Exercise and Strengthening - Why YOU need it!

The simplest reason I could give you is that people who have a reasonable degree of fitness and strength recover from injuries MUCH faster than those who don’t. However I think that Jodie Iliani (a long time fitness and personal trainer in the Southern Highlands), said it best when she once told me that every person she ever met who feels generally well and happy, moves a lot.

Please note that you don’t need to read all of this blog to get the basic message. I have written this blog so that as you read on the information gets more detailed. You can choose how much information you want to digest.

So what does exercise and strengthening do?

I will go into more detail later on the cellular physiology but for those who just want the basic facts and observations, here goes.

Exercise and general movement helps move fluids around. It increases the number of blood vessel sprouts and gets these blood vessels developing deeper into the muscles. It also helps flush all the cells in our bodies. Organs get a good squeeze which also helps with the interchange of nutrient and wastes. Motility (a technical word for movement and contraction) of the intestines is also improved. Strengthening exercises also make the structural system of the body - muscles, connective tissues and bones stronger making them more resistant to injury. Exercise helps our nervous system operate more effectively - with better reflexes and balance as obvious examples. This makes us less likely to injure ourselves, preventing falls for example. I cannot count the number of times that a patient has told me that their mother or father was doing fine until they had a fall and then everything went down hill from there.

Increasing our cardio vascular fitness assists the heart and blood vessels in keeping free of fatty build ups (called plaques), thereby preventing strokes and other cardiovascular related illnesses. Cardiovascular accidents (CVAs) are the ones that can kill us quickly and without warning. Exercise has been shown to be an important preventative measure and when in the habit, is really, really easy is to do.

Scar tissue following surgery is also very important. When not moved, over time scar tissue will always contract. This can cause a painful pull on other pain sensitive structures. Exercise helps to prevent this by keeping the scar tissue moving so as to minimise this contraction. Scars form by laying down connective tissue to an injured area and lay fibers in all directions. So there are fibres everywhere, not just those required to resist the forces applied to the injured area. When you exercise, over time the fibres that remain are mostly the ones that resist the forces applied to the previously injured area. This does not happen when the scar tissue is not moved around.

What type of exercise is best?

Aim for low impact exercise over high impact exercise. This ensures that the joints last longer and you are able to do so for many years to come. This is especially important if you are starting later in life when there is probably a degree of wear and tear in the joints already. Interestingly though no matter how late someone starts exercising (short of needing a joint replacement), they always seem to get the benefits down the track, it just takes longer for your body to adjust. You don’t need to exercise so hard you are in pain for days on end but expect some genuine discomfort when you start as your body is adapting to a new stimulus and must undergo changes at a cellular level. Push through the initial discomfort and you will find that in time, you may be a bit sore following your exercise session but this will only last for a couple of hours at most.

Good examples of beneficial low impact exercise includes walking, cycling, swimming, yoga, pilates and Taichi (Taiqi). However the most important thing is DOING SOMETHING so some high impact exercise should still be considered if it makes you get up and move. For example I do martial arts training that would be considered very high impact but I love it and it keeps me motivated when its time to do the low impact stuff that I find otherwise boring like stretching.

Work out at an intensity and/or combination of exercises to get to your breathing to the point where you would be slightly breathless if talking to someone whilst engaged in your chosen activity. This will give you the optimum heart rate for exercising to be healthy rather than “fit” in the usual sense of the word.

Do I really need strength training?

Resistance training for strengthening is vital. This does not involve building up like Arnold. It can be high or low impact depending on how you do it. Our lifestyles are now so automated that we just don’t do any of the day to day manual activities that we would have years ago. Just talk to anyone of grandparent age and you will find that they did a lot of day to day manual activity - they walked everywhere and most jobs had at least a manual component. For example, most people had a vegetable garden and washing, wringing and drying of clothes was all done by hand. Because of this, people were generally much stronger and leaner. Take a look at pictures of Diggers heading off to the World War I and II - you will not find anyone who isn’t lean and strong looking.

You need to do some strengthening exercises to optimise your health. My observation after many years in clinic is that stronger people are just so much more injury resistant and recover ridiculously faster than those who do not engage in this type of activity. In addition to strengthening muscles and connective tissues, as already noted, resistance training also helps to keep our bones strong and healthy. This is becoming more and more important as our population ages. Bones that are “osteopenic” (in the early stages of losing mass and structure) can be restored to a state that is normal for your age. However once bones become “osteoporotic”, a recovery is not really possible. This alone is an excellent reason for resistance training.

Strength training also stimulates your metabolism which means you even burn calories whilst you’re resting!! That should be good news to anyone who struggles with the extra kilos.

Exercises like pilates, Taichi (if “push hands” is involved), and some varieties of yoga have the advantage of getting the cardiovascular system working at the same time as providing adequate resistance training. Great choices if you are time constrained.

How about stretching?

Stretching should not be overlooked as part of any exercise program. Whilst the exact mechanism seems to vary with the decade, we do know that stretching helps reduce post exercise soreness and prevent injuries. My take on this is stretching helps to lengthen the blood vessels within the muscles and gets the most surface area available for the best interchange of nutrients and wastes, thus aiding recovery. Stretching also gets the muscles and connective tissues integrated with the nervous system to give the best combination available between strength, agility and flexibility. All of this adds up to better injury prevention. Stretching really is uncomfortable when you first start but you will get used to it.

How often do I need to exercise?

The standard line is to do this 3 times per week and this is fine for maintenance of your existing condition. HOWEVER, you really need more than this if you want to improve on where you are currently at. If you know you need to improve rather than maintain, you need to do 5-6 times per week. Sorry about this but I find too many people are given the 3 times a week line and then give up when the results don’t come. The good news is that you only need about 30mins a day. It takes about 6 weeks to feel the benefits and about 3 months to actually see the results, a slimmer waist line and better muscle tone for example. “3 months! You’re kidding!” is the response I usually get. However, I’m talking about a life long habit, so what’s 3 months?

Small habits that lift your general level of activity compounded over time can make a big difference to your health long term. For example, when you go to the shops, park your car in one spot and walk everywhere in between rather than driving the car 300metres to the next shop!! If you don’t live too far away, ride your bike rather than drive. Don’t ignore the escalator but at least walk up it.

Do I need to change my diet if I exercise?

Strangely enough, exercising often improves your diet. Exercise seems to stimulate a need to eat better - more fresh foods in the form of an increase in fruits and vegetables. I have seen no experimental evidence to prove this claim but definitely note this as an observation from patients and friends. It does seem logical though that as you increase your level of activity, thereby placing a natural stress on your body, you will need more nutrient dense foods to repair and maintain your system. One thing that has been well tested is the assertion that people who eat a lot of fruit and vegetables have far less problems with degenerative illnesses.

Increased activity and healthy, nutrient dense (as opposed to calorie dense) foods gets us closer to the lifestyle our genetic code was designed for, that of a nomadic hunter gather. If we use our bodies in a manner close to what it was designed for, it just makes sense that it will operate at an optimum level. How lucky are we to live at a time and in a country where we have such an abundant food supply and can pick and choose foods providing good nutrition and choose exercise as a matter of leisure rather than survival.

Summary

In summary you need patterns of exercise that get your whole body working. Best results occur when you choose exercises that include your cardio-vascular system some strength training and stretching. Aim for 5-6 times per week if you know you need to improve your health, 3-4 times per week if you want to maintain where you’re at. However to start with I just want you to do whatever you like to do best - just start with something!

Hopefully that convinces you that exercise is essential and you will now get out and do more. Exercising for health can actually be very simple and time efficient. Come in and talk to us if you want some ideas or advice on where to start. For most people the problem is just getting started and once you get into the habit, its a lot easier than you think. If your problem is more complex, we can steer you in the right direction whether directing you to a personal trainer or even your GP if necessary. In fact why not visit your GP, get some blood test results then compare again in 3 months? You won’t be disappointed in the results!! You will also feel so good that the improved results won’t even surprise you.

More detailed cellular physiology

For those that just want to know what they should do and why they should do it, you can stop reading now. For those that want brief technical details of what is happening at a cellular level, here goes....

Keep in mind the Osteopathic principles when reading what follows:

1. the body is a unit and all parts work for the benefit of each other
2. structure and function are inter-related
3. the body has self healing and regulating mechanisms

Part of Osteopathic philosophy is that movement is required for life. Our body is just a collection of small cells specialised for the task they carry out. The cells operate for the benefit of each other and thereby the organism (us) as a whole. Liver cells clean and draw nutrients from the blood, cells of the small intestine draw nutrients from food, the nervous system carries messages to enable us to interact with and navigate the world. The skin provides a barrier from the inside of the body to the outside environment.

The bones provide a structure so we are not just a blob of tissues and the joints, muscles and connective tissues move us around. Traditionally this was to get us to our next meal or to run from or fight off danger. This is where things have gone astray and we will get back to this point in another blog where we will look at the “autonomic” system (fight and flight response) and how it affects cell structure and health.

I said that movement is required for life to exist. Well this is true at the level of every cell. Each cell has it’s own “cyto-structure”, like a skeleton for the cell, it also has a cell wall that separates the inside environment from the outside. There are also mechanisms to generate energy for the cells processes, methods of drawing in nutrients and getting waste products out of the cell. It even has it’s own memory bank - the nucleus of the cell. Sound familiar? It is almost like the cell is a mini version of us! So nutrients are being drawn in, wastes expelled and there are processes going on in the cell at every moment. There is a lot of movement going on and energy expended by every cell in our bodies!! The cell is totally dependent on its environment for its nutrients. So the cell cannot operate at full capacity without the conditions both inside and outside the cell being absolutely optimal.

Moving our bodies around, creates movement in the blood supply and the fluid filled space between the cells. The blood gets nutrients to the cells by diffusing fluid and nutrients into the fluid space between and around the cells. This “micro” movement of fluids is enhanced when you are moving your body and is absolutely essential to keep these fluids moving and thereby constantly flushing this space between the cells. This is what creates optimal nutrition and waste removal.

As mentioned at the start of this blog, the organs themselves get a good squeeze when exercising and moving about generally. This further enhances the micro environment for nutrient exchange and even helps the organs to do their job. For example exercise helps the intestines, both large and small move food and later fecal matter thereby assisting absorption of foods and prevention of constipation. Exercise also give the heart and lungs a good workout, increasing the capacity of both organs.

Have you ever had your arm in one position for some time and had it “go to sleep”? This is a great example of what I am talking about. Your overall body movement has been compromised, blood keeps getting pumped into the area and it doesn’t get removed at the same rate that it is going into the area. Nutrients are actually still getting to the tissues of the arm but the waste products (CO2 etc) can’t get out fast enough so the cells can’t use the nutrients available. (No different to eating a load of chocolate cake and then having no room left for the vegetables) So the nerves get “starved” of oxygen and the arm “goes to sleep”. Leave it there for a while longer and the muscles etc also build up waste products, at this point it will get very painful. Move the arm around, it is very painful at first and then as the blood and fluids begin to flow once more, a happy balance is restored and things return to normal. The pain goes away too.

This optimisation of the environment around the cell also has a positive effect on the cell structure itself. Research is increasingly showing that the cell wall is indeed the brain of the cell rather than just the nucleus. The nucleus stores the memories, the code of the proteins that the cell needs to produce but the cell wall is what reacts to the outside environment. The cell wall builds new receptors into the wall itself that are a direct consequence of the hormones and nutrients available to it. This in turn creates the cascade of events that determine how the cell actually works. Without the correct environment, the cell cannot even get the elements it needs to operate effectively. It is exercise that increases the efficiency of nutrients flowing to the cell. This means that the cell wall has the elements available to build the cell in a way that optimises cell function. To put it another way, without the right environment, the cell is not able to access the building blocks it needs to work efficiently. A cell that functions properly creates a happy organ and thereby creates a happy body. A happy energised body tends to create a happier us!

And really that’s the whole point of good health - to be happier and more able to interact with the world around us. Ask any of my aging patients and they will tell you that as health declines, quality of life falls away. When the process of chronic degenerative illness starts, the progress picks up speed. Why not try preventative measures instead of looking for the magic bullet in the form of a pill or procedure that never really matches the natural function of your body. Exercise is a crucial component of maintaining good lasting health!

Please feel free to make an appointment and discuss any of these points and we will help you with a program that’s best for you. We will also help steer you in the right direction if you have other issues that need to be addressed before commencing a general program.

My back has just “gone out”!!! What do I do now??

First of all don’t panic!! Whilst extremely painful, the vast majority of acute back or neck episodes are very short lived. Especially if you look after it properly in the initial stages. The first few days are very important to ensure that the problem does not last long or become an on again, off again chronic problem.

Firstly what to do. The best thing to do is to CHANGE YOUR PLANS FOR THE NEXT 2-3 DAYS. Accept the fact that you are just going to have to take it easy and that screamingly important project, meeting, whatever is now not as important as getting back on your feet again. I can’t count the number of times that I have treated someone for what should be a simple and transient condition but because the patient decided to go and landscape or sit at a desk all day at work, their bodies natural healing mechanisms never had a chance to work properly. This often results in months of low grade pain with frequent acute episodes.

Bed rest for the first day definitely and most likely the next day as well. You also want to have regular but BRIEF periods of movement. This means about 5-10 mins each hour. If you can get up and walk around then do so. Often you will loosen up a little as you move around but then go and lie down again anyway. If you overdo it, you will get sharp stabbing pains again.

If you can’t walk around, do some pelvic tilts:

1. Contract the abdominal muscles and draw the pubic bone to the front of the ribs (like a mini “crunch” exercise). You will feel the lumbar spine flatten slightly. Do about 10-20 repetitions.
2. Then do a sideways tilt, where you squeeze the abdominals at the sides so the side of the pelvis goes to the side of the ribs. Again about 10-20 reps.
3. Repeat until you have done a total of about 5 minutes

If the pain is in the rib cage or thoracic region then lightly rock your body to get a rotation through the area then do some extensions (as if you are flattening the spine) again for about 5 minutes.

For a painful neck spasm, rotate the neck in both directions. One side will definitely feel easier than the other side.

Please note that these are just small movements, not large enough to work hard into the spasm. You are trying to create a little movement, NOT exercising and “working through the pain”!!!

In the initial stages, cool/cold packs work better than heat packs. There is often some confusion here. Heat makes the area feel better but also increases the inflammation response whereas cold packs don’t feel as good but the result in faster healing. This is the aim, fast healing.

Use a bag of frozen peas that everyone should have in the freezer for moments like these (and for general sports injuries). Place on the area where you feel the pain is coming from for 20 minutes and then take it off and DON’T use again for 2 hours. Work this cycle as often as possible for the first 2 days. The frozen pack may often be too cold to put on the skin directly (the aim is to cool, not freeze the area) so wrap it in a towel that is thick enough so it is just a little uncomfortable. You can take the cool pack off during the 20 mins if it gets too cold but put it back again as soon as you are able.

Ring and make an appointment but aim to get in at the end of the day AFTER the injury or even the next day. Ideally we want about 1-2 days to have passed before we start moving you around on the table. We have found that this gets by far the best result as you are getting a treatment as the inflammation cycle is starting to slow down. The purpose of osteopathic treatment is to enhance the bodies natural healing response. If you get treated straight away when the injury occurs, the inflammation response is still increasing and this is why you don’t seem to get much initial relief.

Another reason that I often don’t like to treat people immediately following the injury is that patients often use this as an excuse to get straight back to work rather than taking an appropriate rest. This usually ironically results in more treatment being required and whilst it does pay for my training trips to China, it’s also incredibly frustrating for both patients and myself!!

Of course talk to your doctor and/or pharmacist about appropriate pain medication. Note I said appropriate, please don’t get angry with them if they won’t prescribe the equivalent of morphine! After all they also know that, as unpleasant as the pain is, when properly managed it will subside substantially after a few days.

That is about it for management. For those of you who want to know what is actually happening, please read on.....

What you have (in the vast majority of cases) are just simple muscle and joint strains. Your back hasn’t actually “gone out” of joint at all. The small but strong muscles around the joint are in spasm and pulling the joint in one direction more powerfully than in the other directions. This means that the joint is held in a restricted position and can’t move through its normal range of motion. The joint itself still has normal integrity.

What‘s important to know is that the muscles that hold us upright against gravity work a bit differently than say your biceps in your upper arm. The biceps is designed to lift a heavy load and then have a nice long rest before being used again. Because of this function, it uses a large number of it’s “motor units” in a single lift and it’s also why if you go to the gym, it takes no time to get them bulging for the beach. Your postural muscles that hold you upright against gravity are also able to brace your body for these heavy lists. However because they work all the time usually just holding your body upright, the muscles share the load. So at any one time, some parts of the muscle are working and other parts are taking a break.

Patients mostly walk in and say that they “put their back out” just putting on a pair of socks or doing a simple bend to pick up something off the floor! When questioned, I find in every case that someone was doing some heavy work in the week leading up to the acute episode. In our area this is usually cleaning a stable, doing gardening or spending longer than usual in the office chair. This puts some of these postural muscles under a heavier than normal load. So the muscles are already a little tired and the body is busy removing the build up of waste products and drawing in extra nutrients and repairing any small areas of damage.

All this is completely normal and happens every day, in this case the micro damage is a little more than normal. When you bend down to put your socks on, you do a full bend at the waist to get down to your feet (or lift your foot which creates the same bend anyway) and a small section of the postural muscles goes under a heavy load. Usually this is no problem for your body as when you straighten again, another group of motor units just takes on the load. But this time is a little different, all the other motor units are taking a break too so the area of heavy load goes into a spasm to force you to stop loading it.

You have just discovered another difference between these postural muscles and the other muscles such as your biceps. When the biceps gets tired, it just stops working and fails to lift anymore. The postural muscles can’t really do this as lets face it - you won’t stop moving about unless forced to - so that’s just what your body does by creating a muscle spasm. The spasm is designed to protect the other muscles around it.

So why is this 2-3 days of rest so important? This is the normal inflammatory period for your body. If you get an ache or pain from a muscle or joint sprain and it goes away within a few days, then your body is operating exactly as it should. Of course this may indicate a need to strengthen the area so as to prevent a re-occurrence but it does not necessarily mean that there is something very wrong that you should be overly concerned about.

Without trying to be too technical, inflammation occurs with any trauma. It is just the amount of inflammation that varies depending on the severity of the injury. When a tissue is injured it releases substances that open spaces in the blood vessel walls to get extra fluid into the area and also draws in the special cells produced by the immune system that come in and clean up the damage and others that repair the damaged tissues. This is why the area gets hot and swollen. Your body will tend to over react to an injury rather than under react and this is why rest and good management becomes important to get the fastest possible healing time.

When people don’t rest and just try to work through the pain, the body keeps this active inflammation going. It will do it’s best to get you moving as quickly as possible but it just isn’t able to finish the job. This is why if an injury isn’t managed well, it just seems to keep going on and on and on.....

Truthfully, just taking a short rest for a couple of days will make a massive difference in the time to full recovery. The world really will keep on turning without you, try not too worry too much about taking some necessary time out!

Perhaps the most important reason to manage an acute injury properly is not the acute pain - even though it is a horrible experience. The big problem is where acute pain becomes chronic pain. This is where the body doesn’t shut the inflammation process off completely and/or the pain pattern is cemented into the nervous system.

The progress of acute pain to chronic pain is important so we will leave this for another blog posting.

Fitball Squat

The fitball squat is really good for strengthening the back, hips and knees.

Lean back into the fitball and let it support your weight. Feet shoulder width apart and facing straight ahead. Sit the bottom down as if you are going to sit on a stool directly under the buttocks.

Squat until the knee is bent to 90 degrees. In this position, the shin should then be 90 degrees to the ground. If it's not, then adjust the position of the feet and the body lean into the fitball until this alignment is achieved.

The last part of the clip shows a squat with a small knee bend only. It is useful as a starting point for this exercise if the knees are sore and/or arthritic.

For all exercises and stretches on this blog, please ensure you are taught how to perform the exercise by a qualified member of Original Osteopathy. We accept no responsibility for any exercise attempted that we have not shown you! If you have been shown the exercise and experience any unexpected symptoms, discontinue and contact Original Osteopathy.

Theraband Neck Stretch

This neck stretch is very effective because it relies on the band to do the stretch for you and helps prevents you from straining the neck by over stretching. The intensity of the stretch is determined by the colour of the band used.

Start by doing a warm up with a few shoulder rolls in both directions.

Then hold each position as shown:

1) Ear to shoulder

2) Looking to the right and left (only turn until neck rotation stops, don't force it)

3) Nod the head forward and to 45 degrees

Hold each position for the amount of time instructed (usually 30-45 secs)

Note the postural position. Chest up and shin in.

For all exercises and stretches on this blog, please ensure you are taught how to perform the exercise by a qualified member of Original Osteopathy. We accept no responsibility for any exercise attempted that we have not shown you! If you have been shown the exercise and experience any unexpected symptoms, discontinue and contact Original Osteopathy.

Original Osteopathy at "Clean Up Moss Vale Day"

Saskia and Rod represented Original Osteopathy at the "Clean Up Moss Vale Day" on Saturday 15 August organised by Kathy Barnsley of the Moss Vale Chamber of Commerce.

We took on the Clarence Street area around the shops and car parks. We collected a lot of rubbish but on the whole were amazed at just how little there was for an entire year. It seems that the Moss Vale locals really are good at cleaning up after themselves (with a bit of help from the council no doubt). Basically it should have been called the "clean up the cigarette butts day" instead!! We were simply astounded at the amount of cigarette butts people throw on the ground......

Saskia and Rod won second prize for the strangest item collected - a computer monitor, mouse and keyboard. Interestingly not the hard drive though. Saskia found the computer equipment in the car park opposite the delivery dock to the IGA on Elizabeth Street. Just in case you're thinking that computer equipment is not really that strange....we actually got the prize because within half an hour of moving the computer to the collection site, someone had already decided to do their own recycling and took the computer monitor for themselves. Good luck to them, hope it works out well!! (Incidentally first prize was a ring and a spanner).

Other highlights included the lunchtime sausage sizzle put on by the Lions Club. Also our Chamber president, Michael Craig being knocked over by a bus when using the whipper snipper at the old car site on the Robertson Road roundabout. No-one can question Michael's commitment to the cause - he got back up and kept right on going!!

What is Osteopathy

What is Osteopathy?

Put simply, its a form of manual therapy that recognises 3 very important principles:

The body is a unit

Structure and function are inter-related

The body can heal itself

These principles seem amazingly obvious and simple. Yet time and again, people come to our clinic and it’s obvious that no-one has ever approached the problem with these simple principles in mind.

Let’s look at an example of each principle:

Your body does indeed operate as a single unit. So if you have a sore neck and your lower back pulls your shoulder down towards your hip, you are going to need to have both areas treated to remove the neck pain.

Structure and function are inter-related. We have an opposable thumb that allows us to hold a telephone. So without a thumb (the structure) we cannot use a telephone (the function). This same principle holds true right down to the cells in our bodies. For example, a liver cell under a microscope looks distinctly different to a kidney cell. Consequently they produce different proteins and have different receptors in their cell walls, in other words the function of each cell is related to it’s structure.

When a cell is compromised it will actually undergo a structural and functional change. A simple example of this is a muscle in long term spasm. Your body will shorten and thicken the connective tissues in and around the muscle - commonly known as scar tissue. This structural change has the functional effect of slowing nutrients flowing in to the muscle and at the same time slowing the rate that waste products are released. The result is painful, constant low grade inflammation.

The fact that your body can heal itself is about the best news you’ve had all day! Notice that when you get a cut on your arm, your body fixes it up all by itself? Your body can also heal itself in such a way as to stop the process that is creating the pain. If normal function is returned to a compromised area - say for example a muscle in spasm, then your body will stop producing the inflammation that is creating your pain.

Your body's ability to heal itself is even more important than you probably realise - the body you have today is NOT the same as the one you will have in years to come. This can be for better or worse. Start looking after your body better today than you did yesterday and this healing process begins. You can actually reverse the process that is causing your aches, pains and the chronic illnesses you may be experiencing. This can be as simple as reversing the process causing your neck pain or can be as significant as reversing the process that leads to Type II diabetes!

Osteopathy uses a variety of hands on techniques, some of which you may already have been exposed to or know about that have been used effectively for thousands of years like manipulation and soft tissue therapy. However osteopaths have invented other techniques not so well known outside our profession such as muscle energy, counterstrain (also called positional release), functional and cranio-sacral techniques. Whilst these later techniques are now being copied by other professions, they are mostly not used with the same level of effectiveness. This is because these techniques were designed to work within the framework of osteopathy. Without the osteopathic approach, they are just a jumble of techniques with no unifying approach.

Osteopathy is therefore a tool that looks at the structure of your whole body and uses a variety of hands on techniques to remind your body how to function normally, thereby allowing your body to heal itself. Along with regular low impact exercise and a good diet, your body can then perform to its optimum level, pain free and with less risk of developing chronic debilitating illnesses.

Basic Neck Stretch

This basic neck stretch can be performed any where you can find a seat.

Sit on the hand of the side to be stretched to pin down that shoulder. Sit up very straight and keep the sternum up. Turn your head to 45 degrees away from the side to be stretched. Use the other hand to gently guide your head down/forward in the 45 degree direction.

If you slouch and don't sit up straight, the stretch will not be effective.

For the first week of performing this stretch, hold each side for 20 seconds. Increase the time to 30 seconds after the first week.

Some pain is normal during the stretch but stop if you feel sharp pain or if pain persists for more than 10 minutes after completing the stretch.

For all exercises and stretches on this blog, please ensure you are taught how to perform the exercise by a qualified member of Original Osteopathy. We accept no responsibility for any exercise attempted that we have not shown you! If you have been shown the exercise and experience any unexpected symptoms, discontinue and contact Original Osteopathy.

Seated Twisted Torso

An easy stretch to perform any where, any time! Very good for people spending too much time at the desk.

Cross one leg over the other, reach the opposite hand over the outside knee and turn your body away from the knee.

Hold the stretch for 30-45 seconds.

For all exercises and stretches on this blog, please ensure you are taught how to perform the exercise by a qualified member of Original Osteopathy. We accept no responsibility for any exercise attempted that we have not shown you! If you have been shown the exercise and experience any unexpected symptoms, discontinue and contact Original Osteopathy.

Twisted Torso Stretch

A basic back stretch that improves rotation through the whole torso and gives a light stretch to the buttock as well.

Flex the hip to 90 degrees and then pull across the body. Stretch out the arm on the same side as the hip being stretched. Turn your neck to look at the outstretched hand as long as this doesn't cause neck pain.

Make sure your neck is supported by a pillow as shown.

Hold the stretch for 30-45 seconds.

For all exercises and stretches on this blog, please ensure you are taught how to perform the exercise by a qualified member of Original Osteopathy. We accept no responsibility for any exercise attempted that we have not shown you! If you have been shown the exercise and experience any unexpected symptoms, discontinue and contact Original Osteopathy.

Back Stretch

To make this stretch really work, get into the position as shown and then walk the fingers forward to increase the stretch through the back.

Hold the stretch for 30-45 seconds.

For all exercises and stretches on this blog, please ensure you are taught how to perform the exercise by a qualified member of Original Osteopathy. We accept no responsibility for any exercise attempted that we have not shown you! If you have been shown the exercise and experience any unexpected symptoms, discontinue and contact Original Osteopathy.

Hip Flexor Stretch

The hip flexor stretch opens the front of the hip and groin area. It is a great stretch for people who spend a lot of time sitting at a desk or driving long distances. Cyclists also need to do this stretch regularly.

Hold the stretch for 30-45 seconds

Note that the knee is in contact with the mat. The pressure on the knee should be light however as the foot on the side being stretched tries to reach as far behind you as possible. Use a pillow or towel under the knee if it gets sore from the pressure.

Note that I am using the bar for support. This is so I can concentrate on a deep stretch and not have to worry about keeping my balance!

For all exercises and stretches on this blog, please ensure you are taught how to perform the exercise by a qualified member of Original Osteopathy. We accept no responsibility for any exercise attempted that we have not shown you! If you have been shown the exercise and experience any unexpected symptoms, discontinue and contact Original Osteopathy.

Pec (Front of Chest ) Stretches

In BOTH stretches the foot on the side you are stretching steps forward. So if you are stretching your right pec, step forward with the right foot.

Bent Arm at Elbow

The strongest of pec stretches and also opens out rounded shoulders.

For all exercises and stretches on this blog, please ensure you are taught how to perform the exercise by a qualified member of Original Osteopathy. We accept no responsibility for any exercise attempted that we have not shown you! If you have been shown the exercise and experience any unexpected symptoms, discontinue and contact Original Osteopathy.

Pretzel (Advanced Buttock) Stretch

The pretzel stretch is a strong stretch to the buttock region. It also has the advantage of providing a light traction to the lumbar spine.

The trick to getting it right is to make sure one of your hands reaches between your legs and the other goes around the legs.

Make certain that your head is resting on something like shown in the photo. Otherwise you will be calling us to fix your neck!!

Hold for 30-45 seconds.

For all exercises and stretches on this blog, please ensure you are taught how to perform the exercise by a qualified member of Original Osteopathy. We accept no responsibility for any exercise attempted that we have not shown you! If you have been shown the exercise and experience any unexpected symptoms, discontinue and contact Original Osteopathy.

Arm Openings

Arm Openings is an exercise from Pilates. The aim is to increase the range of motion in the upper back and neck. Its an articulation exercise rather than a stretch so at first it feels like not much is happening but stick with it as the results are amazing!

Note that the movement is slow and controlled.

The rotation is timed with the breathing. Every time Saskia's hand is going to the roof (vertical position), Saskia is taking a breath in. Every time Saskia's hand moves away from the vertical position, Saskia is breathing out.

Please also note that the hand and nose are always in line with each other. The hand NEVER stretches past the nose/chin line. So the hand will only reach around as far as the neck and torso can comfortably turn.

For all exercises and stretches on this blog, please ensure you are taught how to perform the exercise by a qualified member of Original Osteopathy. We accept no responsibility for any exercise attempted that we have not shown you! If you have been shown the exercise and experience any unexpected symptoms, discontinue and contact Original Osteopathy.

Adductor (Inside Thigh) Stretch

The adductor stretch opens up the groin region. The foot up on the stretching bar needs to be pointing straight up and the support foot needs to be at 90 degrees to the bar. Your body should face side on to the bar.

Do not over stretch!! This is usually a very inflexible area for most people so progress slowly.

Hold the stretch for 30-45 seconds.

To increase the force of the stretch place your hand on the side being stretched on your inside thigh with the palm facing forward.

Place the other hand over your head to further increase the force of the stretch

For all exercises and stretches on this blog, please ensure you are taught how to perform the exercise by a qualified member of Original Osteopathy. We accept no responsibility for any exercise attempted that we have not shown you! If you have been shown the exercise and experience any unexpected symptoms, discontinue and contact Original Osteopathy.

Basic Gluteal (Buttock) Stretch

The basic gluteal stretch is the starting point for getting more flexible muscles is the buttock region.

Make sure your head is comfortably resting on a pillow

Hold the stretch for 30-45 seconds

For all exercises and stretches on this blog, please ensure you are taught how to perform the exercise by a qualified member of Original Osteopathy. We accept no responsibility for any exercise attempted that we have not shown you! If you have been shown the exercise and experience any unexpected symptoms, discontinue and contact Original Osteopathy.

Calf Stretch

Points to remember when doing a basic calf stretch:

- keep your back leg straight

- keep both heels down (especially the rear heel)

- lean forward and support you body weight as shown

- ensure both feet are pointing forward (this is the most common error and in fact my rear foot should be straighter than shown)

Hold stretch for 30-45 seconds

For all exercises and stretches on this blog, please ensure you are taught how to perform the exercise by a qualified member of Original Osteopathy. We accept no responsibility for any exercise attempted that we have not shown you! If you have been shown the exercise and experience any unexpected symptoms, discontinue and contact Original Osteopathy.

Quadriceps (front of thigh) Stretch

The quadriceps stretch opens up the front of the thigh.

Make sure that the knees stay together during the stretch otherwise you don't stretch the "rectus femoris", the only muscle (of the 4 muscles that make up the quadriceps) that crosses the hip joint as well as the knee joint.

Bring the foot towards the buttock. If you can't reach, wrap a towel around the leg being stretched and pull the foot towards the buttock. This makes the stretch a lot easier.

Hold the stretch for 30-45 seconds.

For all exercises and stretches on this blog, please ensure you are taught how to perform the exercise by a qualified member of Original Osteopathy. We accept no responsibility for any exercise attempted that we have not shown you! If you have been shown the exercise and experience any unexpected symptoms, discontinue and contact Original Osteopathy.

Hamstring Stretch

The hamstring stretch is a VERY important stretch for the lower back! Flexible hamstrings can drastically reduce back pain if performed regularly and correctly.

Hold the stretch for 30-45 seconds.

The first picture shows the starting position. Make sure your support foot is pointing more towards the stretching leg than sideways. The foot of the leg being stretched should point straight up. For maximum effect keep leg being stretched straight. However if you have a knee problem then a slight bend in the leg being stretched may be necessary.

The second stage of the stretch involves leaning forward from the hips to increase the force of the stretch. Note that the back is kept straight. This protects the lower back from injury.

For all exercises and stretches on this blog, please ensure you are taught how to perform the exercise by a qualified member of Original Osteopathy. We accept no responsibility for any exercise attempted that we have not shown you! If you have been shown the exercise and experience any unexpected symptoms, discontinue and contact Original Osteopathy.