John Nicholls has been practising Osteopathy for over 20 years and has practices in Clifton and Shirehampton in Bristol, and in Chepstow in Wales.  Below he talks to Ben Winter, a personal trainer with JW Fitness Solutions, about his work and how it can help individuals overcome injuries and maintain a mobile and healthy liftestyle.

 

Ben:  Hi Jon!  How are you?

John:  Hi Ben, I'm great thank you.

Ben: Okay, good stuff, just to let you know around half of the questions today come from clients and Facebook members and the other half from the trainers at JW Fitness Solutions.  But I won’t name names or anything like that.

So firstly John congratulations are in order, last weekend you skippered a rather successful boat team, is that right? 

John: Well that's very kind of you Ben – yeah, we managed to win our first race of the season – along with a bottle of Plymouth gin for our efforts which pleased my girlfriend hugely but me less so (as I hate gin).

Ben: Well done, that's fantastic news!  And thanks very much for taking the time out of your schedule to do this interview, you have a great deal of knowledge and I think people will learn a lot from you today.  Let's first learn a little bit about you.  What are your educational qualifications? 

John: I trained as an Osteopath straight from school & A levels (science) at the British School Of Osteopathy in London and graduated in 1987.

Ben: Fantastic.  What made you want to be an osteopath?

John: Mmm I guess part of it was the experience of my mum falling down the stairs when I was about 16 and really injuring her back – she went to the Dr for months with little success until one of her friends suggested she see an Osteopath – after three visits she was back to normal and just wouldn't stop going on about it! 

At the time I was choosing my A levels and looking at doing something medical / science orientated and I guess this broadened my horizons sufficiently to find Osteopathy!

Ben: Great answer!  John, you probably have some of the highest regarded Osteopathic clinics in the south west, how long have you been in the industry?

John: I've been doing the job now for approaching 23 years (am I really that old?) and I've had my own practice in the heart of Clifton since 1989, started Chepstow in 1990 and then finally the Shirehampton clinic in 1995.

Ben:  So John, in its simplest form, what is Osteopathy? 

John:  Osteopathy put simply is the applied science of human biomechanics – as osteopaths we believe that structure governs function – so if any part of the body's framework is distorted then its function will be disturbed – all we have to do is find the area that has been injured, correct it, and normal pain free function should then be restored….. Mmm, sounds easy doesn't it!

Ben:  Ha ha good stuff.  What are the most common cases you have coming through your door? 

John: I guess 50% of the patients I see come in complaining of Lower Back problems, either with or without accompanying Sciatica, 25% come in complaining of Neck & Shoulder pain and stiffness ( often associated with computer use) and the remaining 25% makes up all the rest – the sports injuries and knee & ankle sprains etc.

Ben:  Are the sessions painful?

John:  Treatment shouldn't be painful – it can be a bit uncomfortable sometimes and occasionally the 'click' noise that is made when we manipulate the spine can be a bit of a shock but generally treatment should be a relatively pleasant and soothing experience.

Ben:  Great.  Osteoporosis.  Who's most at risk of getting osteoporosis, how can we avoid it, and what do we do if we have it?

John: Osteoporosis rarely affects men under 80 so the real risk groups are women – and for various reasons I guess the most common would be post menopausal women because of decreasing hormone levels that regulate calcium metabolism – but HRT has hugely improved things from this point of view in recent times. 

Another cause could affect either gender and that's Anorexia as the bottom line is – Insufficient nutrient intake results in the body using what it already has stored.  Either way regular weight bearing exercise and a good balanced diet can help reduce the risk of Osteoporosis.

Ben: Can osteopathy sessions help relieve any of the symptoms?

John: For Osteoporosis to become symptomatic you are looking at a 50% reduction in bone density and this will lead to spontaneous fractures from simple accidents like missing the edge of the kerb – so any form of physical therapy would be totally contra-indicated.

Ben: You mentioned Sciatica.  What tends to be the cause of sciatica and is there any way to alleviate the pain? 

John: Sciatica is caused by the sciatic nerve ( the longest nerve in the body) becoming trapped as it leaves the spinal canal – this is commonly caused by an inflamed or bulging disc or can be caused by boney degeneration (arthritis).  Treatment of the area of the back where the branches of the sciatic nerve exit is usually successful in alleviating the symptoms.

Ben: Whiplash is something I find a lot of my clients have suffered from in the past, are there any things in particular people affected by whiplash should avoid, and what can be done to rehabilitate the injury?

John: Whiplash disturbs the mechanical integrity of the junction of the neck with the upper back causing muscle spasm, joint strains and occasionally nerve irritation which refers pain into the arms.  In the short term people should minimise driving, computer work, strenuous sport or anything that aggravates their symptoms, but after a little treatment to get things on the mend, a return to graduated strengthening exercises and normal activity have been proven to be hugely beneficial in the long term.   

Ben: Is osteopathy just for injured patients? Or can it be used as a supplement to a healthy lifestyle?

John: I guess the majority of people that come to me initially, do so because of pain or injury, having said that once they've been sorted out a proportion of them find their increased flexibility and fitness as a result of treatment will make them book in for periodic 'check up's' say three or four times a year -  the feedback is usually "it helps keep my golf swing stronger" or something similar and I guess if this occasional treatment is able to increase people's enjoyment of their various leisure pursuits and sports then the investment is probably worth it!  

Ben: One member has said sometimes when she sits watching telly on her side or in a slightly awkward position for a period of time when she goes to move, her entire back seizes up with pain “like there's an iron bar” down her spine, and it takes a few minutes of stretching and “Moving like a robot” before it eases off, any idea what that could be?  And could a session with you help it?

John: I always tell people with bad backs never to sit on the sofa with their legs up to one side as it jams the spine into a bent / twisted position which will aggravate their condition – even if you don't have a bad back staying in this position for a while will cause the muscles and spinal joints to seize up resulting in a feeling of extreme discomfort & stiffness which needs plenty of stretching to undo!

Ben:  No way…

John:  If it's an ongoing problem treatment can help with this but if it's just bad sitting posture – better just change it!

Ben:  Great answer, good bit of practical advice for people.

Now I bet you thought some of these questions were coming…..What's the difference between a chiropractor and an Osteopath?

John: Historically they are very similar, as Chiro was an offshoot of Osteo in the US back in the 1920's.  In practical terms I guess Chiros tend to be more focussed on correcting boney mis-alignments of the spine with specific 'adjustments' – what we call manipulation. 

Osteos tend to be more focussed on the bio-mechanical function of the whole body – treating muscles, joints and ligaments with equal emphasis using a combination of manipulation and soft tissue (massage / stretch) techniques. 

Ben: Why is it, do you believe, that Osteopaths are held in higher regard by the medical establishment than Chiropractors?  And do you believe that Chiropractors have a place in the preventive and injury-based field?

John: I think the perception is simply a historical one – Osteopaths have been trained & practising in the UK since 1917 and Chiropractic has been around over here for considerably less time.  Osteopaths were the first 'complementary' medical profession to gain statutory regulation in the UK so I guess we just have a greater sense of familiarity and Britishness.

We both have our roles to play in primary health care and are both able to provide efficient, effective treatment for a wide variety of conditions.

Ben:  What's the best part of your job?

John:  I guess it sounds a bit corny but I think it's the job satisfaction I get, seeing rapid change for the better in the patients that I see on a daily basis that keeps me going – of course it also helps having a stream of patients coming through the door every day telling me I'm great (some days it's a bit tricky getting my head back out the front door!) 

Ben:  Ha!  Good man.  A few different clients asked why they often wake up in the night with pins and needles in their hands, why is this and what can be done to help?

John:  This is caused by mild compression of the nerves in the base of the neck – which supply sensation etc to the arms.  It's basically a pillow / mattress issue.  Too small & their heads drop towards the mattress (squashes the nerves).   Too big & the head is held too high (stretches the nerves).

There is often an underlying problem with neck / shoulder / back mobility which aggravates this – usually too much squinting at a PC screen etc.  If sorting the pillow situation out doesn't work then a bit of treatment should sort it. 

Ben:  That leads me nicely on to my next question.  What's your opinion on the memory foam pillows and mattresses?  Especially the pillows that claim to be designed for "BACK SLEEPERS"  "Side sleepers etc".

John:  One word, final answer…… CRAP!

Personal opinion only of course – some patients love them, some reckon it's the worst money they've ever spent.   The pillows are OK if you only sleep on your back but just don't give the support when you lie on your side – put simply one size just won't fit all.

I always recommend a good old fashioned duck feather pillow that gives good support and can be moulded to the right shape.  Mattresses are again OK for light people (under 10 stone) otherwise you spend the night in a memory foam 'ditch' so again go for a good old fashioned medium-firm pocket sprung mattress.  Lovely!  

Ben:  Awesome, I think that might have saved a few people some money.  On a personal note I just purchased a memory pillow and that hit the nail on the head, on my back it’s great but on the side or even front it’s awful.

John:  Front sleeping is another big no no I'm afraid as it makes you much more prone to neck problems – if you must sleep on your front – throw the pillow out of the bed – you're better off without it!

Ben:  Yeah you lot don't sleep on your front (woops)

One of my clients has a relation with strong rounding of the back (kyphosis) and often can’t walk for long periods of time.  When I spoke to her she said that she was “Beyond help now, I don't think there's anything anyone could do to help me”; is that true or do you think you can help alleviate the pain of even quite extreme cases?

John:  It could be that they are suffering from a condition called 'Ankylosing Spondylitis' this is a progressive inflammatory arthritic fusing of the spine which eventually results in the spine being so bent over that the sufferers can barely hold their heads up to see where they're going.  If it isn't this and it's just a postural issue which has got out of control some treatment may help loosen things up a bit.

Ben:  John you have been personal training with me for around 6 months now.  Firstly, have you found the sessions to be effective for your health and fitness goals and secondly do you think personal training has a place in the rehabilitation of patients and staving off some degenerative bone issues? 

John:  Personally I'm stronger and fitter with better stamina and less prone to hurting myself, due to the physical nature of my job, now, than I was when we started out so I'm very satisfied with the outcome! Professionally I have been recommending PT to patients for a long time now.

(It just took a while for me to take my own advice) as regaining strength & stamina after an injury is an essential part of a preventative regime – the stronger and fitter the body the less the chance of injury and the greater the probability of continued health.

Ben:  Thanks very much for such a great interview.   Is there anything you would like to add?

John:  Ben it's been a pleasure talking to you, I hope I've given some good honest answers to the questions you've posed!  I'd be more than happy to practice my typing skills again if you want to do a follow up interview so keep the questions coming!  Does this mean you'll go easy on me in PT this week??  Cheers Mate!

Ben:  Ha ha, I will do I promise, and thanks again, would be great to interview you again in the future.