Osteopathy

'Sebastian Coe wrote in an article, for the Observer Magazine, that if John McEnroe hadn't introduced him to Osteopathy, he wouldn't have made it to the Olympics.'

Osteopathic medicine, founded well over a hundred years ago, understands that if your bones, muscles, joints, ligaments and tendons are in all good structural balance, then your nervous system, circulation and therefore your whole body will function well. Osteopathic treatment does not target the symptoms only (although this is the basis of short term pain relief) but treats the underlying, abnormal structural pattern that has resulted in the symptoms in the first place.

In Britain, complementary medicine is defined as a group of diverse medical approaches, using non-surgical and non-pharmaceutical techniques to treat disease. Osteopaths are under the same rigorous government regulations as doctors, and have the same diagnostic responsibilities as a doctor- and therefore sit somewhere between conventional and complementary, and are probably best termed ‘Primary Health Care Physicians’. In 1993 Osteopathy became the first complementary health care profession to obtain statutory recognition. This means it is a criminal offence to use the title without proper training and that the Osteopath is bound by a similar responsibility for their patients' welfare as a medical doctor.

Osteopathic training is a five year under-graduate degree course, similar in structure to the medical degree. More emphasis is based on anatomy and musculo-skeletal medicine but training does include x-ray and MRI diagnosis, orthopaedics and pharmacology, alongside several thousand hours training in osteopathic techniques on both students and 'real' patients. The UK is the only country in the world that decided it would not take the title 'doctor’. This was purely a decision by the governing body.

Millions of people visit their GP every year with some 70% complaining of musculo-skeletal related problems. These might consist of, neck; back; wrist; joint; sciatic or arthritic pain whiplash injuries; headaches (including migraine type pain); pelvic dysfunction and sports injuries which are all conditions seen regularly by Osteopaths. Last year, more than 10 million patients were seen by Osteopaths and many thousands of hours were lost due to back pain alone.

Osteopaths use a wide range of techniques, from massage to joint manipulation, cranial osteopathy, exercise rehabilitation, dietary advice, ergonomics and self-management. Their patients range from the newly-born to the elderly and include such diverse groups as pregnant women and athletes.

Excerpts taken from Osteopathic Medicine by Gavin Burt. Other source: the General Osteopathic Council.

For more information contact the General Osteopathic Council 020 7357 6655 or visit their website.

Problems referred to Osteopaths

• Lower back pain (lumbar pain)
• Herniated and bulging discs (“slipped disc“)
• Sciatica
• Upper back pain (thoracic pain)
• Neck pain (cervical pain)
• Whiplash
• Headache
• Migraine: extremely bad headache: a recurrent, throbbing, very painful headache, often affecting one side of the head and sometimes accompanied by vomiting or by distinct warning signs including visual disturbances.
• Repetitive strain injury (RSI)
• Wrist injuries
• Tennis elbow
• Golfer’s elbow
• Frozen shoulder
• Shoulder dislocation (glenohumeral and acromioclavicular)
• Rib injuries incl. recovery from fractures
• Sternal pains
• Hip pain
• Pulled hamstring and other muscle tears and strains
• ITB (ilio tibial band)
• Achilles tendon tear and strain
• Sprained ankle and other sprains
• Foot pain
• Sports and running injuries

See Cranial link for mother, baby and dental.

Cranial Osteopathy - for Babies and Children

Covers the following types of problems:

• Crying babies
• Colic, sickness, and wind
• Feeding difficulties
• Sleep disturbances
• Recurrent infections
• Ear infections
• Asthma
• Sinus and adenoidal problems
• Behavioural problems
• Learning difficulties
• Cerebral palsy and other types of brain damage

Osteopathic techniques that utilise the cranial approach are very gentle and safe for babies and children. In an ideal world Cranial Osteopaths would like to see all children during the post natal period. Our approach helps to reduce some of the structural stresses and or strains retained in individual tissues following the birth process. Cherry Harris believes this to be instrumental in the development of good body symmetry and providing a template for balanced dental occlusion. The practice recommends that children be seen annually to assess potential unwanted effects of knocks, bumps, falls, etc and to ensure balance and optimal growth and development in all areas achieved for the individual child.

It is a common belief that babies and children should have no structural stresses or strains in their bodies, because they are 'so young'. The reality is very different. Birth is one of the most stressful events of our lives. The baby is subjected to enormous forces, as the uterus pushes to expel the baby against the natural resistance of the birth canal. The baby has to turn and twist as it squeezes through the bony pelvis, on its short but highly stimulating and potentially stressful journey. The baby's head has the remarkable ability to absorb these stresses in a normal delivery. In order to reduce the size of the head, the soft bones overlap, bend and warp as the baby descends. The baby's chin is normally well tucked down towards its chest to reduce the presenting diameter of the head. Many babies are born with odd shaped heads as a result. In the first few days, the head can usually be seen to gradually lose the extreme moulded shape, as the baby suckles, cries and yawns. However, this unmoulding process is often incomplete, especially if the birth has been difficult. As a result, the baby may have to live with some very uncomfortable stresses within its head and body.

What problems can Cranial Osteopathy help with in babies?

Some babies cope extremely well with even quite severe retained moulding and compression, and are contented and happy. For others it is a different story, and they can display a variety of problems. Cranial osteopathy may help with:

• Crying, screaming, irritability. The baby may be uncomfortable, with a constant feeling of pressure in the head. This may be made worse by the extra pressure on the head when lying down.
• Feeding difficulties. The baby takes a long time to feed and one feed merges into the next. They may be a 'windy' feeder. Feeding is difficult and tiring due to mechanical stresses through the head, face and throat. The nerves to the tongue may be irritated as they exit from the skull, which makes sucking difficult.
• Sickness, colic and wind. Regurgitation of milk between feeds, bouts of prolonged crying due to colic and wind. Often worse in the evening. The nerve to the stomach may be irritated as it exits from the base of the skull, which can impair digestion. The diaphragm between the chest and the abdomen may be stressed or distorted, which further compromises both digestion and the ability of the stomach to retain its contents. Stress from a difficult or fast birth can leave the digestive system in tension trapping wind. Any strain through the umbilical cord, for instance if it was around the baby's neck, can add to strains in the abdomen.
• Sleep disturbances. The baby sleeps for only short periods, and may sleep little during the day (or night!). They wake to the slightest noise and are- "jumpy". The tension on the bony and membranous casing of the skull keeps the baby's nervous system in a persistently alert state.

What problems can cranial osteopathy help with in older children?

As the child grows, the effects of retained moulding can lead to other problems. The following are the most common, but it is by no means an exhaustive list.

• Infections. Retained moulding and birth stresses take their toll on the body's reserves, and also deplete the immune system. This leaves children more vulnerable to all types of infection.
• Ear infection. Recurrent ear infections, gradually becoming more frequent. May lead to 'glue ear' and some temporary loss of hearing.
• Retained birth compression within and around the bones of the ear impedes fluid drainage from the ear with partial or complete blocking of the Eustachian tube. Infections may never fully clear, leaving a vulnerability to the next infection and a depleted immune system.
• Sinus and dental problems. Persistent mouth breathers. Constantly blocked or runny nose. Impaired growth and drainage of the sinuses and bones of the face due to retained moulding compression. Later, this increases the chance of dental overcrowding.
• Behavioural problems and learning difficulties and special needs. Poor concentration, constant fidgeting, difficulty sitting still, hyperactivity. Continuation of the restlessness as a young baby. Retained moulding compression makes them uncomfortable in one position for too long which becomes habit forming. Severe compression can modify normal patterns of learning in the brain. Severe birth trauma may be a factor in cerebral palsy, and conditions such as Down's Syndrome may involve restrictions within the head and body which can be helped with cranial osteopathy.
• Headache, aches and pains (headaches begin from age 7-8). Growing pains. Vulnerability to sprains, or other aches and pains. Retained moulding may focus areas of pressure in the skull, as the bony joints of the skull fully form at around the age of 7-8 years. Patterns of tension retained in other areas make the body more vulnerable to strain and fatigue.
• Asthma. Vulnerability to chest infections. Aggravation of all degrees of asthma from mild to severe. Retained moulding compression can aggravate a tendency to asthma. General lowered immunity leads to more chest infections. After infections, the chest remains tense and the ribs do not return to full function, aggravating an asthmatic tendency. Osteopathic techniques to release birth stresses and help to improve chest function are often beneficial in reducing the frequency and severity of asthma attacks.

Cranial Osteopathy and possible adverse reactions

Osteopathic technique using the cranial approach is gentle, safe and effective for babies and children. Very specific, skilled, light pressure is applied where necessary to assist the natural ability of the body to release stresses and tensions.

Reactions to the use of these techniques are variable. Often the baby or child is very relaxed afterwards and sleeps well. Others may experience a burst of energy, usually followed by a good nights sleep. Occasionally, children may be unsettled but this is a temporary situation, and usually clears within 24-48 hours.

Cranial Osteopathy - Pregnancy and Childbirth

Pregnancy is a unique and powerful experience. Enormous physical, hormonal and emotional changes take place over a relatively short period of time. The body has to adapt to carrying up to 20lb of baby, waters and placenta, which can impose physical strain on all the organs and tissues.

The deployment of Osteopathic techniques during and after pregnancy can be beneficial in a number of ways:

• Easing some of the physical discomforts of pregnancy.
• Preparing for the demands of labour.
• Helping the mother to recover after birth.

Discomforts of Pregnancy

Aches and pains are common during pregnancy, as the body changes shape to accommodate the increasing size and weight of the uterus. This involves considerable changes to posture. If the mother has existing back problems, or strains in her body from past accidents or trauma, it may be more difficult for her to accommodate these changes, and she may suffer more discomfort as a result.

The ligaments of the whole body soften during pregnancy due to the action of hormones. This allows the bones of the pelvis to separate slightly during the delivery to facilitate the passage of the baby's head through the pelvis. Unfortunately this softening affects the whole body and makes it more vulnerable to strain during the pregnancy.

Postural changes may cause backache, neckache, headaches, aching legs and undue fatigue. Osteopathic techniques can help the body adapt, and make the pregnancy much more comfortable.

Nausea and Vomiting

Osteopathy can help by releasing debilitating physical strains caused by vomiting, and restoring ease and balance in the body's soft tissues. Techniques to improve the circulation to and from the liver can help reduce nausea.

Heart burn

As the uterus expands, it can stretch and squash the diaphragm contributing to heartburn. Osteopaths can often reduce tension and relieve the symptoms of heartburn.

Breathing Difficulties

Postural changes through the lower ribs and spine can impede the action of the diaphragm and make breathing difficult. Osteopathic techniques to improve function of the whole rib cage allows full use of available lung capacity.

Varicose Veins and Haemorrhoids

Tension within the pelvis or diaphragm area can increase resistance to the return of venous blood to the heart from the lower half of the body. This can cause or aggravate varicose veins in the legs, and haemorrhoids.Patients report that the release of tension in the pelvis and diaphragm regions is helpful in the prevention and treatment of these conditions

Threatened Miscarriage

There are many reasons for miscarriages, and many are not preventable. In a relatively small number of cases physical limitations in the mother's body make it difficult for her to carry a pregnancy beyond a certain stage. This may cause repeated miscarriages at a similar stage. Osteopathic techniques may assist in stabilizing a pregnancy and allow it to proceed to full term.

Preparation for Labour and Position of the Baby

As labour is likely to be more difficult if the baby is not lying correctly, it is worth trying to help them to move into a better position. The baby generally settles in a head downward position and facing backward with their spine curled in the same direction as the mother's spine. This puts the baby in the most advantageous position for passing through the birth canal during labour. As babies grow and take up more space within the abdomen there is less space for them to move about and they will find their own preferred position. The mother's posture has to adapt to accommodate the position of the baby, and if this conflicts with her own postural needs it may cause undue aches and pains. This is the reason that one pregnancy may be much more uncomfortable to carry than another. An important part of preparation for childbirth is to ensure that the mother's pelvis is structurally balanced and able to allow the passage of the baby down the birth canal.

Trauma to the pelvic bones, coccyx or sacrum at any time in a mother's life can leave increased tension in muscles and strain within the ligaments and bones of the pelvis. This can limit the ability of these bones to separate and move out of the way during labour, and thus limit the size of the pelvic outlet.

Osteopathic techniques are intended to release old strains within the pelvis, thus giving the best chance of an easy and uncomplicated labour. There are further techniques that are designed to ensure that the pelvis and uterus are correctly balanced and aligned. These can help with discomforts caused by the baby's position, and can often help the baby turn into a better position.

Self-help Tips to Encourage the Baby to Lie Correctly

• Try to keep as active as possible throughout the pregnancy.
• 'Walk tall', pushing your head upwards as if suspended by a string. Do not allow your lower back to slump into a very hollow position.
• Sitting slouched in soft chairs encourages the baby to turn into the back to back position. Where possible, sit with your bottom well back in the chair and the lower back supported. Better still, sitting on a foam wedge, or on a chair that has a seat that tilts forward, actively encourages the baby to lie correctly.
• If your baby is lying in either a breech or back to back position, then spending some time each day in an 'all fours' position can help it to turn.

Treatment after Birth

Birth can be traumatic for both mother and baby, and osteopathy can be effective at helping both to recover.

For the mother. The mother's pelvis is vulnerable to lasting strains from the forces involved, particularly after a difficult delivery. Some of these strains can have a profound effect on the nervous system, and contribute to postnatal depression.

After giving birth, the body not only has to recover from the changes it made during pregnancy but also from the effects of delivery. All this whilst doing the very physically and mentally demanding job of caring for the new baby. Caring for a baby can place enormous strain on the back, during such activities as nursing in poor positions, lifting car seats especially in and out of the car, reaching over the cot, or carrying a child on one hip.

Unresolved childbirth stresses in the mother can contribute to ongoing back problems, period problems, stress incontinence, constipation, headache and more.

Osteopathy can help the mother to return to normal, physically and emotionally, after birth by releasing strains from both pregnancy and labour. This allows her to relax and enjoy her new baby.

Baby. The baby can suffer long-lasting effects from the moulding process during birth, and an osteopathic check-up is recommended. See our page on osteopathy for babies and children.

Is Osteopathy Safe During Pregnancy?

Osteopaths are highly skilled and undergo a minimum of four years training. Gentle osteopathic techniques are perfectly safe at all stages of pregnancy. The cranial osteopathic approach is a particularly gentle way of working with the body's own natural mechanism for releasing and re-balancing tensions, without force.

Cranial Osteopathy - Dentistry

Common links with:

• Face pain
• Headache
• Migraine
• Congested sinuses
• Ear infections, blocked ears
• Neck and back pain
• Fatigue
• Poor concentration

We offer a unique interface with Dental practitioners trained in dental orthopedics in treating patients with dental overcrowding. This combined approach with an emphasis on whole body health can restore arch width and in the majority of cases avoids the need for tooth extractions.

Osteopathy is selectively poised to treat head, neck and face pain. ie. trigeminal neuralgia and jaw joint disfunctions. It has been shown to be helpful in some cases of vertigo, tinnitus and menieres disease.

The importance of the relationship between cranial osteopathy and dentistry cannot be overstated. Conditions affecting the mouth and teeth have a very direct effect on the rest of the body.

The face is composed of a number of different bones. Some of these bones are very delicate, and they are intricately linked together in a very complex way. All the bones of the face, like those in the rest of the skull, are free to move very minutely, which they do in a gentle rhythmical way. This movement between the bones is important in maintaining drainage of the sinuses, and permitting the free passage of air through the nose. Trauma to the face may restrict the normal movement between the bones, and can have very wide reaching effects in the whole body. One of the most common causes of trauma is dental treatment.

Common (dental) Causes of Stress in the Face

Extraction of teeth: The forces used to extract teeth may be transmitted through to the articulations and joints of some of the delicate bones of the face. This may strain and disrupt their normal movement. Common Symptoms are Sinus and ear problems, headache, migraine, neck or lower back pain.

The immediate pain and tenderness after an extraction can mean that one side of the mouth cannot be used for chewing, thus creating an unequal bite with resultant strain on the rest of the face, head and neck. This situation can persist if there are gaps left between the teeth, particularly if more than one gap exists.

Dentures and plates: An upper plate or denture has the effect of holding the bones of the upper jaw rigidly together, preventing or severely limiting their natural movement. Common Symptoms: Headache, congested sinuses, ear problems, eye strain.

Prevention: Plates and dentures should be removed at night to allow the face to free itself off for some hours during each 24 hour cycle.

Loss of all the teeth leads eventually to a loss of bone from the face. It is important that the correct distance or height between the upper and lower jaw is maintained. If the height of the teeth is wrong this can cause imbalance in the action of the jaw muscles and a marked degree of tension in the face and jaw. Dentures should be replaced regularly as they wear down, and may have to be built up to allow for bone loss over a period of time.

No back teeth: Occasionally people have all their back teeth removed leaving just the front incisors. If no dentures are worn, all biting and chewing is done on the front teeth. This places enormous strain on the structures of the head and neck. It almost always leads to a great deal of neck tension, causing headaches and neck pain.

Braces and Orthodontic work: Orthodontic treatment has a dramatic effect on the normal functioning of the face, and can have repercussions throughout the whole body. Enormous stresses are imposed through the bones of the face as the teeth are forcibly moved in their sockets. This restricts and disrupts normal motion of the facial bones. Common Symptoms: Headache, clicking jaw, painful joints, irritability, reduced concentration, neck pain, lowered immunity and an increased vulnerability to musculoskeletal strains.

After the brace is removed the stresses do not always dissipate, and are almost always palpable many years later in adults. Osteopathic consultation is strongly recommended BEFORE the brace is fitted, to reduce the underlying stresses as much as possible. DURING the time the brace is being worn, occasional follow-ups to help the body accommodate the additional load can reduce the secondary symptoms and also helps the teeth to move quicker. AFTER the brace is removed, osteopathic intervention is recommended to reduce its long term effects.

Bridges: Bridges generally cause no problem within the mechanics of the face. The exception is a midline bridge across the two upper front teeth. In this situation the bones of the upper jaw become permanently fixed together, which prevents normal movement between the bones. Common Symptoms: The stress induced by a fixed midline bridge will highlight any area of weakness in the body. Symptoms can be almost anything including headache, sinus or ear problems, neck and back pain, even knee and foot pain.

Clicking Jaw: Pain and clicking in the temperomandibular joint (TMJ) is fairly common. There are many causes, one of which may be imbalances and stresses through the face or teeth, and osteopaths can sometimes help.

Bruxism (grinding teeth): Many people grind their teeth at night or clench their jaw when they are concentrating or under stress. In children, night grinding may be the result of pressure in the head or face from retained birth compression. Common Symptoms: Tension, tenderness and irritability in the muscles of the face, head and neck.

How Can an Osteopath Help?

It may seem after reading this that any dental treatment should be avoided! This is definitely not the case, and much dental work is skilfully performed with the minimum of stress to the mechanics of the face. However, it does highlight the very important connection between stresses resulting from dental treatment, and the types of problems that osteopaths see. The wide subject of facial mechanics is a fascinating one which is often relevant to the patient's presenting symptoms.

Many of the above problems can be successfully treated osteopathically. Obviously if there is a dental problem that is consistently aggravating and causing stress, it is important to have this dealt with by a dentist. Osteopathic techniques used to treat strains within the face are very gentle.

We have developed a symbiotic approach with local dentist Helen Harrison, at Granta Dental, by using Cranial Osteopathy to complement the work done by Helen in treating patients with malocclusion (when teeth and jaws are not in proper alignment with each other). Using a combination of dental treatment and osteopathic therapy can be very effective in reducing stresses in the cranial bones and improving associated muscle function. Many children suffer from difficult births or trauma that lead to strain patterns that can effect facial develpment and ultimately dental mechanics and function. Some signs that may be obvious are thumb sucking, mouth breathing, ear infections and headaches.

For further details of this approach contact Alexander Taylor or Helen at Granta Dental.

Osteopathy for Sports Injuries

Sportsmen and women are increasingly seeking to resolve injuries by consulting osteopaths. Athletes from many disciplines and at many levels are seeking the osteopath’s unique combination of skills and detailed knowledge of the body mechanics. Osteopathy can help keep you at your training peak and also enable a swift return to sport following strains and overuse injuries.

In the past, sports injuries have been examined and treated as separate problems and considered in isolation from the rest of the body. Treatment has been to only the injured part. Osteopaths consider all the factors, which may have led up to and contributed to the injury: these are often just as important as the injury itself and may slow or even prevent total and speedy repair. The osteopathic approach also helps the body’s various parts to function, as they should, ‘for you and your sport’, the ‘whole’ body functions better and greater potential for improved performance is the natural consequence.

What Problems are Referred to Osteopaths?

Osteopathy is particularly suited to assisting the sportsman or sportswoman with complaints as varied as back pain and tennis elbow, or hip problems and recurrent muscle injuries.

The osteopath’s unique approach to appraising an injury as well as the wide range of techniques and approaches employed by osteopaths makes them ideal for dealing with sports injuries. When a sportsperson consults an osteopath, he/she examines the posture and condition of those parts, which make the human body a dynamic machine - these include the muscles, ligaments and tendons of all joints from head to toe.

The osteopath examines the strength and flexibility of these tissues and considers how well adapted they are to the individual sportsperson and the chosen sport. This approach is suited for both complex and/or recurrent injuries.

Injury Prevention

The osteopath’s skill in assessing the interaction between the many different tissues that combine to determine your body’s structure, to differentiate between areas of normal and abnormal function and to therefore recognise patterns that are potentially developing into sites of stress, strain and/or injury enables him/her to provide you with advice and approaches that should prove extremely valuable in helping you to recognise possible injuries before you are suffering any symptoms and, together with the osteopath, to prevent such injuries from occurring.

Mobility of the body is of the utmost importance to an athlete. Poor flexibility in the joints will prevent the body performing at its best and is often an important contributory element to injury.

By using manual techniques, the osteopath provides the body with the best environment for repair, and enables it to function at its best.

Advice on self-care is always given to maximise the effects of the techniques used and to minimise the possibility of recurrence. This may include specific exercises, technique tips, postural advice etc. Whether you’re an enthusiastic amateur or an elite professional, an osteopath can help with the prevention and treatment of common sporting injuries.

Many sports clubs at international level use the unique skills that osteopaths can offer. Currently, osteopaths are involved in Football, Cricket, Rugby, Golf, Tennis, Athletics, Swimming, Squash, Cycling, Show jumping and Hockey.

 

Dr Cathy Speed

Alexander and his team work exclusively with consultant Dr. Cathy Speed BMedSci, MA, Dip Sports Med, PhD, FRCP, FFSEM (I) (UK) where cross referral is necessary. In addition to the Directorship of Sports Medicine UK, Cathy also holds the following posts:

• Consultant, in Rheumatology, Sports & Exercise Medicine, Addenbrooke's and Cambridge Lea Hospitals, Cambridge and Hospital of St John & St Elizabeth, London
• Lead Physician to the English Institute of Sports, Eastern Region.
• Physician to Badminton England
• Physician To Middlesex CCC at the Lords Ground, London
• Physician to English Ladies Golf Association
• Medical Officer for the Centre of Cricketing Excellence,Cambridge.

We may refer patients to Dr. Speed where futher examination may be required, or more detailed diagnostics, such as X-ray, MRI scan etc. are needed.

Alexander and his team also refer to other consultants, especially Mr Graham Tytherleigh-Strong, a local Orthopaedic Consultant who is a specialist in shoulder surgery.