Your questions

What people commonly ask us

• Am I going to have this pain forever?

  Pain forever?

  No. Pain is transient. It is not a sign of damage, it is a sign of your body trying help you and communicate with you. Pain can be a normal daily occurrence, not having it would be abnormal.

  Your body only has one language when 'talking' to you and that is the language of pain. When a muscle is weak, pain is felt, when feeling stiff pain is felt, when feeling tense, and stressed, pain is felt. Pain is a form of communication not a sign of damage, let's start viewing it that way.

  It's up to you to work out how to respond to the communication you are receiving. Persistent pain can be annoying, it can alter mood and even cause depression, so it is not something to ignore and hope it will just go away. You may need guidance from your GP, physiotherapist, osteopath, Pilates teacher or yoga teacher but the key is keep investigating what works for you as it is different for everyone.

  Working with the human body for all of these years, we have discovered that there are 3 essential components needed: movement, strength, and reassurance. Our recommendation to you is find a discipline, such as, physiotherapy; osteopathy, yoga, or Pilates, and discover movement, strength and learn the ‘language’ of your body and mind.

• Do you do sports massage?

  Physiotherapy & osteopathy massage

  Massage is a big part of what we do, osteopathy and physiotherapy massage aims to work deeply into the muscles to reduce pain and help the muscles relax. Sports massage does the same thing, so, although we do do sports massage, we call it, osteopathy and physiotherapy massage.

  Have you tried it? Osteopathy massage and physiotherapy massage aims to get deep into the muscles, if anything it aims to get the joints moving as well that lie underneath the muscles. Muscles are filled with a huge blood supply and nerve receptors, so during massage these two important anatomical structures will be stimulated. We like to get things moving, the pressure on the massage technique will increase the blood supply and hopefully bring some oxygen and nutrients with it. The aim is to work enough into the muscles so they feel they have been worked into but not so much that all we are doing is pressing on a group of superficial nerve endings and making it uncomfortable. The aim is to get the muscles and joints moving and not solely make it a ‘no pain no gain’ experience.

  What is the difference between sports massage and osteopathy or physiotherapy massage?

  Very little. They are very similar. The main difference would be that the physiotherapist or osteopath would not ignore a joint that feels a bit stiff so will therefore work to improve the movement in that joint.

  How do a I book?

  Simply book with us for physiotherapy or osteopathy and let us know that you have tightness in which ever part of your body and would like a deep tissue massage. There will be very few questions, just basic ones to check all is well and it is safe to do massage and then we will get to work. We hope this answers your questions, we often get asked if we do sports massage, the answer is yes but… read from the top.

• Do you treat muscles or bones?

  It’s a question we hear fairly often at our Get Strong physiotherapy & osteopathy clinic in Kew. The answer is, we treat the person not solely muscles and bones. Osteopaths often have the reputation of just treating bones and physiotherapists have the reputation of just treating muscles. Neither are true, both professions treat the body as a whole, an ankle injury, headache, neck pain, or back pain, do not independently walk in on their own, you are part of the whole picture.

  Muscles and bones have tons of pain receptors, all ready to send that lovely sensation of pain whenever they have been stimulated. Bone can be very painful, have you ever been kicked in the shin..? If you have, you will know exactly how painful it is.

  Muscles are a bit more communicative in that they have more ways to feedback to you, if they are tired, thirsty, weak, tight, or stressed the receptors will send a signal to your brain and from your brain back again with a pain signal. When we say pain does not mean damage, it usually relates to this feedback system, which only has one language, and that is the language of pain.

  Pain and owning a human body go hand in hand, without pain, something has probably gone amiss. Pain is something to listen to and learn from, it should not be feared or ignored. Not ignoring pain does not mean worrying or obsessing about it either, like everything else in life there is a balance. This is where we as physiotherapists and osteopaths can help, once we have cleared any serious injury or the possibility of disease we will look at your movement pattern for example how you move from the moment you walk into the clinic, to how you describe your symptoms; including your pain experience, injury history, and how you responded to it.

  We treat you

  Within the first 5 minutes of meeting you, we already have an idea of how you move, what body type you may have, what your pain levels are, how you respond to, and feel about pain. All of this information will be collated with movement tests, postural analysis and muscle and joint palpation. The information gathered is to discover your unique movement pattern, which we will work with, tweak, explore and improve.

  Treatment consists of mobilisation and massage of joints and muscles, if protective patterns have been detected we will encourage you to move more freely by exploring some painful and stiff movements. Massage aims to improve movement and not just ‘polish skin’. Your movement pattern is something that you can work on throughout your life, all it takes is a bit of awareness, willingness to learn and to move. Your movement is your strength!

• How can I strengthen my big toe?

  Running & Your Big Toe

  Have you ever considered what your big toe does? Probably not, but there is good reason to include it in your workout routines. My experience of treating runners is that they are enthusiastic about running but less so about strengthening and conditioning. Understanding why you are doing an exercise increases the likelihood of doing it regularly and effectively. This blog aims to give you some insight into the importance of the big toe in running efficiency and offer suggestions on how to include it in your exercises.

  The big toe may seem insignificant and runners can run marathons without a second thought to it. Strengthening calf muscles is a key part of training because they are the powerhouse of running. The calves contribute to the bulk of the work involved in the foot striking the floor; absorbing the forces that travel up from the ground through the foot and propelling you forwards. The big toe helps set up the other joints in the foot and the plantar fascia so the calf muscles can therefore generate power. To perform its role well the big toe needs a good range of movement and strength, so let’s have a look at the structure and function of the big toe.

  Structure and function

  The big toe is four times bigger than the other toes with more muscles attached to it because it bears more weight and produces more power. Unlike the other toes it only has two joints rather than three, allowing for extra stability and therefore power. What the big toe does or doesn’t do, will have an effect on the other 33 joints in the foot; to the plantar fascia (maintains the arch of the foot), and to the kinetic chain leading to the knee, hip and lower back.

  The primary movements of the big toe are extension and flexion (bending up and down). Between 40 and 90 degrees of extension is considered the normal range of movement, most of which is required for running. This movement of the toe bending upwards creates a huge amount of essential tension in the plantar fascia, needed for push off during running, which in turn may prevent early fatigue and pain in the calf muscles. 

  What happens at the big toe affects the rest of the foot; a lack of movement and weakness can lead to a breakdown in the kinetic chain resulting in injuries such as plantar fasciitis, calf strains, knee, hip and back pain. These conditions are commonly attributed to tightness in the calves and hamstrings when in fact, the big toe can be the cause. Tightness in the calves and hamstrings are often tight because they have that essential tension needed for powerful movements such as running, and we all know that running requires a lot of power.

  It’s simple to check the movement in your big toes and I recommend runners do. You can check their range of movement by lifting them up and scrunching them down, whilst sitting or standing. You could even turn this into a regular exercise to help improve mobility. If you go to a physiotherapist or osteopath with plantar fasciitis or any other foot or calf injury, they should check the movement and strength in your big toes. 

  Awareness and exercises

  Start to become aware of your big toe movements by simply scrunching them, lifting them upwards and spreading out all your toes. Combine big toe movement with strengthening exercises you may already do for your calves. Let’s use the heel raise exercise as an example: stand with your feet shoulder width apart and lift up and down on your tiptoes. Repeat between 15 and 30 times (remember that runners need strong calf muscles, so 30 repetitions should be manageable). As you lift your heels, tune into your big toes, feel the pressure travelling through them and be aware of the ground. They should be participating in the movement (there is a natural tendency to roll on the outer side of the foot as you go up, thus avoiding the big toe, so try to not let this happen). You will be surprised at how many people avoid using the big toe during this exercise especially if there is a history of injury. Watch this video of a patient with a history of left plantar fasciitis. You will see that they are reluctant to use their left big toe. https://youtu.be/LvwXsLw6VF0

  Due to the big toe being a highly specialised joint, the brain can become protective or reactive if stress or repetitive movements are detected. The brain will send pain signals and reduce movements, however, this may lead to stiffening and weakening, the opposite of what we need. Tight fitting shoes and walking on flat surfaces may also contribute to reduced movement, weakening and also a lack of awareness of our big toes in general. By being more aware of our big toes we can check their function and challenge them to move more and to keep them strong. 

  It’s easy to improve the range of movement and increase your big toe’s strength and flexibility. Here are a few key exercises and you can also check our demonstration videos: www.getstrongphysio.com/exercises/

  I hope this blog has helped create a little awareness that will help you towards injury-free running. If you currently have any pain or are unsure about how to do any of the exercises, please seek advice from your physiotherapist or osteopath, or please feel free to contact me for further advice or treatment.  You can book or contact myself Claire at Get Strong physiotherapy & osteopathy here: www.getstrongphysio.com

  Exercises

  Toe extension (good for plantar fascia)
Stand with feet together, looking straight ahead. Lift all your toes up as far as you can and back down. Repeat 20-30 times. 

  Toe flexion (good for toe joint)
Standing, bend your toes on one foot at a time underneath, apply a little pressure to create more movement. This should not be painful, if it is, reduce the pressure you apply and seek advice. Repeat five times. 

  Plantar fascia strengthening (good to improve toe range of movement)
Crouch down on to the balls of feet and put hands on the floor in front of you. Lean forwards so that your knees go towards the floor but do not touch it and then back again. Repeat 20 times. 

  Heel raises 
Stand with feet shoulder width apart, raise up on your tiptoes and down again. Be sure to move through your big toes and not on the outsides of your feet. Repeat 20-30 times. 

• How do I relax my muscles?

  Relax!

  This is a strange question to answer but we get asked this quite frequently, probably because we see a lot of people with tense muscles.

  Tense muscles are uncomfortable at best, and are very painful at worst, in either situation they can make us feel moody and irritable.
  Muscles work hard for us all day every day, they have to work even when they are tired and weak. Not working for us is not an option, they have to keep us standing up, sitting, moving and walking. When they fatigue they become tense, when they are tense they ache and give us pain.

  Once the pain begins, the muscles have probably been fatiguing for some time, weeks, months, or even years. The reason for the fatigue is probably best answered by you, be it, because of too much desk-work; not enough exercise, too much stress, etc. You will know why more than we will.

  Fatigue has an effect on muscles by weakening them, this in turn, keeps the muscles in the tension-fatigue-pain cycle.
  What to do.

  Change your routine, add movement to it, even whilst you are at work. Go to a Pilates or Yoga Class. Get out of the tension-fatigue-pain cycle by adding strength. Treatment at Get Strong physiotherapy & osteopathy will help to reduce pain and tension and show you how to move and strengthen your muscles.
  Book online https://www.getstrongphysio.com/book/

• How many sessions will I need?

  Anything from 2 to 6 sessions. Some people decide to have maintenance treatments to keep on top of their movements.

• How much will it cost?

  Prices are £60 for your first appointment and for follow-ups.

  To save a bit of money you can buy a package deal of 5 sessions upfront for £270.

• If I am moving all day in my job, isn't that enough?

  No not really.

  Unfortunately we don't get strong with day to day activity even if you are up and down staris and walking a lot. You still need to do specific exercises and movements.

  Movement is something we did freely up until we became adults. We would run, jump, hop, crouch, crawl and roll without a second thought. Now we sit, stand, walk all in a straight line. What the body needs is a wide variation of movement that will improve and strengthen your muscles and joints.

  A patient once said, "I am up and down a ladder all day isn't that enough movement?" Yet when I looked at how he was actually moving, his lower back wasn't bending at all. He was able to get up and down the ladder but his lower back had very little movement going on. I gave him the lower back movement exercise on our exercises page.

• Is it ok to run if my back is sore?

  Yes it is ok, it can make your back feel better however, read on because sometimes it can make it feel worse.

  The risk of damage to your back if you go for a run whilst it is sore is minuscule, however, running may cause more pain and tightening but remember that pain does not mean damage.

  What happens to the muscles and joints in my back when running makes it feel better?

  Running especially if it’s a gentle run when the back is sore, brings lots of blood to the muscles and ‘feeds’ them with oxygen and nutrients allowing them to feel more relaxed and energised. The forces that travel through the body from the ground as we run are much greater than when we stand or walk. When our muscles are feeling strong and relaxed and the joints are moving well, the forces they receive are efficiently re-directed to other parts of the body for absorption and dissipation, and are also used to give us power for momentum.

  Now, in the scenario when the muscles are sore, they are not injured or damaged, more sore, tight and feeling stiff with movement. When running the forces are much greater travelling through our bodies, and because the muscles are sore and tight the forces that arrive are not so efficiently dealt with, they are now more like a thump to our muscles and joints, this is sounding negative, but maybe we can use this ‘thumping’ to our advantage, it may just be what our muscles need to give them a workout and improve their strength by overloading them just enough so that they Get Strong!

  What happens to the muscles and joints in my back when running makes it feel worse?

  The same things happen as above but this time the muscles have not been able to cope with the extra forces. As the forces arrive at your lower back the muscles and joints have been unable to use it efficiently for power, or send it on for absorption, resulting in the muscles fatiguing and becoming more painful rather than being energised. Don’t worry, nothing has been damaged but it is advisable that you rest and get some treatment.

  Our advice is do a gentle warm-up before going for a run; move your lower back side ways, backwards, forwards, and strengthen your back!
  Check our exercises page: https://www.getstrongphysio.com/exercises/

• Is the pain because I am getting older?

  No, not really. There is a natural change in our joints and muscles as we age but this is not a painful process. We do not get pain from wear and tear. Many of our patients tend to diagnose themselves with osteoarthritis but this is a disease and fairly rare so the likelihood is, you have what most of us have and that is tension, weakness, stiffness in your muscles and joints which all communicate to us as pain.

• Paediatric osteopathy - What experience do you have treating babies?

  My experience treating babies by Noemi Panella

  When people ask me what my specialism is or in which osteopathic field I specialise in, I simply answer “I am an osteopath, and therefore I treat all types of patients: sportspeople, elderly people, adults, pregnant women, and babies”

  When I discovered osteopathy, I didn't know who could benefit from the treatments and I certainly didn't know that osteopathy could be effective with children. People react in amazement when I say that treatments are useful for newborns. They ask me "what do you do to them? A massage?" "But aren’t they too young?" I always answer these questions with a smile first and then with an explanation of what paediatric osteopathy does, because even I am amazed at how great osteopathy is. The approach for babies is biodynamic, cranium-sacral and rebalancing, because childhood reveals itself in all its spontaneity and beauty in therapy.

  My experience with children started during the paediatric clinical internship at my university. The first time I put my hands on a child's skull was like having a pulsating life in my hands.

  The osteopathic techniques and their effects on children are perceived much faster and last longer than those on adults because children’s learning ability is so plastic and fast that changes are immediately perceived under the osteopaths hands.

  I remember that after the osteopathic treatment of a baby, the mother was surprised that her daughter had instantly fallen asleep, as she is not known to be ‘a sleepyhead’. The child’s energy is much more active than that of an adult, and this energy is used in the osteopathic treatment often resulting in a sudden change and improvement.

  Children generally enjoy the treatment because I try to make the treatment playful whilst respecting the professionalism of my work. Sometimes I ask mothers to interact because it is good that the child is aware of the constant presence of the parent. Children are very curious, they are attracted by shadows, strong colours and faces so I always try to get their attention by talking to them and making them participate.

  Babies and children benefit from osteopathic treatment also from the psychological point of view. They come out of the state of restlessness and annoyance they face in everyday life, by freeing them from some dysfunctions, results in a reduction of symptoms.

  Osteopathy is also closely related to the quality of life of the child's family. Considering how important this can be for the parents, it is a return to the state of well-being for everyone, often a state of relief, when the child returns to a normal level of comfort”. We try to offer comfort and relief, improving the daily life without having the pretension to solve their pathology with osteopathy.

  Awareness of its limitations, paediatric osteopathy is a guiding principle that the osteopath must always keep in mind, not only when it works with children but also when working with parents and other healthcare professionals.

• Pregnancy osteopathy - is treatment painful?

  Will treatment feel painful and what affects should I expect afterwards?

  Osteopathic treatment is usually a very gentle process and I work very hard to make treatment as painless as possible, but you may experience some discomfort during and after treatment. Your osteopath will warn you if they think that the technique that they are about to use is likely to be uncomfortable and will stop if you tell them to.

  Following treatment, you may experience some mild soreness in the area of the body that was treated, it is also possible that you feel more tired and want to sleep even in broad daylight. This is because the osteopathic treatment balances the autonomic nervous system and improves the basal state of well-being. Both the soreness and tiredness will normally resolve within 48 hours.

• Pregnancy osteopathy - What should I expect from the first visit?

  Your first visit

  Osteopaths are healthcare professionals who are specifically trained in diagnosing health issues. At the start of your first appointment, I will ask you questions about your medical history and lifestyle, as well as any symptoms you may be experiencing. You will be asked questions related to your general health and your lifestyle before pregnancy, questions related to conception method (timing, in vitro) and questions in relation to how your pregnancy is going. All information will be treated as confidential in accordance with standards of practice set out by the General Osteopathic Council and the Data Protection Act 1998.

  I will need to examine the area(s) of your body causing discomfort. I will perform some orthopaedic tests if needed and finally I will carry out the treatment following the patient's needs. If you are uncomfortable with any part of the treatment, you have the right to ask me to stop at any stage, without prejudicing your future treatment.

• Pregnancy osteopathy - what should I wear?

  What to Wear

  As with any healthcare appointment, it may be necessary for you to remove some clothing. This is so I can see and touch the areas of your body causing you concern. For the first visit it is essential that I see your body in underwear clothing because observing the skin for the circulatory component is also very important. It is important that you feel at ease, therefore if you feel uncomfortable undressing to your underwear, clothing such as shorts and a sports bra, or close-fitting garments such as short leggings are recommended, You are also welcome to ask a friend or relative to accompany you and be present throughout your appointment.

• Pregnancy osteopathy - what will treatment consist of?

  What to expect during treatment

  As well as deep tissue massage, a range of gentle hands on techniques are used. they focus on releasing tension, stretching muscles and mobilising joints. Together with exercises that you can do at home and helpful advice designed to help you relieve or manage your pain, keep you active and maintain health and wellbeing.
  The osteopathic techniques used are:
  - Myofascial release. It uses a constant pressure until release is achieved. It is primarily used for myofascial structures.
  - Cranial and Cranium-sacral osteopathy. It is a light touch that feels and ‘listens’ to your body much like when the medical history is taken. Contacts are made at the base of the spine, the head as well as other areas depending on the symptoms.
  - Deep tissue soft tissue massage or manipulations is a manual technique used to stretch or relax dysfunctional soft tissue structures.
  - Visceral osteopathy: our visceral organs form an important part of our anatomy and physiology, making them a significant consideration when formulating an osteopathic diagnosis and treatment plan. The holistic approach to osteopathy emphasises this. This is usually preformed through a gentle external massage often on the abdomen.

• Pregnancy osteopathy - when should I book my first visit?

  First visit

  Most manual therapists tend to encourage the first visit to be after the first trimester as this is a delicate period for both the mother and the foetus. The technical reason is to wait for the complete installation of the placenta.

  Regarding new mothers, you can usually book a first visit or follow-up even immediately after giving birth, especially if you have musculoskeletal and / or visceral disorders, but it depends on how you feel. So, it can be different for everyone.

  Osteopathy, in the case in which the mother comes in the clinic even 1 or 2 days after the birth, treatment will not be invasive; techniques will be used of balancing the autonomic nervous system in such a way as to find a balance between the parasympathetic system (known as "rest and digest") and sympathetic system (known as “run away and flee").

• Pregnancy osteopathy - when will I feel better?

  How many visits do I have to make to feel better?

  This is a very general question because it depends on the person and the type of symptoms experienced. Osteopathy tries to see the person from a holistic point of view so one treatment is often not 100% effective. Moreover, especially for pregnant women, the posture and the body will be constantly changing so it is good to have regular monitoring by the osteopath for the first 3/4 week and then lengthen the time between visits. The classic process that I recommend is characterised by 5 close ‘base’ meetings, and subsequent ‘reminders’ that will be distributed one month apart from the other. For example, if the first 5 treatments take place (ideal situation) between the fourth and fifth month, the following meetings will be: one during the sixth month, one during the seventh, one during the eighth, one during the ninth. Clearly, we must consider that every woman is different from the other, which is why there is no real protocol of treatments.
  The process will therefore be customised according to the patient's needs. 

• Pregnancy osteopathy - which symptoms can osteopathy help with?

  Osteopathy can help with:

  Orthopaedic

  • Back pain
  • Neck Pain
  • symphysis pubis dysfunction
  • coccyx pain
  • general tension
  • trapezium tension
  • foot pain
  • unbalanced posture
  • carpal tunnel syndrome
  • sciatica
  • groin pain/cruralgia/pelvic girdle pain
  • pain after epidural

  General

  • anxiety
  • stress
  • sleeping disorder
  • migraines
  • tiredness
  • Breastfeeding issues

  Digestive system & respiratory

  • heartburn
  • nausea
  • vomiting
  • constipation
  • diarrhoea
  • breathing difficulty

• Pregnancy osteopathy - Will I have to lie on my back for long?

  Which position will I be treated in?

  Depending on which trimester, it may be discouraged for pregnant women to lie on their back for more than a few minutes. Compression to the different structures in the upper abdomen whilst in this position can make it uncomfortable for the expectant mother.
  Nevertheless, if you are at the beginning of the second trimester, you may be asked to lie on your back for some treatment techniques. If you are in the last trimester, positions on the side with a pillow between the legs are used more for comfort and to ensure effective treatment.

• Pregnancy osteopathy - Will the osteopath touch my belly?

  Belly of the pregnant mother

  Normally, direct manoeuvres should not be carried out on the stomach of a pregnant woman unless the gynaecologist or midwife performs them and for a significant reason. It is possible that the osteopath puts a hand on your belly and the other hand on the sacrum (the lower part of the back) to balance the palpatory sensation and have a conception of the body as a unit. Techniques could be performed on the diaphragm and on the upper part of the belly especially if the mother has visceral symptoms such as nausea.

  During the last trimester, there are many techniques that can be used to improve movement and reduce pain that do not involve touching the mother’s belly. Positions such as side lying, sitting, and sitting with crossed legs can be adopted so the mother is comfortable and ensure effective treatment.

• Should I avoid movements if it makes a noise?

  Noisy joints?

  Every joint and muscle in your body has the potential to make noises so don't let that worry you. It is more than likely that the noise coming from your shoulders, knees and ankles etc are needing a bit more movement than they are getting so move and keep moving. The noise will probably reduce as you continue to move.

• Should I use ice or heat?

  Ice or heat?

  It’s a question we get asked many times from our patients. To answer this question, it’s important to know what is causing the pain.

  When to use ice:

  If the pain were being caused by acutely inflamed (hot and swollen) joints, muscles, tendons or ligaments then Ice would be the best option. This will help to restrict blood flow temporally to the area that’s problematic helping to reduce swelling, ice also has an analgesic numbing effect that can help to reduce pain.
  
  We would commonly recommend no longer than 10 minutes every 30min-1hour.

  When to use heat:

  When an injury has become less acute and the initial inflammation has calmed down, it is common that you can feel stiff and achy. Due to muscles tightening and guarding areas that have been injured in order to protect them, as a result the muscles tend to fatigue. By applying heat, this can help to sooth and relax the ache caused by these tight, tired muscles. This is done through increasing blood flow bringing oxygen and nutrients.
  We would commonly recommend hot baths or hot water bottles/wheat bags for 10-20 min.

  WARNING!

  When applying either heat or ice, you must make sure that you have something between the skin and the source. You can burn yourself with both ice packs and hot water bottles!

  If you feel either applying ice or heat exacerbates the pain then stop. It is not going to mean you will not recover from an injury if you do not use them! You will recover, start to move better and get stronger. Your movement is your strength!

• What happens during treatment session & how long does it last?

  How long & what happens?

  Your physiotherapy or osteopathy treatment will take around 45 minutes, give or take 5 minutes, depending on your injury. If it’s your first appointment with us, we will ask a few questions about you; how you are feeling, what injuries, if any you have, in order to work out the best plan to help.

  The questions generally take around 5 to 10 minutes. We will then have a look at some of your movements to see what’s going with your muscles and joints. After that we will ask you to lie on the couch so we can work on different areas of your body.

  We may ask you to take your top and trousers off, so bring shorts if that helps you feel more comfortable. We are used to seeing people in their underwear but understand that the person may not feel that comfortable, we have towels to keep you covered.

  Towards the end of the session we will teach you a few movements and exercises so that you can learn how to keep areas of your body moving and feeling stronger. We will email an exercise programme if you wish.

• What's the difference between physiotherapy and osteopathy?

  There's not a huge difference these days. Physiotherapists used to work predominately in the NHS in a variety of different wards such as, orthopaedic, neurological, elderly, respiratory, musckuloskeletal etc. Due to the pressures on the NHS Physiotherapists are often limited on how much hands-on treatment they can provide and often mainly prescribe exercises.

  Physiotherapy is now more common in the private sector which has lead to the growing similarity to osteopathy.

  Physiotherapy and osteopathy in the private sector work a lot with hands-on treatment such as massage, joint articulations, joint clicks and stretches. Both professions prescribe exercises.

  Osteopaths may click your joints more but physiotherapists can also do that.

  Osteopaths focus on removing barriers of the body so that the body can heal itself. Barriers could be a stiff rib cage causing neck pain or a knee that doesn't bend backwards enough causing lower back stiffness. A big misconception about osteopathy is that they only treat back pain, this is not the case. Osteopaths treat much much more, anything from tension headaches to ankle sprains and more.

  It is a difficult question to answer, there are some similarities and some differences however, they have a common goal and that is to reduce your pain, improve your movement and get you stronger.

• Where are you?

  Get Strong physiotherapy & osteopathy are based near Richmond in Kew on Sandycombe Road inside a pilates studio called Boomerang, they have 6 reformers here and spend a lot of time getting people strong too.

  Our address is:
  Get Strong physiotherapy & osteopathy
  245 Sandycombe Road,
  TW9 2EW

  We are just 5 minutes walk from Kew Gardens Tube Station. When you exit the station turn left on Sandycombe Road, walk past a parade of shops and you will see our sign on the left hand side. Ring the buzzer and take a seat.

  Being based near Richmond in Kew providing osteopathy and physiotherapy we are lucky and proud to be helping the community achieve pain free movements and continue with sports such as running, triathlons, ironman's etc.

• Where can I park my car?

  There is free street parking on Sandycombe Road before 10am and after midday. It is permit holders only during those two hours. Otherwise there is pay and display in Kew Village Parade just outside the station.

  It can get quite busy, many patients park on The Avenue just opposite the clinic.

• Which mattress would you recommend?

  How old is your mattress?

  It’s a common question I ask as an osteopath to my patients at Get Strong physiotherapy & osteopathy. Many of us lose track of how old our mattress really is. When we think back to when we bought it, we realise that it maybe time to replace it, as it has been well over the recommended 8-10yr life cycle of the mattress.

  It can be a daunting task when looking for a new mattress. Commonly patients will ask what I would recommend. Most of the time I ask them what they have been using already, and whether they find it comfortable. In some cases it might be worth buying the exact same mattress again!

  The mattress that will be best suited for you, will mainly depend on how heavy you are, as well as how you sleep. The heavier you are, the firmer your mattress needs to be so it can support you while you sleep. It’s normally advised you get a medium-firm to firm mattress. Its important to ask to try the mattress on a similar bed to the one you will put the mattress on, as this can drastically change how a mattress feels!

  A Mattress should be BOTH comfortable and supportive. Not just one of those things.

  A good thing to do when mattress shopping, is have someone take a photo of you while you lie in your preferred position. You want to look for your spine being aligned, and relatively straight without it bowing down too much if you're on your side. If you sleep on your back, you don't want to be rounding, with your hips and lower back sinking into the mattress.

  If you lie on your side predominantly you may want to have something that has a bit of padding on the top of it, whether that be part of the mattress itself, or as an additional topper. This is particularly helpful for patients who suffer with hip problems.

  Pocket sprung, Latex, Memory foam, Combo. There are lots of different types of mattresses out there, and which you choose, will come down to personal preference. Memory foam or latex mattresses may feel comfortable, but if you’re someone who gets easily hot at night, it might not be the best for you. Most people will suit pocket sprung mattresses best, and although they generally cost a small amount more they tend to last longer.

  I always advise patients to get the largest bed that they can fit into the space allocated for their bed. Even if you don’t share a bed with a partner, having a bigger bed will create a healthier sleeping environment. If you do have a partner you’re sharing with, it will also make it less likely that you disturb one another during the night! If you and your partner like very different beds, look into options of ‘zip and link’ mattresses.

  Take your time when choosing a mattress. Don’t rush into a decision to buy a mattress based on lying on it for a few minutes, and don’t be tempted to just buy a mattress because its on sale and cheap, or that it’s the most expensive in the showroom! Most companies will offer a descent trial period before needing to return it if you happen to buy one you don’t get on with. Just make sure before parting with your money! Remember however, that you will spend more time on this piece of furniture than any sofa or car most likely, so it is important to get the one that will help you sleep best.

• Which would you recommend Yoga or Pilates?

  What is yoga?

  Yoga is a mind body practise that originated in ancient India. The goal is to connect the body with the mind through an ancient form of exercise that focuses on strength, flexibility and breathing to improve physical and mental wellbeing.

  Many of the yoga poses are done on the mat, holding your own body weight and moving from one posture to the next all whilst connecting with your breathing. Depending on which type of yoga practise it is, it can be a bit of a workout and a form of meditation. Power yoga is one type that can get you a bit sweaty and shaky, but don’t worry, there’s always the option of going into a child’s pose if you get too tired. Yoga takes you through postures that you probably don’t habitually do on a daily basis, such as lifting your chest forwards and extending through your lower back. These are essential movements that are required throughout our lives but unfortunately we don’t do them very much.

  Many of the exercises prescribed to our patients are taken from yoga poses, they are really good because they work a number of things all at once, such as working the big toes and the shoulders as during a downward dog. Movement, including bending, extending, twisting, and rotating are a big part of the philosophy of yoga and the idea is that the strength will follow. A similar philosophy to Pilates, osteopathy and physiotherapy, once movement is there, strength will follow. Yoga reminds your brain of all the movements your body are capable of doing, the muscles will follow and Get Strong!

  Yoga is great because it really connects your mind to your body and gets you strong from your big toes to the muscles in your neck. You do not have to be flexible to do it, you just need to be willing to get on the mat and hold your own body weight. Movement, flexibility and strength will come, but at no point do you need to be good at any of these. The aim is the journey of movement not the destination of being flexible.

  We would love to see you at our yoga class. You will find it in the Marwood Room within St. Luke's Church, Richmond every Wednesday evenings. Hopefully see you there!

  What is Pilates?

  Pilates provides a whole-body workout and works with breathing which in itself works wonders on the mind and body. Pilates can help you breathe deeper and with less effort, it makes you realise just how differently you have been breathing. The body really is a reflection of how the mind is feeling but nothing changes until something moves, and that’s the philosophy of Pilates, movement. When there’s movement, strength will follow. Breathing is movement and believe it or not, sometimes we don’t do it well, the difference felt when breathing is done well and easily is unmeasurable.

  Pilates teach movements that are contrasting, you may be stretching your arms up to the ceiling but your mid back will be reaching backwards towards the reformer or mat; you may be squatting down but your head and spine will be rising upwards. It’s a very similar philosophy to physiotherapy and ballet.

  It’s that thing where you don’t realise how stressed you were until you step out of it, in Pilates, you don’t realise how disconnected to your own body you have become until you have a session from a good Pilates instructor, and don’t worry strength will follow, you just have to be willing to learn. Pilates is great for rehab post injury or surgery, we also send a lot of our athletic patients and ballet students to Pilates because we believe that there is a deeper level of strength gained. All the deep muscles in the body are challenged rather than just the big muscles on top of your body.

  Pilates is highly recommended if you are willing to learn and reconnect with your body, you will feel strength again in a way that you didn’t realise you missed.

  Our recommendation is try both, Pilates and yoga, and try different ones until you make a connection, not just with the discipline, and teacher, but to your own body.

• Why is hiking downhill more gruelling than climbing up?

  How to protect your knees while walking: Why is hiking downhill more gruelling than climbing uphill?

  STYLIST got in contact to ask why knees work harder when walking downhill, the article can be found here: Stylist

• Will you ask a lot of questions during the first appointment?

  First appointment.

  Will you ask a lot of questions?
  When you arrive at Get Strong physiotherapy & osteopathy we will check that we have your correct contact details. After that we will ask how we can help.

  To determine how best to help we will ask a few questions and check movements of your joints. This can take between 5 and 10 minutes at the most. Treatment consist of a combination of massage of the deep tissues, mobilisations of the joints, movements of your body and education of why pain or injury occurred.

  Here is a list of the type of questions we may ask:
  What happened for the injury to occur?
  When did the pain start?
  Is it there all the time?
  What aggravates it?
  What makes it feel better?
  How are you feeling?
  What concerns you most about your pain/injury?
  Is it stopping you from doing anything, such as sports or housework?
  What would you like to return to and when?
  Have you had any injuries before?
  How’s your general health?

  The questions often happen in the way of conversation, it's a way of getting to know you as well as what is possibly causing the pain. The treatment part of the first appointment will take up the bulk of the session. We gather just as much information about your symptoms and body type during treatment as we do during the actual assessment.