Osteopathy has gained more attention in recent years due to the shift in focus to a holistic approach to health.  Lemon Water Wellness Clinic now offers Osteopathy Manual therapy treatments as part of its integrative approach to wellness.  Although, osteopathy has been around for over a century (founded by Dr. Andrew Taylor Still) and well known in Europe, its practice is relatively new in Canada.

For this reason, the general population is for the most part unclear about what it involves. The purpose of this blog entry is to help provide some insight into what osteopathy is, the philosophy, and other frequently asked questions regarding treatment.

What is it?

Osteopathy (http://osteopathyontario.org) involves gentle hands-on treatment that focuses on removing restrictions and the restoration of movement and function to the entire body in order to restore the body’s natural balance, optimal function, and healing ability. It is unique, in that the practitioners have a deep understanding of the anatomical and physiological interrelationships of the body.

It considers the whole person:  body, mind, and spirit with treatment individualized to determine the underlying cause of health concern, not just focusing on symptoms.

Osteopathy Manual Practice utilizes fine-tuning precise palpation to assess and treat in order to restore or maintain health. It involves a silent dialogue between the patient’s tissues (fascia, fluidic, energetic rhythms) and hands of the practitioner. Sensory palpation and a very specific and deliberate motion is applied to the intended tissue.

Key components of Philosophy of Osteopathy:

1) The body has an inherent ability to self-regulate and self repair constantly adapting to maintain its balance. The body needs to be mobile to be able to carry out this function. Osteopathy is based on supporting the natural mechanisms of the body by identifying and helping to remove barriers that would interfere with the body’s expression of health and self-healing ability.

 2) The functional unity of the body.  This means that one part of the body or one system (circulatory, nervous, visceral (organs), musculoskeletal, emotional) does not act in isolation. The body acts as a unit and there is constant communication between systems to maintain health. If one system or area is in dysfunction this will impact the other areas of the body.  The body has an important connector called fascia that essentially unites the body.  If you pull on the bottom of your t-shirt you will feel tension at the top and vice versa. The t-shirt can be used as a metaphor for fascia and gives an idea of what can happen within your body. 

3) The structure of the body affects its function. When an area of the body is not moving well it will disrupt the function of not only that local area but also may disrupt global health and function of the individual.

4) The movement of fluids is essential to health- this refers to the importance of maintaining a free pathway for all fluids of the body-lymph, arterial, venous return. If one area of the body is not mobile it can compromise the movement of this fluid flow that ultimately disrupts the health of the person. Supporting a clear pathway for neurovascular flow is a key part of osteopathic practice.

Some of the osteopathic treatment techniques that may utilized when appropriate include:

• Cranial sacral therapy
•  Muscle energy
• Gentle spinal and joint mobilizations
• Myofascial/soft tissue techniques
• Counterstrain technique

Examples of conditions (not limited to) that osteopathy assists in treating:

• Sports injuries
• Chronic pain
• Asthma
• Sinusitis
• Back pain
• Neck pain
• Sciatica/SI joint pain
• Urinary Incontinence
• Headaches
• Migraines
• Insomnia/sleep difficulties
• TMJ/jaw pain
• Digestive problems-Irritable bowel/constipation/bloating
• Anxiety/Stress
• Post Concussion Syndrome

Frequently Asked Questions:

What should I wear to my osteopathy appointments?

Loose, lightweight clothing is recommended during treatments. To evaluate your skin/spine a sports bra/bra/tank top is helpful for women.

What can I expect during my osteopathy initial appointment?

• Health history: We will discuss your current health symptoms as well as your lifestyle and past medical history. To identify the underlying cause of your health symptoms and rule out serious pathology, it is important to have a thorough understanding of your health history. The body has to adapt to physical stresses, injuries, traumas, and emotional stresses that we experience throughout our lifetime. Your current pain/discomfort may be a sign of the body’s difficult adapting further.
• Observation of Posture and Gait
• Hands-on assessment: A physical assessment will be conducted to help determine primary problem areas. A hands on assessment through palpation and gentle mobility testing of various body structures to evaluate joint biomechanics, tissue restrictions, tone and mobility. Functional strength and range of motion testing may be used as well.
• Upon completion of the assessment, I will discuss the treatment plan with you with recommendations
• Referral to medical doctor (eg. blood work, x-rays) if there is any indication from your symptoms/assessment that further testing is needed prior to osteopathic treatment.
• Initial treatment-hands on evaluation and prioritize what areas to treatment first. Areas that get treated first may not be where you are experiencing symptoms. This is because, osteopathy works on underlying strain patterns to ultimately help your body balance itself. There is a trickle down effect as the body balances itself.

 What to expect on follow up treatments?

Each treatment session, the practitioner re-assesses areas and evaluates how the body has adapted to previous treatment.  As an Athletic Therapist, Lindsay also has expertise in therapeutic exercise and functional movement. This may be incorporated into treatment when appropriate.

• Review of changes in medical history/symptoms
• Quick re-assessment active testing and hands on assessment
• Treatment including local, regional, global integration

Is the treatment passive?

No from the patient’s perspective or from an observer it may appear passive but it is quite the opposite.  The Osteopathic Manual Practitioner acts as a facilitator for your body to balance itself. This is why it is important to not sleep during the sessions. You may be asked during treatment to focus on breathing, do active movements, or bring your awareness and presence on tissue tension changes. There is a “silent dialogue” between the osteopathic manual practitioners hands and patients tissues during treatment. Because of this there are times when it is best to not speak during treatment.

What to expect immediately after treatment?

24-72 hours post-treatment is the body’s integration period. During this time, it is common to feel more soreness, fatigue, muscle tension, headaches. Sometimes people experience a temporary exacerbation of symptoms. The body is integrating the treatment and changes during this time. It is important during this time to keep activity light and hydrated to help with integration.

It is also recommended you refrain from other treatment modalities during this integration period (eg. massage, physiotherapy, chiropractic treatment)

Follow up appointments are not scheduled before 1 week following treatment to allow the body to integrate.

How many treatments do I need?

The goal of osteopathy is to help facilitate the innate healing ability of the body. Osteopathy is not symptom or condition focused rather it involves treatment of the whole person to help restore natural balance. Because of this, individuals often do not experience significant changes until after 4-5 sessions while longer standing problems often require more treatment. However, some people do notice changes in 2-3 sessions. The longer you have been experiencing a problem, the longer it may take to resolve. Ultimately, it is individual and so the osteopathic manual practitioner will provide an idea of number of treatments, timing and re-assess along the way.

Why are you treating my neck when I have back pain? Why are you treating an area where my pain isn’t located?

Osteopathy is based on the interconnections of the body. Often due to these interconnections where you have pain isn’t the primary area that needs to be treated.

Should I book appointments with osteopathic manual practitioner when I don’t have any current injuries, health concerns or my symptoms resolve?

Yes. The focus of osteopathic treatment is to help facilitate the natural self-healing mechanisms of the body. Booking preventative check-in treatments can help to keep body in balance and maintain wellness similar to booking regular cleaning visits with your dentist.

Insurance Coverage  

Osteopathic treatment fees are eligible for coverage under most extended health benefit plans. My professional designation is D.O.M.P. (Diploma in Osteopathic Manual Practice) from the Canadian College of Osteopathy and I am a member in good standing of the OAO (Ontario Association of Osteopathic Manual Practitioners). 

 These are the credentials required for coverage by most plans in Ontario.

Stay tuned for future blog entries on osteopathy perspective on health concerns.

Practitioner Lindsay Dixon

416.304.9088 info@lemonwaterwellness.ca

Pilates is an exercise regime that has been consistently thriving. Its ever-growing popularity has made it a favourite among celebrities, athletes, and the general population alike. So how does Pilates fit in to the rehab industry and aiding in your recovery?  

Rehab (or Clinical) Pilates utilizes the classical principles developed by Joseph Pilates with traditional physiotherapy to help individuals establish control and regain balance in order to return to their pre-injury level. It consists of a set of exercises most often completed on special apparatuses, designed to improve strength, flexibility, and posture, and enhance mental awareness. The mind-body approach to these exercises help develop a strong and stable core by integrating the trunk, pelvis, and shoulder girdle. We hear the word core a lot, but what exactly is the core? The core or inner unit is a group of four muscles: the diaphragm, mulitifidi (tiny muscles found along the spine), transverse abdominis (the deepest layer to our abdominal muscles), and pelvic floor. When the core is inhibited, the body’s inherent response is to compensate by looking for stability elsewhere in the body. As a result we tend to overuse muscles in the upper or lower extremity, leading to restriction and overuse injuries.  

Pilates is a great addition to traditional physiotherapy exercises and treatment because the exercises work two-fold, to elongate and strengthen muscles. This improves muscle elasticity and joint mobility, creating a more balanced foundation for the body. And a body with balance between strength and flexibility has been proven to decrease the likelihood of injury.

Dry Cupping 

Dry Cup Approach - targets fascia and body fluids, affecting deeper tissue, removing fascially restricting bonds/adhesions residing in and around muscles, tendons, and joints allowing for an increased range of motion.

Cupping is recognized by the World Health Organization as effective treatment, however, with a modern understanding of microbiology and pathology, blood-letting techniques (wet cupping) have been mostly abandoned. When no bleeding is involved it is called dry cupping.

The effect we want cupping to have on the body is, mutual allowance between tissue layers, suction draws neovascularization (new blood) to the skin, creating a negative pressure below the skin which will cause neovascularization within the area below the skin. This process often leaves the client/patient with ecchymosis (blood between skin layers caused by ruptured blood vessels). Cupping literally increases extra-cellular fluid and ground substance between layers of fascia which will allow for better slide and glide of tissue layers over one another (mutual allowance).

Electro-Acupuncture

Neurofunctional Approach - targets motor points, also synonimis with trigger point or neuro-functional point. These areas are where the muscle fibres become innervated (plugged in by the nerve). Basically, we know that humans are a unique system (organism), one in which contains many separate systems (organs), all functioning together to carry out one common task as a life force - to keep ourselves, and the planet we live on, alive and well. A neurofunctional approach to acupuncture simply acknowledges the importance of nervous system governence within the body and is used as a tool to modulate muscle tissue dysfunction.

Through this approach however, we must maintain our holistic understanding of the entire anatomical-functional unit - the human body. On a nutrient level, vitamins and minerals, are essential for nerve conduction, called neuro-transmittters. Understanding conduction constituent utilization, hertz capacity and current velocity through an ion channel is necessesary for effective treatment to maintain itself, in other words, this is a artificially induced metabolic process with nutritional demands.

1. Get rid of that afternoon lull-start your day with a protein dense breakfast- Amino acids found in proteins are essential for the proper functioning of our system; they are required for a wide range of processes and reactions that happen in our body. Amino acids will allow for a better balance of blood glucose levels throughout the day, they will help maintain energy levels throughout the day and decrease cravings for sugar. They will also support the proper functioning of organs such as our liver, which plays a major role in detoxifying harmful compounds.
   
   

2. Watch out for health foods and consume whole foods instead- Many health foods such as vegan alternatives, vegetarian alternatives, gluten-free alternatives and fat-free alternatives that we find in our grocery stores actually contain high amounts of sodium, sugar and sometimes chemicals and preservatives; you are not doing your body a favor by consuming those products and they may cause an increase in blood pressure and blood sugar levels. If you were to look at the labels you’ll find that in many fat-free alternatives, for example, the fats have been replaced with sugar, sodium and chemical flavors. Stay away from pre-packaged foods even if they are vegetarian, vegan or gluten-free. Choose the full fat option because, in moderation, fats are actually healthy for you and always go for whole foods such as raw whole vegetables, whole grains and fermented foods. Stay away from anything refined, especially refined flour and refined sugar. 
   
   

3. If you’re trying to lose weight, do not diet-Eating a very low in calories diet and exercising excessively is actually a recipe for metabolic havoc. The idea of burning more calories than you are eating will cause your metabolism to slow down and will change your body’s composition to contain more fat, less muscle mass and is not sustainable for most people. This type of diet will most often result in gaining all the weight back very quickly and will make it harder to lose weight the next time you try to lose it. When it comes to achieving sustainable weight loss there is no “one size fits all” solution. It is about working with your own unique metabolism, finding out what works best for you and implementing life-long dietary and lifestyle habits.
   
   

4. Recover from alcohol, stress and bad dietary habits-Regular alcohol consumption causes many deficiencies in our body, a major one being a depletion of B vitamins. It also increases inflammation, creates a significant burden on our major detoxification organ, our liver, and increases our risk for many chronic conditions such as cardiovascular disease, liver disease, type 2 diabetes, hypertension and much more. Stress will result in certain nutrient depletions, hormonal imbalances and an imbalance in blood sugar levels to name a few. Bad dietary habits means that we are not only adding to the toxic burden of our body but also not providing our body with all the nutrients that it requires to function optimally. If our organs are not functioning optimally and we are not providing our system with the nutrients that it needs to function properly a slue of symptoms and conditions will incur. For this reason, I recommend that my patients get tested to evaluate for any vitamin, mineral or nutrient deficiencies in order to correct any deficiencies that exist using both dietary counseling and orthomolecular medicine. In addition, naturopathic medicine has much to offer in order to naturally support our body’s detoxification pathways, starting with making sure you are having regular bowel movements. Examples of botanicals that support the liver in its detoxification function are Sylibum Mariamun, Schisandra chinensis and rosmarinus officinalis. From an orthomolecular perspective N-Acetylcysteine is a very powerful antioxidant that functions to support the liver’s detoxification pathways.
   
   

5. Decrease screen time before bed-Stay away from computer, phone and tablet screens at least 30 minutes before bed. Many of us have issues falling asleep and often the cause can be traced back to screen time right before bed. Looking at a screen will cause photoreceptors in the retina of our eye to detect light and inhibit our natural ability to produce a hormone called melatonin. Melatonin is a neurohormone produced in the brain by the pineal gland; its secretion is stimulated by darkness and suppressed by light. This means that Melatonin is implicated in the regulation of our circadian biological clock, meaning that it signals our body that it is time for bed. Ensuring that you’re getting good quality sleep is extremely important for hormone balance, mood balance, libido and energy.
   
   

6. Take good care of your gut-There are many ways to ensure the health of your digestive tract. Gut health may be at the root of a wide range of diseases such as anxiety, depression, cardiovascular disease, arthritis and skin issues amongst others. The main determinants of gut health include: eating well, removing inflammatory foods that may be causing an issue, making sure absorption and digestion is optimal, healing the lining of our digestive tract and making sure that there is a healthy balance between good and bad bacteria. All those things will go a long way in the maintenance of general wellbeing. Additionally, it is important to remember that there is a great concentration of hormones that reside in our gut and those hormones influence mental health and mood.
   
   

7. Build repair times into your life-It is of utmost importance that you schedule time for yourself. We all lead very busy lives and making sure you make time for yourself has become increasingly difficult. Making time to do something that you love will provide you with a healthy outlet for stress and impact your internal physiology for the better. Making time for yourself at least once per week to do something relaxing, enjoyable and fulfilling is a very healthy way to manage your stress and will keep you healthy long-term. This will help you be more productive and efficient because you’ve taken the time to nourish and refresh yourself. Whether it is meditation, journaling, painting, playing a sport, exercising, taking a hot bath, playing an instrument or being creative; find whatever it is that relaxes you and makes you feel like you are doing something for yourself, do it and do it as often as possible.

As summer approaches you may be thinking about getting that bicycle out of the garage, dusting it off, and going for a nice ride around the city! Here are a few tips to help the ride be as enjoyable as possible:

1. Make sure the bike is the right fit for your needs.

There are many different types of bikes out there, and there is one for every type of rider. From the occasional city rider to the hardcore mountain biker, make sure you are getting a bike that fits your needs. The type of terrain you are riding on, the length and distance of your rides, whether you are seeking comfort of speed, these factors will help determine the type of frame that is best for you. For example, if you are looking to do the occasional ride around the city, a simple cruiser may be all you need. But if you are looking to tackle some dirt trails, a mountain bike or hybrid might be a better option.

2. Get your bike adjusted to your frame.

Once you’ve selected the right type of bike, you will want to get it adjusted to your body. Minor adjustments can make a huge difference. The position of your seat and handlebars will determine how efficient your body will be when pedalling. It will also determine how relaxed and comfortable your posture will be. Getting it fitted properly before your first ride will help reduce joint and muscle pain down the road.

3. Posture.

Whether you have a straight bar or a drop bar on your bike, you should always ride with a neutral spine. This means bending at the hips and avoiding hunching your mid-back. If you are on a drop bar and find yourself needing to hunch your mid-back to be comfortable, you may need to adjust your hand position or replace your bar entirely with something that will allow your hands to rest comfortably without reaching forward.

As you ride it is important to engage your core and limit excessive upper body movement. Your abdominal and back muscles help support your body as you ride and proper engagement will allow you to use your back as a fulcrum rather than swaying your body to gather momentum. 

4. Engaging your hamstrings.

A properly fitted bike will allow you to engage the back of your legs so that you are not just pushing down on the pedals (which can cause knee pain) but also pulling upwards.

5. Take it easy.

Especially with the first ride of the season, make sure you don’t overdo it. Warm up before your ride and remember to hydrate and take breaks.

6. Enjoy yourself.

Remember that cycling is fun! Stress can lead to further injury and reduces reaction time, so choose paths you will be comfortable with and don’t push yourself.

• benign paroxysmal positional vertigo (BPPV)
• post-concussion syndrome
• unilateral vestibular hypofunction (vestibular neuritis, labyrinthitis)
• bilateral vestibular hypofunction (ototoxicity,　vestibular deficits secondary to head trauma and aging)
• Meniere’s Disease.

• a reduction in feelings of dizziness and vertigo
•  improvements in standing balance and steadiness when ambulating leading to a reduction in falls
• improved coordination and ability to adapt to perturbations or challenges to balance
• reduction of headaches, double or blurred vision
• improved ability to concentrate and read without experiencing vertigo

• Do you experience dizziness or vertigo?
• Do certain movements, positions, or environments provoke your dizziness?
• When the symtoms are present, how would you best describe them?
• imbalance
• environment spinning
• feeling that you are spinning
• lightheadedness
• swimming or floating
• headache
• nausea & vomiting
• blurred or double vision

• Do you have difficulty walking in a straight line? 　If so, what best describes your symptoms?
• unsteadiness
• feeling that ou are being pulled to one side
• spinning sensation

• turning over in bed or looking down or up overhead
• turning your head to look at something to the side of　you
• walking in dark rooms, at night or on uneven　surfaces
• moving your head to look at objects while walking
• watching moving objects in periphery
• being in crowded areas or supermarkets
• watching television or reading