Flat footed? Do you need treatment?

pes planus

Have you ever been told you are flat-footed? Or have you noticed that the arches in your feet are not quite the same as others? Although we are all a part of the same species, many of us have variations in our anatomy that make us unique. Look at a crowd of people and you’ll notice many different shapes and sizes. Our feet are the same. Some people have very developed arches in their feet, others have under-developed arches and have an almost ‘flat’ look to their feet. This phenomenon is known as ‘pes planus’.

Why does it occur?

There are two main reasons a person may develop flat feet. They are:

  • Congenital: A person is born with it and the feet fail to develop an arch through childhood into adulthood. A small percentage of the population have a connective tissue disorder which can leave the joints in the body less stable and more mobile. These conditions (namely Ehlers-Danlos and Marfans Syndromes) are also associated with having flat feet.
  • Acquired: A person develops flat feet as a result of trauma, tendon degeneration, or through muscular or joint disease.

Most babies will look flat-footed at birth, but usually by the age of 10, a strong and supportive arch has developed. For some people, the arch simply does not develop, and this may or may not lead to problems down the line.

Signs and symptoms

The obvious sign to look for is a flattened arch of the foot. If you look at someone from the front or slightly to the side, you may notice that the majority or whole of the inside border of the foot is touching the ground, as opposed to there being a clear space between the heel and ball of the foot. 

What effect can this have on the body? It is quite possible and very common, for someone to have flat feet and have no symptoms at all. This is known as being ‘asymptomatic’. It may surprise you to know that only 10% of people with flat feet experience symptoms. These people are known as ‘symptomatic’.

People who do experience pain as a result of this condition do so because the lack of arch supporting the inside region of the foot has a knock-on effect to the mechanics of the rest of the limb. This then affects how the pelvis and spine function too. Pain in the middle part of the foot, heel, knee, hip and lower back are all common complaints. It is also not uncommon for someone with flat feet to experience recurrent ankle sprains, where they regularly ‘roll  the ankle.

Treatment

Do I need treatment if I am flat-footed?” If you have no symptoms and having flat feet does not affect your life in any way, the answer is simply ‘no’.

If you have pain caused by this problem, then this is where we (and other professionals) come in. Pes planus is a great example of how a problem in one part of the body may lead to pain and dysfunction in a completely different part of the body. It’s an osteo’s dream! Not your pain, of course… However, we are experts at recognising the root cause of a problem and putting a plan in place to get it resolved fast.

Techniques we use may include soft tissue massage, joint mobilisation of the foot, ankle, knee, hip or spine and strengthening exercises. Exercises will aim to strengthen the arch itself, but may focus up the chain to the thigh, glutes and trunk as well. A large part of our job here is to also educate a patient on which footwear to use and whether or not they require the help of orthotics (these are special insoles for your footwear). Some children and adults may need some extra support inside their shoes to help reduce the effect of mechanical change up the limb. We may decide that you will benefit from seeing a podiatrist or other foot specialist who is able to design and supply you with insoles that are unique to you and the shape of your foot. Being obese can also increase the load on the lower limbs, therefore increasing the effects of pes planus in the process. In these cases, we can help to advise on how you go about losing weight through changes to your diet and exercise regimes.

For the majority of cases, a combination of these treatments above will result in improved mechanics and reduced pain, allowing the patient to continue doing the things they love. For the very few people who do not respond to treatment, an orthopaedic specialist’s opinion may be required for long term management. This is always a last resort.

Check out your feet. Do you look flat-footed when you stand up and weight bear? Is there any associated pain? If so, call us today on 02 4655 5588 or book now and we’ll tell you what needs to be done to beat the pain! Arch you glad you read this now?! 😉

References:

  1. Radiopedia. 2020. Pes planus. [Online]. Available from: https://radiopaedia.org/articles/pes-planus. [Accessed 08 May 2020].
  2. Raj, MA. et al. 2020. Pes Planus. Stat Pearls. [Online]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK430802/. [Accessed 08 May 2020].

Pandemic Posture

Pandemic neck pain

It has been and continues to be, uncertain times for many of us as the COVID-19 pandemic continues to sweep across the globe. Lockdown has meant many of us have had to batten down the hatches and re-discover what it means to be ‘at home’. We ask you the question “how is your body being affected?” Are you suffering from Pandemic Posture?

Let us take you on a scan of the body, focus on some potentially problematic areas, and give you some advice to avoid any long-term issues.

Head and neck

The first stop is the very top! For all of you that normally head out to the office every day, the pandemic might mean you’ve had to start working from home. Not having your usual desk set up can place a great deal of stress on the neck region. Are you now working on a laptop instead of a desktop computer? Are you sitting on the sofa instead of an adjustable chair? Close your eyes for 30 seconds and hone your thoughts into your neck. Move it around… How does it feel? Is it tight, restricted or does your head feel heavier than usual? It could be that your new ‘desk’ set up’ is causing some strain in places it doesn’t usually. Think about the effect of having your head looking down at a laptop for 8 hours a day compared to straight up at a monitor set to the ideal height… Your poor muscles must be feeling the strain too.

We recommend trying to recreate your office space as close as possible to the real thing. If you don’t have a desk at home, a dining table may be more suitable than sitting on a sofa or armchair. You also need to ensure you are moving your neck and shoulders more regularly to avoid them being in a strained position for too long. Take a break every 30 minutes and move into a different position.

For more information to help combat pandemic posture, click here for a copy of our latest E-book “Working from Home: How to set up Ergonomically Set Up your workstation”.

Spine

Our spine sits at the core of the body, and we need good function throughout to ensure our limbs can also function with minimal effort and maximum efficiency. Are you used to an active job and now you find yourself homeschooling the children, or trying to break the day up with a bit of reading, gaming, TV or doing a crossword? Life is suddenly much more sedentary for most of us, so it’s important to avoid getting stiff. Sitting with poor spinal posture for extended periods, day after day can wreak havoc. Our spines curve ‘out  in the mid-back and ‘in ’ in the lower back. If we don’t look after those curves carefully by protecting our posture from excessive strains, then we leave ourselves open to sore backs and poor functioning limbs as a result.

We recommend avoiding long periods of sitting or lying down. Save it for bedtime! Try some standing spinal twists or bends (gently, of course), go for a walk around the garden, or do a session of yoga, Pilates or simple stretching through the day to mobilise your spine. If you have kids, get them to do it with you. They will enjoy a break from their school work, no doubt.

Hips

Anyone who works in a seated position knows what effect this can have on the hips. Having your hips in a ‘flexed’ or in a seated position for long periods of time can leave your hip flexor muscles tight and short. This decreases your ability to open the body out into a fully straight position, reducing flow of fluids through the central part of your body and leaving the back chain of muscles in a lengthened state, which can eventually result in the weakening of the chain.

We recommend lots of upright exercises for this one. Counteract the time spent seated working or binge-watching a TV series with some standing-based exercise. Jumps, skipping, walking, running or bridging is a nice way to open those hips and get the blood flowing.

Our underlying message through all of this is to move, move, move! You are a movement machine, so regularly start the ignition and go for a spin. Look after yourselves and please get in touch today on 02 4655 5588 or book now if you need help keeping your pandemic posture in check!

References

  1. Office of Industrial Relations. 2012.  Ergonomic guide to computer based workstations. [Online]. Available from: https://www.worksafe.qld.gov.au/__data/assets/pdf_file/0006/83067/guide-ergo-comp-workstations.pdf. [Accessed 04 May 2020]

To brace an injury: when it is helpful and when it isn’t

To brace an injury: when it is helpful and when it isn’t

A very common question we get asked at Completely Aligned is “Do I need to wear a brace to help with my injury?” Well this is very much a ‘depends’ sort of answer. It depends on the injury, where along the injury process you are and your personal circumstances.

Let’s first outline the advantages of wearing a brace and give some examples of when you might need to wear one.

Braces are items we place on a body part, usually over and around a joint, to provide extra stability to that area. They come in different forms but are generally quite flexible and elastic to ensure they move with the body, whilst being strong enough to protect the joint simultaneously.  Some braces are quite movable whilst others can lock a joint in a particular position.

When is it helpful?

The advantages of bracing include:

  • Providing stability to an injured body part to aid with treatment, rehabilitation and return to sport or work scenarios
  • Allowing faster healing by limiting movement at an injured body part
  • Reducing pain by de-loading injured structures
  • Can be easily put on and removed for any given situation
  • Are widely available and affordable

A common injury where you may need to use a brace is in the early stages of a moderate to severe medial collateral ligament (MCL) sprain of the knee. Imagine your knee has been forced inward whilst your foot is planted on the ground. If the force is great enough, the ligament stretches, tears and the stability of the knee is compromised. In this case, a brace is helpful to stop the knee from falling inwards again, which would interrupt the healing of the ligament. As healing progresses, the brace can be used less frequently or removed altogether to allow for more movement and activity. Other examples where a brace may be required include:

  • Wrist and ankle sprains
  • Tennis or golfer’s elbow (see recent blog for more info)
  • Knee cruciate ligament sprains
  • Pelvic instability (these are particularly helpful during pregnancy)
  • For stabilisation and re-training of scoliosis cases (i.e. abnormal spinal curves)

When isn’t it helpful?

One of the most common negative effects of bracing that we see is over-reliance. When someone has injured their ankle playing netball, part of the rehab process to get them back on the court quickly may be to wear a brace to provide them with the confidence to play to their full potential without fear of re-injury. This is all well and good as long as they wean off using the brace as rehab progresses. Many people end up wearing the brace as a safety net for 6 months, a year, or even longer because they are scared of re-injury. If you rely on a brace for support, it means the body part that was injured won’t have the necessary forces placed through it to ensure a full recovery to a pre-injury state. This could affect many factors including muscle strength, ligament stability and the body’s ability to know where the joint is in space (a.k.a ‘proprioception’). In order to return to that state, it’s necessary to move and exercise completely unaided.

Other disadvantages include:

  • Failure to achieve full joint range of motion post-injury
  • Possible muscle wasting
  • Increased loads placed on other body parts, which can risk another injury elsewhere

Our best advice to you is to never see a brace as a replacement for good movement and rehab. Always follow the advice of your practitioner as to when you should and shouldn’t wear a brace. If you have any doubts or questions, please call us on 02 4655 5588 to discuss, or book an appointment with one of our Osteo’s here. 

References

  1. Chen, L. et al. 2008. Medial collateral ligament injuries of the knee: current treatment concepts. Current reviews in musculoskeletal medicine. 1 (2). 108-113. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2684213/
  2. Brukner, P. et al. 2017. Clinical Sports Medicine. 5th ed. Australia: McGraw Hill Education

Should I see an Osteo if I have a headache?

Headache

Hello readers! This month’s blog topic is one that millions of Australians (and billions around the world) can relate to. Have you ever had a headache? We’d be surprised if you said no, because a headache is one of the most common symptoms experienced by our species. Nearly everyone at some point in their life experiences a headache. If you or someone you know is part of the minority that has never had one, then come forth… Medical researchers will want to get their hands on you!

The list of headache types is as long as the distance between your shoulder and the tips of your fingers! Some types of headache are very common, others very rare. Some of the different types of headache include:

  • Tension-type
  • Migraine
  • Cervicogenic (i.e. something in the neck leading to pain felt at the head)
  • Eyestrain
  • Withdrawal
  • Dehydration
  • Temporomandibular joint dysfunction (i.e. a problem with the jaw joint causing head pain)
  • Many others of non-serious and serious causes

The burning question

If you have been a headache sufferer for a long time, there is a good chance you have tried every remedy out there. Finding the solution is hard, but fear not, help is at hand! We regularly get asked “can you help me with my headaches?” The answer is always “maybe”, but there is a good chance we can. So why see an osteo over another medical professional? The short answer is we’re awesome! The long answer is we are experts of anatomy of the human body (4-5 years of study!), we sit and listen to you tell your story, we have excellent problem-solving and clinical skills, we have magically soft, caring hands, and we are highly trained to help people get to the bottom of their ailments, headaches included. Other medical professionals are also awesome, we just love the osteopathic philosophy of treating the person and the body as a whole.

What to expect from your osteo

The reason a person is in pain is usually down to many factors. It is therefore very important to get a full story from each patient that presents with a problem. This is where we shine. Your initial consultation will entail a very thorough questioning session where we ask you lots of questions about your current issue, the history surrounding it, and other questions relating to your medical, lifestyle and work history. From the word go, we will be painting a picture of what is going on with you. From the information you give us and the questions we ask, we will be ruling in or out which type of headache you could be experiencing.

Some types of headache have very specific features, and we may be able to come to a conclusion quite quickly. Other types may be less easy to recognise, but by the end of the questioning we will have a list of conditions in our mind that we need to test for. This is where we perform our clinical tests. Some of the more common types of headache are due to problems relating to the muscles and joints around the neck and head region, so we’ll ask if we can have a good feel of these areas. We’ll watch you move, then we’ll move you around, feel and compare between the two. We may need to test the nerves that give your head and neck their function, or we may need to take your blood pressure… Either way, we can do it all.

For headaches, we will be particularly interested in what your head, neck, mid-back, shoulders and general posture look and feel like and how everything moves together. We will always be looking at the bigger picture though, so if you’re wondering why we’re checking the levels of your pelvis or the length of your legs, it’s because we’re searching for every possible reason as to why your headache is occurring. After careful consideration and once we are happy with our diagnosis, we will sit and have a chat about what is going on and what the plan is to get you feeling good again. At this point we’ll get to work on your body using the many techniques we have at our disposal. We will also offer advice on any lifestyle changes you may need to make to ensure the headache is being attacked from all angles. A headache diary is often a suggestion so we can keep track of your headaches from week to week. However, this will be discussed in your initial consultation.

Sometimes a headache can be the sign of a more serious problem that we may not be able to help you with. If this is the case, we will ensure you are directed towards the right people for the job. This may entail us writing a letter to your GP with our findings and recommendations. Whether we treat or not, you will receive the highest level of care from us. We pride ourselves on it!

Final comments

If you or anyone you know is experiencing headaches, please pick up the phone and call us on 02 4655 5588 or book online to see one of our Osteo’s today. Now you know what we can do to help, we hope the next time you are asked the question “Should I see an osteo if I have headaches?”, your answer will be a solid YES!

P.s. We can even help with ice cream headaches (a.k.a ‘brain freeze’)… Our advice is simple—slow down and enjoy it! (we get how hard that is)

References:

  1. Migraine & Headache Australia. 2019. What is headache. [Online]. Available from: https://headacheaustralia.org.au/what-is-headache/. [Accessed 15 Jan 2020]
  2. Migraine & Headache Australia. 2019. Headache types. [Online]. Available from: https://headacheaustralia.org.au/types-of-headaches/. [Accessed 15 Jan 2020]
  3. Biondi, BM. 2005. Cervicogenic headache: a review of diagnostic and treatment strategies. The Journal of the American Osteopathic Association. 105 (4). 16S-22S. Available from: https://jaoa.org/article.aspx?articleid=2093083

Magnesium: A Necessity for 21st Century Living

Magnesium: A Necessity for 21st Century Living

Chronic Stress Depletes Magnesium

There is no escaping the pressures of modern life! You may be familiar with common stressors experienced by the majority of people, such as financial strain, relationships, pressures at work or school, toxins, diets high in processed foods, and constant Wi-Fi and screen exposure. The main
problem is that these assaults to your system are constant. Extended periods of stress can result in a loss of the important mineral, magnesium, at the time your body needs it most. Ensuring you have good magnesium levels helps make you a warrior during stressful times.

Are You Low in Magnesium?

Fatigue, muscle cramps, headaches and difficulty sleeping are common signs of magnesium deficiency in both adults and children. Pre-menstrual syndrome (PMS) and mood disorders including anxiety, depression, and constant stress are all associated with poor body stores of magnesium. Talk to your Practitioner today about whether you have an increased need for magnesium.

Running on Empty – What Causes Low Magnesium?

There are many different factors that contribute to magnesium deficiency. These include:

  • Inadequate intake from foods.
  • Continual stress. As increased levels of stress hormones diminish precious magnesium stores, this can lead to a vicious cycle of magnesium depletion, making it even harder to cope.
  • Caffeine, alcohol and certain medications. These increase the loss of magnesium through urination

The Many Benefits of Magnesium

Being the fourth most abundant mineral in the body, magnesium plays many roles in supporting your health. It helps dampen the effects of stress hormones to promote calming sleep, as well as relaxing muscles and reducing cramping. Magnesium protects your brain from memory loss, improves mood, concentration and learning, and lowers anxiety helping keep you stay calm during stressful times. However, that’s not all this mighty mineral helps with! Magnesium also improves blood sugar control, which can positively impact weight, reduce sugar cravings and support energy levels.

Magnesium Fuels Your Energy

When you become stressed, it affects you right down to your core, even causing damage at the cellular level by allowing energy molecules to leak from the cell. These energy molecules are needed for every function in the body; without energy your body’s ability to cope with stress is hindered, resulting in fatigue and other symptoms. But thanks to your cells’ instinctive ability to adapt to perceived stressors, the body uses magnesium to boost energy production, supporting good health and increasing your energy levels.

Daily Protection Against Stress

Utilise the following tips to shield your mind and body from stress and conserve your magnesium: Reduce caffeine to a maximum of 1 cup per day. Increase your consumption of magnesium rich foods e.g. spinach, dark chocolate, avocado, almonds, pumpkin seeds and black beans. Minimise your intake of high sugar and processed foods low in nutrients. Get a good night’s sleep. This will assist your body in repairing tissues and reducing inflammation caused by stress. To improve sleep quality, ensure your bedroom is cool, dark and quiet; and unplug from electronic devices (e.g. mobile phones, tablets, computer, and TV) 1-2 hours prior to bedtime. Exercise regularly to reduce the negative effects of emotional and physical stressors on health.

Choosing the Right Type of Ammunition

We can help recommend an appropriate magnesium for you if stress is weighing you down. Look out for magnesium bisglycinate in particular. This type of magnesium is superior to many other forms as it is well absorbed, gentle on the digestive tract and provides a calming effect. A necessity for 21st century living, magnesium will improve your resilience to the stressors of modern life. So talk to us today on how you can reduce stress using Magnesium!

Magnesium rich foods
Examples of Magnesium rich foods

Content reproduced with permission from Metagenics, 2019.

What pain relief is right for you?

What pain relief is right for you?

Pain has been an ongoing topic for research and discussion for a long time. Nearly everyone feels it (I say ‘nearly’ because there is actually a very small minority of people with a special condition that does not allow them to feel pain), and it varies in character and severity depending on what part of the body is implicated. And for the most part, none of us like being in pain. When we feel pain, normally the first thing we do is to look for a way out of it (or as some of you like to, ignore it – tut tut!). It’s a bit of a minefield knowing where to go for good pain relief. Some of us like a quick fix, others are more interested in fixing the problem long term by putting the hours in to do the rehab. Luckily for you, we are here to help with both stages!

When it comes to the body, we usually feel pain because our body is sending us a signal letting us know something is not quite right. That might be down to a simple muscle imbalance or joint restriction, which is leading us to walk or run differently. Or it might be down to something more serious like a tear of a muscle or tendon, changes in the nervous system or a problem with an organ deep inside the body – the list of causes is long and complex.

Regardless of the cause, when in pain it’s human nature to want to know how to get rid of it. Some of you turn to the experts (i.e. like your local Osteo/Myo/TCM practitioners, and other professionals like doctors), and some prefer to self-diagnose using www.DrInternet.com (how’s that been working out for you?!).

Some of the most common and well-known forms of pain relief include manual therapy, use of temperature, medications, supplementation and diet – you’ll find a brief overview of each below:

Manual therapy

We as humans have been using our hands to treat the body for a very, very, very long time! If you walk into a clinic in pain, be it you have a swollen ankle or the inability to lift your arm above your head, your practitioner will get to work on you using a whole host of techniques (after they have carefully and correctly diagnosed you of course!). Soft tissue massage and myofascial release techniques are widely used in the management of musculoskeletal pain and evidence suggests you aren’t wasting your time by getting the help of your local therapist. Your practitioner may also utilise other techniques, including joint mobilisation and manipulation, to correct your problem and to help get your pain lowered and under control. Usually you will also be given some form of flexibility or strengthening exercises to perform between treatment sessions to back up what happens in the treatment room.

Sore shoulder necl
Heat pack

Heat and cold therapy

If you’ve hurt yourself in the past, there is a good chance you’ve tried some form of treatment relating to temperature to help relieve the pain. Cold therapy can help to reduce pain, blood flow, swelling, muscle spasm, and inflammation. Heat therapy can help to relieve pain, increase blood flow, and tissue elasticity. It’s worth getting advice for the best approach for your problem.

Medication

There are countless different medications out there that can help with pain relief – these are called analgesics. Without getting too complicated, they can generally be split into Non-opioid and Opioid analgesics. Non-opioid analgesics include your well known and easily accessible medications such as aspirin, paracetamol, and anti-inflammatories (such as Ibuprofen) – these are generally good for the control of musculoskeletal pain. Opioid analgesics are there for cases of more severe pain, and include codeine, tramadol and morphine (you won’t be able to get these ones over-the-counter though!). Remember it’s always safest to consult a medical professional before using any form of medication.

Supplementation & Diet

There is no shortage of nutritional supplements available to assist you in the non-pharmacological management of pain also. From anti-inflammatory herbs like Curcumin (derived from Turmeric), Boswellia and Ginger to Fish Oil and Glucosamine and Chondroitin. Similarly, diets high in Berries, Fatty fish like Salmon or Sardines, Green Tea, Avocadoes and Broccoli can assist with reducing inflammation. In conjunction with the avoidance of sugar and highly processed/refined foods, alcohol and trans fats.

If you are injured or in pain or would just like to know more about pain and the many ways to manage it we recommend you to book a consultation with one of our practitioners today so they can talk through your problem, assess you thoroughly, and then advise the best course of action for you.

Our aim is to help get you out of pain and moving better again! Say ‘au revoir’ to pain! 🙂

How massage affects your mood

shoulder injury treatment rotator cuff massage

An apple a day keeps the doctor away… we’ve all heard this phrase. Well how good would it be if getting a regular massage was also good for your health? Look no further and read on! We have some insight into how massage can have a positive effect on your mood, and overall well-being.

When we are treated by our massage therapist, their simple touch starts off a whole chain of activity in our nervous system, changing the levels of lots of different types of chemicals in the body, which ultimately results in you feeling good, relaxed, and ready to take on the world again. The chemicals we refer to are your stress hormones and happy hormones.

Stress hormones

Stress hormones include Adrenaline, Noradrenaline, and Cortisol. Don’t worry if you haven’t heard of them – these chemicals are basically responsible for activating your fight-or-flight response. They’re your body’s natural mechanism for dealing with danger and stressful situations (you know, like when you come face to face with a lion down a dark alley… Not happened to you? Erm, just us then?).

So having these chemicals is good, but if they flow around the body for too long, it can be detrimental to your health, leading to anxiety, increased blood pressure, a lowered immune system and much more. If you’re the kind of person who is regularly stressed in life, the good news is that massage has been shown to lower the amount of circulating stress hormones (think about the fight-or-flight response being reversed or switched off), reducing the risk of long-term complications from having your body in a constantly heightened state.

Happy hormones

Happy hormones include Serotonin, Dopamine, Endorphins and Oxytocin. These chemicals have many roles to play, but important roles include regulating mood, appetite, focus and the body’s ability to make you feel generally positive and happy. So, it makes sense that we want plenty of these hormones regularly being pumped around the body. Good news again… massage, or even just the touch of another person has been shown to increase levels of these hormones, making you feel good, focused and productive, and generally a lovely, happy person to be around.

So, you can see it’s a win-win situation. Massage anyone? Oh go on then… book one now