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How to get moving and keep fit and mobile as you get older

5/14/2017

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This picture is of Man Kaur, from India. In April she won the 100m at the World Masters Games in Auckland, 101 years young. 
The purpose of this article is to educate, promote quality therapy, but most importantly to inspire activity and quality movement. 


Educate
There is one aspect of life that all of us will go through which is ageing. Whether we like it or not we will all physically deteriorate with age. But what can we do about it? Sit back and accept fate with declining health, or be proactive in maintaining the strength and mobility we have…

'I've got creaky knees, my back is a bit stiff, reaching down to put my shoes on is so hard … it must be old age'. As a practitioner, I've heard them all. It's the age old excuse. Some of these complaints are justified, but many of the clients I have come across in both the gym and massage therapy setting will reluctantly admit they just haven't prioritised being active enough. The old adage 'use it or lose it', remains very true. Strength and joint mobility will decrease with age, they will also deteriorate through lack of use. Moving joints can help to increase synovial fluid to the joint capsule and this will keep the joint moving smoothly. Movement will also help the surrounding soft tissues remain both strong and flexible. This is why we need to feel the urge to stretch when we get out of bed, or standing up from prolonged sitting. The soft tissues in our body adapt to a particular position, the stretching is our body trying to prepare these soft tissues for movement. 
Staying mobile and strong is important for more than just being able to tie your shoes and get up the stairs. Being active is linked with decrease chances of mortality. The study by Brito et. al. (2012) assessed 2002 adults aged 51-80 on their ability to move from standing to sitting on the floor and back up to standing again. The people who could stand and sit with ease lived longer. The test can be found here http://journals.sagepub.com/doi/abs/10.1177/2047487312471759
This test is not 100% accurate in telling you when you will die. There are many factors involved in how long you shall live. But the theme of being stronger and more mobile leading to living longer is what I and the authors are trying to emphasise. If you can move better, you are more independent, you are also more likely to exercise. This can help decrease cardiac risk factors, as well as help maintain a healthy weight, which will further reduce many mortality factors. 
There are other factors that will limit your performance in a sit to stand test such as lower limb joint replacement, arthritis, neurological disease, other joint surgeries may also limit your joint range making sitting on the floor difficult. So don't panic if you have co-morbidities that will cause you to score poorly in a test like this.  
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Promote quality therapy
“I'm stiff, sore and don't move with ease, what should I do about it?”. For many people the answer is simply to move more. Move more often, move for leisure, move for exercise, move to break up the monotony of prolonged sitting. If you want some advice on how to move well I have the training and experience to help instruct you. You may require more strength, more mobility, more balance, or a combination of all three. Understanding your weaknesses is the first step to improvement. 

Massage therapy can also play a role in improving movement. Massage can help increase range of motion by releasing tightness in muscle and soft tissue, or minimising the referred pain that tight muscles can cause to a joint. The increased movement around the joint will make it easier to train for strength and balance, this will lead to fewer compensations (such as limping). 

Articulation (movement) of the joint will help to keep the fluid of the joint healthy and nourished. 

​Regular stretching will also help you stay mobile and injury free. Stretching is more effective when designed specific for your needs. If you need help with this, I am more than happy to shed some light on this complicated and sometimes controversial topic.

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Inspire
Movement is important for all ages, the longer you neglect it, the harder it is to get back. Age should not be a barrier for activity, getting out as part of a team may make it more fun. 

28,676 people competed in the World Masters games in Sydney in 2009. The age categories go all the way up to 100 and over age group. If Man Kaur can do it at 101, so can you. That is of course if the threat of increased mortality hasn't already got you out of your chair!

References
Buckwalter JA. Osteoarthritis and articular cartilage use, disuse and abuse: experimental studies. Journal of Rheumatology 1995;43:13–5. 28. 
Brito, L.B. Ricardo, D.R. Araújo, D.S. Ramos, P.S. Myers, J.   Araújo, C.G. 2012. Ability to sit and rise from the floor as a predictor of all-cause mortality.
European Journal of Preventative Cardiology 2012.
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​Reuben Friedlander
Massage therapist, Personal trainer, movement enthusiast.
Bachelor Health Studies (Massage and Neuromuscular Therapy)
Diploma in Health Sciences (Massage and Sports Therapy)
Diploma in Health Sciences (Therapeutic Massage) 
Diploma in Sport (Exercise Prescription) 
Certificate in Kinesiology and Power Taping
Tacfit Level 1 Coach

www.cityosteopaths.co.nz/massage.html Phone 04 4991439

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Childhood Scoliosis treatment at City Osteopaths Wellington

4/14/2016

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I thought I would post a clinical case of a recent patient (I have permission from the parents).
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Two weeks ago, this nine year old boy presented with right knee pain that had been present for about one year. This is a long time  for a child to have knee pain and initially set off my alarm bells of concern, however the family had visited their doctor and an x-ray of the knee had been done which was clear and blood tests were clear. I still had concerns regarding hip pathology (as this can refer pain to the knee) until I had a look at the child's back...

Now I am not sure if it is obvious to everyone, but if you look at the left hand photo, (which was taken on initial examination, before any treatment), you may be able to see some asymmetries. The left shoulder and shoulder blade are higher and the right hip is higher. You can see a reddish mark on the back due to a recent fall onto a tree branch.

Without getting complicated , this child has a scoliosis (which is an 'S' or 'C' shaped curve to their spine). The most common type is called idiopathic, which means the cause is unknown.

In my experience all the children I have treated over the years with idiopathic scoliosis have had a considerable cranial base strain (which can start in-utero, during birth, or from trauma to the head as a child). This cranial base strain can cause strain in the spine and shoulders and ribs due to the extensive muscle attachments between these structures.

 The right knee pain was being caused by extreme tightness of the right thigh muscles, due to the pelvic unleveling and cranial base (head) unleveling. The parents had been massaging the right thigh muscles daily for months to try to help the knee but had not been able to make them relax. This is because these muscles were not the cause of the problem but were responding to the strains higher up.

A very gentle osteopathic treatment with the patient lying on their back, using cranial, balanced ligamentous and biodynamic osteopathic technique approaches was used to treat the head, neck, back and pelvis. There was immediate  improvement as you can see from the middle photo. The right thigh muscles eased immediately which started to take the pressure off the right knee.

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Before first treatment
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Reassessing immediately after the first treatment
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Reassessing before the follow up treatment ten days later.
Ten days later was the follow up appointment and I hope you can see in the right hand photo, that the spine is now much better aligned, the shoulders are level and the scapulae are now even. Also the pelvis is no longer higher on the right side. The knee pain has much improved and despite there being some pains at times in the back as the body was realigning itself, the child and parents are very happy with the changes.

What I think is interesting about this case is:

1) The scoliotic pattern ('s' curve) of the back and pelvis were causing the knee pain. It was not the knee itself. (Osteopaths really do look at the whole body!)

2) There was no structural (ie boney) leg length difference, so there was no need for a heel lift.

3) Only one very gentle osteopathic treatment was required to enable the body to realign itself. (This was helped because the child is still young and the soft tissues were able to change)
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4) The body kept on improving for a time after the treatment. Which shows that given the right input, the body has the ability to heal itself

In an ideal world, all scoliosis would be caught at this age or earlier, the key being to find it and ideally sort it out before the child starts to grow into their adult body (from around age 11 to 18 years of age).

Please note that some types of scoliosis may need surgery and it is important to get diagnosed correctly early on. If a scoliosis like this one was found in an adult, it may need more treatment combined with specific exercises such as Rehab Pilates to achieve long lasting improvements in the alignment of the spine.

Note: Following up six months down the track and the scoliosis has not returned. Thanks for reading. I hope you found it helpful.
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Melanie Young
Reg Osteopath 
​B.A., B.App.Sc.(Clin. Sc.), B.Osteo.Sc. MONZ
​Director City Osteopaths

​www.cityosteopaths.co.nz
​#osteopathyawarenessweek



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How to keep mobile and supple as you get older

1/3/2016

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People around fifty years of age or earlier will usually notice their joints getting stiffer and muscles tighter.

As a Registered Osteopath, I hear this a lot in practice, “Oh its just getting older” is usually the phrase I hear. However have you stopped to think if that is really the case? It is true that our tissues lose some elasticity with the reduction in collagen as we head beyond fifty, however research has shown it is a case of “use it or lose it” rather than the passing years that determines how mobile we are as we get older. 

Movement is crucial for ‘oiling’ our joints with synovial fluid and improving the blood supply carrying nutrients and oxygen to every one of our nine trillion cells in our body.



Here are the top seven points for keeping mobile as we age:


  1. Develop a daily routine of gentle stretches - this can be a short as five minutes but needs to be done daily, once you start, be determined to continue each day for the whole week, then add another week till you get to 3 or 4 weeks and then decide if it is helpful to you. Not missing a day means you never go through being stiff and sore again!

  1. Time your stretches for the same time each day, at a time that works for you. People often find either first thing before breakfast, or when first home from work or just before bed are the best times in their busy schedule. I could say that “you wouldn't miss brushing your teeth for a day so think of your mobility exercise like that and don't miss a day!”

  1. Start gently and slowly build up. Some days you may only manage a couple of minutes and do you favourites, but at least you have not missed a day. Over time you might start to enjoy them so much you go to ten minutes or even twenty minutes on the weekend and really feel the benefits. Adding in a weekly class in Pilates or yoga with a qualified and experienced teacher is also very beneficial to support the daily practice.

  1. If you are not sure what exercises to start with, ask one of our Reg. Osteopaths, we are experts in anatomy, physiology and suitable exercises. Also if we have treated you, we are pretty clued up about what will be best for your body too!
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  1. Ideally get your partner or whole family joining in! If you can encourage each other, this will help you keep going. Also the whole family benefits, with better posture and mood.

  1. Add some balance exercises in there, this can be as simple as standing on one foot as you brush your teeth. Right foot for the top teeth, left foot for the bottom teeth. Falls are what can really set a person back when they are getting older, its the fall and break a hip which may be the injury never quite recovered from. 

  1. PS: If you have already fallen then you don't need a doctors referral to come see one of our osteopaths. We can help you fill out the ACC forms in our clinic. We are able get you back on your feet in the nicest possible way then give you some suitable exercises to help prevent recurrence and to improve your overall wellness and mobility. 


Finally, I speak on this with experience, having just completed two years (to Boxing day 2015) of daily mobility and strengthening exercises without missing a day. Now into my third year, I feel SO good with this daily routine. I found by committing to it and waking a bit earlier I have been able to fit it into each day, while working full-time as an Registered Osteopath and small business owner and being mum to two primary school age children. 


""If you can allocate the small amount of time and make a commitment to yourself to do it daily, I promise you that keeping mobile as you age, IS possible!"

Melanie Young
Reg Osteopath
www.cityosteopaths.co.nz
Phone 04 4991439

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Back Pain, Leg Pain, Sciatic Pain help, City Osteopaths Wellington 

2/23/2015

5 Comments

 
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Back pain is bad enough, but what if your pain also goes down your leg? Is your leg the problem or can it be coming from your back? Where do you go to get effective and lasting relief fast? At City Osteopaths our practitioners are experts in helping back and leg pain. We provide excellent treatment and work with you so you are back to full health quickly.
What is sciatica?
You’ve probably heard people saying they have sciatica – and if you’ve had back pain, you might have even wondered if you’ve got it yourself.  Sciatica is a commonly used (and occasionally    abused) term - but what does it actually mean? 


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The sciatic nerve is the largest in diameter in your body and when its in trouble the pain can be excruciating

The word sciatica describes a set of symptoms, including lower back, buttock, hip, leg and foot pain as well as numbness, weakness, "pins and needles" or tingling in these areas.  


The symptoms are due to irritation of the sciatic nerve, a large nerve about the same circumference as your thumb that starts in your low back and travels down the leg to the foot, supplying power to muscles and sensation to skin along the way.  So while the term sciatica describes the symptoms, sciatica is not a diagnosis by itself – the diagnosis comes from figuring out what is irritating the nerve in the first place – and there’s quite a few potential causes!  Here are a few of the most common causes:

·   If one of your lumbar discs is bulging or herniated, it can press on and irritate part of the nerve as it exits the spinal cord.

·   As we get older, our spines often start to exhibit age-related changes, occasionally growing bone spurs, or just starting to narrow and compress the spinal cord, thus pinching and irritating nerves as they exit the spine.

·  The sciatic nerve passes very close to a muscle at the back of your pelvis, called the piriformis.  When the muscle shortens or spasms, it can compress the sciatic nerve, causing symptoms down the leg. 

PicturePiriformis muscle shown in pink
         
·     During pregnancy, the weight of the foetus can press onto the sciatic nerve.  While it’s not harmful to the baby, it can be very frustrating for expectant mothers!


·   And for the gentlemen, there’s “wallet sciatica”, caused by sitting down with an over-stuffed wallet in your back pocket, thus compressing the nerve as it passes around the back of the pelvis.  There’s a simple solution for this one!






However, there are a lot of other conditions which can cause very similar symptoms.  As osteopaths, we are trained to be able to determine the most likely cause of your symptoms, whether it is something relatively simple, or a more complex condition that might require further specialist attention. 

At your appointment, we’ll make a diagnosis, then discuss treatment options with you.  Treatment will usually involve the application of some gentle and very effective osteopathic techniques to calm the irritation in the area and relieve pressure on the nerve.  We can advise you on what you should and shouldn’t be doing, and offer you some simple stretches and exercises to continue the healing process on your own time. 

We are able to send you for an x-ray if we think it will give us information helpful in the management of your symptoms, and we can refer you for further specialist attention if needed.  



At City Osteopaths, we are excellent at getting you out of pain quickly. We also regularly collaborate with our on-site acupuncturists and massage therapists to provide a well-rounded healing process. 


If you have any questions, call us on 04 4991439 to book an appointment or if you would like Lara to give you a call back.

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Lara Sanders
M.Ost., B.App.Sc. (Human Biol.)MONZ
Reg. Osteopath
To read more about Lara and to meet our Osteopathic Team please click here

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When bad posture isn't really bad posture. An Osteopathic perspective of osteoporosis and what to do about it.

1/25/2015

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When bad posture isn’t really bad posture

As osteopaths, we see many people who are concerned about their posture, often saying “I don’t want to end up like ….(insert name of elderly relative)… He/she is completely hunched over!”.  It’s great to see people who understand the benefits of prevention over cure, but in many cases the person they are thinking of doesn’t just have bad posture.  In fact, they may have an underlying condition such as spinal compression fractures due to osteoporosis.

Osteoporosis causes the bones to become very fragile, occasionally to the point where an action as simple as picking up a bag of groceries causes a vertebra to fracture and collapse, leaving the vertebra in a wedge shape and creating a the effect of a hunched-over posture.  This condition has the somewhat old-fashioned name of ‘Dowager’s Hump’.

Osteoporosis can be prevented from developing by maximising bone density in early life, and minimising bone loss in later life.  Weight-bearing, high impact activities (like skipping rope or running) in early life will increase bone mass, alongside an adequate calcium intake. Best sources of calcium in your diet are green leafy vegetables, broccoli and dairy products (ideally raw, unpasterised and unhomogenised). 


An excessively acid diet will also reduce the amount of calcium in the bones. Avoid excessive red meat, coffee, smoking and carbonated drinks (ie soft drinks) as these all require calcium to be taken from your bones to buffer the acidic environment in your body.

You can also minimise bone loss, especially after menopause, by engaging in moderate-impact exercise and strength training, alongside a higher calcium intake to reduce the calcium losses associated with lower oestrogen levels.  In addition, vitamin D is important for bone health.

Osteopaths are able to assess your risks of developing conditions like osteoporosis and give you personalised guidelines for prevention.  We can give you guidance on other treatment providers who may be able to help, such as nutritionists or naturopaths, or send you for a bone density scan.

Finally, we can help you with any postural problems you are having, giving you treatment to help your body make the appropriate adjustments, alongside exercise to help maintain the changes.

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Lara Sanders
M.Ost.,B.App.Sc. (Human Biol.)

Reg. Osteopath

www.cityosteopaths.co.nz
​
Ph 044991439

#osteoporosis
#excessiveboneloss
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