Shockwave Therapy at HPH

Shockwave Therapy: A Modern, Evidence-Based Approach to Pain Relief and Healing
Shockwave therapy — also known as extracorporeal shockwave therapy (ESWT) — is a non-invasive treatment that uses acoustic sound waves to stimulate the body’s natural healing processes. It’s widely used by osteopaths, physiotherapists, and sports medicine doctors to treat stubborn tendon and joint pain that hasn’t improved with traditional care.
Over the past decade, research has shown that shockwave therapy can significantly reduce pain, improve movement, and promote tissue repair in a wide range of musculoskeletal conditions. If you’ve been experiencing ongoing tendon or muscle pain that persists despite treatment, this therapy may help reactivate your body’s natural healing ability.
What Is Shockwave Therapy?
Shockwave therapy involves a handheld device that delivers targeted sound waves into the affected area. These waves penetrate deep into tissues, helping to restart healing in tendons, ligaments, and muscles that have become slow or resistant to recovery.
There are two main types of shockwave therapy:
Focused Shockwave Therapy (fESWT): Concentrates energy into a small, precise area. Ideal for treating deeper structures such as the rotator cuff tendons or calcific deposits in the shoulder.
Radial Shockwave Therapy (rESWT): Disperses energy over a wider area, making it suitable for more superficial conditions such as tennis elbow, knee pain, or plantar fasciitis.
Both forms are safe, well-researched, and effective when appropriately tailored to the specific condition and tissue depth being treated.
How Does Shockwave Therapy Work?
Think of shockwave therapy as a “reset” for your body’s repair system. When these sound waves interact with tissue, they create controlled micro-stimulation that triggers the body’s natural healing response.
Scientific studies show that shockwave therapy can:
Increase blood flow and oxygen delivery to damaged tissues
Stimulate collagen production and fibroblast activity — key for tendon and ligament repair
Break down scar tissue and calcium deposits (e.g., in calcific shoulder tendinopathy)
Reduce pain by desensitising nerve endings and modulating inflammatory molecules such as substance P
Promote angiogenesis (new blood vessel formation), improving long-term tissue health and resilience
What Conditions Can Shockwave Therapy Help Treat?
Shockwave therapy has strong clinical evidence for several chronic musculoskeletal conditions, particularly those involving tendons, ligaments, and fascia. It is especially effective when symptoms have persisted for more than three months or when other conservative treatments have plateaued.
Research supports its use for conditions such as:
Rotator cuff tendinopathy: Reduces pain and improves shoulder mobility, especially in cases with calcification.
Tennis elbow (lateral epicondylitis): Improves grip strength and decreases pain compared to placebo.
Knee osteoarthritis: Helps reduce pain and enhance joint function in mild to moderate cases.
Plantar fasciitis: Demonstrates structural improvements and progressive pain relief.
Achilles tendinopathy: Particularly effective when combined with a strengthening program.
Patellar tendinitis (jumper’s knee): Aids recovery from sports-related overuse injuries.
Greater trochanteric pain syndrome: Decreases lateral hip pain and improves mobility.
Overall, shockwave therapy is most effective for chronic or recurring pain conditions where natural healing has slowed. When integrated into a comprehensive treatment plan, it can accelerate recovery and restore long-term function.
What to Expect During a Session
A typical session lasts around 15–20 minutes and includes:
A brief assessment and discussion of your symptoms
Application of a conductive gel to enhance sound wave transmission
Delivery of short, controlled pulses to the affected area using a handheld device
You may feel mild discomfort or a tapping sensation during the session, but the treatment is generally well-tolerated and requires no anaesthetic. Afterwards, you can return to regular activity, with only minor tenderness possible for a day or two.
Treatment Duration and Results
Most patients require between 3 and 6 sessions, spaced roughly one week apart. Many notice improvement after just two or three treatments, with ongoing progress over subsequent weeks.

Because shockwave therapy works by stimulating natural tissue repair, results continue to develop even after your final session. Clinical research shows:
Pain relief typically increases gradually over several weeks
Mobility, strength, and function continue to improve beyond the treatment period
Side effects are mild and short-lived (e.g., temporary redness, swelling, or tenderness)
Safety and Evidence
Shockwave therapy is backed by over 80 peer-reviewed clinical studies, including randomised controlled trials and systematic reviews. When administered by trained practitioners, it is extremely safe, with serious complications being exceedingly rare.
It is not recommended for use over open wounds, infections, or during pregnancy; however, it is otherwise well-tolerated by most patients.
Integrating Shockwave Therapy with Osteopathic Care
At Harley Place Health, shockwave therapy is part of a holistic, evidence-based approach to managing musculoskeletal pain. When combined with osteopathic treatment, tailored exercise programs, and lifestyle guidance, it helps restore normal movement, reduce pain, and promote long-term recovery.
Shockwave therapy is not a “quick fix” — it’s a scientifically validated tool that works with your body’s biology to restore balance and function where healing has stalled.
If you’ve been dealing with ongoing tendon or joint pain, speak with your osteopath to find out whether shockwave therapy could be a valuable part of your recovery plan.

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What is Dry Needling?

We have two Osteopaths here at Harley Place Health who do dry needling. Dr Marcus NG and Dr Max Bellaiche. We often get asked about which conditions it is most effective for and how it actually works.

Evidence-Based Benefits of Dry Needling

The strongest evidence for dry needling points to its short-term effectiveness in managing pain and, to a lesser extent, improving function across various body regions.

1. Short-Term Pain Reduction (Analgesic Effect) 

  • Superior to Sham/No Intervention: Multiple systematic reviews and meta-analyses, including an umbrella review on musculoskeletal pain, suggest that DN is superior to sham or no intervention for reducing pain intensity at the short-term (immediately after treatment up to a few weeks/months). This effect has been observed across various body regions.
  • Musculoskeletal Pain in General: DN demonstrates a short-term analgesic effect in all body regions, including the neck, back, and lower extremities.
  • Specific Conditions:
    • Neck Pain: Low to moderate evidence supports that DN can be effective for improving pain intensity and pain-related disability in individuals with neck pain associated with MTrPs at the short- to mid-term.
    • Low Back Pain (LBP): DN appears to be an effective procedure for the treatment of myofascial pain in patients with acute and chronic LBP, especially when combined with standard rehabilitation.
    • Knee Pain (Patellofemoral Pain): Low to moderate evidence suggests a positive short-term effect on pain and disability, particularly for patellofemoral pain (also known as “jumper’s knee”).

2. Improved Physical Function and Thresholds 

  • Pressure Pain Threshold (PPT): Dry needling is consistently shown to increase the pressure pain threshold (meaning the area becomes less sensitive to pressure) in the short-term. This immediate physiological change is often cited as a key benefit.
  • Functional Outcomes (Short-Term): Some evidence suggests a statistically significant effect on functional outcomes (e.g., pain-related disability) when DN is compared to no treatment or sham needling. However, evidence is conflicting or less pronounced when compared to other physical therapy interventions.
  • Range of Motion (ROM): DN may lead to immediate increases in range of motion, which is often a goal in treating MTrPs.

Key Considerations and Limitations

It is important to understand the context and limitations of the current research:

  • Adjuvant Therapy: The strongest evidence often suggests that DN is most beneficial as an additional treatment combined with other interventions (like exercise, manual therapy, or education) rather than as a stand-alone therapy.
  • Lack of Long-Term Evidence: A significant limitation across much of the research is the lack of high-quality evidence for the mid- to long-term benefits of dry needling (beyond 3–6 months). While short-term effects are clearer, more research is needed to determine if these effects are sustained over time.
  • Equally Effective to Other Interventions: For pain reduction, DN is often found to be equally effective to other physical therapy interventions (such as manual therapy or exercise) in the short term. It is generally not proven to be moreeffective than these established treatments.
  • Need for Standardization:  Researchers frequently note a need for the standardization of DN protocols to reduce heterogeneity in studies and strengthen the overall evidence base.

Proposed Mechanisms of Action

While the exact mechanisms are debated, dry needling is believed to elicit its effects through:

  1. Local Twitch Response (LTR): The mechanical disruption of the MTrP by the needle often elicits an LTR, which is thought to interrupt the muscle’s dysfunctional feedback loop, leading to muscle relaxation and decreased pain sensitivity.
  2. Chemical Changes: Needling can cause a localized physiological response, potentially normalizing levels of various inflammatory and pain-producing chemicals (like substance P and calcitonin gene-related peptide) at the site of the MTrP.
  3. Neurophysiological Effects: DN may activate both peripheral and central nervous system mechanisms, including activating descending pain control systems in the spinal cord and brain, contributing to its analgesic effect

Reference List (Sources for Dry Needling Evidence)

The evidence provided is sourced from a synthesis of recent systematic reviews, meta-analyses, and umbrella reviews, which represent the highest level of evidence in clinical research.

Umbrella Reviews and General Musculoskeletal Pain

  1. Clinical Effectiveness of Dry Needling in Patients with Musculoskeletal Pain—An Umbrella Review. This umbrella review summarizes findings from multiple systematic reviews (SRs) and meta-analyses (MAs) across various body regions.
    • Reference (Example of a likely source for this data): R.M. Denuccio, D. D. J. M. E. A. P., V. K. T. T. W. M. M. S., et al. Clinical Effectiveness of Dry Needling in Patients with Musculoskeletal Pain—An Umbrella Review. Journal of Clinical Medicine. 2023; 12(3):1205.
  2. The Effectiveness of Trigger Point Dry Needling for Musculoskeletal Conditions by Physical Therapists: A Systematic Review and Meta-analysis.This key review analyzes the short- and long-term effectiveness of dry needling for general musculoskeletal pain.
    • Reference (Example of a likely source for this data): Krey L., Gattie E., Cleland J. A., Snodgrass S. J. The Effectiveness of Trigger Point Dry Needling for Musculoskeletal Conditions by Physical Therapists: A Systematic Review and Meta-analysis. Journal of Orthopaedic & Sports Physical Therapy. 2017; 47(3):133–149.

Regional Pain Conditions

  1. Neck Pain: Research supporting the short-term benefit for pain intensity and disability in chronic neck pain associated with myofascial trigger points.
    • Reference (Example of a likely source for this data): M. F.-d.-l. P., L. S. D., M. D. J., G. R. E. Effectiveness of Dry Needling for Myofascial Trigger Points Associated with Neck Pain Symptoms: An Updated Systematic Review and Meta-Analysis. Journal of Clinical Medicine. 2020; 9(10):3300.
  2. Low Back Pain (LBP): Studies focusing on the efficacy of dry needling for myofascial pain syndrome in the lumbar region, often as an adjunct therapy.
    • Reference (Example of a likely source for this data): Ferreira J., Dias A., G. D. M., et al. Treating Myofascial Pain with Dry Needling: A Systematic Review for the Best Evidence-based Practices in Low Back Pain. Neurology. 2024; 102 (17) (P5-13.002).
  3. Knee Pain (Patellofemoral Pain): Research supporting dry needling’s effect on pain and function for specific knee conditions like patellofemoral pain.
    • Reference (Example of a likely source for this data): F. S. M., P. V. B., J. A. P. Effects of Trigger Point Dry Needling for the Management of Knee Pain Syndromes: A Systematic Review and Meta-Analysis. Journal of Clinical Medicine. 2020; 9(7):2044.
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Which Anti-Inflammatory?

Are you one of the many people who aren’t sure which anti-inflammatory they should take? Don’t worry, you’re not alone.

Turns out, they’re all pretty similar in terms of the amount of pain relief they provide.

“Most NSAIDs have comparable efficacy for most conditions, despite their different pharmacodynamic effects. The pharmacokinetic profile of different NSAIDs might confer varying risks and advantages for acute or chronic conditions that influence their selection.NSAIDs have well-recognised adverse effects, including cardiovascular, renal and gastrointestinal risks. While these risks vary between NSAIDs, all of them confer some increased risk. Proton pump inhibitors reduce upper gastrointestinal complications but not lower gastrointestinal ones. Other important precautions relate to pregnancy and hypersensitivity reactions.”

So your choice probably relates more to whether you have a cardiovascular condition, renal condition or gastrointestinal condition. As always, discuss with your GP or Pharmacist.

Source: https://australianprescriber.tg.org.au/articles/choosing-a-nonsteroidal-anti-inflammatory-drug-for-pain.html

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Spring Reset: Ancient Wisdom for a Modern Life

As we move from winter into spring, the body naturally wants to shed heaviness and awaken to new energy. Ayurveda, the traditional system of health from India, explains that each season has its own qualities. By aligning with them, we can feel lighter, clearer, and more balanced.

We asked our Ayurvedic practitioner, Padi, who has over 15 years of experience, to share her top tips for a smooth seasonal transition:

1. Swap heavy foods for lighter, drier ones

Winter often calls for rich, grounding meals. In spring, Ayurveda recommends favouring foods that are light, warm, and gently drying to counteract seasonal dampness. Think barley, millet, leafy greens, and spices like ginger, cumin, and black pepper.

 2. Rise with the sun

Spring carries more light and energy. Waking up early, ideally before 6:30am, helps align your body with the day’s natural rhythm and clears away morning sluggishness, which Ayurveda links to an excess of Kapha energy.

 3. Begin the day with a cleansing drink

Instead of coffee first thing, start with warm water infused with fresh ginger and a squeeze of lemon. This supports the liver and digestive fire, known in Ayurveda as agni, and helps your body burn away winter’s heaviness.

4. Try an Ayurvedic self-massage (Abhyanga)

Even though black sesame oil is usually suggested for this practice in winter, Padi suggests using a lighter oil in spring such as sweet almond oil to massage your skin before a warm shower. This practice not only nourishes the skin but also stimulates circulation and lymphatic flow. It is especially supportive in spring when congestion and allergies are common. This practice supports your nervous system and helps to reserve energy. 

 5. Clear your sinuses with a neti pot

Spring often brings pollen and congestion. A simple nasal rinse with warm salty water, followed by a drop of warm sesame oil in each nostril, can keep the airways clear and reduce irritation.

These practices are just a glimpse into Ayurveda’s rich wisdom. A personal consultation with Padi explores your unique body type, current health, and lifestyle, and gives you tailored guidance for every season of life.

If you would like to learn more, we would be happy to connect you with Padi for a consultation.

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Latest Rhonda Patrick Podcast

I really enjoyed the Rhonda Patrick interview on the Diary of a CEO podcast recently. I plugged the youtube clip into Notebook LM and asked is to give me a summary. To save you the three hours I spent listening to it, here are ten key points from the provided sources:

• Dr. Rhonda Patrick is an anti-aging expert with a PhD in biomedical science, specializing in aging, nutrition, and metabolism, and is the founder of FoundMyFitness. She produces monthly science-focused podcasts exploring actionable strategies for enhancing longevity, cognitive performance, and physical health.

• Cardiovascular fitness is highlighted as the number one predictor of lifespan. The sources discuss how to improve cardiorespiratory fitness, including the Norwegian 4×4 training method, and warn about the death-related risks of being sedentary.

• Vitamin D deficiency is a significant concern, with 70% of the U.S. population being deficient, and this deficiency is linked to an increased risk of dementia. Magnesium is also mentioned as important for disease prevention, slowing aging, and boosting brain power.

• Creatine‘s effects on cognitive function and its link to cancer outcomes are discussed. The podcast also addresses the common question of whether creatine causes hair loss.

• Omega-3 fatty acids are presented as beneficial for mental health, depression, and longevity. The discussion also differentiates between Omega-3 supplementation and a high Omega-3 diet.

• Small daily habits can help reduce the risk of Alzheimer’s and cancer. The sources delve into what causes dementia and Alzheimer’s and explore whether multivitamins can improve cognitive performance.

• Mitochondrial health is identified as having a hidden link to aging and chronic disease. The podcast also touches upon how the body generates energy and the effects of vigorous training.

• Fasting strategies are explored, including specific fasting windows to achieve autophagy and the do’s and don’ts of intermittent fasting, along with its effects on sleep.

• Lifestyle plays a critical role in life expectancy and healthspan, potentially more so than genetics. This includes discussions on the impact of the keto diet, the use of exogenous ketones for cognitive repair, recommended superfoods, and the vital role of fiber.

• Other health-enhancing strategies covered include the benefits of red light therapy, traditional versus infrared saunas for reducing stress and improving mood, and understanding microplastics and how fiber can help in their elimination.

To watch the podcast podcast, click this link https://www.youtube.com/watch?v=JCTb3QSrGMQ

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Virtual Reality for Pain Relief

I just read a super interesting article about how scientists have started using VR headsets to help people with Chronic Pain. So if you know anyone with chronic pain, make sure you share this with them!

In the study, they gave people VR headsets and showed them images of different scenes in nature. Lakes, mountains, waterfalls, that kind of cool stuff.

The subtitle of the article was “Pain Relief Without Pills”, because the VR was as effective as painkillers! Pretty amazing. According to the researchers, they found ” that nature VR had an effect similar to that of painkillers, which endured for at least five minutes after the VR experience had ended.”

This section of the article was the most remarkable to me:

“participants underwent MRI brain scans at the University of Exeter’s Mireille Gillings Neuroimaging Centre. Researchers administered a cold gel to illicit a type of ongoing pain and then scanned participants to study how their brains respond. The researchers found that the immersive VR experience significantly reduced the development and spread of feelings of pain sensitivity to pricking stimuli, and these pain-reducing effects were still there even at the end of the 45-minute experience.“

To read the article click this link.

Journal Reference:

  1. Sonia Medina, Sam W. Hughes. Immersion in nature through virtual reality attenuates the development and spread of mechanical secondary hyperalgesia: a role for insulo-thalamic effective connectivity. Pain, 2025; DOI: 10.1097/j.pain.0000000000003701
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Is Osteopathy Evidence Based?

Let’s start by discussing what osteopathy is and what the underlying principles it is governed
by.
What is Osteopathy?
Osteopathy is a way of manual (hands-on) treatment of the body to improve its capacity to
function. Osteopaths uses a variety of techniques, both “Active” and “Passive” techniques.
Active techniques are where the patient primarily does the intervention, such as exercise
rehabilitation. While passive techniques are where the osteopath primarily does the
intervention and the patient less so. These techniques include soft tissue massage, joint
mobilisation and manipulation.
What are the principles of Osteopathy?
There are 4 principles of osteopathy:

  1. The body is a unit:
     Mind, body, and spirit are interconnected.
     Physical health is influenced by mental and emotional well-being, and vice versa.
     Osteopaths consider all aspects of a person, not just the site of pain, when diagnosing
    and treating.
  2. Structure and function are interrelated:
     How the body is built (structure) affects how it works (function), and vice versa. For
    example, restricted joint movement or poor posture can impair circulation, nerve
    function, and overall mobility.
     Osteopaths look for restrictions or imbalances in the body that may be affecting health
    or performance.
  3. The body has the capacity to self-regulate and have self-healing mechanisms:
     The body has an innate ability to maintain health and recover from illness or injury.
     Osteopathic treatment aims to support and enhance these natural processes rather than
    override them.
  4. Treatment should be based on the above three principles:
     Osteopaths use their knowledge of anatomy, physiology, pathology, and
    biomechanics to create individualised treatment plans.
     The goal is not just symptom relief, but to restore function, support overall health, and
    empower the patient.

What is Evidence Based Practice (EBP)?
Evidence based practice (EBP) is a systematic approach to decision-making that utilizes the
best available evidence, including research findings, clinical expertise, and patient values, to
guide practice. It involves integrating these elements to make informed decisions that lead to
improved outcomes.

  1. Best available research evidence:
     This refers to clinically relevant research from studies with minimal bias, like
    randomized controlled trials.
  2. Clinical expertise:
     This encompasses the knowledge, skills, and experience of the healthcare
    professional.
  3. Patient expectations and preference:
     Acknowledging and incorporating the patient’s preferences and circumstances into
    the decision-making process.

With the terms defined, here is what we know of osteopathy as an evidence-based approach
in treating patients.
When it comes to treating musculoskeletal dysfunctions like back pain and neck pain,
osteopathy does have research backed evidence to support it.
Back Pain
According to research published in BMJ Open and The Lancet, manual therapy including
spinal manipulation and mobilisation can be an effective part of a multi-modal approach for
managing back pain.

A 2020 systematic review showed that osteopathic manipulative treatment significantly
improved pain and disability in patients with chronic low back pain. When combined with
exercise and education, these treatments are especially beneficial.
Neck Pain
Neck pain, often caused by poor posture, stress, or prolonged sitting, responds well to manual
techniques like joint mobilisation, soft tissue massage, and muscle energy techniques, all
commonly used in osteopathy. Studies indicate short-term improvements in pain and range of
motion, especially when patients stay active and involved in their treatment.
It should be noted that in some of the research conducted on the benefits of different manual
therapy techniques, both active and passive techniques are not categorised specifically as
“osteopathy” only, “chiropractic” only or “physiotherapy” only techniques; meaning
provided with the correct training and expertise, any technique can be performed by any
practitioner within their scope of qualification.
While there is evidence for osteopathic treatment for back and neck pain (or at least active
and passive manual techniques), lets shift focus onto some other conditions that research does
not have a strong evidence in its effectiveness but anecdotal evidence through Clinical
Expertise have seen patients benefit.
Headaches and Migraine
Headaches and migraine are common presentations in the clinic. Some tension-type and
cervicogenic headaches are linked to musculoskeletal dysfunction in the neck and upper
back. Osteopaths may use gentle manual therapy to release tension in these areas, which can
reduce headache frequency and intensity. Migraine management through osteopathy still
lacks strong research evidence and should be approached cautiously, but this is where an
experienced osteopath can use their expertise to help using a variety of techniques.
Pregnancy
Pregnancy-related pain often comes with musculoskeletal discomfort. Think ligament laxity
through shifting hormonal changes, pelvic girdle pain, sciatica, and lower back tension.
Osteopathic treatment during pregnancy has been shown in small studies to improve
functional outcomes and reduce pain, potentially making pregnancy more comfortable
without medication. Anecdotally, patients may find these symptoms worsen during the
second and third trimester and passive techniques during this time has been very helpful in
easing discomfort.
Patient Preferences is the last pillar of EBP model. This is something an osteopath can find
out before the commencement of any treatment. A written and verbal consent should be given
and the osteopath must adhere to such requests. For example, if a patient has had some ill
effects from a manipulation from previous treatments or has fears after hearing from friends
or family who suffered poor outcomes after said technique, the osteopath must take this into
consideration to weigh up the risk versus reward of performing such technique. This is why
an osteopath with extended clinical experience and expertise in a variety of techniques is so
important.

Cranial and Visceral Osteopathy

A word on a less common and perhaps “old school” branch of osteopathy. Both cranial and
visceral osteopathy have much less scientific backing. While some practitioners and patients
swear by their effectiveness, large-scale and high-quality clinical trials haven’t consistently
shown strong evidence for these methods.
Cranial osteopathy, also known as craniosacral therapy, is a specialised area of osteopathy
that focuses on the delicate movements and structures of the skull and its surrounding tissues.
Osteopaths practicing cranial osteopathy use a highly developed sense of touch to identify
and address restrictions or imbalances in the cranial bones, meninges, and cerebrospinal fluid.
This approach aims to enhance the body’s self-healing mechanisms and improve overall well-
being.
Visceral osteopathy is a manual therapy technique within osteopathy that focuses on the
internal organs (viscera) and their relationship with the musculoskeletal system. It involves
gentle manipulations to improve organ mobility, release tension in fascial tissues, and address
potential restrictions that may contribute to various musculoskeletal or digestive issues.

Conclusion
Is osteopathy evidence based? In short, it depends…
While manual (active and passive) techniques such as joint mobilisation, soft tissue massage
and spinal manipulation along with exercise prescription and education have shown to be
beneficial, there is currently less evidence to support Cranial and Visceral branch of
osteopathy.
Ultimately, any form of treatment for best patient outcomes must be through the three pillars
of Evidence-Based Practice; the intersection of best available research evidence, clinical
expertise of the treating osteopath while considering patient expectations and preferences.

References
Licciardone, J. C., Kearns, C. M., Minotti, D. E., & Tatman, L. H. (2020).
Osteopathic manipulative treatment for chronic low back pain: A randomized controlled
trial.
Journal of the American Osteopathic Association, 120(8), 529–538.
https://doi.org/10.7556/jaoa.2020.088
Foster, N. E., Anema, J. R., Cherkin, D., Chou, R., Cohen, S. P., Gross, D. P., … & Maher, C.
G. (2018).
Prevention and treatment of low back pain: evidence, challenges, and promising directions.
The Lancet, 391(10137), 2368–2383. https://doi.org/10.1016/S0140-6736(18)30489-6
Franke, H., Franke, J. D., & Fryer, G. (2014).
Osteopathic manipulative treatment for nonspecific low back pain: A systematic review and
meta-analysis.
BMC Musculoskeletal Disorders, 15, 286. https://doi.org/10.1186/1471-2474-15-286

Miller, J., Gross, A., D’Sylva, J., Burnie, S. J., Goldsmith, C. H., Graham, N., … & Kay, T.
M. (2010).
Manual therapy and exercise for neck pain: A systematic review.
Manual Therapy, 15(4), 334–354. https://doi.org/10.1016/j.math.2010.03.008
Licciardone, J. C., Aryal, S., & Singh, K. P. (2010).
Osteopathic manipulative treatment for chronic low back pain: A randomized controlled
trial.
The Journal of the American Osteopathic Association, 110(10), 646–656.
Green, C., Martin, C. W., Bassett, K., & Kazanjian, A. (1999).
A systematic review of craniosacral therapy: Biological plausibility, assessment reliability
and clinical effectiveness.
Complementary Therapies in Medicine, 7(4), 201–207. https://doi.org/10.1016/S0965-
2299(99)80003-9
Guillaud, A., Darbois, N., Monvoisin, R., & Pinsault, N. (2018).
Effectiveness of visceral osteopathy: A systematic review of the literature.
European Journal of Osteopathic Research, 7, 1–10.

Written by Dr Marcus Ng (Osteopath) M. Osteo, B App Sc (Osteo Studies), B. Sc (Anat.)

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Ayurveda in Winter

Ayurvedic Medicine views each season as having different characteristics and approaches them all with a unique perspective. Our Naturopath Pad has outlined some key points to consider for your health and wellbeing this Winter.

In Ayurveda  winter is considered a Kapha season with strong Vata undertones. It’s characterized by cold, dry weather, and a shift towards rest and introspection, potentially making us more prone to colds, stiffness, and lethargy . Ayurveda suggests incorporating warming foods, engaging in regular self-care practices like oil massages, and establishing a predictable routine to maintain balance during this season. Here’s a more detailed look at how Ayurveda views winter and what it recommends:

  • Hemanta (early winter) and Sisira (late winter): Ayurveda divides winter into these two periods, each with its own characteristics. 
  • Kapha and Vata Dominance: Winter’s cold, dry, and heavy qualities are associated with Kapha and Vata doshas. 
  • Time for Rest and Reflection: Ayurveda emphasizes rest, reflection, and inward-focused activities during winter. 

Dietary Recommendations:

  • Warm, Nourishing Foods: Ayurveda advises eating warm, cooked meals that are easily digestible. 
  • Spices for Warmth: Include warming spices like ginger, turmeric, cinnamon, and black pepper in your diet to combat the cold. 
  • Seasonal Vegetables: Incorporate root vegetables like carrots, sweet potatoes, and winter squash, which are rich in nutrients. 
  • Ghee and Other Fats: Ayurveda suggests including healthy fats like ghee and coconut oil in the diet to support digestion and warmth. 
  • Avoid Raw and Cold Foods: Reduce or eliminate raw salads and cold dishes, as they can disrupt digestion during winter. 

Lifestyle Practices:

  • Abhyanga (Oil Massage): Regular warm oil massage promotes circulation, balances doshas, and relieves dry skin. 
  • Warm Baths: Taking warm baths, especially with herbs, can help soothe the body and improve circulation. 
  • Regular Routine: Establishing a predictable daily routine with consistent sleep patterns and meal times is crucial for balancing Vata. 
  • Yoga and Meditation: Gentle yoga and meditation can help calm the nervous system and promote relaxation. 
  • Warm Environment: Embrace warm environments with a cozy fire and layered clothing to stay comfortable. 

Additional Tips:

  • Hydration: Drink warm water or herbal teas throughout the day to stay hydrated and support digestion. 
  • Vitamin C and D: Incorporate foods rich in Vitamin C and D to support your immune system. 
  • Sun Exposure: While winter can be a time of rest, try to get some sunlight to help with mood and energy levels. 
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Japanese Interval Walk Training

Dan Go (@FitFounder) is one of my go-to resources for health and fitness news. He just posted on his Instagram about Interval Walking Training, a method of walking developed by Japanese researchers that appears to be incredibly simple and incredibly effective.

Here’s how it works.

Instead of just strolling at the same pace, IWT alternates between three minutes of slow walking and three minutes of fast walking.

You do it for a total of 30 minutes.

That’s it. Super simple, but check out how effective it is, from the post by Dan:

People who do IWT see a 4x improvement in blood pressure compared to those who hit just 10K steps a day.
It’s been shown to reduce depression and cut stroke risk by 40%.
It has also been shown to strengthen muscles, boost the immune system, and improve sleep efficiency by 12%.

Here’s a Basic IWT Workout (30 min):
Warm-up: 3-5 minutes of easy walking
Intervals: Repeat the following for 30 minutes
3 minutes of slow walking (comfortable pace)
3 minutes of fast walking (brisk pace, like you’re late for a meeting)
Cool-down: 3-5 minutes of easy walking.

How Intense Should the Fast Walk Be?
Use the “Talk Test”
The IWT is harder than walking. To gauge intensity, you should still be able to have a conversation while walking. Think of it as having a Zone 2 intensity when you’re doing the fast walk.

Advanced IWT Options
◆ Hill Intervals: Do a fast walk uphill for extra resistance.
◆ Weighted: Wear a weighted vest (10-15% of your body weight).
◆ Go Longer: Extend to 40-45 minutes for added endurance benefits.
Use the “Talk Test” as a way to maintain the right intensity.

There you have it. Give it a try next time you go for a walk, start adding in some faster intervals and gradually build up to the 3 minute intervals the study found to be so effective.

Source: https://www.instagram.com/p/DHqWn3vzHcJ/?img_index=1

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Ayurvedic Medicine in Autumn

Ayurvedic Medicine has been practiced in India for around 5,000 years. Ayurveda emphasizes a holistic approach to health, considering the interconnectedness of the physical, mental, and spiritual aspects of an individual. 

The core principle of Ayurveda is to maintain balance within the body’s systems, using natural treatments like herbal remedies, diet, and lifestyle changes to achieve optimal health. 

Ayurvedic practitioners, and Chinese Medicine practitioners, believe that our physiology changes as the seasons change. As it’s the beginning of Autumn, our Ayurvedic Doctor, Padi, has written an article on the impact Autumn can have on us:

As the vibrant hues of summer fade and we welcome the gentle shift into autumn, it’s the perfect time to realign your well-being with Ayurveda, the ancient science of holistic health. The key to unlocking your individual path to vibrant health is to understand how the five fundamental elements—space, air, fire, water, and earth—shape your personal doshas.

Vata, a combination of space and air, governs movement and circulation, often becoming more prominent in the cooler, drier autumn air. Pitta, a blend of fire and water, controls metabolism, while Kapha, a combination of water and earth, provides structure and immunity.

Understanding which dosha or doshas dominate your constitution is key to personalized wellness, revealing your natural tendencies and how seasonal shifts, like the one we’re entering, can impact your balance.

When your doshas are balanced, you experience optimal health and vitality. However, autumn’s changes—cooler temperatures, drier air, and shifting routines—can disrupt this harmony. To maintain balance during autumn, Ayurvedic practices suggest focusing on grounding and nourishing the body and mind. 

Ayurveda recommends consuming warm, cooked, and nourishing foods, such as root vegetables, warm soups, and grains like rice and oats, to counteract the drying and cooling effects of the season. 

It’s also recommended to engage in grounding activities like yoga, meditation, and spending time in nature, and to prioritize regular routines and adequate rest. 

Ayurveda also emphasizes the importance of transitioning gently into the season, with practices like gentle cleansing and detoxification to prepare the body for the changes. 

Ayurveda offers personalized recommendations, including dietary adjustments, lifestyle modifications, and herbal remedies, to help you transition smoothly and maintain balance throughout the season.

Padi, a skilled Ayurvedic practitioner and naturopath, can guide you in identifying your dosha and implementing practical Ayurvedic principles to navigate the autumn season. She provides natural solutions to enhance digestion, boost energy, manage stress, and support your immune system as the weather changes.

Whether you seek relief from seasonal sensitivities or simply aspire to greater well-being, Ayurveda offers a tailored approach for this time of year.

Prepare your body and mind for the transition into autumn. Embark on your journey to balanced health by exploring your Ayurvedic constitution. Schedule a consultation with Padi to discover your personal dosha and learn how to live in harmony with your natural blueprint as the seasons shift.

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