Confused on a higher level..

I've been on a bit of a training roller coaster the last six weeks and have ended up slightly more confused than when I started!

The courses were held at CPDO in London and the participants were a mixture of Osteopaths, Physiotherapists and Massage Therapists.

The first two courses: Functional Stretching and Managing Shoulder Conditions were taught by Eyal Lederman. Eyal is an Osteopath, co-director of an MSc in Manual and Physical Therapy in Musculoskeletal Health at University College London (UCL) and is one of the Directors of the CPDO. He likes to stir things up a bit! From looking at research over the years Eyal's core beliefs (put very simply) are:

Stretching doesn't work
Bad posture doesn't mean you are going to end up in pain
Weak core muscles do not contribute to back pain
Eyal teaches a lot of movement based techniques to help tissue adapt back to its optimum length.

For the nerds out there here are links to two of his articles:
The fall of the postural structural biomechanical model
The myth of core stability


Quite a lot to take in over a weekend when you've been taught the opposite and use all those principles every day! So I was a bit broken after that..

The third course Positional Release Techniques with Leon Chaitow helped me back into my comfort zone. Leon graduated from the British College of Osteopathic Medicine in 1960, has written over 60 books and is the Editor-in-Chief, of the Journal of Bodywork and Movement Therapies. Positional release techniques are ways to increase range of motion and decrease pain by placing tissue in a position of ease. Leon likes stretching and good posture!

A training course is a product you've bought - it may be the wrong fit, make you feel uncomfortable or you may come away thinking you can walk on water. Since I started as a massage therapist I've always struggled with what I should learn in order to give my clients the best possible treatment I can. There is so much out there for any manual therapist (Osteopaths, Chiropractors, Physiotherapists, Massage Therapists etc.) to choose from. What's becoming more and more clear to me is that there is no one technique or way of working that is the holy grail. Basically, some things work for some people and some things don't. We don't know why a lot of what therapists do works but we know that it does. 

So the main things I've learn't over the last couple of weeks are:

1) There isn't a great difference between a good Osteopath, Physiopherapist or Massage Therapist. We all 

use the techniques that we value which enable us to get results for our clients/patients. Whether that's gentle 

energy work, deep tissue massage, high velocity thrusts (cracking!) or exercise based re-hab. It all works on some level for some people.

2) Research findings shouldn't be ignored  but should not dictate how you treat. There is a lot that happens in treatments that can't be measured. To quote Queen 'its a kind of magic' (sorry couldn't resist..)

3) Having your thinking challenged is really important; however, uncomfortable it may feel at the time.

So I think I'm finally over searching for the 'one size fits all' treatment. It doesn't exist and be very wary of anyone who tells you it does!

PS - I love a good stretch and always feel better when I sit up straight!

Migraines - a game of triggers

As a former migraine sufferer my heart goes out to anyone who gets any type of regular headache. Migraines can be so debilitating - an attack can last between 4 and 72 hours and sufferers experience an average of 13 attacks each year. It's not clear what causes migraines but it has been discovered that they start in the brain with misfiring of neurotransmitters which set in place a chain reaction effecting how sensory information such as pain, light or sound is dealt with by the brain. Migraine symptoms include: throbbing pain usually on one side of the head; visual disturbances; nausea and vomiting; sensitivity to light, noise and smells.

They are many factors which can trigger an attack and for most sufferers it takes a combination of 6 or so to push you over the threshold. Triggers can precede an attack by as much as 6 to 8 hours. Examples of triggers, as identified by Migraine Action, are:

Emotional stress - anger; worry; tension; excitement; shock depression; the end of a stressful or busy time.

Physical Stress - over-exertion/tiredness; change in sleep patterns; bending or stooping; changes in routine; travelling; tension in the neck and/or shoulders.

Diet/food - lack of food or infrequent meals; dehydration; hypoglycemia; foods containing mono-sodium glutamate caffeine and tyramine;  specific foods such as chocolate, citrus fruits and cheese; alcohol.

Environmental - bright, flickering or flashing lights; loud noise; intense or penetrating smells; change of climate or weather; smoking; stuffy atmosphere.

Hormones - menstruation and pre-menstrual period; puberty; menopause; contraceptive pill; hormone replacement therapy; pregnancy (although 75% of mothers find their migraines cease in the later stages of pregnancy owing to the stability of hormone levels at this time)

Other triggers - use of sleeping tablets; high blood pressure; dental problems; eye strain; sinus problems; anything that causes pain or discomfort to the face, neck or head.

Figuring out what triggers your migraines can be so frustrating - you could have 3 or 4 triggers present all the time and then it will only take something else to come along and you may have an attack. Keeping a migraine diary is a really useful tool for working out what your triggers are.

Trigger points (knots in a muscle that refer pain to other parts of the body) in several of the different neck muscles can cause pain in the head and when palpated can reproduce the pain or sensation felt during a headache or migraine. It's well worth having an assessment by a health care professional to see if the muscles and tissue around the head, neck and shoulders may be one of your triggers (they were for me). A clinical/remedial massage therapist will be able to assess the soft tissue, treat it and provide relaxation and stress relief which could really make inroads into those migraine triggers. This is why I love massage!

The following websites provide excellent information on Migraines:
The Migraine Trust
Migraine Action
NHS Choices

Good luck in finding those triggers and zapping them!

Alice x

Posture - how's your middle?

I spend a lot of my time lecturing people about posture and how important it is. I am a total hypocrite though as I've had horrible head and neck pain today from falling asleep in a really awkward position in the armchair last night. It's no coincidence that pain often follows asking your muscles and surrounding tissue to do something they're not designed to do.

The musculo-skeletal system is basically a series of hinges, ropes and pulleys! Think of the vertebrae in your neck as building blocks and the associated muscles as guy ropes. If your neck is nice and straight and your head is not tilting upwards, downwards or to one side then the blocks are nicely aligned and there is no unnecessary tension in the guy ropes. This tension can overstretch or shorten muscles and over time the tissue surrounding them kindly holds them in their new position! This is when trigger points and tender spots are created which can cause a lot of pain. Tight muscles can also pull joints out of alignment which can increase wear and tear leading to osteoarthritis. Unhappy muscles can also press down on (trap) nerves causing a variety of symptoms. Apply this to the whole body and you can see why posture is so important.

Discussing posture and how to correct it can become extremely technical but you can't really go wrong if you imagine a hellium balloon attached to the top of your head pulling you upwards and creating more space between your pelvis and rib cage - it feels great!  Also gently slide your shoulder blades down your back.

Yoga, pilates and soft tissue therapies such as massage are great ways of re-balancing the body and helping you to correct your posture.

Here endeth the lesson!

Take a tablet for neck pain?

The world seems to have gone tablet crazy - I think I've been a bit slow joining this particular party but now I've got one I absolutely love it. I have been known to watch TV on it in the lounge because I'm too lazy to get up and switch the television on...

However, I don't know about you but mine gives me a right pain in the neck after a while. The nature of tablets means that you probably aren't sat at a desk in a nice upright position with good posture when you're using them. Even with a case that creates a wedge to tilt the screen up, if its on your lap or a table you are having to bend you head downwards which puts a strain on your neck muscles.

Here are a few things you can do after a tablet session to help look after your neck:

Its important to have good posture when stretching so stand nice and tall and imagine a helium balloon attached to the top of your head pulling you upwards

• head retractions - move your head slowly but steadily backwards until it is pulled back as far as you can manage - keep you chin tucked down and in as you do this - this will make sure that you are looking straight ahead and not tilting the head up. Repeat 10 times.
•  Retract your head and gently bend your neck to one side - ear to shoulder - and keep it there for 30 seconds or as long as is comfortable. Repeat to the other side
• Gently drop chin to chest (clasp hands behind head and use weight of arms if you can without it hurting) hold for 30 seconds.
• Finish with another 10 head retractions

Remember stretches shouldn't hurt so if they do reduce the stretch or stop. If you are getting persistent neck and shoulder pain or headaches its always best to be assessed by your GP.

Anyway back to YouTube - they must be some more dancing border terriers I've missed...

Happy 2013!

Well that's another year gone but I think it will probably stand out for many us. The Jubilee, Olympics and crazy weather all played their part. I had a fabulous 2012 not least because I married the lovely Gareth in April.

My massage practice has continued to go from strength to strength and celebrated its 6th birthday! Its a real joy supporting people with various conditions, aches and pains. Clients continue to come to me with a variety of conditions that can often be helped by easing restrictions in muscles and other soft tissue. Everything from carpal tunnel syndrome to Osteoarthritic hips, migraine headaches and lots of neck, shoulder and low back pain. The great thing about massage therapy is that you can combine therapeutic techniques with relaxation and stress relief. Treating in 60 minute sessions means that you can work holistically to make sure that the body can come back into balance. Often the site of the pain is not where the cause of the problem is. The more I treat people the more I learn about different conditions and how the body works - its exciting stuff!

Here's to a 2013 filled with health and happiness.

Alice x