Gardening needn’t be a pain in the neck … or the back!

  As well as being a keen gardener myself since childhood, I have been treating gardening injuries for over twenty years… and I have never yet told anyone to stop gardening. But you can make life a lot easier for yourself, particularly at this time of the year when the emphasis lies on tidying up and getting things ready for the winter. So here are our team’s top tips for pain free Autumn gardening:



 

First up LOOK AT WHAT YOU'RE USING

·   Buy light aluminium tools
·   A fist and arm support can be added to handles to help lifting
·   Ensure the handles of rakes and brooms are long enough for you not to have to bend at the     waist and to keep your back straight when working
·   Use a long handled dustpan and brush to avoid bending
·   Keep the cutting edge of tools SHARP – and that includes spades, hoes and bulb planters


 

Secondly, THINK before you start side-on activities such as RAKING or SWEEPING

·    Use a light aluminium rake or broom
·    Do some gentle warm up stretches
·    Work in short bursts
·    Keep hips and shoulders moving towards the work
·    Do not twist your back
·    Avoid bending at the waist by stepping forward with one foot and bending slightly at the knee, allowing your upper body to stay upright in a partial lunge 

 AND

·    Ask yourself whether you have to rake at all? 










Whereas leaf mould is a fantastic resource for any gardener, leaves also make great compost, particularly when mixed with grass clipping so why not collect leaves in the grass box of your lawn mower?

 If you haven’t got a compost heap, simply leave the grass box off your mower and allow the mower to chop up the leaves. Worms will soon pull them underground and the leaves will add nutrients to your lawn … but remember mowers can be bad for your back too – so stand directly behind your mower handle with a straight back and hands resting evenly on the handles. 

WHEELBARROWS can be a gardeners best friend IF THEY’RE USED CORRECTLY

·    To avoid hand, back and arm strain do not overload wheelbarrows
·    Stack evenly with the heaviest load over the wheel
·    Keep your back straight while lifting and pushing
·    Rather than lift heavy objects in and out of a wheelbarrow, use a sack barrow instead.

 

FINALLY, if things do go wrong, remember help is only a phone call away at our friendly expert treatment centres. 

 

The South-West is a Great Place to Live … Particularly if you’re a Chiropractor

I remember the first time a came to Somerset I was impressed by the rolling landscape (at the time I lived in Norfolk!) and just how green everything was (three times more rainfall that Norfolk!!).

I moved here twenty years ago and it has been a truly wonderful place to raise a family … but until the British Chiropractic Association published new research into the state of the Nation’s backs, I

had no idea as to the extent to which the South-West topped league tables for suffering in this regard – and what a good place it was to work in restoring backs to normal function.

More people suffer from back pain in the South-West than in any other part of Great Britain – amost half (47%) of the people surveyed reported that they were currently suffering from back pain, compared with just 40% in the South-East.

And the life style in the region appears to be largely responsible for the epidemic: whereas the top trigger – lifting or carrying heavy objects – afflicts fewer than half of London sufferers, it causes pain for 60% of those in the South-West, more than any other part of the UK.

And it’s a similar picture for the second most common cause, prolonged sitting with just over a third of Londoners adversely affected compared with over half of South-Westerners (52%) – once again topping the Nation’s league tables.

So our local population is more likely to need a chiropractor than anywhere else in the country … good news for us at least and would explain why, in the last 20 years, we have expanded from a single clinic with one chiropractor to a chain of clinics with up to half a dozen chiropractors treating over 500 patients every week.

But don’t despair – there’s plenty you can do to help yourself – first of all let’s deal with those top two triggers for back pain:

• Lifting and carrying: Remember to bend from the knees and not the waist when lifting heavy items – you should look like a downhill skier and not a ski jumper. Face in the direction of movement, and take your time. Hold the object as close to your body as possible, and where you can avoid carrying objects which are too heavy to manage alone, ask for help or use the necessary
equipment.
      

• Take a break: When sitting for long periods of time, ensure you stand up and move around every 30 minutes. When at work, also make sure your desk is set up to support a comfortable position. This is different for everyone so if you don’t feel comfortable in your current set up, try altering the height of your chair or screen.

And, if you want to get proactive, the British Chiropractic Association has created a programme of 3-minute exercises, Straighten Up UK, which can be easily slotted in to your daily schedule to help prevent back pain by promoting movement, balance, strength and flexibility in the spine.

If, however, you have pain for more than a few days you should seek professional help. 

All our chiropractors are university educated to Masters level and belong to the Royal College of Chiropractors, who set standards of excellence for management of low back pain. 

So, if you want professional help you to get moving again without pain, help is just a phone call away on 01935 423138 or you can find all our clinics’ contact details at http://www.yeovilchiropractic.co.uk

What does a chiropractor do … on a Wednesday

Normally Wednesday is the one working day when I spend the whole day in the same clinic … which means I actually get a lunch hour – or more accurately 56 minutes in which to meet with my practice manager, make phone calls, write emails and do the 1001 other things associated with running four clinics and 4 minutes to wolf down a sandwich.

On some Wednesdays I run a specialist headache clinic with two colleagues – an orthodontist (Mark Brickley) and a psychotherapist (Judith O’Hagan) – in which we get to grips with the complicated sort of problems that cause seemingly intractable head and face pain, but which will often respond to a combined approach in cases where no one individual could hope to be effective (http://www.theheadacheclinic.co.uk/index.html). 

Many headaches and migraines come from musculo-skeletal structures (joints, nerves, muscles and ligaments) but if someone is tense, stressed, depressed, clenching their teeth, has an unbalanced occlusion or forward head posture, then they can often undo all a chiropractor is trying to correct within hours … or sometimes even minutes. That’s when identifying the component parts of the problem then treating the mind, balancing the occlusion and preventing the clenching allows the adjustments and exercises prescribed by the chiropractor to start working. Headache clinic days are always great days because you get to work with fascinating people on challenging and interesting patients – I also get to sit down to eat lunch before we start, although this brief period of relaxation is somewhat countered by having to fit three clinics into one day.

This week however, I was not in clinic at all on Wednesday.

Like all regulated healthcare professionals, chiropractors have to complete a minimum amount (30 hours) of continuing professional development every year in order to maintain their professional registration. Even if we didn’t, I would still go to the AGM of the Royal College of Chiropractors … in fact I have been to every AGM since the very first in 1997 (bar last year’s when it was oversubscribed and I couldn’t get a place … so popular and important have they become).

The Royal College of Chiropractors (http://rcc-uk.org) is – and will probably remain – the most important thing that has happened to chiropractic this century.  Much like the passing of the Chiropractors’ Act in 1994, which paved the way to statutory regulation, the setting of minimum educational standards, a Code of Practice and protection of title (when I graduated, anyone could style themselves a chiropractor), the granting of a Royal Charter to the College of Chiropractors in 2012 was a pivotal moment … I don’t think may people yet recognise how pivotal.

For the first time, the chiropractic profession has recognised specialists developing their post-graduate skills though Faculties (of Pregnancy & Paediatrics, Orthopaedics & Rehabilitation, Sports & Exercise, Animal Chiropractic and my own area of specialism, Pain).  The AGM always kicks off with the Faculty AGM’s … this year’s Pain Faculty was taken up for the most part with development, as befits the College’s youngest faculty.  

The discussions were wide-ranging: the new NICE Guidelines for Low Back Pain & Sciatica (https://www.nice.org.uk/guidance/NG59) again include spinal manipulative therapy and exercise and amongst the few therapies that actually work (good news for chiropractors and osteopaths); however, acupuncture is no longer included – although it will, I hasten to add, continue to be offered as part of our treatment packages despite this. 

I pointed out to the meeting that the entire basis for the decision was fundamentally flawed: acupuncture has many different schools with very different approaches (we use medical acupuncture – also known as ‘dry-needling’ – to treat myofascial pain syndromes) and low back pain and sciatica are not diseases but symptoms which have many different causes, some of which will respond and some of which may not. (http://docmartin99.blogspot.co.uk/2015/02/sciatica-is-not-only-condition-thats.html)

What can be said with certainty is that myofascial pain syndromes are an invariable part of almost all low back pain, whatever its cause, and there is abundant evidence that dry-needling is highly effective in treating the trigger points responsible for the pain. The Guidelines therefore demonstrate a failure of joined up thinking … so I got volunteered to write an article for the College’s journal explaining this in scientific terms.

The Faculty also needed a Secretary – and as I was going to clearly be doing some writing anyway … I got volunteered for that too.

And I though I’d got better at saying ‘no’!

The afternoon’s programme comprised the President’s Lecture, delivered by Dr Sarah Goldingay  (http://humanities.exeter.ac.uk/drama/staff/goldingay/) – always good to hear from the great and the good outside of the profession – and then presentations from researchers being funded by the College … it’s nice when you listen to old friends speaking and think of them as ‘my ex-squash partner', ‘my MPhil supervisor’ or ‘someone I used to teach’, rather than Professor this or Dr that.

It also made me realise how cutting edge much of what chiropractic is now doing can be – and how it contrasts with some elements of the profession (mostly imports from countries which ought to know better but apparently don’t) who regard the General Chiropractic Council as a nuisance and want to go on delivering care based on benefit to their bank balance using protocols based on 19th century metaphysics.  

I recall an old dentist telling me many years ago when I was still at College that it took dentistry 50 years to move from being an unregulated profession to being fully respectable … we’ve only had 16 years but at least  (unlike the dentists) we have our own Royal College setting standards to which increasing numbers of chiropractors aspire. 

I for one have reached the stage where my most cherished post-nominals (those long list of letters that professional people put after their name to show how professional they actually are) are the four letters ‘FRCC’ (actually I can put these twice because I am both an ordinary Fellow and a Fellow of the Faculty of Pain, but that would be showing off). 

This is for the simple reason that all my other degrees and qualifications are what has allowed me to become a Fellow of the College – and the College stands for the quality, rigour and clinical governance that is, I hope, inherent in our clinics’ daily treatment of patients.

My shoulder pain isn’t getting better … That’s because it might no be coming from your shoulder!!

As with so much in life, clinical routine has its seasonal features: the overindulgence accident at Christmas; the gardener’s back in March after a winter of inactivity – most of these problems have an obvious cause an effect but there is one problem that strikes every autumn … and nobody is quite sure why.

Ask a chiropractor how they know when autumn has arrived and they will tell you it’s the sudden influx of patients with ‘shoulder’ pain – instead of half-a-dozen per week, suddenly it’s more than half a dozen every single day. 

Theories as to why range from the ‘cold wintery draught on warm skin’ to the effects of rapidly changing day length on serotonin levels, though no theory has yet been proved (it’s not a well-researched subject). What is, however, seems quite clear from clinical experience is that most of these seasonal symptoms are not shoulder pain at all!

If the pain is across the top of your shoulder or between the shoulder blade and the spine, then the chances are it’s coming from your ribs. Patients often look slightly sceptical on being informed that their ‘shoulder’ pain is coming from their costal joints (the joints between the ribs and the vertebrae) – “surely my ribs are in my chest?” they say.  In fact, the top rib actually joins with the base of the neck and acts as an anchor for some of the big muscles that run up the side and back of the neck (which can often feel as if they’ve been ‘pulled’ or ‘cricked’ if the underlying rib is injured).  You can easily feel your top (first) rib, it’s the bony lump you can feel at the base of your neck just behind your collar bone … that’s how high they go.

By comparison, most pain that arises from the joints and muscle of the shoulder is typically felt at the top of the arm. either whether the rotator muscle pass under the collar bone and attach to the arms or coming directly from the joint between the collar bone and shoulder blade or from the cartilage, ligaments and synovium of the ball and socket joint.

The other things patients often complain of is that – unlike ‘true’ shoulder injuries – they’ve no idea how they’ve done it: it just “came on gradually”, or, more commonly, they “woke up with it”.  That’s because the inflammation in the small joints between the ribs and the spine builds up slowly over several hours, so its not the injury (often from lifting at arm’s length) that hurts, it’s the body’s reaction hours later.

So, if you’ve got a intense ache across the top of your shoulder or feel there's a knife in your back just inside the shoulder blade, then you’re probably suffering from costovertebral syndrome, colloquially known as a ‘popped rib’ … and you may well be suffering: it can be one of the most painful of conditions;  fortunately, it is also one of the easiest and quickest for chiropractors to treat, with recovery often in days. 

There's also something you can do to help yourself if you’re suffering from seasonal shoulder symptoms, use an ice pack (or wrap some frozen peas in a tea towel) and apply for ten minutes or so every hour (that will reduce the inflammation), then pick up the phone and ask one of our chiropractic experts for confirmation that it’s your ribs and not your shoulder that are the source of the trouble.

So how can your neck give you a headache?

Chiropractors treat a lot of headaches, it’s a daily presentation and most patients are chronic sufferers who have tried remedy after remedy and have formulated a cocktail of pills, potions and routines to keep themselves functional. 

It is sometimes hard to explain to someone who doesn’t suffer from headaches or migraines what it’s like but try to imagine having a really bad hangover … only without any of the preceding pleasure and with the knowledge that it isn’t going to feel any better after coffee and aspirin, or indeed any time soon.

But what causes headaches? And how can chiropractors treat them?

Which is most important: Your teeth, Your Car … Or Your Back?

You brush your teeth and see a dentist; you check you oil and have your car serviced – but when it comes to backs, almost two-thirds people in the South-West have been suffering for up to 10 years and most haven’t done anything about it. 

Suffering in silence is not only causing untold misery to thousands of Somerset residents – it’s also costing business a fortune.  According to research from the British Chiropractic Association, a third of us have had to take time off work because of back or neck pain.

There is a myth that back pain gets better by itself; unfortunately, on the occasions that it does, it nearly always comes back again – and the problems tend to get more serious with time.

Home cures – used by over 90% of sufferers – are often ineffective: the traditional hot water bottle can actually make many types of back pain worse; bed rest also tends to hinder rather than help recovery and recent research has shown paracetamol of no help for back pain … yet these remain the treatment of choice for most people.

There are, of course, things you can do to help your back: our own #5stepping campaign, featured elsewhere on this site, is there to help your back as well as improve your waistline but, if your spine is groaning under the increasing stress of modern life here are our top tips for easing the load:

• Stand up: Sitting for more than 4 hours a day is not just a recipe for spinal suicide, it’s going to damage your general health too. So take regular, short breaks every half an hour and stand and walk whenever you can.

 

• Walk on: All 5-steppers already know the health benefits of walking – it’s simple to add extra steps to your everyday routine.

• Stop slouching: When you are sitting, relax and make sure you have your bottom against the seat back with your shoulder blades touching the back rest of the chair.

• Drive right: Given that we’re all going to be spending longer in our cars for the next few weeks, make sure the seat leans slightly backwards with your elbows at a comfortable angle for driving.

• Drink up: Like the rest of us, backs are 70% water – try replacing one caffeinated drink a day with a glass of water.

The final tip is pure common sense – you don’t wait for your car to break down or your teeth to rot; if your back’s been hurting for more than a few weeks, or if the pain keeps coming back see a chiropractor: managing back pain is how we make our living!