Whenever I mention breathing to my clients, the reply is usually along the lines of “Breathing? Don’t we all know how to do that already?”
​
Of course, we all breathe, but how we breathe is the interesting part. Do you breathe with your ribcage moving outwards, to the sides and back? Or do you breathe by moving your ribcage upwards, using your neck and shoulder muscles to raise it?  

​During inspiration, when we breath in, our ribcage must expand to make space for the lungs to inflate. This happens due to the muscular action of the diaphragm and the intercostal muscles (the muscles between our ribs). The intercostals pull the ribs up and outwards while the diaphragm flattens and pushes the lower ribs out to the sides. Both actions create space in the ribcage for lung expansion.  
​
The diaphragm is dome shaped and its vertical fibres attach to the lower ribs. When it’s contracted it flattens and these fibres push the lower ribs outwards as they shorten (1). This movement is known as lateral excursion. You can imagine it like an umbrella opening.  

We also need mid-back expansion when we breath. This is the movement of the back, just under the shoulder blades, at the level of the bra-line. Known as posterior excursion, mid-back expansion ensures that the diaphragm can also work to stabilise us in the upright position (2). When we lack good movement of the diaphragm, it reduces our ability to maintain our balance (3). This leads to stiffness in other muscles in the torso, as they take up the slack, causing pain and tension in this area.  
​
If we raise our shoulders when we breathe this shows that we are in a shallow breathing pattern.  It means our ribcage is rising upwards to create space for the lungs to expand. To do this, we are pulling the ribcage upwards using accessory breathing muscles; the muscles that attach from the shoulder to the ribcage (pectoralis minor) and the muscles that attach from the neck to the ribcage (the sternocleidomastoid and the scalenes). This can lead to neck and shoulder pain and tension, and headaches.  

So, what does this mean? Essentially, it means we need to pay attention to the way we breathe. 

When we learn to breathe using lateral and posterior excursion, we improve the strength of the diaphragm and increase the ability of our ribcage to move. Improved ribcage mobility takes the pressure off the neck and shoulders, decreasing pain, tension and headaches. It allows the diaphragm to move through its full range of motion, becoming stronger and more efficient.    

When we breathe using our diaphragm, we activate the vagus nerve which leads to an increased parasympathetic nervous system response, slowing our heart rate and breathing, and calming us down.
​    
Good diaphragm breathing increases our blood oxygen levels, promoting tissue healing and repair (4)  and improving energy and cognition. Anxiety and dizziness reduce as our ability to expel carbon dioxide from the body improves. We get less aches and pains in our neck and shoulders. Our posture improves along with the stability of the spine, reducing back ache. Mobility of the ribcage and mid-back improves, increasing movement in the areas that should move, and stability in the areas that should be stable.

Shallow breathing patterns are very common during everyday stress and especially so during this time of uncertainty. Diaphragmatic breathing is fundamental to our health and wellbeing, and now more than ever we need to breathe well. 

1. Wallden, M. (2017). The diaphragm; More than an inspired design. Journal of Bodywork and Movement Therapies, 21(2), 342-349. https://doi.org/10.1016/j.jbmt.2017.03.013
2. Osar, E. (2014). Corrective exercise solutions to common hip and shoulder dysfunction. Lotus Publishing.
3. Kocjan, J., Gzik-Zroska, B., Nowakowska, K., Burkacki, M., Suchoń, S., Michnik, R., Czyżewski, D., & Adamek, M. (2018). Impact of diaphragm function parameters on balance maintenance. PloS one, 13(12), e0208697-e0208697. https://doi.org/10.1371/journal.pone.0208697
4. Duvall, S. E. (2017). Postpartum Corrective Exercise Specialist [online training programme] [Audiovisual]. Core Exercise Solutions LLC. www.coreexercisesolutions.com​

Research has shown that there is great variation in the nasal cavity and sinus pathways between individuals. Due to natural anatomical variation some of us are more prone to sinus conditions than others. Anatomical variations can influence how out sinuses drain whether it is due to narrow nasal pathways or a mechanical restriction between two or more bones. Factors contributing to disrupted drainage pathways may be congenital (since birth) or traumatic (such as a neck or head injury).

An osteopathic treatment will diagnose your unique condition and look to address the underlying anatomical cause.

Sinus infection is most often viral rather than bacterial. Symptoms of a viral sinus infection do not require antibiotics and can ease on their own. Alongside osteopathic treatment, there are a few things you can do at home to help:

• Rest and slowing down
• Drinking plenty of fluids
• Elevating your head with an extra pillow when lying down
• Steam
• Humming
• Irrigation techniques (neti pot)

Indications for a bacterial sinus infection include fever, tenderness of the face and changes in the colour of mucosa.

​Whether it's a long term thing, or fluctuating seasonal symptoms, osteopathy can help relieve your sinus symptoms by addressing the underlying cause contributing to your unique condition.

Bibliography

• Cappello, Z. and Dublin, A. StatPearls [Internet]. StatPearls Publishing; Treasure Island (FL): January 2020. Anatomy, Head and Neck, Nose Paranasal Sinuses
• Lafci Fahrioglu S, Andaloro C. StatPearls [Internet]. StatPearls Publishing; Treasure Island (FL): Nov 14, 2018. Anatomy, Head and Neck, Sinus Function and Development.
• Gach P, Tuchtan-Torrents L, Delteil C, Adalian P, Piercecchi MD, Ebert LC, Gorincour G. Virtual reconstruction of paranasal sinuses from CT data: A feasibility study for forensic application. Diagn Interv Imaging. 2019 Mar;100(3):163-168.
• Mahmood HT, Shaikh A, Fida M. Reliability and validity of maxillary and sphenoid Sinus morphological variations in the assessment of Skeletal maturity. J Ayub Med Coll Abbottabad. 2018 Jul-Sep;30(3):360-365.
• Villarreal R, Wrobel BB, Macias-Valle LF, Davis GE, Prihoda TJ, Luong AU, McMains KC, Weitzel EK, Yao WC, Brunworth J, Clark DW, Nair S, Valdés CJ, Halderman A, Jang DW, Sivasubramaniam R, Zhang Z, Chen PG. International assessment of inter- and intrarater reliability of the International Frontal Sinus Anatomy Classification system. Int Forum Allergy Rhinol. 2019 Jan;9(1):39-45
• Weitzberg E, Lundberg J. American Journal of Respiratory and Critical Care Medicine; 2002. Humming Greatly Increases Nasal Nitric Oxide. Vol 166(2), pp.144-145

​

Although we all consider exercise to be a key component of a healthy lifestyle, regular stretching is often overlooked and is not always integrated into our exercise routine. Whether we’re exercising regularly or not, it is important to stretch for both our physical and mental health. Many people consider stretching to be time consuming and so it’s either done very briefly, or not at all. Now that we are currently in isolation, people have more time to consider their physical and mental wellbeing at home. We can use this opportunity to incorporate stretching into our daily lifestyles.
​
If we are working from home, or simply taking this time to rest and recuperate, it’s likely that tension will build up in our muscles after prolonged periods of sitting. It is important to stretch daily to help to keep this tension as minimal as possible. The great thing about stretching is that everybody can do it, regardless of flexibility or age, and you don’t need any equipment or a huge amount of time to be able to feel the benefits. 

​Benefits of stretching

Improve posture
Office workers, or anybody who is seated for long periods of time tend to build up muscle tension in the chest, back and legs, if they don’t regularly stretch. This can dramatically impact your posture because as tension builds up, your muscles will become tighter and shorter in length, causing us to develop rounded shoulders and a slouched and slumped spine. Over time, if this is left untreated, your posture can get progressively worse and can begin to cause musculoskeletal pain. Stretching regularly will help the body respond better to stresses that we put on it through prolonged positioning and will also help to prevent chronic tension from building up.

Reduce chance of injury
Muscle injuries tend to occur when they’re tight and put under strain by being stretched too far. This can happen during simple day to day activities or sometimes through exercise. A regular, consistent, gentle stretching routine will help to keep muscles more supple and flexible, thereby reducing the risk of injury.

Improve range of motion
Tight muscles will prevent your range of motion. For example, tight hamstrings may prevent us from being able to straighten our legs fully, or bend forwards to touch our toes. Regular stretching will improve the flexibility within your muscles and therefore allow an increased range of motion to occur.

Reduce pain and stiffness
A form of active recovery for sore muscles is to do regular, light stretching of the affected muscle group. Many studies have shown that regular stretching can help to decrease pain levels and reduce stiffness, for both acute soreness and also in individuals with chronic neck and lower back pain. 

Calm the mind
Although stretching can feel a bit uncomfortable at first, the more regularly you stretch, the greater the benefit will be for both your mind and body. Focus on taking deep, mindful and slower breaths when you are stretching. This can help to relax you further and help your stretching routine to be calming and enjoyable. 

How often should I stretch?
When it comes to stretching, consistency is key. By doing a few simple stretches daily, our muscles will remain supple, our flexibility and posture will improve and our chance of injury will be reduced. Keep the stretches gentle if you’re doing them throughout the day e.g. lunch time stretches. The best time to stretch more deeply is after exercise when our muscles are warmer e.g. after walking or running.
 
How long should I stretch for?
Hold each stretch for 30 seconds and try not to hold your breath whilst your stretching. Don’t ‘bounce’ in the stretch, this can cause injury. Just take the stretch to the point that you can feel tension in the muscle and hold it there. You should not experience pain when you are stretching. If you do experience pain, ease out of the stretch to find a more comfortable level of tension or contact us for further advice.
 
Keep an eye on our social media where we will soon be posting stretches that you can easily do at home. 

​Rhianna Smith 
DO M.Ost. Reg. Osteopath, MONZ 
www.cityosteopaths.co.nz
​Phone 04 4991439

Acupuncture can be an excellent treatment choice for that annoyingly persistent ganglion!

At Happy Body Acupuncture, we use a unique treatment technique in acupuncture called ‘Surround the Dragon’ to treat ganglion cysts (this essentially is surrounding the cyst itself). By doing this, blood flow is stimulated to the affected area; increasing the circulation and assisting with reducing inflammation and encouraging the body to repair.

I recently had a patient present for acupuncture treatment of a general musculoskeletal condition. During our consultation she mentioned she had suffered an irritating ganglion in her wrist that had been there for years. She didn’t feel hopeful that anything would remedy it except surgery. When I related to her that I had had a large Ganglion in my wrist some years ago, that I removed simply with self-administered Acupuncture, she was open to trying this, for as she explained “What do I have to lose?!”

We followed the same acupuncture technique described above, involving treated the local area of the ganglion, along with focusing on the condition she initially came in for. Our follow up appointment was a week later and the first thing she mentioned with utter shock was that her ganglion was gone!

She had woken the morning after the single acupuncture treatment to find it had disappeared, her comment was “I’m unsure what kind of witchcraft you do but I’m not complaining!”. I explained to her that simply by redirecting the body’s attention to the area of the ganglion, it ‘remedied’ the inflammation  and stimulated healing to finally take place. ​

Sharlene is able to be contacted or booked through City Osteopaths 044991439 or direct email: sharlene@happybodyacupuncture.co.nz 

A female patient very much wanting to get pregnant, presented with a history of two consecutive 'failed to respond to stimulation' IVF cycles. This meant that no eggs were able to be collected from the ovary, so no embryos resulted.

The female patient then came in for a fertility acupuncture appointment including treatment with our Registered Acupuncturist Sharlene McInness, just one week prior to undergoing her third cycle. Her case history revealed no underlying pathology affecting conception, except ‘advanced maternal age’. This unfortunately, is a far too common influencing factor for successful conception.

The acupuncture treatment became immediately focused on encouraging the development of healthy mature eggs during the stimulation phase of her IVF cycle. During this brief time, the acupuncture treatment was twice weekly with the addition of CoQ10 supplementation, which offers additional nutritional benefits for ovarian stimulation. Upon this third IVF attempt , a wonderful result of nineteen eggs were ready for collection with a total of twelve eggs fertilised. An embryo transfer to the hopeful female patient was performed with additional embryos able to be frozen.

A very happy patient, feeling hopeful and excited, approaching her first pregnancy confirmation. This is an extremely positive result in such a short time following two previously failed IVF cycles.

Acupuncture can be a very  effective treatment addition whilst you are undergoing IVF treatment or ovarian stimulation, to increase embryo receptivity and encourage development of mature healthy follicles.

For personal queries pertaining to your own Fertility treatment Sharlene is contactable through City Osteopaths 044991439 or direct email: sharlene@happybodyacupuncture.co.nz 


Best wishes in your Fertility journey 💜"