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Foot and Ankle pain

Ankle and Foot Pain

Did you know?
One quarter of your bones are in your feet! 

Ankle and foot pain can occur at any age for a multitude of reasons. It is probably most common however in sports people, especially those who do a lot of running. This is due to repeated high impact through the feet and ankles, a tendency for tight calf muscles and increased likelihood of ankle sprains due to awkward landings.
Unsupportive and constricting footwear, especially amongst women is also a common cause of foot pain. High heels place immense strain on the calf muscles (as well as the lower back and hips), while flat shoes or flip flops provide inadequate support to the foot arches.

Common Causes of Ankle or Foot Pain

  • Plantar fasciitis leading to pain on the sole of the foot and/or heel pain. This can be due to overuse (eg. running), increased weight (eg. pregnancy) or unsupportive footwear (eg flip flops, flat-soled shoes).
  • Sprained ankle due to awkward landing, pre-existing ankle injury or hypermobility.
  • Achilles tendinopathy due to overuse, excessive stretching, foot over or under-pronation.
  • ‘Wear and tear’ of the foot joints due to osteoarthritis.
  • Unsupportive or constricting footwear (eg flip flops, flat-soled shoes, pointed, high-heels).
  • Referred pain, cramps or ‘pins & needles’ from the lower back.

How can Osteopathy Help with Ankle or Foot Pain?

An Osteopath can assess what is causing your ankle or foot pain. We can provide treatment and advice for all of the conditions above. Treatment may include massage, joint mobilisation, stretching and advice on exercises to do at home. As well as treating the foot and ankle directly, we may also work on the hips, knees pelvis and the back, if assessment reveals contributing factors in those areas. 

When Is Osteopathy Not Suitable?

Ankle and foot pain may be caused by something that is not suitable for osteopathic treatment, in which case we would refer you on to a specialist. Examples include: cardiovascular problems, inflammatory conditions such as rheumatoid arthritis or gout, fractures or congenital bony anomalies.
 
If you need any further advice or would like to arrange an appointment please call 07908 415376
Hannah Ramsay
Osteopath

Osteopathy Treatment during Pregnancy

What to expect.

To begin with your practitioner will take a detailed case history of your presenting symptoms, your medical history and some questions surrounding your pregnancy and what you are looking to achieve from the treatment. We will then run though an examination of the area where you are experiencing pain and any global postural patterns.

Treatment usually consists of massage mobilisation and sometimes where appropriate manipulation.

Keeping you and your bump safe and comfortable

Pregnancy Pillow

Our aim is to keep you and your baby as comfortable as possible whilst we deliver our treatment. We often will use a pregnancy pillow, this can be seen in the photograph to the right. We make sure you are supported on your front and that your bump is not being restricted in any way or touching the couch below. This can be a very comfortable position to receive treatment.  

Side laying

Side laying is more useful for some Osteopathic techniques as it allows the body to move in away that just isn’t achievable when you are lying prone. We use pillows placed between your knees and under your bump to make sure you are supported and comfortable. 

Sometimes we will work with you laying on your back especially when working on your neck and shoulders but the couch is usually propped up at around 45 degrees and we check regularly to make sure you are feeling well and comfortable throughout the session, however if this isn’t working for you most of these techniques can be done in a seated position too. 

Treatment is always adapted for you as an individual and we plan our treatment techniques to suit you and your pain presentation. This being said, if you would specifically like massage techniques using the pregnancy pillow please let your practitioner know and we will use it providing it is safe and comfortable to do so.

Kinesiology Taping

What is Kinesiology Taping

Kinesiology taping is a treatment option if you’ve had an injury or illness that leads to mobility and motor function problems. It involves placing strips of special tape on your body in specific directions to help support your joints, like a knee, ankle, or wrist, as well as muscles and tendons. It can be used to help facilitate muscle function, stabilize joints, or inhibit muscles from contracting improperly. It can also be used to help decrease pain, swelling, and muscle spasm.

What Does Kinesiology Taping Do?

……………..and how does it differ from athletic tape? 

While kinesiology tape seems a lot like elastic athletic tape, there are differences between the two. 

  • Kinesiology tape is used to facilitate motion and inhibit pain and spasm, while athletic tape is used for support and to limit motion, typically because of existing pain.
  • Kinesiology tape is a flexible material that moves when you move; athletic tape is relatively inflexible. 
  • Kinesiology tape helps to improve lymph transport and increase circulation. The tight binding nature of athletic tape serves to decrease circulation.

How Kinesiology Tape Works

There are different theories about how kinesiology tape works. First, it is thought to change the proprioception input of the sensory nervous system in the muscles, joints, and skin. This is the sensation that allows you to know where your body is in space (say, how high your arm is raised).

The tape is thought to improve the interaction between the skin and the underlying structures to help reset the circuitry of this part of the nervous system, resulting in improved muscular activation and performance.

Kinesiology tape is also thought to inhibit nociceptors (pain pathways) in your muscles, skin, and joint structures. Decreasing painful input to the brain is thought to normalize muscle tone, resulting in decreased pain and muscular spasm.

Kinesiology tape can be applied in different ways, depending on why it’s needed. Your physical therapist can show you how to use the tape and cut the adhesive strips into the right configuration.

Some of the taping types include:

  • The “I” strip: This shape can be used to make the other types of strips below. “I” strips are used to support muscles, tendons, and ligaments. They are often used to facilitate your rotator cuff, gluteus muscles, quadriceps, or Achilles’ tendon. It can also be used on your low back and middle back to help you maintain proper posture.
  • The “X” strip: This type is used when kinesiology tape is needed to cover a large area or cross multiple joints. The tabs of the “X” strip cross over sensitive areas such as the back of your knees or front of your elbows. This strip is commonly used to facilitate your hamstrings, which cross both your hip joint and the back part of your knee joint.
  • The “Y” strip: This strip is used to cross sensitive areas of your body such as behind your knee or in the front of your elbow. It is also commonly used for applications to control the position of your kneecap. The “Y” strip is typically not as long as the “X” strip.
  • The “fan” strip: This type can help control swelling of your leg or arm. It is commonly used in lymphedema management or for superficial contusions and swelling.7
  • The “lift” strip: Commonly referred to as the Band-Aid, this strip is often used to support injured tissues or to treat muscle knots or trigger points. It helps to lift skin and tissues off sore muscles and trigger points. It is also used to treat superficial bruises.

Your therapist or sports medicine provider can ensure that you’re placing the tape in the proper position and that the tape is not too tight or restrictive. They’ll also let you know how long to wear the kinesiology tape.

Some specific uses of Kinesiology Tape

  • Facilitation: Kinesiology tape can be used to help improve muscular firing and contraction patterns. This can lead to normalized muscular tone and can also help improve athletic performance.
  • Inhibition and pain management: Kinesiology tape can be used to help decrease pain and muscle spasms that may occur after injury. It can help decrease nociceptive input to the brain which can help decrease muscle guarding and protective spasms.
  • Support and stability: If you have a condition that requires a specific joint to be held in place, kinesiology taping may be right for you. Conditions like patellofemoral stress syndrome, iliotibial band friction syndrome or shoulder instability may benefit from extra support provided by kinesiology tape. The tape can support your joint while still allowing for some motion.
  • Swelling management: If you have had swelling from an injury or surgery, kinesiology tape may help decrease the swelling by decreasing pressure between the skin and underlying tissues. This provides a pathway for excess fluids that have accumulated since your injury to travel through. Kinesiology tape is sometimes used in lymphedema management or for superficial contusions.

Your physical therapist may use various treatments and exercises to help treat your specific problem. Kinesiology tape may be a part of your treatment. Talk to your Osteopath or Sports Massage Therapist to learn about the tape and set realistic goals for its use.

How to avoid soft tissue injuries:

How to avoid the most common workout injuries, according to experts

Soft tissue injuries are the bane of any physically active person. They are the most common injuries in sport, can be difficult to heal and often reoccur, knowing how to help prevent them is key to staying healthy and active.

Your soft tissues support, connect and surround your bones and internal organs, and include muscles, tendons, ligaments, fat, skin and blood vessels. The most common soft tissue injuries occur in the muscles, tendons and ligaments. Think injuries such as hamstring strains, tennis elbow or ankle sprains. These afflictions often happen while exercising or playing sports, although sometimes they occur from unknown incidents.

Soft tissue injuries are generally traumatic or repetitive. That is, they can occur suddenly — rolling your ankle when you step off a curb, for example — or from overuse. While traumatic injuries are the most dramatic, repetitive injuries are more common. 

Repetitive soft tissue injuries occur when a tissue undergoes more damage than it can heal from over time. The ultimate cause of all repetitive soft tissue injuries is simply doing too much, too soon.

To prevent a repetitive injury, you need to take a measured approach to exercise and sports and not have the weekend warrior approach in which you’re inactive all week, then run 15 miles at the weekend. It’s also important to acclimate your body slowly to a given activity. 

A good rule of thumb: Don’t increase your workout volume more than 10% per week. And every four to eight weeks, give your body a rest by significantly reducing the volume and intensity of your workouts. 

Avoiding soft tissue injuries isn’t necessarily all about training, however. Research suggests major changes in your environment may affect your risk of injury, too, so eat well, get plenty of sleep and perhaps skip tough workouts when your stress levels are high. 

Take any injuries seriously

If you do get injured despite your best precautions, take it seriously. Even when people realize they have a soft tissue injury, they often carry on with their program hoping it gets better with time. More often than not, it just gets worse and worse until it hurts badly enough that the person simply can’t train due to the pain.

Instead of ignoring that muscle or ligament strain, see a qualified health care provider, Physiotherapist or Osteopath and expect to spend a few weeks to a month or more recovering, depending on the severity of the injury, your age and other factors. Most importantly, complete your entire rehabilitation process to reduce the risk of another injury.

Osteopathy and Covid Recovery

COVID-19 – how Osteopathy could support your rehabilitation post infection.

Disclaimer: This post is based on our clinical findings in patients who’ve had COVID-19, therefore it is mainly anecdotal. Internet links have ben added where appropriate.

The main symptoms of COVID-19 are changing all the time but over the course of the pandemic we’ve seen patients suffering with the musculoskeletal effects of the virus, which have had a profound effect on the way they breath. This, in turn, has a knock-on effect on other areas of the body and even the nervous system. Patterns have continued to emerge in those contracted the virus. 

What happens to the musculoskeletal system?

Lung capacity is sometimes reduced in patients who’ve had COVID-19 causing shallow breathing, this reduces oxygen intake leading to post-viral fatigue. This may be exacerbated by a continuous cough. Over time the ribcage may become restricted, and the patient is no longer be able to breath deeply. 

Common clinical examination findings in patients who’ve had COVID-19:

  • Restriction in the ribcage and back caused by shallow breathing, limiting thorax expansion, and coughing, leading to intercostal muscle tightness/spasm.
  • Shortening of the diaphragm muscle (primary muscle of respiration) due to limited ribcage expansion. 
  • Use of “secondary muscles” of respiration to enable the patient to take a deeper breath. These muscles are found in the neck and upper back; this can lead to tightness/pain in the neck and shoulders due to muscle fatigue and even headaches if the neck becomes restricted.

How can Osteopaths help?

  • Retraining and strengthening breathing with exercises and mediation techniques. 
  • Mobility exercises and stretches for the neck, thorax and lower back to optimise movement through the spine and reduce restriction.
  • Hands on treatment using diaphragm stretching and articulation through the ribcage and neck. 
  • Cranial treatment is sometimes effective rebalancing the nervous system.

What can patients do to help themselves?

  • Rest! In the first few weeks after contracting the virus it’s important to rest and recover. Avoid strenuous activity as this will create too much stress on the body.
  • Slowly reintroduce exercise, with gentle walking, stretching and breathing exercises.
  • Keep hydrated. 
  • Avoid stimuli such as alcohol, caffeine and sugar. These can be inflammatory and will hinder your body’s recovery.
  • Book an osteopathic consultation and see how we can help you. 

Everyone responds differently to any virus; many people have experienced all the symptoms of COVID-19 whilst others were completely unaware they had it in the first place. It’s important to understand what you can do to help yourself. The NHS Covid recovery website is a good resource for those looking to tailor their own recovery. 

Janine Norris

Abshot Osteopathy

Top 10 Tips – how to avoid musculoskeletal gardening injuries!

Top 10 Tips on how to avoid musculoskeletal gardening injuries!

The temperature is climbing, the sun is shining and we can’t wait to be outside but, before you leap back into gardening you may wish to consider the 10 points listed below as a precaution:

1) Warm up – having a brisk walk around the garden and doing some simple stretching exercises is good preparation for time in the garden
2) Build up gradually – we’ve all done it – there’s so much to do – the temptation is to hit it hard. The problem is that the musculoskeletal system takes time to adapt, particularly as you get older and this can be a common cause of injury. If you’re not used to it, start out by doing a little bit first of all – tackle a small area of the garden and see how you get on with a short period of physical activity each day. Gradually build up the time and intensity.
3) Vary the workload – chop and change whilst you’re in the garden. Apart from the physical demands of some tasks, it can get boring working on just one part of the garden. Scarifying the lawn is a workout so try interspersing this job with an easier task like weeding. This will help you avoid overuse injuries affecting hands, wrists and elbows most commonly.
4) Think about your position – some activities, particularly repetitive ones, can easily lead to injury if you don’t get your body posture or technique correct. In spring time, you are also using tools and equipment that you haven’t used for 6 months. Make sure you are comfortable doing the task – if not stop and re-adjust. You can also vary the jobs depending on whether they require you to sit, stand or bend – as your back is unlikely to tolerate endless amounts of heavy bending or lifting.
5) Listen to your body – remember that pain can be your body’s way of telling you to stop. If you start to feel any discomfort, give yourself a break. Pushing through the pain may seem like an admirable quality, but it will most likely just make things worse.
6) Don’t be afraid to ask for help – we can all picture the scene – you start digging out some old hedging and you need some extra strength to get the last bit out – but no one’s around. You can struggle on but the risk of injury is high. Why not leave it until someone can give you a hand (maybe after social distancing rules have been relaxed!)
7) Decide in advance what you’re going to do – get the right equipment, plan what is involved and tell someone else if you can so they are aware of what you’re doing. Many accidents occur as a result of poor planning.
8) Look after your back and knees – if you can, straighten your back, look ahead and lift using the power of your knees and legs rather than allowing the lower back to take all the strain. You could also try using a foam-padded kneeler to prevent knee pain and backache when planting, weeding or tending to low growing plants
9) Use long handled tools – Use long handled tools if you can, as this will reduce the amount you need to bend, reach or stretch
10) Warm down – after you’ve been in the garden it’s good to do some simple back exercises which can help to counter the strain and keep your spine healthy and pain-free 
We hope that you will stay safe and well in the garden. However, we are aware that injuries happen to even the most conditioned and prepared gardener. During this period of social isolation, Osteopaths are on hand should you suffer an injury.


Hannah
Osteopath (and keen trainee gardener)
07908415376

Osteopathy and pregnancy

Pregnancy is one of the most significant changes a woman’s body goes through. As well as her body’s shape altering dramatically, there are also physiological changes. For instance, increased hormones can cause ligaments to loosen. These factors lead to postural changes, joint strain and altered fluid movement around the body. As a result, pregnant women often experience:

  • Back and neck pain
  • PGP (pelvic girdle pain) or SPD (symphysis pubis dysfunction)
  • Hip and knee pain
  • Sciatica

Osteopathy provides safe, gentle hands-on treatment which can alleviate pain, helping the body to adapt more comfortably to changes experienced during pregnancy. In addition, regular osteopathic treatment leading up to labour, is a good way to help the body cope with, and recover from the physical and psychological challenges ahead.

Post Natal

Following birth, a woman’s body will slowly return to its normal form. However, underlying changes in supporting muscles and joints, particularly around the pelvis, can make her more vulnerable to back pain. In addition, becoming a mum presents a whole set of new stresses: post-birth exhaustion, lack of sleep, lifting heavy car-seats and breast-feeding posture to name a few.  Osteopathy can help resolve aches and pains, women commonly experience after giving birth, ensuring that those early years can be enjoyed to the fullest.

Janine Norris our new Associate Osteopath is particularly interested in women’s health and has experience treating pre and post-natal women. She is also knowledgeable in nutrition and promoting the benefits of diet, exercise and lifestyle in preparation for labour.
 

If you would like an informal chat or to book a consultation please do call or message 07908 415376and we will do what we can to help.

Hannah Ramsay
Principal Osteopath

Not just Backs!

We care about you from your head to your toes.

It is a common conception that osteopathy is a therapy used only to treat back problems, however this is not the case. Osteopathy has been shown to provide effective treatment and management of conditions such as:

  • Generalised aches and pains
  • Joint pains including hip and knee pain from osteoarthritis as an adjunct to core OA treatments and exercise
  • Arthritic pain
  • General, acute & chronic backache, back pain (not arising from injury or accident)
  • Uncomplicated mechanical neck pain (as opposed to neck pain following injury i.e. whiplash)
  • Headache arising from the neck (cervicogenic) / migraine prevention
  • Frozen shoulder/ shoulder and elbow pain/ tennis elbow (lateral epicondylitis) arising from associated musculoskeletal conditions of the back and neck, but not isolated occurrences
  • Circulatory problems, cramp
  • Digestion problems
  • Joint pains
  • Lumbago
  • Sciatica
  • Muscle spasms
  • Neuralgia
  • Fibromyalgia
  • Inability to relax
  • Rheumatic pain
  • Minor sports injuries and tensions

Headaches – cranial and structural Osteopathy treatments.

What is a cranial osteopathy – and how effective is it for tension headaches?

You may have heard of “cranial osteopathy” and think a “cranial” osteopath is an osteopath who only deals with problems regarding the “cranium” or head, or that if they are suffering from conditions such as tension headaches that they need to see a cranial osteopath rather than a regular osteopath.
 
Cranial osteopathy can feel very relaxing for the recipient in much the same as reflexology can be. For some patients, particularly the very young, cranial osteopathy may be an appropriate and effective technique, however patients with conditions such as tension headaches who are exclusively treated with cranial osteopathy may be missing out on more effective forms of manual therapy that directly address the precise source of their pain, such as referred pain from the neck joints or “Trigger Points” in the neck / shoulder muscles.
 
As an Osteopath with particular interest in treatment of migraines and tension headaches I may use a combination of both cranial and structural Osteopathy to treat patients depending on their individual presentation.

Hannah Ramsay
H B Osteopathy

Osteopathy, what to expect.

What happens when you visit an Osteopath?
What is a treatment is likely to cost? and How to find an Osteopath near you.

Before you book your first appointment, do call and speak to the receptionist or the Osteopath you would like to see.
Osteopathic practices should be able to provide information about the Osteopath, the clinic, what the treatment involves, payment methods and anything else you need to know in advance of your first visit.

At your first appointment your Osteopath will start by listening to you and assessing you.
Osteopathy is a patient-centred, system of healthcare. A first appointment generally lasts about 45 minutes to allow the osteopath adequate time to:

  • Listen and ask questions about your problem, your general health, other medical care you are receiving or medication you are taking, and record this in your case notes. The information you provide will be confidential.
  • Examine you properly. It is likely the osteopath will ask you to remove some of your clothing. Tell your osteopath if you are uncomfortable about this. You should expect privacy to undress and a gown or towel should be provided. You can ask a friend or relative to accompany you and be present throughout your treatment.
  • Ask you to make simple movements and stretches to observe your posture and mobility. Because of the body’s structure, pain or stiffness you are experiencing in one part may be linked to a problem elsewhere.
  • Examine the health of the joints, tissues and ligaments using their hands and a highly developed sense of touch called palpation.

Your osteopath will also check for signs of serious conditions they cannot treat and may advise you to see your GP or go to hospital. They should provide you with a letter explaining what they believe to be the problem.

Diagnosis and treatment
Osteopathy specialises in the diagnosis, management, treatment and prevention of musculoskeletal and other related disorders.
Your osteopath will give you a clear explanation of what they find (their diagnosis) and discuss a treatment plan that is suitable for you. They will explain the benefits and any risks of the treatment they are recommending. It is important to understand and agree what the treatment can achieve, and the likely number of sessions needed for a noticeable improvement in how you feel.

Treatment is hands-on and involves skilled manipulation of the spine and joints, and massage of soft tissues. Your osteopath will explain what they are doing and will always ask your permission to treat you (known as consent). Ask questions at any time if you are unsure what you have been told or if you have any concerns.
Self-help measures and advice on exercise may be offered to assist your recovery, prevent recurrence or worsening of symptoms.

How much does it cost?
Most osteopaths work in the private sector and this means you will usually need to pay for treatment. Fees vary across the UK depending on a number of factors including the osteopath’s location; but the majority of osteopaths tend to charge an initial consultation fee of £55 to £70 and between £40 and £55 for subsequent sessions.
The initial session is often a longer one and generally can last about 45 minutes, with follow-up sessions generally lasting around 30 minutes. But again this will vary.

Most major private health insurance providers provide cover for osteopathic treatment but you will need to ask your insurance company about the level of cover available and whether you need to be referred for treatment first by your GP or a specialist.

Some osteopathic treatment is available through the NHS. For information on who to contact in your region of the UK, ask your GP.

Ongoing care
Because of the physical nature of the treatment, it is not unusual to sometimes feel sore in the first 24-48 hours after treatment. Your osteopath will explain any likely reactions that you could expect. If you have any concerns it is important to contact the osteopath and ask their advice. It may require more than one visit before your problem is resolved. The osteopath will review your progress at each subsequent visit and seek your consent to any changes to your treatment plan.

​Is referral from a doctor necessary?
Most patients ‘self-refer’ to an osteopath for treatment, there is no need for a GP letter. You can use the statutory Register of osteopaths on Institute of Osteopathy website to find local osteopaths or simply do an online search.

Although referral by a GP is not necessary, you are encouraged to keep your GP fully informed, so that your medical records are current and complete. This will ensure you receive the best possible care from both health professionals. With your permission, your osteopath may send a report to your GP with details of your condition and treatment. You can also request a letter for your employer if this is helpful.