FAQ’s

Advice

Gentle osteopathic and physiotherapeutic techniques are perfectly safe at all stages of pregnancy. The cranial osteopathic approach is a particularly gentle way of working with the body’s own natural mechanism for releasing and re-balancing tensions, without force. During the 1st Trimester, however, many manual therapists may have to stop or alter their treatment approach based upon their clinical reasoning.

Some food supplements can have a beneficial effect on joints, reducing inflammation and helping to repair worn out cartilage. Useful supplements include Glucosamine sulphate; this is thought to be effective treatment for osteoarthritis, improving symptoms of pain, joint tenderness and swelling. Fish oils can help to reduce inflammation. Vitamin C makes up collagen, this helps renewal in tendons and bones. Green mussel extract and vitamin E also help reduce inflammation. Talk to your Osteopath/Physiotherapist or Doctor before starting on a course of supplements, as there can be contraindications to taking some. We promote the value of a balanced healthy diet as a priority. City Osteopathy & Physiotherapy always tries to stock a good range of high quality vitamins and supplements at very reasonable prices.

Specific exercises given to you for your condition should be carried out as directed by your Osteopath or Physiotherapist. They should be carried out regularly in order to effect a change. This may be little and often if you have an acute problem or trying to change habits, otherwise they may in sets of repetitions that are asked to be repeated two or three times daily. It is only be repetition that you can change the muscles to help correct postural imbalances or to strengthen injured muscles.

Side lying with knees slightly bent tends to be the most comfortable position to sleep in for most conditions. It is important to make sure that the neck is well supported by having a correct pillow height. The head should remain in a straight line to the rest of your spine. Side lying however may irritate existing shoulder problems, in which case lying on your back may be more appropriate. Hip and pelvic problems may be strained when side lying, and many patients find it helps to place a pillow between the thighs as this reduces torsion through the pelvis. Sleeping on your front is generally not good as it causes your head to be rotated, so causing strain to the joints in your neck and if you also use a pillow, your neck will be rotated (bent backwards) which can aggravate neck problems. Lying on your stomach may also lead to lower back sagging-so increasingly concave bend (the lordosis) which can also result in low backache.

When an Osteopath/Physiotherapist manipulates your back you will hear a click. The click is due to the surfaces of the joint coming apart creating a potential vacuum. The aim of this is to separate the joint surfaces, which leads to increased movement between the bones that make up the joint, and causes the muscles surrounding the joint to relax. You may feel a little twisted and stretched as the Osteopath/Physiotherapist prepares you for manipulation should not cause pain.

Clinic Advice

Most health insurance companies cover both physiotherapy and osteopathy treatment, as they are seen as crucial to ensuring that patients make a full recovery from any surgeries or physical injuries that they may suffer. If you are unsure, please contact your insurance company to check. Some companies may require you to visit your local GP or orthopedic specialist to get a referral. We at ‘City Osteopathy and Physiotherapy’ do not charge for completing medical insurance forms, but an administration fee is charged if an official letter is required to be produced for the insurance company.

The term ‘Chiropractic’ means to practice by hand with manipulating or adjusting spinal vertebra ‘with one move’. It varies from the Osteopathic approach that first works with the supporting muscles and ligaments in conjunction with re-alignment of the musculo-skeletal system.

Therefore mainstream Chiropractic is more a system of joint release only while Osteopathy addresses the supporting tissue involvement prior to joint mobilization and gentle manipulation.

Despite the origins and philosophies of the professions being different, both employ the use of manual and physical therapy techniques techniques and treat very similar musculoskeletal conditions. Both can be very successful in helping a patient to recovery.

Within the professions there are different styles of treatment, whereas Physiotherapists largely employ structural techniques and sometimes use of electrotherapy, Osteopaths tend to use a more holistic approach and more commonly will also use visceral techniques and cranial sacral therapy (also known as craniosacral therapy). Physiotherapists tend to use more exercise based rehabilitation as an adjunct to treatment. Physiotherapists tend to refer back to substantiate their treatments from a research base. Both professions can use dry needling techniques depending on their training.

There is overlap between the professions and some techniques work very well for some people and others respond to another approach but they can also be used together to enhance each others practice and management of patients dysfunctions.

At City Osteopathy and Physiotherapy, we are able to work and refer between each others specialities for the best outcome of our patients.

A full history is taken of your condition, your presenting symptoms and any signs or triggers you may have noticed which can be of great help in understanding the background to your problem. In order for the Osteopath or Physio to examine and subsequently treat you, you may be asked to remove some of your clothing (Women are provided with a clean ‘hospital type’ gown or can stay fully dressed of preferred by the patient).

The Osteopath/Physio then performs a full and thorough examination, may do various orthopedic or neurological tests and examines any x-rays you may have with you. It may be necessary in some severe or complex cases to have x-rays or an MRI taken before proceeding with treatment, if you don’t already have them. The diagnosis and treatment plan will be discussed with you before treatment commences.

The treatment approach has been mentioned above but in Osteopathy, this will usually commence with a thorough soft tissue work up involving extensive therapeutic massage and various Osteopathic release techniques so that the joint restriction can be corrected more easily and more gently. The emphasis is to balance the musculo-skeletal system especially the pelvis and to mobilize any painful restricted spinal and peripheral joint.

In Physiotherapy, treatment will vary depending on the presenting problem and individual. It may consist of soft tissue and joint mobilising techniques to relieve acute symptoms, as well as techniques to address the root cause of symptoms and teaching of techniques for self help. Strapping can be used, but advice and home exercises are prescribed to be able to continue progress in between appointments.

Following the initial consultation, a medical report is prepared listing the complaint history, the examination findings, the diagnosis, treatment plan, response to the initial treatment. Advice is given on what to do and what not to do especially regarding work, sport, exercising, stretching and general movement and recommendations on how to get the most out of your treatment. You will be advised when to have your follow up treatment and given an idea as to how long it will take to correct your problem which will depend on whether your problem is a recent acute injury or a chronic complaint.

You may be asked to undress down to your underwear depending on the area of your symptoms. A hospital type gown is available for ladies if required. Patients are welcome to wear shorts if they feel more comfortable. There are male and female practitioners available at the practice.

An initial Assessment session lasts for 30 – 45 minutes dependent on the complexity of your problem and individual practitioner.

At the first consultation, the health practitioner will compile a full case history of your symptoms, and may ask you for additional information about your lifestyle and diet. They will observe you making some simple movements to help make the diagnosis. You will usually be asked to remove some clothing near the area of the body to be examined.

Both Osteopaths and Physiotherapists are trained to examine areas of the body using a highly-developed sense of touch, known as palpation. They may use different techniques to determine conditions and identify the body’s dysfunction. They provide a ‘package’ of care that includes skilled mobilizing and manipulative techniques, reinforced by guidance on exercise and lifestyle advice. Osteopaths may give more specific advice on diet and its contribution to your problem.

The practitioner will discuss with you the most appropriate treatment plan, estimating the likely number of sessions needed to treat your condition effectively. If the Physio /Osteopath thinks that your condition is unlikely to respond to their particular speciality, they may suggest that you see another specialist with different skills within the practice or alternatively you will be advised about how to seek further care. Both Osteopaths and Physiotherapists are skilled in diagnostic techniques and trained to identify when a patient needs to be referred to a GP or other medical practitioner. City Osteopathy and Physiotherapy work closely with Orthopaedic surgeons/ Podiatrists/ GP’s as well as other medical and complementary practitioners and will be able to advise on suitable specialists with a special interest in your problem.

Clinical Information

There are many causes of sciatica. The term sciatica describes irritation of the sciatic nerve and this may occur any where along the course of the sciatic nerve. The sciatic nerve originates from the sacral plexus. The sciatic nerve may be trapped by a lumbar disc prolapse causing compression at the nerve root, or it may be compressed more peripherally by the piriformis, a muscle that lies deep in the buttock. It may occur after prolonged squatting, immobility, or fractures or dislocation of the hip joint. Osteopathic treatment involves identifying the cause and trying to release the pressure on the nerve by improving range of motion, relaxing soft tissues and taking the strain off the structures involved.

In between the bony vertebra are discs, which are mainly made of fibrocartilage. There is an inner part called the nucleus pulposus, which is more jelly like in consistency and an outer part called the annulus fibrosus, which is the strong fibrocartilage to protect the inner nucleus pulposus. The purpose of the disc is to space the vertebrae apart whilst attaching them together If there is some weakness in the outer annulus fibrosus, some of the gelatinous nucleus pulposus can protrude, this causes a bulging on the outside of the disc, which can then press on nerves exiting the spinal cord at that level. There are different degrees of severity ranging from a small protrusion to a severe prolapse when the nucleus pulposus pushes all through the annulus fibrosus. Naturally the disc will heal through shrinkage and breakdown of the extruded disc material. However in severe cases surgery may be required to fuse the joints at the base of the spine or remove any material in the spinal canal.

Complementary Therapies

Herbal Medicine focuses on using plant-based materials to treat specific symptoms or diseases. It is based on the traditional knowledge of herbs drawn from different cultures that have been used in remedies for centuries and that are becoming increasingly accepted by mainstream healthcare practitioners as improvements in analysis and quality control and advances in clinical research show the value of herbal medicine in treating and preventing disease.

Herbal remedies are prescribed and formulated specifically for each individual and may form part of a more comprehensive treatment plan, that takes diet and lifestyle factors into consideration.

Like reflexology, iridology is based on the principle that the iris, the colored part of the eye, reflects a microcosm of the body. There are no two irises exactly alike; every iris is as unique as a fingerprint. Reading the color and pattern of the iris fibers gives insights into underlying inherent weaknesses passed down through three generations. Iridology is therefore a diagnostic tool used to uncover individual predispositions. Whether health issues develop from these predispositions depends on what you eat and drink, and the way in which you think, live and love.

Reflexology is based on the principle that certain parts of the body reflect a perfect microcosm of the whole body. Principle reflex points, which relate to all organ systems, glands and muscles of the body, can be found in the feet, hands, face and ears. These points respond to pressure, stimulating the body’s own natural healing process. By applying pressure to these reflexes the body is able to progressively clearing blockages, re-establishing energy flows and balancing itself, resulting in better health and emotional well-being.

The focus of reflexology is to release tension, improve circulation and normalize body function. It is a holistic therapy since every reflex is worked with some reflexes being emphasized more than others. Whilst clients may experience “good pain” the reflexes are worked within the pain tolerance of the client to prevent discomfort or injury to the soft tissues of the area being worked. It is advisable to drink plenty of pure water to enable the flushing out of toxins released during treatment.

The usual client response to a reflexology treatment is one of increased relaxation and a greater sense of well-being.

Naturopathy is based on the belief that every person is unique individual with an inherent healing ability. It places great emphasis on the role of natural substances, healthy practices and preventive strategies to promote health & wellbeing. The naturopathic use of non-toxic, natural and effective methods of treatment such as the use of herbs, flowers essences, nutritional supplements, manual techniques and dietary and lifestyle advice is increasingly being supported by science.

A naturopath takes time during a consultation to look beyond the symptoms of a disease to the underlying causes of ill health. Even though the symptoms may be the same in two cases, for example high blood pressure, the treatments will be different; in other words, two patients with the same condition may require different treatment strategies.

As well as treating the current illness, a naturopath will be looking to increase the general health and well-being of a patient, which will make them less susceptible to illness in the future.

Osteopathy

Cranial osteopathy is a refined and subtle type of osteopathic treatment that encourages the release of stresses and tensions throughout the body, including the head. It is also known as cranio-sacral therapy or cranio-sacral therapy/ osteopathy.

It is a gentle yet extremely effective approach and may be used in a wide range of conditions for people of all ages, from birth to old age. Osteopaths may have different specialties including sports injuries, paediatrics, and visceral osteopathy (treating the internal organs of the body). Cranial osteopathy embraces all of these.

Cranial osteopaths are trained to feel a very subtle, rhythmical shape change that is present in all body tissues. This is called Involuntary Motion or the Cranial Rhythm. The movement is of very small amplitude, therefore it takes practitioners with a very finely developed sense of touch to feel it. This rhythm was first described in the early 1900’s by Dr. William G. Sutherland and its existence was confirmed in a series of laboratory tests in the 1960’s and ’70’s.

Tension in the body disrupts the cranial rhythm. Practitioners compare what your rhythm is doing to what they consider ideal. This shows them what stresses and strains your body is under at present, and what tensions it may be carrying as a result of its past history. It also gives them an insight into the overall condition of your body, for example if it is healthy, or stressed and tired.

When we experience physical or emotional stresses our body tissues tend to tighten up. The body may have been able to adapt to these effects at the time, but a lasting strain often remains. Any tensions which remain held in the body can restrict its free movement. Gradually the body may find it more and more difficult to cope with accumulated stresses and symptoms may develop.

Osteopaths treat all musculo-skeletal injuries and dysfunction of every part of the body as well as visceral or constitutional problems. Osteopaths take a holistic approach to your problems with a bio-mechanical re-alignment and balancing emphasis in conjunction with a keen interest in your diet, nutrition, posture, exercise and lifestyle as these impact directly and indirectly on your health and wellbeing. They are wellness practitioners.

Injuries and dysfunction can occur from incorrect lifting, falls and sprains, horse, bike and car accidents, from sporting injuries, from bad posture or a bad work station at work, on the computer and from general slouching particularly in the car and relaxing at home.

Osteopaths treat all muscles and joints of the body including the neck, spine, ribs and pelvis, the hips, legs, knees, ankles and feet, the shoulder girdle, arms, elbows, wrists and hands and even the jaw or temporo-mandibular joint (TMJ). Below are a few examples of some of the conditions that Osteopaths treat (this list is not exhaustive!).

Treatments

  • Jaw pain and dysfunction, clenching and grinding of your teeth
  • Cranial Osteopathy
  • Cervical or neck pain including whiplash injuries
  • Headaches and migraines
  • Thoracic or back pain including rib pain and sternum pain
  • Lower back pain, pelvic pain, hip pain and gluteal or buttock pain
  • Sciatica and referred pain, ITB pain
  • Curvature of the spine, scoliosis and spinal dysfunction
  • Subluxations, back strain, back injury, correct alignment and musculo-skeletal balance
  • Frozen shoulder, shoulder girdle, stero-clavicular and acromio-clavicular pain
  • Elbow pain, wrist pain, hand and finger pain
  • Tennis elbow, golfers elbow and other sports injuries
  • Knee pain, ankle pain, foot pain including plantar fasciitis and metatarsalgia, toe pain
  • Sprained ankles including Achilles tendon pain
  • Muscle spasm and cramps including dietary advice / magnesium supplementation
  • Muscle and ligament strains and tears of arms and legs eg calf tears, hamstring tears
  • Lymphatic drainage, bloating, abdominal cramps and pain, constipation, sluggish bowel
  • Pregnancy, neonatal and childcare treatment and advice
  • Arthritis pain and stiffness relief, dietary and supplement advice

Advice

  • Heat or ice, when to apply
  • Postural correction, movement and exercise, how to sit, move and sleep with back pain
  • Spinal analysis / spinal assessment, diagnosis and treatment or management plan
  • Full medical report and treatment plan provided with all initial consultations
  • Work cover assessment / treatment including RSI (repetitive strain injuries) from overuse
  • Ergonomic assessment and advice
  • Medico-legal reports, corporate assessments
  • Supplements to maximize healing and minimize injury especially sports nutrition

Osteopathy, at present, is the fastest growing and safest allied health profession in Australia. Osteopaths are registered with the medical board in Australia and the general osteopathic council in the UK. Osteopaths like general practitioners are classified as primary care practitioners meaning they are trained and registered to diagnose and treat in Osteopathy. To be registered, Osteopaths must complete a science degree and a post graduate masters degree in Osteopathy, a total of four or five years full-time tertiary training (depending on which college you train at). All courses involve a two year internship where real patients are treated in an out-patients clinic.

The training is broad and diverse and includes a wide range of techniques including neck, spinal and pelvic mobilization, manipulation and balancing, cranial, cranio-sacral and sacro-occipital techniques including jaw or TMJ (tempero-mandibular joint) re-alignment, soft tissue massage, deep tissue massage, myo-fascial and neuro-muscular release techniques, trigger point therapy, stretching, strain / counter strain techniques and visceral techniques for constitutional problems of the cardio-vascular, gastro-intestinal, pulmonary, lymphatic and uro-genital systems.

Osteopathy is a very safe, gentle and effective system because of the time taken in preparing the soft tissues prior to joint mobilization and so safe it is used on children, the elderly, pregnant women and even new born babies.

To put it into context, the first drug to be manufactured was aspirin in 1899 by Bayer. Prior to that medical doctors had a more diverse role than today, dispensing herbal remedies and other plant drugs such as foxglove (1785) and morphine (1803), mineral drugs including large doses of heavy metals, tending, cuts and abrasions, stitching wounds, setting broken bones and performing Osteopathy. In the Hollywood Westerns, doctors are often referred to as “sore bones”.

It is not surprising that in settling America lots of injuries occurred and new medical schools flourished. The first Osteopathic college was established by a medical doctor, Doctor Andrew Taylor Still, in 1892 in Kirksville Missouri. Unhappy with the way other doctors prescribed the medicines of the day to excess Still sought more holistic approaches. He rejected the idea that germs alone cause disease but that diseases where more common when bones moved out of place and disrupted the flow of blood or the flow of nervous impulses making the body more susceptible to disease. He therefore concluded that one could cure diseases by manipulating to restore the interrupted flow. Observing that the human body had much in common with the machines he worked on in earlier life, Still approached the study of the human body as one would approach the study of a machine. Over time and with his study of medicine he developed a series of specialized physical treatments for which he coined the name ‘Osteopathy’.

Today Osteopathy is taught in 19 different medical schools in the United States, three universities in Australia and ten in the UK.

Osteopathy is a manual therapy based predominantly on the health and healing of the musculoskeletal system. Hands on techniques are used to influence the body’s structure. Osteopaths believe that when the body’s framework is balanced and working correctly, the bodies systems can also function well.

Osteopathy is a holistic philosophy, the body must be considered as a whole due to the connections that link the entire body; every part of the body can influence another. Additionally, Osteopaths take a holistic interest in the external factors on the body such as diet, exercise and lifestyle.

Osteopaths aim at treating not only symptoms but also underlying causes to dysfunction. This ensures the best chance of long-term relief.

Osteopathy focuses on all structural elements of the body including muscles, joints and bones and in doing so can influence the health of the bodies systems including lymphatics, viscera, nerves and circulation.

Osteopaths are trained and qualified to assess and diagnose your problem and then provide you with a treatment plan.

Physiotherapy

Physiotherapy training is now a University based Bachelors or Masters degree course (previously hospital based diploma). This involves either three or four years extensive training studying the human body, particularly the muscle and joint system. It involves studying anatomy, physiology, biomechanics, the nervous system, psychology, medical conditions and disease processes, musculoskeletal conditions, exercise prescription and electrotherapy.

Initially on qualification, many Physiotherapists will have a rotational job within a hospital, this gives them a broad knowledge of other specialities which are useful to recognize in musculoskeletal settings such as neurology, rheumatology, orthopaedics, paediatrics and others.

It is a professional requirement that they continue their professional development throughout their career and Physiotherapists are constantly furthering their education by attending specialist courses and keeping abreast of current concepts and research development. They constantly reflect on practice to ensure they are giving their patients the best possible treatment.

Many go on to extend their normal practice by becoming specialists working with elite sports or performing roles in conjuction with the Orthopaedic medical profession that would have traditionally been the medical domain such as ordering MRI’s , X rays and blood tests. This is to aid in diagnosis of musculoskeletal conditions and exclude other conditions.

Physiotherapy was first documented in Greek history when the use of massage was proposed and also Hydrotherapy (exercises in water). However, the current profession started to evolve in the early 19th century in Sweden who used massage, manipulation and exercise . The first formalized society was set up by some nurses in UK who recognized the need for an independent profession. Schools opening in the UK, New Zealand and the USA in the early 20th century.

The profession really gained recognition and became established after the First World War, treating injured soldiers with remedial exercises and also using exercise to help treat disabled children suffering from Polio. It has worked alongside the medical profession and therefore its benefit to patients has been recognized since this time.

The profession developed over the 20th century, manipulative techniques started to be used in the 1950’s and then with the progression of technology and computers in the 1980’s there was a shift to use of electrotherapy, ultrasound, muscle stimulation and other devices. The profession then took a shift back towards manual therapy , constantly looking at research to lead and support its evolution. It has influences from many spheres of manual therapy. It is constantly evolving in keeping with the latest evidence in medical science.

Physiotherapy is a science-based methodology that is constantly evolving as new research discovers better ways to treat your body. Your physiotherapist will use their expert knowledge of the human body and highly specialised skills to help restore your aching, stiff and dysfunctional muscles and joints back to health. Physiotherapists promote good health by encouraging their clients or patients to improve and increase control over their own lives through additional exercise prescription.

Physiotherapy focuses on treating the structural components of the body, such as muscles, joints and ligaments, looking at relative strength/ weakness, tightness and laxity/length. They also look at the motor control of the movements which is controlled by the nervous system and help to re-educate normal movement patterns.

A physiotherapist uses natural physical approaches and manual techniques to promote, maintain and restore your body to health and well-being so that you can perform and enjoy your chosen sport, work or everyday activities.

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