Head 2 Toe Osteopathy

27/10/2025

Move to Heal: How Movement and Exercise Help with Long-Term Pain Relief

When you’re in pain, the last thing you want to do is move. But here’s the truth — gentle movement is one of the best ways to help your body heal and stay pain-free in the long run.

As an Osteopath, I see this every day: people start moving again (slowly, safely, and consistently), and their pain levels drop, their posture improves, and their confidence grows.

Why Movement Matters

Pain isn’t always a sign of damage — sometimes it’s your body being overprotective. When you move, you teach your nervous system that movement is safe again. You help your body relax, improve circulation, and remind your brain that it’s okay to move without fear.
Movement literally re-trains your body and your brain.

How Exercise Helps Relieve Pain

Here’s what regular movement can do for you:
✨ Boosts blood flow – more oxygen = faster healing.✨ Releases endorphins – your body’s natural painkillers.✨ Builds strength – so your joints and spine are better supported.✨ Improves posture – less strain, fewer flare-ups.
It’s not about pushing harder — it’s about moving smarter.

Simple Ways to Get Moving Again

You don’t need to hit the gym or run a marathon to feel the benefits. Start small:
Take short walks every day.
Stretch while watching TV.
Try gentle yoga or Pilates.
Do a few strength exercises (bodyweight is fine!).
If you enjoy swimming — perfect! It’s great for sore joints.
The best exercise? The one you’ll actually enjoy and stick with.

“But What If It Hurts to Move?”

That’s a common worry — and it makes sense. But here’s the thing: avoiding movement for too long can make pain worse. Muscles get weaker, joints get stiffer, and the body loses confidence in how to move.
Start small. Move gently. And if you’re unsure where to begin — that’s exactly where your Osteopath can help.

Osteopathy + Movement = Long-Term Relief

During treatment, I help release tension, restore alignment, and improve mobility. Then, I guide you on how to keep that progress going through movement that feels right for you.
Osteopathy isn’t just about hands-on treatment — it’s about helping you take back control of your body.

24/10/2025

Tendinopathy does not typically respond well to stretching alone because the underlying pathology is primarily due to altered tendon structure, impaired load tolerance, and failed healing responses—rather than mere shortness or tightness of the muscle-tendon unit.

Pathophysiology and Load Response

Tendinopathy involves degenerative or failed repair changes within tendon collagen and extracellular matrix, resulting in pain, stiffness, and loss of resilience.

Stretching applies a low-magnitude, static load to the tendon. This does not provide the stimulus needed for tendon adaptation or healing, as tendons require higher mechanical loading (e.g., resistance or eccentric exercises) to initiate synthesis of new collagen and restructure tissue.

Static stretching does not generate sufficient load magnitude, volume, or frequency to promote tendon remodelling or increase tendon’s load tolerance, which are necessary for recovery from tendinopathy.

Clinical and Evidence-Based Insights

Eccentric and heavy slow resistance exercises, which place significant tension through the tendon, are far more effective in reducing symptoms and restoring function compared to stretching alone.

Studies comparing stretching versus loading exercises show that stretching may provide some temporary relief but does not produce consistent or long-lasting improvements in pain, function, or tendon structure.

The most effective exercise regimens are those that challenge the tendon and muscle through progressive, high-intensity loading combined with rest days to allow adequate recovery and adaptation.

In summary, tendinopathy does not improve with stretching because that approach fails to provide the specific mechanical stimulus required for tendon repair and restoration of strength, while loading-based exercises do address these needs and remain the most evidence-based intervention.

22/10/2025

Understanding the biomechanics of running is essential for every runner aiming to improve performance, reduce injury risk, and run efficiently. Running involves coordinated movement patterns, force generation, and energy transfer across muscles, tendons, and joints.

Key Phases of Running

Stance Phase: When the foot contacts the ground, energy is stored in the Achilles tendon and arch for propulsion. Efficient runners strike the ground with their foot beneath the hip, minimizing braking forces and optimising energy use.

Swing Phase: The foot leaves the ground, the body transitions energy from elastic recoil, and the hip drives the leg forward. Backward flexion of the hip is crucial to cycle the foot efficiently and prevent heel-striking far ahead of the hip.

Flight Phase: Both feet are airborne, demonstrating running’s dynamic nature and reliance on joint stability and muscle elasticity.

Injury Prevention Tips

Keep ground contact short to minimise energy expenditure.

Avoid overstriding: Foot should land directly beneath the hips.

Maintain upright posture and relaxed shoulders for optimal breathing.

Relax hands and drive elbows back to counterbalance leg movement and boost cadence.

Gradually implement form tweaks to reduce risk of injury.

Shoes, Individualisation, and Joint Motion

Select shoes suiting foot type and arch profile to support biomechanics and minimise overpronation/under pronation.

Every runner exhibits unique anatomical and movement variations, but core mechanical principles apply broadly.

Proper ankle, knee, and hip motion during the gait cycle distributes force efficiently and lessens joint stress.

Understanding these principles allows runners to fine-tune technique, personalise footwear, and adopt movement drills for improved efficiency and reduced injury risk.

20/10/2025

Focused shockwave therapy is regarded as the gold standard treatment for calcific tendinopathy due to its high effectiveness in breaking down calcium deposits, relieving pain, and restoring tendon function, all through a non-invasive approach with minimal risks.

Mechanism and Clinical Impact
Focused shockwave therapy uses high-energy acoustic waves to pe*****te deep into the tendon, generating microtrauma that directly fragments calcific deposits. This action enhances local blood flow, stimulates the influx of growth factors, and encourages cellular regeneration in the affected tissue. The net effect is accelerated resorption of calcium deposits and improved tissue healing, which translates to better shoulder mobility and reduced pain, often within a few sessions.

Supporting Evidence
Multiple systematic reviews and clinical trials have demonstrated that focused shockwave therapy for calcific tendinopathy leads to significant improvements in pain scores, functional capacity, and reduction in the size of calcific deposits compared to placebo or other conservative treatments (such as physiotherapy or corticosteroid injection). Success rates for pain relief and function restoration approach 90% in some studies, with high-energy focused shockwave found to be especially effective. Focused therapy is also preferable to radial shockwave because it can target deeper tissues and precisely address calcific foci.

Comparison to Other Treatments
Compared to surgery, focused shockwave therapy is non-invasive, involves no downtime, and carries far fewer risks. While corticosteroid injections might offer quick pain relief, they lack the long-term effectiveness and regenerative capacity provided by shockwave therapy and carry potential risks with repeated use. Surgery is now typically reserved for refractory cases where shockwave therapy is unsuccessful or not possible.

Clinical Recommendations
Professional guidelines and systematic reviews recommend focused shockwave therapy as a first-line treatment for calcific tendinopathy, especially of the shoulder (such as supraspinatus tendinopathy), due to its robust evidence base for pain relief and functional improvement.

19/10/2025

17/10/2025

Patellofemoral joint pain (PFP), commonly called runner’s knee, is a prevalent musculoskeletal complaint, especially among athletes and active individuals. Effective management is rooted in evidence-based, conservative approaches, typically centred on exercise therapy and patient education.

Best Practice Recommendations
Recent high-quality guidelines and meta-analyses unanimously recommend knee- and hip-targeted exercise therapy as the primary intervention for PFP. Structured programmes focusing on strengthening the quadriceps, hip abductors, and external rotators over at least 6–12 weeks, preferably under clinician supervision, show significant improvements in pain and function. Hip strengthening, in particular, has demonstrated even greater efficacy in pain reduction than knee-directed protocols, likely due to the role of proximal mechanics in patellofemoral alignment and load.

Education and Multimodal Approaches
Education forms a core part of management, ensuring patients understand risk factors, biomechanics, and the importance of regular exercise. Adjuncts such as prefabricated foot orthoses, movement retraining, taping, and manual therapy can be considered on an individual basis; these should be tailored according to symptom severity, physical findings, and patient preference. Taping and bracing may provide short-term symptom relief, and foot orthoses can be beneficial for patients with biomechanical abnormalities.

Role of Osteopathy and Manual Therapy
Osteopathic manipulative treatment (OMT) and manual therapy are increasingly recognised as supportive options for reducing pain and restoring function. Techniques like myofascial release, strain-counterstrain, and muscle energy have been shown to significantly decrease knee pain and improve joint function when combined with exercise therapy. Meta-analyses indicate a meaningful reduction in pain scores with OMT interventions compared to no treatment, though heterogeneity across studies warrants cautious interpretation.

15/10/2025

Why does it feel like my body is falling apart at 40?!

The body’s decline after age 40 is driven by a combination of cellular changes, hormonal shifts, and alterations in muscle, bone, and metabolic function that occur naturally with aging.

Cellular and Molecular Changes

Studies show that around the mid-40s, both men and women undergo significant biomolecular shifts affecting many systems in the body. These changes lead to visible and functional declines such as slower metabolism, reduced ability to recover from stress or injury, and reduced efficiency of metabolic and immune pathways. Many of these changes are not just related to menopause in women but are seen in men as well, indicating broader biological triggers.

Musculoskeletal Decline

Loss of lean muscle mass (sarcopenia) and decreased protein synthesis begin as early as the 30s and accelerate after 40.
Muscle strength, endurance, and flexibility decline, affecting coordination, balance, and increasing injury risk.
Bone density also decreases, predisposing individuals to osteoporosis and height loss.

Even with regular activity, muscle mass loss is inevitable, but inactivity worsens the problem and contributes to slower metabolism.

Metabolic and Hormonal Changes

After 40, metabolism naturally slows due to loss of muscle and changes in hormones such as testosterone, oestrogen, and growth factors.
The body burns calories at a slower rate, making weight management more challenging even for active people.
Hormonal changes also affect how fat is stored and used, impacting cardiovascular health and energy levels.

Cardiovascular and Pulmonary Function #

The heart and blood vessels stiffen, and the heart fills with blood less efficiently.
The lungs lose some elasticity and capacity, making vigorous exercise more difficult.
The risk of hypertension, heart disease, and reduced aerobic performance increases with age.

Height Loss and Bone Structure

By around age 40, most people begin to lose some height due to spine and bone changes. Osteoporosis risk increases as bone loss surpasses bone formation with age, leading to further decline in mobility and strength.

13/10/2025

Tendinopathy in Runners: Why Focused Shockwave Therapy is a Game-Changer

Runners thrive on consistency, but tendinopathy has a way of halting progress. Achilles pain, a stubborn patellar tendon, or hip tendon irritation can linger for months — sometimes years — despite rest, rehab, and injections. While traditional approaches often provide partial relief, focused shockwave therapy (FSWT) is emerging as a breakthrough treatment that directly targets the underlying problem.

What is Focused Shockwave Therapy (FSWT)?

Unlike radial shockwave therapy, which disperses energy superficially, focused shockwave therapy delivers precise acoustic energy deeper into the tendon. This controlled microtrauma stimulates biological repair mechanisms, including:
Enhanced blood flow to poorly vascularised tissue.
Activation of cellular repair pathways, including collagen regeneration.

Reduction in pain receptor activity, easing symptoms while healing occurs.

Disruption of scar tissue or calcification, restoring tendon mobility.

In essence, FSWT doesn’t just manage pain — it restarts the healing process in tendons that have “stalled.”

The Evidence: Success Rates for Runners
A growing body of research supports FSWT for chronic tendinopathies:

Achilles Tendinopathy: Studies show up to 70–80% of patients report significant pain reduction and functional improvement after FSWT, especially when combined with exercise therapy.

Patellar Tendinopathy: Athletes receiving FSWT demonstrate superior outcomes compared to exercise therapy alone, with longer-lasting relief.
Gluteal Tendinopathy: Randomised controlled trials reveal that FSWT provides better medium-term pain relief than corticosteroid injections.

Overall, clinical success rates for FSWT in chronic tendinopathy range from 65–85%, making it one of the most effective non-surgical options available.

10/10/2025

In the UK, adult physical activity levels have modestly increased over the past decade, but wide inequalities and concerning trends persist, especially among adolescents. Physical inactivity remains a major public health risk, directly impacting the rates of chronic disease and overall population health.

Adult Physical Activity Trends
Between November 2023 and November 2024, 63.7% of adults in England met guidelines for 150+ minutes of moderate physical activity weekly, up from about 61% in 2016, representing a gradual increase in active adults to around 30 million people.
Despite this rise, around 22% of adults in England remain physically inactive, meaning they do less than 30 minutes of moderate activity weekly.
Activity tends to decline sharply with age, and there are notable disparities based on gender, socioeconomic status, and ethnicity.

Adolescent Physical Activity Trends
Only 48% of children in England meet the Chief Medical Officers’ target of 60 minutes of daily activity, representing over 2.2 million doing less than 30 minutes each day—a figure that has worsened compared to pre-pandemic levels.
Girls, children with disabilities, and those from deprived backgrounds are especially unlikely to be adequately active.
Regional data shows some boroughs outperforming the national average, but inequalities remain pronounced.

Health Impact of (In)activity
Physical inactivity is associated with 1 in 6 UK deaths and costs the nation £7.4 billion annually, including nearly £1 billion to the NHS.
Sufficient physical activity reduces the risk of heart disease, stroke, diabetes, several cancers, depression, dementia, and premature death by up to 30%.
In children, regular activity is linked to improved physical development, school readiness, mental wellbeing, and reduced obesity risk.

08/10/2025

Bone stress injuries (BSIs) are among the most feared running injuries, often forcing athletes to take extended time off from training or competition. Defined as the bone’s “focal failure” under repeated loading, BSIs encompass stress reactions and stress fractures—conditions where the bone’s ability to withstand impact is surpassed by running’s repetitive forces.

Why Do Runners Get Bone Stress Injuries?

Runners place substantial, repetitive loads on bones, particularly in the legs, feet, and hips. Most injuries occur when training load (such as mileage, intensity, or frequency) is increased too rapidly, or when poor nutrition, inadequate recovery, or underlying health conditions (like low bone density or hormonal issues) compromise bone remodelling and repair. Runners are also at risk if muscle fatigue prevents shock absorption, transferring extra force to bone and causing microdamage.

Common causes include:

Sudden jumps in training volume or intensity

Poor fuelling or calorie restriction (RED-S risk)

Insufficient rest days and recovery periods

Low bone density, vitamin D deficiency, or osteoporosis

Biomechanical factors (overpronation, lower limb alignment)

Symptoms and Early Warning Signs

BSIs develop gradually, often starting as localised pain that worsens with weight-bearing activity and eases with rest. Key signs include:

Focal bone pain increasing during runs

Tenderness over the affected area

Swelling, redness, or inability to hop or run without pain

Ignoring these warnings increases the likelihood of progressing to a full stress fracture, which requires stricter rest.

How Runners Can Reduce Risk

Evidence-based tactics for prevention:

Progress training loads gradually (no more than 10% per week)

Prioritise rest and recovery; don’t ignore fatigue or pain

Fuel adequately—avoid diets that restrict key nutrients or calories

Monitor menstrual health (in females) for hormone-driven bone changes

Strengthen muscles to support bones and absorb shock

Consult professionals for individual gait analysis, footwear advice, and tailored strength programmes

06/10/2025

Focused Shockwave Therapy for Morton’s Neuroma

Morton’s neuroma is a painful nerve condition that affects the ball of the foot, most commonly between the third and fourth toes. Typical symptoms include sharp, burning pain, tingling, or the feeling of walking on a pebble—even if nothing is present. These sensations can make walking, running, or simply standing uncomfortable, especially for active adults and runners.

What Is Focused Shockwave Therapy?
Focused shockwave therapy uses controlled acoustic waves aimed directly at the neuroma and surrounding tissues. This process promotes blood flow, breaks down fibrous scar tissue, and reduces local inflammation, accelerating the body’s natural healing processes. Patients often report a noticeable reduction in pain after 3–5 sessions, each lasting around 15–20 minutes. The treatment is non-invasive, and most people can walk out of the clinic and resume light activities immediately.

Clinical Outcomes: What Does the Evidence Say?
Emerging research supports the benefit of focused shockwave therapy for Morton’s neuroma, especially in cases that have not responded to conservative care alone. Randomised controlled trials show significant reductions in pain and improvements in foot function, even when neuroma size doesn’t change. Potential side effects—temporary swelling, bruising, or discomfort—are rare and mild, resolving within days.

Osteopathy and Shockwave: Integrated Rehabilitation
Osteopaths often combine shockwave sessions with manual techniques to optimise recovery. By mobilising joints and releasing tight tissues, osteopaths help offload pressure from the forefoot, support better gait patterns, and guide patients through tailored exercise plans. This integrated approach not only tackles the neuroma directly but also addresses underlying biomechanical issues that contribute to foot pain and dysfunction in the long term.

What to Expect
Assessment: Detailed osteopathic evaluation of foot mechanics and whole-body posture.
Treatment plan: Combination of focused shockwave sessions, manual therapy, exercises, and footwear guidance.
Follow-up: Ongoing support, rehabilitation exercises, and periodic reviews.

03/10/2025