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The musings of an Osteopath

Biomechanics

2/8/2021

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Picture
When you bend a joint it undergoes what osteopaths refer to as a 'prime movement'

This is initiated by the agonist muscle or groups of muscles and decelerated or stabilised by the antagonist group(s).

In order this occurs without injury, the joint(s) have to move freely but with enough stability and coordination to avoid excessive glide or shear.

This relies on appropriate muscle strength and coordination and correct nerve firing and balanced joint range of motion.

Most people would be unable to tell if they had a large joint like a hip restricted, let alone one within the spine.

Here's where the plot thickens..

1. Most people don't know they have in imbalance/restriction in the spine as it won't initially cause symptoms

2. Many times we can make inappropriate movements and cause micro-trauma. Tears/damage so small that in isolation cause no issues. Until that is, they build up, repeatedly at the same location- "all of a sudden my back went" is usually the opening gambit we hear in consult.

These are two example of accessory motion, a motion that occurs incidentally and to a degree is absolutely normal.

1. There is an imbalance with the supporting agonist/antagonist muscles- take a forward bend/ flexion hinge in the spine by way of example. As you bend forwards the joints compress slightly at the front and open at the back. In certain spinal joints in the low back, as you reach a certain degree of forward flexing, like a skier facing down a slope, the vertebra will want to glide or shear forwards. If this accompanying (accessory motion) occurs to the right degree, it helps give amazing flexibility to the spine if it is controlled throughout the motion and decelerated appropriately, no problems arise.

2. Restricted joints place more pressure on other joints creating hypermobility. This increase over normal range, particularly involving accessory motion makes the spine much more vulnerable. Like a screw in a loose hole, it can become ever more likely to 'cross thread' and catch at the wrong angle. In the case of a back, this catch can pinch part of the joint capsule or nerve resulting in sudden pain and protective muscle spasm around the joint.

3. They also must receive adequate neural input throughout the action. After injury, joints lose something called proprioception. This is essentially balance feedback and can be relearnt.

It is one of the prime goals of spinal rehabilitation.

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Why is an Osteopath like a car mechanic?

10/4/2016

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A few months after I bought my first car, a light flashed up on the dashboard. I took it in to see Paul at the local garage. He listened to my slightly vague description of the symbol, nodded, felt around the callipers and told me that the brake pads were near their limit and ideally needed changing.

The car seemed to be braking fine. But this was a new wear indicator sensor, fitted now to most modern cars, that gave an early warning, designed to keep you out of trouble.

As the car was on the ramp, Paul called me over to have a look at the inner rim of the front tyres.
"Have you felt it pulling" he asked.

Come to think of it, I had.

"The tracking is out" he said. "Give me a few minutes and I'll sort it out, but you'll need two new front tyres.”

"What causes that?” I asked

"Day to day use” he replied. "And the pot holes.”
"Next time you start to feel it pulling, get in and we'll sort it before it wears the tyres out. It sounds simple. It is simple. But few people actually do it".

I smiled to myself; a very good analogy for an Osteopath in clinic.

Most people get their car serviced, unfortunately fewer get their back checked.
We don't have an obvious visible dashboard light system but we do have an internalised version.
An intricate electrical system of nerves that usually tells us when there is something not quite right and blood tests that can confirm the inner physiology.

Most people notice stiffness. In this analogy this is the 'tracking out'. 
Often a result of day to day use, not a specific event. You can still 'drive around'
This is the stage to get things checked.
As an Osteopath I have a detailed highly specialised knowledge of how the spine should be moving and how to adjust the joints and muscles to ensure it has maximum mobility and stability.

I have access to 'plug-in' diagnostics like MRI scans if I need to refer for them, but most diagnosis can occur fully with a comprehensive clinical examination.

Sadly few people come for an appointment at the stiffness stage, rather opting to wait and see, usually until something more significant happens and pain develops i.e. the 'tyres get worn' 

Were it not for the MOT testing, I wonder how long people would choose to drive seriously defective cars...

Manual medicine involves diagnosis, mobilisation and manipulation as practised by Osteopaths.
It recommended by NICE for the treatment of back pain. You do not need a referral from your GP. In fact unless there is significant acute pain requiring anti-inflammatories or muscle relaxants, seeing a GP can be fairly fruitless.
Friends of mine who are GPs are the first to recognise this.

At the 'tracking out stage' ideally see an Osteopath before pain develops.

If you are reading this and have mechanical stiffness, aches or pains even if they are mild and non-limiting, get yourself checked by a Registered Osteopath.
Treatment is safe and effective for people of all ages, from children to OAPs.

Most people will read this, forget about it and get on with life. 
Take some of the best advise anyone will give you this year.

Get your tracking sorted before the tyres wear out - get one of our friendly, thorough and experienced team of Osteopaths here at Sandbach to give your back the MOT it deserves!

Sandbach Osteopathic and Sports Injury Clinic - 1 Old Middlewich Road, Sandbach, Cheshire. Tel: 01270 759 491

Tim Martin D.O  

Tim Martin is an experienced registered Osteopath and Practice Principal at Sandbach Osteopathic and Sports Injury Clinic, Sandbach, Cheshire. 

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  • Home
  • About Osteopathy
    • K-Laser Therapy
  • Meet The Team
    • Tim Martin - Osteopath
    • Graham Mellor - Osteopath
    • Ariana Torti - Osteopath
  • Your Visit
    • FAQ's
    • Testimonials
  • Book an appointment
  • Blog