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Monday 9:30am - 8pm Tuesday 9:30am - 3pm Wednesday 9:30am - 3pm Thursday 9:30am - 8pm Friday 9:30am - 3pm Saturday 8am - 1pm

Head 2 Toe Osteopathy

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Head 2 Toe Osteopathy

Head 2 Toe Osteopathy offers hands-on treatment, shockwave therapy, and rehabilitation to those suffering aches and pains.

Common conditions include back and neck pain, shoulder pain, tennis elbow, hip and knee pain, and ankle and foot pain. Head 2 Toe Osteopathy offers treatment and rehabilitation to those suffering aches, pains and injuries. The clinic at The Spot Wellness Centre, in the middle of Godstone, is close to Junction 6 of the M25 and the surrounding areas of Caterham and Oxted. We work closely with the team; patients can be assured that they will always receive a highly professional service.

05/09/2025

Barefoot vs. Cushioned Shoes: Key Differences and Considerations

Barefoot (Minimalist) Shoes

Benefits:
- Encourage a natural gait and forefoot/midfoot striking, which may lead to lower impact forces and improved running mechanics for some runners.
- Promote strengthening of foot and lower leg muscles, which helps develop stability, proprioception, and potentially reduces certain kinds of running injuries related to weak foot muscles.
- Heightened ground feel and sensory feedback, enhancing balance and agility.

Risks:
- Increased risk of pain or injury on hard surfaces, long distances, or with high-arched/supinated feet, especially if transitioning too quickly or with poor technique. Stress fractures can occur if the body isn’t adequately conditioned.
- Not everyone benefits—runners with specific biomechanical issues, or those who don’t gradually adapt, may experience higher injury risk.

Cushioned Shoes

Benefits:
- Absorb impact, protect the feet from hard surfaces, and can enhance comfort especially on concrete or rocky terrain.
- May enable improved running speed and endurance: elite runners often use highly cushioned shoes, with some studies showing 2–4% performance gains at top speeds.
- Preferred for those with high-arched feet or whose natural biomechanics don’t provide sufficient shock absorption).

Risks:
- Do not necessarily reduce injury rates—despite decades of cushioned shoe use, annual injury rates have not significantly decreased; suggesting injuries are more related to gait/form and training than to shoe type alone.
- May promote a rearfoot (heel) strike, leading to altered joint angles and impact forces, which could contribute to more knee injuries or inefficient mechanics for some runners.

03/09/2025

How Sleep and Stress Affect Running Performance & Injury Risk

The Role of Sleep in Running Performance
Quality sleep is essential for runners. Sufficient, restorative sleep directly improves aerobic endurance, reaction time, speed, and coordination. Runners who sleep well are less likely to experience fatigue and reach exhaustion too quickly.

Sleep deprivation impairs performance. Lack of sleep raises perceived effort, reduces endurance, slows recovery, and increases injury risk. Studies show runners experience slower sprint times, reduced glycogen stores, decreased strength, and elevated fatigue when sleep deprived.

Injury prevention: Optimal sleep supports immune function, aids tissue recovery, and reduces the likelihood of injuries or infections. Chronic sleep loss increases susceptibility to running injuries because tissues do not repair optimally between workouts or races.

For ultra-distance races, sleep strategies become part of performance: while short-term sleep deprivation may sometimes be tolerated or strategically used in events, for longer distances, sleep loss severely compromises performance and increases health risks.

The Impact of Stress on Runners

Elevated stress levels disrupt sleep, reduce enjoyment, and negatively affect long-term health. Stress leads to poor sleep, higher injury risk, slower recovery, and less effective performance gains from training.

Cortisol, the stress hormone, increases with physical and emotional stress. High cortisol impairs recovery, affects mood, hinders muscle repair, and can even suppress the immune system.

Running under stress: Runners who don't manage stress effectively notice slower times, higher perceived exertion, and often suffer more injuries or setbacks. Stress can manifest as muscle tension, poor focus, and reduced coordination, compounding the effects of sleep deprivation.

01/09/2025

Breathing and Core Stability: Osteopathic Tips for Runners

Why Breathing Matters

- Diaphragmatic (belly) breathing enhances oxygen uptake and endurance for runners, and can stabilize emotions and reduce stress during exertion.
- Efficient breathing patterns (such as rhythmic or 360° breathing) are linked to better core muscle activation and intra-abdominal pressure, leading to greater biomechanical stability during runs.

Core Stability for Runners

- The core isn’t just the abs. It includes deep muscles (transverse abdominis, multifidus), pelvic floor, diaphragm, and lower back.
- Osteopaths highlight that true functional core stability means breathing well while moving dynamically—not holding the breath or relying on superficial, chest-based breathing.
- Good core stability enables power transfer, balance, and posture control, reducing excess trunk rotation and preventing injuries such as low back pain, hip flexor strain, or poor shoulder mechanics.

Key Benefits

- Reduces risk of injury: Prevents excess low back movement, rotation, and compensatory patterns.
- Boosts running performance: Improves energy transfer, stride power, and overall control.
- Minimises fatigue and side stitches: More efficient oxygen use and less trunk strain.
- Supports posture and recovery: Enhances spinal alignment, and aids body’s ability to recover from high-impact activities.

Runners who train both core stability and functional breathing gain lasting improvements in comfort, speed, and injury resilience. Osteopathic approaches prioritise integrating breath into all movement, rather than treating breathing and core as separate entities—a principle that can benefit runners of all levels.

29/08/2025

The Importance of Hip Mobility for Runners
Why Hip Mobility Matters

Hip mobility refers to the ability of the hip joint to move freely through its full range of motion, controlled by muscle strength and joint stability. For runners, hip mobility is a crucial factor for performance, injury prevention, and overall comfort during running activities.

Key Benefits of Hip Mobility

Efficient Running Mechanics: Good hip mobility enables runners to achieve optimal stride length and fluid movement, leading to reduced energy expenditure and balanced gait. Restricted hip movement can shorten stride and decrease running efficiency.

Injury Prevention: Limited hip mobility often causes compensatory movements that place extra stress on other joints, such as the lower back, knees, or ankles. This increases the risk of common running injuries, including IT band syndrome, patellofemoral pain, hip impingement, and muscle strains.

Enhanced Performance: Runners with ideal hip mobility produce longer strides, better cadence, and greater power with each step, which translates into faster speeds and improved endurance. Hip mobility also lets you recruit the gluteal muscles more effectively for propulsion and stability.

Adaptability on Terrain: Mobile hips allow a runner to tackle varied terrain more easily, adapt to obstacles, and maintain balance when running on uneven surfaces.

Improved Comfort and Recovery: Keeping hips mobile reduces discomfort, tightness, and pain in the hips, lower back, or knees. It helps runners enjoy their sport and recover faster after workouts.

Consequences of Poor Hip Mobility

Reduced stride length and speed

Overuse or compensation by lower back, calves, or knees

Greater risk for overuse injuries (e.g., IT band syndrome, shin splints)

Increase in fatigue and discomfort during and after runs

How to Improve Hip Mobility

Incorporate hip mobility drills and dynamic stretches into your warm-up and cool-down routines.

Strengthen hip and gluteal muscles (clamshells, side leg raises, bridges).

Maintain a regular routine that targets both mobility and stability in the hips.

25/08/2025

Why Stretching Alone Isn’t Enough for IT Band Syndrome

IT Band Syndrome Overview
Iliotibial Band Syndrome (ITBS) is a common overuse injury, particularly among runners and athletes, characterised by pain on the outside of the knee. It results from friction between the IT band and the underlying tissue, often triggered by biomechanical imbalances, overtraining, or muscular issues.

Limitations of Stretching Alone

IT Band Structure: The IT band is a strong, fibrous structure, not a muscle. It’s naturally tight and not designed for significant flexibility, so stretching it often yields limited results. Excessive tightness usually signals an underlying problem elsewhere—such as pelvic or muscular imbalance.

Soft Tissue Issues: The IT band can adhere to underlying muscles like the vastus lateralis. These adhesions and soft tissue restrictions can prevent effective stretching and require manual release or foam rolling before any stretching is beneficial.

Stretch Reflex Complications: Aggressive stretching of attachments (like the TFL muscle) can trigger the body's protective reflex, causing these muscles to contract even tighter. This can worsen the syndrome instead of resolving it.

Limited Effect on Long-Term Recovery: Studies show that simply increasing stretching frequency and duration does not guarantee prevention or resolution of ITBS. Improvements in range of motion occur mainly with sufficient and regular stretching time, but stretching does not address the mechanical roots of the problem.

Why a Holistic Approach Is Essential

Identify Root Cause: ITBS is typically caused by mechanical imbalances in the lower body—involving hips, knees, pelvis, or running technique.
Addressing these root causes is crucial for long-term improvement.

Muscle Strengthening: Weak hip and gluteal muscles are major contributors to ITBS. Targeted strengthening exercises (such as clamshells and lateral leg raises) help stabilise your stride and relieve pressure from the IT band.

Release Soft Tissue Tension: Foam rolling, trigger point therapy, or manual releases to the TFL and surrounding tissue are necessary before stretches can be effective.

22/08/2025

Reasons Why Every Patient Will Be Given An Exercise Programme After Their Osteopathy Appointment

Most patients are given an exercise programme after their osteopathy appointment because tailored exercises help maintain the improvements made during treatment, support faster and more effective recovery, and reduce the chance of symptoms returning. Exercise programmes also promote tissue healing, improve mobility, decrease pain, and empower patients to take an active role in their health management.

Key reasons for prescribing exercise after osteopathic care include:

Helping to maintain mobility and flexibility achieved during treatment, reducing the risk of muscles and joints becoming stiff again.

Promoting tissue healing and reducing inflammation, which are important between appointments and speed up recovery.

Supporting self-management and giving patients tools to handle minor flare-ups, fostering a sense of control over their recovery process.
Improving strength, stability, and balance, which is especially important in rehabilitating injuries and preventing future ones.

Serving as a preventive measure: regular and appropriate exercise helps stop recurring problems and preserves the benefits of treatment.

By prescribing these programmes, osteopaths ensure that patients continue progressing after the appointment and develop habits that support long-term musculoskeletal health. Patients who consistently follow their recommended exercises tend to recover faster and are less likely to experience recurring issues

20/08/2025

What is the difference between radial and focused shockwave therapy?

The primary difference between radial and focused shockwave therapy lies in how the shock waves are generated, their energy distribution, and the depth and precision of tissue pe*******on they achieve:

Generation and Wave Pattern:
Radial shockwave therapy (RSWT) uses a pneumatic system that propels a projectile to create pressure waves which spread out radially (diverge) from the application point, affecting a broader but more superficial tissue area.

Focused shockwave therapy (FSWT) generates shock waves electromagnetically, concentrating energy into a small, defined focal point inside the body, delivering a convergent wave with high precision.

Depth of Pe*******on:
Radial waves have lower energy density and pe*****te superficially, typically up to 3-4 cm depth. They lose energy as they spread, making them most effective for superficial tissues like tendons near the skin surface.

Focused shockwaves can pe*****te much deeper, from about 2 cm up to 12 cm or more, depending on the device and settings, making them suitable for targeting deep tissues, tendons, bones, or calcifications.

Energy Intensity and Treatment Precision:
Radial shockwaves deliver lower maximum intensity that dissipates over a wide area, suitable for broader tissue regions and less intense pain relief.

Focused shockwaves deliver higher energy density concentrated precisely at the pathological tissue, enabling treatment of deeper, more severe, or localised conditions.

Clinical Applications:
Radial shockwave is preferred for superficial conditions such as plantar fasciitis, tennis elbow, and Achilles tendinopathy.

Focused shockwave is favoured for deep or complex conditions including calcific tendonitis, non-union fractures, deep muscle injuries, and certain orthopaedic or urological conditions.

Patient Comfort:
Despite delivering higher energy, focused shockwave therapy can often be less painful as energy bypasses skin and concentrates at depth, whereas radial shockwaves may cause more skin irritation due to dispersion at the surface.

18/08/2025

How does radial shockwave therapy help with chronic muscle tension?

Radial shockwave therapy (RSWT) helps chronic muscle tension through several key mechanisms:

Mechanical Pressure and Microtrauma: RSWT delivers high-energy pressure waves to the muscle tissue, causing controlled microtrauma. This stimulates the body's natural healing response by activating fibroblasts (cells involved in tissue repair) and promoting tissue regeneration.

Increased Blood Flow and Vascularisation: The shockwaves stimulate the formation of new blood vessels and improve local circulation. Enhanced blood flow delivers oxygen and nutrients needed for muscle healing and helps remove metabolic waste products that contribute to muscle tension and pain.

Pain Reduction via Nerve Effects: Shockwaves reduce pain by affecting nerve fibres. They decrease the release of pain-related neuropeptides like substance P, and may selectively disrupt sensory nerve fibres, resulting in long-lasting analgesia. This helps break the pain-muscle tension cycle.

Stimulation of Cellular Metabolism: RSWT activates cellular activity, encouraging production of important molecules like transforming growth factor-beta (TGF-β1) and insulin-like growth factor 1 (IGF-1), which promote tissue repair and reduce inflammation.

Breakdown of Pathological Deposits: In some cases, RSWT helps dissolve calcifications or fibrotic tissues in muscles or tendons, improving tissue flexibility and reducing tension.

15/08/2025

What is a shoulder "stinger"?

A “shoulder stinger” (also called a “burner”) is a type of nerve injury that typically occurs in contact sports such as football, rugby, or wrestling. It happens when the nerves that run from the neck into the shoulder and arm—specifically the upper roots or trunks of the brachial plexus—are suddenly stretched or compressed due to a traumatic force.

Key features:

Symptoms: Sudden, intense, burning or stinging pain that shoots from the neck or shoulder down the arm. It can be accompanied by numbness, tingling, and temporary muscle weakness in the arm or shoulder.

Mechanism: Often occurs when the head is forcefully pushed in one direction while the shoulder is pushed down in the opposite direction, stretching or compressing the nerves.

Duration: The pain and sensory symptoms usually resolve within seconds or minutes, but weakness or soreness can last for hours to several days. Recurrences are possible if the nerve is injured again.

Risks: Most stingers resolve quickly and do not cause lasting damage, but recurrent injuries can lead to chronic pain and weakness. “Red flag” symptoms like bilateral symptoms, persistent pain, or neck pain may signal a more serious neck or spinal injury and require immediate medical attention.

Treatment: Rest, ice, anti-inflammatory medications, and physical therapy if needed. Athletes should not return to play until all symptoms have resolved and strength has returned.

13/08/2025

Why does chronic tendinopathy have fluctuating symptoms?

Chronic tendinopathy’s fluctuating symptoms—periods of worsening and improvement—arise from the complex interplay between tendon overuse, degenerative changes, and partial healing cycles.

Why Symptoms Fluctuate

Overuse and Healing Cycles: Tendons endure repeated stress and microtrauma with activity, leading to small tears in their fibres. When rest or modification of activity occurs, some healing takes place, decreasing symptoms. When the tendon is stressed again, symptoms flare up.

Reduced Tendon Tolerance: After injury, a tendon’s ability to tolerate load is lower. If activities exceed this reduced capacity before the tendon heals and strengthens, pain returns. Conversely, appropriate exercise and rest can temporarily raise this threshold, making symptoms subside.

Degenerative Nature: Chronic tendinopathy—unlike acute inflammation—mainly involves collagen breakdown and degeneration (tendinosis). This makes tendons structurally fragile and slow to recover, leading to “good days and bad days” depending on recent load and healing status.

Intrinsic Factors: Age, metabolic health (e.g., diabetes), and biomechanical factors can all slow healing and make symptom patterns more variable.

Activity Changes: Sudden increases, changes, or decreases in physical activity, footwear, or technique can tip the balance between tendon load and capacity, causing symptoms to emerge or recede.

Fluctuating symptoms reflect the slow, incomplete healing of chronic tendinopathy. Periods of activity can cause overload and pain, while rest and rehabilitation allow partial tissue recovery—producing the characteristic cycles of better and worse days.

11/08/2025

What is the latest evidence for using shockwave therapy for erectile dysfunction?

The latest evidence from 2024–2025 strongly supports the use of low-intensity extracorporeal shockwave therapy (Li-ESWT) as a safe and effective non-invasive treatment for men with erectile dysfunction (ED), especially vasculogenic ED. Recent meta-analyses and randomised controlled trials (RCTs) demonstrate significant improvements in standardised erectile function measures compared to sham treatments, with benefits sustained up to 12 months post-treatment.

Key findings from recent research:
Meta-analyses (2025): Large systematic reviews of RCTs including nearly 900 men show that Li-ESWT leads to a statistically significant improvement in the International Index of Erectile Function (IIEF-EF) and Er****on Hardness Score (EHS) compared to sham therapy.

Prospective trials: Comparative studies of different shockwave protocols found that both approaches were equally effective, showing substantial improvement at 6 and 12 months with minimal or no side effects.

Safety: Shockwave therapy is consistently reported as well-tolerated, with no adverse sequelae in published trials.

Treatment protocols: There remains some variability in the number of sessions, devices, and intensity used across studies. Evidence suggests that increased frequency (twice weekly) and higher pulse counts may enhance efficacy, but no universally accepted protocol exists yet.

Population focus: Most included studies focus on men with vasculogenic ED, and men with post-prostatectomy ED are typically excluded from analyses.

Caveats and limitations:

Objective measures are limited: Many studies rely primarily on self-reported scores like IIEF rather than objective assessments such as pe**le Doppler ultrasound.

Long-term data: While short-to-mid term efficacy (up to 12 months) is well-supported, larger multicentre RCTs with longer follow-up are needed to confirm durability of benefit.

Patient selection: The greatest benefit is seen in men with vasculogenic ED; efficacy in diabetic men, men with severe or comorbid ED, or after prostate surgery is still being investigated.

08/08/2025

Effective Strategies for Managing Osteoarthritis in the Spine

Living with osteoarthritis in the spine can feel overwhelming. This condition impacts everyday tasks, from getting out of bed to enjoying leisure activities. Being proactive about managing these symptoms is essential for maintaining movement and comfort. Here are some effective strategies to help manage osteoarthritis and improve your daily life.

Understand Your Condition

Regular Exercise

Maintain a Healthy Weight

Osteopathy and Shockwave Therapy

Heat and Cold Therapy

Medications

Adapt Your Daily Activities

Mindfulness and Stress Management

Address

98-104 High Street
Godstone
RH9 8DR

Opening Hours

Monday	9:30am - 8pm
Tuesday	9:30am - 3pm
Wednesday	9:30am - 3pm
Thursday	9:30am - 8pm
Friday	9:30am - 3pm
Saturday	8am - 1pm

Telephone

+441883338318

Website

http://www.head2toeosteopathy.com/

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