Sports Osteopathy: Sports Injuries. Dynamic Osteopaths

Osteopaths are increasingly  becoming a key provider of physical therapy and sports medicine within sports. Furthermore, osteopathic medical research is becoming larger within the National Institute of Clinical Excellence. 

The use of manual medicine or joint manipulation for the treatment of athletic injuries dates back thousands of years. The osteopathic approach to sports related injuries is a unique one. Athletic performance related to a particular sports is broadly viewed as musculoskeletal efficiency. The body, including cardiovascular and pulmonary systems has to be finely tuned to the increasing demands placed upon them by the musculoskeletal system. The athlete is subject to biomechanical, strength and flexibility demands in relation to a particular sport. Therefore the aims within sports osteopathy is to go beyond providing relief of immediate symptoms, but to promote function of homeostatic and protective properties of the body so the body can heal optimally whilst promoting injury prevention. 

Sport Examples:


  • Stinger/ Burner – Burning pain from the shoulder to hand/ tackling injury where the shoulder and neck are stretched apart causing tension on the nerves.
  • Dislocation/ subluxation – Often caused by the arm being fully stretched out to your side and upwards/ usually requires re-location and possible operation if a recurrent problem.
  • Shoulder AC joint – Chronic pain at the shoulder end of the collar bone/ normally caused by wear and tear and damage to the AC ligaments.
  • Labral tears – Damage to cartilage in the shoulder joint/ can be caused by scoring a try with the arm outstretched or by recurrent dislocations
  • Spinal injuries – joint and muscular pain.


  • Rotator cuff – (as discussed earlier)/ an impingement of the tendons/ can be an acute injury or a chronic wear and tear
  • Posterior instability (leading shoulder) – repeated swinging of the club can lead to overstretching of the muscles and joint at the back of the shoulder
  • Anterior instability (non-leading shoulder) – an unstable feeling of the shoulder as the ball slips slightly from the socket (normally felt at the front of the joint)
  • Chronic low back pain – related to local chronic inflammation around the joints in the lumber spine.


  • Look out for a change in stroke pattern
  • Pain in the recovery phase is normally an impingement (as mentioned previously)
  • Pain in the pull-through phase is normally a labrum injury or a rotator cuff injury

What we can do at Dynamic Osteopaths:

Firstly, it is imperative to diagnose what tissue is causing your pain. This is done by the use of a few tests to determine the cause of the problem, following a case history as to how the injury occurred and any previous problems or injuries you may have had, and then moving onto examining your complaint. There are some very simple “mobility testing movements” as well as orthopaedic tests we can do that will give us a very clear idea about your injury. Once we know the cause of the problem we can then see about getting you back on the road to full fitness. Hopefully it’s just a case of a series of treatments as well as a course of exercises to promote you rehabilitation. It may be that your injury requires further investigation in which case we can refer you to a local specialist to discuss your options.

Case study:

– 28 year old professional footballer with a 2 year history of left side groin strain.

– Despite cases of rest, NSAIDs and cortisone steroid injection, the complaint has continues and spread into the lower back and buttock, in addition to recurrent calf strains. An Osteopath was then called in by the club doctor for a second opinion. 

– Osteopathic examination relieved no abnormalities of basic neurological and cardiovascular examination. However, among all the various positive findings, those that were of relevance were; an anteriorly rotated right iliac innominate, an absence of back-locking of both knees, a fixation of the lumbosacral joint on the left into extension, reduced active and passive thoracic rotation and various muscular imbalances.

– Treatment plan: mobilisation of the right ilium into posterior, mobilization of the thoracic spine, which inevitably was a factor including in the LSJ/SIJ restriction. Mobilisation of L1/2/3 on the right, decompression of the left LSJ (thus reducing the effects of sciatic nerve compression) and stretching out the hamstrings and popliteus to allow for increased knee extension. A further foot examination and correction was also provided.

– The player responded very well and was fully playing again within 6 weeks.

Dynamic Osteopaths regularly see sports injuries and provided sports-related rehabilitation on a frequent basis.

For further information please contact us a Dynamic Osteopaths /




Living Well with Osteoarthritis: A guide to keeping your joints healthy

Review from Harvard Medical School:

Arthritis can be distracting. Distressing. And disheartening. It can make you hesitant. It can frustrate — and even prevent — you from doing all the things you love to do. It is, quite literally, a pain.

The good news is that you can live — and live well — with osteoarthritis, the most common type of arthritis. You can get relief from its pain and its consequences.

Don’t let arthritis pain get in your way!

End the relentless aches and aggravation and start enjoying a more active and pain-free life once again!

The report will brief you on breakthroughs in joint replacement surgery. Do you want to learn about the role of physical therapy as well as complementary procedures. And because medications remain the first line of defense, the report examines the effectiveness, safety, and possible side effects of more than 40 medications used to treat arthritis and relieve its pain.

Self-care strategies for coping with arthritis: Exercise

Even the healthiest people find it difficult to stick with an exercise regimen. But those with arthritis commonly discover that if they don’t exercise regularly, they’ll pay the price in pain, stiffness, and fatigue. Regular exercise not only helps maintain joint function, but also relieves stiffness and decreases pain and fatigue. Feeling tired may be partly the result of inflammation and medications, but it’s also caused by muscle weakness and poor stamina. If a muscle isn’t used, it can lose 3% of its function every day and 30% of its bulk in just a week. A recent review of numerouse studies asserts that both aerobic and muscle-strengthening exercises are safe and effective for people with chronic arthritis. Below are brief summaries of different forms of structured exercise programs (most of which are offered by local Arthritis Foundation chapters) and their potential benefits.

Land-based programs. These include community-based group classes led by health or fitness professionals with specialized training in instructing people with arthritis. Examples include Fit and Strong!, a program targeted to older adults with osteoarthritis; the Arthritis Foundation’s Exercise Program (AFEP); and its Walk with Ease program. All include some combination of a warm-up routine and three standard exercise goals, plus specialized activities to enhance body awareness, balance, and coordination. Studies have found that people with arthritis in their hips, legs, and feet who took Fit and Strong! classes were able to exercise longer, felt more confident about their ability to exercise, and reported less joint stiffness compared with those in a control group. Many of the benefits lasted between six and 12 months. Those attending AFEP classes for eight weeks had less pain, stiffness, and fatigue, and these improvements persisted at least six months, as well. In one study, people who completed the Walk with Ease program (which also teaches participants about managing their disease) had more confidence, less depression, and less pain, compared with participants who attended classes focused on pain management.

Water-based programs. Also known as aquatic or pool therapy, these group classes are done in water that’s nearly 90° F and feature a variety of exercises, including range-of-motion exercises and aerobics. According to one study, people who took the Arthritis Foundation Aquatic Program improved knee and hip flexibility, as well as strength and aerobic fitness. Other investigations suggest water exercise lessens pain and boosts physical functioning, and the benefits after the 12-week session were sustained for three months after the last class.

Strength and resistance training. This form of exercise, which uses equipment such as weight machines, free weights, and resistance bands or tubing, strengthens not only muscles but also your bones and your cardiovascular system. Resistance training improves muscle strength, physical functioning, and pain. One Japanese study compared people with knee osteoarthritis who either took NSAIDs or did twice daily knee extension exercises to strengthen their quadriceps (the muscles on the front of the thigh). At the end of the eight-week study, both groups had less pain and stiffness, as well as improved functioning and quality of life.

Tai chi. With origins in Chinese martial arts, this low-impact, slow-motion exercise also emphasizes breathing and mental focus. A number of small studies suggest tai chi helps people with different forms of arthritis, mainly by increasing flexibility and improving muscle strength in the lower body, as well as aiding gait and balance. The Arthritis Foundation, along with Dr. Paul Lam, a family physician and tai chi instructor, developed a standardized form of tai chi designed specifically for people with arthritis. Based on Sun-style tai chi, one of the discipline’s five major recognized styles, it includes agile steps and a high stance (meaning the legs bend only slightly).

Yoga. Scant research has explored the benefits of yoga for people with arthritis. One study showed that people with knee osteoarthritis who took eight weeks of Iyengar yoga (a form of yoga that focuses on correct body alignment, and uses blocks, belts, and other props to assist in performing postures) had less pain and could function better at the end of the study. Another study of people with rheumatoid arthritis found benefits from participating in twice-weekly Iyengar sessions for six weeks — namely, less pain and depression and greater mobility. But both studies were quite small, and neither included a comparison group.

For further information please visit Dynamic Osteopaths or contact us at

Scientists unravel the molecular secret of short, intense workouts

Scientists unravel the molecular secret of short, intense workouts

Sports Medicine: Fitness. Link Sports Med: Fitness

In the last few years, the benefits of short, intense workouts have been extolled by both researchers and exercise fans as something of a metabolic panacea capable of providing greater overall fitness, better blood sugar control and weight reduction – all of it in periods as short as seven minutes a few times a week.

Now, in a new study, scientists from the Florida campus of The Scripps Research Institute (TSRI) confirm that there is something molecularly unique about intense exercise: the activation of a single protein.

The study, published recently by The EMBO Journal, revealed the effects of a protein known as CRTC2.

The scientists were able to show that following high-intensity exercise, which enlists the sympathetic nervous system’s “fight or flight” response, CRTC2 integrates signals from two different pathways – the adrenaline pathway and the calcium pathway, to direct muscle adaptation and growth only in the contracting muscle.

Using mice genetically modified to conditionally express CRTC2, the scientists showed that molecular changes occurred that emulated exercised muscles in the absence of exercise.

“The sympathetic nervous system gets turned on during intense exercise, but many had believed it wasn’t specific enough to drive specific adaptations in exercised muscle,” said Michael Conkright, PhD, a TSRI assistant professor who led the study. “Our findings show that not only does it target those specific muscles, but it improves them – the long-term benefits correlate with the intensity of the workout.”

Mobilizing Resources

In the genetically altered animal models, this resulted in a muscle size increase of approximately 15 percent. Metabolic parameters, indicating the amount of fuel available to the muscles, also increased substantially – triglycerides went up 48 percent, while glycogen supplies rose by a startling 121 percent.

In an exercise stress test, the genetically altered animals improved 103 percent after the gene was activated, compared to an 8.5-percent improvement in normal animals.

“If you think of the adrenaline system as something that mobilizes resources when you encounter, say, a bear on your way to work, what we found is that the system also gets you ready for your next bear encounter,” Conkright said.

The new findings open the door to a range of potential exercise enhancements.

“Nothing can supplant exercise; however, just by activating one protein, we clearly improved performance in animal models,” said Staff Scientist Nelson E. Bruno, MD, PhD, the first author of the study and a member of the Conkright laboratory. “We are now searching for molecular therapeutics that will activate the CRTC2 protein so that even an average exercise routine could potentially be enhanced and made more beneficial.”

Further information can be found at Dynamic Osteopaths or by contacting

The Secret To Joint Pain Relief – Exercise

Review from Harvard Medical School 2014

The secret to joint pain relief — exercise

Joint pain: it throbs, aches, and hurts. It may make you think twice about everyday tasks and pleasures like going for a brisk walk, lifting grocery bags, or playing your favorite sport. Sharp reminders of your limitations arrive thick and fast, practically every time you move.

What are the causes of joint pain?

  • osteoarthritis
  • old injuries
  • repetitive or overly forceful movements during sports or work
  • posture problems
  • aging
  • inactivity

How can exercise can help joint pain?

Ignoring the pain won’t make it go away. Nor will avoiding all motions that spark discomfort. In fact, limiting your movements can weaken muscles, compounding joint trouble, and affect your posture, setting off a cascade of further problems. And while pain relievers and cold or hot packs may offer quick relief, fixes like these are merely temporary.

By contrast, the right set of exercises can be a long-lasting way to tame ankle, knee, hip, or shoulder pain. Practiced regularly, joint pain relief workouts might permit you to postpone — or even avoid — surgery on a problem joint that has been worsening for years by strengthening key supportive muscles and restoring flexibility. Over time, you may find limitations you’ve learned to work around will begin to ease. Tasks and opportunities for fun that have been weeded out of your repertoire by necessity may come back into reach, too.

Beyond the benefits to your joints, becoming more active can help you stay independent long into your later years. Regular activity is good for your heart and sharpens the mind. It nudges blood pressure down and morale up, eases stress, and shaves off unwanted pounds. Perhaps most importantly, it lessens your risk of dying prematurely. All of this can be achieved at a comfortable pace and very low cost in money or time.

For more on developing and mastering a plan to relieve your joint pain, please feel free to contact us at or email us on


joint pain relief

Orthotic Prescription: Joint Pain, Posture & Hyper-mobility

Orthotic Prescription: Joint Pain, Posture & Hyper-mobility

Prescribing therapeutic orthotics in addition to Osteopathic care works extremely well in the treatment of numerous clinical conditions and improves a patient’s ability to maintain improved body mechanics and function.

Orthotics promote postural stability and balance within the body, enhancing the integrity of overall musculoskeletal alignment and physiological function. This is because the feet are the foundation of the body in terms of ground reaction and their influence must be considered even in cases involving other body structures. If a patient’s condition is affected by gravitational forces, structural imbalance, or joint disturbances, orthotic prescription may very well be helpful in speeding recovery and preventing reoccurrence. In cases of specific trauma that produce an area of weakness, healing can be accelerated when strong support is provided by a balanced foundation.

Treating the Patient as a whole:

Recognition of the interrelationship of structures in the musculoskeletal system is a fundamental concept of osteopathic practice and is something that is carefully considered daily here at Dynamic Osteopaths. The ability to see the body as an interrelated unit, instead of treating isolated symptoms, generates results that build patient satisfaction and professional success.

In addition, understanding the relationship between a balanced foundation and total postural health improves the effectiveness of individual case of patient management. Gravity forces work through the mechanics of the feet, knees, and legs into the spine and pelvis and then all the way up the spine into the skull. These forces have huge mechanical consequences if maligned. The body functions as a total unique kinetic chain, where movement at one joint influences movement at other joints.

Foot dysfunction occurs in an estimated 80% of people over the age of 40. Often, patients are unaware of their problem because symptoms refer to structures away site. Many pelvic and spinal distortions can be traced to dysfunction in foot biomechanics. Here at Dynamic Osteopaths our sports osteopaths out of Solihull and Birmingham are well trained in identifying these biomechanical abnormalities.

Tracing the Kinetic Chain

Excessive pronation of the subtalar joint is the most common foot disorder that contributes to chronic postural problems (otherwise known as collapsed arches). A natural inroll of the foot must occur during gait/walking so that body weight propels forward, knees can flex, and natural shock absorbers protect upper body structures from heel strike forces. When the degree and duration of pronation exceed established norms, consequences extend throughout the closed kinetic chain. Clinical example:

At the knee: Flattening of the longitudinal arch stretches the retinaculum on the medial side. The patella is pulled laterally in the femoral grove during flexion, setting the stage for chondromalacia patellae.

In the pelvis: Lack of pedal support prolongs inward rotation of the lower extremity, causing inward hip rotation related to myofascial back pain.

At the spine: Excessive pronation effectively creates a functional short leg, leading to pelvic unleveling. Shear strain on the articular facet joints, compensatory scoliosis, and intra-articular capsule changes are possible consequences.7

Orthotic Correction

Here at dynamic osteopaths we promote and prescribe custom fitted Vasyli Medical 6 degree orthotics serving to control motion within the foot, including the angle and timing of pronation. It is extremely important to facilitate but not restrict movement, to avoid a compensatory hypermobility elsewhere in the kinetic chain. These orthotics prescribed by your osteopath allow movement to occur, but check the degree of inroll as if a wedge were placed at the point of weakness.

Several studies verify the effectiveness of orthotic support in stabilizing the pedal foundation for better postural health. In one, pronation measurements were taken on both an injured and a normal foot. When an orthotic was worn on the injured foot, the degree of pronation was almost equal. Another study involving the used of flexible orthotics focused on three key postural measurements:

Femoral head height. Healthy posture shows little or no difference in head height. Variance reflects functional or structural problems in the feet, knees, pelvis, or spine.

Sacrovertebral angle. The accepted optimum angle is 110 degrees. Pelvic tilt or lumbar lordosis will cause a change in angle measurement.

Lumbosacral disc angle. The standard measurement is between five and nine degrees. Outside these limits, weightbearing stress can effect the facet articulation and disc.

Subjects in the study wore spinal pelvic stabilizers for four months, but received no chiropractic adjustments and made no other lifestyle changes. At the end of the period, measured improvements occurred in all three areas. Members of a runners’ club demonstrated that orthotics provide a high level of symptom relief. Almost 350 people who had been using orthotics for an average of two years completed identical questionnaires about specific musculoskeletal symptoms. Complete resolution or great improvement in their symptoms was reported by 75% of respondents.

Among their complaints were pain in the knees, feet, ankles, shins, and hips. The top three conditions in those diagnosed by health care professionals were excessive pronation, plantar fascitis, and Achilles tendinitis.

A study focusing on patients with leg length discrepancy involved 1,157 subjects with discrepancies of less than 10 millimeters. Over a 15-year period, they demonstrated a 75 percent reduction in low back pain, sciatic pain, and hip pain when shoe insert were worn. Pain would often occur the same day that inserts were not used, and go away when used resumed.

Identifying Imbalance is a standard Osteopathic system. With a trained eye, many osteopaths can determine the likelihood of imbalance as the patient walks into the examining room. These include:

Foot flare: toeing out while walking indicates excessive inroll in one or both feet.

Medial patellar rotation: impact of pronation on the knee as described above manifests in abnormal rotation of the patella.

Bowed Achilles tendon: inroll of the foot stresses soft tissues, creating a distinctive curve of the Achilles tendon.

These factors serve as general indicators of foot imbalance. During the routine patient exam, be alert to more specific symptoms, including:
The presence of shin splints, patellofemoral disorders, Achilles tendinitis, plantar fascitis, or stress fractures.

Local signs such as corns, calluses, bunions, neuralgia, or altered circulation.

Leg length inequality, especially in the presence of low back pain, unilateral hip arthrosis, or lower extremity stress.

General complaints of leg cramps, knee or hip pain, spinal distortion, cervical tension, mid-thoracic or low back pain, sciatica, or fatigue.

Collapsed Arches:

The integrity of the body’s Biomechanical foundation has a direct impact on total musculoskeletal health. The Biomechanical kinetic relationship between the feet and upper body structures can affect the effectiveness and longevity of osteopathic care and treatment management.

Osteopathic orthotic description aids normalizes foot structure and motion to provide a more stable base for the musculoskeletal complex. Even though the feet may not hurt, symptoms referred elsewhere in the body manifest as chronic pain or lack of permanence in osteopathic manual medicine.

Clinical studies and field research verify the value of orthotics in relieving pain and improving structural integrity. Flexible orthotics control pedal motion without restricting function and creating compensatory hypermobility in other structures.

For further information please do not hesitate to contact us at
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We have Osteopathic clinics operating out of Henley in Arden, Solihull and Harborne Birmingham.

Sports Medicine: Exercising With Lower Back Pain: Prescription for Health

Sports Medicine: Exercising With Lower Back Pain: Prescription for Health

Sports Medicine – Exercise is medicine!

Back pain is one of the most common medical complaints in the world. Don’t let low back pain get you down! A well-designed exercise program can help speed recovery from low back pain, reduce pain levels, and possibly prevent reinjury. In fact, regular physical activity has been shown to increase muscle strength and endurance, enhance mobility and reduce the risk of falling is superior to spine therapy at helping people cope with back pain and at keeping it under control! The key to maximizing the benefits of exercise is to follow a well-designed program that you can stick to over the long-term.

Getting Started

The goal of exercise training is to improve overall fitness (cardiovascular, muscle strength and endurance, flexibility, coordination and function).

Talk with your health care provider before starting an exercise program and ask if they have specific concerns about you doing exercise. Most people do very well with regular exercise and sufficient time, but some people do need surgery.

The goal of exercise training is to improve overall fitness (cardiovascular, muscle strength and endurance, flexibility, coordination and function) while minimizing the stress to the lower back.

Choose low-impact activities, such as walking, swimming, and cycling.

Strong abdominals, back, and leg muscles are essential for helping you maintain good posture and body mechanics. Once the acute pain subsides, you can begin doing light strengthening-training exercises designed to help your posture.

Yoga and tai chi may help relieve or prevent lower back pain by increasing flexibility and reducing tension. Be careful, however, not to do any poses that could exacerbate your condition.

Start slowly and gradually progress the intensity and duration of your workouts.

Do low- to moderate-intensity cardiovascular exercise for 20 to 60 minutes at least three to four days per week.

Exercise Cautions

Avoid high-impact activities such as running.

While low-impact aerobic activities can be started within two weeks of the onset of lower back pain, exercises that target the trunk region should be delayed until at least two weeks after the first sign of symptoms.

Never exercise to the point of pain — if something hurts, don’t do it.

Your exercise program should be designed to maximize the benefits with the fewest risks of aggravating your health or physical condition. Consider contacting us here at Dynamic Osteopaths to cover realistic goals and design a safe and effective program that addresses your specific needs.

For more information, visit us at Dynamic Osteopaths in Solihull and Birmingham at or email us at