Tag: health

Feet

Published on by Caroline WhitehornLeave a comment

I love feet! Not in some weird way. Feet are often an ignored part of our self care. We run, workout, do pilates or play tennis. Keeping our body fit and our heart in tip top shape, but we often don’t think about our feet. Our feet have 26 bones, 33 joints and 29 muscles in the foot (well, some start outside the foot and finish in the foot). They need working and moving like the rest of our body. So how much do you move your feet joints and muscles?

If you are wearing stiff or firm soled shoes then the joints in the foot aren’t doing a great deal and therefore the muscles aren’t being used optimally. Do you ever walk around your home bare foot?

All the little muscles and joints need to move!

Often, pain in the foot can be from lack of movement through these muscles and joints over months or years, through foot wear or training changes or activity changes. Things like plantar fasciitis develop due to lack of flexibility through the foot and it’s arches. Tight calf muscles can be a part of it, as this can restrict the flexibility of the foot. This is a very common condition which can cause an awful lot of discomfort and affect normal daily activities or exercise.

Ideally, you should be able to walk around your home bare foot, without pain (if you get pain it may be you need to get an assessment and rehab advice). Also, have a go at moving each toe individually, can you spread your toes to create space between them?

Can you raise all your toes and lower each one individually to the floor?

Can you bend and create movement through your foot?

These are all signs of good and strong foot health. You can work on these and make your feet stronger. You can start with these things:

Scrunching your toes against the floor.

‘piano’ playing with your toes.

Moving your big toe away from the second toe.

Heel raises- both feet and single foot

Use your hand to wiggle your foot in different directions.

Hip pain?

Published on by Caroline WhitehornLeave a comment

Hip pain can be worrying, especially if you are thinking it is your joint and you are in your 50s or 60s or older. Often people assume they have arthritis in the hip. They come to me worrying about whether I am going to say they need to see the GP and then a consultant because their hip is worn down. Sometimes, it is true, this can be the case. wear and tear or degenerative change does happen over time and after the age of 25 we are all slowly deteriorating! Great news! Aging is normal.

However, often people come to me and describe they have hip pain. On further investigation I realise they are not talking about the hip joint. Commonly, hip joint pain shows itself in the groin, the pain is in the crease at the top of the thigh. I see people with worries about needing a hip replacement but what they are describing is lateral hip pain, pain on the outer side of the hip area.

How people describe the symptoms is part of the picture and the onset. A diagnosis is never one thing alone.

Women are more likely to suffer this when they are around the peri-menopause or menopause years. But they are by no means the only ones. Lateral hip pain can affect younger active people or older men.

What is it then if it isn’t my joint?

If after assessment your joint is cleared. There are several different tissues on the outer thigh that can be causing this, there are little fluid filled sacks called bursas, they can become inflamed and irritated, tendons can become irritated too. Also, the gluteal muscle can have a tear. These can happen individually or a few together. They cause pain on walking, going upstairs, standing.

What causes it?

It can be a change in activity, either an increase or decrease in activity. Have you had a recent lifestyle change or weight loss or gain? Have you taken up a new activity and increased the amount you do, or have you previously been quite active, stopped for a while and then tried to start again?

Irritatingly, you could be trying to become fitter or improve your activity levels only to come to a halt due to pain!

What to do about it?

First thing is to try to reduce the irritability of it. This can be by using ice over the area, or anti inflammatories if they are ok for you (speak to a pharmacist or GP if you are unsure or you are on other medication which may conflict with it). Trying to reduce the activities for a time that irritate it. For example, If that is after a certain distance of walking, reduce your walking. Pace activities that require you being on your feet. Or if you have an exercise regime reduce it to a level where you weren’t getting the pain.

There are exercises which can help alleviate the pain. These need to be suitable for where you are after diagnosis and progressed appropriately. That’s the good news. The bad news is it can take several weeks or even a few months to get to where you want to be, especially if you leave it ages to get it looked at.

Understanding Hormonal Fluctuations in Women’s Fitness

Published on by Caroline WhitehornLeave a comment

Last week, I attended a women’s health conference. There were speakers from different elements of women’s health such as endometriosis, specialist menopause doctors and lifestyle coaches. It was great to get the most up to date information about these issues.

What is possibly most useful to my sphere of interest is the advice regarding exercise and the effect on the menopause or perimenopausal woman. It is interesting in the subtle changes that can happen where the same work out you have done for years or the same activity such as running or cycling may not cut it, when it come to weight management and maintaining fitness. Of interest to me is the effect on tendons the rollercoaster ride of hormones has.

This rapid moment by moment change in hormones explains why one day a peri/menopausal woman feels fine and the next feels awful or achy or low in mood. Our hormones don’t plummet in a linear decline over a gradual period of time, neither do they drop off a cliff in one fell swoop. No they, drop and rise and plateau and drop again. This could be over a few months or few days then even out.

I think this is worth understanding when it comes to the ability to maintain regular physical activity and healthy balanced eating habits. If you can imagine, feeling great one day so you go and work out or have the run or bike ride, have a lovely balanced meal then the next day your oestrogen has dropped. You feel basically p***ed off at the world. Who wants to exercise in that frame of mind? Will you choose the lovely nutrient filled buddha bowl for lunch or the carb and starch loaded bread roll and chocolate bar?

Then to add to the fun, we chuck in the loss of resilience of tendons. So your now erratic training or exercise sessions are inconsistent and not gradually loading the tendons, because you had 4 days off then a day exercising then another few days off. The impact of this putting you at increased risk of injury is now increasing.

This is often where I meet women, Is they have a tendon issue and wallowing around in the weeds trying to work out what went wrong and how they can resolve it. I will talk with them a lot about consistency and how tendons love predictability. They don’t enjoy or respond well to sudden loading or persistent inactivity. This is where shoulder (rotator cuff issues) pain can start or achilles or lateral hip pain. Together we work out how to manage the pain, modify activities and progress to return to previous activity levels.

Remember tendons don’t like surprises!

Dealing with hip pain – 3 ways to tackle it

Published on by Caroline WhitehornLeave a comment

Recently, I was working with a lady called Jenny. She came to see me because she was gradually getting pain around her hip and it went down the thigh a bit. She had been through a bit of a rough time. After hitting 48, she was noticing she was gaining weight. Jenny felt this was a combination of factors. She had changed jobs which meant she had to drive longer to work and was sitting at work more. In addition, due to the training required for her new role she was not able to continue her usual exercise routine. She self-reported that it wasn’t an intense work out but she had been walking for 30-40 mins most days and had a small weights routine at home. Jenny also said she thought she was beginning to show signs of being peri-menopausal. Whilst we were talking, she confided in me that the hip pain she was getting worried her, now she was 48 maybe she was starting to get arthritis in her hips.

As we continued the appointment, and I assessed I was able to reassure her that the pain was unlikely to be arthritis and more likely to be lateral hip pain or tendonitis or a bursitis (this is either an inflamed tendon around the hip or bottom or an inflamed bursa). I was able to work on her stiff back and movement through her joints and tight muscles. From here we worked out an exercise rehab programme for her to do.

I love these sorts of interactions, where someone has a fear or concern and through assessing and talking, we can work out the issue and I can give reassurance, treat and provide useful, applicable advice, exercises and management techniques. I also had the time to explain that a big part may be her lifestyle change. Due to her reduced activity levels, she may have irritated the soft tissues. We talked about things she could do to avoid this. We also discussed that this is a common issue for women around the time of menopause. We looked at different ways the menopause and change in hormone balance can effect the musculoskeletal system. (Name was not real name)

3 Ways to head off this sort of lateral hip pain can include:

Exercises that get your gluteal (buttock) muscle working

Avoiding sitting for long periods especially in low seats

Break up long periods of sitting!

Stay in touch to read the next article about how menopause can contribute to aches, pain and sports injuries.

My philosophy of care

Published on by Caroline WhitehornLeave a comment

Let’s take a break from talking about sleep, food and activity goals. I am going to bring it back to why I do what I do the way I do!

I like to spend time with my patients. My appointments are longer than typical health care practitioners in similar fields such as other osteopaths, chiropractors or physiotherapists. Having worked in this industry since 2007, I have heard a lot of feedback from patients about what they value, often they have felt unheard or rushed by a health care practitioner. I have come to learn that a lot of pain management and pain resolution starts when a patient feels heard. This works in two ways;

One, the patient feels they have the time to say what they want to say about their experience of pain.

Two, as a practitioner it allows opportunity to really understand someone’s pain and their personal values and attitudes towards life, lifestyle choices and any treatment or rehab I suggest.

I see what I do as a partnership with the patient. We discuss and share the decision making of how to manage and treat. I want patients to feel empowered by what we discuss and how I treat. This enables me to help a patient develop the tools to often help themselves and really understand what is going on with their injury or issue.

My initial appointment, if we have never met, I allow an hour. This gives time for the niceties and a full assessment with lifestyle choices and previous history included, It allows for a thorough physical assessment. This may include special tests, recognised by any healthcare practitioner, range of movement, replicating things that aggravate the issue. Finally, I summarise what I have found or assessed for, and treat with manual therapy (AKA hands-on treatment ) and advice on appropriate rehab exercises to do. Because I allow a good length of time we have chance to really get to grips with more nuanced lifestyle choices and personal values.

A follow up appointment is up to 40 minutes. I give this time to be able to really check in with the patient and understand what has worked, how they feel they have improved and how the exercises went. I see a lot of people that in life just feel rushed and enjoy wanting to provide that extra time. This is about patients being individuals and having their own story to tell and I want to hear it.