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Elbow Pain? It could be Tennis Elbow

20/5/2022

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By Liam Neyland

So, what is it?

Lateral epicondylitis, or more commonly known as 'tennis elbow', is a condition where the tendons of the elbow become inflamed
resulting in pain occurring during certain motions or during restful periods. Despite the name ‘tennis elbow’ this condition is quite common among the general population and is not exclusive to athletes. The pain that people feel when suffering from tennis elbow occurs most commonly at the bony bump located on the outside of your elbow where the tendons of the extensor muscles attach. This pain can be quite erratic with some presentations only at the elbow, or at both the elbow and other areas such as the forearm and wrist.

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What are the symptoms?
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The most common symptom that presents when suffering tennis elbow is pain, along with a decreased grip strength either due to pain or generalised weakness. The pain experienced from tennis elbow can range from either a burning sensation, sharp, stabbing and or a dull ache just to name a few examples. A major indicator of tennis elbow is experiencing pain when performing tasks such as holding a cup of coffee, turning a door knob and or shaking someone's hand.

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What causes it?
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The most common cause of tennis elbow is simply the overuse of the extensor muscles. When performing repetitive actions such as typing, using hammers or playing a musical instrument these motions can result in the tendons of the extensor muscles becoming inflamed. This normally is not an issue as the body will naturally repair any damage done to the tendon. However, if the tendon is not allowed ample time to heal this inflammation can progress to microscopic tearing.  This in turn makes the pain experienced more pronounced and or generalised along the forearm, and increases the time needed to properly heal.

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How is it diagnosed? 
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The most time efficient and simple way to determine if you may be suffering from tennis elbow is to have a physical exam performed. These exams can be performed by Doctors and most if not all Manual Therapists such as Osteopaths. After these examinations it is not uncommon for a Doctor or the Manual therapist to suggest some form of x-ray or MRI. These tests are mostly used to help identify any factors that should be considered before commencing treatment such as calcification of the tendon or to simply confirm the diagnosis.

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How can an Osteopath help?

An Osteopath can implement a wide range of treatment options that are dependent on the stage of the condition as well as how complicated it is. For early stages advice and lifestyle changes are normally implemented along with hands on treatment such as soft tissue or myofascial release to name a few. For more advanced stages of the condition the previous treatments can still be used but would be implemented in conjunction with rehabilitation programs that may or may not involve the use of other treatment methods such as dry needling. 

If you have been suffering from elbow pain and this sounds familiar to you, the Osteopaths at HMC Osteopathy are happy to help you and are equipped with knowledge and experience to treat any and all complaints. 
​


References:
Lateral Epicondylitis - Physiopedia (physio-pedia.com) , Tennis elbow - PMC (nih.gov),  Tennis elbow | healthdirect

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Osteopathy and Babies

13/4/2022

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By Kirby Edwards

Why would a baby need to see an osteopath?

Osteopathy for babies is a gentle non-invasive hands-on approach to treatment. Babies (and Mums) may retain tension in their tissues (muscles, fascia, vessels, bones) from the birth and other experiences. This may be quite uncomfortable. Osteopathy looks at structure, function and movement of the tissues. By looking at those complex relationships through the body, including the bones of the head, pelvis, limbs and torso, Osteopaths can aim to optimise the body’s own self-healing and self-regulating mechanisms. 

Before we begin hands-on therapy, we will talk to the parents about the pregnancy, birth, medical history of the baby and family, feeding and digestion, sleep patterns and movements of the baby to gain as much information as we can as well as answer any questions you have. Osteopaths will assess how the body is generally moving, respiration, cranial bones of the skull and possibly check inside the baby’s mouth to check out the tongue.

What can an osteopath do for babies?

Osteopaths with a special interest in newborns and paediatrics can support and assist newborns or infants in a variety of issues:
  • Birth/Delivery trauma (including interventions – ventouse/vaccum, forceps or prolonged or short delivery time)
  • Digestive issues (constipation, reflux, gas)
  • Head shape asymmetries or blocked tear ducts
  • Torticollis (when the muscles of the neck are tighter on one side, especially a muscle called the sternocleidomastoid and cause the neck to twist to one side – this can interfere with feeding, cause headaches and other discomforts)
  • Asymmetries (crawling, walking, hips, shoulder tensions from birth etc)
  • Breastfeeding challenges (latching difficulty, favouring one side). We also work with lactation consultants to optimise this for everyone! ​

​In some cases, the earlier we can get baby in, the more of a difference we can make, but it is never too late!
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How do you treat a baby? 

As babies are still very flexible and mostly cartilaginous bones, we do not perform any type of sharp manipulation or firm treatment. Our approach to babies is much gentler, often using cranial osteopathy or working with the fluid dynamics or fascia of the body to release any tissues that are under tension and restore optimal balance to the baby. We may place our hands on their rib cage, pelvis or skull. We can also work with tensions around the mouth and jaw to optimise feeding and digestion for the baby. We work closely with lactation consultants and other professionals should there be any other issues, such as a tongue tie release being required. 

The long-term implications of tongue ties can influence the jaw and palate development and position altering how the baby’s airways are forming, thus leading to altered or suboptimal posture breathing mechanics. It can also lead to too much air in the baby’s tummy and discomfort (as a result, excessive screaming).

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​What is cranial osteopathy?
​

This is a gentle hands-on treatment that helps the body to find better balance and optimise movement. Osteopaths are trained to develop their palpation skills. With Osteopathy in the Cranial Field (OCF) we are trained to feel subtle motion in the whole body. This is called the Primary Respiratory Mechanism (PRM). Although the name is ‘cranial,’ this mechanism can be felt and worked on from anywhere in the body. One of the principles of Osteopathy is that it is all connected. Osteopaths see connections between different parts of the body and by working with this principle aim to optimise the body’s function. OCF is a subtle refined approach that can affect all systems of the body aiming to restore balance and health. Cranial Osteopathy can be of benefit for everyone, but due to its gentle effective approach is ideal for babies and children.

What can I expect post treatment?

As with any treatment for anyone, there is an adjustment period to the new balanced normal. Each baby (and person) can react differently, but often they are very sleepy, hungry or maybe a little agitated. It can take between 1-3 days to settle down, although some may settle down straight away. Feel free to give us a call if you have any questions. 
​

We may also send you off with a referral to a GP, midwife, or lactation consultant, if the issue is out of our scope.
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Osteopathy and Children

13/4/2022

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By Kirby Edwards
​
What would a child need to see an osteopath?
​

Children are very resilient and often bounce back from injuries quite well. However, sometimes problems earlier in life can lead to discomfort later on. This may include postural issues, movement, breathing, overall development and re-occurring infections. We aim to release any tension or strains in the tissues to prevent any compensatory changes throughout their prime growing time.

What can an osteopath do for older children and toddlers?
Osteopaths can assist with:
​
  • Hip pain
  • “Growing pains”
  • Spinal curves or poor posture from phones/games, heavy school bags, sport or instruments. 
  • Asymmetry of movement of limbs including bow-legged and knock knees
  • Headaches
  • Thoracic and Abdominal pain
  • Developmental delay
  • Speech and hearing people
  • Learning difficulties and behavioural issues
  • Recurring ENT disorders (ear, nose and throat) as well as sinus infections. 
  • Asthma or respiratory issues
  • Traumas – including significant falls especially on head or tailbone, these would need to be cleared of any severe injury by a doctor (broken bones, concussion etc)
  • Anxiety – including breathing, digestive problems

As the children transition from adolescent to teenage years – traumas that the child may have experienced can become more obvious with the influence of hormones and onset of puberty. Some of the changes that you may notice include scoliosis, headaches, poor concentration, brain fog.

How do you treat a child?


Before we begin hands-on therapy, we will talk to the parents about the pregnancy, birth, medical history of the baby and family, feeding and digestion, sleep patterns and movements of the baby to gain as much information as we can as well as answer any questions you have. When we place our hands on, we will assess how the body is generally moving, respiration, movement of the cranial bones of the skull and specific muscle or joint issues. We will then discuss a treatment plan which may include some referrals, homework or exercises as well as potentially some lifestyle or diet changes. 
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The treatment will depend on what the child/toddler presents with, their personality and what age they are. There may be a gentler approach – similar to the one we have with babies where we avoid any sharp manipulations or firm treatment and approach the toddler or child using cranial osteopathy or working with the fluid dynamics of the body to release any tissues that are under tension and restore optimal balance. 
If they are a little older, we may use some other techniques such as METs (muscle energy techniques) or other techniques which we will discuss with the child and parent before performing.
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What is cranial osteopathy?
​

This is a gentle hands-on treatment that helps the body to find better balance and optimise movement. Osteopaths are trained to develop their palpation skills. With Osteopathy in the Cranial Field (OCF) we are trained to feel subtle motion in the whole body. This is called the Primary Respiratory Mechanism (PRM). Although the name is ‘cranial,’ this mechanism can be felt and worked on from anywhere in the body. One of the principles of Osteopathy is that it is all connected. Osteopaths see connections between different parts of the body and by working with this principle aim to optimise the body’s function. OCF is a subtle refined approach that can affect all systems of the body aiming to restore balance and health. Cranial Osteopathy can be of benefit for everyone, but due to its gentle effective approach is ideal for babies and children.

What can I expect post treatment?
​

As with any treatment for anyone, there is an adjustment period to the new balanced normal. Each toddler or child (any person) can react differently, but often they are very sleepy, hungry or maybe a little agitated. It can take between 1-3 days to settle down, although for some may settle down straight away. Feel free to give us a call if you have any questions. 

Some injuries/traumas may need to be assessed by the emergency or a doctor. After serious illness or injury has been excluded, Osteopathy may be able to assist to get your child back on track. If your child has had a trauma and has any of the following:
  • Altered consciousness, altered eye movement or becomes very sleepy following a fall, changes in speech,
  • Suspected broken bones or infection,
  • Difficulty breathing or bleeding badly, 

Please take your child to emergency or a doctor. Some things are out of the scope of Osteopathy and need medical attention as soon as possible.
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Sit up straight! Improving work ergonomics to decrease pain, increase energy & productivity

23/3/2022

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By Angus Nicol

Slouchy slouch - How are you sitting?
​

Ever heard of the saying “sitting is the new smoking?” As the health conscious reader I know you are (since you’re reading this blog), I’m almost sure you have. And it’s true, prolonged periods of “sedentary” behaviour (physical inactivity) over long periods can have detrimental effects on both your physical and mental health. This is worrying, since an estimated 81% of Australians work in occupations that require some sitting, with over half of Australians reporting that they sit for work “all the time” or “often”.

​Today I’m not here to lecture you about all the health consequences of sitting (that may have to wait for another time), but rather to give you some hints and tips about proper desk posture and ergonomics - so that when you are sitting, at least you’re doing it in the healthiest possible way! I feel this is becoming increasingly important given that there are more people than ever working from home in less than ideal workspaces (whether that be in bed/on the couch, at the kitchen table etc).


I’m sure you would all recognise the classic “desk posture”. Generally what you will see is four basic characteristics in the upper body:
  1. The shoulders slouch forwards
  2. The upper back becomes more rounded/hunched
  3. The base of the neck thrusts forwards
  4. Your head tilts back so you can continue looking forwards

This happens because when we’re sitting at a desk, everything we need is in front of us, so we slouch to get closer to it. This causes the muscles in the front of our chest to become short and tight and holds us in this rounded shoulder position. The opposite happens to the muscles in our back, over a long period of time the muscles between our spine and our shoulderblades may get weak and lazy, and they may no longer have the strength or endurance to hold our shoulders backwards.

This contributes to the upper part of the back becoming increasingly rounded and stiff, making it hard to sit up tall. This means that to continue looking straight ahead, you have to tilt your head backwards slightly. This requires excessive use of the muscles in the base of your skull and back of your neck and they may then become tight and give you neck pain. These muscles also refer up towards your skull, so tightness in these muscles may also be responsible for headaches! I feel it’s important to note that stress commonly causes these muscles to become tense, and exacerbate your neck pain and headaches.


Have a look in the mirror - look front-on and side-on, and notice the position of your shoulders, the curve in your upper back and the position of your neck.

Does any of it fit what I just described?

Well fear not, you’re not alone.

This is one of, if not, THE most common complaint I see in practice… but the good news?

YOU CAN DO SOMETHING ABOUT IT!


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Ergonomics 101 - The quick fixes

A good place to start is by checking your work/desk setup… because if this isn’t ideal, chances are you’re going to be fighting an uphill battle. Where possible (and I know it may not always be!), try to have a dedicated area that you work from if working from home. Try to avoid sitting on surfaces that are too soft (eg beds or soft couches), as these are sacred bits of furniture that should be used for relaxation and enjoyment purposes only! Not to mention they are a posture nightmare! Here are some tips to try and ensure good posture when sitting at your desk. If possible, read this next part at your desk, and make adjustments as you go. It should only take a couple of minutes, and could save you a lot of pain and discomfort!

  1. Sit as far back in your chair as possible so that your back is against the back support.
  2. Have a look at the position of your feet and knees. You should be able to sit with your feet flat on the ground, and your knees should have no more than a 90 degree bend (they should not be any higher than your hips). If your feet cannot touch the ground, you may consider adding some kind of foot support (you can buy special feet supports… or any stable/flat surface you can place under your feet may work just fine). If your knees are bent more than 90 degrees, you may need to adjust your seat higher.
  3. So, that’s the lower body sorted, now your upper body. Repeat Step 1 and see how it feels. Now I want you take note of how far away, and how high, your desk is. Ask yourself a few questions:
    1. Am I having to lean forward with my back or hunch my shoulders forward to reach my keyboard? If the answer is yes, then it is likely your chair is too far away from your desk. This can often happen if you have a chair with arm rests that do not slide comfortably under your desk; or if the desk is too thick (eg has shelves), too low, or too shallow, and you can’t slide your legs under it properly.
    2. Am I shrugging my shoulders up towards my ears? If yes, then your desk height is probably too high (or seat height too low!). This can cause tension in your upper traps muscles that extend from the base of your neck out towards your shoulders (these muscles can also be responsible for headaches!).
    3. Can I rest my elbows comfortably at (or slightly below) 90 degrees, without shrugging my shoulders? If the answer is no, and your forearms/wrists are above elbow level, this is another indication that the desk is too high, and/or too far away. Consider adjusting seat or desk height.

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Need some help? Here are some people and gadgets to assist you.
​

Okay, how are you feeling now? Although it may seem relatively straightforward, getting this right can be a bit tricky. Sometimes some problem-solving, a bit of imagination and a helping hand is necessary. So, if you’re still struggling to achieve an ideal desk setup, it might be time to try to enlist some help. There’s a few ways you can go about this! First of all, take a photo of your current desk setup (ideally from side on with you sitting in it) and bring it into your local osteopath! We may be able to offer tailor-made advice and recommendations to perfect your desk setup. Other healthcare practitioners such as physiotherapists, chiropractors, GPs and occupational therapists (OTs) may also be able to offer sound advice!

Furthermore, there is an overwhelming amount of gizmos and gadgets out there designed to help improve your work ergonomics and make you as comfortable as possible. There is anything from ergonomically designed seats, sit-to-stand desks, ergonomic mouses and keyboards, footstools, back braces and much more! However, not all of these may be necessary for you, and there are some dodgy ones out there, so I highly recommend consulting your local healthcare practitioner to assess what may be useful for you, before wasting money on expensive fancy and potentially unnecessary things!

Another little hot tip… many large corporations (and even some small-medium organisations) employ professionals to perform ergonomic assessments, so it may be well worth your while and a good excuse to stand up and go for a wander to HR, or to your managers office, and ask if they can get someone to inspect for you. Sometimes workplaces are willing to cover expenses for any equipment that you require too! Because after all, happy, pain-free employees are likely to be more productive and make them more money… so your comfort is in their best interests too!


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Visit your osteo!
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Great! So now you have a perfect desk setup. But wait… there’s more. Think about your current job, and previous jobs before that. Do you think you could calculate the time spent sitting (probably with poor posture)? Guess what, a new desk setup isn’t magically going to reverse years of poor posture! BUT some hands-on treatment and some simple, easy exercises may help. Osteopaths can assess the main cause of your pain/discomfort and provide manual therapy and personalised exercises to help alleviate your pain, headaches and improve your posture! We may also take into account any other factors that may be influencing your pain (eg stress levels, diet & sleep etc). However, from a purely biomechanical perspective, an osteopaths goals may include:
  1. Release off any tightness in the front of the chest and neck that may be pulling your back and shoulders into a hunched/rounded position.
  2. Release off any tightness/stiffness in the muscles and joints in the neck that may be causing neck pain and/or headaches
  3. Assess and improve the mobility (or lack of) in your upper back, that may also hold you in a hunched position.
  4. Assess and improve the strength and endurance of muscles between the shoulderblades and spine, as well as the strength of your core muscles, to be able to hold you upright for extended periods of time
  5. Assess and improve the strength of muscles in the front of your neck, to ensure your head sits directly over your shoulders.

Most of the time, postural complaints are not something that can be fixed instantly. Things that have been there for a long period of time often take a while to resolve. However, with a little bit of hands-on treatment and some dedication to rehabilitation exercises, you can see significant improvements in pain and headaches within 2-8 weeks… which is not long considering how long it may have been an issue for!

Please see below for a few easy exercises you can do whilst at your desk, however this is just the tip of the iceberg, come and see us for a more personalised and comprehensive approach tailored just for you!



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Let's get aware- Endometriosis

4/3/2022

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By Liam Neyland
​
As march is Endometriosis awareness month, we at HMC Osteopath’s thought it would be a great time to share some helpful information about this condition.
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What is Endometriosis?
​ 

A fair few of you may be wondering what exactly is Endometriosis? Despite the condition affecting approximately 1 in 9 women before they hit their 40’s in Australia, it is a relatively unknown condition within the public. Simply put endometriosis is when cells (endometrium) that usually line the cavity of the uterus, better known as the womb, grow in other parts of the body. These cells can occur at almost any site within the pelvis, but is most commonly found to be sitting on the peritoneum of the pelvis, behind the vagina and uterus, underneath the ovaries and sometimes on the ovaries themselves. In it’s more severe forms this condition can even grow inside the Fallopian tubes or even within the ovary itself. However, there have been cases where these cells have been found outside the pelvis like for example the lungs (thankfully these cases are extremely rare). Despite the fact these cells are not present in the uterus they still respond to hormonal messages from the ovaries. This is especially true during the menstruation period of a women’s cycle, as these cells will bleed every month resulting in inflammation, scarring and in some cases organs to stick together. It is for this reason why women suffering from endometriosis can have such debilitating pain. Along with debilitating pain the disease can affect fertility.

How does Endometriosis affect Fertility?

The link between fertility and endometriosis is unfortunately unclear, however the stage of the condition and location do play a major role on possible fertility issues. Examples of this are if extensive scarring within the pelvis could result in pain during intercourse, lowering a women’s enjoyment and or dreading the act of intercourse as a whole. Another example would be the Fallopian tubes could become tangled in the scar tissue limiting it’s ability to safely transfer the egg from the ovary to the womb. These are two of many possible outcomes that endometriosis can effect a women’s fertility. Thankfully, many women with this condition can still become pregnant as an estimated 70% of women with mild to moderate endometriosis get pregnant without the use of external treatment.

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What are the Symptoms of Endometriosis?
​

The symptoms that women experience while suffering from endometriosis will be different by a case to case matter. As the severity of the condition does not necessarily coincide with the symptoms felt but instead where the lesions are located. 

Common Symptoms include:
  •  Abdominal (tummy) or pelvic pain: either before or during a period, during or after sex, when going to the toilet. 
  • Bloating or the sensation of bloating with or without pain
  • Increased fatigue
  • Infertility 
  • Heavy or irregular periods 
  • Changes to bowel habits: needing to urinate more frequently or blood being present during urination

What causes Endometriosis? 

Currently there is no known cause of endometriosis, however factors that increase the likelihood of the condition are as follows.
​
  • Retrograde menstruation: When menstrual blood flows backwards into the Fallopian tubes and pelvis.
  • Family History
  • Frequent or short periods
  • Long and heavy periods
  • Starting your period before the age of 11
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 How is it Diagnosed?

Unfortunately due to difficult it is to identify many women go undiagnosed for many years with the average being around 7.  Currently the only way to confirm a diagnosis of endometriosis is to have a laparoscopy, which is a particular surgery where doctors are able to look for endometriosis tissue within the abdomen and take a sample to examine in a laboratory. During the surgery the grading of endometriosis would be determined as well.

Grade 1 (mild): small patches scattered around the pelvis

Grade 2/3 (moderate): disease is more widespread and can be found on ovaries and other parts of the pelvis.

Grade 4 (severe): Has spread to most of the pelvic organs.

If you suspect that yourself or someone else may have endometriosis, please talk to your doctor about any and all symptoms you may be experiencing. A helpful tool has been designed to help health professionals and yourself in identifying and assessing endometriosis symptoms, which may also reach a faster diagnosis. It is called the Raising Awareness Tool for Endometriosis (RATE), which can be accessed through the provided link. RANZCOG - RATE

What are your treatment options?

Conventional treatment of endometriosis is wide ranging as not all therapies may be effective or the possible side effects could have an overall net negative for a person’s health. It is important to discuss with your doctor about any and all side effects with any treatment options. As stated in the previous blog, currently there is no cure for endometriosis, so in that regard all treatments are aimed at pain management or general management of the condition. 

Non-manual therapy treatment option
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  • Use of pain relief medications, such as non- steroidal anti-inflammatory drugs (NSAIDS) such as Nurofen (Ibuprofen).

Hormone Therapies, are used to help suppress the growth of the endometrial cells and stop or limit bleeding, including during the menstrual cycle. Examples include:
​
  • ​​Combined oral contraceptive pill (COCP), where the contraceptive pill is taken continuously without the sugar (hormone free pills).
  • Progestogens (both natural and synthetic): It is not known how Progestogens provide pain relief but it is believed they suppress the growth of endometrial tissue in some way. It has been found that up to 80% of women experience pain relief from this treatment.
  • ​GnRH (Gonadotrophin- releasing hormone) agonists and antagonists: Is used to suppressing ovulation and in turn the production of oestrogen and progesterone by the ovaries. This low level of oestrogen in the body creates a ‘temporary chemical menopause’ where endometrial cells are no longer stimulated and gradually shrink. 

Surgery: aim is to remove as much visible endometriosis as possible and to repair any damage found.


  • ​Laparoscopy: Keyhole surgery, where a thin telescope with a light is inserted into the abdominal cavity. If endometrial tissue is found it is removed by vaporising (destroying cells with electrical energy) or by cutting the tissue, the method depends on location and severity. 
  • Laparotomy: A similar surgery to a Laparoscopy but instead of key hole the surgery is an open operation requiring a larger cut into the lower belly. Is only used for severe/extensive or if Laparoscopy isn’t an option.
  • Hysterectomy: Only considered an option if the patient does not plan on having kids, when quality of life is severely impaired or all other treatments have failed. This surgery is the removal of the uterus and both ovaries along with the Fallopian tubes, resulting in a surgical menopause. This treatment usually is in combination with Menopausal hormone therapy to help offset the symptoms or effects of the early menopause. 
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Self care treatment 

It is important to remember that the pain and or discomfort a women may experience from Endometriosis is unique to them and will vary from person to person. With that in mind here are some examples of at home treatments you can use to help with managing your pain.
 

Exercise

  • ​Is a natural pain relief as when the body exercises feel good hormones are released that naturally dull the pain experienced. A study found that women with endometriosis experienced a reduced level of daily pain and improved quality of life when completing 2x 90 min sessions of yoga per week over a 2 month period, when compared to women who did not participate.
  • Exercise has been found to improve fatigue and ‘brain fog’ that is commonly experienced with endometriosis 
  • ​Exercise has also been found in many studies to help improve mood and manage symptoms of anxiety or depression: Women with endometriosis or other chronic pain issues are more likely to experience anxiety or depression. Evidence suggests that people suffering from anxiety or depression experience a negative feedback loop with pain levels where more pain equals more anxiety and more anxiety increases perceived pain.  

Other supportive self care treatments are:

  • Heat: heat packs or hot water bottles are helpful in managing pain levels that do not involve pharmaceutical intervention. Just be cautious as to avoid overuse as skin burns can occur with too much use. 
  • Mindfulness and Meditation: Evidence suggests that the use of psychological and healthy mind body practices show positive outcome on pain levels, depression, anxiety, fatigue and stress in women with endometriosis. 
  • Sleep: Most chronic pain sufferers struggle getting the recommended hours of sleep, studies have shown that poor quality of sleep is associated with a poorer quality of life and depressive symptoms in women with endometriosis.

What can my Osteopath do?

When treating endometriosis, it is best that a multi-disciplinary approach is used. Where a range of health professionals including your GP work together to provide the best possible care for you. Osteopathy would provide a range of hands on, non-invasive treatment methods to best optimise the body’s natural function. Examples of possible treatments that an Osteopath could provide you are as follows.

  • Nervous system desensitisation: With long lasting pain the nervous system becomes more sensitive and easily triggered. Osteopaths would provide treatments or advice that can reduce this sensitivity of the nervous system either through movement, manual therapy and or education.
  • Stretching/flexibility exercises: Osteopath’s can provide a wide variety of stretch’s and exercises to improve mobility in the hips, abdominal’s and spine which can be useful in reducing pain and relaxing the pelvic floor.
  • Whole Body treatment: Chronic pain sufferer's rarely ever have only one thing causing or contributing to their pain. Osteopaths may use a wide variety of techniques such as soft tissue, joint articulation, muscle energy techniques or manipulation depending on if other issues are found. 
  • General Advice: currently there are a wide variety of at home treatment tools that you may implement. These tools range from TENS (Transcutaneous electrical stimulation) machines which uses a low level electrical stimulation for pain relief, all the way to devices that can play a role in limiting pain during intercourse. An Osteopath can help give advice or even suggest the use of these equipment’s for at home treatment.
  • Goal Setting and patient education: An Osteopath wants to make you better and make you the best possible version of yourself. By educating patients and creating realistic and obtainable goals, patient and practitioner can work together to achieve these goals. As an added bonus by setting goals and becoming more knowledgeable about your condition, studies suggest you can experience a lower pain intensity then those who do not.
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What can my friends and family do to help?
The best thing that friends or family can do to help is be a reliable source of support. Many people suffering from endometriosis feel alone in their struggles. Something as simple as bringing your loved one a heat pack when you notice them struggling or allowing them to sleep in a little longer can go a long way in helping someone suffering to feel more validated. Always remember that just because you cannot see the illness does not mean that it does not exist. It is important to remember that symptoms for endometriosis are varied and unique to the individual and that the condition does not have a set rhyme or rhythm. So please be understanding that someone with this condition cannot control or predict when a ‘flare’ will occur.


References
How does endometriosis affect fertility? | Tommy's (tommys.org) 
Where Does Endometriosis Occur | Gynaecology Molloy 
Endometriosis | healthdirect 
Endometriosis (who.int)
Exploring effect of pain education on chronic pain patients’ expectation of recovery and pain intensity (degruyter.com) 
Management & treatment of endometriosis | Jean Hailes 
Treating endometriosis | The Royal Women's Hospital (thewomens.org.au) 
Endometriosis Australia | Home
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Harness your Superpower....Sleep!

9/2/2022

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By Jamuna Edwards
​​
“Sleep is your superpower; it is your life-support system and mother nature’s best effort at immortality. Wonderfully good things can happen when you get sleep, and alarmingly bad things when you don’t, for both your brain and body” (Professor Matthew Walker). 
 

The average person will spend approximately one-third of their life asleep, yet it is
something not many of us fully understand or appreciate. In this blog, I will cover some of
the basics of sleep and give some advice on how you can make it your superpower!

Why is sleep so important? 
​

An immense cascade of health benefits occur when we sleep. It is often thought that the
brain “shuts off”, this could not be more wrong. In fact, your brain is up to 30% more active
in certain stages of your sleep cycle. During the day our bodies go through many processes
that cause a build-up of waste products and it is during the night, when we are in our deep
sleep stages, that these wastes get cleaned away. Sleep is also when we strengthen our
immune system by producing antibodies to fight illness, when we undergo tissue repair and
growth, and when our minds process our experience of waking life and consolidate all of
this into memories.
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What are the stages of your sleep cycle?

We have four stages of sleep, the first three are NREM (Non-Rapid Eye Movement) and the
last stage is REM (Rapid Eye Movement) sleep. These stages of sleep alternate throughout
the night in a cyclical fashion and different stages affect your brain and body differently! 

Stage 1: This is the transition from being awake to falling asleep, usually lasting 5-10
minutes. 

Stage 2: This is light sleep, lasting from between 10-25 minutes. During this stage your heart
rate and breathing slows, your muscles relax, eye movements stop, your body temperature
drops and brain waves become much slower. Your body is getting ready for deep sleep!

Stage 3: Deep sleep, lasting from between 20-40 minutes. This stage is incredibly important
for your overall body health, during this stage your body performs maintenance and repair
all the way down to a cellular level. Tissues are repaired and regrown, bone and muscle are
built, and the immune system is strengthened. 
This deep sleep is needed for you to feel refreshed and well-rested the next day. 

Stage 4: Your first REM cycle will occur approximately 90 minutes after you first fall asleep.
As the night progresses each REM period will typically get longer, ranging from anywhere
between 10 minutes to an hour. During REM sleep, your heart and breath rate increase,
your muscles become paralysed (thought to prevent us from acting out our dreams in real
life) and brain activity resembles similar levels as when you’re awake. Sometimes the
brainwave activity may be even higher, and this is when we have intense and vivid dreams. 
REM sleep is important because it stimulates areas in your brain that are essential for
learning, processing and consolidating your day’s experiences and thoughts to create short-
and long-term memories. 

So, we can see that Stage 3 NREM deep sleep is essential to have a healthy functioning
body, just as Stage 4 REM sleep is to have a healthy functioning brain! 
​
So that covers the stages of sleep, but what makes us sleepy and what wakes us up?

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There are two body processes that drive our sleeping and waking periods. They are the circadian rhythm and the homeostatic sleep drive.
 

Circadian rhythms are internally driven 24-hour cycles that are part of your body’s internal clock. Constantly running in the background carrying out many essential functions and playing a vital role in nearly all sys tems of the body. One of its very important roles is the sleep-wake cycle. This rhythm is primarily driven by changes in light and darkness in your surrounding environment. It is regulated by a part of the brain called the suprachiasmatic nucleus. Your brain can tell when the light is changing through the optic nerve in your eyes. As night-time comes and it begins to get dark, the pineal gland starts producing melatonin, while exposure to light prevents melatonin production; thereby synchronising our sleep-wake cycle with night and day. Your exposure to light, especially morning sunlight, strongly reinforces these patterns. 

 Homeostatic sleep drive is the desire for sleep. It grows the longer you stay awake. This desire for sleep occurs because of a build-up of sleep-related hormones in the fluid in the brain and spinal cord, including adenosine, which helps regulate sleep patterns. As these levels increase, the desire for sleep intensifies and your body rams up the response. Then while you are sleeping this build-up of waste products is removed, restoring optimal brain function. 


How much sleep do we need?
​ 

According to the National Sleep Foundation Guidelines healthy adults need between 7-9 hours of sleep per night. While babies, young children and teens need more as they undergo more rapid growth and development. These guidelines also recommend that 7-8 hours of sleep is essential for people aged over 65. It is important to remember that 7-9 hours of time sleeping, not just time in bed. So, if you are aiming to only get 7 hours of sleep allow for at least 7.5 hours of time in bed, depending on how easy/difficult you find it to fall asleep. 

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What happens when we don’t get enough sleep? 

Sleep is when we restore and repair, how we recover from illness, deal with stressors, consolidate memories and solve problems. 

While the short-term effects of not having enough sleep is something we have all likely experienced and are very aware of; it is the long-term consequences of sleep deprivation that can wreak havoc on our bodies and brains. A persistent lack of sleep leads to poorer physical and mental health and increases your risk of many health issues including:

 Cardiovascular disease during deep NREM sleep your heart rate slows, blood pressure drops and breathing rate stabilizes. This reduces the stress on the heart and allows it to recover from the stress placed upon it during waking hours. If you are not getting this restorative sleep your risk of high blood pressure, coronary heart disease, heart attack, and stroke increases. 

Diabetes sleep deprivation leads to increased levels of cortisol (stress hormone) which results in higher blood sugar levels. In an attempt to balance this out your pancreas will produce more insulin; however, it is not as effective in the presence of cortisol and over time the pancreas cannot keep up with the work of keeping your blood sugar levels normal leading to an increased risk of diabetes.

Weight gain and obesity Sleep helps regulate the hunger hormones and not getting enough sleep puts you at a higher risk of overeating and craving higher-calorie dense foods.

Hormonal issues Sleep and the circadian rhythms play an important role in regulating many hormones including: 
  • Cortisol (stress hormone) is a very important hormone in Influencing your sleep-wake cycle and helps you get out of bed in the morning. 
  • Melatonin helps to promote sleep.
  • Growth hormone supports muscle and bone development and metabolism.
  • Leptin and ghrelin (hunger hormones) which help to control appetite and cravings. 
 
Impaired immune response sleep provides essential support to our immune system. Sleep deprivation has been shown to lead to poorer immune function, including an increased risk of infection in people who sleep less than 6-7 hours. You will also be more likely to catch the common cold or flu. 

Pain there is a strong relationship between sleep and pain. New evidence shows that the effect of sleep on pain might be even stronger than the effect of pain on sleep. 
Sleep and pain have a bidirectional relationship, if you are sleep deprived you are at a higher risk of developing pain or that your pain is worsening, while your pain can cause disrupted sleep creating a worsening cycle of sleep and pain. 

Mental health disorders research has found that brain activity during sleep has a profound effect on our mental and emotional wellbeing.
It used to be thought that poor sleep was a symptom of mental health disorders but now the evidence is saying it is mental health disorders that can be a symptom of poor sleep. 
Both sleep and mental health are very complex issues affected by a multitude of factors, 
But, considering how closely intertwined the two are, there is reason to believe that getting adequate amounts of sleep can have a very positive effect on your mental health.


So now we know how vital sleep is for our overall health, how can we improve it? 

Prioritize your sleep and have a consistent sleep schedule! We spend so much time planning our waking life, take the time to plan your sleep. 
 
Find a night-time routine that works for you 
 
  • Try to go to bed and wake up at the same time every day. Going to bed late one night and early the next throws your circadian rhythm off balance.
  • Dim your lights 1-2 hours before bed, bright lighting can interfere with the production of melatonin. 
  • Limit screen time in the evening. The content on our devices is often very stimulating which can lead to cortisol (stress hormone) being released and the blue light from your screens may also decrease melatonin production, the combination of these two could lead to a very poor nights sleep. Set clear boundaries around your devices, such as no screens for 2-3 hours before bed. 
  • ·Have a hot shower or bath, this is both relaxing and helps to drop your core body temperature and fall asleep faster.
  • Allow time for winding down, allocate 30 minutes before bed to do something that relaxes you, such as listening to calming music, reading a book, doing some gentle stretching or yoga or mindfulness and relaxation techniques. Part of my bedtime routine includes having a chamomile tea and using a few drops of lavender essential oil that is very soothing and calming. 
  • Try different methods of relaxation or mindfulness. Instead of making falling asleep your goal, focus on relaxation. Meditation, mindfulness, breathing techniques, and other techniques such as progressive muscle relaxation can put you in the right mindset for sleep. 
  • There are also many supplements that can aid in getting to sleep and sleep quality. However, there are so many things you can try before supplementation so I won’t go into them in this blog. 
  • Keep bed for sleeping and intimacy only. You want to associate your bed with sleep, not wakefulness. So, no eating, watching screens or any other activities in bed. 
  • Don’t try to force it, stop trying to sleep when you are not sleepy. After 20 minutes if you haven’t gotten to sleep, get up and stretch, read, or do something else calming in low light before trying to fall asleep again.
  • And lastly, make your bedroom a sleep sanctuary, keep it cool, dark, quiet and comfortable! 
 
Your daytime activities also affect your sleep quality so here are some more tips on what to do, or what not do for a better night’s sleep 
 
  •  Get enough natural light exposure, especially morning sunlight as it is one of the key drivers of circadian rhythms that will encourage good quality sleep.
  • Avoid long naps during the day, they can be a handy way to regain energy during the day, but they can throw off sleep at night. To avoid this, try to keep naps to a maximum of 30 minutes and limited to the early afternoon only. 
  • Exercise daily, but not before bed. Physical activity has been shown to improve sleep quality and can reduce the symptoms of insomnia. However, high-intensity exercise later in the evening may be stimulating and make falling asleep harder. 
  • Alcohol before bed may seem to help you relax or make it easier to fall asleep, but it actually leads to much poorer sleep quality. It reduces your amount of REM sleep (the sleep that is needed for optimal restoration). Heavy alcohol consumption can also impair your breathing at night which leads to frequent waking, even if you don’t remember doing so in the morning. 
  • Avoid caffeine after midday, it is a stimulant and blocks the signal from adenosine (a crucial sleep chemical produced in your brain). 
  • Quit smoking. Nicotine has been shown to stimulate the body in ways that also disrupt your sleep. 
  • Eat dinner early. However, it is important not to go to bed hungry either. Try to eat a reasonable portion at a reasonable time with ingredients that won’t cause indigestion and negatively affect your sleep. 
 
What works for one person won’t necessarily work for another, so it’s worth trying out some different adjustments to find what helps you sleep best. You don’t have to change everything at once, even small changes can make a difference in improving your sleep. 
 
It is important to note that changing your sleep habits won’t always resolve sleeping problems and if you suspect you have a sleep disorder then you should consult with your GP to identify the underlying cause and how best to address it. 
 
If you want more help figuring out what would work for you any of the team here at HMC can help with lifestyle advice tailored to you and osteopathy can also help by calming the nervous system, decreasing tension in your body and helping to alleviate aches or pains that may be contributing to disrupting your sleep. 

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References
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Brain basics: Understanding sleep. (2019, August 13). National Institute of Neurological Disorders and Stroke. https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Understanding-Sleep

How Much Sleep Do We Really Need?
(2021, March 10). Sleep Foundation. https://www.sleepfoundation.org


Sleep deprivation
. (2021, June 24). Sleep Foundation. https://www.sleepfoundation.org


Sleep hygiene
. (2020, December 8). Sleep Foundation. https://www.sleepfoundation.org/sleep-hygiene 
Walker, M. (2017). Sleep the good sleep. New Scientist, 236(3147), 30-33. https://doi.org/10.1016/s0262-4079(17)32022-5

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Three common pregnancy and post-partum conditions and strategies to manage them

28/1/2022

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By Ramona Packham
​
Pregnancy demonstrates the body’s incredible ability to adapt to change, nurture growth and produce life
. As a baby grows, the mother’s body changes to create more space. Organs get squashed, the diaphragm moves up, the rib cage widens, the muscles of the back work overtime to compensate for the muscles at the front being stretched, the curves in the spine increase, and the pelvic floor takes on an increasing amount of downwards pressure. Given all these wonderful changes, it is not surprising that some pregnant and post-partum women experience conditions that can cause discomfort, pain, stress, and anxiety. Incontinence, separation of the abdominal muscles, and scarring are three of these conditions, and there are strategies available to assist in recovery.
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The Pelvic Floor 
​

Let’s revise an important structure relevant to these conditions, the pelvic floor. Have you ever been told to strengthen your ‘core’ muscles? A lot of people perceive this as the six-pack muscle between the ribs and pelvis. While this muscle forms part of the core, it is just one piece in the puzzle. Think about your core as a cylinder. The broad diaphragm muscle that allows us to breathe forms the roof, and the pelvic floor forms the floor, hence its name! The pelvic floor supports the bladder, uterus, and bowel, and facilitates the birthing process.  As a baby grows, the downwards pressure on the pelvic floor increases. The pelvic floor also works to maintain continence, and functions hand in hand with the abdominal muscles. In the pregnancy and post-partum population, the pelvic floor creates a passageway for the baby to move through in birth and helps to maintain continence afterwards.

Incontinence
​

Approximately 33% of women experience bladder or bowel incontinence after giving birth. While this is an outcome for some pregnant women, it is not inevitable, and it is recoverable. If you suffer from incontinence, seek help.  

​The health of the pelvic floor affects both bladder and bowel continence. The pelvic floor can be weak and underactive or tight and overactive and both can lead to incontinence and produce similar symptoms. If you have a weakened or underactive pelvic floor, symptoms include the feeling that you just can’t hold on when needing to go to the toilet, or accidentally losing control over your bladder or bowel. On the other hand, if your pelvic floor is tight or overactive, you might experience painful sexual intercourse, pelvic pain, straining when going to the toilet, constipation or a feeling of incomplete emptying, or stress incontinence when participating in certain types of exercise, coughing, sneezing, or laughing, 


It is important to find out the type of incontinence and the reason for it as this will be a guide to the most effective management. Many women recover from incontinence following pregnancy without doing anything specific, as the tone of the pelvic floor often improves by itself over time.

However, there can be residual weakness and recovery can be enhanced with the implementation of simple, time-effective techniques, including pelvic floor and postural work. Postural changes can reduce leaking in women with stress incontinence. Some postural elements a health professional will assess include:
  1. The pelvic floor
  2. Head and upper back 
  3. Diaphragm
  4. Abdominal muscles 
  5. Gluteal muscles and pelvis
  6. Hip muscles 
  7. Feet
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Diastasis Recti
​

A diastais recti (DR) is a separation of the large ‘six-pack’ muscle in the abdomen where it joins in the middle of the trunk at a line called the linea alba, a sheet of connective tissue between the muscles. A DR can also be linked to weak pelvic floor muscles. Some separation is normal in pregnancy, and it occurs as the uterus grows and the abdominal muscles stretch. 100% of women have some diastasis at their due date, but most resolve within 6 weeks post-partum. 39% will still have some diastasis 6 months post-partum, and these women are more likely to have urinary incontinence. A DR does not need to be a lifelong condition, they can resolve with time and management.
 

The linea alba requires some training to repair, just like muscles need to be strengthened after injury. The aim is to activate the deep abdominal muscles and pelvic floor, and then to improve the relationship between these groups. This can be achieved through practicing specific exercises. When completing any exercise with a DR, it is important to monitor for bulging in the space of the DR as this indicates that the muscles may not be contracting as well as they could be. 
 

Practice: Observe how flat your abdominal muscles are. Tense your abdominals using your hands to feel what is happening. When you contract, your abdominals should stay nice and flat, and there should not be any bulging outwards. 
​

It is likely that during pregnancy you will need to reduce the amount of exercise, or the load used during exercise, to regulate the pressure going through your abdominal wall. It is especially important for women who have been pregnant in the past to reduce the amount or load of activity earlier on in their pregnancy as the linea alba has been stretched before and will fatigue faster compared to women who are pregnant for the first time. Continue exercise and abdominal work, but do not challenge the body to extremes. Recovery is a marathon, not a sprint!


Get help from a pelvic health professional
​

Pelvic health specialists strongly recommend women to have their pelvic floor assessed and rehabilitated following childbirth. Professionals like osteopaths, women’s health physiotherapists, pelvic health physiotherapists and clinical Pilates instructors can complete these assessments and prescribe a range of specific exercises and therapeutic techniques to suit your body in its recovery. They also assess the position and movement of your rib cage, spine and pelvis which work together to facilitate optimal contraction of muscle. 
Seeking help from these professionals will facilitate your body’s natural healing, prepare for optimal results from exercises, and provide relief from pain and discomfort.

Further recommendations on managing incontinence and DR include:
  • ​Begin core and pelvic floor program
  • Modify exercises and activities if it causes abdominal bulging
  • Physical activity during pregnancy
  • Recovery compression shorts: check out this Australian brand About Us – SRC Health
  • Bowel health: 
  1. ​​Breathe while you push
  2. Fibre and water are your friends ​​
  3. Use a foot stool to put the digestive tract in a better position to pass number two
C-section scars and stretch marks: may contribute to mild pelvic discomfort 
​

In Australia, approximately 36% of women giving birth deliver through caesarean section (C-section). Before we discuss the residual scarring following a C-section, let’s talk about fascia. Fascia is often described as the glad wrap of the body, as it forms a covering over our muscles and creates a smooth pathway for vessels to travel through. Fascia is an important structure in the abdomen, where it holds organs in place and allows them to move freely. When we have scars anywhere in our abdomen, pelvis or even our back, the fascia can become tight and pull organs in different directions making them less movable. This may be interpreted in the body as pain, restricted movement, and a reduction in overall function. Thankfully, the body possesses extraordinary self-healing properties that can work to reduce fascial pulling that occurs with scarring, and aid recovery. 
​

Osteopaths use hands on therapy to treat scarring from C-sections and other surgical procedures frequently. One of the best things about scar tissue recovery is that some techniques can be done by yourself. Anytime. Anywhere. If you live with family or friends, you can even teach them to apply these techniques for you (less work for you, more fun for them). 
Scar tissue massage is easy to learn and may deliver great results with a little bit of commitment.

Here are three ways you can begin your scar tissue massage:  
  1. Friction: Use two or three fingers to contact small sections of the scar at a time. Gently but quickly rub forward, backward, and up and down, over a small section of the scar at a time. This technique aims to break up any sticky sections created by the scar. 
  2. Scar balancing: Using two hands, place two or three fingers above and below small sections of your scar at a time. Play around with the skin and underlying fascia overlying the scar and feel which directions it feels free to move, and which directions it feels stuck. Experiment moving up and down, side to side, clockwise and anti-clockwise. Try your best to follow the tissues under your fingers into the directions it feels easiest and hold that point for 90 seconds. Repeat this process along the entire length of your scar. 
  3. Deep massage: Use the palm of your hand and press a little deeper into your scar. Start on one end of the scar and slowly glide the palm of your hand along the scar’s entire length. Repeat this process slowly over about 90 seconds.  This technique may also help to relieve discomfort in the pelvis.
Exercise during pregnancy
​

Physical and mental health are key to a positive pregnancy and post-partum experience. Participating in regular, moderate intensity exercise is recommended during all stages of pregnancy for reasons which include: 
  • Maintaining overall health and fitness during pregnancy
  • Strengthening key muscle groups in preparation for birth 
  • Preparing your body for an optimal recovery following delivery 
  • Mental health
The goal of exercise during pregnancy is to feel comfortable throughout the activity, and not to push your body’s boundaries. Remember, your heart is already working harder than usual.

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Mind health
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The emotions tied to pregnancy and post-partum recovery can be overwhelming and difficult to manage. Connecting with people you trust is a great way to build a supportive network. One in five expectant women and one in ten expectant men experience anxiety and/or depression during pregnancy and in the first years of parenthood, which is why organisations like Perinatal Anxiety and Depression Australia (PANDA) have been established.  PANDA offers Australians a National Helpline and other resources that can be found on their website to aid recovery. 
Their helpline is available on 1300 726 306 Monday-Friday, 9am-7:30pm (AEST). 
The PANDA website may be accessed through this link  PANDA - Perinatal Anxiety & Depression Australia


Other local businesses that may be helpful during the pregnancy and post-partum period: 
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Secrets from the Honey Tree Secrets from the Honey Tree – Eumundi Traditional Health and Healing Centre located in Eumundi 
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Pelvic health Physiotherapist, such as Pre and Postnatal Care (alchemyinmotion.com.au) located in Noosa
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Kirby's Go-to Anxiety Tool Kit

10/12/2021

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By Kirby Edwards
​
Hi HMC team!

Recently I have been having a few discussions about anxiety and stress.

So, I thought I would share some of my tools that I have in my tool kit. Please note, I am not a psychologist, doctor, counsellor, or psychiatrist. This is my ever-growing tool kit (and am open to more suggestions, the more tools the better!)
​
If you feel like you need a little extra help, there are resources available including counsellors, psychologist, psychiatrists, lifeline, beyond blue and your GP. Your GP is the best avenue to pursue counsellors, psychologists and psychiatrists. And Lifeline and Beyond Blue are fully staffed with 24-hour hotlines


So what is Anxiety..?
​

Anxiety is our body’s way to alert us to danger. Short term it is a good thing because the body releases hormones that stimulate our sympathetic nervous system (fight or flight) and helps us to react to fearful or stressful situations quickly. Short term this is amazing! Long term, it is not ideal. Anxiety is a unique experience and can feel different for everyone. Some people may not have ever experienced it and some people may experience it but not know what it is. Be kind, you never know what someone is going through on the inside.  

While there are different types of anxiety and it is very individual, beyond blue talks about some common signs and symptoms including:
  • “Physical: panic attacks, hot and cold flushes, racing heart, tightening of the chest, quick breathing, restlessness, or feeling tense, wound up and edgy
  • Psychological: excessive fear, worry, catastrophizing, or obsessive thinking
  • Behavioural: avoidance of situations that make you feel anxious which can impact on study, work or social life”
Here are some tools that may help you if you are experiencing any of the symptoms of anxiety:
Breathe
Breathing is your best friend, and a necessity. We know that our body is so clever that we can breathe without thinking, but when was the last time you took a conscious breath? Sometimes we forget to breathe or might find yourself even holding it. Let it go… a nice slow exhale. A deep breathe in and doubling your exhale stimulates your vagus nerve, which is a branch of your parasympathetic nervous system also known as our ‘rest and digest’ state. This will help to steer you away from the elevated ‘fight or flight’ mode (the sympathetic nervous system) that we are in when we are stressed/anxious. Check out other HMC blogs for more information on the benefits of breathing.  There is also a great book called “Breathe” by James Nestor that has lots of great info.


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Hand/finger Breathing
A great one for kids and adults alike. Hold up one hand in, stretching the fingers out. We are going to trace our fingers with our other pointer finger. Start at the thumb and trace it slowly from the bottom to the top of the thumb as you BREATHE IN, when you get to the top, trace the thumb slow down as you BREATHE OUT. Repeat this all the way along the fingers – repeat on the other hand if you need to.

Journaling
Either writing or use your voice memos on your phone. Sometimes we just need to get our thoughts out of our head to remind us you are not your thoughts, it is feelings, and what you feel is valid, but feelings will pass. 


Feel Good List
When you are feeling good, write down a list of things that you enjoy or that make you feel good, then when you’re not feeling great you can look at the list and pick something… For some of us at HMC it’s nature, surfing, yoga, breathing, nature, music, swimming or hugging our kids/grandkids or a tree…
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Move
Movement or exercise can help you get out of your head… it releases good endorphins which can help shift your mood. The benefits of exercise/movement are epic. I say move because it doesn’t matter what you do, just start. Research has shown 10 minutes a day is helpful to shift your mood. That’s 3 songs if you like dancing, about 1 kilometre of walking, sweeping and mopping the floor (or half of it if you have big house), parking a bit further away to walk to the shops. Get creative but get moving. Try it! Sometimes I like to walk and talk into my voice memos, there is a feeling of moving forward from whatever is going on at that time for me.

Sleep
Taking care of your physical health supports your mental health as well. Due to the many aspects of sleep and anxiety, getting better sleep may help combat feelings of anxiety. Examples of possible changes include, building healthier sleep habits/hygiene, limiting stimulants such as caffeine and alcohol, relaxation techniques or breathing. Previous blogs on our HMC site include information the importance of sleep and sleep hygiene/routine and boosting our immune systems. The implementation of these small but powerful habits can have a big impact on how your body/mind responds to stressful situations.
Diet
Research has been shown that a healthy diet can assist with anxiety. A poor diet, which consists of foods with high sugar, salt and fat content, highly processed and low nutritional value, could lead to an increased risk of experiencing anxiety (amongst other things). Eating a balanced diet including fresh fruit, vegetables, whole grains, limited fat dairy, lean poultry and meant, legumes, seafood, nuts and delicious healthy oils can help to minimise anxiety. 


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Alcohol and Caffeine
These guys get their own tab. Alcohol is a depressant and caffeine has a half-life of 3-7 hours and as a result may make it difficult to sleep if consumed too late. I generally cannot have full caffeinated coffee after 11.30am to 12 noon. Due to the characteristics of alcohol and caffeine, they can aggravate anxiety or trigger panic attacks in certain people. Limit the intake, switch to decaf or try some alcohol-free or low alcohol options as an alternative.

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Self-talk or Observing your Thoughts

Negative self-talk can be a challenging cycle to break or shift to a more positive self-talk. One way to do it is to think of what you might say to a child or to a dear friend that is having a hard time. Also, a reframing of the language can help to shift your perspective to understand that is not going to be forever. For example, instead of “I have anxiety, it’s just the way it is” we could try “I am experiencing some anxiety at the moment, it will pass. I will breathe and look for some tools to manage it.” Or instead of “I should not feel like this” try “I am learning how to manage this”.
​

If this is interesting to you, it might be worth looking for a counsellor/psychologist etc, that works with Cognitive behavioural therapy (CBT) or Acceptance and Commitment therapy (ACT). By observing your thoughts, you can start to correlate triggers or patterns. This can be helpful to mitigate anxiety. For example, if I know I have a stressful situation coming up, I exercise beforehand. Over the years of trial and error, I have found that by exercising beforehand, I have a better handle on the situation, and I am more likely to respond, rather than react. 

Another question to ask yourself is “is it mine?”. We can sometimes find ourselves getting caught up in other people’s emotions/stresses etc. This is a very compassionate and empathetic way to be, however, is it really necessary to carry other people’s anxiety/stress around as well? This self-questioning is NOT a blame game, this is just a reminder to take a moment, a deep breathe and ask if this emotion is yours, if it is not than it is ok to let it go. If it is yours, then breathe again.


Supplements that can support
Some handy ones I keep in my handbag include - Emergency Bushflower essence, bach flower or rescue remedy drops, ashwagandha tablets, lavender oil. You should always speak to your doctor or health professional before starting on supplements as they may interact with certain medications
and may be toxic to the body in large quantities and/or may not be suitable for you for various reasons.
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Take some time for you
You cannot pour from an empty cup, so what fills up your cup? Is it the soul nourishing humans you need to make a call to or is it that walk around the block that you missed to keep you grounded. Refer to your list of “feel goods” if you need to.

Communicate with your family, friends, and your Team 
Reach out if you need to, chances are you know someone else who has also experienced anxiety to some level. One of the phrases I use is “Hi friend. I am currently experiencing some anxiety, could you please listen to me, I do/don’t need someone to solve my problem right now, I need someone to listen.” This statement may rustle a few feathers at first but the direct way of communicating means that person is aware of what you need right now in your current situation. There is no guessing. Not everyone has experienced anxiety and as it is such a unique experience, some people don’t know how to help when you reach out. If you are reaching out to them, it is likely they love you and will want to help. Try not to be shy about what you need at that time.
Counting
Sometimes counting can be helpful. Counting to 10 while taking some deep breathes can sometimes be a quick change from reactive to responsive.
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Gratitude
Benefits of gratitude include enhancing mood, positive emotions and thoughts, better communication, improved physical health (including sleep) and more!
This r
esearch has found that our brain releases dopamine and serotonin, which are two feel ‘good’ neurotransmitters when we express gratitude. In some studies, it has also shown to reduce pain and release toxic emotions. Sometimes I forget this, so for me to be accountable, I recruit a friend, at the end of each day we text each other 3 things we are grateful for… Eg. “Hi friend, today I am grateful for fresh water, friends and my dog”. I have some friends that do it with their children at the end of the day.

Meditation
Even just 5 minutes a day can make a difference – take that 5 minute of your screen/scrolling time and meditate instead… My favourite is ‘yoga nidra’ on you tube. A previous HMC blog is about Progressive Muscle Relaxation, which is also a goodie!

3-3-3 rule 
Look around you and name three things you can see, three things you can hear, three things you can feel. Also do a quick body scan and unclench anything that is clenched. Some common ones are your shoulders, jaw, pelvic floor or hands…
Stay hydrated!
If we are not hydrated enough, it can lead to restlessness, poor concentration, low energy and agitation.
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Superman Power Pose
Ok, this one is a bit far out but try it, do it on your own if you like but this pose – standing with your feet hip distance apart, hands on hips, chest out and eyes forward or slightly looking up – can help shift your mood.

Podcasts
There are a lot of good podcasts out there, take it all with a grain of salt and trial a few to see if they help. Some of my favs include the Huberman Lab, the Mindset Mentor, Ted talks, anything by Brene Brown, oh also sometimes you just need to laugh – so throw a funny one on and laugh until you feel lighter!

How can osteopathy help?

The mind-body connection is undeniable. Even for people who don’t experience anxiety, even just listen to your body when you are nervous about something or excited? Butterflies? Sweaty palms? Increase in heart rate? That’s your body responding to your mind.  
​
Some of the principles of osteopathy include:
  1. The body is a unit; the person is a unit of body, mind, and spirit.
  2. The body is capable of self-regulation, self-healing, and health maintenance.
  3. Structure and function are reciprocally interrelated.
  4. Rational treatment is based upon an understanding of the basic principles of body unity, self-regulation, and the interrelationship of structure and function.
As you can see, we want to look at the whole body and will often send you away with homework as the work doesn’t stop when we are done on the table. 

With regards to anxiety, Osteopathy can help with working on:
  • Tension headaches or jaw - Stretching connective tissue including tight muscles and fascia (especially those shoulders you wear as earrings ;),
  • Optimising your breathing mechanics (around your diaphragm and ribs),
  • Digestive problems – if that ‘rest and digest’/parasympathetic nervous system is not at play, then the digestion can sometimes be different presenting as constipation or diaherra, a loss of appetite, nausea or cramps and bloating. 
  • Posture – sometimes anxiety can lead to lack of self-confidence and it may manifest in your posture. Hunched forward etc. In this predominately forward flexion world (work, driving, couch, phones etc) we do not need any other additions to make are hunch over. This posture may result in sore neck, back, shoulders, headaches just to name a few.
  • Ultimately, we will work to optimise your structure and function so that your body can do what it knows how to do best. Keep you going! We can work with you and your nervous system with a variety of techniques for the vagus nerve which is a key player in our parasympathetic nervous system.
Some previous blogs have some information that may be helpful including a progressive muscle relaxation, breathing, sleep and the lymphatic system… oh who am I kidding, they are all GREAT reads ☺

Remember you are worthy, you are not your thoughts and it will pass. 

You can only control what you can control, try not to spend too much (if any) time in the what ifs, and more time in gratitude. 
You don’t have to stay in this state of anxiety, it is often treatable. It is just a matter of exploring the best fit for you. Some of these lifestyle changes listed here may be enough to help. Or you may need to seek more help from the below resources or your GP or a counsellor. There is help available. 

Take care and be kind to yourself (and each other).
​

Cheers Kirby ☺
Resources
https://www.blackdoginstitute.org.au/resources-support/anxiety/ 
https://www.beyondblue.org.au/the-facts/anxiety/signs-and-symptoms
https://www.lifeline.org.au/get-help/information-and-support/anxiety/ 


References and further resources below:
https://www.hmcosteopaths.com/blogs 
http://www.thecalmcorner.com/2018/11/material-share-monday-5-finger-breathing.html 
https://positivepsychology.com/neuroscience-of-gratitude/ 
https://www.facebook.com/totalbalancehealth/photos/happiness-chemicalsim-sure-you-have-heard-about-all-these-different-chemical-com/3301269156585465/ 
https://dietitiansaustralia.org.au/wp-content/uploads/2016/07/NR06_pg014-anxiety-Tania-Matthewson.pdf 
https://www.sarahwilson.com/2017/01/interrupt-anxiety-with-gratitude/ 
https://www.sleepfoundation.org/mental-health/anxiety-and-sleep 
https://blog.ted.com/10-examples-of-how-power-posing-can-work-to-boost-your-confidence/
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The lymphatic system - Clearing the body’s Sewerage System to promote natural immunity

1/12/2021

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By Angus Nichol
​
​Over the past couple of years, it has been impossible to escape the all-encompassing
pandemic we’re currently living through. There has been a lot of emphasis placed in the
media about the importance of vaccination to protect us against coronavirus, but there has
been limited information given about how we can support our body’s immune system to give
us the best chance of fighting it off… well, any type of infection. This may be particularly
important as restrictions start easing and the promise of national and international travel (for
people and the viruses they carry) becomes more realistic.
​​The lymphatic system can be thought of as the body’s “sewerage system”, and it plays an important role in enhancing and facilitating the function of the immune system, as well as other important roles in maintaining fluid balance and aiding the absorption of dietary fats for metabolism and storage. However, this blog will focus on the lymphatics system role in immunity, how osteopaths and other health professionals can support your lymphatic and immune health, and other ways that you can keep your lymphatic (and immune) system strong enough to fight off whatever potential invaders life throws at us!
 So… what is the lymphatic system?
​ The lymphatic system is a division of the body’s circulatory system that is separate, but also closely related to the vascular system. It consists of a network of lymphatic vessels and nodes, as well as various organs that have specialised functions. The lymphatic system helps protect the body against infection by producing white blood cells called lymphocytes, which help the body fight off disease-causing microorganisms. The organs and tissues of the lymphatic system serve as major sites of production, differentiation, and proliferation of two types of lymphocytes—the T lymphocytes and B lymphocytes (aka T and B cells). Although lymphocytes are distributed throughout the body, it is within the lymphatic system that they are most likely to encounter foreign microorganisms. Here are some of the major components:
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​Bone marrow - The bone
marrow it’s the soft, squishy
substance inside the hard outer
casing of the bone. All
lymphocytes derive from stem
cells in the bone marrow. Stem
cells destined to become B lymphocytes
remain in the bone marrow as they mature,
while prospective T cells
migrate to the thymus to undergo
further growth.

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Thymus - Your thymus sits in the upper part of your chest ,just behind your sternum and in front of the heart. This is where T lymphocytes (T cells) proliferate, differentiate and mature.

Picture
Spleen - The spleen sits behind your lower ribs on the left side. One of it’s main functions is that it acts as an interface between the vascular and lymphatic system, bringing blood into contact with lymphocytes. Both blood and lymph (lymphatic fluid) contain specialised cells that aim to identify, destroy and remove disease-causing microorganisms.

Picture
   Tonsils - Humans have three sets of tonsils. The tonsils at the back of our
   throat that we think of are known as palatine tonsils, however we also have adenoids and
lingual tonsils. These act as security guards to ward off any nasty foreign intruders trying to
enter the body through the mouth and nose. They also contain B and T cells used to fight
infection.

Picture
​Lymph nodes - The lymph nodes, or lymph glands, are small, encapsulated bean-shaped structures composed of lymphatic tissue. Thousands of lymph nodes are found throughout the body along the lymphatic routes, and they are especially prevalent in areas around the armpits (axillary nodes), groin (inguinal nodes), neck (cervical nodes), and knees (popliteal nodes).

Lymphatic vessels - The lymphatic vessels connect all the lymphatic organs to form the
plumbing or sewerage network in your body. They transport fluid away from tissues and are similar to blood vessels, but they don't carry blood. The fluid transported by lymphatic vessels is called lymph. Lymph is a clear fluid that comes from blood plasma that exits blood vessels at capillary beds.This fluid becomes the interstitial fluid that surrounds cells. Lymph vessels collect and filter this fluid before directing it toward blood vessels near the heart. It is here that lymph re-enters blood circulation. Lymphatic vessels from various regions of the body merge to form larger vessels called lymphatic trunks. The major lymphatic trunks are the jugular, subclavian, bronchomediastinal, lumbar, and intestinal trunks. Each trunk is named for the region in which they drain lymph. Lymphatic trunks merge to form two larger lymphatic ducts.

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How can your Osteopath help?

So, now we know what the lymphatic system is and how it works… but how can your local
osteopath treat the lymphatic system, and aid your immune system? I’m glad you asked.
Two of the main principles of osteopathy is that structure governs function, and that the body
works as a unit. Lymphatic vessels may be squished by overlying musculoskeletal structures
such as tight muscles and fascia (connective tissue), much like standing on or running over
a garden hose. Furthermore, stiff joints may may cause kinks in these internal hoses and
reduce our mobility, thus restricting the flow of lymph through our sewerage system.

Osteopaths can assess where there might be be lymphatic blockages present. We can then
use a variety of soft tissue/massage, joint articulation and other movement based techniques
to relieve the pressure on lymphatic vessels and clear the blockages in our plumbing system. This will encourage the free flow of lymphatic fluid, thus increasing the circulation of all those
disease-fighting cells around the body. Furthermore, osteopaths may also manipulate the
connective tissues surrounding organs (for example, the spleen or tonsils) to encourage
optimal function of these organs.

Pretty cool, huh?

But guess what… there’s plenty of other health professionals who can help
in treating the lymphatic and immune systems. GPs are the gatekeepers of serious disease,
and they may prescribe you with medications or send you off to a specialist specific to your
immune condition. Naturopaths, Traditional Chinese Medicine (TCM), Acupuncture and
Kinesiologists can be invaluable alternative therapies that may help you to assess
vitamin/nutrient deficiencies and prescribe natural alternatives to pharmaceuticals and/or
supplements to help boost your immune system for prevention and treatment of immune
conditions.

Even though there are plenty of professionals out there who can help, in the end it’s YOUR
body and YOUR immune system…
and guess what, there are some simple and effective
ways to optimise your own immune and lymphatic health. Vaccination isn’t the only way to
fight disease.

​Let's start with the simple things that you may already be practicing in your everyday routine...  
  • Eating a healthy and well-balanced diet
  • Trying to drink 2-3L of water per day,
  • Ensuring you get at least 7-8h good quality sleep
  • Trying to do 30-60 minutes of exercise per day
  • Exposing your arms and legs to 15-20 mins of sunshine per day
  • Being creative 
  • Staying connected with nature and other people are all ways to help support your natural
        immunity.

This seems like a lot, but each thing you do has an additive effect in enhancing
your immune system health and overall wellbeing. So, start with something small and try to
make it a habit, and then add more good habits over time!
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​Do you want to know a few more specific ways to promote your lymphatic function…? I got you!
Swimming, yoga, dancing and trampoline all use gentle (and sometimes less gentle) full body movements that can help release tension in your muscles and fascia,
improve joint mobility and encourage lymphatic flow through your body. Furthermore, regular
breathwork (see my previous breathwork blog for beginners) can help the body’s primary
pump (well… maybe after the heart) to get you up and moving.

Furthermore, there are a wide variety of supplements that are available to help support the
immune system. You should always speak to your doctor or health professional before
starting on supplements as they may interact with certain medications, can be toxic to the
body in large quantities and/or may not be suitable for you for various reasons. Here, I will
focus on three supplements which may help support the body’s immune response to
coronavirus.

Vitamin C - An antioxidant and free radical scavenger that has anti-inflammatory properties,
helps strengthen blood vessels and influences cellular immunity that may help to protect
against infection. Good dietary sources of Vit C include broccoli, capsicum, potatoes,
tomatoes, citrus fruits and many more!

Vitamin D - Vitamin D has been theorised to be a protective against coronavirus. One study
found that regular Vit D supplementation was associated with 34% less chance of COVID-19
infection. Sun exposure helps your body to naturally create Vitamin D, so spend a bit of time
(but not too much) soaking up some rays.

Zinc - Zinc may help prevent COVID-19 from entering the body through three complex
mechanisms; it may also directly prevent the ability of the virus to replicate; and also helps to
balance out the immune system’s reaction to coronavirus.

So, whether you’re trying to avoid COVID-19 infection, trying to prevent side-effects after
vaccination or boosters, or just want to support you general well-being… visit your local
osteopath or other healthcare practitioner and ask how they can help you to support your
own immune and lymphatic systems! Stay healthy and stay happy!

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Foot or Heel pain? It could be Plantar Fascitis

24/9/2021

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Picture
By Sam Dyer
​
Do you suffer from foot/heel pain...?
​

​Could it be Plantar Fascitis?

Firstly, what is Plantar Fascia?

​Plantar fascia is connective tissue that starts from the middle of your heel and inserts into the different tendons of all five toes. It is a really important structure to ensure that you are using your foot correctly, it has crucial role in keeping the foot stable during all types of movement and plays a role as shock absorber. 


The plantar fascia, for many reasons, can become damaged. Most commonly by repetitive stress (micro trauma) when this happens the plantar fascia becomes strained/ stretched or inflamed it is labelled plantar fasciitis. It is one of the most common causes of heel pain!! 

How do you know if you’re suffering from plantar fasciitis? 

There are numbers of ways that it may present, so if you are suffering from heel pain, I’d recommend coming in and seeing one of our osteopaths to help you get to the bottom of your pain, but, there are a couple of things that you can look out for that might point you in the right direction. 

  1. Heel pain, particularly first thing in the morning or after long periods of being off your feet eg. Sitting at a desk chair at work for an extended period of time. 
  2. Noticing a restriction in range of motion in your ankle particularly with a movement called dorsiflexion (trying to point your toes back towards your body) 
  3. Pain is usually more uncomfortable when on hard surfaces or having to climb stairs 

What can you do at home to help relieve some of your pain? 

Whilst there are some practical things you can be doing at home to assist with your plantar fasciitis, for long term recovery it is important to get to the bottom why the plantar fasciitis occurred in the first place.

​As I mentioned in the previous paragraph that’s were our osteopaths can be super beneficial in helping assist with your diagnosis. However here are a few things that may assist in pain reduction and can be great place to start! 


  1. Using a golf ball/ frozen bottle of water/ spikey (massage ball), place it underneath the foot and whilst putting pressure through the foot (not too much) roll it around underneath the foot. 
  2. Using some calf stretches (google 'Foot to Wall Stretch' for a great calf stretch) 
  3. If tolerable also strengthening the calf by simply doing some calf raises 3x10 per day can also be effective 
  4. Wearing slipper or comfortable shoes around the house, particularly if the house is predominantly tiled floor!

If any of these causes more pain then its best to cease immediately and seek some further advice/ treatment. 

If you have been struggling with any of the above symptoms for more than a week or two it’s time to get some extra assistance. That’s where any of the osteo’s at HMC can HELP YOU, osteopathic treatment can be extremely effective in assisting anyone suffering plantar-fasciitis. 


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