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Whiplash Injury

What is Whiplash?

By Helen Amembal - Registered Osteopath

Neck pain caused by whiplash is very common. According to one leading insurer, it accounts for 76% of all bodily injury claims made in the UK.

Whiplash is a neck injury caused by a sudden movement of the head forwards, backwards or sideways. Whiplash injuries need not be the result of car accidents only. It can be due to a sudden blow to the head – for example, during contact sports such as boxing or rugby, a slip or fall where the head is suddenly and violently jolted backwards or being struck on the head by a heavy or solid object

How is whiplash caused?

Normally the joints at the back of the neck glide over each other but a whiplash injury forces them together damaging the surrounding area containing nerves, muscles, ligaments and discs. The damage to the nerves can cause the most problems as they are very sensitive compared to the nerves in the rest of the body.

The pain from a whiplash injury doesn’t always happen immediately after the accident. The body can compensate in the short term for injuries and often it is not until later that pain develops. The neck pain and stiffness is often worse on the day after the injury and may get worse for several days afterwards.

Common symptoms of whiplash include:

  • neck pain, shoulder pain and stiffness
  • tenderness over the neck muscles
  • reduced and painful neck movements
  • headaches

If you experience prolonged pain, you may find it difficult to carry out daily activities and enjoy your leisure time. It may also cause problems at work and could lead to anxiety and depression without treatment.

 How can you help your neck pain?

Gone are the days of lying in bed for a week to rest your injury – GPs traditionally recommended rest for neck pain but the research now disproves that. In the beginning if your see a GP or an A&E Doctor they may give you a soft collar it may offer some relief but do not use it all day. If you become reliant upon your collar the muscles of the neck will be come weaker as their job is being performed by the collar.

I always recommend that you move around gently and regularly (within your pain limit) which improves your recovery time and strengthens the damaged area. We also recommend that our patients at home use ice and heat to help the pain and also an over the counter pain relief medication for the first 24 hours if you know it is safe for you.

If possible sleep with your spine in a straight line so make sure that pillow is not too high or that you are not using too many pillows. It is better to sleep on your back or on your side rather than on your front with your neck twisted to the side.

To prevent the whiplash pain from worsening, review the things that aggravate it triggered it in the first place such as not exercising regularly, sitting for too long and using computers or driving.

Getting the right advice and treatment is important for neck pain to resolve as quickly as possible but also important if you want to prevent it from coming back.

A note about serious Injuries. Since some symptoms of neck pain are similar to those of more serious conditions, it’s important to get checked out by a medical professional. if in any doubt you should seek help immediately.

Why back pain doesn’t ‘Just Go away’

Helen Amembal - Registered Osteopath

When my Clients use the Internet to learn about back pain they can find a common myth repeated – that back pain can resolve on its own within 2-8 weeks. But as I explain to my Clients, you’re not “healed” just because you don’t feel pain. When it comes to the most common injuries affecting the back, pain is usually the last thing to show up, and the first thing to go away.

These are the top three reasons why back pain sticks around……..

 

  1. Our muscles and brains are linked

Our nervous system changes when we are injured, say in our back. In some cases, our brains stop “seeing” the area that was injured, and research has shown that your brain stops telling your back muscles to work in the damaged area. This means that your back muscles become weaker and unable to support your spine regardless of whether you feel pain or not. Consequently, the link between your brain and the muscle and joints in the injury is altered following an injury, without treatment.

 

  1. Deconditioning

One of the common myths surrounding back pain is that you need to rest for it to get better (I talk about this in my ‘back pain myths’ post).  Lack of activity is also a key reason for the breakdown in the body’s ability to control and withstand the stresses imposed on it. Using our muscles and joints to support our posture is fundamental to preventing injuries from occurring in the first place.

Evidence has shown that poor endurance in our back muscles is a risk factor for developing low back pain – and this is an important thing that I get my patients to do; start exercises and self treatment at home to build up back strength so that their injury does not come back.

 

  1. Just because it doesn’t hurt

If we scratch our skin or cut it, we have a constant reminder of that damage through the formation of a scar. However the minute back pain goes away it is easily forgotten – there is scar tissue but we can’t see it. The scar tissue replaces the muscle fibres in your back that have been injured – but this scar tissue forms in ‘clumps’ and sticks to the muscle tissue which makes the muscle weaker. So injuries will happen in that area again and more easily. But if healing muscle fibres or joints are gently moved and stretched it encourages the scar tissue to grow stronger and prevent further injuries.

 

One way to think of it is when you put spaghetti into a pot of boiling water and then leave it without stirring, it all clumps together like a knotted up ball of string. If you add motion, like stirring the pot, you help to separate the spaghetti and keep it from sticking together. Your body is the same way: Motion is Lotion!

What causes back pain/ sciatica?

Helen Amembal - Registered Osteopath

Back pain is very common – 49% of the adult population of the UK report low back pain during any year. It’s the second most common reason people see their doctor.

Some back pain occurs due to a lifetime of bad habits. Other back pain causes include accidents, muscle strains, and sports injuries. Although the causes may be different, most often they share the same symptoms.

However as debilitating as back pain can be, most instances of it are manageable, and people who get proper care and advice often see improvement within a matter of weeks. Here we look at the main types of back pain, the causes, and symptoms and what you can do to get better.

Lower Back Strain

Is the main cause of back pain, whether short term (acute) or long term (chronic). Symptoms of lower back strain include:

  • Pain and stiffness in the back.
  • Pain in the buttocks and the legs, often in the back of the thigh.
  • Pain that worsens when bending, stretching, coughing, or sneezing.

Lower Back Strain occurs because a series of muscles and ligaments in your back hold the bones of your spinal column in place. You can strain these muscles by stretching them too far, causing tiny tears. The muscles are then weakened, so they may not be able to hold the bones of your spinal column in place correctly. The spine becomes less stable, causing low back pain. As nerves stretch out from the spinal column throughout the entire body, low back strain can cause pain in areas other than your back.

Low back strain can be caused by:

  • Extreme physical exertion.
  • Repetitive movements such as lifting, driving, bending, twisting may also result in a bad back.
  • Accidents such as a fall
  • Poor posture, especially when sitting
  • Being overweight
  • Weak muscles in your back and abdomen
  • Sitting in the same position for long periods of time.
  • Emotional stress

Keep in mind that low back strain can’t be blamed for all back pain. There are many other causes, like ‘slipped discs’, fractures, pinched nerves, arthritis, and infections.

Sciatica

Sciatica is another common type of back pain affecting the sciatic nerve, a large nerve extending from the lower back down the back of each leg. For some people, the pain from sciatica can be severe and debilitating. For others, the sciatica pain might be infrequent and irritating, but has the potential to get worse.

The Symptoms of Sciatica are

  • Pain in the buttock or leg one side side that is worse when sitting
  • Pain, burining or pins and needles in the leg or foot
  • Weakness, numbness, or difficulty moving the leg or foot
  • A shooting pain that makes it difficult to stand up

Sciatica usually affects only one side of the back and lower body. Often, the pain extends from the lower back all the way through the back of the thigh and down through the leg. Depending on where the sciatic nerve is affected, the pain may also travel to the foot or toes.

What Causes Sciatica?

Sciatica is caused most commonly by the Sciatic nerve being irritated, either by a tight muscle near to the nerve or by pain chemicals that are released in your body when you have an injury.

There are less common causes of Sciatica; narrowing of the spinal canal in the lower back, the discs in the spine losing their height through wear and tear or disease, or one vertebra slipping forward over another – sometimes due to a fracture in the vertebrae or just how the bone is formed at birth.

 Spinal Disc pain

Most patients know this type of back pain as a ‘slipped disc’ although the discs do not actually slip.

The symptoms of disc pain

Spinal discs are fibrous rings (like in a tree), containing a soft gel-like ‘cushion’ between each of the bones of your spine. Discs cannot ‘slip’ because they are attached to the spine but the term ‘slipped disc’ can mean a tear in the fibrous rings, where the gel can push through.

The resulting pressure or irritation on the nerves that exit your spine can cause pain in your back, or referred pain over an area through which the nerves pass such as your legs. Leg pain, pins and needles, weakness or numbness can be caused by nerve irritation or pressure in the lower spine.

What causes disc pain?

Although a violent injury can damage a disk, problems with disks are often brought on by the normal aging process or by everyday activities, such as lifting heavy objects the wrong way, or slips and falls. A sudden movement like this can cause the fibrous outer covering of the disk to break or distort to the point that the gel leaks out and presses on a nerve or releases chemicals that irritate the nerve.

Discs can also suffer wear and tear through normal living but research has so far proven only that genetics is a factor in this.

How can you help your back pain?

Gone are the days of lying in bed for a week to rest your injury – GPs traditionally recommended rest for back pain but the research now disproves that.

At TCHP we recommend that you move around gently and regularly (within your pain limit) which improves your recovery time and strengthens the damaged area. We also recommend that our patients at home use ice and heat to help the pain and also an over the counter pain relief medication for the first 24 hours if you know it is safe for you.

Getting the right advice and treatment is important for back pain to resolve as quickly as possible but also important if you want to prevent it from coming back.

To prevent back pain coming back, review the things that may have triggered it in the first place such as being overweight not exercising regularly, sitting for too long, wearing high heels, or sleeping on a mattress that is too soft.

A note about serious Injuries. Since some symptoms of low back strain are similar to those of more serious conditions, it’s important to get checked out by a medical professional. Any numbness and weakness in your legs, bowel and bladder problems, or pain at nighttime that is not eased by changing position can be a sign of nerve damage and is serious and could lead to paralysis so if in any doubt you should seek help immediately.

How to ease your back and neck pain in 15 minutes

By Helen Amembal - Registered Osteopath

I am so impressed with the Mobiliser that I have bought one for my Clients to use at the Claygate Clinic. The Mobiliser is also used in Professional sports – the GB Cycling Team, Sir Steve Redgrave and Golfers such as Bernard Gallacher.

Bernard wanted to tell his story to the Mobiliser manufacturers as it helped him to fight a career-threatening back injury:

“In late 2004, just before I went out to commentate on the Ryder Cup, I experienced agony throughout my back. An MRI scan confirmed a prolapse [‘slipped disc’] at C5 [neck]. My Consultant said it was going to be a two year recovery period, which left my golfing career at great risk”

“As luck would have it I found the Mobiliser. I was sceptical that it could help. My first experience of using it was very uncomfortable, [but] I’d been prewarned that it might hurt, so I persevered, and within two or three days of using it the Mobiliser no longer caused discomfort”

“Within two weeks the difference in my whole body was obvious, and after a month, the pain was less and my flexibility was better than it had been for years.”

“After four months I am back playing golf and I’ve begun to increase the intensity of the Mobiliser to seek further improvement. I’m looking forward to renewing my play on the Seniors’ tour later this year. I want to emphasise the sense of optimism that I have. The Mobiliser really helped the rehab from my prolapse and by combining this with [Therapists’] advice and a good Alexander teacher I am very optimistic of recovering more quickly. I feel all three are a permanent part of my regime to prevent a recurrence and to keep my back flexible”

“I’ve become aware how golfers assume that increasing age means decreasing ability. Yet I’ve found out for myself that it is possible to restore spinal flexibility. I can strongly recommend the Mobiliser! Not only to any golfer who wants to recover from back injury, but to those who find their enjoyment of this great game is limited by not being able to rotate fully and freely.”

You can book a free Mobiliser introduction session (including a postural assessment) at the Complementary Health Partnership on 01372 464659 / info@www.comphealthclinic.co.uk

Could IBS be causing your bloating?

By Ann Shaw - Nutritionist

IBS, (Irritable Bowel Syndrome), is the most common functional gastrointestinal disorder, typically characterised by abdominal pain and bloating and often constipation and diarrhoea. In my experience, I would say that one in three people consult me with a host of symptoms that are associated with IBS, including Candida Albicans. Research suggests that IBS affects up to one in five people in the UK at some stage of their life.

It can be exasperating when you have tried everything from elimination diets, the fodmap diet, the candida diet, excluding commonly known triggers such as gluten and dairy, over-the-counter remedies and many other hopeful solutions. But, one area you may have not thought to investigate is parasite infestation, the symptoms of which can mimic IBS.

Millions of people have parasites without realising, but they conclude it must be IBS. Some patients who have had a stool test from their doctor have received a clear result, as a single test may not detect the cycle of parasites when they are in a dormant egg stage. To properly explore what is happening, a group of three samples are required over a number of days, using functional laboratory testing. These tests will also detect other pathogens, which may be contributing to your overall health issues.

One patient with IBS symptoms told me that she felt permanently disorientated and could hardly walk from the door to my desk when she first came to see me. Laboratory testing confirmed she had many parasites, and it was not until we tackled these, that she regained her health again. Some parasites are very resistant and difficult to get rid of, and each requires a specific form of treatment. So attempting to treat the condition with a generic treatment, such as herbs, or antibiotics without knowing the exact strains you may be suffering from is pointless.

Parasites need tackling because they rob your nutrients and impair your immune system. Weakened immunity significantly increases the risk of infection by these unwanted organisms, and parasites are no exception. They can be transmitted surprisingly easily, from fruit and vegetables that have not been washed properly, walking bare-foot on the beach, animals, tap water, raw fish, babies nappies and food poisoning.

These are some of the symptoms associated with parasites:

Abdominal Pain & Cramps, Anal Itching, Anaemia , Nausea, Diarrhoea, Anorexia, Distension/Bloating, Overweight, Arthritis,Dysentry, Autoimmune Disease, Fatigue, Bloody Stools, Fever, Chronic Fatigue, Flatulance, Colitis, Food Allergy
Constipation, Foul Smelling Stools, Crohn’s Disease, Gastritis, Depressed Siga, Rash And Itching Of The Skin, Headaches, Low Back Pain, Inflammatory Bowel Disease, Malabsorption, Altered Intestinal Permeability, Nervousness, Irregular Bowel Movements, Irritability, Irritable Bowel Syndrome, Weight Loss, Joint & Muscle Aches & Pains, Skin Conditions, Sleep Disturbances, Rectal Bleeding, Teeth Grinding, Urticaria, Vomiting

You may be experiencing some of the above symptoms, in which case please contact me, and I will be happy to help you. My approach is to look at the underlying causes of your IBS symptoms, some of which can be Candida, Parasites, Stress, Dysbiosis, Bacterial infection or Food Allergies.

If you find yourself suffering multiple food allergies or any of the above symptoms, consider parasite infestation as a possibility.

Written by TCHP Resident Nutrition Expert – Ann Shaw  DThD.DNMed.T.A.S.K.M.BANT.NTCC.CNHC

 

For more information contact the clinic or call the clinic on 01372 464659

Study shows that Patients Do Better After Surgery If They Do ‘Prehab’ First

By Helen Amembal - Registered Osteopath

“People are often told to follow a rehabilitation program following surgery to speed recovery. But starting weeks before going under the knife might help them regain function even faster”

“So-called “prehabilitation” to prepare someone for an upcoming stressful event has been used quite a bit in orthopedic surgery, Dr. Julie Silver, a physiatrist at Spaulding Rehabilitation Hospital in Boston USA, tells NPR.org’s Shots. And there’s increasing interest in using it before cancer treatment, especially to help frail or elderly patients better tolerate what lies ahead, she says.

Researchers from McGill University in Montreal studied 77 patients scheduled for colorectal cancer surgery. A kinesiologist gave the patients aerobic exercises and strength training to do at home. A registered dietitian gave them nutritional counseling and prescribed a whey supplement to make up any protein deficits, and a psychologist provided anxiety-reducing relaxation exercises.

Half of the patients were told to start the program before surgery – an average of about 25 days before – and to continue afterward for eight weeks. The other group was told to start right after surgery.

Not surprisingly, the group assigned to prehabilitation did better on a presurgery test that measured how far they could walk in 6 minutes. And it paid off.

Two months after surgery, the prehabilitation group walked an average of 23.7 meters farther than when they started the study. Rehab-only patients walked an average of 21.8 meters less than when they started. (A change of 20 meters is considered clinically significant.) And a greater proportion of the prehabilitation group was back to baseline exercise capacity by then.

The study appears in the journal Anesthesiology”

This story was originally posted on NPR.org

Acupuncture and Sports Injuries

By Tracy Slater and Helen Amembal

Acupuncture has a very successful record with sports injuries. Many professional sports teams have acupuncturists on staff to decrease healing times and resolve stubborn ailments. But the use of acupuncture to treat acute injuries from intense or repetitive physical activity began centuries ago. It was and still is one of the primary means of quick healing for the martial arts. Specific acupuncture styles and techniques were developed to stop pain and dramatically increase recovery time. This tradition continues today, and its use has expanded into competitive athletics that result in similar injuries.

Common Injuries treated

Common medical diagnoses that fall under the umbrella of Sports Injuries include: medial & lateral epicondylitis, frozen shoulder, plantar fasciitis, acute olecranon bursitis, acromioclavicular joint separation, rotator cuff tendonitis, osteoarthritis of all joints, meniscal tears, bicipital tenosynovitis, lumbar disc herniations, anterior & posterior cruciate ligament tears, patellofemoral syndrome, Osgood Schlatters syndrome, and more.

How Does Acupuncture Help?

Acupuncture is an effective treatment for Sports Injuries because it reduces pain, increases range of motion, increases recovery and healing time, and strengthens weakened parts of the body. These effects are accomplished during treatment because acupuncture:

1. Decreases inflammation
2. Reduces swelling
3. Relaxes muscles and relieves spasms
4. Decreases bruising
5. Lowers the body’s pain response
6. Improves local blood circulation to increase delivery of nutrients

When to get Acupuncture

Acupuncture divides sports injuries into two main categories, which determine how treatment typically proceeds. Acute injuries (that happened recently) and chronic injuries (unresolved for 3 or more months).

Acute Injuries

Acute injuries need to be properly assessed before any type of treatment can begin. Most people are all too familiar with the feeling of a strain or sprain. If someone is unsure, however, it is best to get examined and properly diagnosed (possibly with the help of an X-ray or MRI) to rule out a more serious injury.

Acupuncture should then begin as soon after an injury as possible for the best results.
Acupuncturists classify acute injuries as Excess conditions. An Excess condition is just what it sounds like: there is an excess physical response (too much pain) or an excess biochemical reaction (too much inflammation or swelling). Acupuncture treatment given soon after an injury occurs encourages the body to deal with and process this excess in a rapid fashion. An improvement is usually noticed within one or two treatments. If an injury is not very severe, 3-4 treatments typically resolves the condition. More serious injuries require 4 treatments before an accurate prognosis and treatment plan can be given. Right after an acute sports injury happens it is helpful to remember the acronym RICE. Each letter stands for
one of the four steps to follow immediately after an injury: Rest, Ice, Compression and Elevation. This will help quicken recovery and provide short term relief.

Chronic Injuries

Chronic injuries also need to be properly assessed before any type of treatment begins. It is important to determine if there is an underlying structural cause for a lingering injury such as a loss of cartilage, formation of scar tissue or degenerative damage of any kind. Once the complete underlying framework of the injury is understood, an acupuncture treatment plan can be devised to address both the main symptoms and their causes. This may include acupuncture treatments, stretches and exercises, diet modifications and the use of
liniments or balms.

Acupuncturists classify chronic sports injuries as Deficient conditions. Deficiency refers to a weakness or lack. Over time, unresolved sports injuries lead to areas losing strength, flexibility and stability. Instead of focusing on removing excesses, acupuncture for chronic conditions focuses on invigorating and strengthening specific parts of the body. This is done while also decreasing the pain that commonly accompanies most chronic sports injuries.

It is more difficult to generalise the length of treatment for chronic conditions because medications, prolonged inactivity, low morale & surgeries complicate treatment. Even so, a person should notice a positive change in his/her specific condition within 8 to 10 treatments, although many chronic injuries respond quickly to acupuncture. After which, an accurate prognosis for complete resolution of the problem can be given.

A 1999 study published in the medical journal Pain by researchers at University of Heidelberg in Germany compared the effectiveness of acupuncture for rotator cuff tendonitis against fake acupuncture needles. The researchers found a significantly measurable improvement in the athletes that had acupuncture for their shoulder pain and rotator cuff tendonitis than those athletes that had placebo acupuncture needles.

What is Taping Therapy? It is a major Therapy in correcting the balance of human body by regulating tension and relaxation on muscles and ligaments, by attaching the special tape to the skin. As a non-drug therapy, there are few side effects, and it is available to apply to children and the elderly

By Tracy Slater and Helen Amembal

Tracy Slater

Acupuncturist

How can a Biomechanical assessment help?

“Its great to be on mission to get fit – and a Biomechanical Assessment can help you to reach your goal…..”

A Biomechanical Assessment may come in handy when you are looking to increase your activity, be it running, bootcamp or even something more gentle like walking.  It involves an examination of the lower limbs, looking at their structure, alignment, strengths and weaknesses. The foot is a complex structure of bones, ligaments and muscles, bearing our body weight as we walk every day. It is especially important in sport due to the pressures and forces put through the lower limb.  The amount of foot-based injuries people sustain in sport, is quite prolific, and so much of it can be avoided by knowing what type of footwear will best support the individuals’ needs.

If you are experiencing pain in the foot, ankle or knee or if you have a problem with your feet i.e. your arch is collapsing, then a biomechanical assessment would be beneficial for you. Everyone is different, and an assessment will tell you whether you have a problem with the joints or muscles and how this can be corrected to relieve your discomfort. You may be offered orthotics, strengthening exercises, and footwear advice to aid your recovery. Remember, the earlier you identify the problem, the sooner you can hit the sporting arena pain free and with confidence. And then you can get back to running, ruby, football, dancing or whatever takes your fancy!”

If you would like to book or find out more information about Biomechanical assessments, please call our reception team on 01372 464659

 

 

Allergy Testing Claygate, Surrey

SAIL THROUGH PERI-MENOPAUSE AND MENOPAUSE

By Ann Shaw

Have you suddenly become aware of gradual weight-gain that feels like it isn’t going to stop? A lack of energy and motivation? Low libido? Erratic or heavy periods? Mood changes, hot flushes and sleep problems? Have you noticed hair loss? Faced with all these symptoms can be overwhelming for many women particularly if you don’t have a clue what is happening to you. Well, it is quite common because these can be the symptoms of being perimenopausal and typically they start at around the age of 40, although sometimes late 30’s.

Some women may experience depression, insomnia or anxiety some while before the onset of perimenopause, but by paying attention to your diet and ensuring that it is nutrient-dense as well as balancing your hormones with the correct dosages of good quality supplements, can make all the difference. Balancing your hormones is vitally important so that you do not become high or low in either oestrogen or progesterone. Throughout perimenopause, there can be a huge change in your hormone production as the cycles become more unreliable and anovulatory (without ovulation). This could make you feel as though you have permanent premenstrual tension and affect your functionality, but this can be addressed with if you go about it correctly.

Progesterone (which help keep oestrogen in balance), can be constantly low at the Perimenopause which can be termed as a progesterone deficiency. The symptoms of low progesterone can be much heavier periods lasting longer than usual. This can be coupled with uncomfortable and swollen breasts as well as weight-gain. There can be increased irritability and mood swings which can be higher oestrogen to progesterone balance.

As you near the menopause, your periods can change by becoming more erratic and you may experience vaginal dryness and hot flushes because oestrogen is gradually decreasing. It is at this time that you must take care to balance your blood sugar levels and avoid becoming adrenally exhausted through stress. Our adrenal glands are important because they supply oestrogen and progesterone to keep hormonal balance. You are far more likely to acquire ‘belly fat’ as it is known, if your adrenals do not supply an adequate amount of oestrogen.

To avoid menopausal symptoms and going on to HRT I would advise keeping off the foods you know you are allergic to, ensuring the correct dosage of zinc, magnesium and essential fatty acids. I had already avoided the foods I knew were wrong for me for quite a number of years, so that bit was easy. I then made sure I always took the correct supplements, particularly zinc, magnesium and fish oils. My menopause lasted eight years without a single symptom. I remember being late for two appointments which brought on a 2-3 minute warm feeling whilst driving and that was it.

Look to eat healthily to boost your nutrients including foods that contain good healthy fats such as avocados, organic virgin coconut oil, fish oils and oily fish. Fibre from fresh vegetables. Phytoestrogens from oats, fruit, vegetables, sage, seeds, garlic and fennel, and of course lean protein from meat, fish, nuts and seeds. Look to avoid canned, fizzy drinks, caffeine and too much alcohol and make sure to stabilise your blood sugar levels and exercise regularly. I cannot stress enough the importance of taking the appropriate vitamin/mineral supplements and fish oils that are high quality, and remember the menopause is not an illness or disease but a process that we go through. If you prepare well beforehand you could sail through the menopause as I did.