We are Covid-secure and open for face-to-face consultations.

As front-line healthcare workers, 1st Call Osteopaths are delighted to be able to continue doing our bit for the health of the community with face-to-face consultations during this current lockdown.  We now have availability 6 days/week.

To book your appointment or to ask any questions, ring us on 020 8366 0831

In Praise of Movement

active, jump, happy

In praise of movement

Having just praised rest, I’m going to contradict myself and look at the benefits of movement. There has been a lot of interest recently about how bad inactivity is for our health – it has been described as ‘the new smoking’. Clearly, sitting all day at the computer, coming home, and then sitting for a few hours on the sofa is not good for us.

It’s actually very easy to avoid being totally inactive and it has enormous benefits, so it’s not one of those ‘oughts’ and ‘shoulds’ that we need to get too stressed about! Here are some thoughts and ideas that will get you moving:

Even those who are unfortunate enough to be confined to bed or a to wheelchair can do movements. A simple technique is to move each joint in turn, starting from your feet. Gently move the joint up and down a few times, or rotate it (e.g. ankles, shoulders and hips).

In the same way, being confined to the desk needn’t stop you moving. As well as moving each joint in turn, you can exercise your legs and hip muscles by pushing your feet down, leaning into the back of the seat, and clenching your buttocks 5 or 6 times. This exercise causes your weight to come off the seat a bit and keeps your buttocks from getting chair-shaped!

Take active breaks from your desk every 25 minutes. Get up and move around the office or home.  It will refresh your brain as well as your body.

Exercise doesn’t have to be always about getting out of breath. Light exercise can help your circulation, your coordination, your mood, the health of your joints, and has numerous other benefits.

Getting a bit out of breath and breaking into a sweat helps exercise the heart and lungs, but this doesn’t mean you have to drag yourself down to the gym. For example, why take escalators and lifts if you are otherwise healthy? Also, if you have to walk to work, walk a bit faster than you normally do, using your whole body including your shoulders and hips in the movement. What’s a good idea is to start off walking at a leisurely pace for a few minutes. Use that time to relax your whole body and let it find it’s rhythm, then put on some power!

Being inactive won’t necessarily provide the rest you feel you need. Perhaps you need a rest from the computer and the stress of work. Going out for a walk can help provide all the rest your body needs. Exercise can also improve your sleep, and that can be crucial for recovery, and for muscular aches and pains.

Ask your body what it wants. You might feel mentally exhausted and dispirited but your body might be tired of sitting down and being confined.

Do things that your body is not used to. We tend to do the same things every day and this gives the body a rather limited set of movement patterns. A great way to give the body something different to do is to dance! It really doesn’t matter how bad you are at dancing – the worse the better! No one needs see you shaking a tail-feather to the radio in the kitchen!

Finally, how can I praise both rest and movement? “Isn’t that a confusing message?!” I hear you ask. What I want to get across is that we spend far too long neither at rest nor in motion, but in a state of inactive stress. For example, sitting at the computer sweating about a spreadsheet, or sat collapsed on the sofa watching the latest antics of Donald Trump on the news, wondering if we’ll all survive his presidency! Or maybe watching someone being shot on a detective series. When you rest, really rest, both mind and body. Otherwise be active!!

In praise of rest…

In praise of rest

Watching the clouds go by…

…and our tips on how to get some.

Are you getting enough rest? When you’ve done what you need to do, can you stop everything, do nothing and feel relaxed and content?  Do you find that you still feel guilty and tense with a list of ‘to dos’, ‘shoulds’ and ‘oughts’ lurking in the back of your mind? Do you drive yourself hard until you give up, exhausted and dispirited?

We see many patients who could really do with a proper break. This is especially the case when they are suffering from some sort of painful condition and the body is just crying out for rest and recovery.  If you don’t listen to your body, it will only prolong the pain.  If this is you, here’s how to break free from the cycle of pain and guilt.

Our advice to those suffering from pain and exhaustion:

  • Recognise that you’re in pain and in need of rest. Typical signs to look out for are that your performance at work is deteriorating, despite you trying harder, you’re not sleeping well, your appetite has changed and you’re becoming snappy and irritable.
  • Approach this realisation with kindness. It may be your instinct to talk harshly to yourself when your perceive you’re failing in some way, but instead, stop a moment and cultivate a little gentleness to yourself and your body. Listen with a quiet mind to what your body is telling you. Filling your head with judgement or fearful speculation will mean you’re not able to tune in to your body’s signals. You could start by imagining how you might listen, gently and without judgement, to a distressed child. You might not like what your body is telling you at first, but stay with it and breathe into the pain or unpleasant feelings. Reconnecting with your body will ultimately allow you to gain insight into what is triggering your stress and what you need to rest from.

So, if you’re tired and in pain, break the habit of talking to yourself harshly, take your foot of the accelerator and become aware of what your body is telling you. You might learn, for instance, that you need time away from what is causing your shoulders to tense up. Maybe you need a break from the computer, and a walk around the block is what’s required. Or maybe you’re physically exhausted and just need to put your feet up for a while. That way your body’s stress hormone levels will decrease and allow you to recover and rebuild.

Slow down and start listening to your body today.

Why does my back hurt?

Did you know that around 85% of all cases of back pain have no known cause?


Specialists call these “non-specific” or “mechanical”. “Mechanical” because pain is typically aggravated or relieved by a particular movement or position, such as bending forward or standing still. Non-specific back pain can range from mild aching and stiffness to severe and disabling pain.

At one time, specialists believed that back pain was due to injury or “wear and tear”, visible on X-rays or scans. Now we know that signs of disc injury or wear and tear are very common and have only a very weak relationship to pain.

The mysterious nature of idiopathic back pain is a real problem. Sufferers often go to their GP, who often feels under pressure to provide some sort of explanation. Unfortunately this is sometimes “it’s your age” or “wear and tear” when in fact it’s neither of those. Often people with back pain are referred for an X-ray or MRI scan if it’s not getting better. If the report comes back saying the back is normal, you could be left with the impression that either your back has some sinister undiagnosed disease, or you are complaining for no good reason. If you get to read the report, you might be lead to believe that normal wear and tear indicates your back is damaged and weakened. Not a happy situation.

Most cases of back pain can’t be diagnosed by MRI, X-rays or even blood tests. However, these can be useful to rule out more specific conditions. So what does cause back pain in most cases? How can you get a painful and disabling condition without disease or injury?

Well, there is a third alternative to disease and injury: dysfunction. That is, the tissues are basically healthy but the organism is in some way uncoordinated, and that puts strain on tissue, leading to symptoms: pain and stiffness.

But how can the back become “uncoordinated”, and how does that lead to pain and stiffness? The thought that the back (or the body in general) could let you down like that is rather unsettling! You have to remember that the body, like everything else in the physical world, must obey the laws of mechanics. When designing a mechanical device, an engineer is faced with certain trade-offs and needs to find the right balance. In the case of the human body and the spine, evolution/God (take your pick) has also had to ‘decide’ between stability and adaptability.

redundant chain

‘Redundant’ chain-like structures such as the spine have many ways of to carry out the same task.

This leads us to how “redundancy” is used in the design of mechanisms. Redundancy means having more than one way to do the same thing. Consider the design of spacecraft. Unlike cars, they have many layers of redundancy built in because you can’t just call out the AA if it breaks down. So, for example, the NASA Curiosity rover has six wheels instead of four, each with its own engine.

Similarly, the human spine has a ridiculous number of joints in it – 74, not including the joints between the spine and the ribs. No-one ever needs that many joints, not even for the most extreme contortionist’s party trick! Think how many joints you actually need for bending forward – you only really need one hinge joint. No engineer in their right mind would design a crane, for example, with 20 hinge joints. It would be grossly unstable unless you had a very sophisticated control mechanism, sharing out the load just right.

On the other hand, the problem of building a crane with just one hinge joint is that if that joint seizes up the crane will not work at all. But if you have two, you can use the control mechanism to change the motion pattern, which will allow the crane to carry on working. Here lies the benefit of having a spine with so many joints. There are many people walking around with worn-out intervertebral discs who have no back pain or stiffness. Their spines have adapted happily to this change.

Unfortunately, the spine doesn’t always adapt in such a way that it can carry on regardless. The fact that it can move in an infinite number of ways also means that it has the freedom to move in ways that put excessive load on certain parts of the system. It can also fail to coordinate properly so that the muscles are working against each other, leading to painful spasm. Muscle is often the immediate source of the pain in these cases because it has the ability to cut off its own blood supply. When a muscle contracts, the pressure inside the muscle rises and it doesn’t take much for that increased pressure to counteract the weak pressure pushing the blood through the muscle. If a muscle stays contracted for too long, the lack of oxygen will lead to pain and stiffness.

These cases of back pain are like an engine out of tune. If you were to take an engine that is out of tune and X-ray it, or even take it to pieces, you wouldn’t find anything wrong with it. But if you were to run it, you would hear that the engine was not coordinating properly, causing strain and back-firing.

Osteopaths aim to restore normal function to sort out the back problem. We make extensive use of palpation (locating and assessing painful areas by touch) and observation to detect things like muscle tightness, shortening, uneven distribution of spinal joint motion, imbalance of muscle activity and so on. Through advice on movement and posture, exercises, manual treatment of tight tissues and joints we aim to get the engine back in tune.

Do I need a new mattress?

If we had a fiver every time someone asked us this…!

bed3The first thing is, do you really need a new mattress? After all, they are not cheap. Good sleep is important with any muscular condition, as muscles regenerate during deep sleep. Deep sleep is also important for the immune system. If you find you’re dreaming a lot, you might not be getting deep sleep, and a good mattress might be what is required. Some other indications that you might need a new one are these:

  • You often wake up in the morning with pain and stiffness. This symptom is not necessarily caused by a bad mattress, but if you find that your back feels less uncomfortable on another bed, that is quite a strong indication.
  • Your mattress is more than 10 years old. If it’s a cheap mattress, it will probably not last as long. Also, if it hasn’t been turned regularly, it might lose its consistency prematurely.
  • The mattress has lumps, or is dipping. It has definitely had its day!

So let’s say you do need a new mattress. Which one should you go for? An ‘orthopaedic’ mattress? Unfortunately, the term orthopaedic, when used in reference to mattresses, is just marketing hype. It does not mean it has been recommended by orthopaedic specialists, and it may well be too hard for you. It’s a myth that you should sleep on a hard surface if you have back pain. Some people may feel better after sleeping on a hard surface, but it is not a general rule.

How about memory foam mattresses? Opinions are divided here, and there seems very little independent research to support their use. In general, we don’t recommend them. They tend to make the body to ‘nest’ too much. In other words, the mattress moulds to the shape of your body making it more difficult to move into another position. If you see films of people sleeping, speeded up, you will see they move quite a lot. Also, many people complain that they make them feel too hot at night. Those who are predisposed to pressure sores, due to medical problems, may possibly benefit from a memory foam mattress.

So which mattress should you choose? The most important thing is to go to the shop and try it yourself. Generally we recommend a well-made, standard mattress from a good manufacturer. Look for a mattress that has a long guarantee. These are usually constructed using springs. Here are some tips when testing a mattress:

  • Try leaning your weight on the edge of the mattress. A cheap mattress will not support your weight, and it can be difficult getting out of such a bed if your back is hurting.
  • Lie down on the mattress for at least 30 seconds in your usual sleeping positions to get a good feel for it.
    Roll from side to side. You should move easily without feeling your shoulder is pressing hard into the mattress (too hard), or feeling like you are trying to roll out of a dip (too soft).
  • Lie on your back. Feel under your low back. If it is floating in the air the mattress is probably too hard. If it sags into the mattress, it’s probably too soft.