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



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.

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.

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!

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.

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.

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!

Harley Place Health Osteopath Jerome Smith has studied advanced dry needling, so he may recommend it for you depending on your condition. What does it actually do?

Dry needling is commonly used to address deep myofascial tension. Often it can be painful or very difficult for a practitioner to work deep enough to hit these points, so using a needle is a great way to release the underlying tension.

During a session, myofascial trigger points may be felt by both you and your practitioner. For your practitioner, it will present as a hard, focused point of tension. For you, a description a lot of people use is that they feel a ‘knot’ in a certain part of a muscle.

The indication for treatment would be reducing muscular pain and stiffness, improving range of motion or flexibility. Studies have shown varied results with respect to effectiveness, but the trend in studies is that it is effective for reducing pain and improving mobility. This is backed up anecdotally, with patients reporting a profound release when the needle hits the trigger point.

If you have any questions about dry needling email us harleyplacehealth@gmail.com or if you would like to book a session with Jerome visit our booking page.

We are very excited to welcome Jerome Smith to Harley Place Health. Jerome has extensive experience with professional sportspeople and will be a fantastic addition to our team of practitioners.