Reform & Renew Osteopathy

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Quality over Quantity

I wanted to share with you a podcast I listened to recently on Marathon Talk, which was an interview with Stephanie Davis who recently ran 2.27 for a marathon.

When training for a marathon, we can get consumed by having to do the miles, with many of them being ‘junk miles’. Some people, don’t believe or realise  the benefits of cross-training (bike, swimming and Cross-trainer). It can help you of load your tired legs, prevent injuries and strengthen muscles that aren’t used or over-used when running. 

Going into London 2018 and Amsterdam 2019 a lot of my training was done on a Cross-Trainer due to injuries! For me, it played a big role in the times I was able to run. Numerous clients ahem asked, how I didn’t get bored. The simple answer is I did but its amazing how many seasons of programmes on Netflix you can get through when cross-training!

For some clients, they see cross-training for when they are injured because if they aren’t running the miles then it doesn’t count or its not beneficial. Unless you are using maximum resistance on your chosen piece of cross-training equipment, you usually aren’t using as much effort as you would be running unless you train by heart rate. So this can help build up your aerobic endurance, which is vital when running for a marathon!

I hope you enjoy listening to the podcast and as always, any feedback would be greatly appreciated.

The Role of Vitamin D in your diet

I was in the gym recently and I may have listening to a group of ladies discussing being diagnosed with a Vitamin D deficiency. Most of us are deficient in certain minerals and vitamins as we can’t consume enough in our diet or through our daily lifestyle activities. 

Vitamin D is also know as the ‘Sunshine Vitamin’ as it’s produced by the skin, in reaction to being exposed to it.

This vitamin plays an important role in maintaining your immune system, depression and most importantly it facilitates and regulates the absorption of calcium and phosphorus in the body.

What is vitamin D deficiency

Vitamin D deficiency has been variably defined by The IOM has defined a serum 25(OH)D concentration of 30nmol/L or less. However the general medical consensus is, a true definition and sufficiency is lacking. If you are referred for a blood test by a health care professional then your results and treatment are determined by the NICE guidelines. https://cks.nice.org.uk/vitamin-d-deficiency-in-adults-treatment-and-prevention#!scenario

Prevalence 

Vitamin D deficiency (serum 25-hydroxyvitamin D (25 (OH) D)< 50 nmol/L or 20 ng/mL) is common in Europe and the Middle East. It occurs in< 20% of the population in Northern Europe, in 30–60% in Western, Southern and Eastern Europe and up to 80% in Middle East countries. In particular, elderly subjects are considered as a high-risk group due to low sun exposure and a decline in subcutaneous vitamin D synthesis capacity. There have been a number of studies recently looking at the ole of vitamin D deficiency in those who are obese and those who are in their adolescent years. 

Signs and Symptoms of Vitamin D deficiency can include;

  • Tiredness
  • Fatigue
  • Generalised aches and pains
  • Stress Fractures

Factors that effect Vitamin D Levels

  • Lack of exposure to sunlight
  • Living in high polluted areas
  • Having darker skin
  • Diet

How can you help your Vitamin D levels?

Most importantly, get outside! If you are sat at a desk throughout the day, go for a 30 minute walk in your lunch, evening or even before work (when it’s not dark!) Consuming Vitamin D rich food in your diet is next. If you have removed calcium based foods ie, cows milk and yoghurts, make sure you substitute with soya based products that have added Vitamin D in them. I have been told that you have to consume 1 pint of Soya milk a day to get the recommenced daily intake of calcium. If you have also removed animal based products from your diet then supplementing Vitamin D may be necessary or consume plenty of Tofu!

Animal Sources of Vitamin D include;

  • Salmon
  • Sardines
  • Egg Yolks
  • Shrimp
  • Milk

Vegetable sources of Vitamin D include;

  • Mushroom
  • Orange Juice

If you have any concerns in regards to your Vitamin D, please do not hesitate to contact a health care professional. 

References

Current vitamin D status in European and Middle East countries and strategies to prevent vitamin D deficiency: a position statement of the European Calcified Tissue Society. Lips P,Cashman K D, Lamberg-Allardt C,Bischoff-Ferrari H A, Obermayer-Pietsch B Bianchi ML,Stepan J,Fuleihan, Bouillon R. Eur J Endocrinol 180, P23-54, 2019

Dietary intake and main food sources of vitamin D as a function of age, sex, vitamin D status, body composition, and income in an elderly German cohort. Alexandra JungertAndre SpinnekerAnja Nagel, and Monika Neuhäuser-Berthold. Food Nutr Res. 2014; 58: 10.3402/fnr.v58.23632.

Why visit an Osteopath

Why visit an Osteopath?

With a growing trend of people qualifying in a health care professions who have the ability to help treat injuries, I wanted to write a little blog on why visiting an osteopath could benefit you.

To become an Osteopath, we have to undertake a degree at either bachelors or masters level, with some universities offering diplomas in Naturopathy. Most courses are 4 years full time but some can be done over more years as a part time course.

In those 4 years of study, everything about the human body is covered and I mean EVERYTHING! Anatomy, physiology, biochemistry, gynaecology and obstetrics, human dissection, pharmacology, psychology and radiology are just a few subjects to name.

From the first week of term we are observing the human body in standing examinations! After the first year we are qualified in massage therapy, which I took and decided to find a job doing sports massage to help develop my knowledge whilst working alongside clients. 

From year two, clinic observation starts to allow us from year 3, to see our own clients within a clinic setting, so that means by the end of the 4 year degree, every qualified osteopath has a minimum of 2 years of clinic experience. 

AFTER QUALIFICATION

As part of our yearly registration, every osteopath has previously had to do 30 hours of CPD (Continual Professional Development) which comprised of 15 hours of learning with others and 15 hours learning by themselves. This year, the CPD structure has changed. It is now 90 hours over 3 years but it is still a minimum of 30 hours a year. There is also a structure that we have to follow which now includes; peer review, communication and consent and objective activity. This has been done to help us offer the best practice and service to our clients.

Being able to do CPD allows us to attend courses and even complete other qualifications that we are interested in. 

WHY ARE WE DIFFERENT 

Some osteopaths describe our degree as a medical degree for the first two years and then we go on to specialise. Part of our degree is medical diagnosis. We are taught all the signs and symptoms, complications and red flags that are associated with medical diagnoses. We cannot treat some conditions but it allows us to refer you to other medical professions that we deem necessary.

I commonly get asked what is the difference between an Osteopath, a physiotherapist and a chiropractor. Firstly, everything listed above is one big difference. Secondly, it’s the philosophies we are taught on how to be an Osteopath. These come from the founder of Osteopathy, A.T.Still.

The General Osteopathic Council who each registered Osteopath is regulated by describes Osteopathy as… 

osteopathy is a system of diagnosis and treatment for a wide range of medical conditions. It works with the structure and function of the body and is based on the principle that the well-being of an individual depends on the skeleton, muscles, ligaments and connective tissues functioning smoothly together.

To an osteopath, for your body to work well, its structure must also work well. So osteopaths work to restore your body to a state of balance, where possible without the use of drugs or surgery. Osteopaths use touch, physical manipulation, stretching and massage to increase the mobility of joints, to relieve muscle tension, to enhance the blood and nerve supply to tissues, and to help your body’s own healing mechanisms. They may also provide advice on posture and exercise to aid recovery, promote health and prevent symptoms recurring.

WHY VISIT REFORM AND RENEW OSTEOPATHY

I ( Abigail Fudge) qualified as an Osteopath in 2011 with a Masters Degree in Osteopathy and a Diploma in Naturopathy. Since I qualified, I have completed additional courses in Cranial Osteopathy and Dry Needling which I use in day to day practice. I have also completed a number of courses including; Taping for injuries, Low Level Laser Therapy and Nutrition.  I have 8 years of qualified osteopathic experience with an additional 2 years in university clinic and 11 years of treating clients with sports massage therapy. 

To offer the best course of treatment to each client, I tailor their examination to their needs and with their consent put together a treatment plan that will suit them best along with advice including hydrotherapy and exercise prescription. I have been known to be very honest to some clients, some may or may not like that but I do it for the patients best interest. If I advice you not to so something, it’s out of the clients best interest. The help each patient, I also use my own personal history of injuries to help each client.

At Reform and Renew Osteopath, we encourage clients to contact us if they have any questions or concerns so they can get the best possible outcome of their treatments.

A polite reminder

I don’t know if this is an apology post or a bare with me post!

Over the weekend (whilst I was away) I received an email from a client stating they need to be in real time communication with their osteopath and to cancel any future appointments. I apologised to them because quite simply I forgot to reply to them.

Yes I am an osteopath, the sole osteopath, receptionist, accountant and all other jobs at Reform and Renew Osteopathy except cleaner ( thank you mum), however most importantly I am a mother and a wife and I  also have a life outside of work. 

In the last year I have learnt my cortisol levels are through the roof, my endocrine system does not work properly, so to put it simply I am stressed and tired. Yes, running played a massive part in that and so did work as I was offering times that were convenient for clients which meant I was fitting my life in around clients. I am now finding different ways to manage my stress, which includes not being on my phone and social media as much and making time for myself in my working days. This may mean, I don’t reply as quickly or I don’t answer the phone (hopefully a receptionist from Blue Zinc will though).

I honestly try my best to offer the best service I possibly can to clients. My approach may be a bit more relaxed than other clinics but my main aim as an osteopath is to help people and try and prevent the pain/ symptoms from re occurring. 

So quite simply, if I don’t reply to you, please give me a polite reminder that I need to reply and I promise I will but I am human and forget sometimes. 

Thank you

😘

I am completely overwhelmed with all the love and support I have received after telling you all my story.

To hear that some of you can relate to my story is good to know and that I’m not doing this in my own but it is also concerning that so many struggle with mental health issues and feel that they can’t talk about them. 

If one thing comes from me sharing my story, is that I want you to know, you can talk to me. Whether it’s the comfort of my room as an osteopath, where everything is confidential or it’s over a cup of coffee and a slice of cake or a well deserved glass of prosecco. I am happy to listen and I’d needs be, share my coping mechanisms. 

There is no better therapy than talking and laughing.  

For me, I am now excited for the future. I’m looking forward to catching up with friends, going for long walks, rebuilding friendships and finding new hobbies and interests. The world is my oyster!!

Finally I would like to thank my family. You have dealt with my mood swings for so long due to me not having hormones, I can only apologise as they will get worse when my menstrual  cycle returns 🤣. On a serious note, to my family and friends, thank you for continued support, I promise that I will be a stronger and happier person with your help.

Oh also I would like to clarify, Lily you are not getting a little sister just yet!! Stop speeding rumours!!! 

World Mental Health Day 2019

10th October 2019 – World Mental Health Day. Today is the day that I admit my truth to you all. On Tuesday, I decided to write my latest blog and share it with my nearest and dearest before sharing it with you all today, so here it goes…..

I’m writing this 12 days out from Amsterdam Marathon, walking on a treadmill after completing my first interval session running in what feels like months.

This marathon build up has been from ideal… chronic injuries, 30th birthdays(best summer ever!!) , my busiest year working and being on antibiotics at the moment. I’m going in not knowing what sort of shape I am in but for once the only goal is finishing with my friends and Ben.

The reasons for me writing this post is not for sympathy but for once I’m asking for help. For so long running has been my saviour from the daily stresses but for the last 3 years, it has been my enemy. 

In June of this year I met with Renee McGregor and Niki who are promoting the #trainbrave campaign and specialise in REDs and Eating Disorders. After sending them my diet diary and training schedule and then talking through my daily life they were brutally honest with me.

I cried for about 24 hours. Why? Because they told me what I was too afraid to admit. I was over training and underfuelling and I had developed an eating disorder as I saw food as something I could control, when everything else in my life I couldn’t. I had no structure to my life. I was available to work all day every day and fitting training in when I could and then doing double days to cope with stress. They told me not to run Amsterdam due to the state I had put my body in but in agreement they produced a nutrition plan, we adapted my training and hey presto we are the present day.

Amsterdam will be my last marathon for a long time. It’s time to heal myself and find other enjoyments in life. Running will be limited and at low intensity. Food will be increased and hopefully I won’t be surviving on coffee to get me through the tiredness!!! I have already condensed my working hours, so I have some time to myself whilst Lily is in childcare. In the evenings, I have started colouring again to reduce the time I am on social media, taking away the bad influences on exercise and food. 

So why am I asking for help. Along with the eating disorder, I am also mentally struggling and will throughout the coming months. So if I look and don’t sound like myself, please just give me a hug, ask if I’m ok and from now on, I will be honest, instead of hiding from the truth. For years I have struggled with acceptance and feeling like I’m being take for granted. My job does not help but it’s a career I’ve chosen and enjoy. I’m learning slowly that some people won’t say thank you if I help them but most of all I’m learning to accept myself. I won’t be skinny, I won’t be fast but I will be healthy. 

I also ask, please do not ask what I am training for or what marathon I am doing next, because I am not. If I do an event, it is for fun or someone has asked me to run with them. I don’t know if I will find anything that will replace the sense of achievement that I get when finishing a marathon but its something I need to find. So if there is something that you will think that I will enjoy, please share it with me!

Thank you for taking the time to read this post. I hope you understand why I am asking for help and sharing my issues with you.

Confessions of a Runaholic

The Autumn season has been full of both big and local marathons. From Berlin to the Pilgrims marathon, finishing with the New York City Marathon yesterday. I have had the pleasure of helping many clients to get to the start line of their autumn races by either helping them recover from injury, or by preventing injuries with regular osteopathic treatment and sports massages. It has been a pleasure to hear about all of their accomplishments.

I have been following many elite marathon runners on instagram and reading about their build ups. Some went for the usual 16 week training programme, where as others chose only 13 weeks. I was excited to watch the New York Marathon yesterday and did so with friends, I was mostly looking forward to watching the domestic battle of the elite women marathon runners. Shalene Flannagan was going in as the defending champion and was up against the experienced African, Mary Keitany. There were some less know American athletes lining up too; Molly Huddle, Allie Kieffer and Desiree Linden.

For me Allie Kieffer has been an inspiration. She has been promoting, strong not skinny and trying to promote positive body confidence. She has admitted she has been her heaviest weight going into the New York Marathon this year and that’s even with running 115 miles a week and using nutritionists. Allie has been trying to educate why you don’t have to be ‘skinny’ to be a runner.

For any marathon runner, fuelling yourself is key, from long runs to recovery runs and even on race day. Getting the right balance of carbohydrates, fats and protein is key. For a lot of athletes they under fuel. Their calorie expenditure is greater than their intake. For some, if that continues over a long period of time, it can decrease essential bodily functions. In women, that can stop your menstrual cycle. Some would say why is that bad? If this occurs for longer than 6 months, it can be. Your oestrogen levels will decrease, which will then affect your bone health, which can result in stress fractures and the start of osteoporosis, osteopenia can occur. This issue is being described as the female athlete triad, which is an interrelationship of menstrual dysfunction, low energy availability (with or without an eating disorder), and decreased bone mineral density. The effects on the body can cause issues such as; mood swings, lack of concentration and fatigue (1).

It is so easy to compare yourself to others with what is being published on social media today. For some, it encourages the need to exercise to create the ‘perfect’ body, or push yourself to run a PB because thats what everyone else is doing. But are you doing what is best for you and your health?

With having completed a marathon less than a year after giving birth to Lily, I put my body under a lot of stress and then being encouraged by how well I was running, I continued the marathon mileage and then decided to move house, which caused a lot of stress on my body. For me this has resulted in absent periods. No matter how much I eat, whether I eat excessively or track my calories, I cannot get my periods to return. I have been to the doctors, twice this year demanding blood tests, their response; ‘ We aren’t concerned.’ This is infuriating!!!! I will happily admit, I have over exercised and under eaten to get the ‘bikini body’ and ‘perfect wedding dress body’. Looking back, yes that was the wrong thing to do and this is another reason why I have come off certain social media platforms and have unfollowed things on Instagram, which would encourage this behaviour again.

I have decided to decrease my mileage, I have changed my approach to quality over quantity, have a complete rest day, enjoy life, take twice daily calcium tablets and multi-vitamins and not do a marathon. So yes, for those that keep asking if I am doing a marathon, next year. This is why! Although watching the marathon yesterday was inspirational and I know I am going to be jealous as clients and friends start the build up for their spring marathon, I am concentrating on myself and my health! 

For those who are concerned, either about themselves or a fellow athlete, do not be afraid to talk to them. This is something that needs to be talked about in female athletes. In searching for some answers on how I can help myself, I have found great app, called FitRwoman. It allows you to track your cycle (which doesn’t help me at the moment) and guides you on what training you should do in what phase of your cycle. 

  1. Ackerman K, Nazem TG. The Female Athlete Triad. Sports Health, 2012, Jul: 4(4): 302-311.

World Mental Health Awareness Day 2018

I am not afraid to admit I have and still do suffer with Mental Health Issues. From my mid teens I have suffered from Depression. I have had periods where I have been very low , although they are now rare, each day I battle the demons as to whether I am able to do things and if I am doing a good enough job being a mum, wife and Osteopath.

I know the triggers and people always ask why do I run so much. Simply because it helps me. It helps me to release any frustration. It helps set me up for the day, knowing I have completed some form of exercise, gives me a great feeling of accomplishment. The goals I set myself with running, help to keep me on track. When I was injured going into the London Marathon this year, having the target of finishing the marathon, whether it was just getting round or running the best I could on that day, helped me get through the 6 weeks of injury.

Exercise has so many benefits to your mental health, including releasing endorphins, improving your mood and memory along with muscle function and strength. If you feel like your having a bad day at lunch time, why not try a walk without your phone in your lunch break, or in the evenings find a pilates or yoga class? 

As an Osteopath, I see how pain affects peoples mental health and daily activities. There are times when clients get emotional and I encourage them to let out their feelings as it will help, and it will allow me to teach them how to deal with the pain they are experiencing and how we can prevent it from happening again in the future. Whether this is through exercise rehabilitation or referring to another practitioner, you do not have to suffer in pain. 

To those who feel they have to suffer alone and that they can’t talk to anyone, please do. You are not alone and we are here to listen. Whether its over a up of tea, a few cocktails or even in the treatment room, do not suffer in silence. Express your feelings. Talk to someone. Mental Health disorders are not a stigma, they are something not to be fought alone.

Inspiration from a blog ‘ Does it count if it’s not on Strava?’

I recently read a blog called ‘Does it count if it’s not on Strava’? This made me have a big think about my running as at the time I was struggling mentally and physically as it was after I returned from California. I was constantly comparing myself to others and questioning why I wasn’t faster times than I was.

With the encouragement of a good friend I came off Facebook and Twitter earlier this year so after a little nudge, strava was disconnected from my Garmin and I logged out.

I knew I had a race coming up which was my focus for the season, which was last week. I sat down with my coach, the legend that is Coach Fudge and we sorted my training schedule for the 6 weeks leading into the race, Ron Neil, helped me get my head back in the game and gave me some well needed advice on my pacing 😂. There were certain runs, I left my Garmin at home and just ran. I didn’t worry about pace or times, I just ran and started enjoying the process again. It was nice getting home and not seeing a Strava segment or seeing what fellow runners had done that day and getting competitive! I went back to old school pen and paper to record my sessions so I wasn’t constantly analysing what I had done.

For the past 3 years, strength and conditioning sessions have been a big part of my training and with the help of Dave Cole and Mike Bowery we focussed on getting some speed and power in my hamstrings and upper body. I owe you both a big thank you for pushing me harder than ever and helping me prove to myself I could complete whatever challenge was given to me.

Throughout this last year, there is one person who has inspired me. He nearly gave up this year but he fought back through injury and ran two sub 18 minutes 5kms in August. I knew if he could find the speed and inner strength, I could.

So what was the end result and was it all worth it…. a 25 second PB for 5km….. 19.11. So yes it was totally worth it. Hearing my little girl saying well done along with the congratulations from Ben made it all with it.

The last 6 weeks have been a big learning curve and I’ve learnt a lot about myself.
I don’t need social media
I don’t need Strava
Have faith in the process
Surround yourself with people who motivate, encourage and most of all support you. Team Coach Fudge are some of the best and most supportive friends I could ask for.

So whats the next goal? I will keep that to myself!!

From this blog, I hope I can inspire some of you, not to be so competitive over social media and when you are struggling, just disconnect and concentrate on yourself!

Flip Flops…..

Why Flip Flops aren’t the best footwear to wear

With warmer temperatures both here and abroad, it is more comfortable and convenient to slip on a pair of flip flops, but people do not realise why they are not the best footwear to wear.

Studies have shown through analysing participants gait, that whilst wearing flip flops, changes occur to your gait cycle. Even when walking, we are dependant on a good big toe push off. However when wearing flip flops, all our toes become scrunched to allow the shoe to stay on whilst the heel comes off the floor. This causes the plantar fascia to become over stretched and if repeatedly done over a period of time, not only does this change your gait cycle, it also affects your foot mechanisms and every other joint in your lower limb, pelvis and lower back.

A lack of arch support in flip flops is also a contributing factor to an altered gait. This can put excessive and unnecessary stress on tendons, ligaments and muscles.

Common injuries that occur from wearing flip flops include;

  • Plantar Fasciitis
  • Achillies tendionpathy
  • Bunions
  • Ankle sprains
  • Lower back pain

Other complications that canoccur from wearing flip flops over a long period of time, relate to your foot health. Fungal infections and dry, cracked heels and calluses commonly occur.

So what is the best advice in regards to wearing flip flops….

Only wear them for short periods of time. If you can find some with additional straps on them to try to add support to your feet and ankles. Make sure you stretch your calf and achillies afterwards to compensate for the strain that they have been put through.

From personal experience, walking the Las Vegas strip  numerous times in 2013 in flip flops, was a bad idea. It resulted in a long period of Achillies tendinopathy. Did I learn… No….until this year. I only wore flip flops to and from and around the pool on my recent holiday and then threw them away so I did not come home with them. It did aggravate my achillies slightly but after plenty of stretching and accentric loading of the achillies and calf muscles, I am now able to walk pain from in the mornings!