Shin Splints

What are Shin Splints?

Shin Splints are the common name for a condition in which the muscles on top of the shin bones – the tibia and the fibula, become tight and as a result cause pain.

It mostly occurs after an increase in activity – either frequency, length or intensity, and can last for an undetermined amount of time depending on various factors such as exercise, rest and strength.

Medial Tibial Stress Syndrome:

Medically, shin splints are referred to as Medial Tibial Stress Syndrome (MTSS). It is caused by overuse and is commonly seen in athletes and military personnel. The cause of MTSS is not known however many factors can cause it including overtraining, poor unsupportive footwear, ankle muscle imbalance, tight triceps surae muscles (calf/soleus) and your back being out of balance.

Typically MTSS presents with a diffuse (wide spread) palpable pain worse after exercise – it is more common in females than males. The pain is usually described as a dull ache that gets better with rest. One reason MTSS is so painful is due to periostitis – the inflammation of the periosteum (covering of the bone) where the muscle attaches.

Specific movements that may cause pain is knee extension – that is the straightening of the leg, as this activated the muscles affected. Inflammation of the Achilles tendon (Achilles tendonitis), the bursa on the back of the heel (retrocalcaneal bursitis), plantar fasciitis (irritation of the plantar fascia), medial arch discomfort, calf pain and cramping, iliotibial band syndrome and Osgood Schlatter’s can also occur at the same time as MTSS.

One of the risks of having MTSS repeatedly or long term is a stress fracture. Signs this has occurred is when pain occurs after activity has finished into cooldown and daily activities. Another sign is when the pain becomes less wide spread and more specific to the inside of the tibia (shin bone) and the from halfway up the shin down after exercise. Imaging such as x-ray and magnetic resonance imaging (MRI) can be used to detect other sources of pain as well as stress fractures.

Treatment:

Treatment of MTSS varies depending on therapist and sport. In the acute, short-term treatment use of compression stockings, anti-inflammatories, rest and either ice or heat depending on the varied evidence. Kinesiology taping uses tape that aims to relieve pain, facilitate proprioception, change muscle activation and correct abnormal movement patterns.

Long term orthotics (inserts) and supportive shoes can be used to try and correct the posture of the foot. Increasing the supination (weight on the outside of the foot), strength of the inverter/evertor muscles and releasing the muscles on the bottom of the foot can also be helpful. Supplements such as vitamin D, calcium for bone health/density and magnesium for muscle fatigue should be taken long term as preventatives.

Manual therapy, such as osteopathy can be beneficial in both the short and long term phases of shin splints/MTSS. Through various techniques such as soft tissue, myofascial release, mobilisation and manipulation treatment is aimed at decreasing muscle tension, improving joint mobility and releasing the fascia of the foot and lower leg.

References

Bhusari, N. and Deshmukh, M. Shin splint: a review. Cereus, 15 (1), e33905. https://doi.org/10.7759/cureus.33905

Guo, S., Lui, P. (2022). Efficacy of Kinesiology taping on the management of shin splints: a systematic review. The physician and sports medicine 50 (5), 369-377. https://doi.org/10.1080/00913847.2021.1949253

Schulze, C. Finze, S., Bader, R., Lison, A. (2014). Treatment of medial tibial stress syndrome according to the fascial distortion model: a prospective case control study. The Scientific World Journal, 790626. https://doi.org/10.1155/2014/790626


Yüksel, O., Ozgürbüz, C., Ergün, M., Işlegen, C., Taskiran, E., Denerel, N., Ertat, A. (2011). Inversion/eversion strength dysbalance in patients with medial tibial stress syndrome. Journal of sports science & medicine 10 (4), 737-742. Inversion/Eversion strength dysbalance in patients with medial tibial stress syndrome – PubMed (nih.gov)

Ozgürbüz, C., Yüksel, O., Ergün, M., Işlegen, C., Taskiran, E., Denerel, N., Karamizrak, O. (2011). Tibial bone density in athletes with medial tibial stress syndrome: a controlled study. Journal of sports science & medicine 10 (4), 743-747. Tibial bone density in athletes with medial tibial stress syndrome: a controlled study – PubMed (nih.gov)

 

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The Principles of Osteopathy

Osteopath Runaway Bay

 

What is osteopathy?

Osteopathy is a holistic manual therapy that can have an impact on the bodies musculoskeletal system; that is the joints, muscles, ligaments, bones, tendons and fascia of the body.

A holistic approach not only looks at the physical body, actions and ergonomics, but also the mental emotional and social wellbeing.

Osteopaths treat various musculoskeletal complaints in all areas of the body including osteoarthritis, tendonitis, bursitis, muscle/joint strains, ligament sprains and more.

We can treat in various ways such as using soft tissue like massage therapists, mobilisation, strengthening and rehabilitation like physiotherapists, manipulation like chiropractors as well as more indirect osteopathic techniques.

What are the osteopathic principles:

  • Structure governs function and function governs structure. This describes the importance of physical structure affecting and influencing the body’s function and vice versa.
  • The rule of the artery is supreme. This describes the importance of the blood to the body’s functioning.
  • The body can self-heal and regulate. This principle describes the inherent healing processes within the body.
  • The body is a unit, the person is a unit of the body, mind and spirit.

What are some techniques we may use?

There are many techniques your osteopath may use in your treatment – typically in combination

 Soft tissue:

While your osteopath is not a massage therapist and the whole treatment will not be soft tissue, they may work on the muscles to decrease tension through massage techniques. This is often done with oil or moisturiser, and we ask you let your therapist know of any particularly sore points.

Muscle Energy Technique:

The theory behind muscle energy techniques (MET’s) are that after contraction of as low as 10% strength the muscle once relaxed will be fully relaxed for 3-5 seconds. In this time the osteopath will take the muscle to its new point of “bind” or tension. This can also be done as proprioceptive neuromuscular facilitation (PNF) where more force (up to 90%) is used during muscle contraction.

Trigger Point Therapy:

Trigger point therapy (TrP) is the process of applying pressure to a point of muscle soreness and can be performed at any point in the body.

Manipulation:

Known as HVLA (high velocity low amplitude) manipulation can be used to return a joint to a neutral position if it is rotated or side bent. This is done in a controlled manor with proper explanation as to the technique and position. The theory behind this technique is that it is beneficial in resetting the sympathetic nervous system to increase/decrease output and encourage increased joint range of motion and muscle relaxation.  

Other Modalities:

Some osteopaths may have undergone further training and be qualified to perform taping, cupping, needling and more. If your osteopath thinks it appropriate, they may apply some of these modalities during their treatment.

Indirect Techniques:

Sometimes the body may be in an acute condition with high levels of pain and will be flared if the direct techniques above are used. As such, osteopaths are taught indirect models of treatment such balance ligamentous tension (BLT), Balance Membranous Tension (BMT), Strain Counter Strain (SCS), Functional and Positional Release. These techniques aim to take the tissues into a position of ease where they are able to unwind and return to normal function.  

Further Advice:

Osteopathy is not only about how we can help you, but also how you can help yourself through ergonomic and environmental changes.

During the consultation with your osteopath, they may ask you about factors that could be contributing to your issue such as sleeping posture, work posture, driving, work and leisure activities and exercise.

They may recommend changes to posture and exercise as well as prescribe you stretching or strengthening for specific points of issue.

References:

Better Health Channel. (2012). Osteopathy. Vic.gov.au. https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/osteopathy

Trigger Points. (2009). Physiopedia. https://www.physio-pedia.com/Trigger_Points

Licciardone, J. C., Schultz, M. J., & Amen, B. (2020). Osteopathic Manipulation in the Management of Chronic Pain: Current Perspectives. Journal of Pain Research, Volume 13, 1839–1847. https://doi.org/10.2147/jpr.s183170

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Back Pain

Back Pain

What is Back Pain?

According to the Australian Government 16% of the Australian population experience back pain. Back pain can contribute to psychological distress, chronic pain other comorbidities such as arthritis (AIHW, 2023). Back pain is reported at an increased rate as you age and can interfere with activities of daily living (AIHW, 2023).

Common conditions that may cause back pain include sprains and strains, herniated discs, spinal stenosis, scoliosis, joint degeneration, inflammatory back pain and osteoporosis (Casiano et. al., 2023).

Causes of low back pain can include heavy physical work, frequent twisting, bending or lifting, weak musculature and more. It is important to see your doctor if there are any changes to bowel and bladder movements or incontinence, no improvement or worsening in pain levels as well as numbness, tingling or weakness in the lower limb or groin (Casiano et. al., 2023).

Osteopathy is targeted towards the improvement of physiological function and support of homeostasis when altered by impaired somatic dysfunction of the musculoskeletal system (TFLBPCG, 2016). The American Osteopathic Association analysed studies on both acute and chronic non-specific low back pain and found that osteopathic manipulative treatment was effective at reducing pain and increasing functional status.

A study by Rehman et. al. (2020) found significant evidence that OMT was effective in reducing pain and disability. It focused not only on muscular treatment but also visceral osteopathy – a more indirect modality. It showed that 8 weeks of osteopathic treatment when compared to standard care was shown to have significant improvement in return to work.

Another study by Licciardone et. al. (2014) investigated osteopathic manual therapy in regard to pain reduction and biomechanical dysfunction. The study looked at 230 patients receiving treatment for 15 minutes every week. In the study a low back pain response was considered a decrease of pain of 30% or greater between the initial appointment and the 12 week follow up. The study focused on various anatomical landmarks and their position to determine biomechanical dysfunction and used 3 different outcome measures to assess results.

A range of techniques were found to be effective in decreasing pain including HVLA manipulation (High Velocity Low Amplitude), soft tissue, myofascial release, positional release, muscle energy technique. In addition, the study highlighted the importance of the psoas muscle due and its contribution to low back pain in the increased likelihood of low back pain returning if the psoas was not focused on.

Economically, Verhaeghe et. al. (2018) found OMT (Osteopathic Manipulative Treatment) to be a cost-effective treatment option for low back pain with improved health outcomes (measured as quality adjusted life years) when compared with usual care.

While osteopathy is a manual therapy there are also aspects that patients can do at home to improve their health. Owen et. al. (2019) used a variety of exercise types and criteria to identify the most effective form of exercise. Pain is best modified through exercise such a pilates, aerobic exercise and stabilisation/control exercise.

Physical  function an capability is best improved using stabilisation/control exercise and resistance training. These were followed by water exercise, pilates and yoga. Mental health greatly contributes to physical health and healing and as such is an important fact to consider in both hands on and exercise therapy. Resistance and aerobic training were most beneficial for mental health and muscle strength.

In addition to strengthening you can also stretch to relieve muscle tension. Some stretches that you may find helpful include the “Cat Cow”, “Thread the Needle” and “Lumbar rotation”.

Instructions for Cat Cow:

Start on your hands and knees with your back in a neutral position. Make sure your hands are under your shoulders and knees under your hips. Arch your back while lifting your head up and tailbone out. This will make a dish like shape with your spine. Hold this position for 5 seconds. Bend your back, tuck your head and tail bone making a sad face shape with your spine. HINT: pull your bellybutton to the ceiling. Hold this position for 5 seconds and then repeat.

Instructions for Lumbar Rotation:

Start lying on your back with arms outstretched palms facing the floor. Keeping one leg flat on the floor bring the other to 90 degrees. Roll the bent leg over the straight as far as is comfortable. You will feel a stretch in your back and opposite armpit. Repeat on both sides. This can be done as a static stretch or as a fluid side to side movement.

Instructions for Thread the Needle:

Start facing the floor with hands and knees equal distance apart, hands under shoulders and knees under hips. Bring one hand off the floor and reach between your other hand and leg. Follow with your shoulder and head moving towards the floor taking the hand towards the opposite wall and allowing your back to twist and stabilising elbow to bend. A stretch should be felt down the side, shoulder blade and neck. Hold and then return to the starting position. Repeat.

References:

Australian Institute of Health and Welfare. (December 14, 2023). Back Problems. Chronic musculoskeletal conditions : Back problems – Australian Institute of Health and Welfare (aihw.gov.au)

Casiano, V.E., Sarwan, G., Dydyk, A.M., Varacallo, M. (2023). Baack Pain. StatPearls. Back Pain – StatPearls – NCBI Bookshelf (nih.gov)

Licciardone, J.C., Kearns, C.M., Crow, W.T. (2014). Changes in biomechanical dysfunction and low back pain reduction with osteopathic manual treatment: Results from the osteopathic trial. Manual Therapy 19 (4), 324-330. https://doi.org/10.1016/j.math.2014.03.004

Owen, P.J., Miller, C.T., Mundell, N.L., Verswijveren, S.J.J.M., Tagliaferri, S.D., Brisby, H., Bowe, S.J., Belavy, D.L. (2019). Which specific modes of exercise training are most effective for treating low back pain? Netwrk meta-analysis. British Medical Journal, 1-12. https://doi.org/10.1136/bjsports-2019-100886

Rehman, Y., Ferguson, H., Bozek, A., Blair, J., Allison, A., Johnston, R. (2020). Osteopathic manual treatment for pain severity, functional improvement, and return to work in patients with chronic pain. Journal of Osteopathic Medicine 120 (12). https://doi.org/10.7556/jaoa.2020.128

Task Force on the Low Back Pain Clinical Practice Guidelines. (2016). American Osteopathic Association Guidelines for Osteopathic Manipulative Treatment (OMT) for Patients With Low Back Pain. Journal of Osteopathic Medicine 116 (8), 536-549. https://doi.org/10.7556/jaoa.2016.107

Vergaeghe, N., Schepers, J., Van Dun, P., Annemans, L. (2018). Osteopathic care for low back pain and neck pain: A cost-utility analysis. Complementary Therapies in Medicine 40 207-213. https://doi.org/10.1016/j.ctim.2018.06.001

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What is Osteopathy and How Can it Help You?

What is Osteopathy and What Are the Benefits?

Osteopathy is a holistic approach to healthcare that focuses on the understanding that the body’s structure, including bones, muscles, joints, and connective tissues, plays a crucial role in its overall function and health. Osteopaths, professionals who practice osteopathy, aim to promote the body’s self-healing capabilities by manipulating and strengthening these structural components. This evidence-based practice has gained popularity as a non-invasive and drug-free alternative to traditional medical treatments.

The Principles and Techniques of Osteopathy

Osteopathy is grounded in four fundamental principles:

  1. The body is a unit: Osteopaths view the body as a whole entity, where all parts, systems, and structures are interconnected. They consider all aspects of the body, from physical to emotional, when diagnosing and treating patients.
  2. The body has self-healing mechanisms: Osteopaths believe that the body has the innate ability to heal itself under favorable conditions. They aim to identify and remove obstacles that hinder proper healing.
  3. Structure and function are interrelated: Osteopaths focus on the relationship between the structure and function of the body. Any structural abnormality, such as misalignments or imbalances, can affect the body’s overall function.
  4. Treatment is primarily hands-on: Osteopaths utilize a wide range of techniques, including manipulation, stretching, massage, and mobilization of joints and tissues. These hands-on techniques aim to restore optimal function and reduce pain.

The Benefits of Osteopathy

Osteopathy offers numerous benefits to individuals seeking a holistic approach to their healthcare:

  1. Pain relief: Osteopathic treatments can effectively alleviate pain caused by various conditions, including musculoskeletal disorders, joint pain, and sports injuries. By addressing the root cause of the pain, rather than merely treating the symptoms, osteopaths aim to provide long-term relief.
  2. Improved mobility and flexibility: Osteopathic techniques help restore proper joint mobility and increase flexibility. This can be particularly beneficial for individuals with restricted movement due to injury or chronic conditions.
  3. Enhanced blood circulation and lymphatic drainage: Osteopathy aims to optimize the flow of fluids throughout the body, including blood and lymph. Improved circulation and drainage support proper tissue function, immune response, and overall well-being.
  4. Reduced stress: By promoting relaxation and relieving muscle tension, osteopathy aids in reducing stress levels. This can have a positive impact on mental health and overall quality of life.
  5. Enhanced postural alignment: Osteopaths assess and treat postural imbalances, helping individuals achieve better alignment. Correcting posture not only improves appearance but also reduces the strain on muscles and joints, leading to decreased pain and improved functioning.

Note: It is important to consult a qualified osteopath for a thorough evaluation and appropriate treatment tailored to your individual needs.

Evidence-Based Practice

Osteopathy is supported by a growing body of scientific evidence. Numerous research studies have demonstrated the effectiveness of osteopathic techniques in treating various conditions, such as back pain, migraines, and digestive disorders. It is crucial, however, to rely on evidence-based practices and seek treatment from qualified osteopaths who are registered and regulated by relevant professional bodies.

Research has shown that osteopathy can be particularly beneficial for conditions such as:

  • Lower back pain
  • Neck and shoulder pain
  • Headaches and migraines
  • Osteoarthritis
  • Sciatica
  • Repetitive strain injuries

Individuals suffering from these conditions may find relief and improved quality of life through osteopathic treatments.

Osteopathy offers a holistic and evidence-based approach to healthcare by focusing on the body’s structure and function. By addressing the underlying causes of pain and dysfunction, osteopaths aim to promote the body’s self-healing capabilities, leading to long-term relief and improved well-being.

If you are considering osteopathic treatment, be sure to seek out a qualified and registered osteopath who can provide a comprehensive assessment and develop an individualized treatment plan tailored to your unique needs and health goals.

5 Causes of Lower Back Pain and How an Osteopath Can help

5 Causes of Lower Back Pain and How an Osteopath Can help

5 Causes of Lower Back Pain and How an Osteopath Can Help

Introduction

Lower back pain is a common issue that affects millions of people around the world. It can significantly impact one’s quality of life, making even the simplest tasks unbearable. Understanding the underlying causes of lower back pain is crucial for effective treatment. In this blog post, we will discuss five common causes of lower back pain and how an osteopath can help alleviate the discomfort.

The Osteopaths at Eclipse Health and Osteopathy have more than 20 years combined experience and have seen and helped many patients with lower back pain. It is one of the most common reasons people seek help from and Osteopath.

Cause 1: Muscle Strain

One of the primary causes of lower back pain is muscle strain. This occurs when the muscles in the lower back are overstretched or torn due to improper lifting techniques, sudden movements, or poor posture. The pain from a muscle strain can range from mild to debilitating, making it essential to seek proper treatment.

Treatment by an osteopath involves a thorough assessment of the affected muscles and surrounding tissues. The osteopath will use a combination of manual techniques, such as soft tissue manipulation, to relieve muscle tension and promote healing. In addition, they may provide tailored exercises to strengthen the muscles and improve posture, reducing the likelihood of future muscle strains.

Cause 2: Herniated Disc

A herniated disc is another common cause of lower back pain. This occurs when the soft, jelly-like center of a vertebral disc pushes through a tear in the outer layer, irritating nearby nerves. Herniated discs can be caused by age-related wear and tear, repetitive movements, or sudden injuries.

An osteopath can help alleviate the pain and discomfort associated with a herniated disc through various techniques. They may use gentle spinal manipulation to relieve pressure on the affected disc and nerves. Additionally, they can provide exercises to improve core strength, which helps stabilize the spine and reduce the risk of further disc issues.

Cause 3: Arthritis

Arthritis, a condition characterized by inflammation of the joints, can also contribute to lower back pain. Osteoarthritis, in particular, is a common form of arthritis that affects the spine. It occurs when the protective cartilage between the vertebrae wears down over time, leading to pain and stiffness.

Osteopathic treatment for arthritis involves a holistic approach to manage pain and improve mobility. An osteopath will use gentle manipulation techniques to relieve joint stiffness and restore proper alignment. They may also provide advice on lifestyle modifications, such as exercise and nutrition, to help manage arthritis symptoms effectively.

Cause 4: Poor Posture

Modern lifestyles often involve prolonged sitting or standing in improper postures, which can strain the muscles and ligaments of the lower back. Poor posture places undue stress on the spine, leading to pain and discomfort over time.

An osteopath can assess your posture and identify areas of imbalance. They will provide tailored exercises and advice to improve posture, thereby relieving strain on the lower back. Additionally, they may use manual techniques to release tension in the muscles and promote better alignment of the spine.

Cause 5: Stress and Emotional Factors

Believe it or not, emotional factors such as stress and anxiety can contribute to lower back pain. When our bodies are under stress, we tend to tense our muscles, including those in the back, leading to pain and discomfort.

Osteopaths recognize the influence of emotional factors on physical well-being. They may combine physical techniques with relaxation and breathing exercises to help reduce stress levels and alleviate lower back pain. By addressing the emotional component, osteopaths can contribute to overall pain relief and improved mental well-being.

Lower back pain can significantly impact one’s daily life, but with the help of an osteopath, relief is possible. By understanding the underlying causes of lower back pain, such as muscle strain, herniated discs, arthritis, poor posture, and emotional factors, an osteopath can provide effective treatments tailored to the individual’s needs. If you are experiencing lower back pain, don’t hesitate to consult with an osteopath and take the necessary steps to restore your comfort and quality of life.

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