what is FODMAP?

I see lots of patients with chronic digestive problems like diarrhoea, constipation, pain in the abdomen, flatulence and bloating. Many of these symptoms fall under the Irritable Bowel Syndrome (IBS) umbrella, but even with a formal diagnosis, IBS can seem vague when it can present in such different ways, and finding an effective treatment can be difficult. The low FODMAP diet doesn’t help everyone, but it has caused dramatic improvements for many people with digestive complaints.

FODMAPs are fermentable Oligo-, Di, and Mono-saccharides and Polyols. they are all naturally occurring carbohydrates (sugars) which are in whole foods like fruit, dairy, beans and grains. Some are used in high quantities in sugar-free foods.

These sugars, when digested, can draw water into the digestive tract from surrounding tissues and can produce carbon dioxide. Consuming high levels of FODMAPs can cause intestinal discomfort for anybody, but some people have a lower tolerance to them, so even normal levels of FODMAPs can cause problems. A low FODMAP diet can reduce the effects of the intolerance.

FOODS TO AVOID

dairy products
fruits: apples, pears, cherries, raspberries, watermelons, mango, papaya
vegetables: artichokes, asparagus, cabbage, garlic, mushrooms
grains: wheat, rye, barley, spelt
honey

WHATS LEFT!?

fruits: bananas, blueberries, strawberries, oranges, grapes, kiwi
vegetables: carrots, green beans, lettuce, parsnip, potato, spinach, tomato
grains: gluten free bread, rice, oats, millet, quinoa
lactose free milk
hard cheese
brie
camambert
gelati
sorbet
olive oil
small quantities of sugar and golden syrup

There are other causes of digestive problems, such as back problems.  If anything persists, or there is any blood in stools, consult your GP.

Get instep with feet

This week we’ve been focusing on feet. Many people think osteopaths only treat backs, but it’s not true.

On Wednesday we learned all about why and how to mould orthotics from one of the world’s top podiatrists, and yesterday we were hearing how best to manage the foot and ankle from London’s top foot and ankle surgeon, Dr Sam Singh.

Feet tend to get forgotten, poorly treated and squeezed into unsuitable shoes, but they are the foundations of the body. No matter how good the other joints of the body are, they will suffer in time if the foundations aren’t aligned and stable.

Lets have a look at some of the common conditions that can be caused by poor foot alignment:

– Bunions
– Pain in the ball A-the foot / metatarsalgia
– Plantar Fasciitis I Heel spur
– Sever’s Disease (children’s heel pain)
– Achilles Tendonitis / Heel pain / ‘Pump Bump’
– Shin splints (pain at the front / side of shins)
– Knee pain in adults and children
– Hip pain
– Low back pain and sciatica.

Now if we have a look at a skeleton that needs orthotics before and after:

Its clear to see that if the body on the left goes on running / jumping / dancing that it won’t be long before one (or all!) of the joints forced out of their normal position become sore or stiff.

“Why see an osteopath for a problem coming from the feet? Shouldn’t I see a podiatrist?”

Well there’s two things about us here
at HOPE osteopathy:

1 We look at the whole body. Whereas podiatrists only look at the feet. We know that a dropped arch on one foot only may be due to the foot accommodating what looks like a longer leg… Which might be due to a hip problem. It can be complicated but osteopaths are trained to detect where the root cause of the problem is coming from, and what the knock on effects of an orthotic would be. If an orthotic were to be placed under a dropped arch as described in this case, it could make one problem better, but possibly hips / knees / low back much worse.

2 We would much rather nature heal the body. We believe orthotics should only be used when the foot position is the root cause of the problem, and without orthotics, the pain would keep coming back on it’s own in time.

We are offering discounted packages for a limited time of £70 (normal price £95) for consultation, bio mechanical assessment, orthotic fitting and one pair of orthotics if required (£45 for assessment and referral or treatment if orthotics aren’t needed).

Visit www.hopeosteopathy.co.uk or call 02072054333 for more information or to book.

3 Great Ways to Prevent Back Pain

1 SITTING FOR LONG PERIODS

The body was meant to move, so by sitting in the same position for prolonged periods of time can cause increased pressure on certain parts of your spine.  

Discs are at the front of the spine.  When we sit, the hamstrings (muscles at the back of the legs) pull our pelvis underneath us, causing the natural curve in the small of our back to flatten, and weight to go onto the discs at the front of the spine.  Weight being put onto our discs causes them to become damaged and painful(1), and may predispose to slipped discs.

Try not to stay in one position for too long, whether it’s driving, watching a film or sitting at your desk, and do try to move around at least once an hour.  Pilates, yoga, swimming & walking are great forms of exercise to relieve the pressure on your back from sitting for too long.

 

 

2 SLEEPING ON THE CORRECT MATTRESS

Mattresses should provide support all through the night, and a medium-firm mattress has been shown to be the most effective at helping back pain during the night and even through the day(2).

Soft mattresses don’t provide the support needed to provide correct spinal alignment whilst we are sleeping.  This causes our weight to overstretch the ligaments and discs of our spines and this strain is then maintained through the whole night.

If you like the feel of a soft mattress, use a soft or down mattress topper on top of a medium-firm mattress for comfort and support.

The better sleep council also recommends that mattresses should be changed every 7 years!(3)

3 OSTEOPATHIC EXAMINATION

Here at HOPE osteopathy, we pride ourselves on locating the root cause of back pain.  The NICE (National Institute for Health and Clinical Excellence) and the NHS recommends Osteopathy for treatment and prevention of back pain(4).  We also offer Orthotic Prescription, Acupuncture and Massage, the other recommendations for management of back pain at the clinic(5,6.

There are often structural problems and stiffnesses in the spine that can predispose to back pain, so it is a good idea to have your spine checked, even if you are not yet feeling pain, just as you would have your teeth checked by a dentist.

To request a free call back from one of our osteopaths, please email info@hopeosteopathy.co.uk

 

(1)  Spine (1996) 21(4):434-8. Sustained loading generates stress concentrations in lumbar intervertebral discs. Adams MA, McMillan DW, Green TP, Dolan P.

(2)  The Lancet (2003) 362 (9396):1599–1604. Effect of firmness of mattress on chronic non-specific low-back pain: randomised, double-blind, controlled, multicentre trial. Kovacs F, Abraira V, Peña A, Martín-Rodríguez J, Sánchez-Vera M, Ferrer E, Ruano D, Guillén P, Gestoso M, Muriel A, Zamora J, Gil del Real M, Mufraggi N

(3) http://bettersleep.org/mattresses-and-more/caring-for-a-mattress/replacing-a-mattress

(4) http://www.nhs.uk/conditions/Osteopathy/Pages/Introduction.aspx

(5) Brinkhaus B, Witt CM, Jena S, et al. Acupuncture in patients with chronic low back pain: a randomized controlled trial. Archives of internal medicine 2006;166:450-7

(6)  J Am Podiatr Med Assoc. 1999 Mar;89(3):109-17. Chronic low-back pain and its response to custom-made foot orthoses. Dananberg HJ, Guiliano M.

(7) Preyde P (2000) Effectiveness of massage therapy for subacute low-back pain: a randomized controlled trial CMAJ June 27, 2000 vol. 162 no. 13 1815-1820

Having Trouble Sleeping?

Many patients come to me with neck pain, complaining that it’s sore when they wake up, its sore when they’re trying to get to sleep and it wakes them up in the middle of the night.  Being sleepy and grumpy certainly doesn’t help with managing the pain.

Before we get to the DO’s, let’s start with one big DON’T.

DON’T SLEEP ON YOUR FRONT

Sleeping on the front forces the neck into extreme rotation and forced extension.  The position of your neck is similar to looking as far as you can over your shoulder, then tipping your head to the same side (tip your ear backwards) and then looking up towards the ceiling.  I think we can agree that’s not very comfortable.

Wrinkles! Sleeping with a crumpled up face all night won’t assist the expensive anti-wrinkle lotions and potions in the fight against ageing!

If you absolutely must sleep on your front, don’t put a cushion under your neck & face, either put it under your shoulders and face, or sleep without one, as this takes a small amount of extra pressure off your neck.

DON’T SLEEP IN THE FETAL POSITION

This can be less easy to manage.  Sleeping in the fetal position compresses the diaphragm and digestive system restricting normal breathing mechanics & digestion.  Curving the back forward, and bringing the knees up compresses all of these joints, which can aggravate joints under a lot of strain, or arthritic ones, making morning stiffness in these joints worse.

Again… Wrinkles!

Do use a pillow in this sleeping position, it is necessary to fill the gap between the shoulder and the ear when the pillow has weight on it.

OK:   Sleeping on side

With the right pillows (as advised above) sleeping on the side can be good for people with back pain who might find the arching of the back involved in lying on the back painful.

Sleeping on the side can also allow the back to have the freedom to move around and fidget into the right position.  Flexible people may find that their back twists a lot and becomes uncomfortable during the night.  For keeping the back in alignment, putting a pillow between the knees can be very helpful.

Lying on the side with a pillow between the knees (and under bump!) is often the most comfortable position during pregnancy.

Lying on the side is usually better than other sleeping positions for reducing snoring.

DO LIE ON YOUR BACK  

The weight is distributed comfortably over your entire body.  Assuming the correct use of pillow: 

The neck and back remain in the optimum alignment reducing undue stress and strain on muscles, ligaments, nerves or blood vessels of the neck.

If the low back is arching when lying flat, put a small pillow under the knees to take the pressure off.

AND FINALLY, IF AFTER TRYING THESE TIPS YOU ARE STILL WAKING UP WITH ACHES AND PAINS, BOOK IN FOR AN EXAMINATION, OR CONTACT US FOR MORE INFORMATION on 02072054333

Why huge handbags are a pain in the neck

We busy women love a big handbag.  They contain our lives.  Along side the keys, wallet, phone, they are our briefcase, our makeup bag and our gym bag AND a great fashion statement… all rolled into one!!

HOWEVER!!

I regret to inform you that these bags aren’t great for your health!

Let’s have a look at how these bags are influencing our posture…

Heavy Bag

Normal

Please let me draw your attention to the following:

— The side-to-side curve.  The spine takes on a reverse ‘S’ shape curve to try and counterbalance the weight added by the large shoulder bag.  Your body will always adapt to the centre of gravity to stop you from falling over, fine if this is a temporary measure… but walking for one, maybe two hours a day in this position!?! The side that your spine curves towards (the right for the mid back in this example, and the left side of the neck) will suffer from added pressure onto the joints.

— The uneven shoulders.  The shoulder on the side carrying the bag gets higher in an attempt to keep the bag from falling off.  This causes an increase in muscle activity in the carrying shoulder, and I often find patients have shortened/ hypertonic/ “knotted” muscles on their carrying arm.  The lifting of this shoulder also works to compress that side of the neck EVEN MORE, adding all the more pressure onto the joints on that side of the neck.

— The straight, forward facing head.  The brain always likes the eyes to be on an even plane.  Therefore regardless of ALL the wonkiness & unevenness going on below the neck, the eyes are brought back straight.  This means that the muscles on the left hand side of the neck are likely to work even harder and get even shorter.  Carrying a bag in this position every day for a long time can lead to irritation to the joints of the neck and shoulder, overstrain of the muscles of the neck and possibly even effect the nerves of the neck (potentially leading to headaches/ eye pain).

— It looks UGLY!

Now I guess I need to provide some solutions to this problem!

The HOPE guide to continuing your relationship with your beaufiful, big Birkin!

1. Wear your bag on the right side if you are right-handed, on the left if you are left-handed.

We have naturally uneven shoulders, depending on our handedness. What that means is that it is usually the case that your right shoulder is lower (if you are right handed), or your left shoulder is lower (if you are left-handed)

Without even realizing it, you are probably adding to this uneven-ness by constantly wearing your bag on your non-dominant side (i.e.-the side that is already higher!).

2. Unpack your bag every night. 

Buy a gorgeous tray. Put it in your front hallway. Every night, take out your wallet, keys, papers, phones, everything. So now you have the bonus of never losing your keys again, * and * you will become aware of what is essential and what is not essential for your daily life.

Same moisturizer coming in and out of the bag every night and you are not using it?  Chuck it.

Half-drunk water bottle? Toss it or downsize.

3. Wear the strap around your forearm…or your hand.

Keeping the weight away from strong muscles in our upper body that love to shrug and hunch us over (I’m talking to you trapezius and pectorals) will reduce the stress on the spine.

The key here is hold the bag as close as you can to your body. The further away you hold it, the more your spine will have to bend to compensate (think of the x-ray) and your muscles will have to asymmetrically shorten.  However this way of carrying your handbag may well lead to “Arm-hook crook”.

4.  Take a page out of Cara Delevigne’s Book

Cara Delevingne leads the backpack revolution (Picture: DKNY)

From: Metro

5.  SEE AN OSTEOPATH

Shameless self-promotion – I know, I know but we know how to keep your spine healthy and make sure you don’t develop bad postural habits over time. Book your appointment HERE or fill in the form below to receive offers, news, or for us to get back to you!

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Welcome!

HOPE osteopathy launches on 21st October!

find out more at http://www.HOPEosteopathy.co.uk and watch this space for more, coming soon!