•  What is a scar?

​Scar is a formation of tissue that occurs as a result of an inaccurate healing process.

•  What are the causes of scar tissue?

All lesions secondary to wounds, burns, acne, insect bites, piercings, tattoos, lacerations, surgeries, including Cesarean section, produce scar tissue. 

​There are few types of scars depending on the excess of the collagen components in the epidermis and dermis. 
 


 
These may adhere to the underlying layers, causing pain and affecting soft tissue mobility and range of motion. 

• Osteopathic manual treatment ​

Osteopathic manual treatment is able to reduce the deposition of collagen during the healing phase, applying external and orientated mechanical force with the hands on the scar tissue. This phenomenon is called as ‘Mechanotrasduction’. The reaction is a biological change that reduces the inflammatory process and induces a recovery of elastic proteins.
 

At City Osteopaths we provide a specific assessment of the scar, applying an evidence-based treatment and considering the timing of the healing process and mobility of the Fascia.
 
Our fascial osteopathic technique consists in a gentle pressure on deep scar structures, in order to decrease the adhesion density spots and consequently restore the functionality and elasticity of the tissue.

Over the past twenty five years in New Zealand, the awareness of osteopathic treatment for babies has increased, however we are still often asked when to seek treatment for a baby. We also often see older children who could have benefited from treatment as a baby. We are keen that all babies and children who need help, receive it in a timely fashion.

This article is to inform parents when to seek osteopathic treatment for their baby and what to look for in an osteopath.

​A baby will often communicate there is a problem by being unsettled, irritable or wakeful.
​Symptoms in a newborn baby to be aware of are:

• colic
• excessive wind
• continuous crying
• difficulty feeding or a preference to feed from one breast
• sticky eyes
• sleeping difficulties
• stiffness of the neck muscles
• favouring the head to one side 
• a misshapen head
• tongue tie or jaw restriction

What education do Osteopaths have?

Osteopaths train for forty hours per week for five years full-time at university and are required to competently pass well over one hundred exams and undergo clinical competency training and exams.

Osteopaths are government regulated and registered with the Osteopathic Council of New Zealand and must partake in ongoing professional education each year. We are also ACC treatment providers.

Osteopaths who treat babies and young children ought to have done extra post graduate study in addition to their undergraduate paediatric study.
​

Why would a newborn baby have anything wrong with them that is needing help by an osteopath?
A baby's passage through the birth canal is usually a difficult process however nature ensures that the bones of the skull are pliable enough to overlap to enable this to happen. Sometimes the bones do not return to their normal positions after delivery. This can happen if the labour is unusually long or fast, if there is a large baby passing through a small pelvis, if a baby has a large head or if intervention is necessary for example a forceps delivery or ventouse extraction. A baby may suffer a cranial base, neck, shoulder or back strain during the birth process. Pre-term babies may have strain from being out of the uterus too early and there is also likely to be alterations in nervous system function.

A Caesarian birth may involve trauma to the baby who is stuck in the mother's pelvis. Alternatively, problems can occur in utero if there is insufficient amniotic fluid.

Very often your midwife or lead maternity carer will refer you and your baby to see an osteopath for assessment and treatment, particularly if the birth has been difficult. We also work with Lactation consultants to help with feeding issues. This can include jaw and cranial base problems that may be affecting the baby's ability to latch, or to treat the tongue and surrounding structures in cases where a posterior tongue tie is affecting baby's function.

How soon should my baby see an Osteopath?
If there is nothing particularly troublesome going on for your baby then we recommend two weeks after the birth is a good time to have made an appointment as that gives you time to feel settled at home and also figure out how to get out of the house and travel with a new baby.
If the birth has been difficult or your baby is very upset and won't settle, then we recommend bringing them in to see a cranial osteopath as soon as possible.
​
What does the assessment and treatment look like?
First a medical history of the mother and baby is taken relating to the pregnancy and birth and any concerns you may have. Then your baby is gently assessed from their feet up to their head. Findings and treatment process are explained and then treatment will take place with your consent.
The treatment looks calming and is very gentle for your baby. If necessary we can treat your baby while they are being breast fed or sucking on a finger to help soothe them. Osteopaths use their hands to gently help the baby undo strains in the fascia (the connective tissues of the body), to help restore better alignment and function. We are also able to assist the autonomic nervous system of the body, calming the sympathetic and boosting the parasympathetic nervous system. This is very relaxing and helps the digestion to settle and ideally the whole body to be in self healing mode. Please note cranial osteopathy is not just to do with the head, any tissue in the body can be  treated with this gentle approach. Our clients find it is surprisingly effective.

Afterwards your baby may be more hungry than usual and be a bit unsettled or sleep for longer periods as their body works with the treatment to undo strains and find better alignment and health. 

Ideally all pregnant mums would be assessed and treated at around 35 weeks pregnant to help balance up the pelvis and ready the connective tissues of the body for birth.
Research shows 
http://jaoa.org/article.aspx?articleid=2092759) that this results in a better birth with fewer interventions. This also means post birth we can see you for a one hour 'Mother and baby' check up together.

Some research:
Meta-analysis of research shows Osteopathic treatment reduces length of stay and costs in preterm infants. March 2017 insights.ovid.com/crossref?an=00005792-201703240-00043
Osteopathic treatment of children with cerebral palsyjaoa.org/article.aspx?articleid=2093549#72971939
Research evidence for cranial bone mobility:
http://www.icnr.com/articles/radiographic-evidence-of-cranial-bone-mobility.html
​Research on cranial rhythmic impulse and the Traube-Hering-Mayer oscillation:
http://jaoa.org/article.aspx?articleid=2092406 
Research on measuring intracranial wave form pulsatility:
http://www.ncbi.nlm.nih.gov/pubmed/9779147
Pre-term-infants(Research:http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0127370 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3648440/)
Research on treatment of colic http://​www.sciencedirect.com/science/article/pii/S1744388105001350
Research on plagiocephaly www.sciencedirect.com/science/article/pii/S174438811100020X
Research evidence on safety of Cranial Osteopathy: http://jaoa.org/article.aspx?articleid=2093194

​While particular attention should be directed towards the pelvis, osteopaths try to make sure the whole body is able to adapt efficiently to the incredible changes that happen on many levels during pregnancy. Some things we focus on pre-conception are improving blood flow and lymphatic circulation in the pelvis and abdomen. This is so important these days when most people spend hours sitting at their desks or in vehicles. Balancing the autonomic nervous system (which usually means reducing the effects of stress by calming the sympathetic nervous system) is another area that often needs help and can make for a very different experience once a woman becomes pregnant, for both herself and the baby.

While sorting out dysfunctions that can be dealt with pre-conception is ideal, treatment in pregnancy is very beneficial and often needed. Pregnancy is a very dynamic state where the body undergoes some profound changes in a relatively short space of time.



​​I will touch on a few of those below and mention briefly what osteopaths can do to help “support the change” or reduce discomfort if the changes are not happening as smoothly as they should:

1) Postural/mechanical changes: as the body’s centre of gravity shifts for obvious reasons, the posture changes dramatically. It is of vital importance to ensure that there are no major restrictions so the structure is able to adapt to new demands. One very important aspect is to ensure normal mobility of the sacrum so that it can move during labour thus making it easier for the baby to pass through the birth canal. But it’s not just about the pelvis. Chronic sitting in desk workers often leads to tension and sometimes constant pain in the shoulders/neck or between the shoulder blades. Not only is this uncomfortable and stressful, restrictions there would prevent a woman from achieving a deep squat with good form - which is one of the most useful exercises in pregnancy as well as a great position during labour that helps the baby descend. Having a mobile thoracic spine and ribcage also means you can breathe more efficiently getting more oxygen for yourself and the developing baby, have more energy and a clearer head! 

Some research on Osteopathic treatment in Pregnancy:
Osteopathic manipulative treatment for nonspecific low back pain: a systematic review and meta-analysis.www.ncbi.nlm.nih.gov/pubmed/25175885 
Acute improvement in hemodynamic control after osteopathic manipulative treatment in the third trimester of pregnancy. https://www.ncbi.nlm.nih.gov/pubmed/24280470
​

​Aydan Hajiyeva Honours Diploma in General Medicine, DO M.Ost. Reg. Osteopath MONZ
Aydan has an Integrated Master’s Degree course from the European School of Osteopathy (UK).
Having previously completed six years medical doctor training, she really appreciates the holistic nature of the osteopathic approach. She has been exposed to a variety of treatment approaches at university, including classical, cranial and visceral osteopathy and has undertaken post graduate education, including biodynamics of osteopathy, primitive reflexes and pregnancy care, which have helped her develop her vision of osteopathy. Aydan regards osteopathy as a philosophy allowing her to create a positive change in a patient, by facilitating the expression of the inherent wisdom of the body.
www.cityosteopaths.co.nz 
​Phone 04 4991439

What does an osteopath even do?
By Claire Richardson

We get it. Lots of people don’t really know exactly what we do. First of all, it doesn’t help that our name is a massive misnomer, a relic of the past where bony “alignment” was emphasised far more than what we know to be useful today.
In medical terms, Osteo = bones. Path = disease. Therefore, osteopaths treat diseases of bones right? Well, wrong actually!

Secondly, osteopaths seem to be associated with mainstream medical clinics, but also alternative therapies. Are osteopaths just greedy fence sitters who can’t make up their mind?
First of all – an osteopath isn’t some weirdo replacement for your GP. We’re University trained manual healthcare practitioners.

Our brief job description is simple. We assess, diagnose, treat and rehabilitate conditions of the human body, in particular, the musculoskeletal system. We do this in an allied health setting, with input from other healthcare professionals such as GP’s, exercise physiologists, psychologists, personal trainers and so on.

The vast majority of osteopaths will predominantly deal with musculoskeletal issues such as low back pain, neck pain, headaches, sports injuries etc.Some osteopaths have trained in treatment of other conditions such as constipation or period pain, which can be related to the muscles within our bowels or uterus.

A typical appointment with an osteopath will include a thorough discussion about your condition and your concerns. The osteopath will discuss with you your medical history, and ask questions about your work habits or other relevant health related topics such as diet or exercise.

Following this, the osteopath will assess the area of pain or dysfunction. This might include getting you to move in a certain way, or feeling the muscles. The Osteopath might poke or prod certain areas to get an idea of whether they are moving or functioning properly.

The osteopath at this stage will have a diagnosis of your condition, and will inform you what seems to be causing the problem. If the problem is something that the osteopath can confidently treat, they will begin with your consent. If the osteopath believes that your condition is being caused by something non-musculoskeletal or more serious (such as infection etc.), they will refer you to an appropriate practitioner such as a GP.

Treatment will vary between patients, because each individual body is different, and each presentation of a condition is different. Some patients respond well to gentle treatment, such as light massage, breathing techniques or stretching, whereas others will do better with stronger techniques such as deep tissue massage, manipulation (cracking) or active stretching.

Most of the time, an osteopath will apply some hands on treatment, however, depending on your condition your osteopath may instead get you doing some specific, tailored exercises to help activate or “wake up” certain muscle groups.

Sometimes, osteopaths will also run an education session for patient with chronic pain (long lasting), to help them implement strategies to decrease their pain long term.

So, osteopaths are manual therapists with a dodgy name. No, it’s not just bones. We deal with the musculoskeletal system, we deal with pain, we deal with injuries, and we deal with rehabilitation.

Are we fence sitters? Nope. Osteopaths in Australia and New Zealand are Allied Health practitioners who work with, not against GP’s. Whilst some osteopaths may choose to work with naturopaths or other alternative therapists (just like some physiotherapists do), this doesn’t override their ability and training to refer to a medical professional when necessary and indicated, or sway their likelihood to do so.
​
Osteopaths hang their hats on providing patient centred care. This can only happen with a team care approach – so we want GP’s and their medical expertise on board!

Claire Richardson
Reg. Osteopath
Victoria, Australia

To see one our Reg. Osteopaths in Wellington, phone 04 4991439 or check out our website www.cityosteopaths.co.nz/osteopathy.html