid adding extra salt to your meals.

There has been some research highlighting a link between too much Vit A and increased bone fractures so it is advised to avoid supplements with retinol and avoid consuming liver more than once a week.

Heavy alcohol consumption and a high calorific diet are also associated with increased bone fractures.

Sources:  NHS, The National Oesteoporosis Foundation and World Health Organisation websites. 

The more rapid the onset and the more acute the onset, the more likely it is that this could represent a stress fracture.  Stress fractures are subtle fractures that occur in the bone as a result of putting too much constant stress on the bone, to the point where the bone starts to break — initially at a microscopic level.  Stress fractures are common in athletes or runners who have changed their training schedules, increased the amount of time that they are playing or running… or simply bad luck.  The pain from a stress fracture will typically be present from the first step you take on the court or the road.  

The pain from shin splints or medial tibial stress syndrome tends to build gradually and is a form of compartment syndrome.  You can usually initiate a run, or a game and then the pain begins shortly thereafter, or possible after the game or run itself.  Medial tibial stress syndrome (or ‘shin splints’) is characterised by pain along the lower part of your leg or tibia, and the pain is along the inner border of the tibia.  This is a very common cause of disability in runners and they often develop after sudden changes in physical activity, such as running longer distances or on hills, or increasing the number of days you exercise each week. Flat feet (weak arches) are another factor that can contribute to increased stress on the lower leg muscles during exercising.

Chiropractic care has been shown to be a great option for athletes in both treating and preventing sports injuries and pain. One such study found that chiropractic treatments led to less muscle strains in the legs. Another study showed that chiropractic adjustments improved athletic performance among competitive athletes. Through soft tissue techniques and spinal manipulation, combined with advice, we can work to prevent injury occurance.

Botelho, Marcelo and Bruno Andrade. “Effect of Cervical Spine Manipulative Therapy on Judo Athletes’ Grip Strength. Journal of Manipulative and Physiological Therapies. 2011; 35(11): 38-44.

Hoskins W, Pollard H. The effect of a sports chiropractic manual therapy intervention on the prevention of back pain, hamstring and lower limb injuries in semi-elite Australian Rules footballers: a randomized control trial. BMC Musculoskeletal Disorders 2010;11:64.

Reinking M, Austin T, Hayes A. A survey of exercise-related leg pain in community runners. International Journal of Sports Physical Therapy 2013; 8(3): 269-276.

A common complaint seen at TWC is Tendonitis, increasingly referred to as Tendinopathy. 

Tendonitis is caused by tendons - the thick cords that join your muscles to your bones- becoming irritated or inflamed.  Tendinopathy refers to damage done to a tendon usually due to repeated use. Tendonitis / Tendinopathy can cause acute pain and tenderness and make it difficult to move the affected joint. 

Any tendon can develop tendonitis, but it is more likely to develop in the shoulder, knee, elbow, heel, or wrist which is why it is often referred to as:

• swimmer’s shoulder
• pitcher’s shoulder
• jumper’s knee
• golfer’s elbow
• tennis elbow

Tendinopathy is more usual in the  Achilles tendon and Rotator Cuff tendons.

What causes tendinitis?

Tendons help us to make a certain movement over and over. Tendonitis may develop if the same motions are frequently made, such as when while playing sports or working, and the risk increases if the motion is performed incorrectly.

Tendonitis can also result from:

• Injury
• Aging
• Certain diseases, such as diabetes or rheumatoid arthritis
• Certain antibiotics (quinolones such as Levaquin)

Athletes who participate in particular sports, such as tennis, golf, bowling, or basketball, are at a higher risk of tendonitis. Individuals may also be at a higher risk if their job requires physical exertion, overhead lifting, or repetitive motions or tasks.

Symptoms

The pain from tendonitis is typically a dull ache concentrated around the affected area or joint, which increases when the injured area is moved. The area can also be tender to touch, feel tight and difficult to move, and there may also be some local swelling.

What are the treatment options?

Treatment options for tendonitis help reduce pain and inflammation in the tendon. Some basic home remedies include:

• Resting the tendon
• Applying heat or ice
• Taking medications, such as pain relievers and anti-inflammatories.
• Stretches and exercises to build strength and improve mobility in the area

A single corticosteroid injection can reduce pain and inflammation, but repeated injections can cause the tendon to weaken and increase your chances of injury.

It may be helpful to have imaging of the area such as ultrasound to determine how advanced the changes are in the tendon.

Chiropractic Treatment

Before commencing any treatments, our Chiropractors would take a thorough case history and perform a physical examination to determine which structures are affected, as well as exploring potential causes.  They would then implement management strategies which would be tailored to the patient and their needs.

For example - hands-on care for tennis elbow would include, education, muscle and tendon manipulation, acupuncture/dry needling, kinesiology taping, exercise and tissue loading management. 

When treated early, tendonitis usually resolves quickly. For some people, it can recur and become a chronic or long-term problem. If repetitive movements or overuse led to your tendonitis, you should change those behaviors to reduce your risk of developing it again after it heals.

How to keep tendon inflammation at bay

Take these simple steps to lower your chances of developing tendonitis:

• Keep physically fit and build your muscle tone.
• Warm up before exercising.
• Avoid over use and repetitive motions.
• Cross-train if you are an athlete.
• Use proper posture when working at a desk or doing other tasks.
• Don’t remain in the same position for too long. Move around periodically.
• Use proper equipment at work and during athletic activities.

If you begin to feel the pain of tendonitis, stop your activity. Take a 20-minute break to apply ice and rest.

Look out for our blog next month where we will look at how the use of Vitamins and Supplements may help with certain inflammatory conditions.

Janda's Theory -' The Domino Effect of Forward Head Posture 

Professor Vladimir Janda is one of the biggest contributors to our understanding of nervous systems influence over muscle control. Through his observations he provided original theories that scientists, via improved experimental methods are now able to confirm.

One prominent area of his studies was the development of three stereotypical patterns associated with distinct chronic pain syndromes;

•         upper-crossed syndrome(UCS)
•         lower-crossed syndrome (LCS)
•         layered syndrome (a combination of UCS and LCS)

These syndromes are characterized by specific patterns of muscle weakness (inhibited) and tightness (facilitated) that cross the body (as shown in the diagram above).

Specific postural changes seen in UCS, include forward head posture, increased cervical lordosis and thoracic kyphosis, elevated and protracted shoulders, and winging of the scapulae. Specific postural changes are also seen in LCS including anterior pelvic tilt, increased lumbar lordosis, lateral lumbar shift, lateral leg rotation, and knee hyperextension.

We know that when our centre  of gravity changes the rest of our body shifts its balance to compensate, below explains how UCS can lead to Layered Syndrome.

An example of the domino effect can be seen below:

Janda found that the UCS pattern of imbalance caused spinal joint dysfunction, particularly at the atlanto-occipital joints, C4-C5 segment, cervicothoracic joint, glenohumeral joint, and T4-T5 segment.

He also found that LCS created joint dysfunction, particularly at the L4-L5 and L5-S1 segments, SI joints, and hip joints.

Correcting these muscle imbalances through stretching and strengthening can help reduce stress on your joints and muscles and in turn reduce pain.

For further details of Janda’s life and contributions, read the paper by Morris and colleagues, Vladimir Janda, MD, DSc: tribute to a master of rehabilitation. (Spine. 2006 Apr 20;31(9):1060-4.)

Text adapted, and image taken from http://www.jandaapproach.com/ cited 11/2/2013

Gardening

Gardening – Don’t overdo it with the trowel!

As a nation, we love our gardens and spend a considerable amount of time and money on them. As we rush to get those jobs in the garden done, there is a risk that gardeners may injure themselves. What everyone wants is to be fit and healthy enough to actually enjoy sitting in their garden and enjoy the fruits of their labours come summer time, so here are some helpful tips from the British Chiropractic Association.

Clothes

 Don’t wear clothes that are tight or could constrict your movement.

Warm Up 

 Gardening is like any other exercise; you need to warm up first. Don’t go straight into heavy garden work; start off with lighter jobs as this will lessen the chance of muscle strain.

Using a ladder

·         When using a ladder or steps, make sure you are always facing it, keeping your shoulders, hips and knees pointing in the same direction.

·         Rather than leaning or reaching, move the ladder or step regularly to keep up with where you are

·         Any kind of ladder must be firmly and safely planted in position and, if possible, have someone else there to keep an eye on things.

Clever pruning

·         Get as close as possible to the things you are pruning and avoid overstretching to reach the area you are dealing with.

·         Invest in some long handled secateurs to reach plants and bushes that are beyond normal reach.

Take a break

·         Vary your activity by spending no more than 20-30 minutes on any one thing and make sure you take regular breaks. Be clever with the paving

·         If laying a patio, keep the slab close to your body and bend your knees; it is sometimes better to bend one knee rather two, as your supporting leg gives you a position of strength.

·         If using railway sleepers, two people will probably be needed.

Plan ahead

·         If you are planning a trip to the local DIY store to buy heavy items such as cement or gravel, buy smaller bags rather than one big bag as they are easier and safer to carry.

·         If you do buy heavy items, use a trolley and if on your own, ask an assistant at the store to help you.  If buying things like compost, sand or gravel in bulkier amounts, shovel the contents of the large bags straight into smaller containers or wheelbarrow from the back of the car.

·         Don’t lift with your arms straight out, keep the elbows bent and to your side to minimise the stress on your back.

·         If having items delivered, have them unloaded as close to where you need them as possible; this will save the effort of moving them again.

·         A specialist garden trolley might be worth investing in to move these sorts of materials around, especially if you have lots of patio pots to move around as well.

Courtesy of British Chiropractic Association