Diaphragmatic pain- treatment and prevention

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As the diaphramatic pain blog got a fair amount of interest in terms of people looking at it, I re-read it and obviously there is a lot of information about what is happening and why things are hurting, but not so much about how to stop it happening or how to treat the pain.

As alluded to by one of the comments I have been in touch with a couple of people and suggested some stretches, which seems to have stopped the symptoms. I basically sat down and worked out some things which would stretch out the tissues mentioned.

The general key when stretching out psoas/iliacus/abdominals is that you don't just sit there and stretch out one portion of the fibres. Move around within the stretch and get into the different fibres of the muscles. They don't just work in one plane, and have a multitude of minor variation of angles which it is beneficial to stretch into.

Here are a couple of pics of the stretch cycle that I tend to do before a run/race to warm up the torso ready for the miles that lie ahead. These are a series that stretch one hip flexor, you then have to do it all in a mirror image to get to the other.

Make sure the back knee doesn't touch the ground, and look UP to the hand. Move back and forth, into and around the stretch. Apologies for the non-level shot, but Lynne didnt think she'd get me in the frame.

Now look at the other hand, again, the back knee doesn't touch the ground. Move around in the stretch, feel the different fibres of muscles and breathe into them. Don't count the seconds. Do it so that it feels right.

Last one, stretch out over the top, this is stretching the same area as the last 2 stretches, but puts the enphasis on other parts of the tissue and fascia. Again, breathe into it. To stretch the other Hip flexor do it all again but starting with the other leg forward to begin with.

You can follow these if you like, or make up your own, I find they work. If they don't work for you, find something that does.

Another point that is worth making is that if the psoas or iliacus has become chronically shortened through overuse/abuse/misuse, it may be that just stretching might not be enough to loosen the structures out enough to be able to run painfree (hopefully it will be, but maybe not). In that case, all is not lost. It is a treatable condition, and there are a number of things that we might be able to help out with - involving assisted stretching, muscle facilitation and Soft Tissue Release, (much like the well vaunted and much publicised Active Release Therapy- its the same thing, just under a different - and I believe patented- name).

Obviously every situation is different, and each client is individual, but if you do have an issue with this and want to get it looked at to see if we can help you out, please do drop us a line, Lynne or I would be glad to help. (I've had it and self-treated it, and Lynne has treated me and knows what its all about - psoas, iliacus and diaphragmatic release are underused by a lot of soft tissue therapists, but having come to realise just how important they are, we try to implement it in our treatments as much as possible).

Diaphragmatic pain while running

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I have mentioned pain in my diaphragm when running in a couple of blogs recently. I used to get it a bit when I was starting out, it put me off running for a while, and then I went back and hoped it wouldn't hurt. Sometimes it would, sometimes it wouldn't. I never really knew what it was, and didn't think about it until recently when I started to get the same pain in races, stretching out on down hills, or just running on the flat.
Funnily enough, it never really happened when I was running uphill.

So I went about trying to workout what it was that was hurting.
The area that was most in pain was just under the xiphoid process (the bottom of the central part of the rib cage), to the right of centre. Somewhat contrary to common sense I tend to start poking around things that hurt to see if I can make it hurt more, generate a response and see if I can find trigger points - even when I'm running.

After this happened a couple of times in races, and running around with my hand jammed into my solar plexus, racing while trying to work out what hurts is a little detrimental to your final placing - but is a good way of working out what it is that actually is causing the pain.
I worked out that it was the diaphragm that was hurting... it has an attachment to the inner surface of the lower 6 ribs and to the xiphoid process. As I poked around, I could feel that the pain continued around the inside of the ribs, left and right, but it was mostly painful right under the xiphoid process.

I also noticed that as I was running, I felt more free when my body turned in one direction (twisting at the waist), than in the other. Hmmm. Rotation around the spine was easy in one direction, but restricted in another.
Interestingly, the diaphragm attaches posteriorly (at the back) on the upper 2 or 3 Lumbar vertabrae.

Following along a logical trail, there must be something else that is causing this pain - to hammer home a point, I was pretty sure that this pain in the diaphragm was the smoke, the symptom of something not being quite right, and the fire - the cause was somewhere else.

Working Anterior to Posterior, what muscles could possibly be causing this pain?
Directly attaching to the cartiledge of the lower 6 ribs is the Transverse Abdominus, favourite of Pilates instructors, and a muscle that compresses the abdominal contents,
Internal Obliques also attach to the bottom 3 ribs AND the abdominal aponeurosis (fascia)
Rectus Abdominus attaches to the xiphoid process and 5-7 ribs
External Obliques attach to the lower 8 ribs.

A very rough idea of whats going on. Black is External obliques, Green is internal obliques, Blue is Rectus Abdominus, and red is obviously the pain. (this is not an exact representation of origins and insertions, more to give an idea of where the tissues are and which direction the fibres go in).

Wow. All the flexing and rotating muscles of the front of your body, all attaching to pretty much the same place. Fascially they are all very much connected. If any one of them is slightly off, or is crossbridged to another by collagen, or is damaged, then its going to upset the whole lot. Once that happens, because they fascially connect together and are fascially connected to the diaphragm, guess what happens.
Yes, they will affect the breathing.

slightly difficult to draw on a person

After a bit of abdominal self massage I worked out that although they were a little tender, they were not spasming, and they didn't seem to be eliciting the pain that I was feeling in the diaphragm. So the obvious has been ruled out. What other structures are associated with the same attachment points as the diaphragm?
Well, posteriorly, psoas attaches to the bodies and transverse processes of L1-L5, lower down it shares an attachment with iliacus. Both are major hip flexors, and have a lot to do with running. Both are often neglected when it comes to massage, and psoas is a muscle that is fascially connected to the diaphragm.
Hmmm. Thats a possibility.
The way to test this is to stretch out before a race and see what happens.

Interestingly, if you go ahead and really stretch out the psoas and the iliacus, there is no way you can stretch them out with out also stretching the main abdominal group which I have also been talking about. By working through one muscle group, the other is automatically worked as well.

I have been working specifically on hip flexor flexibility for the past couple of weeks now, including stretching before races, and I haven't had any of the pain which bugged me in past races. I'm not going to come out and say that it was specifically psoas, or it was specifically iliacus, restraining psoas and making the diaphragm spasm, or it was specifically the abdominals and I'm going to refrain from making a statement like that for good reason.

All these muscles are fascially connected, the only reason they have different names is because someone went around arbitrarily dissecting and naming things, actively disgarding the fascia as they did so. I suspect it is something to do with an imbalance in the muscles and fascia somewhere, perhaps some collagen binding between psoas and iliacus, and aggravated by weak abdominal muscles. However, the answer seems to have been to stretch out the muscles and fascia associated with the motion of flexing of the hip - and so far, that answer has been vindicated.

As a minor note to this, from my visit to an Osteopath recently, it seems that my sacrum was wonky - which may well have contributed to the feeling of freedom on one side of my body, and stiffness on the other. Muscle, bone, and fascia are all linked and connected and the more I learn, the less physical distinctions I seem to be making.

Yes, I know they are only drawn on, but still.... grrrr.

Wormstones

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Well, I've been waiting for this one to come along for a while. A local race, 5 miles long with 1350ft of ascent. Another midweek counter for the Glossopdale bunch, but with a number of the "big names" away on a jolly to the jolly isles of Rum and Eigg, this was going to be a good one for those still remaining in the citidel that is Glossop, to get out there and steal some useful points.

I didn't see the route until yesterday, when a photo of a map was put up on fellrunner. It was kind of what I expected, but with a bit of an extra kick. A run up the hill, past Wormstones, on to Harry hut Trig point, turn right, down to the road and over, through a couple of fields, then up a steep kicker of a hill to the top of Herod farm, and a wonderful descent through the farm, then down the track to the end.

That second hill- the kicker. That was the bit that I was a bit concerned about, simply because it was a second hill. I didn't realise just how much hill there was until I got to it.

The Glossopdalean gaggle

We arrived a little later than usual to the race (which had a somewhat unusual 7pm start, which certainly caught one runner out), and there was a gaggle of Glossopdaleans hovering around. Andy made a rare appearance, actually being able to get to this one as its very local, which was going to make my race a little tougher than I anticipated. We wandered around to the starting area, and there were a fair number of runners already buzzing around, warming up, running up and down the flat beginning bit. Lynne and I had just walked over from home, which provided a bit of a blood going around the legs, so I concentrated on stretching out my psoas on both sides, and also my hamstrings, which are still feeling a bit tight from training on Monday.
In hindsight, I should have gone up the track a little ways to see what was in store for us in the first couple of hundred yards, but I managed to keep out of trouble.

After a quick group photocall for Des, and a short verbal description of the route, proceedings were handed over to the time keeper, who proceeded to say .... GO!
agh. Minor anarchy in the pack. Thankfully I was at the front, so I just had clear space to run at- nearly forgot to turn my watch on in all the excitement. And we were running.

The first part of the run was along relatively flat terrain, kind of open, but with a couple of trees and bushes thrown in for good measure. I was somewhere in the top 20 or so, and I saw Charlie hurtling along beside me muttering about being "too far back". Ah, I should have checked the first bit for pinch points... I bet there is one just ahead. Accelerate, overtake a few people, pinch point 1, a bridge- single file, and the guy behind me is pushing me despite the fact that there is a queue. Some people just don't get race etiquette. Over the obsticle happily, and then, almost immediately, the second pinch point. Literally a pinch point with one runner at a time fitting through a thin gap-stile. I reached there about 15th, and could see the leaders just accelerating up the hill to the right, so charging on, I followed on.
Up through the wood, out, onto the road a "hi" to Pennine Steve who was marshalling today (props to the guy for doing Snowden at the weekend and coming top 60 or so) and then the first of the stiles. Wierdly there were 2 stiles in very close proximity over the same bit of wall, and everyone was using the Right one, so I launched over the Left one and gained a place.
The hill started.

I've done a hill session on the lower part of Wormstones before, but on a different path, so I knew I could keep up a certain level of pace... the key being, could I then tack on another 4 miles on the end... at speed?
A guy with glasses on was in front of me, and I thought I could overtake him quite happily, he glanced over his shoulder, and took off (kind of... took off in the way that you marginally increase speed going up hill and slowly accelerate away from the person behind). But I followed him and we overtook 3 or 4 people, including Charlie and Andy, who I had seen shoot off at the start. The guy in glasses was about 30 metres ahead, and bascially stayed there for the entire climb. Up over the second stile, past the rocks, passing another runner in the meantime. I could see figures strung out in front of me and managed to count the people up the hill- 11? maybe 12?
Wow, thats alright. Lets try for the top ten.

Me in the white shorts just getting to the first pinch point- just as the leaders have crossed

Getting toward the top, I was feeling my legs a bit, and glasses man had got a bit more of a lead, but as we crested the trig point I began to stretch out and bounce down the hill with a bit of renewed vigour. By a third of the way down I had caught him, and by two thirds of the way down I had overtaken him. As I did so I heard "aright Tim!"... so I waved vaguely in his direction and carried on, hellbent to get to the bottom. Just needed to stretch out and eke out a bit of a lead over him, but my heartrate monitor was getting loose... damn, there I am, hooning down a hill trying to adjust a glorified bra-strap thing, keep it up, because that second hill is coming up any moment now.

Bottom of the hill, over the stile with a bit too much aggression and nearly fall down the slope into the layby, pointed down the road by Steve (he appears to have teleported here from the last road crossing... I wonder if I've found out why he's so good at fell running....?) down the road, I think I can hear footsteps behind me, left into a field, and a vault over the gate, down, past a herd of bewildered sheep to the bottom of the field, I can see the slope rising above me, with a string of runners... now very much "walkers" hacking up the hill.
I have had bad race experiences on hills like this having lost about 6 places in the Kinder Trog on one, and the same on Mount Famine. Not a good record.
2 gates to vault over, cross a stream and onto the hill. Just keeping it going, all the way up the hill expecting to be overtaken at any moment. I can hear thudding footsteps at the foot of the hill where the chasers are catching up. Keep moving the legs...
The guy in front of me, the only person I care about catching now is zigzagging around, trying to make the gradient less steep for his legs. Even as I take the direct approach, he doesn't seem to be getting any closer. As for anyone behind, I have no idea. Never look back. They could have sat down for a picnic for all I knew, (it was far more likely that they were gaining on me, but I have no clue).

The hill went on forever. It wasn't a gradient you could run, but was a walking/crawling hill all the way to the wall, and then fence that we vaulted over at the top. A short section of flat(ter) ground with tussocks making life difficult, and then, a longer ascent up off camber sloping grass. This fell running is a lark, isn't it?

This was the killer. You do the crazy uphill scramble, think its all over, and then a long and nasty uphill section to the top. All the way, the guy in front continued to be about 100m in front. It was all I could do to keep moving and not walk. Is 10th possible? Can I catch this guy?
I still have no idea whats going on behind me- concentrate on the one in front. Thinking about the hills I've run in training, I've not once stopped running. If I've not stopped in training why should I stop in a race? Is what is training if not practice for actually running a race?
No excuses.

Up to the top, following the flags. painful progress, and then flatness, then blessed descent. He is still 100 metres in front. As it stands now, if we finish like this Im going to be 11th, by about 20-30 seconds. Lets see if we can't cut that down a little bit. Stretch the legs out, keep going faster, give the guys behind something to chase.
The path cuts up, over another gate, 10 yards down, turn right and over another one, then down. Down a steep bilberry covered slope. Following the flags I can't see the man I'm chasing, until I reach the real steep part, slipping down, a recovery, and I see he is struggling with going down. Switch off the head and let the legs do it all, I develop a technique for getting over the unstable, but patterned ground in a faster way. By the gate at the bottom I'm right behind him. Vault the gate and run, overtake done, by the time I'm over the gate he is just swinging his second leg over.
Track to the end now, keep it together.
We pass Herod Farm, and the occupant claps us on, I hear a "how far is it mate?" from behind me... honestly, I have no idea. Does it finish at the bottom of the track or half way down? "No idea mate!" I shout back, and lengthen my stride.
The way mu lungs feel I certainly HOPE its halfway up the track, I'm coming close to the red point where I run out of steam.
Pound down the hill, no-one in front to chase, just hammer down and keep away from the footsteps behind.

Halfway down the track the finish appears and I feel like I could actually go on to the bottom. Keeping the speed I dash through the finish line in about 35:10, I think, 10th place, with no-one to be seen behind me for a fair way.

I couldn't stick around for the prizes unfortunately, but Gwyn, again came 1st, Mark 3rd, and I believe we won the team prize, but I don't know about that yet. Pretty cool if we have done though.
A successful evening out. Thanks to those organising, marshalling and doing all those good things that keep races like this going.

And here are the stats for the race

Shining Tor Fell race

Me and Nev, pre-race.

Another Wednesday, another mid-week counter for Glossopdale. This time, over onto the White Peak Map for the Shining Tor race. 5.9 miles, and 1600ft of climbing. 2 uphills and 2 downs, and a right kicker at the end. Not much on its own, but 200yards uphill on a track at the end of that lot, well, it was always going to be an amusing one.

The Glossopdale turnout was, unsurprisingly pretty good, and there were some fast runners in the mix. I was pretty sure that I wasn't going to repeat my effort from last week- 3rd from Glossopdale, but I was going to have a damn good go.

Spot the Blue and Orange tops...

After the hill session on Monday, which was pretty harsh on my legs and Cardiovascular system I didn't know whether to feel good or not about the race. The midges did though. They were out in force, and at the start, there was a jumping, swatting, cursing mass of about 200 runners just waiting to get going. It was quite a sight to see, but not one that we relished being a part of!

Run away from the midge!

After a very brief speech about the route and comments about the midge, a fairly unceremonious Ready, Go was uttered, and we went as fast away from the midges as we possibly could. Despite being pretty close to the front- maybe four rows back, I still got caught behind about 2 or 3 runners who decided they were going to take it even easier than me right from the off. So I headed around them, and saw a mass of Blue and Orange in the front group, steadily making their way down the road away from me. They were setting quite a pace, and I certainly wasn't going to try to keep it.

A right into the woods and we were going uphill. I chose a pace, and stuck to it, all the way up. To begin with I was sticking within a group, and then, all of a sudden, people started walking. The ground was still pretty good, but the hill was just going on for longer and longer. I kept on going, and saw John and Julien up ahead. John - I've seen once before in a race, but never Julien. Something is very wrong about this.

But I just kept on plugging away, at a relatively decent pace, there goes John, nice work... but have I played my cards too soon? Before I know it, I've overtaken Julien, who is walking up the hill. Ah. I think I've done it now. Yes, not even 300 metres later, Jules comes bounding past - just as I expected. Well, keep plodding away and see what happens.

The path headed up and out of the wood, across the moor and onto the flagstones. Not my favourite thing to run on, but it had to be done. I followed Julien up the flags, they became less steep and more like an undulating surface toward the top, and he pulled out ahead of me, pretty much as I was expecting, then a short downhill before a minor kicker, and then a long, long downhill which I thought I would love.

By the time we got there, John had gained back on me, but I figured I wouldn't lose too much time, if any on the descent.
Wrong.
As soon as I started stretching out on the descent, BANG, back came the pain in the diaphragm which I talked about back in the Mount Famine race. No... that can't be.
The only way to sort this out is to slow down, and so slow down I shall have to, despite the fact we're only about a third of the way through the race.
So I cut down my stride so that the pain wasn't so bad, and began losing time to John, first a few metres, then 10, then 20, 2 people overtook me, but there was little enough I could do, as soon as I stretched out, the pain came back so badly that it slowed me down even more.
Right, damage limitation.

Keep going as hard as possible, without the pain coming back, even if I can't keep up with these guys.
Finally, the end of the (what should have been delightful) descent, through a gate, overtaken by another, and down through the trees, Hairpin right, and I'm losing sight of those in front.
I really hope that the path is well marked.
Through the trees, left, down more, through a river and right, along. I hear more people behind me. Damn, I still hurt, keep it going.
Down some very slippy steps, across a bridge and up more steps, left, and overtaken by 2.
But now its uphill again, and the pain has gone.

Weird.
So I start making up time on those in front. Just. Keep. On. Moving. Turn right, and I see a Dark Peak vest behind me - I swear its the same guy as I beat last week, up the climb I manage to keep him behind me, and then over the moor, I realise that I can no longer see John in front of me and there are more closing behind me.
I get overtaken by 2 more as we turn left down the path next to the road, and I know there are a couple more as well.

Hell for leather down the hill, remembering the words on Mark Twight's site- "there is always something more to burn - even if its brain matter" Give it all you've got.

suffering

I hang on to what I have going down the hill, and a left turn into a wood, just as I hear footsteps behind me. Trust the shoes, it's loam underfoot now, if anything goes wrong, it's tree time.
Straight into the wood and dodgy underfoot, but the footsteps get further behind me. Down, drop like a stone, through neck deep ferns and I can't see my feet, or what they are landing on, another person behind me, we have 500 yards to go now, through a gate, across a green field in front of a dam, legs burning, lungs burning, everything hurting, I know there is the kicker coming up, and I have to keep something in reserve.
I let her overtake me, just coming up to the gate, but she goes to the wrong end of the gate, and I get through first.
Onto the final ascent, and take it easy for 30 metres as we round the corner, then, there it is, 200 yards ahead, the finish, right. What do I have left? There is one person that I can see, he has 30 yards to go.
So I run like it's going out of fashion, teeth gritted, veins pumping battery acid, legs that feel like they are made of lead, I close in on him, but not in time to get past before the funnel.
Of the people behind me, not a sign.
Thank goodness for uphill finishes.

51:11
Enough for 31st out of about 180. I managed an average pace of 4:55 per Km, which isn't bad given the circumstances.  Without that diaphragm issue, I'm thinking maybe 20th could have been on the cards. However. It didn't happen.
Why?

Well, I had about 40 mins while I ran to try and work out what was going on biomechanically, and I noticed that I was a lot freer in movement on one side than on the other. The spiral line from right leg to left shoulder opened out fine, not a problem, but when I tried to open out left leg to right shoulder, I couldn't do it.
Psoas major and iliacus, both hip flexors, were tight, and psoas attaches to the Lumbar vertebrae - L1 through L5 bodies and transverse processes. The diaphragm also attaches to the Lumbar vertebrae - and a lot of fascia is common ground between the two muscles.

What I think was happening, was as I was stretching out on the down hills, my legs were stretching away and psoas was too tight, in the end, it was the leg stretching that was pulling the psoas on the Lumbar vertebrae, which in turn was pulling onto the diaphragm, which gave me pain and shortness of breath.
So
Psoas release and hip flexor stretching is very much on the programme from now on. I'm improving on the uphills, who would have thought it would be the descents that would cause me problems? Well, I think I have worked out what it is, so onward and upward!

Gwyn and his prize. Sorry about the quality... the lens steamed up.

Well done to Gwyn for winning (again!), and congrats to Beryl for her catogory winning run as well. Julien- in a couple of weeks time, the stats are on your side for a few more prizes as well!

In the mean time, here are the stats

Injuries Part 1

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There is nothing more annoying than being injured. I know. Currently I'm suffering from an ITB issue - excruciating pain on the outside of my knee when I try (try being a very poignant word) to run down hill. Frustration at not being able to run in the hills seems even more frustrating as I've only been living in Derbyshire for the past 3 months. Seeing the hills so close is mighty tempting.

And that is where I went wrong. Too much, way too soon. The excitement of having hills on my doorstep overrode the common principle of increasing mileage slowly (10% per week is a good guide). So for me coming from running not that far, maybe 8km at best in London on the roads mostly, 10km in the fells was a bit optimistic. I for one should have known better. Now I pay the price with a slow recovery. I think this was the same over-excitedness that takes over common sense of others when they set off on a new challenge.

Now I'm one for being overly cautious about returning to running too soon, though I think I'm in the minority - most people preferring to return to training too soon and doing more damage than they had originally - and a subsequently longer period of inactivity. Given this, it always jumps out and surprises me when the pain kicks in again after what seems a remarkably long rest period. So where am I going wrong. It is slowly dawning on me that rest alone is not sufficient to get me back to fitness. I need to focus my recovery on not only rest, but also strengthening my glutes and my left psoas (hip flexor) which was considerably weaker than on the right.

So what are the possible factors that can contribute to or lead to an injury? We can break that down into two parts: internal and external factors. Internal factors, or intrinsic, are all things that are within us, inside our body or the stuff that is our natural make up. We can change some of these, and some we can't. In this category we have fitness, technique, body composition, anatomical variants, gender, age, past injuries, and finally psychology. The factors that may contribute to whether we get injured which are external, or extrinsic are those which come from outside of us: the environment, equipment we may use and the training and competition we undertake. It's safe to say we have a much greater degree of control over the extrinsic factors - but equally they're all interlinked.

I've given you an introduction the issues surrounding injuries, with some insight into the experience I've been through recently. I did my first rehab running session yesterday, going out for 30 minutes but with 5 mins warm up, then 1 min walk/1 min run for 9 sets, and the remainder of the time walking to cool down. I'm pleased to report that there was no pain in my knee and with the exception of it being a hot and humid evening the run was very pleasant. There's been plenty of foam rollering and sports massage too, which both contribute to a good rehab strategy. For those of you who are interested, I'll write more about the extrinsic and intrinsic factors soon.

Lynne

Osteopathy

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The introductory page on the General Osteopathic Council website defines osteopathy as:

"Osteopathy is a system of diagnosis and treatment for a wide range of medical conditions.  It works with the structure and function of the body, and is based on the principle that the well-being of an individual depends on the skeleton, muscles, ligaments and connective tissues functioning smoothly together.

To an osteopath, for your body to work well, its structure must also work well.  So osteopaths work to restore your body to a state of balance, where possible without the use of drugs or surgery.  Osteopaths use touch, physical manipulation, stretching and massage to increase the mobility of joints, to relieve muscle tension, to enhance the blood and nerve supply to tissues, and to help your body’s own healing mechanisms.  They may also provide advice on posture and exercise to aid recovery, promote health and prevent symptoms recurring."

I've included the full introduction, as it is important for a well rounded understanding of what this modality is about. I particularly like the quote that they "work to restore your body to a state of balance". 


My reason for posting about osteopathy is because I have just seen one. My reason for this was twofold. Firstly, from a professional viewpoint I need to know who in my local area is good, and who I can refer my own clients to. I found this particular practitioner on recommendation from a good friend - the best way to find a therapist in my view. But, I do not blindly send my own clients to someone unless that person has treated me personally.


The second reason I saw the osteopath is because I felt wonky! I have no serious or acute issue, I just felt like something wasn't quite right with my alignment, and no quantity or sports massage from my colleague was going to fix that as we don't manipulate hard structures, i.e. bones. I have had neck ache on and off for some time, putting it down to perhaps stress of relocation, entering the world of self-employment, or perhaps an underlying and long standing issue from some years back when my neck "froze"...I had a period of about three weeks six or seven years ago when I couldn't turn my neck at all. Perhaps that was a precursur to me becoming a sports massage therapist, but I digress. 


So, professional curiosity and personal need for perhaps a little realignment took me to the osteopath today.


He did quite a lot of work on me, partly because he knew I understood the anatomy and reasoning behind his treatment. This meant that he could reduce the amount of time explaining what he was working on and spend more time treating, but mostly because he know I was prepared and understood what was happening.


Realigned were:

• Left tibia/fibula (the two bones in your lower leg) - the head (top) of the tibia was too high - this caused me pain on the bone at the outside of my lower leg, just below my knee. Because of that my ITB was tight and caused me knee pain when running. Was this travelling up the body and giving me pains in my neck? Who knows...everything is linked afterall!
• Pelvis - slightly misaligned, with tenderness, especially at the iliosacral joint. Could this have been causing the neck pain? 
• T5 and T8 - two vertebrae around shoulder blade area . Were these responsible for my neck pain?
• C2 - a vertebrae in my neck - rotation of my neck wasn't quite so free looking round to the right, which is where the pain was manifesting, but not necessarily the key cause. (I think my fellow writer, Tim, refers to smoke and fire, and this analogy springs to mind here).
• C1 - the top vertebrae - this one wasn't going to play today. I was holding or protecting it too much and like all good practitioners, if something isn't allowing you to treat it, it is for a reason so leave it alone for now.

All the time he was realigning bones he kept checking and rechecking how my range of movement was, how joints felt - whether they were springy, hard, blocked - and asking me for feedback.


Muscle testing also took place, the result being that I have an overly tense (hypertonic) right psoas muscle. This muscle attaches from the vertabrae in your lower back to the inside of your thigh bone (lesser trochanter of the femur). It's deep inside your abdomen and you have one on each side. For me, my left psoas muscle has become weak so we did some work on strengthening it. I've also got an exercise I can do at home (with help from someone) to continue to strengthen that side. I may need a little work to ease the tension on the right side, but with the left becomes stronger it should ease the right side naturally - thereby creating balance - which is what this is all about! 


How do I feel now? At the end of the session the tension and blocked feeling on the right of my pelvis had gone, and my neck rotation improved, it certainly feels easier. A few hours later and I still feel good. It feels like I want, and more importantly can, stand upright on two feet. Now that might sound funny, but for ages now I've tended to put most of the weight through one leg - something that's bound to cause an imbalance, or be the cause of an imbalance.  I'll certainly be recommending more clients to see osteopaths after my experience today.