Our Osteopath Chris Jones recently discovered that he had high cholesterol. Here is how he navigated the decision on whether to try to reduce this with diet and supplements, or with medication.

“It was a bit of a surprise as I eat well, exercise regularly, don’t smoke, and maintain a pretty healthy weight. But genetics can play a role and a family history and DNA testing showed some genes that have the propensity to increase my cholesterol. So my Cardiologist recommended a statin, which is a medication that lowers cholesterol.”

“There are side effects to statins, and once you start them, you’re kind of on them for life. New alternatives are in development, but they are a couple of years away still, so it was really down to statins or supplements, as there was nothing really terrible in my diet I could change that would make an enormous difference.

“I found there are a couple of supplements, like Niacin and Bergamot, which can help, and then I found an article by one of my favourite podcasters Peter Attia, a healthy aging doctor in the US. He wrote a piece on how he decides whether to recommend certain medications to certain people, which I found really helpful, and so I thought I’d share it with you:

Although powerful, this tactic can be challenging to discuss as it is highly individual. So instead of telling you to “take X” or “never take Y,” I find it more beneficial to approach this tactic with a 3-part framework

  1. What is the objective? 
    1. The more clearly you can define your objective, the more clearly you can assess if this is the right tool for accomplishing that objective. 
  2. Is there a biomarker?
    1. How do you plan to customize, track, and adjust your treatment over time? If there is no biomarker to monitor as a measure of effectiveness, it doesn’t mean you shouldn’t take the supplement or medication; it just means you may need to be more intentional around monitoring results in other ways.
  3. Does the risk outweigh the reward? 
    1. Everyone has a different tolerance for risk. Some questions to consider when weighing risk vs. reward: What is the mechanism of action? How many patient years of use exist? What are the short-term and long-term risks of taking the medication? What are the risks of not taking the medication?

“Another thing I found in my genetic testing was related to which kind of exercise will be best for my heart, so I will be working with Kenny and Anthony at Physio K to tweak the exercise program a little.

If you have any questions feel free to shoot us an email harleyplacehealth@gmail.com

Our thoughts and prayers are with the families and friends of Rod Marsh and Shane Warne. The tragic passing of these legendary Australian Cricketers last week has prompted a lot of people to start thinking about their heart health.

What can we do to prevent a heart attack?

Dr Ross Walker is a leading Cardiologist, and he very generously took the time to pen a few thoughts on this topic over the weekend. The link to his article is https://drrosswalker.medium.com/the-death-of-two-cricketing-legends-on-the-same-day-4c0af842fa10. A few key points from his article for you to share with anyone you think may find it interesting:

Almost all cardiovascular disease can be prevented if detected early and there are now very accurate cardiovascular screening tests that are available freely to us all that can detect early disease with preventative management, if necessary, commenced immediately.”

” 70% of atherosclerosis and therefore heart attack (as I’ve stated the commonest manifestation of atherosclerosis) is directly related to the insulin resistance gene”

” This gene is present in 30% of Caucasians, 50% of Asians and close to 100% of people with darker or olive skin. Thus, when anyone with this gene is exposed to modern living, it is very common to develop diabetes (or prediabetes), high blood pressure, specific cholesterol abnormalities which include high triglycerides and low HDL, along with abdominal obesity.”

Dr Walker then goes on to outline the specific tests he recommends for a comprehensive screening, as well as the kind of treatments and supplements he recommends. He finishes with a pretty powerful line: “the most important coronary arteries in this world are your own, if you’re not prepared to look after them why should anyone bother to help you? Take the first step now & see your doctor to start this process.”

We’ve recently been seeing a lot of people who caught Covid in December/January. Even a couple of our practitioners caught it. Obviously the numbers in NSW were huge at that time, and more people were travelling, so it’s not surprising at all.

Most people, thankfully, had very mild symptoms that only lasted a few days, and did not result in any ongoing issues. But some people have continued to feel the effects weeks to months later.

We thought it might be useful to talk about the kind of things we’re seeing in our patients who had Covid, and the kind of home exercise advice we’ve been giving as well, in case you or anyone you know might find it helpful.

Probably the number one symptom people have reported to us is Fatigue. When we’re fatigued, our posture slumps, causing upper back and neck tension and compression/tightness in the lower back and hips.

Fatigue also leads to less movement generally, and less exercise as well. So anyone who was sleeping more, laying around more, and moving less, will lose flexibility. And anyone who stops their normal exercise for an extended period of time will lose a little strength.

So it’s important you return to exercise gradually. We saw this last year when the gyms/yoga/pilates studios were closed. People went back in after a period of not exercising and tried to do too much too fast, and ended up getting hurt.

Apart from returning gradually, you want to work on your mobility and core activation. If you don’t have good mobility and you’re trying to do a compound exercise like a squat, you can put a lot of pressure on your lower back and pelvis. And if your core has not yet reactivated, your lower back is really at risk.

Another commonly reported symptom is Muscle Soreness. This is linked to the lack of movement from being fatigued. Moving less, reduced circulation, less blood flow to the muscles, leading to a shortening and tightening of the muscles that is really palpable.

Apart from returning to things like core abdominal exercises or strength, you need to return to the long slow cardio activities like swimming, walking and running gradually too. As you start to increase the amount of cardio you do and your endurance returns, your posture will also improve (as fatigue can lead to slumping) and your general inflammatory levels will decrease.

It’s worth considering supplements like Magnesium (for muscle tightness), Fish Oil (for inflammation), and Vitamin D to assist in your recovery.

Joint Stiffness is another thing we are seeing a lot of. It follows on from what we’ve already discussed, and it’s pretty easy to address. Take more micro-breaks in your work day, Lay on your foam roller or spiky ball. Stretch more. Book a Massage or check in with your Osteopath.

If you have any questions or need any advice, don’t hesitate to give us a call or send us an email harleyplacehealth@gmail.com

Research is awesome. It helps us discover things that can change our lives. One recent discovery is helping us learn new ways to treat the dreaded DOMS!

DOMS is Delayed Onset Muscle Soreness. It’s the fancy way of describing the pain you feel the day after you do strenuous exercise. That pain you feel after going back to the gym for the first time in months. The pain you feel after playing an intense game of touch football. The pain you feel after moving house where you had to lift a hundred boxes, as well as couches, washing machines etc.

There’s been all sorts of theories over the years about what exactly is going on. Why exactly are we SO SORE after going to the gym? Is it lactic acid in the muscles? Is it ‘toxins” in the muscles? Did we do some micro-damage to the muscles?

The results of a 2021 study could have provided the answer. Our Massage Therapist Lewis found this article and provided this summary.

The previous theories focused on the MUSCLE – which makes sense, as that’s where the pain seems to be. In this study however, researchers looked at the FASCIA. And it appears that this is where the action is taking place.

The link to the full study can be found here, but to break it down for you, here is what they found. The fascia, which surrounds and connects muscles, gets stretched and tiny little tears occur. This then causes a contraction / tightening of the fascia.

This explains why the pain is so widespread! Fascia is everywhere, it’s what holds our body together. So if it tightens, the pain will not be in one small spot, it will feel like everything in that region is affected. Your whole leg feels sore, or your entire back, and so on.


Well, it tells us what we should be doing to reduce it. One thing you can try is collagen. Collagen supplementation will help repair the micro damage.

Next, self massage techniques like FOAM ROLLING, spiky balls, lacrosse balls, peanuts, etc etc, will help release the contractions.

Dynamic Stretching will also be effective, as opposed to static stretching.

So feel free to get back in the gym and crush that workout, but just make sure you’ve got the foam roller handy tomorrow!

We’ve certainly seen an increase in the number of people who have used Botox in the Eastern Suburbs of Sydney in the last couple of years. Well, that’s obvious if you go to Icebergs or Catalina’s I guess. But what we’re talking about today is the use of Botox for things like Migraines, TMJ disorders, and things like neck or back pain.

Apart from making your neck pain look more youthful, does it work?

We found a research paper which summarised the results of 9 different studies on this topic to get an overall picture.

What were the results?

Regarding Neck Pain:

High quality evidence suggests there was little or no difference in pain between BoNT-A and saline injections at four weeks…and six months for chronic neck pain.

Regarding using Botox combined with Exercises compared to standard painkillers:

“Very low quality evidence indicated little or no difference in pain between BoNT-A combined with exercise and analgesics with exercise for patients with chronic neck pain at four weeks and six months”

Comparing injecting Botox with injecting a placebo for headaches:

“Very low quality evidence from one trial (32 participants) showed little or no difference between BoNT-A and placebo at four weeks for chronic cervicogenic headache.

Authors’ conclusions?

Current evidence fails to confirm either a clinically important or a statistically significant benefit of BoNT-A injection for chronic neck pain associated with or without associated cervicogenic headache. Likewise, there was no benefit seen for disability and quality of life at four week and six months.

To read the full study click here https://www.academia.edu/26002187/Botulinum_Toxin_for_Subacute_Chronic_Neck_Pain?email_work_card=title

Our Massage Therapist Lewis, who also studied Sports Science, took a look at this question.

This is a question we get asked a lot, especially after a tournament like the French Open where we see all these tennis players with bright pink tape on their knees and shoulders. It looks amazing, but does it actually work?

A 2015 study looked at 8 previous Randomised Control Trials (RCTs) into the effectiveness of taping for back pain and spinal injuries. These are very high quality studies.

What did these studies find?

Regarding low back pain they found that: “Meta-analysis of RCTs on low back pain demonstrated that elastic taping does not significantly reduce pain and disability immediately post-treatment

Regarding standard taping and the newer, more colourful, elastic taping methods: “Results from single trials indicated that both elastic and non-elastic taping are not better than placebo or no treatment on spinal disability.”

In other words, for back pain taping doesn’t appear to help.

Regarding neck pain: “Positive results were found only for elastic taping and only for short-term pain reduction in WAD or specific neck pain.” They did note, however, that ‘generally, the effect sizes were very small or not clinically relevant’.

In summary, the research has not yet shown that taping appears to do much for back pain, and at best might help a little bit with neck pain.

To read the full study go to https://www.academia.edu/12470074/Effect_of_Taping_on_Spinal_Pain_and_Disability_Systematic_Review_and_Meta_Analysis_of_Randomized_Trials?email_work_card=title

Prolonged sitting is one of the single worst things you can do for your health. Not only is it a cause of lower back pain and poor posture (slumping), it is associated with numerous other health outcomes.

They include obesity and a cluster of conditions — increased blood pressure, high blood sugar, excess body fat around the waist and abnormal cholesterol levels — that make up metabolic syndrome.

For now I want to talk about the effects on your lower back. One of the ways sitting causes lower back pain is by compressing and tilting your pelvis. The longer you sit, the more that tilt becomes ‘locked in’, effectively causing you to lose mobility in your lower back and pelvis.

You can regain this mobility with simple exercises. Here is a link to an article showing 5 exercises you can do in just a few minutes to decompress your lower back and improve your pelvic tilt.


Often when you get a scan done, whether it’s an Xray, MRI, CT, or something else, the report comes back showing one problem or another. It can be a bit of a trap to then attribute your symptoms to the problem found in the scan. But is that necessarily accurate? How worried should you really be if you get a scan and it shows something is wrong?

We asked our Massage Therapist Lewis Horenko to do a deep dive on the research on this topic, and his conclusions might surprise you.

One study that really answers this question perfectly came out in 2020. In this study, researchers grabbed 230 people with no knee symptoms, and gave them extremely high resolution MRI scans. They then correlated the scan results with questionnaires on pain and function.

In a truly stunning result, 97% of people had something show up. Remember, these are people with zero symptoms whatsoever. No pain, no stiffness, nada. To them, their knees were perfectly fine.

31% of people had “severe cartilage lesions”.

30% of people had meniscus tears.

There were all sorts of problems found, from partially ruptured anterior cruciate ligaments to high grade tendonitis.

And yet, zero symptoms.

All of these things are the kind that would make anyone freak out a little. But the reality is, they’re clearly incredibly common, and will not necessarily cause you any problems.

If you have any scan results you need interpreted feel free to contact us at any time.

To read the full study https://pubmed.ncbi.nlm.nih.gov/32060622/

This is an interesting question, and one that we get multiple times a day.

We asked our Massage Therapist Lewis Horenko to give us his thoughts, as he also has a background in Sports Science.

The first thing to say is that the answer will vary depending on the injury you have, as people with mild aches are very different to people in severe nerve pain. But the findings of one study are worth considering when we look at this.

In this study, people were given an ultrasound to measure the thickness of the Lumbar Multifidus muscle, which is a key lower back stabilising muscle. Then they had their back adjusted (aka ‘cracked’). Then they had another ultrasound to assess the thickness of that muscle again.

They found that the muscle was thicker. This is a good thing, as it indicates the muscle is larger, and stronger.

Apart from this measurement, they gave the participants questionnaires on things like back pain and function. There were improvements across the board here as well.

What does this mean for exercising after treatment? Well, I think you should be trying to capitalise on this. If you’re in acute pain, if you have been specifically advised against exercising for some reason, then you want to take it easy for a few days, but outside of that it would make sense to take this bigger multifidus muscle and use it in some core strengthening exercises!

Here is a link to the original study https://www.academia.edu/20911196/Association_Between_Changes_in_Abdominal_and_Lumbar_Multifidus_Muscle_Thickness_and_Clinical_Improvement_After_Spinal_Manipulation?email_work_card=title