Injury blog: Winging of the shoulder blades

Hey everyone! We hope you are keeping well. We’re carrying on with life as close to normal as possible, so here is your monthly reading material. Perfect time for a tea or coffee we say! This month we’re taking a close look at the shoulder, specifically a condition that affects the shoulder blade. Do you have, or have you ever seen someone whose shoulder blades stick out on their back and look a little bit like wings? This condition is aptly named ‘winging’ of the shoulder blades.

Anatomy

Osteopaths love a bit of anatomy! The shoulder blade or ‘scapula’ is a largely flat bone that sits on the back of the rib cage and is an important ingredient in what makes up the various joints of the shoulder. As well as the larger flat part, a few extra lumps and bumps makes for a very odd shaped bone when looked at in isolation. One of the bony protrusions actually makes up the ‘socket’ part of the ball and socket joint in the shoulder. The ‘ball’ part being made from the head of the upper arm bone (aka the ‘humerus’).

Interesting fact… There are 18 muscle attachments on the shoulder blade. It is through fine balancing of these muscles which keeps the shoulder blade stabilised and flush to the back of rib cage and allows us to move our shoulders through an extremely large range of motion. As you can imagine, keeping all of these muscles in full working order takes a bit of co-ordination. And with so many players involved, there is room for dysfunction to creep in and movement to become affected. Sometimes the dysfunction is great enough to cause the shoulder blade to flip outwards from the rib cage, and this is what we refer to as ‘winging’.

Causes of winging

The causes of shoulder blade winging can be broadly broken down into:

  • Muscular: As we previously mentioned, lots of muscles are responsible for controlling the position and movement of the shoulder blade. Injury to these muscles, or an imbalance in the strength, length and function of the muscles over a prolonged period may lead to this issue. The main muscles involved here are the Serratus Anterior (a muscle which attaches to the ribs and the underside of the shoulder blade), and the Trapezius (a kite shaped muscle which covers the back of the neck, shoulders and upper back… Aka ‘traps’). It’s more complex and there are more muscles involved, but these are the key players when it comes to winging.
  • Neurological: Muscles require a nerve supply in order to move, so if any of the nerves that supply the key players (i.e. Serratus and Traps) are injured, this can stop the muscles from being able to perform their job. Nerves can be injured through entrapment, where something presses on a nerve as it travels from the spine down to the muscle it supplies. Other causes may be from acute traumas as seen with car or sporting accidents where the shoulder takes a direct blow while the arm or neck are suddenly pulled.

Other ways these injuries may come about include prolonged wearing of a heavy backpack, complications following surgery, or as a result of a viral infection that affects the nerve.

Signs and Symptoms

The main sign is a shoulder blade that doesn’t sit snug to the rib cage, particularly when trying to move the arm upwards in front of the body or out to the side. Many people with scapula winging feel no pain whatsoever, but this can be a very painful condition if the cause is from a severe nerve injury. Another key sign is the inability of a person to lift their arm above their head.

Treatment

The treatment of shoulder blade winging very much depends on the cause. If the shoulder blades are winging because of a muscular imbalance, these are a little easier and faster to rehab. After careful assessment of your shoulder, neck and other spinal movements, we will aim to restore full functioning of the muscles that control the position and movement of the shoulder blades. This might include techniques which aim to lengthen short or tight muscles which are pulling the shoulder blade out of position. If there is a weakness to a particular muscle or group of muscles, we will also prescribe you strengthening and movement re-training exercises which aim to return the shoulder blade to its functional position.

Winging caused from nerve entrapment or injury is notoriously harder to treat. If entrapment of the nerve is caused by muscular tension in another part of the body, or because you’ve been carrying a heavy backpack for too long, then we will work on the relevant muscles and nerves to release the entrapment and pressure. We might also need to adjust how you wear your backpack and how much weight is inside while we focus on improving your physical impairments. Nerve-related injuries can take much longer to resolve. Winging caused by paralysis of the nerve which supplies the Serratus Anterior muscle has been known to take up to two years to resolve. The good news is, most people will make a full recovery in this time with surgical procedures saved only for more complex or unresolved cases. Which if you ask any Osteo, is always the goal!

If you notice winging of the shoulder blades, or difficulty with achieving full shoulder range of motion, then get in touch today on 9078 2455. We would love to chat to you about your issue in a phone or video consult and get you on the road to recovery as soon as possible.

References

  1. Brukner, P. et al. 2017. Clinical Sports Medicine. 5th ed. Australia: McGraw Hill Education
  2. Snell, R. 2012. Clinical Anatomy by Regions. 9th ed. USA: Lippincott Williams & Wilkins
  3. Magee, D. 2008. Orthopaedic Physical Assessment. 5th ed. USA: Saunders Elsevier

Flat footed? Read on…

Feet of woman doing exercises with rubber ball in clinic

Have you ever been told you have flat feet? Or have you noticed that the arches in your feet are not quite the same as others? Although we are all a part of the same species, many of us have variations in our anatomy that make us unique. Look at a crowd of people and you’ll notice many different shapes and sizes. Our feet are the same. Some people have very developed arches in their feet, others have under-developed arches and have an almost ‘flat’ look to their feet. This phenomenon is known as ‘pes planus’.

Why does it occur?

There are two main reasons a person may develop flat feet. They are:

  • Congenital: A person is born with it and the feet fail to develop an arch through childhood into adulthood. A small percentage of the population have a connective tissue disorder which can leave the joints in the body less stable and more mobile. These conditions (namely Ehlers-Danlos and Marfans Syndromes) are also associated with having flat feet.
  • Acquired: A person develops flat feet as a result of trauma, tendon degeneration, or through muscular or joint disease.

Most babies will have a flat foot at birth, but usually by the age of 10, a strong and supportive arch has developed. For some people, the arch simply does not develop, and this may or may not lead to problems down the line.

Signs and symptoms

The obvious sign to look for is a flattened arch of the foot. If you look at someone from the front or slightly to the side, you may notice that the majority or whole of the inside border of the foot is touching the ground, as opposed to there being a clear space between the heel and ball of the foot.

What effect can this have on the body? It is quite possible and very common, for someone to have flat feet and have no symptoms at all. This is known as being ‘asymptomatic’. It may surprise you to know that only 10% of people with flat feet experience symptoms. These people are known as ‘symptomatic’.

People who do experience pain as a result of this condition do so because the lack of arch supporting the inside region of the foot has a knock-on effect to the mechanics of the rest of the limb. This then affects how the pelvis and spine function too. Pain in the middle part of the foot, heel, knee, hip and lower back are all common complaints. It is also not uncommon for someone with flat feet to experience recurrent ankle sprains, where they regularly ‘roll  the ankle.

Treatment

Do I need treatment if I have flat feet?” If you have no symptoms and having flat feet does not affect your life in any way, the answer is simply ‘no’.

If you have pain caused by this problem, then this is where we (and other professionals) come in. Pes planus is a great example of how a problem in one part of the body may lead to pain and dysfunction in a completely different part of the body. It’s an osteo’s dream! Not your pain, of course… However, we are experts at recognising the root cause of a problem and putting a plan in place to get it resolved fast.

Techniques we use may include soft tissue massage, joint mobilisation of the foot, ankle, knee, hip or spine and strengthening exercises. Exercises will aim to strengthen the arch itself, but may focus up the chain to the thigh, glutes and trunk as well. A large part of our job here is to also educate a patient on which footwear to use and whether or not they require the help of orthotics (these are special insoles for your footwear). Some children and adults may need some extra support inside their shoes to help reduce the effect of mechanical change up the limb. We may decide that you will benefit from seeing a podiatrist or other foot specialist who is able to design and supply you with insoles that are unique to you and the shape of your foot. Being obese can also increase the load on the lower limbs, therefore increasing the effects of pes planus in the process. In these cases, we can help to advise on how you go about losing weight through changes to your diet and exercise regimes.

For the majority of cases, a combination of these treatments above will result in improved mechanics and reduced pain, allowing the patient to continue doing the things they love. For the very few people who do not respond to treatment, an orthopaedic specialist’s opinion may be required for long term management. This is always a last resort.

Check out your feet. Do you have a flattened arch when you stand up and weight bear? Is there any associated pain? If so, call us today 9078 2455 and we’ll tell you what needs to be done to beat the pain! Arch you glad you read this now?! 😉

References:

  1. Radiopedia. 2020. Pes planus. [Online]. Available from: https://radiopaedia.org/articles/pes-planus. [Accessed 08 May 2020].

2. Raj, MA. et al. 2020. Pes Planus. Stat Pearls. [Online]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK430802/. [Accessed 08 May 2020

Fractures Let’s ‘break’ it down

Have you ever broken a bone? We hope you haven’t, but it’s a common injury that happens to people every day! Any break in the structure of a bone is known as a ‘fracture’. We’ve written a quick guide to understanding all the lingo relating to fractures below. Let’s check it out!

Cause

Fractures are usually caused in one of three ways:

  • Excessive force: This can be through either a direct force to a body part (i.e. a high tackle in football which breaks the shin-bone) or an indirect force (i.e. having your foot planted and twisting your leg which leads to a fracture of the shin-bone).
  • Repetitive stress: These result from repetitive, strenuous activities like running or jumping.
  • Other disease: These are fractures secondary to another disease process in the body which leaves the bone more prone to breaking. This may be a hereditary disease like Osteogenesis Imperfecta (aka Brittle bone disease) or as a result of cancer or infection.

Types of fracture: General description

Fractures are broadly classified into two main types:

  • Closed: The bone fractures and the overlying skin remains intact.
  • Open: The bone fractures and protrudes through the skin exposing the bone and other tissues to the elements. These types of fractures are prone to becoming infected, which complicates everything.

We can also classify fractures on whether they are:

  • Complete: A clean break of a bone into two or more pieces
  • Incomplete: The bone is not completely broken with some of the outer structure of the bone remaining intact.

Types of fracture: Now let’s REALLY break it down!

Each fracture can also be given a more specific description based on where exactly the bone is broken and in what way it has broken:

  • Transverse: A horizontal break across the shaft of a bone.
  • Linear / fissure: A vertical break along the shaft of a bone.
  • Oblique / spiral: A diagonal, or as the name suggests, spiral type fracture around the shaft of a bone.
  • Greenstick: One side of a bone has broken but the other side remains intact. This is common in children where bones are much more flexible than adult bones.
  • Comminuted: The bone is broken into more than two pieces, possibly into several fragments
  • Impacted: Two parts of a bone fracture are forced into one another
  • Crush: Usually seen in the spine caused by vertical and forward bending forces down through the vertebrae
  • Hairline: A tiny crack in the bone — these are so small that they are commonly missed on an x-ray!
  • Avulsion: A piece of bone is ripped away from the main bone by way of tendon or ligament injury. (Remember tendon attaches muscle to bone and ligament attaches bone to bone).

Which type of fracture have you had in the past? We hope this guide will help you work it out. Next time you come across a fracture (fingers crossed you don’t) you’ll know exactly what the doctors are talking about!

Stay safe!

References

  1. Brukner, P. et al. 2017. Clinical Sports Medicine. 5th ed. Australia: McGraw Hill Education
  2. Xui, P. 2012. Pathology. 4th ed. UK: Elsevier Mosby
  3. Tortora, G. and Derrickson, B. 2011. Principles of Anatomy and Physiology. 13th ed. Asia: John Wiley & Sons

Vertigo: symptoms and treatment

Welcome back readers! This month we are switching focus to the head, and specifically a condition which causes a person to feel dizzy. We welcome you to the world of Benign Paroxysmal Positional Vertigo (BPPV). In simple terms, a non-serious sudden attack of dizziness brought on by a change in head position.

What is vertigo?

Vertigo is a type of dizziness where a person experiences the sensation of whirling, spinning or swaying. A person will usually feel that they, or objects around them are moving when they are not. There are several causes of vertigo, with the most common cause being BPPV. Other common causes include Ménière’s disease (vertigo with hearing loss and ringing in the ears) and labyrinthitis (inflammation of the inner ear).

The ear is made up of an outer, middle and inner section. The outer ear is the ear that we see on the head and the opening that leads into the head itself. This connects to the middle ear — a small area inside the head which houses the ear bones, connects to the inner mouth and also the inner ear. The inner ear is the section which houses our hearing and balance organs — the cochlea and the vestibular system. It is this most inner section which is involved with BPPV.

What causes BPPV?

The structure of the inner ear is quite complicated. It is a maze of hollow chambers and canals all connected together and filled with fluid. There are three semi-circular canals which are expertly positioned to detect movement in the 3 planes that our head can move (nodding up and down, tilting left and right, and looking left and right). Inside the chambers live tiny crystals which, when movement of the head occurs, move and send important information to the brain about what type of movement is occurring. Sometimes these crystals become detached from the chamber and move into the canals where they can play havoc.

Basically, the crystals move through the fluid which stimulates nerve endings in the canal. The nerves then send a message to the brain which the brain perceives as movement, even though the head isn’t actually moving. Because this information doesn’t match with what the eyes are seeing and the ears are detecting, we experience vertigo. It is one big mismatch of information which is tricking the brain. And the effect is quite unpleasant!

An attack of BPPV can be brought on by a quick change in head position, when rolling over in bed, sitting up from lying down, or when looking up to the sky. A recent head injury or degeneration of the inner ear system can precede episodes of BPPV.

Signs and symptoms

The main symptoms as discussed include a sensation of spinning or swaying. People may also experience feelings of light-headedness, imbalance and nausea. Attacks will usually only last a period of a few minutes and may come and go. It is not unusual for a person to have a period of symptoms followed by a period of no symptoms for months at a time. If symptoms persist for longer than a few minutes at a time, then it is likely the vertigo is from a different cause.

Some conditions that cause vertigo can also give symptoms of headache, hearing loss, numbness, pins and needles, difficulty speaking, and difficulty coordinating movements. Episodes of vertigo may also be much longer or constant. If you experience any of these symptoms they should be reported immediately as they could be signs of more serious issues, which will need to be investigated.

Can it be treated?

BPPV is very treatable. Many people with dizziness end up seeing their GP first, but it is common for a GP to refer these cases to us here at Inner West Health Clinic for ongoing management. After a thorough session of questioning and assessment, if we are happy with our diagnosis of BPPV, then we can get to work right away.

BPPV can affect any of the semi-circular canals mentioned above. For treatment, we need to first bring on the symptoms. It sounds sadistic, but it is necessary to ensure we resolve the symptoms for you. Treatment for BPPV consists of a series of head and body movements where you start seated, move into a lying down position and end sitting upright again. This series of movements is known as the Epley Manoeuvre and is used to treat the most common form of BPPV. If the source of the problem is coming from a different canal, then the treatment will be slightly different.

We then send you away with some general do’s and don’ts. You may have to keep your head relatively still for the rest of the day (sorry, heavy exercise is not recommended at this stage) and to sleep propped up for the first night after treatment. We will then organise for you to come back in within a few days to reassess and if necessary, continue with another treatment.

Final comments…

Interestingly, we often get patients come in who think they have vertigo, but in fact, it’s other structural issues contributing to their dizziness (which we diagnose and treat). That’s why it’s so important that we have a thorough consultation, to ensure we develop the right treatment plan for you. If you think you are experiencing vertigo, please come in and speak to us. Osteopaths are highly trained medical practitioners who can help treat more than you think. Call us today on 9078 2455 to book your consultation.

References:

  1. Vestibular Disorders Association. 2020. Benign Paroxysmal Positional Vertigo (BPPV). [Online]. Available from: https://vestibular.org/understanding-vestibular-disorders/types-vestibular-disorders/benign-paroxysmal-positional-vertigo. [Accessed 28 Feb 2020]
  2. Healthline. 2018. Benign Positional Vertigo (BPV). [Online]. Available from: https://www.healthline.com/health/benign-positional-vertigo. [Accessed 28 Feb 2020]
  3. HANDI project team. 2013. The Epley Manoeuvre. Australian Family Physician. 42 (1). 36-37. Available from: https://www.racgp.org.au/afp/2013/januaryfebruary/the-epley-manoeuvre/

The effect of obesity on the body

Obesity is, and has been for a long time, a hot topic. The stats on obesity are startling… The World Health Organisation (WHO) report that global obesity rates have tripled since 1975. In 2016, it was estimated that 1.9 billion adults were overweight across the world, with a third of those being obese (this stat rose to 2.1 billion in 2019). In that same year, 41 million children under 5 years of age were classified as overweight or obese. This is worrying stuff. But what is obesity, and what does it mean to be obese?

What is obesity?

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Obesity (and being overweight) is defined by the WHO as “the abnormal or excessive fat accumulation that presents a risk to health”. Obesity is traditionally measured using a person’s Body Mass Index (BMI), which is calculated by dividing their weight by their height (in metres) squared.  A BMI which equates to 25 or over is classified as overweight… 30 or more equals obese. Due to the inability to distinguish gender and fat from muscle, the process is flawed. The Relative Fat Mass index (RFM) which takes into account someone’s gender, height and waist circumference is a more accurate tool in measuring someone’s fat mass and their risk of developing health problems from it.

Effects of obesity on the body

Now we know what obesity is, let’s explore what this means for the body. These are some of the known negative side effects of being obese:

  • Increased risk of numerous diseases: With obesity comes an increased risk of developing high blood pressure, heart disease, type-2 diabetes, stroke, respiratory conditions including sleep apnea, osteoarthritis, gallstones, menstrual issues, incontinence, many types of cancer, and mental illness (e.g. depression).
  • Increased risk of death: Being obese puts you at increased risk of death from all causes, but especially relating to cardiovascular disease (e.g. heart attack/failure).
  • Complications during pregnancy: Mother and baby are both at risk. Mothers are more likely to develop high blood pressure and gestational diabetes, as well as difficulties during labour and retaining weight post-pregnancy. For the baby, the risk of late fatal death increases, as does the risk for developing neural tube defects (e.g. spina bifida).
  • Increased levels of pain: Evidence suggests obesity puts the body in an inflammatory state causing pain. Increased load on the joints leads to breakdown of cartilage which drives more inflammation. There is an increased rate of depression which exacerbates the pain experience as well. People then become afraid to move through pain and being sedentary means lack of movement through the joints, and they continue to degenerate. It’s a vicious cycle!
  • Poor quality of life: Obesity makes life hard. Carrying out everyday tasks becomes laborious. All of a sudden, hanging out the washing and cleaning the house or car can seem harder than they should do. It can also affect people’s desire to go out and be social. People who are obese are also at risk of developing undesirable body odour which can make social situations difficult.

The side effects of being overweight, especially obese, are many and very serious. It is simple… Being obese will increase your chances of serious disease and death, as well as impact your life negatively in many other ways.

It is daunting and challenging trying to lose weight. If you need help, please talk to us during your next visit here at Inner West Health Clinic and we will be happy to discuss options with you. We can work alongside your GP, or other health professionals, to help work out what the best and safest option is for you – getting you on the right track to a healthier, happier self.

References

  1. World Heath Organisation. 2020. Obesity. [Online]. Available from: https://www.who.int/topics/obesity/en/. [Accessed 01 Feb 2020]
  2. Kobo, et al. 2019. Relative fat mass is a better predictor of dyslipidemia and metabolic syndrome than body mass index. Cardiovascular Endocrinology & Metabolism. 8 (3). 77-81. Available from: https://journals.lww.com/cardiovascularendocrinology/Fulltext/2019/09000/Relative_fat_mass_is_a_better_predictor_of.4.aspx
  3. National Heart Lung and Blood Institutes. 1998. Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obese Adults: The Evidence Report. National Institutes of Health. No. 98-4083. Available from: https://www.nhlbi.nih.gov/files/docs/guidelines/ob_gdlns.pdf
  4. McVinnie, DS. 2013. Obesity and pain. British Journal of Pain. 7 (4). 163-170. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4590160/
  5. NHS. 2019. Body Odour. [Online]. Available from: https://www.nhs.uk/conditions/body-odour-bo/. [Accessed 01 Feb 2020]

Should I see an Osteo if I have a headache?

Hello readers! It’s a new month which can mean only one thing… It’s time for a cuppa and a sit down so you can read our new blog. This month’s blog topic is one that millions of Australians (and billions around the world) can relate to. Have you ever had a headache? We’d be surprised if you said no, because a headache is one of the most common symptoms experienced by our species. Nearly everyone at some point in their life experiences a headache. If you or someone you know is part of the minority that has never had one, then come forth… Medical researchers will want to get their hands on you!

The list of headache types is as long as the distance between your shoulder and the tips of your fingers! Some types of headache are very common, others very rare. Some of the different types of headache include:

  • Tension-type
  • Migraine
  • Cervicogenic (i.e. something in the neck leading to pain felt at the head)
  • Eyestrain
  • Withdrawal
  • Dehydration
  • Temporomandibular joint dysfunction (i.e. a problem with the jaw joint causing head pain)
  • Many others of non-serious and serious causes

The burning question

If you have been a headache sufferer for a long time, there is a good chance you have tried every remedy out there. Finding the solution is hard, but fear not, help is at hand! We regularly get asked “can you help me with my headaches?” The answer is always “maybe”, but there is a good chance we can. So why see an osteo over another medical professional? The short answer is we’re awesome! The long answer is we are experts of anatomy of the human body (4-5 years of study!), we sit and listen to you tell your story, we have excellent problem-solving and clinical skills, we have magically soft, caring hands, and we are highly trained to help people get to the bottom of their ailments, headaches included. Other medical professionals are also awesome, we just love the osteopathic philosophy of treating the person and the body as a whole.

What to expect from your osteo

The reason a person is in pain is usually down to many factors. It is therefore very important to get a full story from each patient that presents with a problem. This is where we shine. Your initial consultation will entail a very thorough questioning session where we ask you lots of questions about your current issue, the history surrounding it, and other questions relating to your medical, lifestyle and work history. From the word go, we will be painting a picture of what is going on with you. From the information you give us and the questions we ask, we will be ruling in or out which type of headache you could be experiencing.

Some types of headache have very specific features, and we may be able to come to a conclusion quite quickly. Other types may be less easy to recognise, but by the end of the questioning we will have a list of conditions in our mind that we need to test for. This is where we perform our clinical tests. Some of the more common types of headache are due to problems relating to the muscles and joints around the neck and head region, so we’ll ask if we can have a good feel of these areas. We’ll watch you move, then we’ll move you around, feel and compare between the two. We may need to test the nerves that give your head and neck their function, or we may need to take your blood pressure… Either way, we can do it all.

For headaches, we will be particularly interested in what your head, neck, mid-back, shoulders and general posture look and feel like and how everything moves together. We will always be looking at the bigger picture though, so if you’re wondering why we’re checking the levels of your pelvis or the length of your legs, it’s because we’re searching for every possible reason as to why your headache is occurring. After careful consideration and once we are happy with our diagnosis, we will sit and have a chat about what is going on and what the plan is to get you feeling good again. At this point we’ll get to work on your body using the many techniques we have at our disposal. We will also offer advice on any lifestyle changes you may need to make to ensure the headache is being attacked from all angles. A headache diary is often a suggestion so we can keep track of your headaches from week to week. However, this will be discussed in your initial consultation.

Sometimes a headache can be the sign of a more serious problem that we may not be able to help you with. If this is the case, we will ensure you are directed towards the right people for the job. This may entail us writing a letter to your GP with our findings and recommendations. Whether we treat or not, you will receive the highest level of care from us. We pride ourselves on it!

Final comments

If you or anyone you know is experiencing headaches, please pick up the phone and call us on 9078 2455.  Now you know what we can do to help, we hope the next time you are asked the question “Should I see an osteo if I have headaches?” your answer will be a solid YES!

P.s. We can even help with ice cream headaches (a.k.a ‘brain freeze’)… Our advice is simple—slow down and enjoy it! (we get how hard that is)

References:

  1. Migraine & Headache Australia. 2019. What is headache. [Online]. Available from: https://headacheaustralia.org.au/what-is-headache/. [Accessed 15 Jan 2020]
  2. Migraine & Headache Australia. 2019. Headache types. [Online]. Available from: https://headacheaustralia.org.au/types-of-headaches/. [Accessed 15 Jan 2020]
  3. Biondi, BM. 2005. Cervicogenic headache: a review of diagnostic and treatment strategies. The Journal of the American Osteopathic Association. 105 (4). 16S-22S. Available from: https://jaoa.org/article.aspx?articleid=2093083

Online Appointments.

Online Osteopathy Appointments

We're online at IWHC
Online appointments are now available with our practitioners at Inner West Health Clinic

Osteopaths are able to use their expertise in management of physical stress and tension by providing postural guidance and exercises via Telehealth

This a remote consultation undertaken via Zoom with your osteopath. The osteopath will be based at Inner West Health Clinic or their home office and you can stay in the comfort of your own home.

Requirements: You will need to have a computer/phone that includes a camera with audio.

We have 2 options depending on your needs.

Please Note: ONLINE OSTEOPATHY CONSULTATIONS MAY NOT BE SUITABLE FOR YOU! Before booking this consultation, please email info@innerwesthealthclinic.com.au with your name and contact details (email and phone number) so that we can touch base via email or phone to determine if this consultation is suitable for you.

OPTION 1:

10-15 minute consultation

You are entitled to 2 free short consults.
Future consults charged at $20.

Designed to enable an online, face to face conversation between clients and practitioners, to touch base and briefly discuss –

  • Current state of your existing condition.
  • New injuries or complaints
  • Concerns regarding exercise management plan
  • Quick look and review of home work space ergonomics.

OPTION 2:

30-40 minute Telehealth consultation

The consultation may include the following:

  • Case History of your presenting complaint
  • Movement assessments where relevant
  • Practitioner guided movement based therapy / Exercise prescription / review where appropriate.
  • Treatment and management advice (includes highly detailed video based exercise prescription).
  • Detailed ergonomic assessment of home work space. (If you would like a detailed report for your employer, this can also be provided $105.)

Payment: Payment for online consultations are required prior to the consult. Payment options include payment over the phone (with credit card details) or electronic bank transfer.
A receipt will be emailed following payment.

*** BULK BILLING IS AVAILABLE FOR ALL CHRONIC DISEASE MANAGEMENT PLAN AND DVA CLIENTS. ***

The benefits of fasting

Hello everyone. Let’s have a chat about fasting. In the last few years, fasting has been gaining popularity across the world as a way of improving human health. Did you know that fasting has been around for centuries and centuries? Humans have been doing it since time began and animals do it too. So let’s see what all the fuss is about…

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What is fasting?

Fasting is a total or partial abstinence from food. In simple terms this means that for a period of time a person will not eat any, or certain types, of food and drink. Fasting is carried out across the world for many different reasons including as part of religious ceremonies or rituals, as well as for health reasons.

Types of fasting

There are many different types of fasting. We’ve broken down a few of the more popular ones below:

  1. Water fasting — definitely one for the purists. This type of fasting involves drinking nothing but water for a set period of time with the aim of purifying the body and allowing our much-overused digestive systems a well-deserved break. This is apparently one of the hardest types of fasts to carry out.
  2. Juice fasting — this type of fasting involves only drinking fruit or vegetable juices for a set period of time. Somewhat easier than water fasting due to all of the juicy goodness you are getting from the fruits and vegetables.
  3. Intermittent fasting — this appears to be the craze at the moment! This type involves fasting for certain times or days in the week and having an unrestricted diet for the remainder of the time. There are a few different types of intermittent fasting. These include:
  4. Alternate day fasting — eating every other day
  5. 5:2 fasting — eating a normal diet for 5 days of the week and having a drastically reduced caloric intake on the remaining two days (the two days are not allowed to be consecutive days)
  6. Time-restricted fasting — eating only within a set time period, i.e. between 7am — 3pm with nothing but water outside of these times.

It is with intermittent fasting where most of the scientific research has been carried out and health benefits have started to be documented much more.

Benefits of fasting

So, the big question is… Why fast? Below are some of the documented health benefits buzzing around at the moment:

  1. Weight loss: It’s a great way of limiting calorie intake without having to be excessive. Fasting helps in the production of certain hormones which help to boost your metabolism. It has been seen to help reduce body fat whilst preserving muscle tissue.
  2. Reduces chronic inflammation: Studies have shown people who fast intermittently have reduced levels of inflammatory markers in the blood after one month. This could be great for a whole host of inflammatory conditions out there including rheumatoid arthritis and multiple sclerosis.
  3. Improves heart health: Current research shows benefits on the cardiovascular system including lowered blood pressure and cholesterol levels.
  4. Increases levels of Growth Hormone (GH: People who fast intermittently have been shown to have increased levels of GH after their fasting period. This hormone is important in growth, muscle strength, metabolism and aiding weight loss.
  5. Controls blood sugar: Promising for our type 2 diabetics out there, although larger studies are needed for this area of research as evidence is a bit mixed at the moment.   Watch this space!

There are also a whole host of other benefits starting to emerge from animal studies which could be bright for our human future when more research is carried out. These areas include benefits seen in brain function, delayed aging and prevention of cancer. This is exciting stuff!

We hope this has been a helpful insight into the world of fasting. If you are considering doing a fast yourself or would like more information, please get in touch and we’ll be able to point you in the right direction. It is always safest to consult a medical professional before attempting any type of fast yourself as there are certain conditions with which fasting is not allowed. Here’s to a healthier life 🙂

References

  1. Dictionary.com. 2020. Fast. [Online]. Available from: https://www.dictionary.com/browse/fasting. [Accessed 08 Jan 2020]
  2. Healthline. 2018. 8 health benefits of fasting, backed by science. [Online]. Available from: https://www.healthline.com/nutrition/fasting-benefits. [Accessed 06 Jan 2020]
  3. Harvard Health Publishing. 2018. Intermittent fasting: surprising update. [Online]. Available from: https://www.health.harvard.edu/blog/intermittent-fasting-surprising-update-2018062914156. [Accessed 06 Jan 2020]
  4. American Osteopathic Association. 2019. Intermittent fasting: can we fast our way to better health? [Online]. Available from: https://thedo.osteopathic.org/2019/01/intermittent-fasting-can-we-fast-our-way-to-better-health/. [Accessed 06 Jan 2020]
  5. British Institute of Osteopathy. 2020. What are the effects of fasting? [Online]. Available from: http://www.british-institute-of-osteopathy.org/articles/fasting.aspx. [Accessed 06 Jan 2020]

Happy New Year – resolutions?

Healthy habits for 2020

Hello to our readers and a very Happy New Year to you all! We trust you have had a jolly good break over the holiday season. We’re getting straight into it this month. January… the month for those dreaded resolutions that many of you have good intentions of sticking to when you set out, but struggle to stick to as the months tick by. After an indulgent Christmas break, being healthy is often at the top of the list. As your trusty go-to health advisors, we’re here to give you some tips on making 2020 a healthy year. Please read on for your healthy habit manual!

Move, move, move!

A group of people playing football on a field

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This sounds easy, but for many it’s a big struggle. We are a sedentary world compared to the past. We have everything at our fingertips with supermarkets, stores and online shopping providing everything we need. Phones, tablets, TV, gaming and desk jobs mean people tend to sit a lot, even during leisure time. There is a huge obesity issue in our world. Did you know that since 1975, obesity rates have tripled and continue to rise?! That is a very worrying stat. If you want to do all you can to avoid becoming overweight or obese, then one very simple thing to do is move more. Your bodies are designed for it and will love you for it. We suggest going for a short walk or bike ride on a regular basis to keep the heart healthy and the waistline in check. If you get the train or bus to work, try leaving a bit of extra time and get off a few stops early to walk the rest of the way. Park at the back of the car park and walk that little bit further into the shops. You’ll soon get your steps in. Better still, go with a friend or family member… After all, exercise feels less of a chore when you have company.

Have a routine

This follows on nicely from our last point. As part of your promise to move more, why not have a little exercise routine that you can bust out on those nights you choose to stay in and watch your favourite show or movie. It doesn’t matter what you do but doing something is better than just sitting there vegging out. We’re all for chill time, however, aim to work on your body a little every day and the results will be seen in no time. Have a yoga mat, resistance bands, light weights and a foam roller nearby and get to work on them whilst you are enjoying an episode or two. Fifteen minutes is all that is needed. If you want help working out a suitable routine, speak to us next time you are in for a session.

See your osteo regularly

So, you are in for a session with us, good work! Who better to ask for help than a professional expert in body and health? We know a lot of people go to osteo’s when they are in pain, but we’re here for you in the pain-free times as well. Osteopathy is a way of life – it’s not just about bones and backs! Yes, we love to work with people to perfect their bodies, but we also love to give lifestyle advice too. Whether it’s dietary, exercise, sleep or working out which sofa to buy (OK, the last one is all you, but feel free to ask us anyway!), we can help. If you have some new year aches and pains, then don’t let them build. Come and see us right away and we’ll get you on the path to full health. Lifestyle advice included!

Less screen time

Here’s some lifestyle advice for you. Aim for less screen time this year. It’s so easy to get dragged in to being on your phone or tablet all the time. They travel round in our pockets, we use them to talk, email, check the news, play games… The list is endless! How many of you wake up and the first thing you do is check your phone? How many of you also put the phone down last thing at night before closing your eyes? The long-term effects of increased screen time are not yet known and probably won’t be for years to come, but some recent research shows that increased screen time correlated to lower scores in thinking and language tests in children. Other negative effects include sleep disturbance, lack of creativity and becoming disconnected from your social circle. We don’t think any of this is particularly good, so why not vow to reduce screen time and instead dust off the board games. You’ll get awesome family time, lots of laughs (hello happy hormones!) and a happy brain. Win win win!

Cut down on treats

We had to include something dietary here. At the end of the day, you get out what you put in. So, put in more good stuff than bad stuff (we’re not against treats altogether) and your body will shine. The body loves plant-based foods as they are easy to digest, low in calories, and full of good nutrients. We won’t tell you to cut anything out altogether, but try substituting a few treats for some fruits, veggies or yummy yoghurt. Your insides will thank you forever, and you’ll be ticking one more box towards a healthier, happier you.

There you have it. Five easy steps to take in 2020. Let’s make this a winning year! If you would like to discuss any of the above points in detail, please ask us next time you are in and we will be happy to chat and offer our top-notch advice. Happy New Year.

#osteopathy #innerwesthealthclinic #newyearnewyou

References :

  1. World Health Organization. 2019. Obesity and overweight. [Online]. Available from: https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight. [Accessed 11 Dec 2019]
  2. National Institute of Mental Health. 2016. Adolescent Brain Cognitive Development (ABCD) Study. [Online]. Available from: https://www.nimh.nih.gov/research/research-funded-by-nimh/research-initiatives/adolescent-brain-cognitive-development-abcd-study.shtml. [Accessed 11 Dec 2019]
  3. Harvard Medical School. 2019. Screen time and the brain. [Online]. Available from: https://hms.harvard.edu/news/screen-time-brain. [Accessed 11 Dec 2019]

Shoulder Impingement

Suffering from shoulder pain? Lucky for you that our blog is all about shoulder pain… We’re good like that! As osteopaths, shoulder pain is up there as one of the most common complaints we treat, after lower back and neck pain. Office workers, gym goers and overhead sports people, such as basketballers and netballers are all regular victims of shoulder pain.

Two people sitting at a table

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A common shoulder complaint that we see is shoulder impingement, otherwise known as subacromial impingement. Say ‘shoulder’ and most people think of a ball and socket joint. This joint does indeed make up a large part of the shoulder, but there is much more to it than that. Over the top of the ball and socket joint sits a bony ‘bridge’ which is made up of the collar bone (aka the clavicle), shoulder blade (specifically the ‘acromion’ part of the shoulder blade) and a joint which connects the two (aptly named the ‘acromio-clavicular’ joint). Beneath the bridge and above the ball and socket joint is a small gap called the sub-acromial space (sub = underneath).

It is within this space that the abovementioned impingement occurs and if present, may cause pain when moving the arm.

Why does impingement occur?

Well, there are quite a few soft tissues which run through this space that help keep the shoulder functioning. These parts include the tendons of the biceps and one of the rotator cuff muscles, a ligament and a fluid-filled sac called a ‘bursa’. Bursi allow smooth, frictionless movement around joints and can be found all over the body. Any of these body parts can be involved in shoulder impingement if they become inflamed. Repeated, overhead arm use in throwing sports, or chronic poor positioning of the shoulder and posture in desk workers can lead to these soft tissues becoming irritated and inflamed. For example, a cricketer who spends a large part of their career throwing a ball could lead to increased stress placed on the rotator cuff tendon that passes through the space, leading to inflammation, wear and tear, and poor movement. This then has a direct effect on other surrounding structures, so a person may end up with an inflamed bursa too.

Signs and symptoms

When someone has shoulder impingement, they may experience any or all of the following:

  • Pain when moving the arm (e.g. our cricketer above may feel pain when throwing)
  • Decreased range of motion in the shoulder
  • Weakness when using the arm on the affected side
  • Reduced ability to perform everyday tasks such as reaching up high in a cupboard, doing up a bra, putting on a coat or holding/lifting a child

Get to the osteo quick sharp!

If you want to get on top of your shoulder pain quickly, then we recommend a trip to see us here at Inner West Health Clinic After some thorough questioning and assessment, we will work out what lifestyle or movement factors are responsible for your pain. We’ll get to work with our hands straight away. Using a combination of soft tissue massage, joint mobilising, and many other techniques, we will aim to reduce your pain and get you moving better. Someone with a shoulder problem nearly always has an issue related to neck or back movement, so don’t be surprised if we go looking further afield on the body for answers to your problem.

If you are a thrower, we may ask you to demonstrate a throw so we can see how you are moving (don’t worry, we won’t ask you to do this if you are in acute pain). Likewise, if you are a desk worker, we may ask to look at your desk set up and sitting posture. Getting you to take a photo of yourself at your desk is often helpful for us to see if you need to make some changes that may be affecting your posture day-to-day. When it comes to any lifestyle advice, whether it’s the hobbies you have or the way you sleep, we’ve also got you covered!

We pride ourselves on awesome treatment, but shoulders are often tricky to treat, and some cases may take longer than others. To ensure you get back on the right path as quick as possible, always follow our advice between treatments, and please do your exercises! If you have weakness somewhere which is leading to your pain, a few treatments are not going to resolve this. Weakness and instability need strengthening, and strength takes time to build. Consistency is key with exercise. We will educate you on what you need to do, but you need to be the one to do it at the end of the day. It’s a team effort. We know it’s hard to keep motivated, but rest assured we will always be there on those days when you need a hand!

If you have shoulder pain, then don’t stand on ceremony, book an appointment today by contacting our clinic on 9078 2455 or info@innerwesthealthclinic.com.au  We’ll have you back throwing balls from the boundary quicker than you can say howzat! And if you have no idea what howzat means, then we suggest you ask the audience or phone a friend! 🙂

References :

  1. Brukner, P. and Khan, K. 2017. Clinical Sports Medicine. 5th ed. McGraw Hill Education : Australia
  2. Umer, M. et al. 2012. Subacromial impingement syndrome. Orthopedic Reviews. 4 (2). e18. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3395987/
  3. Bennett, S. et al. 2017. The use of osteopathic manual therapy and rehabilitation for subacromial impingement syndrome: A case report. Explore. 13 (5). 339-343. https://www.sciencedirect.com/science/article/abs/pii/S1550830717300149