Preparing for Surgery – 6 things you can do


6 Reasons why it’s important to not just sit and wait

Being on a waiting list for a bad knee, hip, shoulder or any other joint in your body can be a really frustrating time. It’s tempting to see the surgery date as a reason not to do anything in the meantime assuming that the surgery will solve all the problems and you can move on from there. It’s worth considering, though, that with a bit of work and preparation beforehand your chances of making a faster  more pain free recovery substantially increase.

  1. Having surgery is traumatic to the joint and so exercising the muscles afterwards can be really hard. Your physio, who will be familiar with the procedure you’ll be having, can advise and demonstrate which exercises you can safely do beforehand to strengthen the area so that post surgery you’ll feel stronger quicker.
  2. Maintaining an adequate level of fitness of the injured tissues prior to surgery allows these tissues to stay hydrated and well supplied by nutrients.
  3. Injured joints lose their ability to balance, this type of skill is called “proprioception”. A joint whose proprioception has been exercised before surgery  will be a more stable joint after surgery too.
  4. When it comes to legs, the good side needs attention too! Strengthening the opposite or good side will help your body to cope with the natural postural compensation that will follow surgery for the very first weeks.
  5. Focusing on the strengthening of the surrounding joint (say elbow and forearm if your shoulder is getting surgery) helps your body cope with the temporary lack of function that the operated joint will suffer.
  6. Getting a physiotherapist to understand your condition before surgery makes you feel in safe hands as well as confident in the rehab process yet to come.

At Kennington Osteopaths and Physiotherapy we offer support, treatment and advice pre surgery as well as rehabilitation packages to accompany you from day one after surgery to the full return to your every day routine, with patience, care, competence and professionalism.

If you want to know more about preparing for surgery or want to know if we can help call us on 02077356813.

Post Surgical Recovery


How to Achieve Post Surgical Recovery

At some point in our lives some of us may face the prospect of surgery being the best solution to repairing a body part after injury, illness or through wear and tear. Whilst this can be a painful and traumatic time there are a number of initiatives and therapies that can be used to speed up the healing process and ensure that you achieve the best recovery possible from your surgical procedure. Read more

Skiing injuries and protecting the ACL


Most common of all Skiing Injuries- knee ligament sprains and strains

Anterior cruciate ligament (ACL) tears

These occur most commonly when you’ve twisted your knee whilst ‘sitting in the back seat’  ie, leaning your weight back over your heels which puts the ligament is on full tension and risking a tear when you then put another (rotatory) movement through your knee.

If it’s a serious tear, and your knee swelled up, and still feels very unstable, its advisable to get a scan to identify if you’ve fully ruptured the ACL and if there’s merit in surgical repair. We can refer you for a private scan if needed.

If your knee is swollen and painful and feels a bit precarious but not very unstable, you may have a partial tear or strain and you’ll need to start some gentle stabilisation exercises and progress onto strengthening exercises.

Exercises to protect the torn ACL

Here’s how you can improve your quadriceps muscle strength so your kneecap slides evenly in its groove:

  1. Sitting or lying: place a rolled up towel underneath your knee to bend it slightly (around 15 degrees). Gently straighten your knee to press the towel down and hold for 10 seconds then release. Repeat 10 times per 2 sets (of 10). Your vastus medialis obliquus (VMO) will thank you for this – it is active in the last 15 degrees of knee straightening.
    excercises for skiing injuries
  2. Lying on your back, point your toes up and outwards (very important when targeting vastas medialis), lift your whole leg about 6 inches from the floor and hold the position for 10-20 seconds. Repeat 10 times per 2 sets.  Priming the injured knee muscles to help you balance and reduce risk of re-injury
    Excercises to prevent skiing injuries
  3. Single leg stands (as long as this is not too painful and/or you haven’t been advised otherwise by a traumatology consultant): stand on both feet with a minimal degree of bend at the knees. Slowly lift the non-injured leg off the floor while you make sure the hip level stays even on both sides. Maintain the balance for 10 seconds, repeat 10 times.
    leg stand exercises for skiing injuries
  4. Squat against the wall (you will feel your quads): stand with your back against a wall with your feet pointing forward on a hip wide stance. slowly slide your back downwards allowing for a gradual knee bend. You will find yourself in a sitting position but don’t go too low (keep your hips higher than your knee) otherwise coming back up will be too strenuous! Hold the position for 15-20 seconds and slide up again. Repeat 10 times.
    Squats to protect your ACL - skiing injury
    Feeling stronger?
  5.  Sideways lunges (more dynamic yet not straining your ACL): stand with your feet close together, aim for a side step and alternate this on both sides for 10 times (don’t  cheat – this means 10 sidesteps per side so count 1 every other step!). Don’t aim for a sharp angle of the knee when you lunge sideways, especially at the early stages – increase the knee bend of a few degrees per day.


All of the above exercises should be performed daily or twice a day if possible. This doesn’t replace a full physiotherapy rehabilitation protocol but it is a great, simple backup routine.

If you would like to know more or book an appointment please use the form below.  Or tune in next week for more insightful info on the type of services we offer.



Skiing Exercises to Avoid Injury


Do you change your exercise with the seasons?

We get a lot of calls from patients with long-term injuries in January and February a week or two before they go skiing who are desperate to know whether they are at further risk of injury if they ski.

Common Injuries

Here are some of the most common injuries that are likely to occur if you ski and HOW TO AVOID THEM….

  • Knee sprains leading to injury of the following ligaments: lateral and/or medial collateral ligament, anterior and/or posterior cruciate ligament, meniscal tears.
  • Arms/wrists and coccyx fractures which occur from falls. The answer? Don’t fall!! So get an instructor to improve your technique if you are a beginner and take it easy on the first day while your body remembers what skiing is all about.  

5 Easy Exercises

Here are five easy exercises to perform daily to strengthen your hips, knees and ankles and to improve your proprioception to limit the risk of falling.

  1. Reaches: Standing on one leg with a minimal amount of knee bend, lean forward reaching with your arms in front of you as you stretch the other leg backwards to counterbalance your weight. Glut workout on extended leg, stability and proprioception on the weight bearing leg.

    exercises for avoiding skiing injuries - reaches

    1. Reaches

  2.  Squats: Take 6 seconds to descend into full squatting position, hold for 1 second at the bottom, come up in 2 seconds to standing position. This type of timing will strengthen your hamstrings in the descent phase as well as improve your explosive power (during the squatting to standing phase). 3 sets of 10

    exercises for avoiding skiing injuries - Squat

    2. Squats

  3.   Squat hold on tiptoes: position yourself into a semi squat so that the angle at your knee is about 90 degrees, then raise your heels off the floor to reach a tiptoes position and hold it for 10/15 seconds for 5 times.

    exercises for avoiding skiing injuries - Squat hold on tiptoes

    3. Squat hold on tiptoes

  4. Core stability: do some gentle crunches, do them with a twist, do them with your belly button pulled back, with a leg in table top … the more regularly, the better!
  5. Muscle length as well as strength, joint mobility and overall flexibility are a must to enable your body to cope better with potential falls or traumas, so regular yoga and pilates are super useful. Join a class, do them at home (the NHS website has some great 30-minute and 40-minute classes), do them with friends. And remember, frequent exercise matters more than the duration of each session!

If you would like to know more or book an appointment please use the form below.  Or tune in next week for more insightful info on the type of services we offer.


5 Things you didn’t know about Acupuncture and Dry Needling!


Our acupuncture and dry needling sessions are very popular and deliver successful results.  However many new clients are unaware of what acupuncture can do and what it actually is.  So we have collected together our 5 top things you may not have know about acupuncture and dry needling.

  1. Acupuncture represents only one part of the ancient healthcare system known as Traditional Chinese Medicine (TCM). TCM also includes herbal medicine, Chinese massage and Chinese exercise (tai chi, qi gong..).
  2. Acupuncturists diagnose the state of different organs by palpating of the radial pulse on both wrists. There are about 29 different pulse qualities that can be assigned to a variety of pulse positions which together identify the health of different organs.
  3. Because of their location over arteries and nerves acupuncturists can use some powerful acupuncture points to enhance the beneficial effects of their treatments. Some martial arts practitioners make use of these powerful acupuncture points for precisely the opposite purpose – to enhance the effects of their combat. Dim Mak is a martial art that makes extensive use of certain acupuncture points to devastating effect!
  4. Osteopaths and physiotherapists often practice dry needling acupuncture, also called medical or western acupuncture. This application of needles is determined by the musculoskeletal system. Although it can affect the nervous system it does not target energy imbalances in the body as TCM does. So dry needling uses similar techniques to TCM but doesn’t share TCM’s  philosophical beliefs.
  5. Dry needling can be used to treat conditions such as fertility, by utilising an overlap in the central nervous system between internal organs and musculoskeletal structures that share the same nerve root. This overlap explains why a heart attack might feel like a pain in the arm or jaw. It also explains why applying dry needling to the abdominal wall or feet can affect the nerve supply to the ovaries.


If you would like to know more or book an appointment please use the form below.  Or tune in next week for more insightful info on the type of services we offer.


Pelvic floor rehabilitation in women’s health


Pelvic floor rehabilitation in women’s health 

– by Ana Aguila

Pelvic floor disorders are common in women, from young age until after menopause. Their dysfunctions include incontinence, pelvic organ prolapse, painful sexual intercourse and lower back or pelvic pain.

The pelvic floor is a diaphragm of musculature supporting the bladder, uterus and bowel, which are embraced by muscular walls. The side walls of the cavity are formed by muscles that assist hip rotation, but in pelvic floor problems, our focus is on the pelvic diaphragm. It is as a diamond shape sling of muscle attached to the pubic symphysis at the front and the coccyx and its ligaments at the back.
The main role of pelvic floor muscles is to support organs, to maintain urinary and fecal continence and to provide resistance and strength during maneouvres such as lifting. Also, well-conditioned muscles play an important role during sexual intercourse and childbirth.
Dysfunctions in the pelvic floor can be caused by childbirth, hormonal imbalance, fatigue and demanding activities such as lifting heavy weights.
Symptoms may include:

  • a sensation of a bulge or something coming down or out of the vagina, which sometimes needs to be pushed back
  • discomfort during sex
  • problems passing urine – such as slow stream, a feeling of not emptying the bladder fully, needing to urinate more often and leaking a small amount of urine when you cough, sneeze or exercise (stress incontinence)

During childbirth, the nerve that supplies the pelvic floor can be stretched or compressed and is especially at risk from with small pelvic size combined a large baby, assisted delivery and baby getting stuck. Nerve compression can be both extremely painful, and affect one of the muscles that prevents incontinence. Episiotomy during childbirth can also leave this muscle weakened and ineffective.
Prolapse of pelvic organs through the vaginal wall (pelvic organ prolapse) is common after pregnancy and childbirth due to increased abdominal pressure on the pelvic floor form the growing baby and pushing during delivery.
Muscles can repair and strengthen with training. However, before starting pelvic floor training we recommend achieving alignment and mobility of pelvis, lower back and hip joints. Once these structures are balanced, training can be established to strengthen the pelvic floor.
If you are able to perceive pelvic floor contractions and your weakness is mild, it is appropriate to start training with simple exercises.
The first exercise to help pelvic floor muscles strengthen would be simple contraction as in holding your urine in or interrupting urine flow. The contraction should be held for 5 seconds and repeated 10 times. Gradually, you will increase length of contraction from 5 seconds to 8 or 10 seconds as well as increasing repetitions to 12. It is important to avoid fatigue which is one of the factors causing urine incontinence.
However, when weakness of the pelvic floor is severe or you are not capable of contracting the pelvic floor, is advisable to use biofeedback which will help to engage the pelvic floor and train not only the muscles themselves but also helps you visualise which muscles to contract. With biofeedback you can learn about how to contract your muscles progressing onto further stages of rehabilitation.
In conclusion, an accurate physiotherapy assessment will provide you with the correct diagnosis to start rehabilitation and begin to create harmonious pelvic floor muscle stability.

1. Fonti, Y; Giordano,R; Cacciatore, A; Romano, M; La Rosa, R. (2009).Post-partum Pelvic Floor Changes. Journal of Prenatal Medicine. Volume 3(54-59)
2. Marques, A; Stothers, L; Macnab, A. (December 2010). The Status of Pelvic floor muscles training for women. CUAJ. Volume 4 (issue 6), 419-424
3. Rose Day, M; Leahy-Warren, P; Loughran, S; O’Sullivan E. Community- Dwelling Women´s Knowledge. (November 2014) British Journal of Community Nursing. Volume 19, (issue 11), 534-538.

Pilates for scoliosis, how does it help?

, ,

Pilates for scoliosis, how does it help?

– by Chrisen Hall

Scoliosis is a sideways curvature of the spine. The severity of the curve differs from person to person and scoliosis is very common in the UK and it affects all ages. According to the NHS UK, around three to four in every 1000 children need treatment for scoliosis. The degree to which scoliosis will affect a person’s daily life depends upon how serious the curve is in their spine as everybody is very different. Scoliosis can be very mild, or significant and potentially disabling. If somebody is living with a severe scoliosis, it will affect the entire alignment of bones through the body. Not only does scoliosis impact your vertebrae, but it will also impact the structures around it. Scoliosis can shift the height of hip bones, resulting in two different leg length, it can shift the height of the shoulder blades and it can torque the rib cage, which can affect breathing.

As you could imagine, this can create pain and discomfort in the body. In particular it will reduce range of motion in areas of the body which can lead to complications in traditional exercise modalities and can limit a person from exercising as freely as they want to. There are not many things that will straighten a scoliotic spine after the spine has fully matured in an adult and Pilates is perfect for reducing the pain and discomfort associated with scoliosis. Unlike traditional exercise modalities, Pilates is low impact on the joints and it works to pull and glide muscles and bones into more of a natural alignment. The Pilates Reformer machine is perfect for exercising with scoliosis, the machine supports the body and teaches you quickly how to find proper alignment without strain.

I have worked with many clients who as as a symptom of their scoliosis hold tension in their back and neck, are stiff around the thoracic (mid back) and rib cage area. My goal in developing a Pilates program for scoliotic clients is to create more symmetry throughout the body to reduce daily discomfort and improve quality of life. We will achieve this by stretching the muscles out that are excessively weak, and by strengthening the muscles that are weak due to the scoliosis condition.

How does massage help PTSD, stress and anxiety?

, , ,

How does massage help PTSD, stress and anxiety?

– by Kimberley Pledger

Post-traumatic stress disorder (PTSD) is classified as a mental health diagnosis for which the primary treatments are anti-psychotic and anti-depressant medication and talking therapies.

Despite its classification, PTSD is a prime example of the body and mind working as an integrated whole, where changes happen in tandem on a mental, physical and physiological level. In other words, PTSD exists in the mind and the body. This means that the current treatments for PTSD, based as they are on an outdated idea of a separation between the functioning of the mind and body, overlook the physical symptoms of this disorder.

Recovery from PTSD is not just about minimising or eradicating the psychological symptoms, it’s also about feeling yourself again, which means feeling in charge of your body and being able to trust it again.  This article will review the physical symptoms of PTSD and consider how touch therapy (massage), as a complement to medical and psychotherapeutic treatment, can help you regain your sense of self.

The Physical Symptoms of PTSD

There are ten physical symptoms commonly associated with PTSD so lets look at each of them in turn and consider how regular massage can help to address them.

1. Insomnia
Insomnia is itself a symptom of the hypervigilance experienced with PTSD — it stands to reason that if you’re always on guard and you never switch off then you’re going to struggle to get to sleep and stay asleep. The physiological reason you are hypervigilant is that your sympathetic nervous system is in overdrive. The sympathetic nervous system is made up of the parts of your brain and body that kick in when you’re in danger and control whether you fight back, flee or play dead. Positive touch stimulates the parasympathetic nervous system — the parts of your body and brain that are activated when you are relaxed and experiencing something that gives you pleasure. The rhythmic stroking and kneading of the body that takes place during massage activates the parasympathetic nervous system and induces a feeling of sleepiness. This feeling normally starts a short while into a massage and is accompanied by a sense of well-being which should last for several hours after the massage has finished. In fact, it is not uncommon for a person to feel the effects of a massage for a few days afterwards so you can see how regular massage could really help someone with PTSD to overcome insomnia.

2. Exhaustion
Exhaustion as a symptom of PTSD is partly the knock-on effect of insomnia, but also a result of the body being stretched to its limits because it is always on alert.  Massage deactivates the parts of the body and mind that are stimulated when under threat and effectively reverses the effects of hypervigilance. Instead of feeling wide awake and jittery you feel sleepy and calm; instead of working in overdrive your body moves into cruise control and eventually slows down into sleep. If this happens regularly it reminds the body that rest is possible and desirable so over a period of time you start to wake up feeling refreshed instead of exhausted.

3. & 4. Accelerated Heart Rate and High Blood Pressure (Hypertension)
In order to maintain the heightened state of readiness demanded by the sympathetic nervous system in a person with PTSD, the heart beats faster so it can quickly pump blood to where it is needed most — the larger muscles to get them ready for fight or flight. One of the factors in high blood pressure is an accelerated heart rate, which is why hypertension is commonly found in people with PTSD.

Massage effectively switches off the sympathetic nervous system and activates the parasympathetic so the heart slows down, breathing becomes deeper and a feeling of wellbeing spreads through the body. There have been several studies showing how regular massage can help to keep blood pressure at lower levels.

The hormone cortisol is known to be a factor in hypertension and is also evident in high levels in people with PTSD. Although it is not yet fully understood how cortisol contributes to either PTSD or high blood pressure, what is known is that cortisol levels drop following massage.

Unsettled babies and osteopathy


Unsettled babies and osteopathy 

– by Laura Wheatley, MOst, Diploma of Paediatric Osteopathy

People often ask us how osteopathy can benefit babies and wonder how our approach in treating them compares with treating adults. 

Far and away the most common symptom we see babies for is unsettled behaviour. It’s the lower back pain of the baby world if you will. And it manifests in a variety of ways – most commonly crying and irritability, trouble getting wind out (either end), vomiting and sleep disturbance.

Where a visit to the GP would likely result in a diagnosis of ‘colic’ or ‘reflux’ and a prescription, as osteopaths we find these diagnoses to be too broad, and commit ourselves to investigating and explaining WHY such symptoms are occurring. We feel it is our role as osteopaths to do the detective work.

We take a thorough case history including details of the pregnancy, birth and postnatal period, and listen keenly to Mum who knows her baby best and is the expert on her child. Following a head to toe examination assessing overall wellness and health, milestone attainment, joints, neuromuscular status and primitive reflexes we then put our hands very gently on the baby, and listen to what the baby’s body tells us. We are also able to pick if there are any signs of serious issues that may need referral.
We make a treatment plan tailored to the baby to unwind and resolve any tensions that may be palpable in the body and causing discomfort in some way. Treatment involves very subtle movements and light forces working with the baby’s natural physical tendency to seek balance, equilibrium and health.

To give a few examples – a baby diagnosed by the GP with reflux may have had a rapid delivery and experienced a shock on transitioning to life on the outside, tightening their diaphragm and leading to increased regurgitation or vomiting; a baby who seems colicky may have been subjected to a long and difficult labour, perhaps with forceps or ventouse intervention, and therefore be experiencing pain; and a baby with sleep disturbance may have experienced compression in an odd position in the womb and struggle to get comfortable. It’s important to add here that every baby is different and tells a their own unique story.

I must also add that currently any qualified osteopath may legally treat babies and children. At Kennington Osteopaths & Physiotherapy, we feel that expert knowledge of the specialised anatomy and physiology (and their associated problems) is essential to treating babies and children effectively and safely. Therefore both Andrea and I have completed a two-year postgraduate qualification at the Osteopathic Centre for Children.


Osteoporosis – You ARE AT RISK unless you KNOW YOU AREN’T


Osteoporosis – You ARE AT RISK unless you KNOW YOU AREN’T

Osteoporosis is really not a fun subject. But it is REALLY important that you think about it now. This has been driven home to me this year in both a personal and a professional capacity.

In 2016, the Institute of Osteopathy has teamed up with the National Osteoporosis Society to raise awareness of this very serious condition. Osteoporosis can be painless until you fall and have a fracture. If you have fragile bones and weak muscles, the recovery from fractures can be very difficult.

Half of women and a fifth of men over 50 years old are affected by bone thinning.

One in three people have undiagnosed spinal fractures that may cause no pain but will eventually lead to bone loss and spinal curvature.

My story

A beloved relative fell over in September 2016, for the first time, at the age of 78. Her balance is usually excellent, but on this occasion a large dog jumped up in excitement when she went to pat it and she stepped back and lost her balance.

She had been taking alendronic acid (a bone density drug) for several years but this didn’t prevent her from badly fracturing her pelvis and requiring pins through her femur to pull it out of her crushed hip socket (I agree its grim, but I don’t want us to shy away from the facts).

The first two weeks following her fall were excruciatingly painful and she required assistance for every single move and manoeuvre. She has now been in hospital for over six weeks, simply waiting for the fractures to slowly knit — her bones are just too fragile to stabilise surgically.

This situation breaks my heart because I know it was completely avoidable if she’d taken measures earlier in her life to improve her musculoskeletal health.

She is lucky to have a very strong community and family around her and visiting her in hospital but she is of course bored, frustrated and scared. I’m scared too. When she is allowed home she will be much more vulnerable to further falls and further fractures. We are taking serious measures to make sure she has plenty of rehabilitation from physiotherapists and physical therapists to reduce the chance she’ll lose her balance, or be too weak to prevent herself from falling.

My own wonderful grandmother died of complications related to osteoporosis. She had an increasingly hunched posture, and eventually fell, broke several ribs and died several weeks later. My mother has been reminding me for years that I have a family history of osteoporosis. This has somehow always been filed in my ‘mother banging on about medical problems’ category and therefore essentially ignorable.

As a direct consequence of her mother’s terrible death, my mother exercises frequently, is careful about her diet and has really fantastic posture. This has made it all too easy for me to ignore my own immediate family history of osteoporosis!

First, try to establish that you ARE NOT AT RISK

Here is a link to an online tool that will help you assess your fracture risk. Follow this link then select Calculation Tool tab and put in your stats.


If you’re worried you may have thinning bones, the most conclusive way of finding out is by having a Bone Density Scan. This assesses your bone density at different sites in your skeleton and can establish the risk of incurring into a stress fracture.

This is why is so important to get it done if you are peri- or post-menopausal or if you identify with the risk factors for osteoporosis. The stage before becoming osteoporotic is called osteopaenia and shows a small reduction in bone density which is also visible on a bone density scan.

Being aware of it as early as possible will increase the chances for you not to even get to an osteoporotic state and to start working on it successfully addressing your diet and physical activity.

Here are some signs that you may already have osteoporosis

You may have noticed a loss of height (a sign of slow vertebral collapse caused by compression fracture), or a dowager’s hump accompanied by a bulging tummy, or breathlessness, and needing the loo frequently all caused by a change in your spinal shape.

You may have a relative with a history of osteoporosis. Long-term use of steroids can weaken bone. Poor digestion can reduce your capacity to absorb calcium and Vitamin D so inflammatory bowel disease, long term gut dysfunction, and coeliac disease can all predispose to thinning bones.

If you have established risk from a family history, or know you have osteoporosis here are the best ways to reduce your risk of fracture.

Osteoporosis – 9 ways to prevent or treat it

Load bearing exercise
Nutrition – lots of calcium (tinned fish and green veg)
Aerobic exercise
Vitamin D – to absorb the calcium (egg yolk, supplements and sunshine)
Resistance exercise
Maintaining a consistent weight (slim not skinny)
Improving your balance with stabilisation exercise
Osteopathy to treat functional anatomy of bladder / bowel
Drugs – bisphosphonates (alendronic acid)/ raloxifene / teriparatide

How can Kennington Osteopaths and Physiotherapy help?

Our new physical therapist, Mr Andrea Bartolini, has a number of treatment package options to strengthen, condition, stretch and stabilise. He is also a trained nutritionist and sports and public health so can advise you about diet as well as prescribing appropriate exercise to improve your posture and increase your bone density and reduce your risk of falling in the first place.

If you’ve already had a fall or a fracture and have been injured our phsyiotherapists and osteopaths are brilliant at rehabilitation and pain relief. You don’t have to live in pain and you don’t have to live with dysfunction. We all also offer treatment packages that offer a really cost effective way of helping you to look after yourself.

Osteoporosis – 5 signs you might have it

Loss of height
‘Dowager’s hump’
Heartburn or vomiting
Weak bladder (urge incontinence)
Family members who have (had) it

Osteoporosis – 4 symptoms that might indicate you have it

Bulging tummy (spinal fractures can reduce space in the abdomen)
Breathlessness (spinal curvature reduces lung capacity)
Back pain (spinal fractures may be extremely painful – but are sometimes painless)
Worrying about your balance (weak muscles make balancing harder)