When will it feel like I don’t have to keep coming back on such a frequent basis?
“When will I feel better?” – Most of our clients seeking Osteopathic treatment ask this question at some stage in their healing and recovery journey. This blog will address this frequently asked question with the aim to educate and manage expectations.
While it’s difficult to provide an exact answer, as everyone is different. We can however give you an idea of the ‘average’ recovery period and the factors that might hasten your recovery.
Some people find the problem they came in with disappeared almost straight away. Others find it improves with each session, but over the first few weeks, it seems to keep coming back. This can sometimes feel like a boomerang, and you can become concerned that while treatment provides relief, it doesn’t appear to go away completely.
So how long does it take to get better after an osteopathic treatment?
While we know that by the 4th or 5th session, you will be well on your way in the healing process. We have also observed over and over again that it’s generally not until about the 8th session that clients really start to feel the transformation.
Can you explain why you recommend such a long treatment plan?
Within the first session or three, you will notice considerable relief and more mobility. You likely will even notice changes and improvements throughout the week. These improvements between sessions occur as your body continues to process and assimilate the changes and space created in the treatment session.
While you’ll feel some improvement, you may find your body is feeling less comfortable again. This usually happens by the end of the period between sessions. If you notice this, we understand it’s easy to feel disheartened, and wonder whether a change is happening, or if you have to keep coming back…
What can I do to aid my recovery?
Eat well – your body’s ability to heal is aided by good nutrition
Rest after treatments
Understand your body is trying to heal itself
Reduce emotional stress and strain as it slows recovery
Follow the treatment plan, do the exercises – Your daily exercises make a HUGE difference
Trust your body and follow the treatment plan
Our message to you, is this: keep an open mind, trust your body and follow the plan that we have created with you. As your body continues to heal and assimilate, a transformation happens! As stated above, this often is around the 8th to 10th session. At this point, you likely still are not “fixed”, but your body has started to stabilise. In this more stable place, your body can relax a little, allowing you to keep healing and strengthening, but simultaneously feel more resilient.
At this stage, you’re less likely to fall back into the old habits, movements and pain. And when a small disruption happens, you notice your body has more resilience, such that previously, when whatever challenge occurred, you would have been in pain for days. Whereas now, if there is pain, it seems to easily resolve itself in a day or so, or does not create a noticeable problem at all.
Treating underlying issues and maintenance
At this point, the space between treatment sessions can also increase. So that we can continue to stimulate healing and realignment, and deal with the underlying issues that contributed to your injury or compensation patterns in the first place, while allowing you to do more home-based maintenance. Allowing you to be in control of maintaining, improving, and dealing with any minor flare-ups along the way. While you focus on strengthening yourself in a more balanced way, to help you stay well and strong, and without pain.
It’s easy to forget
Some people quickly forget the problem they initially came in with. They become aware of all the other issues that they either: didn’t realise they had, didn’t realise that we could assist with. Often, in this situation, you can become so aware of the current symptom, and that it’s not as perfect as you would like yet, that it’s easy to forget the symptoms that have greatly improved or even completely disappeared. In this scenario, it’s probably not until the later stages of the first or second phases of the treatment process, around 10 sessions or more, that you begin to notice how far you have come and how good you feel – in general, and especially compared to what you felt when you began treatment.
Most importantly, know you can smile, and exhale, as Alexis’ caring, compassionate approach, combined with professional skills and qualifications as an Osteopath, means you are in safe hands.
If you are unsure about your response to treatment or would like some advice, don’t hesitate to contact Alexis directly, and she will do her best to guide you through.
Hemp is a plant, very similar to marijuana and is often confused as the same. While the leaf of the marijuana plant contains tetrahydrocannabinol (THC), which is activated when the leaves are heated, leading to pychoactive effects, hemp only contains tiny amounts of THC.
Used nutritionally, hemp seeds are used either whole or crushed to release the oils. Heating is avoided to keep the fragile oils, vitamins, minerals and other phytonutrients bioactive.
A Good Source of Healthy Fats
Hemp is a good source of plant-based omega 3 fatty acids. It is one of the largest sources of ALA, a precursor to EPA and DHA (the bioactive forms of omega 3 fatty acids found in wild, deep sea fish). While ALA does not convert at high levels, being a rich source of plant based healthy fats, it is very beneficial, especially for those who choose to live a vegan lifestyle.
Hemp also contains GLA, a specific omega-6 fatty acid as well as many phytosterols. Phytosterols have been shown to have the potential to actually help to remove fat build up in arteries.
A Great Source of Vegan Protein
Containing all of the 10 essential amino acids required for making and repairing proteins, hemp is a great plant source of “whole protein”. Further, while many plant sources of protein contain phytates which can be called “anti-nutrients” as they are difficult to digest, reduce mineral absorption and can create gut irritation in some people, hemp does not contain phytates.
A Real Powerhouse!
So, Hemp seeds are a good source of macronutrients (carbohydrates including fibre, fats and proteins).
Well, they are also a good source of micronutrients, containing many vitamins and minerals including: calcium; iron; magnesium; phosphate; potassium; zinc; some B vitamins (including folate); vitamin C; vitamin A; and vitamin E.
This makes hemp seeds a powerhouse of nutrition. It may be especially important as a good source of magnesium as many people these days are tend to be deficient and it is a mineral that is important in many biological functions. While magnesium deficiency can be linked to issues such as insulin resistance, cardiovascular disease and bone health. Supplementation shows promise in alleviating symptoms of PMS such as bloating, insomnia, water retention, weight gain and breast tenderness, along other things
So, Do I Try It?
Hemp seeds then, contain many healthful compounds, are a good source of proteins, carbohydrates ad healthy fats, do not contain a significant amount of THC and so far, at least, have not shown evidence of any potential negative side effects. It may then, be worth having a try, to see how it affects you, take it cautiously at first and write in a journal any changes you feel. If after a week of taking up to 2 Tablespoons a day has helped your feeling of wellbeing and hasn’t shown you any concerns (remember to read back over your journal to find any possible correlations), then maybe you can continue to use them in your health regime. If you find you don’t like the results, then maybe they are not right for you, remember, each person has a different biochemical make up, so the aim is to find things that work to support you and your unique body.
I Sleep, but I’m always TIRED… Maybe its my Thyroid
Depending on which source
you look at, Thyroid conditions affect women somewhere between 4 and 10 times
more than men. The Thyroid Foundation of Canada states that about 5% of the
world population is affected and the Australian Thyroid Foundation adds that 1
million Australians currently have an undiagnosed Thyroid issue (that’s 1 in 25
people!). As rates of thyroid conditions (especially hypothyroidism) tend to increase
as we age and we have an aging population, we may expect to see numbers
increase further. The Thyroid Foundation of Canada goes on to state that Thyroid
disorders are very treatable. Given that a large percentage of the affected
population is unaware of their situation, this would lead to a substantial number
of people, unnecessarily feeling fatigue, irritability, discomfort and with an inability
to be fully productive.
The Thyroid gland is an
important part of the endocrine system. Its job is to control many bodily
functions via secreting hormones – T3 (triiodothyronine)
and T4 (thyroxine). They
regulate the body’s temperature, metabolism and heart rate and in doing so affect
many areas. The Pituitary (and Hypothalamus) glands monitor and control the
amount of T3 & T4 that the Thyroid releases. Thyroid conditions create either a state of Hyperthyroidism or
Hypothyroidism, that is, too much or too little thyroid hormone production,
Thyroid disorders may
be caused by iodine deficiency; autoimmune diseases (namely Hashimoto’s
Thyroiditis and Graves’ Disease); viral and bacterial induced inflammation (thyroiditis);
congenital; malignant (cancerous) and benign tumours/nodules on the thyroid
gland, disfunction of the pituitary or Hypothalamus glands; or as a result of some
treatments (surgical removal of the thyroid gland [or part there of] & toxic
changes from radioactive iodine therapy).
tend to vary as there are many factors involved, further, as symptoms tend to
start slowly and gradually progress, it may take a while for sufferers to
realise that they are not just tired or stresses etc.
weak slow heart beat
muscular weakness and constant fatigue
sensitivity to cold
thick puffy skin and/or dry skin
pale and cold (maybe clammy) skin
voice may be croaky and hoarse
slowed mental processes and poor memory
weight gain/difficulty losing weight
goitre (increased size of the thyroid)
rapid, forceful heartbeat
muscular weakness (due to muscle loss)
weight loss (due to muscle and fat loss) in spite of
restlessness/irritability, nervousness/anxiety and
Generally is treated
by medicating with T4 thyroid hormones (and sometime T3 also). This is a life-long
treatment and requires frequent blood test monitoring.
Hashimoto’s is an
autoimmune condition creating a low level of Thyroid hormones and is the most
common cause of Hypothyroidism. As with all autoimmune diseases, the immune
system is over-active and is associated with inflammation. A diet and lifestyle
that reduces inflammation and supports the immune system to balance, may be of
benefit in combination with medication and monitoring. It is also worth noting
that generally only T4 hormone medication is given, but some people respond
better with a combination of T3 & T4 hormone medications. Further, some
people find that animal derived Thyroid hormones are more effective for them
than the synthetic medications. So be aware that there are a few options out
there and if your symptoms are not responding as expected, some experimentation
with the support and guidance of your GP is possible.
Lifestyle changes that
may assist in the management of hypothyroidism include:
Reducing gluten intake
Checking MTHFR gene function and your body’s
ability to absorb and use Folic acid/folate/folinic acid effectively – and supporting
Supporting Adrenal overload and the body’s
herbs (such as Siberian Ginseng, Rhodiola and Ashwaganda)
Supporting Kidney and Liver functions and the
body’s detoxification processes
Eating an anti-inflammatory diet
dairy, red meat, processed sugar, packaged foods
omega 3, green leafy vegetables
Supporting optimal Thyroid function
(electrolytes) – using water, sea salt and honey
Graves’ Disease (a
genetic autoimmune disease) is the most common cause of Hyperthyroidism.
Nodules on the Thyroid (cancerous or benign) and Thyroiditis caused by viral or
bacterial infection can also be causes.
Treatment is based
around reducing the levels of thyroid hormone in the body. This can be done via
Thyroid blocking drugs
Destroying thyroid cells with radioactive
Surgically removing the thyroid gland (partial
treatment is required, a healthy lifestyle may generally support optimal
response to treatment, your general health and your resilience.
It is also important
to note that the treatment of Hyperthyroidism may result in a subsequent hypothyroid
state, meaning that Thyroid hormone medication may be required.
Pelvic pain and dysfunction part 3: 7 tips to nip that pain in the butt
In part 1 and part 2, we discussed the symptoms and causes of chronic pain and the basics of an effective treatment and management plan. Let’s discuss what you can do NOW to help improve your situation.
While effective treatment and management requires a multi-faceted approach, there are a number of lifestyle modifications that can be easily implemented to start reducing triggers, allowing the nerves more mobility and reducing the nervous system tension in order to directly impact the negative cycle and start increasing comfort now.
Tip # 1:
Minimise activities that
tend to trigger and aggravate pudendal and perineal nerve irritation such as:
riding a bicycle (especially for long periods)
jumping (for example, on a trampoline)
lifting weights (anything over 5 kg is too much)
anything that causes intense pain (if 0 is no
pain and 10 is the worst pain imaginable, do not go over a pain scale of 7/10).
Tip # 2:
For any activity where
you know pain comes on after a certain period of time (for example sitting for
more than 5 minutes):
Ensure that you set an alarm and only sit for 4
minutes at any one time.
When the alarm goes off – get up!
go to the toilet
or get a drink or stretch before continuing to sit
sitting again, ensure the alarm is set for another 4 minutes.
Tip # 3:
Ensure you have good
posture in any activities you perform for a prolonged time (more than a few
minutes). Get ergonomic advice if required.
ensure that your knees sit at the same level or
slightly lower than your hip joints.
allow your pelvis to rotate forward slightly, keeping
a slight extension in your lower back – this happens naturally when your knees
are lower than your hips, helping to keep the natural spinal curves.
ensures your back is “straight” with your head sitting directly over your
also helps your shoulders to sit in a good position, not rounded forward or
held up high towards your ears.
Make sure that you don’t lean on your elbows or
put too much pressure on your wrists (or you will get elbow or wrist strain injuries)
(it also pushes your shoulders up and tends to make you lean to one side).
ensure that your feet are flat on the floor
(use a floor stool if required for comfort)
ensure the seat is cushioned a little
(especially if you have pudendal nerve pain) – you can use a doughnut ring if
pain is more severe.
Tip # 4:
Lie with your legs up
the wall for 5-10 minutes in the evenings
lie on your back, on the floor with your
shoulders relaxed and rotated backwards
get your bottom as close to the wall as
possible. Adding a cushion underneath your bottom to raise the angle of your pelvis.
place your legs up the wall and relax (you could
use a meditation or relaxation app at the same time)
only stay for 5 minutes initially, but if it
gets painful, stop. Aim to get to 10 minutes per night.
allows pain relief in the pelvic area – for
vaginal issues, haemorrhoids, pudendal nerve pain, period pain and also assists
with reducing pressure associated with incontinence issues
increases blood return to heart, therefore
helps with venous return in general and varicose veins/haemorrhoids etc
allows the spine to relax and lengthen after a
day of compression forces from standing and sitting.
Tip # 5:
Avoid straining on the
To avoid constipation, it’s important to keep
hydrated, eat healthy fruit and vegetable fibre, exercise regularly and use a natural
laxative if necessary (avoid stimulant laxatives).
Don’t sit for extended periods as this
stretches the ligaments and increases the pressure in the wrong spots
increasing likelihood of pain around the buttock (inferior cluneal nerve) or
haemorrhoids. If it’s not coming, stop and go for a little walk and come back
when you feel more ready.
Aim to sit correctly on the toilet (not squat
over it) as this tends to constrict rather than relax the area, increasing
downward pressure and reducing ease of toileting.
Tip # 6:
Perform a relaxation
and strengthening program for the pelvic floor muscles daily.
massaging the perineum to help relax the pelvic floor muscles, relax the
nervous system and improve circulation in the area
bathroom or a private area, use a small amount of unscented, natural oil
(coconut, olive or jojoba are best)
area right in the middle – between your anus and your vagina in women or base
of the penis in men
fingers with the oil and gently rub that central area in a clockwise motion for
gently rub in a counter clockwise motion for another 20 rotations.
Use a simplified Kegel-reverse
Kegel pelvic floor exercise to help your pelvic floor re-learn to strengthen
its contraction as well as relax when contraction is not needed (many issues
are due to an over-tense pelvic floor).
stand with good posture, feeling your head being pulled up in the centre, your
shoulders relaxed and back a little, your chest “out”, your natural back curves
present and not accentuated and equal pressure either through both sit bones or
through the front and back of both feet.
breathe in, allow your pelvic floor to relax – feeling that centre point
(located in the previous exercise) drop, and breath in for a count of 4-5.
breathe out, allow your pelvic floor to gently contract and pull together –
feeling that centre point gently squeeze together and up towards your pelvic
organs and breathe out holding that squeeze for a count of 6-7.
Tip # 7:
activities. Some people find that sex is painful or that afterwards, symptoms
seem to worsen.
Always use a gentle lubricant (that works for
you – jojoba oil is great)
Using a relaxation technique may be of benefit
Play around with positions to find what is most
comfortable for you.
If you would like to chat about your situation, drop
us an email, call, or book an appointment with Alexis.
In part 1, we shared some of the causes and symptoms of pelvic dysfunction. In part 2, we discuss chronic pain (as compared to an acute condition) and why chronic pain can be so complicated to deal with effectively. It’s important to understand what’s going on in your body first, so that you can work out the steps you need to take in order to help heal yourself. It also helps you feel more confident in your approach and in the fact that improvement CAN happen, as well as give you motivation to keep going (healing has good and bad days and times when it feels like nothing is changing, then suddenly, but only after consistent action, things improve and you suddenly realise, the pain you “always” had is no longer there).
Pelvic dysfunction is a complicated subject, because:
There are so
many variations of pelvic dysfunctions and symptoms.
multiple possible causes and a large number of associated factors and triggers.
taboo subject so most people don’t want to talk about it.
don’t generally ask their GP or health practitioner for help for the above
reason and don’t realise that there is anything that can be done to help.
don’t talk to their physical/manual therapists (such as their Osteopath,
Chiropractor or Physiotherapist) as they don’t expect that lifestyle factors
and muscle imbalances can be an easily treated part of the solution.
Because of these above
issues, it often becomes a chronic pain condition. But what exactly is a chronic
The definition of chronic
pain is any pain that extends beyond the expected healing time for an injury.
Generally, it’s accepted that most tissues have healed by 12 weeks. So, any
pain that has continued for longer than 3 months is chronic pain. Conversely,
acute pain is any pain condition that has resulted from a direct injury and is
still within its expected tissue healing time (thus any pain less than 3 months
The brain is a pain
modulating unit. That means that any pain stimulus, via nerves, alerts the
brain to a potential issue and the brain then uses all the information it can
gather before deciding if there is a problem or a potential problem and how
dangerous it is. The intensity of the pain we feel is based on the brain’s
interpretation of the level of injury or danger at hand. The information the
brain uses to decide is vast and includes things like past experience, imminent
danger in our surroundings (such as a car coming straight for you) and our fear
Because of this, the
brain is able to turn up or down the volume of pain you feel based on its need
to keep you safe. Generally, the more threat there is to further harm, the
louder the pain signals one feels. Yet, because the brain’s job is to keep us
safe, it can turn down the level of pain to allow necessary action, hence the
“apparent paradox” in stories you may have heard when for example a person has
badly broken their leg, yet managed to walk many kilometres to get to help or
run from an explosion etc.
However, when pain
continues for extended periods, the wiring in the brain for that location
begins to change. Just as a dirt path used over and over again gets deeper, so
does the neural pathway. This means that the brain becomes hyper aware of that
area of the body and is over sensitive to any nerve input that comes from that
location, alerting us to potential injury, via pain, even if there is no risk.
Can you remember a
time when you got a cut on your finger and it became inflamed? That area may
have begun to feel painful even at the slightest touch such as the gentle
swiping of fabric across it? In fact, even the adjacent finger sometimes feels
painful, for no apparent reason. This is an example of sensitisation.
This is further
intensified by our interpretation of the situation, such as how bad the injury
is, our belief that any movement that causes pain is in fact worsening the
injury and slowing or preventing healing, the level to which our injury has
been affecting our daily life and functioning, and our fear that this situation
will never end and might only get worse.
As you can see, the
brain collects information from many places and can be influenced by many
factors including our individual interpretation of what is happening to us.
Thus, we feel increased pain when
our general levels of stress are high
we avoid all activities that hurt (including
ones that help heal) because we believe they are damaging us
we fear having pain in general – because
that there is something wrong and we are making it worse
understand the biology of our situation
that we’ll never improve and we catastrophise the worst about what that might
mean for our future
afraid that there is something seriously wrong with us.
These factors make
treating chronic pain more difficult because in fact the tissues, while they
may not be functioning correctly are not “damaged” anymore, so one cannot just
deal with the “damaged” tissues nor just the musculoskeletal imbalances that
are perpetuating the functional symptoms (such as reduced strength or
management and treatment must therefore deal with as many of the above-mentioned
types of psychological aspects as well as the physical factors. This requires
education (about pain and the specific process happening in one’s own body),
lifestyle modification, minimising triggers, reducing stress, increasing neural
relaxation, education and techniques for learning to deal with always having
pain (in some cases), rehabilitation exercises and more. Further, all of these
components are unique to the individual, so body awareness, support and
guidance, and some trial and error are required to build the correct plan of
action. Given this complicated and individual nature of chronic pain, I hope
the importance of a multi-factorial approach, starting with education and body
awareness, is clear.
Once we understand the
injury we have, the biology of pain and what is happening inside us, and which
activities, if any, to avoid, our fear is reduced. We can also be confident in
a stretching and strengthening program and doing activities that cause pain as
we understand the difference between hurt and harm. This gives us control,
piece of mind and discipline to continue the healing activities required to
balance the tissues in the area and re-wire the brain to reduce its pain alert
system. Further, we can understand the reason behind any lifestyle, habitual
activity and postural modifications as well as stress reduction techniques
required, making compliance easier.
Ok, so it’s
complicated, where do I go for help?
A practitioner who has some specific knowledge
about pelvic pain and dysfunction is important (potentially an Osteopath,
Chiropractor, Physiotherapist or even Acupuncturist – but you need to ask). A
good practitioner can:
help you deal with the musculoskeletal
imbalances and give you exercises
discuss and explain chronic pain with you and
how you can use techniques and exercises to help re-wire your brain
assist with neuro-feedback, to ensure that you
are using your pelvic floor correctly and give you both pelvic floor
strengthening AND relaxation exercises
give advice on correct toileting techniques and
support and training for lifestyle interventions to treat different types of
incontinence issues (urge and stress)
assist with medicated creams, medications and
referral to surgical (laser etc) interventions IF and only if necessary (generally
a GP or gynaecologist – but you need to ask specifically, and I would recommend
seeing a specialist gynaecologist for this type of thing as with a practitioner
at Sydney’s WHRIA clinic who are researchers and leaders in this field and have
minimal invasive and best results-based interventions).
If you would like to chat about your situation, drop
us an email, call, or book an appointment with Alexis.
Stay tuned for part 3
where we share 7 simple tips to improve your situation NOW.
Pelvic pain and dysfunction part 1: Shhh we can’t talk about that!
Do you suffer from:
incontinence (urinary or bowel)
urinary frequency; urgency
bowel or bladder irritation (with
or without pain; can feel like a full sensation)
pain (electric shock like,
shooting, aching, itching or a raw feeling) of your clitoris, vagina, labia (or
penis, scrotum), urethra or perineum (space between your vagina [or scrotum]
and your anus)
Pain around your sit bone(s) when
you sit (especially for long periods)
Pain during sex (or afterwards)
Pain in your buttocks that may
often or sometimes travel down your leg and foot (can be one sided or affect
Did you know that help is available?
In this three-part series, you’ll
learn about the key symptoms and causes of pelvic dysfunction, pain and
incontinence. We’ll touch on chronic pain and discuss the basis of an effective
management and treatment program. We’ll also reveal 7 simple actions to help
you take control of your health and improve your individual symptoms of pelvic
pain and dysfunction.
This is a difficult and sensitive
subject and often not discussed due to its private nature.
It’s important to realise that in
many cases there is a lot that can be done to help – there is no need to suffer
Symptoms can be wide-ranging, and
diagnosis can’t be confirmed with just one test. Instead it requires a look
into your personal symptoms and a physical assessment of your pelvic structures
to identify imbalances of the joints, ligaments and muscles (tightness,
weakness etc) and locations where nerves can become irritated and “trapped”.
Can include (but are not limited
pain in the buttocks around where you sit
(sometimes in the legs and feet too)
sharp, electric type shooting pain around or even
within the vagina in women and scrotum (or even shaft of the penis) in men
pain during (or after) sex
bladder or bowel
Pain that can refer or radiate to include part
of, or even the length of the leg (generally down the outside) and even go
down into the bottom of the foot.
There is no one cause, and
generally multiple factors are involved
Pudendal nerve entrapment –
long periods of cycling
excessive physical exercise
straining (from heavy lifting or
straining on the toilet)
previous pelvic or perineal
Musculoskeletal imbalances –
long periods of cycling
excessive physical exercise
straining (from heavy lifting or
straining on the toilet)
previous pelvic or perineal
Neuropathic (nerve related) pain
Trauma – including from
gynaecological and/or colorectal surgery or issues (eg internal
abdominal adhesions or uterine fibroids and the like)
Infection (including skin
If you’re suffering
from any of the above issues, or some sort of dysfunction of the pelvic/lower
abdominal area or genital region, it’s likely that an in-depth history and
physical assessment plus a multi-pronged treatment approach can be of great
assistance. So, talk to a primary health practitioner (pelvic physiotherapist,
GP or Osteopath for example) and find out more. If the advice you receive does
not seem logical or if you don’t receive the options that help you gain back
control, we suggest you try another practitioner, until you get the support you
And remember, working
with a combination of such practitioners to get an integrated and diverse
treatment and home care plan is your best chance of success.
If you would like to
chat about your situation, drop us an email, call, or book an appointment with
Stay tuned for part
2, where we discuss chronic pain and its complicated nature as well as the
basic idea behind effective treatment and management of pelvic pain and