Coronavirus Update

Looking after your health at a time like this takes on greater importance than ever, and we take your health very seriously. As such we will be staying open and operating normal business hours for you.

With the current concerns we would like to reassure you that we are following WHO and Australian Government updates daily with respect to minimising the spread of the virus.

We can all play a part in helping to minimise the spread of the Coronavirus. As such, we are taking every measure and appreciate your understanding and cooperation while we all work together to do so.

We understand that some patients are choosing to remain at home and reschedule existing appointments in an effort to align with social distancing. In this instance please ensure you notify us if you will be not be attending. Please contact us if you would like to explore the option of a skype consultation.

This is an evolving situation and we will keep you updated as things change. Our priority is to always ensure the health and safety of our amazing patients and team.

Some additional measures we are implementing effective immediately:

Understandably, our practitioners will no longer be greeting you with a handshake. A warm greeting and smile will still show you the love is there.

We will be regularly changing all linen between appointments, and using antiseptic wipes and santisers, as well as good old fashioned soap and hot water. This is to escalate our already stringent hygiene procedures.

Please remain calm and resilient in these difficult times. It is often the fear of the unknown that fuels anxiety contagion. We are all in this together and will be more resilient to the stress it brings if we keep the lines of communication open.

Modern humans have an inherited herd mentality, and its influence is being felt throughout society today. We simply want to feel safe and prepared. But this is not a time to be stupid and inconsiderate. Don’t think you’re the exception. Don’t do things that benefit you, at the expense of others.

The goal now is to flatten the curve.
⁃ To slow the spread of the virus until our hospitals can handle them.
⁃ To prevent the unnecessary spreading of the virus.
⁃ To prevent unnecessary overloading of medical professionals, emergency services, airlines, and other critical infrastructure, so that the people who actually need it can access it.

No one individual can accomplish this by themselves, but each of us, acting rightly, collectively, can make a big difference. Now is the time to offer compassion, support and gratitude for our communities and loved ones.

This too shall pass. In the meantime, above all, be kind — to each other and yourselves.

We are keeping up to date with the latest advice from the World Health Organization and will let you know more as soon as we do.

WE are here for you! ️

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How to Boost your Immune System Function to Reduce your Risk of Infection

We wanted to talk you through some basic strategies you can employ to boost your immune function so that if it does get to you, its impact will be far less.

Immunity is strongly linked to the autonomic nervous system (stress response). When we are stressed and our sympathetic nervous system is in full swing (fight or flight mode), adrenaline and other stress hormones surge in our bodies and this can cause short term suppression of our immune system. 

This means our bodies are then less equipped to deal with opportunistic infections. It is also the reason long term stress is linked to chronic inflammatory diseases such as rheumatoid arthritis. 

We’ll break this down into the supplements you can take to boost your immune system, the habits you can employ to reduce your risk of infection, and the exercises you can do to have your body primed to stave off infection.

Supplements: Our neighbour and great friend Tania Flack sat down with us to discuss the best supplements for immune function:

Vitamin C – This 2017 study talks about which dose to use to get the best immune system boost https://www.sciencedaily.com/releases/2017/03/170330115246.htm

Vitamin D – Here is a link to a 2019 study explaining its role in boosting immune function https://www.sciencedaily.com/releases/2019/04/190417111440.htm)

Zinc – Here is a link to a study showing how it modulates infection https://www.sciencedaily.com/releases/2013/02/130207131344.htm)

ArmaForce (my personal favourite)

Olive Leaf Extract – to reduce severity of symptoms. Here is a 2019 study showing its effectiveness https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6412187/)

Habits:

Wash your hands. Here is a video showing great technique https://edition.cnn.com/2020/02/28/health/how-to-wash-hands-coronavirus-trnd/index.html. And here is an article with song suggestions https://edition.cnn.com/2020/02/28/health/how-to-wash-hands-coronavirus-trnd/index.html as they say you should wash your hands for as long as it takes to sing Happy Birthday Twice!

Soap and water are better than hand santiser but definitely use hand sanitiser if that is all you have access to.

Try to reduce how often you touch your face. This is one of the best ways to reduce the spread of infection. I find it hard to never touch my face, but I can easily reduce how often I do it by 50%, and am aiming for more.

Exercises from an Osteopathic Approach:

I am going to talk about 2 articles which showed how Osteopathic treatment can help fight infections of this nature, and the lessons you can learn to prime your body to fight off infection.

The first study looked at how osteopaths do lymphatic drainage techniques to improve immune system function, specifically focusing on pneumonia https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3437985/.

The second looked at the mortality statistics during the Spanish Flu Pandemic of 1918-19 where an estimated 40 million people died. In the US Osteopaths work in hospitals and according to data of people treated by Osteos during that time the effectiveness of treatment was huge.

In people treated by an Osteopath, only 0.25% died.

In people not treated by an Osteopath, 5-6% died. That’s a 20-25 times higher death rate.

What does that mean for you? The treatment involved work on upper back, chest, ribs and neck to improve breathing, reduce pressure on lungs, improve blood flow in the area, and stimulate the immune system by improving lymphatic drainage.

  • So you should do some foam rolling to increase mobility in your upper back.
  • Stretch your chest and neck and shoulders. 
  • Get up from your desk and move more to improve your circulation. Ideally get out in the sunlight to get some natural Vitamin D.
  • Drink lots of water to keep your system well hydrated.
  • Get plenty of sleep, as sleep has been shown to affect immune function in a huge way. Going from 8 hours to 7 hours a night can increase your risk of catching a cold by 3 times. Going to 6 hours increases your risk SIXFOLD!
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Been sitting at your desk too long? Here’s what can happen….

The working year is now well underway and people are back spending long hours in front of computer screens. 

One of the common conditions we see is something called Upper Cross Syndrome, and yes, even this early in the year we are already having people coming in for osteopathic treatment for this.

This “syndrome” refers to a particular configuration of overlapping overactive and underactive muscle groups in the neck, chest, and shoulders – a bit like ‘slouching’. 

Typically, poor posture causes the syndrome, including the forward head posture, overuse of upper shoulder muscles, shortening of the chest (pec) muscles and weakening of mid back muscles. One of the aggravating causes is from sitting in front of computers for long periods of time.

The list of symptoms that this will lead to ranges from headaches and neck pain to jaw pain and pain thru the shoulders, upper back and ribs, numbness and tingling in the fingers and decreased range of movement

The big tip for you during you working day is to get up from your desk at regular intervals and do a few simple stretches thru you upper back and neck and squeeze you shoulder blades down and together, have a quick walk around – get that cup of tea or glass of water, before sitting back down 

Click on this link https://www.medicalnewstoday.com/articles/318897.php#prevention for a bit more information about this and what you can do to help. 

Management of your body is the key to injury prevention. Call us for an appointment here at Harley Place Health to help out. Our team are here across the week from Monday to Saturday.

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Studies say a slumped posture can cause you to DIE earlier. Is it true?



Wow, that’s a pretty big call. When I first saw this study I thought it sounded a bit ridiculous. Just being excessively slumped is associated with dying earlier? Sounded a bit dramatic. Then I read the study, and a few other studies on this topic.

Slumping forward is one of those things that tends to happen as we age. I’m sure you have seen older people walking along, looking down towards the ground as their back arches forward.

As we age our backs become stiffer, the discs become a little dehydrated and can shrink, and this is compounded by things like arthritis and osteoporosis which will really exaggerate the slump.

So how does that cause us to die earlier?

Researchers tracked around 1500 people for a few years and measured all sorts of parameters. They found that people who are more slumped than others performed worse in a number of physical tests, all of which have been linked to longevity. Things like

1. Risk of falling

2. Ability to get out of a chair

3. Grip Strength

4. Ability to walk with ease (ie is walking difficult for them?)

They concluded that “hyperkyphotic (excessively slumped) posture was specifically associated with an increased rate of death due to atherosclerosis”. Maybe being slumped compresses the ribs and affects heart and lung function somehow?

One of the best things you can do for the upper back, to reduce this forward flexion, is FOAM ROLLING. Studies have shown that just a few minutes is enough to increase mobility in the upper back.
https://sanartewellness.com/products/doble-roller

Here are all the links to the studies cited above:

https://www.ncbi.nlm.nih.gov/m/pubmed/15450042/?fbclid=IwAR2LUJpIrPUG5280AHc3nUHDzWCtRBqFp5gRW_Y6_OsOQGfXhpYh-eShodw

https://www.ncbi.nlm.nih.gov/m/pubmed/15972617/?i=2&from=/15450042/related

https://www.ncbi.nlm.nih.gov/m/pubmed/17595423/?i=3&from=/15450042/related

https://www.ncbi.nlm.nih.gov/m/pubmed/16491290/?i=4&from=/15450042/related



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When to worry about back pain (and when not to)

When you experience sudden, sharp pain in your back, it can be pretty scary. How do you tell if something serious is going on, or if it’s something more straightforward?

Here is a link to a great article I just read which outlines in basic terms the key differences between back pain that is musculo-skeletal in nature (ie straightforward), and back pain that is coming from a more serious underlying condition. A lot of times when the pain is severe it can be extremely concerning, and this article helps explain a lot of what is going on.

Some key points:

People understandably assume that if their pain is very intense, then that means it is a really bad problem. In fact, pain intensity is a poor indicator of back pain ominousness.

Herniated discs aren’t actually that big a deal, most back pain goes away on its own (even “chronic” low back pain! especially if you’re Australian), and simple muscle knots can be shockingly intense without ever being dangerous.

If you are experiencing true numbness around the groin and buttocks and/or failure of bladder or bowel control, please consider it serious — do not wait to see if it goes away.

These symptoms indicate spinal cord injury or compression and require immediate attention.

The article also has a list of the more serious causes (cancer, infections, inflammatory arthritic conditions) and their features. The names of the conditions link to carefully chosen articles from good sources.

CLICK HERE TO READ THE ARTICLE.

Osteopaths are trained to differentiate between serious underlying pathology and normal musculoskeletal causes of back pain. They study for 5 years and are registered with AHPRA as Doctors in Australia. If you have back pain and want to ask us a question, email harleyplacehealth@gmail.com any time and we will be happy to have a chat to you.

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Making New Years Resolutions STICK

I wanted to share this article from the Harvard Medical School website which outlines steps you can take to make sure your New Years Resolutions come true.

It’s a great idea to make resolutions, especially if they involve improving your health or taking better care of yourself. But making the resolution is only the beginning. Improving your health involves making regular efforts to eat well, exercise more, drink less etc.

It can be hard to instantly make these kinds of changes so this article gives some great advice to help you be successful.

Click here to read the link.

The 7 steps are:

1. Dream big.

2. Break big dreams into small-enough steps.

3. Understand why you shouldn’t make a change.

4. Commit yourself.

5. Give yourself a medal.

6. Learn from the past.

7. Give thanks for what you do.

At the bottom there is also a link to a free download for further information:
Get the Special Health Report, Simple Changes, Big Rewards: A practical, easy guide for healthy, happy living to learn how to incorporate simple changes into your life that can reap big rewards.

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Advice If You’re Flying This Holiday Season

For those of you who are lucky enough to be jumping on a plane to head somewhere this holiday season, we wanted to outline a few tips and tricks to make your trip as pain free as possible.

Travelling is great, but it’s also easy to hurt yourself. Sitting on planes for long periods of times, lifting heavy bags, sleeping in weird beds, using a different pillows, and getting out of your normal exercise routine. All of these things can conspire to cause injury or pain and ruin your holiday.

Here are a few things to think about.

One of the most common times people get injured is right at the start of their trip. Lifting a bag into an overhead locker can do it – if your bag is heavy, or you are being squashed in the aisle by other passengers, or the space you are trying to fit the bag into is cramped. Any of these can make a relatively easy lift much more difficult. Take your time, look for the gap, or get some help if you think you need it.

When you land and are picking up your bags is another risky time. You may have been sitting for many hours on your flight, and be stiff as a result. You may be dehydrated. You will almost certainly be tired. These are risk factors. So when you get to the baggage carousel, be careful. The two worst things you can do when lifting are reach a long way, or bend and twist at the same time.

So get as close as you can to the carousel, and lift from front on. Don’t let other people cramp your style, and don’t rush to grab your bag and do it the wrong way. Take the extra minute to find a place you can lift safely from and do it properly, your back will thank you.

I take a massage ball when I travel in my carry-on luggage. I use it to massage my hamstrings, plantar fascia, and glutes to keep them loose. You can also use it when you get to your hotel room to release between your shoulder blades. A foam roller water bottle is also a good idea – you need a bottle to stay hydrated, and having a foam roller at the other end is a godsend after that 24 hour trip to the other side of the world.

The other key thing is to keep moving. I don’t sit a lot at airports. I’m about to be sitting for a long time, so I walk around, do a couple of little stretches, and drink lots of water before I board. That way if I do happen to get stuck drinking gin n tonics for a few hours watching B grade movies I’ve at least given myself a good headstart. Same in transit – walk the corridors of the transit airport, stretch, get the blood flowing. The more you move, the better you’ll feel at the other end.

Safe travels and if I don’t see you, have a fantastic holiday period, take some time to relax and recuperate, and my best wishes for a happy and health 2020!

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Getting in Shape for Summer

At this time of year we always see a lot of people with injuries related to the sudden desire to quickly get in shape. Their exercise regime drifted a little over the winter months but with Summer approaching they need to get their bikini body back. Bravo I say! But, we need to temper that enthusiasm/desperation with a little common sense. If you’re trying to fit 6 months worth of training into the next 6 weeks you could overdo it and hurt yourself.

I think the most common times people get injured is when they start a new activity, or when they make a big change to the amount of exercise they are doing, even if it is something they have done before. To give you an example, if you’ve never included running in your fitness program but start doing so, that’s a time when your body is adjusting to the new stimulus and as such you’re prone to injury. Or if you usually run 5km three times a week but change to 10km five times a week, that’s also a time when you’re prone to injury.

It’s a fine line; you want to push yourself to get fitter, but if you push too hard you can hurt yourself. When you’re exercising, there inevitably comes a time when you will feel a bit of discomfort. When you reach that point you might wonder whether you can keep going and push through it, or if doing so could cause an injury. There is such a thing as ‘good pain’, which is the pain you feel during exercise but in the absence of an injury. Then there’s ‘bad pain’, which is the pain you feel when you have suffered an injury.

How do you tell the difference between good pain and bad pain? In other words, what are the signs that you may have injured yourself and you should stop your workout? Bad pain has the following characteristics:

• The pain you’re feeling is ‘sharp’

• The pain you’re feeling is ‘shooting’, or accompanied by numbness, tingling or pins and needles

• There was a sudden onset of pain

• The pain developed in association with something ‘popping’, ‘clicking’, ‘snapping’ or ‘giving way’ underneath you

What does good pain feel like? Think about when you climb a really tall set of stairs or a steep hill. As you start to breathe harder, you get less oxygen to your muscles. When that happens you start to develop lactic acid. At the beginning you feel almost nothing, then it becomes slightly uncomfortable, then if you’re able to keep going, it becomes really uncomfortable. So we would say that one point of differentiation from bad pain is that good pain has more of a gradual build-up.

The location of the pain is also a clue. Good pain will be generalised to a region, whereas bad pain is quite specific. For example, if you’re ‘feeling the burn’ in your quads from climbing stairs (good pain), then most likely the entire front of your leg will feel it, all the way from your knees to your hips. On the other hand, if you tear or strain your quadriceps (bad pain), the location of the pain will be a lot more specific – you’ll feel sharp pain right at the point of the tear and in a small area surrounding it.

I’m sure you’ve all watched something like the Olympic Games, where you can see prime examples of the two types of pain. For instance, in the 100m when someone tears their hamstring, they grab their leg as if they’ve been shot. They feel sharp, shooting pain that has a sudden onset, the leg gives way underneath them and they’re unable to continue.

Then you see someone in a longer-distance event with a grimace on their face as they push on and on. They’re definitely in pain, but the pain has built up gradually and doesn’t affect their ability to keep running (well, for a while at least). While this is not a nice feeling, this is the ‘good pain’ we’re talking about.

There’s a fine line between pushing yourself and hurting yourself. It just comes down to using a bit of common sense. Build up your training gradually. Warm up a little before going too hard. If something doesn’t feel right, you’re better off missing part of a session and being okay for your next session than trying to get a little bit more done and having to miss the rest of the week.

If you’re concerned that you may have hurt yourself, give us a call or send us an email and we can guide you on what to do next.

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What’s the difference between an Osteo and a Physio?

osteopathy bondi junction

We are commonly asked what the difference is between an Osteopath and a Physiotherapist. Our Osteopath Jerome Smith spent the last 5 years working in a clinic that employs both osteopaths and physiotherapists, so he is uniquely positioned to answer this question.

In Australia, physiotherapists specialise in rehabilitation. Rehab is a very diverse field, with physio’s working for sporting teams, and physio’s working in hospitals helping stroke victims walk again. They are probably best known for work with soft tissue injuries. For example, if you were to tear a ligament in your knee, and required surgery, a physio is the best person to see to help rehabilitate that injury. Apart from ligament tears, things like torn muscles or tendonitis type injuries are other things a standard physiotherapist would work with.

Osteopaths look at soft tissue injuries like muscle strains, tendon and ligament injuries as well. But they also work on the skeletal system – bones, joints, and general structural alignment. The reason they look at both is because of the interactions involved – muscles and tendons attach to bones, ligaments attach to either side of a joint and so their actions become inter-related, and they directly affect each other.

So it makes sense to look not just at the soft tissues, or just at the joints, but to look at them in combination. For this reason Osteopaths are described as wholistic practitioners, meaning they look at the body as a whole.

Your Osteopath may also talk to you about things like ergonomics. For example, how does your posture at work impact your back or neck. They may talk to you about nutrition, in terms of the role food plays in your general health and wellbeing, and how things like sugar might affect your inflammation levels and affect your healing rate. And they will almost certainly give you advice on mobility or strengthening exercises that might help you prevent future relapses of your injury.

To learn more about what Osteopaths do or to enquire about a booking, click this link.

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Do you have Shin Splints, or something more serious?

WHAT ARE SHIN SPLINTS?

Shin Splints is a slightly vague term, and it gets used a lot when people have pain in the lower leg. Sometimes it’s really straightforward, but it can represent a more serious problem, so if it’s been ongoing for a little while, especially in a child, it’s important to get it checked. 

It is common in sportspeople, but can affect anyone who is on their feet a lot. It’s most often associated with running, but shin splints are also common in sports such as soccer, AFL and rugby, and in sports played on hard surfaces such as basketball, netball and tennis.

In practice, shin splints will be one of the following 3 injuries:

1. Medial Tibial Stress Syndrome

MTSS is caused by a sudden change in the amount or type of activity you are doing eg starting a new sport. This leads to the muscles of the lower leg pulling on their attachment on the tibia or ‘shin bone’. There are a number of additional factors that play role a shin splints including fitness, biomechanical efficiency in the lower limbs, footwear, playing surface, recovery, fatigue and dehydration.

Depending on the particular muscles involved, the area of discomfort can be variable (front of the shin vs. inside of the shin), however the typical pattern of pain following exercise is a common feature.

At this point it is really straightforward to treat, and we use a combination of treatment in clinic with home exercises to get the best result. If left unchecked it can progress.

Long bones such as the tibia have a thin covering called ‘periosteum’ that muscles grip onto at their site of attachment. Excessive loading of weak muscles in the lower leg will cause the periosteum to ‘peel away’ from the underlying bone and a layer of fluid will develop in the tibia as a result of a local inflammatory response. The problem here is that the fluid will weaken the bone in the affected area and the patient will be at increased risk of a stress fracture (read on).

2. Stress Fracture

A stress fracture develops over a period of time when the stress on a bone has exceeded the bone’s ability to heal at the normal rate. They are usually subtle injuries that are difficult to visualise on x-ray because they affect the micro-structure of the bone, rather than the whole structure. However, x-rays can demonstrate swelling of the periosteum, which is a clue that there could be an underlying stress fracture. In this case, MRI follow up is the best course of action in order to check for stress fracture.

Female athletes are at increased risk of developing stress fractures, because there is an established link between low bone mineral density, an irregular or absent menstrual cycle and eating disorders. We call this type of presentation the ‘Female Athlete Triad’. Working with Premier League female soccer teams taught me to maintain a high suspicion for underlying stress fractures and to help minimise the risk through early screening, preventative home exercise programs and patient education.

Stress fractures are usually painful at the time of exercise and will often prevent a person from exercising. It is important that this condition is managed correctly and appropriate imaging is obtained to provide a time scale for treatment.

3. Compartment Syndrome

Rather than affecting one small part of the bone, like a stress fracture does, CS affects a larger area. It results from overuse, inflammation or a direct impact to the connective tissue ‘compartments’ that contain the muscles and vessels of the lower leg. 

Pressure inside one or more of these compartments increases with exercise (which brings on the pain) and then reduces after exercise – this is distinct from MTSS where pain is normally felt after exercise and not during.

Increased pressure in the compartments of the lower leg can cause compression of nerves and blood vessels that supply the foot, causing pins and needles, numbness and/or weakness. This is a case for urgent medical attention as there is a risk of long-term nerve damage and infection. Don’t ignore these symptoms!

If you have shin pain, the first steps are to determine what type of shin splints you have and exclude a stress fracture or compartment syndrome. Then we must formulate a treatment plan that incorporates manual therapy to provide relief and exercise rehabilitation to prevent symptom recurrence.

Dry needling is particularly useful as we can treat muscles in the lower leg effectively without applying pressure to the affected area – this would normally be very painful for someone suffering from shin splints. We can also help you modify your exercise program and address other factors that are playing a role in your condition.

If you think you may be developing shin splints, don’t delay in booking an appointment to get the problem managed properly. Early detection and intervention will stop the problem from worsening and reduce your time away from sport, so that you can focus on your performance rather than an injury!

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