Osteopath, Chiropractor or Physio?

What’s the difference between an Osteopath, a Physiotherapist and a Chiropractor

This is a question we get asked all the time and one, which can produce widely different responses depending on who you ask, the nature of your problem and your background.

Firstly let’s look at the similarities between the professions which include;

We all treat musculoskeletal pain conditions;

We all have university based education.

We all have protected titles, meaning that someone cannot call themselves an Osteopath, a Chiropractor or a Physiotherapist, unless they have completed the relevant accredited course. All the courses are validated to ensure the highest safety standards. Training doesn’t just then end there. We are required to complete a specific number of ongoing continual professional development hours to remain on

the register.

Osteopaths will use manual, hands on techniques to restore structural alignment with the aim to improve pain and function. They commonly do this with more gentle techniques than manipulation, but can manipulate. Osteopaths look at the interaction between your muscular,

skeletal and nervous systems to see what could be contributing to your issue. Then they look at what aspects of your sporting, work or recreational life may also be contributing to your problem. Our practice treats many patients with back pain, shoulder issues and neck pain. The Osteopathic philosophy maintains that it movement exists and is balanced then good health will follow. This absence of movement is assessed through manual palpation

Most Chiropractors have a particular focus of treating problems using manipulation of the joints (adjustments), either in the spine or the limbs. Manipulation is a quick manual technique that aims to improve the range of motion. Osteopaths will use manipulation, and some, but not all Physiotherapists are trained in joint manipulation. Chiropractors generally view manipulation as a first option with additional massage and exercises to aid recovery.

Physiotherapy is very popular within the NHS and is frequently referred to by GPs and hospital doctors and surgeons. 'Physio' is a health care profession which emphasises the use of physical approaches in the prevention and treatment of disease and disability. It is a systematic method of assessing musculoskeletal disorders including pain and loss of function. Some, but not all physiotherapists are trained in joint manipulation. Most will include exercises to aid injury recovery.

Top tips for pregnacy

Top tips for pregnacy

Pregnancy can be simultaneously the most delightful experience, but also a time of discomfort and uncertainty in a woman’s life. Studies have shown 50-80% of women report experiencing significant back problems during pregnancy. Unfortunately some back issues can have long-term consequences of pregnancy-related pelvic-girdle and back pain – in some cases, affecting women for many years after giving birth.

Whilst everyone knows that a woman’s body changes dramatically during pregnancy, all in order to accommodate a growing foetus, less obvious however, are the effects of hormonal ligament softening to accommodate the new arrival. Teeny-tiny feet jammed in between your ribs can be very uncomfortable, not to mention postural changes and

stresses due to weight gain.

Osteopathic treatment during pregnancy aims to assist the body in adapting to pregnancy related changes, using safe gentle and efficient techniques. Treatment focused on your rib cage to accommodate for the growing baby as the ribs flare and optimal pelvic and lower back mechanics. These areas sometimes struggle as your body changes its natural shape to support you and your baby throughout all stages of pregnancy.

Osteopathic care doesn’t end once baby has arrived. Both mums and dads often need help to deal with the new aches and pains that come with a baby. With Mums treatment can help to restore optimal pelvic mechanics post-birth, pain from breastfeeding posture.

Both parents can struggle with lifting and holding baby and manoeuvring car seats and push chairs in and out of the car.

Whatever your situation we might be able to help.

Good posture not pain

Not comfortable...could it be due to bad posture?

Everyone has a natural posture, a way that they sit or stand. This is created by what we do and how we are made. Some backs are naturally more curved than others as you can see from the three classic standing postures below. In reality we are usually somewhere in between. If you suffer from back problems, slumping at your desk or on the sofa is likely to be making things much worse.

So here is our guide to potential problems with each classic posture.

The sway back – this is almost the opposite of slouching forwards and sometimes it’s called the lazy posture. It’s almost leaning backwards, with the shoulders behind the hips and the chin poking forwards. This is caused by weak abdominals, stiff spine and weak back ligaments. The back muscles and muscles at the back of your legs (hamstrings) end up over working and becoming tight.

To overcome this problem, the best course of action would be a consultation with an osteopath to establish a treatment plan to get you moving correctly and an exercise management plan to keep you active.

The increased midback curve – A curve in your midback is normal. However, anything over 45 degrees is considered excessive. For some people the curve is genetic. For others, the vertebra might be an abnormal shape, age or poor posture. Poor posture is the most common cause of midback issues. It occurs as a result of slouching and a weakening of the muscles and ligaments of the back.

This is not a great thing to have if you are an office worker. This problem usually responds very well to a course of osteopathy and exercises to keep you mobile.

The increased lower back curve - This is sometimes genetic, but certain conditions can contribute to the condition. The most common ones are obesity, osteoporosis, and spondylolisthesis to name but a few. The trick here is to avoid sleeping on your front as it will increase the lower back curve and strain on your lower back. Pregnancy and excess fat around the abdomen causes the pelvis to tilt which makes the back painful. This problem usually responds very well to a course of osteopathy and exercises to strengthen your core.

The reduced lower back curve – The flat back. This is classically seen in patients with degenerative conditions such as degenerative disc disease and ankylosing spondylitis. It occurs as a result of any condition which causes the front part of the lower spine to shorten. The discs reduce in height (spine shock absorbers) which happens naturally with age and can cause nerves to be pinched. The best course of  action will be dependent on the degree of wear and tear. Usually osteopathy and exercise can help, but sometimes other interventions are necessary. Your osteopath will be able to advise you.

General advice.

Sitting – The important thing here is to get a desk assessment done at your place of work and make sure your prescription for your eyes is correct. Take regular breaks from your work. Do your exercises as and how your osteopathy recommends.

Standing – For people who have a bad back and hate standing in a queue or crowd watching an event, standing can be a nightmare. The best advice I give out is use stick on heat patches and try to move round as much as possible, even if that means just gently swaying.

Lying down – Take your time investing in the right mattress. As a general rule of thumb, memory foam mattresses are good for people with back and hip issues. A pillow in between the knees can work wonders if you like sleeping on your side. A pillow under the knees can help reduce pain for those who prefer to sleep on their back. Try not to sleep on your front because it’s bad for your back and your neck. If you have to sleep this way put a pillow under your pelvis to reduce the lower back strain.

Pillows – Try to keep your head in a neutral position.

The most important, cheapest and most overlooked tip of all… do your exercises. More stretches

and exercise = less trips to the Osteopath.

How to pick a car that won't cause back pain

How to pick a car that’s right for your back.

People spend hours researching everything from horse power to the number of cup holders to get the perfect car. However, despite this careful selection process many people forget the two most important things.

1 – What is the purpose of the car? I changed my car because it wasn’t big enough for the kids and all the stuff that comes with small children. Front and rear doors are essential, as lifting even a small baby in and out puts a massive strain on your back as you lift and twist.

If you’re looking to put heavy stuff in the boot try to pick something without a lip. The most common problem is lifting heavy shopping bags in and out, or gardening stuff such as compost. 

If you havesomething heavy try to put it on the back seat, preferably on something where you can slide it out.

So push and pull rather than lift.

2 – Sport cars are the stiletto heel of the car world. Think twice about buying one if you have a bad back.

Sports cars look amazing, however they may not always be the most practical of cars. Getting in and out of a low car can be a nightmare and the hard suspension might not be your best friend. There is no point investing in something that your body hates. Leg room can also be an issue. For people with

hip and knee problems being squashed up is a real no go. As a point of interest, leather seats don’t work out well for passengers who suffer from motion sickness. Fabric seats are much better. Also automatic cars are kinder for motion sensitive people as it smooths out enthusiastic gear changes.

Things that bad backs like about cars -

Heated seats – these are a real plus point in any car as most muscle issues respond well to heat.

Adjustable seats – when going on any long journey I find it useful to move my seat around so that you’re not stuck in any one position for too long.

A higher driving position – within reason a higher seat is easier to get in and out of than a lower seat.

Doors that open wide enough to get in and out of. 5 doors are always better than 3. The bigger the door, the more space you need to open them. My 3 door car was a nightmare in small parking spaces.

Cruise control – Less foot and leg strain if you are covering large distances

Automatic gears – Less foot and leg strain if you are pottering around town.

The most important thing of all.

If you have any doubt about your choice, why not hire one for the weekend? A quick test drive will

not tell you enough, but a long weekend could save you a small fortune.

Top tips for runners

3 simple steps to running without pain.

So many people start with the very best intentions of running a 5 k only to end up broken or disappointed with the lack of progress. Oh and by the way … it’s hard. No one seems to mention just how much of a struggle it is. There’s finding the time in the first place, getting out of breath, and those little injuries that just don’t seem to go away.

During my 16 years as an osteopath I have had the privilege to work with many weekend warriors, triathletes, and runners. I have noticed a few common problems. Here’s how we can avoid them…

Boom and bust:

Tom Goom is an experienced running physio. He talks about this common problem. It’s the issue of wanting and believing you can push yourself that little bit more (that’s the boom) followed by the muscle soreness or worse, resulting in injury leading to limitation of running (bust!).

Do not increase your running time or distance by more than 10%.

Do not do a long distance run one day followed by a speed session the following day.


There is lots of advice on this in the media. Most of it is conflicting. So in my experience running should consist of the following:

1. Warm up

2. Stretches

3. Running

4. Cool down

5. Stretches

The one thing most professionals seem to agree on is that you do need to stretch. I advise my runners to think about complementing their running with pilates to keep you flexible, and weight training that involves using a balance plate, as this is thought to reduce the risk of injury.

Skiing without pain

How to improve your skiing without spending a fortune on lessons in three simple steps.

People spend ages flicking through the skiing magazines looking at all the options for their holiday, with the idea of fluffy white snow, cosy log cabins and hot chocolate in mind. I started out in my 20’s skiing in Courchevel and have loved the snow ever since - and I’m almost 40.

During the last 20 years I have noticed that my skiing techniques have somewhat plateaued and that various friends have picked up injuries they just couldn’t seem to shift. The problem seems to be that we are all that bit older, that bit busier and carrying a few niggles. So after a bit of investigation, here are a few shocking facts I found out.

Over 50% of leisure skiers don’t correctly do up their boots. This puts people at risk from injury and also means you don’t ski to the best of your abilities.

Despite being one of the first things you learn, 60 % of leisure skiers ski with their weight over their heels. This increases the risk of knee injuries and affects your skiing technique.

Leg rotation is a major limiting problem for 70% of leisure skiers. This affects your hips and upper body and ability to make the turn. 

80% of skiers have a poor leg stance so that the knees are closer together than the feet. This means

that performance is affected and increases the risk of knee injuries.

90% of skiers have a weaker turning direction.

So with all these facts in mind, I am preparing well in advance with my stretching to have the best season and most fun on the snow. This is how I’m going to prepare.

1. Building up my inner leg muscles – this is important to control my stance, my A frame as I make my turns. To do this you need to slowly pull your feet together. The idea is to make the movement last 10 seconds or more. The exercise helps build up the adductor and glute muscles (inner thigh and bum muscles).

2. Ankle flexibility can be tested with a simple slide test. Rest against a wall with your back, keep your heels on the floor and slide slowly down. When you feel your heel rise off the ground you know you are at your limit. Ideally you want around 20 cm of drop. If you have anything less than this stretch your calf muscles. Currently mine is 15 – so I could do better!

To cure this I am doing this stretch:

3. Leg range of movement. I am one of the 70% who have a limited range of movement. For this I am going to stretch out my hip rotators and do hip circles to get things moving.