Advice Blog

Happy Holidays

Happy Holidays

Hopefully, after a year of restrictions,  this Christmas season many of you will be heading away either to visit family, celebrating the new year, skiing, or just escaping. 
So often, when people are on holiday and out of their normal routine, they can end up causing themselves unnecessary discomfort and stress by injuring themselves, so the British Chiropractic Association have put together some top tips to remain fit and healthy when away. 

Suitcase selection – Choose wisely, buy the lightest case possible that has wheels; hard cases tend to weigh quite a lot before you even start to fill them.


Two cases are better than one If possible, take two light suitcases rather than one, so you can distribute the weight more evenly.

Get a good night’s sleep – Travelling when tired increases your chances of injury, so make sure you sleep well the night before a long journey and avoid rushing around.



Make adjustments - Many back problems are caused or aggravated by a poor driving
posture. If you’re driving to your holiday destination, ensure the seat position is
slightly backwards so that it feels natural and that your elbows are at a comfortable and relaxed angle.


Relaxing – Relax at the wheel, as this reduces stress on the spine and allows your seat to take your weight.

Keep an eye on the clock – Stop and stretch your legs (and arms!) at least every two hours.

Clench! – If you are stuck in traffic, exercise in your seat. Try buttock clenches, side bends and shoulder shrugs and circles.

Keep it lose – Don’t wear tight clothing as they will restrict your movement.


Flying high – Avoid alcohol before and during the flight as this will cause you to
dehydrate and, in turn, exaggerate muscle pain. Drink plenty of water instead.


Air-exercise – You will be restricted to your seat for most of the flight, but avoid stiffness by doing shoulder shrugs, buttock clenches and foot circles. Take the opportunity to get up and stretch your legs whenever you can.


Avoid ‘travelators’ – Get your joints moving quickly after a flight and walk to
arrivals rather than the easy option of a moving walkway.


Round and round – Ensure your bags are easily identifiable (e.g. knot a ribbon around the handle) to avoid lifting other people’s heavy cases in error.


Push, don’t pull! – Many wheeled cases encourage you to pull the case handle from behind, but this makes the upper body/back twist. If possible, push the case in front of you or use a trolley making sure you choose one from the stack which does not have ‘wonky wheels’, as keeping it on track will not do your back any good!

At Your Destination

Bed down – When you get to your hotel, if your bed is too hard ask the hotel staff for a spare duvet or blanket to put between you and the mattress. Firm beds are not always best, but it is easier to soften a hard bed than make a soft bed harder.


Lounging around – If you’re heading to the sun loungers in search of the perfect tan, try not to lie on your tummy with your back and neck arched back when reading your book or magazine. Put the reading matter on the floor, so that you can view it over the edge of the sun bed; this should allow you to keep your head and neck in a more neutral position.


Exercise in safety – If keeping in shape is on your holiday agenda, ensure you have a full induction to the hotel gym equipment.


Further information about chiropractic can be obtained by logging
on to
For further information contact the
British Chiropractic Association on 0118 950 5950



'Tis the season to be jolly'

As Christmas day is fast approaching, we are all hitting the shops to buy special gifts for our loved ones.


However all this shopping can be both physically and emotionally stressful, resulting in head, neck and back pain. 

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.


Top tips to avoid back pain this Christmas

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.

'I have overdone it'

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.


Winter Woes

Winter Woes

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.” 

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. 


Helpful tips to manage stress

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.   

Tiredness or lack of sleep

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

Sleeping postions

Your sleeping position is very important as this is where you will spend nearly half of your day.  With the darker nights we may find ourselves retreating to bed earlier than in the summer months.  


REMEMBER DRINK PLENTY OF WATER! This helps us keep our muscles and joints hydrated and therefore pain to a minimum.


AVOID SLEEPING ON YOUR FRONT! A lot of front sleepers present to us in clinic with chronic problems as it’s difficult to maintain a neutral spine position.


Sleeping on your stomach forces your head and spine into an unnatural position, and staying in this position for hours on end is not good for your back or neck and can result is significant discomfort and restless sleep. Patients have seen great results from trying to change their habits.


As I always say, you can't control what you do in your sleep (especially snoring!), and it is hard to change the habit of a life time, but we can try and set up in a good sleeping position to avoid it.

Less sun means less Vitamin D

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:


and the following for an additional press release:

Exercise and Diet

Don't let the cold weather put you off keeping fit and healthy.  Not only will exercise and a good diet reduce your risk of major illnesses such as heart disease, diabetes, help you to live longer but it will give you more energy.  More energy will mean a happier you!



Here are  some tips to keep you moving:

  • Get up, stand up. Inactivity is a leading cause of back pain. If you spend most of your day sitting make sure that you take regular breaks, ideally every 20-30 minutes. Stand up to stretch, change position, and walk around a little.
  • Stretch it out. If you struggle to get away from your seat at work, simple activities such as stretching and shoulder shrugging, and even simply fidgeting in your seat, can all help to keep the joints and muscles in your back moving.
  • Keep moving. Exercise is key to a healthy back, however you don’t need to embark on any extreme fitness regimes. Adding just a few extra minutes of walking a day can have a huge impact on your posture.
  • Straighten Up. Try incorporating some simple exercises into your daily routine. The British Chiropractic Association has developed - - a series of simple exercises designed to improve posture and help prevent back pain by promoting balance, strength and flexibility in the spine.
  • Perfect your posture. Paying close attention to your posture can help you recognise back or neck pain triggers. People who want to improve their posture should try imagining they have a plumb line hanging straight from their ears to ankles - with everything in the middle sitting on the same line. One way to do this is to try standing in a relaxed way and then gently contracting the abdominal muscles. 


There is always temptation to over indulge in the festive season so here are few tips to keep your diet healthy:

  • Remember your 5 a day portions of fruit and veg.  Take advantage of  seasonal vegetables like carrots, parsnips and swede.
  • Avoid comfort eating, keep your meal times regular, and try not to skip meals.
  • Be carb smart.  Carbohydrates are good for us if eaten in the right quantities at the right time.  



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.  


Eating To Beat Stress

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. 


So how do you know if you're a stress eater? Here are some of the common signs and if these signs apply to you, please try to seek some advise from a healthcare professional.



  • After an unpleasant experience, such as an argument, bad day at work etc, do you eat even if you are not hungry?
  • Do you crave specific foods when you're upset, such as feeling the desire for chocolate when you're feeling depressed?
  • Do you eat because you feel there is nothing else to do?
  • Does eating make you feel better when you are down or less focused on problems when you're worried about something?


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.



Some find it helpful to use calorie counting programmes to monitor where those extra calories are coming from, but be honest with yourself and don't leave out those snacks and drinks that all add up.



You should find it easier to manage your weight - or lose weight - by eating in this way. Although regular snacking is not the best thing for everyone, it can be helpful if you're coping with stress, again by helping to keep your blood sugar on an even keel. Base your snacks on whole foods that contain some protein and complex carbohydrates to help avoid spikes in your insulin levels and those pesky cravings! 




“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 

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. 

How our body reacts to 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.


Effects of stress

The symptoms of stress can effect your body, thoughts, feelings and behaviour.


Below is a list of some of the common effects of stress:

  • Headaches
  • Temporomandibular joint disorder
  • Muscles tension
  • Chest pain
  • Fatigue
  • Stomach upsets
  • Sleep disruption
  • Change in sex drive
  • Lack of motivation
  • Irritable
  • Sad or depressed
  • Overeating or Undereating
  • Drug or alcohol abuse
  • Social  withdrawal 
  • Lack of exercise
  • Plus many more


Stress causes pain or pain causes stress?

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. 


Stress realted Musculoskeletal Pain

Temporomandibular Joint Dysfunction



The temporo-mandibular joint (TMJ) is formed from the articulation of the mandible and the temporal bone of cranium.  The joint is unique as the surfaces do not touch as they are separated by an articular disc.


The joint is surrounded by three ligaments:

  • Lateral Ligament
  • Spehnoid-mandibular Ligament
  • Stylo-mandibular ligament

The movement of the joint is produced by the muscles of mastication.  These cause the mouth to protrude and retract, as well as opening and closing the mouth.  


The TMJ is innervated by the auriculo-temporal and masserteric branches of the mandibular nerve (CN V3).


Factors affecting the joint


There are a range of factors which can effect the joint and result in pain or dysfunction:

  • Chronic Pain Syndromes which cause an increased sensitivity to pain
  • Muscle over activity - grinding teeth, clenching jaw
  • Dental issues
  • Intra-articular disc degeneration
  • Osteoarthritis
  • Rheumatoid Arthritis
  • Trauma
  • Hypermobility or hypomobility
  • Infection
  • Tumors




Symptoms can vary on individual bases and there maybe other factors that are causing the dysfunction:


  • Pain around joint or referred to head, neck or ear.
  • Restricted jaw movements
  • Jaw noises
  • Ear ache
  • Headache
  • Neck Pain
  • Locking episodes



Treatment is usually non surgical and can consist of manual therapy and lifestyle changes.


Manual Therapy such as Chiropractic therapy, Physiotherapy, Massage Therapy etc/


Lifestyle Changes:

  • Resting joint by eating soft food and avoid chewing gum.
  • Using hot water bottle or ice pack on joint.
  • Stretching jaw and home exercises.
  • Avoid opening jaw wide and clenching teeth.
  • Relaxation techniques to decrease stress.


  • Painkillers such as paracetomol, iburprofen, NSAIDS.
  • Steroid injections to reduce swelling and help with pain.


Surgery is uncommon for TMJ disorder but can consist or Arthrocentesis, open joint surgery or very rarely total joint replacement.  


Can we help?

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.

How Hypnotherapy can help with Stress

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:



Veganuary Consultation Offer



In Preparation for VEGANUARY 2022



During November and December Loretta has a special offer of



 and follow up appointments at The Whitchurch Clinic.


First consultation 1 hour £30


Follow ups half hour £20

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 affects approximately 3 million people in the UK.  We can start losing bone density naturally after the age of 35 so we are at increased risk of weakening bones as we grow older.


Women are especially at risk after the menopause due to reduced oestrogen levels. 


Medication and supplements can be used to treat osteoporosis but there are many other things that can be done to improve bone density and prevent bone loss.



Some people are at a higher risk of developing osteoporosis, below are some of the conditions that can contribute to this:

  • Taking high-dose steroid tablets for more than 3 months
  • Other medical conditions – such as inflammatory conditions, hormone-related conditions, or malabsorption problems
  • A family history of osteoporosis – particularly a hip fracture in a parent
  • Long-term use of certain medicines that can affect bone strength or hormone levels, such as anti-oestrogen tablets that many women take after breast cancer
  • Having or having had an eating disorder such as anorexia or bulimia
  • Having a low body mass index (BMI)
  • Not exercising regularly
  • Heavy drinking 
  • Smoking

Osteoporosis Prevention

Physical Exercise


Weight bearing and strengthening exercises can all help as the action of muscle on bone strengthens and stimulates bones. Physical exercise also helps strengthen bones and muscles to keep our bodies stable and reduce risk of falls and injuries. Physical activity also helps prevent weight gain and obesity and helps maintain good posture.


The NHS recommends moderate-intensity exercise and say "People over 65 should try to get 150 minutes (2 and a half hours) of moderate-intensity exercise every week."
The Royal Osteoporosis Society and NHS websites both have great guidance and suggested exercise programmes to get you started:



The National Osteoporosis Foundation and NHS recommend 700mg calcium a day and 10 mg Vitamin D daily.  Vitamin D is required to absorb Calcium.



Supplements can be taken but there are also many foods including vegan alternatives which are fortified with calcium and Vit D such as fortified spreads, soya , rice and oat drinks,  brown and white bread and some breakfast cereals.  Calcium set tofu is a great alternative protein source for all including vegans.


*If you are considering a moving towards a more plant based diet or are already there and would like more advice on balanced nutrition, our physiotherapist Loretta is also a Plant Based Nutritional Therapist who can help you plan. visit her page for more details:


Dairy Foods - milk, yoghurt and cheese are all good sources of Calcium. 

Oily Fish - Oily fish eg tinned sardines and salmon with bones are excellent sources of calcium  and fish such as mackeral, salmon, tuna, sardines and pilchards are also a source of VIT D. 

Vegetables – Broccoli, cabbage and okra are all good sources of Calcium and although spinach has calcium, it contains oxalate which inhibits calcium absorption.

Dried fruits & nuts  - figs, apricots, prunes,  raisins and nuts eg sesame seeds and tahini  are another good source.

Red meat and egg yolks -  good sources of vitamin D.



In the UK we get most of our vitamin D from sunlight exposure from around late March/early April to the end of September. 


The sunlight triggers the bodies own production of vitamin D, which in turn helps your body absorb calcium. This process strengthens teeth and bones, helping to prevent conditions such as osteoporosis.


To read more about how to get vitamin D safely from sunlight, and its importance for all the family visit:

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. 

Leg Pain in Athletes

With the growing popularity of community-based races and charity half marathons, more and more people are taking up running for fun. While running is associated with a lot of health and general wellness benefits, some athletes experience overuse injuries while running and training. One of these is exercise-related leg pain (ERLP), otherwise known as shin splints, with pain between the knee and ankle during or after exercise.


M Reinking, T Austin, and A Hayes (2013) looked into the prevalence of ERLP in adult runners and how the pain affected their running and daily activities. They also analyzed risk factors to determine who is most likely to have leg pain from running. Out of over 200 runners, more than 50% of the runners reported at least one episode in the past year. Of this group, about 40% said that the leg pain interfered with running. They found that the most significant risk factor was previous leg injury or pain and participants who had less than three years experience running were at greater risk than more experienced runners. Those who ran less than 15 miles per week were more likely to suffer leg pain than those running more. The greatest occurrence was among amateur runners who raced at a pace of 9 minutes per mile or greater.

Some Causes of Leg Pain in Sport

Trigger Points

A trigger point is a hypersensitive, nodal point of muscle that can refer pain in specific patterns (Travell and Simon's Myofascial Pain and Dysfunction Vols 1 & 2) depending on if they are active or latent. Trigger points can build up due to an acute overload/injury, or chroinic overload such as repetative strain injuries.

This can be caused by a change in technique, increased training, or faulty mechanics in a joint or muscle (scar tissue etc). Trigger points weaken and shorten the muscle, effecting both strength and endurance. This in turn leads to further dysfunction in the surrounding tissues and joints as they compensate and are over loaded. Further trigger points then form in a snowball effect.

Snapping Hip Syndrome

Snapping Hip

‘Snapping hip’ or coxa saltans/iliopsoas tendinitis/dancer's hip describes an audible snapping or popping noise as the hip moves from flexion (knee toward waist) to extension (knee down and hip joint straightened). After extended exercise pain or discomfort may be present caused by inflammation of the iliopsoas bursae. Pain often decreases with rest and diminished activity.

The more common lateral extra-articular type of snapping hip syndrome occurs when the iliotibial band, tensor fascia lata, or gluteus medius tendon slides back and forth across the greater trochanter.

Less commonly seen medial extra-articular type is caused by the iliopsoas tendon catching on the anterior inferior iliac spine(AIIS), the lesser trochanter, or the iliopectineal ridge during hip extension, as the tendon moves from an anterior lateral (front, side) to a posterior medial (back, middle) position.

‘Snapping Hip’ syndrome is commonly associated with a leg length difference (usually the long side is symptomatic), tightness in the iliotibial band(ITB) on the involved side, weakness in hip abductors and external rotators, poor lumbopelvic stability and abnormal foot mechanics (Overpronation). Intra-articular can also be indicative of injury such as a torn acetabular labrum, recurrent hip subluxation,ligamentum teres tears, loose bodies, articular cartilage damage, or synovial chondromatosis (cartilage formations in the synovial membrane of the joint).

Stress Fracture

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.  

Compartment Syndrome

A compartment syndrome is characterised by having too much pressure in the muscle compartments in our leg.  Our muscles are surrounded by very tough tissue we call fascia, it is not very flexible and some runners or athletes experience muscle swelling during activities.  If this swelling is significant enough, the fascia will squeeze or put pressure on the muscle.  This reduces blood flow to the muscle and the muscle will fatigue rapidly and start to hurt. People with compartment syndromes typically have no pain at the start of their run/game, but at some point during the run/game pain will start and steadily build. You will typically need to stop your activity to relieve the pain.  Sometimes compartment syndrome can become so chronic and severe that it requires surgery to reduce the pressure, so best to get it looked at by chiropractor as soon as possible for prevention.

Shin Splints

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.


Tendonitis (tendon inflammation), or Tendinosis (degeneration of the tendon) is a very common issue sports medicine specialists see in sports and runners.  One of the most commonly affected tendons is the achilles. If the tendon, a few inches above your ankle joint is tender, but you do not feel or see any nodules you are most likely suffering from a form of tendonitis or peri-tendonitis where the tendon itself, or the tissue around it is inflamed from chronic use. Achilles tendinosis is caused by a chronic tendonitis, causing nodules or enlargement of your tendon that is tender to touch, diagnostic ultrasound can confirm the diagnosis.  Chronic achilles tendinosis causes scar tissue and weakening of the tendon, which can potentially lead to rupture.


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.


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.


A question of great philosophical debate!

The same could be asked about body pain - 

Does the knee problem create the hip pain, or does the hip problem cause the knee pain?  Is your headache caused by a neck problem, or your lower back?

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 cited 11/2/2013

Avoiding Mishaps when Gardening



Gardening – Don’t overdo it with the spade or 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.



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.



 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