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UK Osteopaths prepare for the London Olympics
If the focus in the media is understandably on whether UK sportsmen and women can repeat their fantastic Beijing performances in London in 2012, then osteopaths are gearing up for their own particular challenge, to provide Team GB with the best possible healthcare and support during the Games.

Writing in the profession's the osteopath magazine, Jonathan Betser, chairman of the Osteopathic Sports Care Association, says osteopaths proved their value during the 2002 Commonwealth Games in Manchester; "We hope to build on the success of the Commonwealth Games and to play an integral role in supporting our nation's athletes at London 2012."

Mr Betser said the Manchester Games had the added benefit of introducing osteopathic treatment "to countless doctors, physiotherapists, etc who had previously known little about osteopathy, but who, after watching osteopathic treatment in action, ended up recommending other athletes for treatment."

A conference was held in late November last year to gather together osteopaths who might be interested in offering their services in London, with one of the main aims being to kick-start an education and training programme to prepare for 2012; "Whilst the majority of us treat sportspeople in our clinics", wrote Mr Betser, "it's evident that to assemble a large enough team of sports injury specialists, an appropriate education programme is needed."

During the conference the osteopaths heard from some prestigious sports healthcare specialists, including Dr Helmut Hoffman, the orthopaedic consultant to German football club Bayern Munich, and John Neal, the performance coach for the Welsh national Rugby Squad.

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Health Clinic

Osteopathic Research
We don't exactly recommend that you order a copy of the International Journal of Osteopathic Medicine from your local library - ‘Test-dependent Osteopathic Treatment of Somatoform Autonomic Dysfunction of the Cardiovascular System' will surely solve any sleeping problems you have - but there is some plain English in there as well, and some of it is interesting.

The December issue, for example, includes articles on subjects as diverse as how to best assess clinical competence in osteopathic training, how the actual experience of pain impacts on your beliefs about pain, and how patients feel after osteopathic treatment.

This last study on post-treatment reactions may be of particular interest to any reader who has undergone osteopathic treatments. In the joint US-UK study, the five authors found that among the most common reported additional affects of treatment were local pain (24.3% of reported effects), local stiffness (18.3%), radiating pain/discomfort (7.5%) and unexpected tiredness (7.3%). It should be emphasised that some short term reaction to treatment is to be expected, and that the researchers found that in 96% of reported cases the reactions were mild or moderate.

Another study, from the US, looked at the issue of treating pregnant women with acute low back pain, and concluded after analysing the treatment of 20 patients that the preliminary data was encouraging, with osteopathic therapy appearing to be "an effective therapy for immediate relief of pregnancy related low back pain and suggests a possible longer term effect on improving functional capacity and bodily pain after three serial weekly treatments.".

What about the study into differing perceptions on low back pain? A Norwegian study found significant differences in options among patients and practitioners. For example, 53% of people currently in pain disagreed with the statement that ‘back pain recovers best by itself'', compared to only 37% of those not currently in pain. Wishful thinking is evidently easier when you are pain free. The study also revealed striking differences between medical professionals, with only 5% of chiropractors, for example, agreeing that ‘in most cases back pain recovers by itself in a couple of weeks', compared to 86% of doctors, who appear (in Norway at least) to believe that back pain isn't a problem at all

So you can learn a lot from the International Journal of Osteopathic Medicine, and if nothing else it's a good way of making your own osteopath feel a bit dim. Next time you visit, try asking about the treatment of somatoform autonomic dysfunction. Practice it.

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Case Study

Achilles Tendonitis
The case: Lindsey, a 44 year old office manager, begins to feel a niggling ache in her right leg, about 3cm above the back of her heel. It comes and goes over a period of a few weeks, but is gradually becoming worse.

She is keen on exercise, but finds it difficult to fit it in around a busy lifestyle. On average she does some form of exercise about twice a week. Over a couple of days the pain suddenly increases. Physical activity is now impossible, and she can be seen to slightly limp even when just walking. Having attended an osteopath with a range of injuries resulting from skiing falls and mountain bike disasters, to a stiff and painful neck from too much computer use, she decides to phone and ask for advice. After a having a brief chat with her osteopath she's aware that this is unlikely to be a pain that will just disappear and makes an appointment.

The diagnosis: After taking a full case history and initial examination, her osteopath is able to find a painful point in her right Achilles tendon. The area is thickened when compared to her other Achilles tendon, and she is tender to palpation in her right calf muscles.

Her osteopath explains that she is suffering from an Achilles tendonitis, where there is a localised inflammation to the tendon, from trauma. At the onset the injury may be very minor, but gradually develops through continued use. The Achilles tendon is the largest tendon in the body and connects the calf muscles with the heel bone (calcaneum), and the muscles in the foot. It allows us to rise onto our toes, and is important in any movement of the foot, such as walking.

Most people are unaware of what caused their injury, but there are several known triggers.

- Overuse of the tendon. Often related to naturally tight calf muscles, and common in women who regularly wear high heels causing shortening of the calf muscles and then greater pull through the tendon.

- Poor foot wear. Usually associated with poor foot mechanics, where the foot falls inward (over pronation), placing an increased load into the tendon. Some studies show this is common in between 60% and 80% of the population.

- Poor warm up before exercise. Not conditioning the tendon, allowing it to stretch with increased activity.

- Rapid increase of exercise, distance or speed. This should be done gradually over a lengthy time span.

- A sudden increase in exercise involving hills or stair work.

The treatment: Lindsey's osteopath used direct soft tissue techniques to the injured area and gentle articulation of her ankle to encourage blood flow, reduce swelling and stimulate tissue repair. She was given some light stretching exercises and advised on her choice of footwear. The use of orthotics, to correct the over pronation of her feet, was discussed.

The outcome: After two weeks Lindsey felt she was on the mend, and her stretching and activity was slowly allowed to increase. A further four weeks and her exercise levels were picking up, with no adverse reaction. She's still no keener on flat shoes, but has agreed to limit heels to ‘going out' occasions.

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Body Talk

Rheumatoid Arthritis (R/A)
What is it? Rheumatoid Arthritis is a chronic autoimmune disease. Autoimmune diseases are where the body's own immune system mistakenly attacks its own tissue. The immune system comprises an organisation of antibodies and cells which would normally target invaders of the body, usually infections. People with autoimmune diseases have antibodies in their blood which attack their own tissues, recognising them as foreign. In rheumatoid arthritis this involves the joints and occasionally other parts of the body.

Who gets it? Rheumatoid Arthritis affects around 0.5% to 1% of most populations. There are approximately 350,000 sufferers in the UK, usually starting in the 30-50 age group, but it can affect people of all ages. It is three times more common in women than men.

What happens? The body's defence system attacks its own joints, causing the membrane lining of the joints and tendon sheaths to become inflamed. This leads to thinning of the cartilage that covers the end of the bones, and then erosion to the exposed bone. At times, for no apparent reason, inflammation can suddenly become worse. These are usually known as 'flare-ups'. The joint becomes warm and red due to increased blood flow and the joint membrane lining producing extra fluid, resulting in a stiff, painful, swollen joint.

Symptoms: Tend to develop gradually. It can affect any joint in the body, but is often first noticeable in the hands and feet. Symptoms include swollen, stiff, painful joints; fatigue; flu-like symptoms; and a feeling of being generally unwell.

R/A affects everyone differently and the symptoms largely depend on the amount of tissue inflammation present at that time. The condition usually goes into periods of remission which can last from weeks or months up to years. It is therefore not possible to predict when the disease may become active again in a flare-up.

In general 75% of sufferers will continue to have flare-ups, 20% will only have mild symptoms, and 5% will develop severe R/A with more serious disability.

Cause: The cause is unknown. There is no single gene responsible for rheumatoid arthritis, but it is thought that there may be a genetic link. Indeed there is a much higher incidence found in Chippewa and Pima Indians (around 6%), and much lower incidence in Japan and China, suggesting genetics do play some part in predisposing people to the disease. However it must be stressed that having a family link to someone with R/A does not mean you are at much greater risk of developing the disease.
Symptoms often improve during pregnancy suggesting that hormones may play a part in triggering the condition.

Some infectious agents, viruses, bacteria and fungi have been suspected, but none have been proven to be the cause. Some scientists have reported an increased risk in smokers developing R/A.

Treatment: Self help, keeping the joints moving, finding the fine balance between helping and aggravating your joints. If the joints are hot and inflamed an ice pack may sooth the pain.
When the joints are stiff a hot water bottle may help with aches and ease movement. There is an increasing amount of drug therapy available with greatly improving results.

Osteopathy: At the moment there is no cure for rheumatoid arthritis. However osteopathy can help with some of the pain, stiffness and joints ranges of movement. Using very gentle techniques, osteopaths can improve the quality of a joints movement, ease muscle tension, producing symptomatic relief. This may give temporary or longer lasting benefits depending on the extent of the condition. Your osteopath can help with advice, possible light exercise routines and answer your questions on this unpredictable condition.

Osteopathy Highlights

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Osteopathic and Health Links

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The Good Health Centre, 116 Street Lane, Leeds LS8 2AL
The Good Health Centre, 1 Cheltenham Mount, Harrogate HG1 1DW
The Good Health Centre, 305 Harrogate Rd, Leeds LS17 6PA - 0113 2697274
Email: Phone:Work Phone/Fax: 0113 237 1173 Phone/Fax: 0113 268 6591