The Benefit of Exercise after an Osteopathic Treatment

Stretches and exercises

As a practising Osteopath, clinically it is essential to give my patients exercises and/ or stretches following a treatment to do at home. When treating a patient, I look at a range of factors at play that may be contributing or causing that patient’s pain. These include:

  • Joint alignment - whether the bones that make up the joint are aligned correctly to allow proper function of the joint.
  • Mobility - the range of motion available throughout the Joint
  • Tissue state - or lack of and tissue state, how healthy the tissue is and its level of tension.

Whilst an osteopathic treatment may resolve or correct any of this issues it is important to realise that if a patient doesn’t do anything outside of the treatment room to maintain the changes that have been made, the likelihood of symptoms returning is higher. 

As osteopath’s we prescribe various stretches and exercises, to help patients give a sense of ownership and control over their complaint. That if symptoms start to reoccur there is something they can do to help. These exercises can also help to maintain levels of mobility, reduce inflammation and promote tissue healing between treatments, contributing towards pain relief and improved function. 

Clinically I have found those patients who take a vested interest in self-management at home or in their workplace and complete the exercises and stretches I give them have both a quicker recovery time but also find in combination with maintenance treatment they are able to use osteopathy as a prevention rather than a cure to their complaint. 

Written By Lydia Armitage, Osteopath at The Osteopathic Clinic, Croydon



PILATES....It's Not Just For Girls!


Why Pilates is Growing in Popularity amongst Men..

The recent rise in male sports personalities promoting the use of Pilates in their training programmes has helped to raise the profile of Pilates amongst men. That’s right guys....if its cool enough for Christian Ronaldo, Mark Cavendish and Tiger Woods, then isn’t it time you incorporated Pilates into your training plans?

Here are some facts about this exercise programme that I’m sure you consider is only liked by females... It’ called Pilates, and it's really good for you too!

Pilates was created and developed by a guy called Joseph Pilates. He developed a system of exercises which were intended to strengthen the human mind and body. The inspiration for his method came to him during World War One whilst being held at an internment camp on the Isle of Man. Over the course of four years, he developed his method working with fellow injured inmates to aid in their rehabilitation, using bed springs from the hospital beds for resistance and to help get their limbs moving again.

How does Clinical Pilates work?

Following a postural analysis, your Clinical Pilates session is tailor-made to suit your bodies needs and limitations. You really can create a beach-worthy body without lifting a single weight, yet you will feel like you have just hit the gym for a hard session.  

This is because Pilates uses a variety of equipment and apparatus to help accelerate strengthening, body alignment, increased core strength and stretching. All the exercises are done with control, your muscles are working against gravity and the spring resistance, in order to control the movement of the body and the apparatus. Muscles you didn’t even know existed will be activated and challenged in a safe and effective manner. This leaves you feeling great, all those happy endorphins will be released, and you will leave feeling taller, stronger and more connected. It’s a of my guy clients reported friends complimenting him on his gym buff bod...he replied, not the’s Pilates!!  

Contrary to popular belief, men do own a pelvic floor too. Yes, it's not just a female issue!

Do you know how to activate it? Do you know where it is? Thought not!

The pelvic floor is a group of muscles at the bottom of our abdominal cavity, located between the pubic bone at the front, and the base of the spine at the back. Our pelvic floor is vital in the role lumbar spine and sacrum stability. Men who are predisposed to groin or hamstring injuries will find Pilates a great tool in rehabilitation from these injuries, and the prevention from further reoccurrence. Stretching and strengthening the pelvic floor can play a huge role in reducing lower back pain too. 

So, whether you are injury prone, have a history of lower back pain, feel muscular tightness and have bad posture, or, if you feel focused to improve your fitness, want new sporting PB’s, or increased endurance during football or rugby matches... why not give Pilates a go!

You have nothing to lose, and a stronger, connected, injury-free body to gain. And, I promise you.... you don’t have to wear leggings to join in!

Written by Rhea Malkin BSc (Hons) Sports Therapist MSST and STOTT Pilates Reformer Instructor at the Croydon Osteopathic clinic.


7 habits that could be causing you pain


When was the last time you took a call with your phone propped between your ear and shoulder while you were doing the washing up? Or the last time you were slouched over your Ipad or Iphone responding to emails? If the answer is today, yesterday or even last week then it’s time to act now.

Everyday habits can cause twinges and aches which, if left, can build up into something more serious. Of course, our team of osteopaths are here to help you get out of any pickle find yourself in - if your bad knee, back or neck is troubling you as you read this please do book an appointment- but we believe in the old adage that prevention is better than cure. 


Below are 7 habits to avoid and why

Sleeping on your front
This is a no-go because it puts strain on the back of your neck. Ideally, sleep on your back or side with your legs flexed at the kneebetween 30 and 45 degrees. If you must sleep on your front put a pillow under your hips or chest to alleviate the pressure.


Reading in bed propped on one elbow
We advise against reading in bed. If you must, avoid being propped on one elbow or lying completely flat on your bed which automatically throws your body out of line. Try sitting in an upright neutral position with pillows placed either side of you. 


Sneezing with straight legs
Coughing or sneezing can increase pressure in the spinal canal causing sharp pain and pressure in the discs. Always bend your knees if you feel a cough/sneeze coming on to absorb the force. 


Choosing a soft office chair
Soft chairs might be comfortable but they’re not good for your posture – they obliterate natural curves which are essential for strength and support. Try and sit in a neutral spine position and avoid twisting and reaching for things.  This is a sure fire way to put something out.  Avoid overstretching by getting up and moving around, which is especially important if you lead a sedentary lifestyle. 


Lifting objects with straight legs
Never lift objects with locked legs as this places enormous strain on the lower back and can cause disc issues. Learn how to lift properly. Bend both knees, keep the back straight and try not to twist. Check out this video here for more information:


Spending hours hunched over a laptop or phone
The brain weighs and average of 3lbs. If the head is tilted five degrees forward that places 150% more pressure on the discs of the lumbar spine. Avoid poor posture and rounded shoulders by limiting screen time – a 30 minute break is recommended to recalibrate. 

Sleeping on a soft mattress
if you wake up in the morning with stiffness there’s a chance your mattress may be too soft. The life of most mattresses lasts between eight and ten years. 


Are you suffering with niggly aches and pains? Book an appointment today with one of our registered osteopaths:  Call 0208 662 1155. 




Osteopathic Clinic Takes Centre Stage


This week our very own Rhea Malkin was featured putting freelance journalist and founder, Helen Gilbert, through her paces in our Cheyne Walk pilates studio. 

Due to ongoing chronic health issues, Helen was keen to try out a less intense form of exercise that would not overly raise her body temperature but strengthen her muscles, so our sports therapist and Stott Pilates graduate Rhea, suggested reformer pilates. 

Our studio is equipped with state-of-the-art specialist equipment including reformers, a trapeze table, ladder barrels and a Wunda chair to help clients engage the deep abdominal muscles that are essential for stability. 

This means that patients who have difficulty performing pilates on a mat, for instance those in pain, do not have to miss out on the benefits of this fantastic workout.

Pilates is a conditioning exercise programme that targets the deep muscles of the abdomen and spine to improve overall core stability, posture, strength, flexibility and muscle tone. 

We use it to treat patients with chronic pain and neurological disorders such as Parkinson’s or Multiple Sclerosis, orthopaedic and sports injuries, osteoporosis and scoliosis of the spine as well as mothers–to-be with pre or postnatal postural alignment issues, and for rehabilitation and ongoing care. 

Pilates is also fantastic for athletic conditioning. Rhea, who completed her first Ironman in the European Championship in Frankfurt last year, credits a one hour pilates session twice a week for improving her core strength and flexibility. 

To read out how Helen fared in her reformer pilates session with Rhea, check out her review here:

If you’d like to book an individual reformer pilates session with Rhea or any of the Team  please call reception on: 0208 662 1155

Please look at the video before and after Helens Reformer Class,

4 things you should avoid when lifting your child



When you’re running around after a two-year-old child, the health of your body is probably the last thing on your mind. It’s easy to dismiss niggly aches and pains as just one of those things. Besides, you’re far too busy to get yourself checked out. 

But then something breaks, you find yourself in a pickle and call us.

It’s a situation we see time and time again in our practice, especially in new mums with lower back and hip strains, shoulder and wrist problems.

One of the reasons for this is the effect of the hormone relaxin, which is released by the brain during pregnancy. Its role is to soften and open the ligaments between the muscles to allow room for the baby to grow but an unfortunate consequence is that it becomes very easy to stress vulnerable parts of the body and it can take at least six months following the birth of the baby for things to settle down. 

In fact, mothers often come to us to help relieve the shooting, stabbing or burning sensations they feel when walking up and down the stairs, standing on one leg or sitting down, which is often the result of Pelvic Girdle Pain. 

With this in mind, we’ve rounded up 4 things you should avoid when lifting your child.

When you’re tired and it’s the middle of the night it can be very easy to forget how to lift properly but locking out your knees will put unnecessary pressure on the lower back and stop you from maintaining a neutral spine. You’re especially vulnerable at this time because of the hormonal situation. Remember to flex the knees slightly when lifting your child and keep the elbows soft and close to the body.

Whether we’re right-handed or left-handed we all have a favourite side and chances are you’ll pop your toddler on the hip that feels most comfortable for you. The trouble with this is that it causes tremendous strain on one side of the body, which stress the soft tissues, ligaments. Before long you'e in extreme pain. Mix up the hips and remember to keep the elbows soft and chest high to avoid neck pain while lifting your son or daughter.

It’s the middle of the night, the baby is hungry again and posture is the last thing on your mind but a designated feeding station can help. Try to have a nursing seat or bench with cushions propped either side of you so that you’re in a balanced position. Also, avoid only feeding from one side which can result in a build-up of muscle tension and cause headaches and shoulder pain down the line.

This is easier said than done but I know many mums who try to do it all. Repeatedly balancing a baby on the hip with a car seat in one hand and a feeding bag in another is asking for trouble and your body won’t thank you for it in the long run. When it comes to lifting your baby in and out of the pram, pushchair or car seat try to perform just one task at a time. This will offload stress on potentially vulnerable areas. 

Did you know that we offer a dedicated osteopathy and postnatal care service for new mums? 
You can read more about it here:

If you’ve been struggling with aches and pains since the birth of your child why not book an appointment with one of our specialist osteopaths today.
Simply call reception on: 0208 662 1155.

Our pilates team also offers pre and postnatal care and we can provide comprehensive programmes to help you through these difficult times and help your body return to its pre-baby state.


5 reasons check ups with your Osteopath are a good idea


Think back to the last time you booked an appointment with me or another osteopath in the clinic. Were we your last minute get out of jail card? Were you hoping for a quick fix so you could get back to your daily activities or game of golf or tennis in a speedy fashion?

The truth is the majority of patients contact us when they’re in extreme pain or something’s gone horribly wrong with their body. But in many instances their problems and the time spent out of action could have been prevented in the first place with a routine maintenance check-up.

As osteopaths, we are experts in joints, muscles, ligaments and tissues and the way they work with other systems in the body. We can quickly identify whether you’re setting yourself up for future problems from your posture, gait and the way you hold yourself and, more often than not, we’ve clocked what’s wrong with you before you’ve eve had a chance to explain your symptoms.

As well as hands on treatment, our team of osteopaths can spot troublesome signs immediately as well as offer advice on how to help prevent future problems developing. 

Below are 5 reasons why yearly check-ups with an osteopath are a good idea.

We think nothing of spending money on personal grooming and clothes but when it comes to our health many of us struggle with the idea of paying out to see an osteopath especially if we feel well. But the truth is a regular treatment ONCE every 3-6 months could work out far cheaper in the long run by nipping a serious problem - that may require four or five visits – in the bud.

It’s easy to ignore those niggly aches and pains but make today about prevention and detection, not reaction. You might not realise it but over time your body goes through the mill. Office workers hunched over a computer may struggle with bad necks and backs.

Builders and nurses may find undue pressure placed on their joints. Busy mums may twist awkwardly and put something out when picking up their children. However, a routine check-up can help stop potential problems from developing and our clinical pilates team can show you exercises to strengthen your core and overall frame.

We all know how long it can take to get a GP appointment but being bone experts osteopaths are ideally placed to identify osteoporosis – thinning of the bones. Often dubbed the Silent Killer because the early stages of the disease are difficult to detect and diagnose, it largely affects the elderly and women who have gone through menopause and happens when the body fails to replace old bone with new and the skeleton becomes brittle and weak. 

Many of us make a plan to get fit and throw ourselves into a new routine. However, we forget that training our body – especially when we haven’t exercised for a long time – puts it under intense pressure.

Everything is affected – muscles, joints, tendons and ligaments are being moved about all over the place and more often than not we end up sore and in pain. This is natural and it’s important to listen to your body and rest. However, if pain persists, your body may be out of alignment. A check up with an osteopath once every six months to a year can help.

How often are you run ragged by the demands of others? How often do you neglect your health and push your needs to bottom of the pile? The trouble if you don’t look after yourself you’ll not be fit to look after anyone. Why not book an appointment with an osteopath and make it part of an entire day devoted to your wellbeing? It could be just the thing to set you up mentally and physically for the week ahead.

We treat people of all ages, from babies to the elderly and everyone in between including pregnant women and elite athletes.  To book an appointment call: 0208 662 1155


Doctors Don’t Help Thy Self


Thanks to one of our patients, a local surgeon, for the following story...

Doctor 1: Middle-aged hospital consultant, late life skier. Last run, of the last day, the birthday run, ooops. Fall, ski jack-knifes; boot stays locked in….ouch…the tear is palpable. Home, Tubigrip. Crutch. Scan – full tear of medial head of calf muscle. Emergency call to The Osteopathic Clinic. “Help! I need help. It hurts and I am on-call all week. I can’t carry on like this. It’s not getting better.” Response from Paul and the clinic “Don’t worry. Just come in when you can. We will sort you out.”

Doctor 2: Late life snorkeler. Flipper gets stuck in coral. Ouch the tearing pain is palpable.  Scan – severe Achilles strain almost complete tear. Tubigrip and walking stick.

Doctor 1 and 2 meet each other, a couple of weeks later by chance at the hospital where they both work. They smile painfully at each other and compare notes about the injury, the crutch, the stick and the Tubigrip. They talk about which exercises to do.

Doctor 1 says to Doctor 2 “Go and see my osteopath. He will get us back on our feet quicker than you and I will buy our own Tubigrips and exercises!”

So here I am, Doctor 1. Having had a couple of weeks of misery at trying to get better with the conventional advice from colleagues (orthopedic surgeons, radiologists and rheumatologists), I literally cried for help and got it.

The Osteopathic Clinic, Paul and his team, were immediately sensitive to the physical and psychological pain and suffering that I was experiencing. Straight away Paul with his holistic approach, based upon a wealth of experience and profoundly sound anatomical and physiological knowledge, started to work upon my recovery. It was clear to me, of a similar scientifically analytical mind, that his knowledge and how he put it into his evidence-based clinical practice would benefit me. Needless to say, he discarded the Tubigrip and crutch swiftly and had me up and around quicker than I would have done so with anyone else. However, this was backed-up by a rigorous programme of personally tailored exercises. Not only was I physically getting better, but also my despairing mind and emotions were being dispelled.

The approach of his contemporary, scientifically sound evidence-based therapy with his fundamental high quality osteopathic skills, have got both myself and Doctor 2 back fully on our feet. His step-wise use of multimodality state-of-the-art techniques, not only the ultrasound machine, but also laser and last by no means least (the best I would say) Shock Wave Therapy have I believe undoubtedly fast-tracked my progress to a whole and complete resolution. He has got me back to the tennis courts in time for this year’s beautiful English summer with the family. He has made me stronger in my body and also given me the vision and targets to keep my body strong and stable for the future… next year please Paul?!

Thank you Paul and The OC! Don’t go anywhere. We need you.

Even surgeons get injured need osteopath and pilates#osteopathicmedicine #pilatesreformer #rehabilitation #skiinjury #kneeinjury

A post shared by The Osteopathic Clinic (@theosteopathcliniccroydon) on Mar 10, 2017 at 11:22am PST

Infant Colic

Infant Colic'My baby is suffering from colic, what to do?' It has now been few days or even weeks that you have welcomed your baby into the world, however, you've noticed that your infant cries regularly.

If you were expecting sleepless nights and few cries, you are now concerned your newborn might be crying more than normal. The repetitive episodes of prolonge and inconsolable crying are becoming a real concern.

It is normal for a baby to cry as it is the only way he can express himself. If he is hungry for example.

However your baby seems to be crying for no apparent reason:

  • he is not hungry,
  • he is not cold or hot,
  • he doesn't have a wet nappy

Your baby may be suffering from infant colic

Colics are on second position, after gastro-oesophageal reflux, in infants health issues and are present in 10 to 40% of infants.


Abdominal discomfort, excessive crying for many hours per day or night and difficulties settling down can be very stressful situations for both babies and parents who often found managing colic overwhelming, as it affects baby’s sleep and feeds.

However, be reassured that your baby is still in good health.

Colic is not a disease in itself and it usually resolves by itsel by 3 months, or during the 1st year of life.

Osteopathy, often combined with medication, can help relieve symptoms of colic.


  • Symptoms usually start week 2 or earlier
  • Inconsolable crying or fussing lasting few hours, and usually worse in late afternoon or early evening
  • Signs of discomfort such as red face, arching back and clenching fists
  • Unsettle, jumpy, difficulty sleeping
  • Crying for no apparent raison: baby is not hungry, doesn't have a wet nappy, is not cold/hot..
  • Excessive and explosive flatulences, excessive bowel sounds, hard and distended abdomen, frequent watery/mucousy stools.



Osteopathy doesn't subside to medical treatment, however it can have an important role in optimising gut function by identifying and minimising the underlying causes of your baby's symptoms. Your osteopath will also rule out other factors that might contribute to it (such as allergies...) and refer your baby for further medical management when needed.

Using gentle techniques, your osteopath will focus on the following areas :

  • The digestive system: Gentle techniques to help get rid of the winds and empty the bowels.
  • The thorax and diaphragm: This can often be strained during delivery, causing a torsion in the diaphragm. Additionally, prolonged and excessive crying due to abdominal discomfort in colicky baby causes tension in the thoracic region, increasing the sensation of discomfort for baby. Your osteopath will use gentle techniques to balance the rib cage and release torsions through the diaphragm.
  • The neck, head and mouth: By gently releasing tension in the neck and around the mouth. Osteopathy contributes to improve suckling, reducing air swallowing during feeds. Also, the vagus nerve, which exits from the base of the skull and supplies the digestive system, can be irritated or compressed during the birth process. Irritation of this nerve is thought to contribute to colicky symptoms.
  • Visceral tensions caused by colic can create spinal tensions, which can affect the mobility of the back and neck, which in turn can interfere with proper food absorption as well as making breastfeeding more challenging.



Tip 1 Tummy massage Tummy massage helps improve the digestive transit and reduce bloating. Gently massage his tummy in clockwise direction, outward from the umbilicus to help move along trap winds and bowels. Avoid tummy massage after feeds.

Tip 2 holding baby in vertical position Try to keep your baby as upright as possible while feeding to reduce risk of air swallowing. If you are breastfeeding, make sure he is fully emptying one breast before moving to the other.

Tip 3 Burping Take time to burp your baby after every feeds. Holding him upright over your shoulder for example then gently rub his back to bring up wind.


Courtesy of OC Osteopath, Sabrina Peyandane

Pilates Aid: Stabiliser Pressure Biofeedback

As part of our ongoing care of to Pilates and back care patients, we're happy to share the following exercise to assist finding the deeper stabilising muscles of your lumbar spine.

This technique was introduced by a pioneer in back care from Queensland University, Dr Carolyn Richardson, who incidentally made an enormous impact on the rehabilitation world and was a lead in the Team creating the term ‘Core Stability'.

With this cuff you can essentially get the deeper stabilising muscles to provide segmental muscular strength.

It's little difficult at first as the cuff gives you feedback to whether you're able to recruit the correct muscles and then consequently challenge by way of mobilising i.e. lifting your knee off the ground.

As always, if you're struggling or feel any discomfort, stop immediately and come to see us in clinic.

Starting Position…

  • Place the stabilizer under the lower back
  • Inflate the stabilizer to 40mm Hg
  • Arch your back and note the decrease in pressure
  • Flatten your back and note the increase in pressure
  • Now return to the mid position of 40mm Hg
  • You must not move your back during the exercise
  • Keep the pressure at 40mm Hg
  • Gently pull in your stomach without increasing the pressure and breathe normally. Do not hold your breath.


  • Slowly lift one leg, until the heel is about 10cm from the floor and return to the starting position
  • Do not push down with the lower leg
  • Repeat 10 times
  • Stop if you are unable to maintain pressure at 40mm Hg throughout this exercise
  • Repeat with the other leg

Link to cuffs:

Professional: PhysioRoom

Patient recommended:  Amazon

Ironman: My Road to Dubai

 The 27th January 2017, will forever be the day I completed my first Half Iron Man triathlon. The biggest physical achievement but also most humbling experience of my life so far. Having always been into team sports growing up triathlon was something completely foreign to me but following a conversation with a friend almost exactly a year ago I decided to give it a go. I started with a sprint distance triathlon (750m swim, 20km bike, 5km run) in June 2016, then another in August and then decided to jump in the deep end and enter the Half Iron Man 70.3 in Dubai. (1.9km swim, 90km bike, 21km run.) A massive jump from what I had done previously, but I love a challenge… and what doesn’t kill you makes you stronger right?

So with only 4 and a half months to train I got straight to it. My eating habits changed, I was now eating to fuel my body and empty calories became a definite but difficult no-no. I had previously had a consultation with our nutritionist Dr Zeeba, so went back to following the diet plan she had designed for me; which made huge differences in both my energy levels, ability to train at the intensity necessary but also my ability to recover from the hard sessions. I was training hard 6 days a week with a mixture of open water and pool swims, bike and run sessions as well as some heavy weight sessions. Training was going really well, I was feeling motivated and positive, my body was changing shape and I was noticing big differences in strength and fitness…. Then 13 weeks before the date of the race following an accident at the gym I was sat in Epsom General A&E fearing a broken ankle.

Those few hours in A&E felt like weeks, I thought that was it, all my hard work had been for nothing and I wouldn’t be on that start like come January. As it turned out it was only a nasty sprain and as soon as I heard the words ‘no fracture’ from the consultant I was formulating my rehab programme in my head.

After a week of complete rest, ice, elevation and compression I was able to squeeze a still very swollen ankle into my bike shoe and get out and cycle. Soon after I took to the pool and was able to swim with heavy strapping but running was going to be a no go for some time. From week one under Paul’s recommendation I was using the infra- red laser we have at the clinic 3 times a week to help reduce the swelling and target the immune response to the injury more locally to the damaged ligaments. Regular treatment from Paul (not always comfortable I might add) in combination with a rigorous stretching and strengthening regime and continuing to build fitness in the pool and on the bike is I am convinced what got me to that start line.

The feeling I had lining up on the start line is something that will stay with me forever. The months of training, coming through the injury and hard work and support from friends and family had all come down to this. So many people had said to me in the lead up ‘oh all the hard work is done now, just go out and enjoy it’ and I somehow hadn’t quite believed them… but they were so right. All the training was done, my fitness was there it just had to go out there and do it. My goal had been to try and complete the race in under 7 hours, but considering the state my ankle had been in just 13 weeks before I would have been happy just to finish in one piece! As it turns out the ankle was fine! And I completed the whole thing in 6hours 24minutes, absolutely exhausted and elated!!

It was the most incredible experience, tough but incredible. One I would absolutely recommend to anyone thinking of having a go. The amount of support from fellow athletes, organisers and spectators was like nothing I’d ever experienced before. I met people of all shapes, sizes, ages, races and nationalities in Dubai, all with a common interest for health, exercise and passion for triathlon. Definitely an experience I will never forget. Onwards and upwards though and onto the next thing.

I really believe you’ve got to push and challenge yourself in life; whether it be physically, mentally, at home or at work. If not we all stand still. Challenge means change and change means progress.